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Foot and Ankle Sports Injuries

What are Foot and Ankle Sports Injuries?

Foot and ankle sports injuries are damage sustained to the foot and ankle during sports and exercises. Foot and ankle sports injuries may be either acute (sprains, fractures, tears) or chronic (tendonitis, overuse injury) injuries.

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Causes of Foot and Ankle Sports Injuries

Foot and ankle sports injuries typically occur when the foot or lower leg twists unexpectedly while playing sports such as football, basketball, hockey, skating, tennis, and athletic activities. These injuries may result from accidents, poor training practices, use of improper protective gear, lack of conditioning, and insufficient warm-up and stretching.

Signs and Symptoms of Foot and Ankle Sports Injuries

Some of the signs and symptoms of foot and ankle sports injuries include:

  • Throbbing pain
  • A deformity of the bone in the foot and/or ankle
  • Difficulty bearing weight
  • Difficulty walking
  • Bruising
  • Inflammation, tenderness, and redness
  • Increased pain during activity and decreased pain during rest

Common Foot and Ankle Sports Injuries

Some of the common foot and ankle sports injuries include:

  • Fractures of the Foot and Ankle: The foot and ankle work together to provide balance, stability, movement, and propulsion to the human body. Anatomically the foot is divided into the forefoot, midfoot and hind foot. The forefoot comprises 5 toes, the midfoot includes 5 bones that form the arch of the foot, and the hindfoot forms the heel and ankle. The ankle is a large joint made up of 3 bones: the tibia, fibula, and talus. Any significant trauma or injury to any of these structures can result in the fracture (crack or break) of the foot or ankle bones. Many fractures result from sports such as basketball, soccer, inline skating, or riding motorized scooters.
  • Ankle Sprains: Ankle sprains are common injuries that occur from overstretching or tearing of the ligaments that support the ankle. Ankle sprains occur due to sudden inward or inverted movement of the foot during sports activities or while walking and running on uneven surfaces. They can also occur from falling or sudden force on the ankle, which twists the joint beyond its normal range, resulting in damage to the ligament. Sprained ankles top the list of the most common sports injuries and are common in sports such as basketball, soccer, and any other sports that involves jumping and pivoting.
  • Achilles Tendinitis: Inflammation of the Achilles tendon is known as Achilles tendinitis. The Achilles tendon is a tough band of fibrous tissue that runs down the back of your lower leg and connects your calf muscle to your heel bone. The tendon is used when you walk, climb, jump, run, and stand on your tip toes. Achilles tendinitis occurs as a result of repetitive stress to the tendon due to overuse or overstress of the Achilles tendon. This overuse injury is common among runners.
  • Plantar Fasciitis: Plantar fasciitis refers to the inflammation of the plantar fascia, a thick band of tissue that is present at the bottom of the foot. It runs from the heel bone to the toes and forms the arch of your foot. The plantar fascia functions as a shock absorber and supports the arch of your foot. Excessive pressure over the fascia may strain and tear the tissue, causing heel pain. Repeated overstretching or overuse causes irritation or inflammation of the fascia. This usually occurs due to stress from excessive training, intense running, or poor shoe support.
  • Stress Fracture: For athletes who take part in rigorous sports that involve a lot of running, stress fractures of the foot and ankle are quite common. Also called a hairline fracture, this fracture appears as small thin cracks in the bone and occurs due to overuse or wear and tear. This type of injury is more common among athletes who run on hard surfaces or athletes who push themselves too hard and too fast.
  • Heel Spur: A heel spur is a calcium deposit that results in a bony protrusion on the underside of the heel bone. Athletes with arches that are too high or too low are vulnerable to developing heel spurs. Repeated running on hard surfaces and wearing footwear that does not correctly support the arch can put additional stress on the heel, resulting in the development of heel spurs.
  • Turf Toe: Turf toe is an injury to the ligament at the base of the big toe. It is a painful condition that usually results from jamming the toe into the ground or excessive backward bending of the toe. As it is more common in athletes playing on artificial turf, especially those involved in field sports, such as football, baseball, and soccer, it is known as turf toe.
  • Morton’s Neuroma: Also referred to as “intermetatarsal neuroma,” Morton’s neuroma is the thickening of nerve tissue in the ball of the foot due to irritation and compression of the nerve. Usually, the neuroma occurs between the bones of your third and fourth toes. Causes include activities that involve repetitive irritation to the ball of the foot, such as court sports or running.

Diagnosis of Foot and Ankle Sports Injuries

To diagnose foot and ankle sports injuries, your physician will conduct a physical examination and order diagnostic tests, such as:

  • X-rays, which provide a clear image of the bones
  • Computed tomography (CT) scans, which provide a cross-sectional image of the foot and ankle bones and offer a much higher level of detail than X-rays
  • Magnetic resonance imaging (MRI), which provides high-resolution images of both bones and soft tissues that are not visible in an X-ray or CT scan

Treatment for Foot and Ankle Sports Injuries

Treatment depends on the type of injury. Your doctor will initially prescribe medication to relieve pain and inflammation, and suggest R.I.C.E. (rest, ice, compression, and elevation of the injured leg above heart level), which may relieve symptoms in mild strains and sprains. Some major injuries may require bracing, or the use of a cast or boot to avoid weight-bearing, and to promote healing.

Severe injuries may require surgery to reduce fractured bones, or repair or reconstruct torn ligaments and tendons.

Procedure

There are many surgical techniques to treat foot and ankle sports injuries. Some of them include:

Open reduction and internal fixation

This surgical procedure for foot fractures involves an incision made to expose the fracture. The fragments of bone are realigned and stabilized with metal wires, screws, pins, and plates. The incision is closed and dressed. The foot is placed in a splint, shoe, boot, or cast.

Percutaneous screw fixation

For some types of fractures, the reduction can be achieved with a closed manipulation of the foot using X-ray. The bone can either be pushed or pulled to set it in place without making a large incision. This method, called percutaneous fracture fixation, can be performed with one or more small incisions instead of the traditional large incision, through which the implants are fixed.

Arthroscopy

This is a minimally invasive surgery where a small camera called an arthroscope is used to view the ankle joint and guide miniature instruments to remove fragments of torn ligament, bone, or cartilage from within the joint.

Reconstruction

Torn ligaments can be surgically repaired with sutures or replaced with a graft, which can be another ligament and/or a tendon retrieved from the foot or around the ankle.

Fusion

In cases of severe injury, damaged bones are fused together so that they heal into one single bone. This limits movement in the joint.

Post-operative Care

Following surgery, your foot or ankle will be immobilized using a splint or cast. You will be advised a course of physical therapy to regain range of motion and to promote flexibility and strength in the foot.

Fractures are monitored for healing with X-rays. You will be informed when it is safe to return to sports and regular activities.

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