Injuries happen during participation of sports and recreational activities are grouped together as sports injury. Some of these injuries may happen during other activity also nor related to sports but are more commonly happen among sports personal. Sports injuries related to foot and ankle are one fourth of the all kind of sports injuries affected. Sports and recreational activity require jumping and running are at higher risk for injury. Foot and ankle bear considerable amount of stress and strain in football, soccer, basketball, volleyball, tennis, track and field, skating, ice-skating, dancing and other similar sports. Which poses considerable risk for foot and ankle related injury. Sports injury of foot and ankle may vary from simple sprain which resolves spontaneously within few days to severe injuries that may not recover fully and athlete may have to end his sports carrier immaturely. Some of these injuries may be overlooked easily and undertreated with potential devastating effect on the carrier of a sports personal. Some of these injuries are acute which grab the attention easily. But some are due to repetitive stress and strain and their symptoms appear slowly. These injuries escape the attention of the athlete and may pose considerable risk for deterioration in their performance.
Common foot and ankle injuries related to sports activity are,
Injuries of Achilles tendon: Click Here for more details
Ankle sprain: Click Here for more details
Ankle fracture: Ankle fracture happens when ankle get trapped in an awkward position that increases the force many folds around the ankle bone and cause fracture. Various combination fracture can happen. Each fracture variation is related to a specific mechanism of injury. These injuries are called malleolar fracture which involves malleolar portion of both tibia and fibula as well as whole fibula shaft. Ankle fracture is nearly always associated with significant swelling. This fracture is inherently unstable due to the configuration of the fracture. And due to this unstable nature, most of the fracture requires surgical fixation.
Malleolar Fracture involving all three malleolar components: Pre and Post of x-ray
Lisfranc Injury: Mid tarsal joints are called Lisfranc joint. This is a joint complex rather than a single joint. It maintains the foot arch by virtue of the configuration of different bone forming the joint and the specific ligaments joining these bones. Lisfranc injury happens when indirect rotational and axial loading force passes through hyper-plantarflexed forefoot a specific pattern of twisting injury of foot. This injury can vary from a simple sprain where only the Lisfranc ligament is injured to significant disruption of the joints associated with fracture of the bones forming Lisfranc joint complex. This injury can cause significant disability if untreated. Sometimes there can be some residual disability even after adequate treatment. Subtle injury often gets missed and always need high degree of suspicion to diagnose. All the obvious injury and most of the subtle injuries require adequate reduction and surgical fixation. This fracture needs long protection in the form of arch support following both surgical and conservative management.
Mechanism of Lisfranc injury
x-ray showing subtle Lisfranc injury
Fracture base of 5th Metatarsal: Fracture base of 5th metatarsal happens due to inversion injury of fore foot. this fracture either can be avulsion fracture of the tip of 5th metatarsal base or jones fracture that involved the base of 5th metatarsal adjacent to articular surface. Most of the time these two fractures do not need surgical treatment. Only pneumatic walker is enough. High arch with supinated foot poses high risk for this injury. Jones fracture carries a higher risk for nonunion and may need surgical fixation. Sometime correction of associated cavovarus (supination) deformity of foot is also need to be addressed for successful union.
Avulsion fracture of 5th MT base
Jones fracture of 5th MT basey
Heel bruise:Inflammation of fat pad following acute injury due to sudden steeping on a small rock or gravel on bare foot. Or repeated impact injury in runner and jumper due to faulty technique or footwear causing inflammation of fat pad. Rest, icing, analgesic and use of silicon heel pad is the treatment.
Turf toe injury:Hyper extension injury of big toe joint causing either sprain or rupture of the planter plate. Usually soccer and football players are in higher risk. This injury happens more among players who plays in synthetic surface (turf). Since this injury got the name of turf toe injury. Surgery is indicated in complete rupture of the planter plate. Otherwise splinting of big toe to prevent extension is the treatment.
Ankle Impingement: Ankle impingements are of main three type; anterior, anterolateral and posterior. Anterior impingement is seen among football and soccer player, in whom osteophyte develops at anterior part of ankle joint both on tibial and talus side. This reduces upward movement of ankle as well as impingement joint capsule which is painful. Anterolateral impingement happens following ankle sprain due to thickening of capsule and ligament at lateral corner of ankle joint which get impinge during upward movement of ankle. Posterior impingement is found commonly among ballet dancers who need to do excessive planter flexion of ankle and causes repetitive stress at posterior aspect of ankle joint.
Stress fracture of tarsal and metatarsal: stress fracture can happen at any tarsal and metatarsal bones. But is common in calcaneum and 2nd to 4th metatarsal shaft. This fracture is commonly seen among long distance runners and army recruiter. Rest, icing, analgesic and pneumatic boot immobilization is the treatment.
Planter fasciitis: Pain at bottom of heel on weight bearing is the main symptom. Long distance runners are affected commonly. For details refer to foot section planter fasciitis.
Sesamoiditis: There are two button shaped bone at ball of big toe within the tendon of flexor hallucis longus. These bones help in weight transfer through ball of big toe during push off phase of walking. Due to repeated impact these bones can have stress fracture, inflammation or arthritic changes and become painful. This is a very nagging painful condition poses severe limitation of activity.
