Lace bite can be a debilitating condition affecting both hockey players and figure skaters. The condition is an irritation in the front of the ankle that can affect the skin and tendons. The cause of lace bite is pressure placed on the anterior ankle from either the skate laces or the tongue of the boot. This pressure is increased during skating and can cause pain anywhere from a dull ache to a sharp, burning pain. The pain will typically occur over time as the laces or tongue rub against the ankle and can be seen frequently with either new skates with a stiff tongue or older skates where tongue begins to break down almost forming a crease in the middle. Most of the pain will be palpable meaning when it is pressed against, but if the tendons become irritated, it can cause pain when flexing and extending the ankle without pressure. Other symptoms may include swelling, a bump or redness in the painful area.

The obvious treatment is rest and staying out of your skates until the condition subsides, but that typically isn’t possible. Ice is a great way to treat these type of injuries. Either using an ice bag wrapped on for 10-15 minutes or even better, rubbing an ice cup on the area for 5 minutes. To make an ice cup, take a disposable cup and fill 2/3 to the top and freeze. Once frozen, tear off the cup and massage the inflamed area with it. Other modalities such as a laser or electrical stimulation can also alleviate the pain and should be applied by a qualified healthcare professional. Adding a pad or foam donut between the skin and tongue of the skate can also help alleviate the pressure and heal the injury.

Understanding the cause of this injury can help alleviate the pain as well as prevent a re-occurrence. Working with an Athletic Trainer and Equipment Manager familiar with the sports and skates can make a difference in your recovery and comfort on the ice.

Chris Phillips is an Athletic Trainer and Strength and Conditioning Specialist with 17 years experience in professional hockey. Chris is the owner of Compete Sports Performance and Rehab in Orange County, California and a preferred provider for US Figure Skating.