We all have limits. Regardless of whether you are involved in lacrosse, track and field, baseball,

tennis or year-round soccer, it is very easy to over-train and extend yourself beyond the state of

physical excellence into the overuse syndrome.

One of the most common overuse injuries is heel pain. In the younger athlete, the problem is often caused by a condition known as apophysitis of the calcaneus (heel bone) or Sever's Disease.

This condition consists of an inflammation of the growth plate under the heel. It is most common in boys and girls between the ages of 10-15. Major causes occur in sports where cleats are worn, which add to the trauma. In the mature athlete, it's the arch-heel syndrome, better known as planter fasciitis.

This is an inflammation of the band of muscles and tendons that originate in the toes and insert into the heel. If the process continues to become chronic, it can develop into a heel spur. In other cases, the pain could be caused by a stress fracture.

In many of these running sports, especially tennis, there may be involvement of the Achilles tendon (the tendon that attaches the calf muscle to the back of the heel). It is most important to know when to stop and rest or perhaps get treatment.

Otherwise, a partial tear or a possible complete rupture may occur. In all sports, we run the risk of fatigue. It may play a role in ankle sprains or collisions between players (especially in lacrosse). There are many injuries that are due to improper foot balance and support when we run. This needs to be

corrected.

In order to prevent injuries, one needs to be well-conditioned and do stretching and strengthening exercises before and after the event. Most important, know the warning signs such as fatigue, decrease in performance and a sore throat accompanied by muscle and joint stiffness. These are the times when we are all prone to injury. Learn to know your body's warning signals as you go in to enjoy your event.

Robert F. Weiss is a podiatrist specializing in foot and ankle surgery. He was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 Marathons and has a practice in Darien: The Foot & Ankle Institute of Darien. For more information, visit his website at www.therunning doctor.net.

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