If the Boot Fits Ski in It: Healthy Footcare Tips for Skiers and Snowboarders

If the Boot Fits Ski in It: Healthy Footcare Tips for Skiers and Snowboarders
If the Boot Fits Ski in It: Healthy Footcare Tips for Skiers and Snowboarders


With the excitement of the Olympics in the air many will be getting off the couch and hitting the ice and slopes. The California Podiatric Medical Association (CPMA) provides an overview of how cold weather sports can affect two of an athlete’s most important assets - his or her feet.

From the downhill rush of snow skiing to the gravity defying acrobatics of snowboarding to the grace and power of ice-skating, winter sports can be a perpetual challenge when it comes to proper foot care. Any problems with the foot or ankle could have serious repercussions for winter sports participants.

“Feet and ankles are particularly important in skiing, as they act as shock absorbers and brakes, as well as helping to steer and accelerate when whizzing down the slopes, so they must be protected as much as possible. Any pre-existing conditions or injuries can not only compromise an athlete’s performance, but also leave one open to further damage to the area. However, these risks can be minimized with the right equipment and training,” says Dr. Kevin Kirby, a podiatric physician specializing in biomechanics and sports medicine.

“Healthy feet and ankles, which act together as accelerators, steering, brakes, and shock absorbers in winter sports, are not only crucial to success in competition, but also help keep the body upright and out of the emergency room.”

In private practice in Sacramento, California for over 28 years, Dr. Kirby says that the single most important element of enhancing one’s performance and staying injury-free during winter sports activities is a properly fitting boot, noting that for skiers and snowboarders the high speeds and force of gravity can have a tremendous impact on the feet, especially during steep, bumpy runs.

“Ski boots are the most important piece of equipment for skiing, and ill-fitting boots can lead to a host of problems,” says Dr. Kirby. “Ski boots should be a snug fit - if they are too loose, the foot and ankle can slide around inside the boot and the pressure exerted by the constant forward motion and side to side movements of skiing could lead to sprains, strains, and fractures. Too tight, and the boot will rub and blister the foot.

“Blistering and bruising are the most common problems faced by skiers, and can be mainly avoided with quality equipment and properly fitted boots, but cannot be avoided altogether. Not everyone's feet are the same and knobby protuberances in the foot and ankle will be prone to bruising and friction, which leads to blisters. The ankle bone, toes, top of the foot and front of the shin are easily rubbed by even the best fitting ski boot, and any moisture held against the foot will cause friction and quickly lead to blisters.

“While these sound like very minor problems, bumps and blisters can keep you off the slopes while they heal and into precious practice time. Do not pop a small blister, but if it breaks on its own, apply an antiseptic and cover it with a sterile bandage.”

Dr. Kirby noted that other problems to watch for include:

Frostbite. It's impossible to overstate the importance of understanding symptoms of frostbite. Skin color changes, from blue to whitish, can't be seen under a boot, but if toes are extremely cold for a prolonged period, feel burning or numb, there is a danger of frostbite. People with a history of frostbite often get it again in the same place.

Neuromas. Enlarged benign growths of nerves between the toes, called neuromas, are caused by compression in tight footwear and can result in pain, burning, tingling, or numbness. Neuromas require professional treatment, including an evaluation of skates and boots.

Sprains and strains. The stress of skiing and skating can result in sprains and strains of the foot and ankle. They can be treated with RICE: Rest, Ice, Compression, and Elevation. If pain persists, seek medical attention.

Subungual Hematoma. Pressure in the toe box of a ski or skate can cause bleeding under the toenail, known as a subungual hematoma. Such a condition should be treated by a podiatric physician to prevent the loss of a toenail.

Bone Problems. Bunions and tailor's bunions, bony prominences at the joints on the inside or outside of the foot, often become irritated in ski boots or skates. Pain at these joints may indicate a need for a wider or better-fitting boot. Other pre-existing conditions, such as hammertoes and Haglund's Deformity (a bump on the back of the heel) can be irritated by an active winter sports regimen. If pain persists, consult a podiatric physician. Fractures caused by trauma require immediate medical attention.

“Most of the patients I see that need treatment have performance issues with their downhill skiing, such as difficulty making turns or edging,” says Dr. Kirby.

“Skiers with minor biomechanical imbalances may encounter difficulty in turning or setting an edge on their skis which may due solely to foot structure and function.  This can easily be treated with appropriate ski boots or in-boot orthotics.”

“In some cases skiers may also become fatigued even though they are in good physical shape. This is generally due to overcompensating for poorly fitting boots or due to feet that are not stable enough to allow for efficient ski turns. If their boot doesn’t fit properly, or if their feet have insufficient stability, people try to make up for it by clamping down on the top of the boot. This may compromise circulation or nerve supply to the feet that results in cold and numb feet at the end of each ski run, which not only makes skiing less comfortable, but also less fun.”

