Athletes needs differ considerably from non-athletic patients. In order to attain cardiovascular and pulmonary effects, the athlete (including recreational athletes) must participate for at least 20 minutes, three to four times per week, with an increased heart rate during that activity of approximately 220 beats/minute minus their age. The level of heart activity can be achieved through various exercises, so if a particular exercise is causing a problem, the practitioner can suggest alternatives. For example, a runner with a foot injury may participate in swimming or cycling and maintain the aerobic conditioning.

Athletes are also determined to correct their problem and usually willing to work at it. Thus it can be beneficial to outline remedial exercises that can be done at home. For example, an athlete with pronated feet and chondromalacia may benefit by doing some quadriceps exercises at home to improve the tracking of the patella. Also because they are dedicated to their sports, athletes will usually be quite willing to come to your office three time or so per week for physiotherapy treatments.

Athletes will often carry on with their sports activities regardless of their problem, so we can be of considerable help with our knowledge of accommodative padding, taping techniques, and, of course, orthoses. Frequently, the athlete will have already diagnosed the problem and taken corrective steps. A long distance runner, for example, may come in and indicate that he has a particular problem for which he has already used padding, orthotics, taping, ultrasound, ice, and rest. It is often necessary for the practitioner treating patients such as this to go a step further in assessing their patient’s problems.

Because of the athlete’s strong desire to get back into their activity as soon as possible, it is often helpful for us to use a “shotgun” approach rather than waiting to see if one therapy works versus another. As an example, for the patient that present with heel pain, some podiatrists may try a heel cup one day, a foam pad the next, some low dye taping the next, perhaps an injection the following week, and then eventually orthotics. It is not unusual for a month of treatments to go by before the podiatrist resorts to the use of orthotic devices after these multiple therapeutic modalities. While everyone has their own philosophy of treatment, using all the modalities in one or two visits including casting for orthotic devices (when indicated) would be of benefit to the athlete in the long run.