Top 5 Sporting Injuries

Treating the injured foot and ankle can be challenging. Although with an accurate diagnosis patient outcomes greatly improve.

Below are the top five common sporting injuries we see.

  1. Ankle sprains

  2. Tendinitis

  3. Plantar Fasciitis

  4. Stress fracture

  5. Toe injuries e.g Turf toe

Ankle sprains

What is it?

A sprained ankle is an injury that occurs when you roll, twist or turn your ankle in an awkward way. This causes the ligaments to either over-stretch (strain) or tear. The ligaments are tough bands of tissue that help stabilise and secure joints in their correct positions.

Roughly 230,000 Australians will consult a medical professional due to an ankle sprain each year. Around 80% of Ankle sprains involve the lateral (outside) ligaments of the ankle, this happens when the foot points downward and twists inward. 

Symptoms 

  • Pain - especially on weight bearing and/or moving the ankle/foot

  • Tenderness when touching ankle

  • Swelling

  • Stiffness

  • Popping sensation or sound at time of injury

How can it be treated?

  • Accurate diagnosis through thorough examination and possible imaging (ultrasound or MRI)

  • RICER protocol (Rest, Ice, compression, Elevation, Rest)

  • Taping or other immobilisation technique e.g. CAM boot

  • Manual therapy to reduce swelling and discomfort - Massage

  • Photobiomodulation therapy (PBMT) i.e. laser therapy

  • Rehabilitation exercise program

  • Footwear advice/ changes, orthotic prescription

References

https://www.physio-pedia.com/Lateral_Ligament_Injury_of_the_Ankle

https://www.ncbi.nlm.nih.gov/books/NBK459212/

https://www.mayoclinic.org/diseases-conditions/sprained-ankle/symptoms-causes/syc-20353225

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ankle-sprains

https://www.nps.org.au/consumers/ankle-sprains-10-things-you-should-know


Tendonitis - e.g. Achilles tendinitis, Tib post tendinitis 

What are they?

Inflammation of fibrous cord that connects muscle to bone which are known as Tendons. The most common places in the body to suffer a tendonitis injury are the shoulder, ankle, elbow, wrist and knee

How does it happen?

Tendonitis is often caused by repetitive movements especially involving high impact or exertion. Incorrect technique when performing movements further increases the risk of tendinitis. 

Your environment can also contribute to the injury e.g. if movements are done on hard surfaces and poor or old equipment e.g. shoes.

What are the symptoms?

  • Pain at site of injury e.g. back of heel/ ankle

  • Mild swelling and inflammation

  • Grating sensation as the tendon moves

  • Tenderness

  • Stiffness of joint tendon/ muscle complex mobilises 

How can it be treated?

  • RICER protocol (Rest, Ice, compression, Elevation, Rest)

  • Reduced exercise levels/ change of exercise type

  • Avoidance of certain movements

  • Rehabilitation exercise program - stretching and strengthening

  • Manual therapy - massage, dry needling

  • PBMT

  • Footwear 

  • Orthotic therapy

References

https://www.mayoclinic.org/diseases-conditions/tendinitis/symptoms-causes/syc-20378243

https://www.healthdirect.gov.au/tendonitis

https://mydr.com.au/sports-fitness/achilles-tendinitis/

https://my.clevelandclinic.org/health/diseases/10919-tendinitis

Plantar Fasciitis

What is it?

Inflammation of the plantar fascia which is a thick band of tissue that connects your heel to your toes. The plantar fascia is designed to absorb and disperse the shock and pressures applied to our feet during movement. 

How does it happen?

Plantar fasciitis is typically a chronic degradation of the plantar fascia from excessive forces due to a multitude of factors. Over time repetitive trauma to the fascia causes micro-tears to happen inside the structure leading to inflammation.

The contributing factors can include:

  • Poor foot posture

  • Poor leg biomechanics (how the body moves)

  • Poor footwear

  • over use due to sports, work or social lifestyle

  • Repetitive high impact e.g. repetitive jumping

  • Obesity

  • Age 

Symptoms

  • Pain at rising

  • Pain underneath heel or arch of foot - typically sharp or stabbing feeling

  • Tenderness when touching heel area 

  • Numbness around heel

  • Pain after exercise or prolonged activity

How can it be treated?