Dr. Kirby recommends first and foremost that skiers buy or rent their boots from a winter sports retail specialist. “If you wear custom shoe inserts, or orthotics, be sure to bring those in with you when trying on boots, and bring in the socks you will be wearing while on the slopes.

“Remember that you will be wearing your boots for around seven hours a day while skiing, so they must be comfortable. Choose boots carefully, trying on a number of models and wearing them around the shop before you make your choice, and if possible, wear your boots at home a few times before heading for the slopes - this will allow your feet to become better accustomed to the boots.”

“If you ski a lot, you might want to consider getting orthotics specifically for your ski boots,” advises Dr. Kirby. “The right orthotics can help improve edging, which can improve control during ski turns. This advantage can make a huge difference in more aggressive and difficult skiing, from intermediate slopes to black diamond runs.

“Street shoes and ski boots are quite different, and orthotics for skiing need to be specifically fine-tuned for the demands of the sport. Some skiers turn well to the left but not to the right –this can be due to differences in the shape and function of the feet. Orthotics can compensate for these differences and improve overall comfort and performance, which in turn reduces fatigue.

“In snowboarding, the feet are more loosely bound by the boots than in downhill skiing. To allow for jumps and acrobatics, snowboard boots are softer and more flexible, and therefore less protective. This leads to a higher rate of foot injuries, primarily sprains, foot fractures and dislocation in the middle part of the foot.

“Snowboarders need to be extra careful. Riding too hard and landing wrong from jumps causes most injuries. Abnormal biomechanical forces like excess motion and instability also can be controlled with custom orthotics, which can improve foot function, minimize stress and help prevent foot injuries.

“If you want to improve your performance on the slopes while reducing fatigue, a custom ski or snowboard orthotic may be just what the doctor ordered. The vast majority of injuries occur in the last hour of the day due to fatigue. So if you are really tired at the end of the day, it is common sense to take it easy to avoid injury and possibly also avoid a trip to the emergency room.

“The good news is that most winter sports foot injuries are preventable and proper foot health can improve your technique,” says Dr. Kirby. “Follow these simple tips for a healthy – and high performance -winter workout:

“Before taking the slopes in cold weather, it’s important to loosen up the muscles by stretching. In the cold, muscles take longer to warm up making one more prone to injury when practicing winter sports such as skiing and snowboarding. Stretching helps prevent muscle pulls and tears, and prepares the muscles for the exertion required by the constant flexing of the joints demanded by skiing and snowboarding.

“Wear the proper shoes for each sport or activity. Wear proper fitting boots because tight ones restrict blood flow and nerve sensation to your feet. If you have difficulty edging or turning in downhill skiing, or if your feet and legs get fatigued excessively during skiing or snowboarding, consider getting custom orthotics for your winter footwear.

“Wear winter weather socks inside your footwear. Socks are part of your insulation from the cold and are crucial in winter sports such as skiing. Good socks will not only help keep your feet dry, by 'wicking' away any moisture from the feet but will also keep them warm and comfortable within your boots. It is essential to take your socks along when having your boots fitted: thin socks are recommended by podiatrists and ski specialists alike, but even so there isn't much room for extras inside a ski boot (or there shouldn't be, if it is fitted properly) so the sock needs to be taken into account during a fitting.

“The best socks are thin and lightweight but still cushion the foot in all the right places. These multi-tasking socks are made of a number of sections to support the different areas of the foot and ankle. As already mentioned, the ability to transport moisture away from the foot as it perspires is essential, so choosing the right material is important.

“What blend you choose comes down to personal choice and comfort, but whatever you do, don't wear 100% cotton socks – they actually hold the moisture against the skin, which will quickly cause painful blistering. If you really need extra warmth, opt for sock liners - preferably silk - which are worn under your ski socks and keep warmth in without encouraging perspiration to hang around.

“Keep your feet warm by keeping the rest of your body warm, especially your upper body and head. Feet soaked in snow should get back indoors quickly to avoid the danger of frostbite. Wear a hat and waterproof gloves and dress in layers to prevent getting cold.

“Warm up your legs and feet prior to activity. Stretch your hamstrings, calves and Achilles tendons.

“Begin your activity gradually. Hit the slopes slowly.

“If you have any swelling or discomfort following an activity, elevate and apply ice to the affected area for 20 minutes.

“If you have any pre-existing foot conditions, such as corns, calluses, bunions or hammertoes, see your podiatric physician for evaluation before buckling or lacing up. A medical examination is also important if you have any pre-existing circulatory problems, such as Raynaud’s Disease (a circulatory disease) or diabetes.”

To find a local licensed podiatric physician visit WWW.CALPMA.org.

Founded in 1912, the California Podiatric Medical Association (CPMA) is the leading and recognized professional organization for California’s doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their long and rigorous education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg.

CPMA - Keeping Californians on their Feet – Healthy, Active and Productive.