Collegiate baseball player

CASE TWO: COLLEGIATE BASEBALL PLAYER

Baseball player with foot & knee pain, needing enhanced stability and rotational injury prevention.

I. Athlete & Injury Overview:

• Athlete: 21-year-old high-level batter, fielder, sub-pitcher.

• Injury: Sesamoiditis (1st toe), lateral ankle instability, knee pain.

• Biomechanics: Ankle varus, valgus foot, rotational stress, foot instability.

• Footwear: Metal cleats (grass), TPU cleats (turf). Primarily uses TPU for training.

II. Podiatric Assessment & Treatment:

• Assessment: Acute pain at 1st MTPJ, sinus tarsi pain, PLC knee pain. Abnormal tibial rotation, abductory twist (right > left). X-ray: midfoot sag, decreased calcaneal inclination, medial sesamoid periostitis. MRI: medial sesamoid bone marrow uptake (early stress fracture).

• Treatment: 2 weeks offloading (post-op shoe), seated/weight-offloaded exercises (core, mechanics). 30 mmHg compression (day). Custom orthotics (week 3): 1st MTPJ offloading (Morton’s extension), thin arch support, medial heel post. Turf cleat break-in before metal cleats

• Timeline: Week 4: return to functional activity, improved knee strain, reduced forefoot loading pain.

III. Product Innovation & Recommendations:

• Footwear: Add thin cork forefoot layer for support in cleats. Eg, in Nike Force Zoom Trout Elite, remove liner and add 1.5mm more depth in toe box with reinforced forefoot layer

• Orthotics:

  • 1st pair for Play in Cleats (fit thickness in office): Semirigid EVA, Morton’s extension, thin tight met pads,thin cork, 4mm inverted skive.

  • 2nd pair Training & athletic shoes: Medial heel post, heel pads, polypropylene shell.

• Compression: 30 mmHg graduated compression sleeve (nylon/spandex) toes to 6 inches above ankle.

• New Ideas: Firmer cleat lining in forefoot with material like high resilience foam (Eva) or cork with a thin layer of polyurethane under it, increased cleat depth for custom fitted thin orthotics to prevent excess movement or tightness, lateral cleat stabilization.

IV. Performance & Prevention:

• Return: 2 weeks offloading, 2 weeks orthotic break-in.

• Prevention: Discourage barefoot walking, orthotics during play, core strengthening, proper cleat fit, batting & fielding mechanics.

• Performance: Orthotic treatment reduced knee strain and forefoot load. Athletic orthotic supports structural abnormalities.

• Long-Term: Rehabilitation, proper orthotics, and cleat modifications for improved performance