Lace bite or skate bite is a reasonably common condition in ice skaters and ice hockey players where compression from tight laces at the flex point of the skates causes a tendinopathy of the tibialis anterior tendon at the front of the ankle. The term is not that well known in the medical community as it appears that most cases are self-managed by ice skaters and they often do not seek medical advice.
Causes of Lace Bite
The cause of lace bite is simply the pressure from the laces in the skate at the front of the ankle joint at the flex point of the boot where there are substantial forces generated. This pressure causes irritation resulting in a tibialis anterior tendinopathy.
Symptoms of Lace Bite
The symptoms are pain and swelling of the tibialis anterior tendon at the front of the ankle that is made worse when the laces are tight on the skates.
Treatment of Lace Bite
The approach to dealing with lace bite is to:
- Pain and inflammation management: Cut back on the time spent skating and in ice skates down to tolerable levels. Use ice packs on the front of the ankle after skating. If needed, non-steriodal anti-inflammatory drugs may be used. As the pain begins to settle the time spent in skates and skating can be gradually increased. A too rapid increase may bring the symptoms back.
- Off loading: There are two approaches here. One is to remove the lacing from a few eyelets at the front of the ankle over the most painful area. The other approach is to use strips of adhesive podiatry felt that are adhered under the tongue to be placed on either side of where the tibialis anterior tendon is. Both of these off loading approaches reduce the pressure on the tendon.
- Protection: After the problem has started to settle, then a lace bite gel padding sleeve can be used. This is worn under the socks and cushions the area to prevent irritation. Those who have a history of lace bite and are prone to this probably should wear these long term to prevent the problem.
Personal opinion on Lace Bite
Been there done that. In my youth I used to skate regularly. I do recall having pain on the front of my ankle from time to time. This was obviously before going to University to learn a lot about feet, so I do not recall if what I had was really a “lace bite” or some other problem. It probably was!
University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger, dad.