  • Rest

  • Footwear education and correction

  • Rehabilitation exercise program - stretching, strengthening, self massage

  • Manual therapy - massage, dry needling

  • Photobiomodulation therapy (PBMT)

  • Shockwave - depending on duration of symptoms/ condition

  • Orthotic therapy

  • Corticosteroid injection - Extremely painful and can cause scarring. 


References

https://www.ncbi.nlm.nih.gov/books/NBK431073/

https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs/

https://www.healthdirect.gov.au/plantar-fasciitis

https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846

Stress fracture

What is it?

A stress fracture is a small crack in a bone due to overuse or repetitive trauma to the affected area. They are most common in the weight bearing bones of the lower leg and foot. They can often be alternatively called a “stress reaction”. You are at more risk of developing a stress fracture if you have an underlying condition e.g. Osteoporosis.

The most common bone to experience is your Tibia (shin bone) where between 20 to 75% of all stress fractures occur. 

What is the most common cause?

  • Repetitive movements involving high load or impact e.g. running, high intensity sports. 

  • Overdoing a new exercise or activity in terms of intensity, duration or frequency. 

  • Changing of workout/ exercise surfaces e.g. from park running to road running.

  • Incorrect movement during exercises

  • Poor equipment when performing activity e.g. footwear

Symptoms

  • Pain on weight bearing and touch

  • Ache at night 

  • Swelling around painful area

How can it be treated?

Accurate diagnosis through physical examination and imaging referrals. Type of imaging depends on the duration of symptoms. MRI and/ or CT scan is preferred imaging especially when an acute injury. If pain is present for over 2 months, X-ray can often diagnose injury.

Offloading injured site or limb through the use of a CAM walking boot or proper supportive footwear and orthotics if CAM boot is not appropriate. 

Rest from excessive weight bearing and rest from exercise advised. 

Surgery to provide internal support to injured bone is explored if conservative options are unsuccessful or severity of injury is too great for conservative management. 

References

https://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/syc-20354057

https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures-of-the-foot-and-ankle/

https://my.clevelandclinic.org/health/diseases/15841-stress-fractures

https://www.hss.edu/conditions_stress-fractures-foot-ankle.asp


Toe injuries e.g. Turf toe

What is it?

Turf toe refers to the spraining of the ligaments surrounding typically the First metatarsal phalangeal joint (big toe joint). The common term for the ligaments and other soft tissues is the Plantar complex. Similar to other strains there are different grades of injury depending on the severity of the strain;

  • Grade 1. The plantar complex has been stretched, causing pinpoint tenderness and slight swelling.

  • Grade 2. A partial tearing of the plantar complex causes more widespread tenderness, moderate swelling, and bruising. Movement of the toe is limited and painful.

  • Grade 3. The plantar complex is completely torn, causing severe tenderness, severe swelling, and bruising. It is difficult and painful to move the big toe.

How does it happen?

Turf toe is caused by over extension of the big toe, causing it to bend “upwards” too far resulting in the plantar complex over stretching. This movement typically happens in sports that involve short explosive movements when athletes are on the balls of their feet e.g. Football, Basketball, Hockey. 

The injury is more common for athletes competing on hard surfaces e.g. wooden courts, artificial grass (Turf) or outdoor courts. 

Symptoms

  • Pain when bending toe upward both non-weight bearing and weight bearing. 

  • Pain when touching the bottom surface of the toe and joint. 

  • Swelling to joint area

Treatment

  • RICER protocol (Rest, Ice, compression, Elevation, Rest) at time of injury

  • Rest from exercise

  • CAM walking boot to offload pressure and stabilise joint (Grade 2 and above)

  • Joint immobilising e.g. splint

  • Physical rehabilitation exercises

  • Surgical repair of ligaments if complete tear (grade 3)

References

https://orthoinfo.aaos.org/en/diseases--conditions/turf-toe

https://www.sydneyorthopaedic.com.au/turf-toe.html

https://my.clevelandclinic.org/health/diseases/17590-turf-toe

https://www.healthline.com/health/turf-toe#symptoms

Andrew Murphy - BHlthSc/MPodMed, MAPodA

With over 6 years experience in the field of Podiatry, Andrew brings an exceptional professional and knowledgeable level of care to our patients.

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