Sports injuries are common among athletes. Athletes who partake in sports which require running and jumping are typically at a higher risk of getting injured. Sports such as running, basketball, soccer, football, dance, and gymnastics involve athletes placing a considerable demand of pressure and performance on their feet, and often are subject to injuries to their ankle, feet, or legs.

Ankle Sprains

Ankle sprains are one of the most common joint injuries experienced by athletes. The injury is common when the ankle is rolled or landed on incorrectly.  Most ankle sprains involve the ligaments and often result from weightbearing injuries. 

Treatment and diagnosis of ankle injuries would have to involve a physical examination in which obvious deformities, ankle instability, discoloration, and swelling would be treated. X-rays can help rule out fractures, loose bodies, and/or degenerative joints (arthritis). Other diagnostic tests including Computerized Tomography (CT) scan, and Magnetic Resonance Imaging (MRI) can be used to isolate and diagnose specific soft tissue injuries.

Treatment of an ankle injury would vary on the severity.  Acute ankle injuries can be treated with physical therapy and stretching exercises. Severe sprains may require immobility for up to four weeks.

Fractures 

The feet and ankles work together to provide support and mobility to the body. A fracture takes place when there is a break in the bone.

Causes – Many fractures occur during sports. Football players are particularly vulnerable to foot and ankle fractures. Tripping or stumbling on uneven ground is another common cause of a foot or ankle fracture. Increased pain, swelling, bruising, redness, or difficulty walking after an injury are definite signs that it’s time to see a podiatrist.

Treatment – Treatment will depend on the injury. If a bone is broken a podiatrist may attempt to reduce the fracture, which means lining up the ends of the bones so they can heal properly. If the fracture is unstable, meaning that the ends of the bones do not stay in place after a reduction, surgery may be needed. Podiatrists can use metal plates and screws to fix broken bones.

Source: APMA, www.apma.org/sprainsstrainsfractures

Metatarsal Stress Fractures

What is a metatarsal stress fracture?

When excessive stress is placed upon the ball of the foot, a hairline break (fracture) of a long metatarsal bone may occur, known as a stress fracture. This occurs most frequently to the second, third, or fourth metatarsal but can occur in any bone. Frequently, the injury is so subtle that you may not recall any specific occurrence. Stress fractures can occur during sports activities, in overweight individuals, or in those with weakened bones such as osteoporosis.

What are the symptoms of a metatarsal stress fracture?

A presentation for someone with a metatarsal stress fracture would be pain and swelling in the ball of the foot. Pressing on the bones in this area of the foot will reproduce the pain. X-rays taken during the first two to three weeks after the injury will often not show any fracture. After several weeks, an X-ray will show the signs of the new bone healing in the area of the stress fracture.

How to treat a metatarsal stress fracture?

Treatment for a metatarsal stress fracture usually consists of initially resting, elevation, and icing. Sometimes a compression bandage is applied to help reduce the swelling. Frequently, a post-op shoe or a cam walker boot is used to prevent one from pushing off the ball of the foot, thus eliminating any additional stress while the bone is healing. The healing time ranges from four to eight weeks. After the fracture is healed, special attention should be paid to using functional orthotics in the shoes to reduce the stress in this area.

Shin Splints 

 A shin splint refers to the pain along the shin bone, known as the tibia, the large bone located in the front of your lower leg. Shin splints are frequent in runners and dancers.  Medically known as medial tibial stress syndrome, shin splints often occur in athletes who have either changed their training routines or intensified them. This increased activity overworks the muscles, tendons, and bone tissue.

What are symptoms of a shin splint?

Common symptoms of shin splints can be tenderness, soreness, or pain along the inner side of the shinbone.  Most cases of shin splints are treatable with rest and icing. Wearing proper footwear and modifying one’s exercise routine can help prevent shin splits from reoccurring.

How to prevent a shin splint?

