PRIMARY CARE OF FOOT AND ANKLE INJURIES IN THE ATHLETE
Section snippets
LATERAL ANKLE SPRAINS
Lateral ankle sprains are the most common injury in sports, especially basketball, soccer, cross-country running, and dance and ballet.8, 27, 28, 32, 40, 42, 45 Studies in Norway and Finland reported that acute ankle sprains accounted for 16% and 21% of all athletic injuries, respectively.42, 60 In basketball, ankle sprains account for 45% of all injuries, and in soccer 17% to 31% of all injuries are ankle sprains.24, 27, 60
Proper diagnosis of musculoskeletal injury depends on a working
CHRONIC LATERAL ANKLE SPRAINS
Chronic symptoms following a lateral ankle sprain require special attention and careful evaluation. Patients with chronic instability typically present with either an acute sprain, which the athlete relates as a recurring problem, or with a complaint of looseness of the ankle and frequent “turning under” or “giving away.” These athletes rarely complain of pain. The complaint of pain should raise suspicion for another diagnosis or an associated injury. Evaluation should include a careful review
WHEN AN ANKLE SPRAIN IS NOT AN ANKLE SPRAIN
Because lateral ankle sprains are such a common injury in the athlete, there is an understandable tendency to view all injuries around the hindfoot and ankle as an “ankle sprain.” Also, the athlete is often unable to recall or describe the exact mechanism of injury, thus clouding the history. Several aspects of the athlete's symptoms are particularly suggestive of an injury other than, or in addition to, an ankle sprain: (1) the inability to bear weight on the foot and ankle (especially after
MIDFOOT INJURIES
Injuries to the midfoot in the athlete vary from metatarsal and tarsal stress fractures to mild tarsometatarsal sprains to frank fractures and Lisfranc dislocations. Similarly, the treatment, recovery, and prognosis range from simple to complex. The more severe injuries can result in career-ending injuries and long-term degenerative arthritis. Thus, the physician attending to these athletes must be able to distinguish the precise injury, recognize its severity, and institute appropriate initial
HEEL PAIN AND ACHILLES TENDON RUPTURE
We subdivide heel pain into posterior heel pain and plantar heel pain. Posterior heel pain typically involves either insertional Achilles tendinitis or acute Achilles rupture. Plantar heel pain is very common, and plantar fascilitis or calcaneal apophysitis is the usual diagnosis.
Anterior Ankle Impingement
Anterocentral and anteromedial impingement is typically bony impingement, whereas anterolateral impingement typically involves soft tissue (see next section). Anterocentral and anteromedial ankle impingement results from repeated bony impingement between the talar neck and the anterior lip of the tibia. This repeated bony impingement stimulates the cambium layer to form osteophytes. Once the osteophytes begin to form, they often grow and increase the impingement symptoms and inhibit
FIRST METATARSOPHALANGEAL SPRAINS (TURF TOE)
Injury to the first metatarsophalangeal (MTP) joint is common in the athlete, especially with participation on hard surfaces while wearing flexible shoes. These injuries most often involve a sprain of the ligaments of the MTP joint. First toe sprains (turf toe) commonly result from forced hyperextension of the MTP joint.6, 15, 59 Forced hyperextension produces tearing first in the plantar portion of the capsuloligamentous complex at its origin from the metatarsal head and neck. The initial pain
SUMMARY
A thorough knowledge of foot and ankle anatomy is required to allow an accurate and focused examination of the injured athlete. This short review has attempted to educate the treating physician on our approach to foot and ankle injuries commonly seen in athlete. We have tried to elucidate less common injuries that present in similar manner to the more common foot and ankle sprains and strains.
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MR Imaging–Ultrasonography Correlation of Acute and Chronic Foot and Ankle Conditions
2023, Magnetic Resonance Imaging Clinics of North AmericaPeroneal Subluxation and Associated Tears
2021, Operative Techniques in Sports MedicineCitation Excerpt :However, the association between fibular morphology as a risk factor for peroneal subluxation has been challenged.2 A fibrocartilaginous rim of two to four millimeters is present in about 50% of the population.3 The superior peroneal retinaculum, the chief constraint to peroneal subluxation, is confluent with the periosteum of the fibula anteriorly and typically has a band that extends posteriorly to the achilles and a band that extends distal and posterior to the calcaneus.4
Adequate return to sports and sports activities after treatment of Lisfranc injury: A meta-analysis
2021, Journal of ISAKOSCitation Excerpt :The degree of (in)stability influences the treatment choice which can therefore vary from conservative non-weight bearing treatment to different surgical interventions.43 The injuries have become increasingly reported which is in great contrast to the deficiency in knowledge on sports outcomes for athletes sustaining the injury.8 9 20 44 45 The aim of the systematic review was therefore to compile the available data on sports outcomes for the different treatment options to determine the rate and time to RTS at different levels.
Isolated Chronic Anteroinferior Tibiofibular Ligament Rupture Repair
2012, Journal of Foot and Ankle SurgeryGroove impaction for the treatment of instable peroneal tendons
2010, Fuss und Sprunggelenk
Address reprint requests to David A. Porter, MD, PhD, Methodist Sports Medicine Center, 1815 N. Capitol Ave, Suite 412, Indianapolis, IN 46202