Sporting Injuries to the Foot & Ankle

Sporting Injuries to the Foot and Ankle

Ankle injuries are very common, and are covered in their own section on the website. Other injuries and soft tissue problems also occur in sport, and some of those are covered here

Heel Bruises

Gavin BowyerBruises to the heel can either be caused by a single incident – most commonly for runners this could be treading hard on a stone or similar – or through repeated trauma (the heel striking again and again on an object inside the shoe for example). Older runners may be more susceptible to Heel Bruises as the thickness of the heel pad decreases with age.

Signs and Symptoms

  • Tenderness when pressure applied
  • Often pain felt with each step taken

Treatment

  • Cold
  • Non-steroidal anti-inflammatory creams/gels

If pain/symptoms continue always seek professional advice from a doctor or physiotherapist.

Iliotibial Band Syndrome (ITB)

Running down the outside of the thigh from hip to the top of the shin just below the knee is a thick band of connective tissue called the Iliotibial Band (or ITB for short). In part the ITB works to stabilize the knee and over exercise on uneven ground or on downhill slopes can result in the band rubbing against bone causing inflammation and pain. Athletes/runners who overpronate or underpronate (if the foot rolls in or outwards as it hits the ground) will be more prone to Iliotibial Band Syndrome as will those with old, worn or inappropriate footwear.

Signs and Symptoms

  • Dull pain/ache on the outside of the knee shortly after starting exercise
  • Increased pain on downhill slopes
  • Tender/painful to the touch
  • Tender/painful when the knee is bent around 30 degrees

Treatment

  • Cold
  • Non-steroidal anti-inflammatory creams/gels
  • Check/replace shoes
  • Flexing/Stretching – physiotherapists can do specific work on this area
  • Ultrasound

If pain/symptoms continue always seek professional advice from a doctor or physiotherapist.

Muscle Pulls

Muscle Pulls are invariably actually muscle tears and are normally the result of a one off incident – an “awkward” or unexpected movement during exercise for example – or the result of sustained over exercise. Sprinting or running much faster that normal training pace can result in tears and are therefore often associated with races, although training in colder than normal conditions can also be a factor. Stretching and carefully considered warm-downs after exercise can help to prevent pulls/tears.

Signs and Symptoms

  • Sudden searing pain in the muscle
  • Muscle spasms
  • Tenderness to the touch
  • Feeling a “knot” in the muscle could be the sign of a more acute tear

Treatment

  • Cold
  • Non-steroidal anti-inflammatory creams/gels
  • Heat rubs
  • Stretching
  • Rest

If pain/symptoms continue always seek professional advice from a doctor or physiotherapist.

Gavin BowyerPeroneal Tendinopathy

Peroneal Tendinopathy is an often painful condition that affects the peroneal tendons which run behind the outside of the ankle and, broadly speaking, are responsible for turning the foot outwards. The injury typically occurs after excessive running on uneven surfaces (cross country and fell runners will be more susceptible) and can also effect those involved with activities that require rapid changes in direction – dancers, squash and badminton players, etc. Inappropriate footwear, such as poorly advised running shoes, may also cause the condition or make worse an existing condition.

Signs and Symptoms

  • Pain (worse during exercise) and possible swelling on the outside of the ankle and/or heel
  • Painful when pressed
  • Painful when the foot is rolled outwards or twisted off centre
  • Possible tight calf muscles

Treatment

  • Rest
  • Non-steroidal anti-inflammatory creams/gels
  • Massage and stretching

If pain/symptoms continue always seek professional advice from a doctor or physiotherapist. If you feel the tendons are flicking or popping out of place that really should be assessed by a foot and ankle surgeon, to discuss the treatment options.

Nerve Entrapment Syndromes

Tarsal tunnel syndrome (TTS) is caused by compression, irritation or trapping of the nerve in the ankle which passes through the tarsal tunnel, less common than other running/sports injuries, it is often caused by over training/running. It can occur more often in those overweight, pregnant, suffering from arthritis or diabetes. Another nerve at the front of the ankle, the deep peroneal nerve, and also be trapped by over-tightened boots or shoes; there is also evidence that ski boots can contribute to the development of nerve compression injuries.

Signs and Symptoms

  • Numbness/tingling of the foot and toes
  • “Pins and needles” particularly at night
  • General weakness in the ankle

Treatment

  • Non-steroidal anti-inflammatory creams/gels
  • Cold
  • Massage

If pain/symptoms continue always seek professional advice from a doctor or physiotherapist.

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