Foot Injuries


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Foot Injuries


Soccer Players 10 Most Common Foot Injuries: Causes, Treatment & Prevention

Dr. Karli Richards, DPM, FACFAS, CWSP

 1. Foot Blisters or Hot Spots

  • Hot spot is irritated skin that is a precursor to a blister

  • A blister is a fluid filled skin irritation caused by friction from a shoe

  • Fluid may be clear or bloody

  • Usually forms on the back of the heel

Treatment:

  • Treat hot spot as soon as it occurs to avoid blistering

  • If blister occurs, avoid popping the blister if possible

  • Clean with soap and water and protect with bandage

  • Eliminate cause such as ill-fitting she

Prevention:

  • Proper fitting shoes to avoid friction

2. Toenail Injury

  • Blood under the toenail (subungual hematoma) or loose toenail (onycholysis)

  • Toenail may elevate off the nailbed, have blood beneath the nail, or even fall off

  • Usually caused by shoes that are too tight or constantly jamming the big toe against the top of the shoe

Treatment:

  • Avoid poor fitting shoes

  • See a Podiatrist to have toenail removed if there is blood beneath the toenail or if toenail is extremely loose

  • Occasionally an antibiotic is needed if there are signs of infection

Prevention:

  • Good shoe fit with adequate room in the toe-box

3. Turf Toe

  • A sprain of the big toe joint, usually a sudden injury

  • Caused by jamming the big toe joint during a push off when running or jumping

  • Other causes include hyperextending the big toe joint when tackled or if the foot gets caught on the field

  • More commonly happens on turf, where cleats are likely to stick and cause jamming of the great toe joint. Injury is less likely on grass

Treatment:

  • X-ray and physical exam by doctor

  • Rest of the foot and immobilization in a walking shoe or boot for 2-3 weeks. Crutches are sometimes needed

  • Physical Therapy

  • In severe cases, surgery is recommended

Prevention:

  • Shoes with good support or insoles to prevent excessive flexion of the great toe joint

4. Plantar Fasciitis

  • Pain on the bottom of the heel, especially first thing in the morning or after rest

  • Pain usually decreases with activity

  • Tight or inflamed connective tissue (plantar fascia) on the inside of your arch that connects to the heel bone

  • Caused by flat feet (overpronation), new shoe gear, or increased activity level. Usually NOT caused by a direct injury

Treatment:

  • X-ray and physical exam by doctor to rule out other problems such as fracture on tendon tear

  • Stretching, foam rolling, ice, and anti-inflammatory medications

  • Arch supports in shoes or better fitting shoes

  • Athletic tape

  • Physical therapy and massage

  • Rest and Ice

Prevention:

  • Good supportive shoes and orthotics

  • Daily stretching of plantar fascia and Achilles tendon (they are connected!)

  • Roll out the foot and Achilles tendon before and after workout

  • Avoid barefoot walking

5. Achilles Tendonitis

  • Pain in the back of the heel or leg

  • A tight Achilles tendon is caused by poor stretching, improper warmups, over-use, over-training, and/or poor shoe gear

Treatment:

  • X-ray and physical exam by doctor to rule out other problems such as fracture on tendon tear

  • Stretching, foam rolling, ice, and anti-inflammatory medications

  • Heel lift in the shoe and better fitting shoes

  • Athletic tape

  • Physical therapy and massage

  • Rest and Ice

  • In severe cases, immobilization with CAM walking boot

  • Severe cases of Achilles tendonitis can lead to Achilles tendon rupture if not treated

Prevention:

  • Good supportive shoes and orthotics, heel lift if necessary

  • Daily stretching or foam rolling of Achilles tendon and plantar fascia (they are connected!)

  • Roll out the Achilles tendon after workout to avoid tightness

6. Calcaneal Apophysitis (“Sever’s Disease”)

  • Pain in the heel bone that gets worse with activity

  • Caused by inflammation of the calcaneal (heel bone) growth plate

  • Only seen in adolescents or children, usually during a growth spurt

  • The muscles and tendons grow at different rates than the bones, the tendons become tight and pull on the growth plate causing pain and inflammation

Treatment:

  • X-ray and physical exam by doctor to rule out other problems such as fracture on tendon tear, and to evaluate growth plate on x-ray

  • Gel heel cups

  • Ice and anti-inflammatory medications

  • Rest from sports until pain resolves

  • Compression ankle brace

  • Physical Therapy

  • Severe cases may require CAM boot immobilization or casting

Prevention:

  • Wear shoes that fit well and have a good heel pad

  • Stretch before and after all practices and games

  • Maintain a healthy weight

  • Ice the heel after activity

  • Use special shoe insoles

7. Metatarsal Fractures

  • Fractures that occur in the long bones of the foot

  • Caused by direct impact or acute twisting of the foot on an uneven field or from a fall or tackle

Treatment:

  • X-ray and physical exam by doctor

  • CAM boot or cast immobilization

  • Usually out of sport for 2-3 months depending on severity of injury

  • If fracture is displaced or if dislocation occurs, surgery may be required

Prevention:

  • Good supportive shoes that fit well

  • Participate on good playing surface

8. Jones Fracture

  • Fractures of the base of the 5th Metatarsal bone, on the outside of the foot

  • Caused by putting increased pressure on the outside of the foot as the foot gets twisted, usually with the heel lifted

  • Other causes include direct impact or tripping and twisting of the foot in an uneven field, or uneven landing from a jump

Treatment:

  • X-ray and physical exam by doctor

  • CAM boot or cast immobilization

  • Surgery is usually recommended for athletes

  • Usually out of sport for 2-3 months depending on severity of injury and surgical procedure

Prevention:

  • Good supportive shoes that fit well

  • Participate on good playing surface

9. Stress Fractures

  • A hairline fracture that can occur in the foot or leg bones

  • Causes include overuse, overtraining, repetitive injuries, poor training surface, insufficient nutrition, low Vitamin D, decreased bone density, and menstrual irregularity in female athletes

Treatment:

  • X-ray, Bone Scan ,or MRI, and physical exam by doctor

  • CAM boot or cast immobilization

  • Rest

  • 6-8 weeks out of sport

  • Check Vitamin D levels, especially in female athletes. Doctor to treat if Vitamin D is low

Prevention:

  • Wear proper and supportive shoes/cleats

  • Allow body to recover between training sessions

  • Change shoe gear for different training surfaces

  • Incorporate strengthening exercises into training routine

  • Balanced nutrition with sufficient calcium with vitamin D

  • Maintain a healthy weight and avoid excessive weight loss

  • Monitor female athletes for menstrual irregularity or amenorrhea

10. Ankle Sprains (see Ankle Injury from US Soccer Recognize to Recover)

  • The MOST COMMON injury seen on the soccer field

  • Caused by a stretching or tearing of ankle ligaments when a player is running, cutting, coming down from a jump, is tackling or tackled

Treatment:

  • Rest, Ice and Elevate (RICE)

  • Compression wrap or ankle brace

  • Anti-inflammatory medications

  • If ankle sprain is severe, X-ray and physical exam by doctor to rule out fracture

  • Physical therapy

  • Occasionally CAM boot immobilization is necessary with severe ankle sprain

  • If pain does not improve with time, doctor may recommend MRI study to rule out ankle ligament tear

Prevention:

  • Good supportive shoes

  • Avoid uneven playing surfaces

  • Dynamic warmups before practice and games