Sports injuries of the foot can be simple or can be serious and complex. The foot has numerous structures that can become easily injured with forced motion or twisting, and sometimes bones can be broken if the injury is serious enough. Sports injuries of the foot need expert care to allow the athlete to return to their sport in a timely manner. Unfortunately, many athletes try to 'toughen out' the injury, which only leads to further injury down the road. Common examples of sports injuries of the foot include:
Achilles Tendonitis and Rupture: The Achilles tendon is the large, thick tendon felt on the back of the heal. It is vital for walking and running, and inflammation of the tendon due to an injury can be devastating. Rest, support, icing, therapy, and anti-inflammatory medications are used to treat this condition. When the tendon ruptures or tears, the ability to walk is seriously compromised, and surgery is often needed to repair it. Chronic, untreated Achilles tendonitis may lead to an eventual rupture as the tendon fibers weaken.
Peroneal Tendonitis: The peroneal tendons are two tendons (one short, one long) that run behind the outside of the ankle from the leg and insert on the side of the foot and underneath the arch, respectively. These tendons help to roll the foot up and out and are important to the walking cycle. When a strong force rolls the foot inward, or when activity on uneven surfaces (like gravel or a field with divots) goes on for a while, one or both of these tendons can become inflamed, fray, or partially tear. This process can take a while to develop. Treatment involves icing, anti-inflammatory medications, therapy, and bracing to allow the tissue to heal and become strong again. Tendons that won't heal will need surgical intervention.
Jones Fracture: When a force similar to the one that causes peroneal tendonitis is severe enough, it can fracture the base of a long bone on the outside of the foot called the fifth metatarsal. One can feel this area by touching the outside of the middle length of the foot and feeling a bony prominence. Just in front of this are is where the Jones fracture occurs. Since the fifth metatarsal is fairly unstable, these fractures are notorious for not healing well. Most athletes elect surgery as the first means of treatment in order to return to their sport quickly, as cast immobilization can sometimes lead to longer healing times.
Ankle Sprains and Fractures: Ankle sprains are common in many sports, and involve tearing of one or more of three flap-like ligaments that support the outside of the ankle when the foot rolls inward. Sprains of the inside of the ankle do occur when the foot rolls outward, but this injury is far less common due to the stronger nature of the inner side ligament. During an ankle sprain, the foot will roll in one direction further than the strength of the ligament resisting this motion will allow. This results in partial tearing of one or more of these ligaments. Sprains are treated with rest, ice, support braces, elevation, and possibly physical therapy. More serious ligament tears may need surgery to prevent ankle instability. Even the simplest of ankle sprains take several weeks to recover from, with most falling in between one to two months. More serious injuries will cause the ligament to rupture completely. When a severe amount of force is placed on the ankle during this injury, the ankle bones can break, resulting in a disabling fracture. Some fractures that are simple and stay in place may only need a cast, crutches, and time to mend. Many others need surgery to put the bones back into place and keep them there until they heal.
Sesamoiditis: The sesamoids are two small egg-shaped bones found under the big toe joint, just behind where the toe meets the foot. Chronic, stressful activities such as high impact jumping or hard surface running can lead to inflammation and bruising of one or both of these bones. Eventually, this may lead to stress cracks of the bone, or even outright fracturing if the injury is severe enough, or if the bone is weakened by long-term stress. Pressure on the inside ball of the foot becomes painful, and running or jumping will become difficult. Treatment centers on reducing the inflammation by reducing the stress to this site. Special pads or inserts which direct pressure away from the sesamoids are used, as well as the usual icing, rest, and anti-inflammatory medications. More serious injuries may need to be immobilized in a walking boot, and fractured sesamoids that won't heal may need to be removed surgically.
Stress Fractures: Any bone in the foot can be at risk for developing a stress fracture. Unlike a regular fracture, a stress fracture does not involve a true break across the bone, but rather an injury to the structure within the bone. Repetitive activities, such as running consistently on a hard surface, can lead to bone bruising, and then ultimately to a partial break in the honeycomb structure of the inner bone. These injures are usually not seen on standard x-rays until after several months. The most common sports-related location of stress fractures in the foot are the long metatarsal bones and the heel bone. When the injury is untreated and at-fault activity is continued, these stress fractures have the potential to turn into full fractures. Treatment involves rest, immobilization in a walking boot or cast, and time to mend. Stress fractures are notorious for taking longer to heal than a fresh fracture, and patience is often needed during the healing process to achieve full recovery.
Plantar Fasciitis: One of the most common foot injuries in athletes and sedentary people alike, plantar fasciitis involves inflammation and microscopic tearing of broadband of tissue (plantar fascia) running from the heel to the ball of the foot. It is seen primarily in people with flat feet (which causes chronic stretching of the fascia) as well as those with high arches (in which poor shock absorption leads to fascia injury). Stepping on hard, blunt objects like a rock or over-stretching the foot on a stair or ladder rung can directly injure the fascia, although these are less common. The fascia can also rupture if the force of the injury is severe enough. The pain of the typical plantar fasciitis is usually felt on the inner side of the bottom of the heel where it meets the arch and is noticed after arising from a chair or bed, as well as after extended activity. This condition can persist for years if untreated. Treatment is fairly simple and involves stretching, inflammation reduction, and orthotics ( specialized shoe inserts) to provide flat feet greater support and high arches more shock absorption. Only in a few cases is surgery needed.