Injury Prevention—Foot and Ankle Focus

Soccer is the most played sport in the world. As a collision sport, soccer lends itself to injuries due to direct impact, sudden changes in direction, and multiple competitors going for the same ball. Other causes of injury in soccer are overtraining/ inadequate rest, unsupportive shoe gear and poor fitness. Injuries to the foot and ankle comprise 60% of soccer-related injuries. Some injuries are unavoidable but a number of these can be prevented with a few basic measures. The most common foot / ankle injuries and their treatments include:

Plantar fasciitis

This is the most common cause of foot pain in athletes and is simply an increase in inflammation of a tendon on the bottom of the foot, due to a lack of arch support. It is characterized by pain at the direct bottom of the heel bone. It is usually worst with first step out of bed in the morning and eases with activity. It generally recurs as the day progresses. The most basic way to treat this condition is an increase in arch support with a firm, somewhat stiff, over-the-counter insert and calf muscle stretching before and after physical activity. The best such insert is the PowerStep and is available at Varsity Sports on Perkins Road in Baton Rouge.

 Growth plate injury

Another common cause of heel pain is Calcaneal Apophysitis. This is pain in the back of the heel and can be diagnosed by squeezing the back of the heel bone from side-to-side. The pain is usually its worst during or immediately after activity. This condition occurs for two (2) reasons: the impact from repetitive pressure and rapid growth of the leg putting extra stress on the growth plate on the back of the heel. This condition also responds to frequent calf muscle stretching, up to 3 times a day. But in contrast to plantar fasciitis, apophysitis responds better to a softer, gel-style heel cushion. These are available at most drug stores and running stores.

Shin splints

The primary symptom with this condition is pain at the midpoint of the shin that worsens with activity. This is a two-part injury: an over-use injury and a muscle imbalance. Any activity that has running as a component of competition, disposes a participant to this injury. Year round running with inadequate rest and time for recovery create excessive pressure on the developing bones in the lower leg, creating this painful condition. Additionally, running readily builds calf muscles while the development of the muscles on the front of the shins lags behind. This creates a muscle imbalance putting strain on the front of the leg. An easy way to build up the front (or anterior) muscle group is to walk about the room on your heels with the toes extended upwards and the ball of the foot off of the ground. Doing 3 or 4 sets of 30-seconds of uninterrupted walking in this fashion can help prevent this condition by better balancing the muscles in the lower leg.

Sprains and strains

A variety of twisting and tweaking injuries occur when the ankle or foot rolls excessively creating pain and swelling. The basic tenets of RIICE (Rest, Ice, Immobilization, Compression and Elevation) are reliable first-line treatments for these injuries. Rest for 48 to 72 to hours from recreational activity can be significant in allowing the injured limb to recover. Immobilization with appropriate splinting or bracing aids resting an injured limb, particularly when it is a weightbearing limb such as the foot and ankle. Ice (never directly on the skin) for 20 minutes on/ 30 minutes off for the first 2-3 days following an injury helps decrease inflammation. Compression with an ACE bandage and elevation of the injured area above the heart are easy and effective at reducing swelling and aiding repair.

General tips:

  1. Light jogging and gentle stretching before recreational activity increases oxygen to muscles, speed of nerve impulses and range of motion helping prevent injury and improve performance.
  2. Buy sport specific shoe gear from a specialty vendor when possible. Adequate fit and proper condition of athletic foot wear is critical in reducing friction blisters and unnecessary tendonitis condition that can adversely affect performance.
  3. When in doubt rest. Ignore the adage “play through the pain” and allow proper rest for healing and gradual, improved conditioning.
  4. Without a doubt, the most common cause for visits to my office among young athletes is lack of arch support. The easiest way to increase support is purchasing a well-fitted, firm insert such as the PowerStep that can be found at Varsity Sports.
  5. If pain persists, if the injured participant has excessive swelling or bruising, if he or she cannot bear weight on the injured limb, then one should seek medical attention.

Dr. Patrick Hall is Board Certified in Foot Surgery and practices at The Bone and Joint Clinic of Baton Rouge.

This entry was posted in Uncategorized. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s