To help prevent shin splints arch supports (custom orthotics) are often recommended. If a runner, it is also recommended to replace your shoes every so often. Exercises to strengthen and stabilize your legs, ankles, hips, and overall core can help prepare your legs to deal with high-impact sports as well.

Source: Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/shin-splints/symptoms-causes/syc-20354105

Turf Toe 

What is a turf toe?

Activities such as football, basketball, soccer, field hockey, and lacrosse show the high incidence of injury to the great toe joint on artificial surfaces. Other non-sporting causes include changes in shoe gear, limited range of motion of the great toe joint, and sometimes, flat foot conditions. Hyperextension of the great toe is the most common cause. This is when the great toe joint is hyper-extended as the heel is raised off the ground. An external force is placed on the great toe and the soft tissue structures that support the great toe on the top are torn or ruptured.

What are symptoms of a turf toe?

Symptoms of acute injury include but are not limited to pain, tenderness, and swelling of the great toe joint. Often there is a sudden onset of pain during the push-off phase of running. Injuries to the great toe that cause turf toe are graded into three categories.

A Grade 1 turf toe injury is mild and the supporting soft tissue structure that encompass the toe are only sprained or stretched. This is the most common type of injury. There is minimal swelling with mild local tenderness and usually no black and blue bruising evident.

A Grade 2 turf toe injury is considered moderate in severity. It is present with more diffuse tenderness, swelling, restricted range of motion, and usually mildly black and blue in appearance. There is usually a partial tear of the supporting ligaments, but no articular cartilage damage.

A Grade 3 injury is considered severe in nature because of the considerable swelling, pain on palpation, restriction of range of motion, inability to bear any weight on the injured foot, and a diffused black and blue appearance of the great toe. There are generally tears to the joint capsule, ruptured ligaments and possibly compression damage to the articular cartilage of the great toe.

How to treat a turf toe?

Treatment is centered on an individual basis as well as the severity of the injury that is sustained. The mnemonic “RICE” (Resting, Icing, Compression, and Elevation) can be employed. Grade 1 injuries do well with strapping and only require few days or rest. Grade 2 injuries should adhere to the RICE principles and usually require one to two weeks of missed sporting activity. Grade 3 turf toe injuries are more severe injuries and the healing process may take four to six weeks of recovery time from physical activities. In extreme cases, surgical reconstruction of the joint capsule, ligaments, and articular cartilage may be necessary to restore proper alignment and function.

Tendinitis

Tendinitis is the inflammation of the tendon. Tendons are thick cords of tissue which connect muscles to the bone. Achilles tendinitis, or an inflammation of the Achilles tendon, is one of the most common causes of foot or ankle pain. Other types of foot and or ankle tendinitis include posterior tibial tendinitis and peroneal tendinitis.

What are symptoms of tendinitis?

Symptoms of tendonitis include pain and swelling along the inside of the ankle and arch along the course of the tendon. Pain is present with exercise, extended periods of walking or standing. In advanced cases, the injury to the tendon that started as tendonitis may progress to full or partial tear of the tendon.

What causes tendinitis?

Tendinitis can result from an injury or over-use. Improper stretching prior to exertion or incorrect form during physical activity can also contribute to the development of tendinitis. Those who have flat feet, tight tendons, or arthritis are particularly prone to tendinitis.

How to diagnosis Tendinitis?

The diagnosis can often be made by your doctor with a physical exam. In many instances, an MRI or ultrasound will be performed to determine the extent of damage to the tendon. A simple assessment of tendon strength can be performed by standing on the “tip of toes” on each foot. The affected foot may feel weak and painful in cases of tendinitis.

What are treatment options for tendinitis?

Treatment can depend on how long the symptoms have been present for and if the amount of strength that is lost (if any) in the tendon.  Custom orthotics, physical therapy, and anti-inflammatories are the first course of treatment. For severe cases cortisone injection, shockwave treatment, and PRP injections may be recommended. Please refer to the services tab for further information.

Source: APMA, https://www.apma.org/tendinitis