Sport Injuries

Prevention

Warming up prior to physical activity can prevent ankle sprains and fractures. So can wearing proper shoes. If you're an athlete, talk to us to determine which shoes are best for your sport, and read APMA's footwear selection tips on our Tips for Healthy Feet page for more information. Athletic shoes should be replaced yearly; running shoes should be replaced every 300–400 miles or so. Avoid running or walking on uneven surfaces.

Wear the correct shoes for your particular activity.
Wear hiking shoes or boots in rough terrain.
Don’t continue to wear any sports shoe if it is worn unevenly.

Immediate Treatment

Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatric physician.

Increased pain, swelling, bruising, redness, or difficulty walking after an injury are definite signs that it's time to see a podiatrist.

BEFORE SEEING THE PODIATRIST

If an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatric physician are easy to remember if you can recall the word “rice.”

Rest. Restrict your activity and get off your foot/ankle.
Ice. Gently place a plastic bag of ice wrapped in a towel on the injured area in a 20-minute-on, 40-minute-off cycle.
Compression. Lightly wrap an Ace bandage around the area, taking care not to pull it too tight.
Elevation. To reduce swelling and pain, sit in a position that allows you to elevate the foot/ankle higher than your waist.
For bleeding cuts, cleanse well, apply pressure with gauze or a towel, and cover with a clean dressing. See your podiatrist as soon as possible. It’s best not to use any medication on the cut before you see the doctor.
Leave blisters unopened if they are not painful or in a weight-bearing area of the foot. A compression bandage placed over a blister can provide relief.
Foreign materials in the skin—such as slivers, splinters, and sand—can be removed carefully, but a deep foreign object, such as broken glass or a needle, must be removed professionally.
Treatment for an abrasion is similar to that of a burn, since raw skin is exposed to the air and can easily become infected. It is important to remove all foreign particles with thorough cleaning. Sterile bandages should be applied, along with an antibiotic cream or ointment.

Myths

“It can’t be broken, because I can move it.” False; this widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: Breaks in the smaller, outer bone of the lower leg, small chip fractures of either the foot or ankle bones, and the often neglected fracture of the toe.

“If you break a toe, immediate care isn’t necessary.” False; a toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatric physician usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatric physician will help prevent improper or incomplete healing. Often, fractures do not show up in the initial X-ray. It may be necessary to X-ray the foot a second time, seven to ten days later. Many patients develop post-fracture deformity of a toe, which in turn results in a deformed toe with a painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.

“If you have a foot or ankle injury, soak it in hot water immediately.” False; don’t use heat or hot water on an area suspect for fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing sensation, and prevents swelling and pain. Your podiatric physician may make additional recommendations upon examination.

“Applying an elastic bandage to a severely sprained ankle is adequate treatment.” False; ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. X-ray examination, immobilization by casting or splinting, and physiotherapy to ensure a normal recovery all may be indicated. Surgery may even be necessary.

“The terms ‘fracture,’ ‘break,’ and ‘crack’ are all different.” False; all of those words are proper in describing a broken bone.

Shoes for Athletics

Sport-specific shoes can really affect the way you play. Make sure to have your feet professionally measured by today's podiatrist to find a correctly sized shoe. If you participate in a certain sport at least two to three times a week, you should wear a sport-specific shoe.

Avoid some serious pain and raise your game by checking out the best shoes for several sports below.

Basketball, Tennis, and Volleyball
Common foot injuries: sprains, stress fractures, tendinitis
The appropriate footwear should:

Have a thick, stiff sole that provides support for impact.
Have high ankle construction that supports the ankle during quick changes in direction (for basketball).
Be lighter, have less midsole support, and contain a sole more responsive to quick starts and stops (for volleyball).

Soccer
Common foot injuries: ankle sprains, turf toe, ingrown toenails, Sever's disease
The appropriate footwear should:

Have a good-quality footbed, which can help provide proper support for the arch and user’s foot type.
Feature the stud type for the ground that will be played on most often: soft, hard, firm, or turf.
Use molded rubber cleats rather than the screw-on variety.

Football and Lacrosse
Common foot injuries: turf toe, Achilles tendinitis, ankle sprains
The appropriate footwear should:

Have a good amount of high ankle support. This support is especially important for linemen and other players who make frequent lateral movements during play.
Allow for proper traction on a grassy field, in both wet and dry conditions.
Never be hand-me-downs; ill-fitting cleats increase the risk of ankle injuries.

Baseball and Softball
Common foot injuries: sprains, stress fractures, plantar fasciitis, tendinitis
The appropriate footwear should:

Offer support to prevent arch pain, which frequently affects catchers. Customized shoe inserts called orthoses may help alleviate the pain.
Not include metal baseball spikes for athletes younger than 13.
Try multi-cleats for children ages 11–15 to avoid heel pain.

Running
Common foot injuries: plantar fasciitis, shin splints, stress fractures, Morton's neuroma
The appropriate footwear should:

Provide shock absorption to help runners avoid injury. Running shoes are made for high-impact forward motion and should not be used for sports with lateral movement.
Match your foot’s arch type (high, medium, low). A podiatric physician can measure your feet and let you know what type to look for.
Be replaced after 600–800 miles of running or walking, or every 6–8 months.

Diagnosis and Treatment

A podiatrist will carefully examine your feet and ankles and take a complete medical history. He or she will also order tests, including an X-ray, ultrasound, or MRI, to determine the extent of your injury. If you have a fracture that's clearly visible on X-ray, you may not need additional testing. Ultrasounds and MRIs are useful for finding soft issue injuries (including torn ligaments) and stress fractures.
Treatment will depend on your injury. If you have a broken bone, your podiatrist may attempt to “reduce” the fracture, which means lining up the ends of the bones so they can heal properly. (You'll be given a local anesthetic to numb the area first.) If the fracture is “unstable,” meaning that the ends of the bone do not stay in place after a reduction, surgery may be needed. Podiatrists can use metal plates and screws to fix broken bones.

Stress fractures are treated with rest and immobilization. You will be instructed to stay off the affected area until healing is complete. Crutches and/or a special “boot” or cast may be used to immobilize the area.
Sprains are also treated with a period of immobilization. Depending on the extent of

your sprain, you may be able to resume activity fairly quickly, or you may need to wear a soft cast or special “boot” and use crutches for a period of weeks.

Professional athletes may undergo surgery to repair torn ligaments.
Oral anti-inflammatory medication, such as ibuprofen, can be used to decrease pain, swelling, and inflammation.