Common Sports-Related Foot and Ankle Injuries

Ankle Sprains

There’s a reason why ankle sprains are by far the most common injury that I see. They can happen to the best of us and occur due to an inversion injury when your foot rolls inward and overstresses the lateral ankle ligaments. These injuries can range from mild to severe and involve partial or complete tears of these ligaments.

Fractures

Fractures of the ankle, heel, and foot are less common than ankle sprains but usually result in more time sidelined. Ankle fractures can occur with severe ankle trauma and may or may not require surgery. Stress fractures can occur from overuse injuries and repetitive forces. Fifth metatarsal fractures are relatively common in athletes and can occur due to both acute trauma and repeated stress.

Forefoot fractures can also occur due to acute trauma or compression forces.

Achilles Tendinopathy/Rupture

Achilles tendinopathy is an overuse injury that develops over time. Patients often notice pain that worsens with activity and improves with rest. Plantar fasciitis is another common overuse injury that presents similarly.

Achilles tendon rupture is usually more acute and can occur during sports that require sudden explosive movements from athletes who have underlying tendon degeneration. Patients typically hear a popping sound followed by pain and weakness in the back of their ankle.

Ankle Sprains in Basketball Players

Lateral ankle sprains are extremely common in basketball players due to jumping/landing mechanics and the cutting/pivoting that occurs frequently throughout games and practices.

Ankle sprains can also lead to Achilles tendon problems and plantar fasciitis from repetitive overload.

Rotational forces can also lead to acute Achilles ruptures.

Injuries Specific to Certain Sports

Soft tissue injuries are common in all sports but some injuries are more common depending on the sport itself.

Soccer

Sports like soccer involve a lot of sudden cutting/pivoting movements and kicking. As a result, lateral ankle sprains, high ankle sprains, and forefoot injuries like turf toe or fifth metatarsal fractures are common in soccer players.

Artificial turf can also increase your risk of injury due to shifts in traction when your foot plants and forces are transmitted through your ankle joint.

Other Sports

Football, rugby, hockey, gymnastics, and dancing also pose high risk for these types of injuries.

Basketball

As I mentioned above, ankle sprains are very common in basketball players. Other injuries like tendinitis can occur from the repetitive jumping and landing associated with basketball.

Common Symptoms

As you can imagine, symptoms depend on the type of injury you experience. Acute injuries will usually cause pain and swelling within the first 24-48 hours. You may also notice bruising and instability.

Overuse injuries may begin as mild discomfort during activity that goes away with rest.

Symptoms typically return after repeated episodes and worsen over time. Overuse injuries can also cause localized tenderness along a tendon or bone.

If you are unable to bear weight, have significant swelling or deformity, or notice numbness it’s time to seek medical attention. An audible pop followed by weakness also warrants urgent evaluation, as this may be due to tendon rupture.

Evaluation

The Ottawa ankle rules are commonly used by clinicians to determine if imaging is necessary for ankle injuries. If there is concern for a fracture based on these rules, an X-ray will be ordered to rule this out. MRI is better for determining soft tissue injuries, tendon injuries, and stress reactions that do not show up on X-ray.

Treatment

The majority of sports injuries to the foot and ankle can be treated non-operatively with proper rehabilitation. Most injuries will benefit from time off of your feet to allow the injury to settle down, protection of the injured area with a brace/boot, and physical therapy to restore range of motion/strength.

Tendinopathies also benefit from structured rehabilitation. The Alfredson protocol is commonly used for chronic Achilles tendon injuries and focuses on slow, progressive loading of the tendon.

Plantar fasciitis usually takes several weeks to months and can be managed with stretching/strengthening exercises and shoe modifications.

Surgical intervention is typically reserved for injuries that do not improve with conservative management or are too severe to heal properly without surgery. Recovery time varies but most surgeries require a few months of rehabilitation before returning to sports.

Prevention

Injury prevention is key in allowing you to continue playing the sport you love. One of the most important aspects of preventing injury is progressive load management. Many injuries are caused by suddenly increasing your training volume/intensity too quickly.

Proper footwear is also important. Shoes should be sport-specific, supportive, and fit well. Avoid playing sports in old shoes that may no longer provide adequate support or have worn down completely.

Finally, strength and stability exercises are important for preventing injuries. If you know you’re going to be jumping a lot, it may be beneficial to do calf and ankle strengthening exercises to improve your ability to control your ankle joint. Balance and proprioception training can also help reduce your risk of ankle sprains.

When to Seek Medical Care

If you’re ever unsure whether or not you should see a doctor, it’s always better to play on the side of caution and get evaluated. Many minor injuries can be treated with home care and simple strategies, but there are certain things that warrant immediate care. Like I mentioned above, if you experience an inability to bear weight, significant swelling or deformity, numbness, or hear a pop and cannot plantarflex your ankle (downwards direction) at the injured area, seek care immediately.

If your injury is causing persistent symptoms that do not improve after a few days, gets worse over time, or is preventing you from returning to your normal activities, it’s time to get evaluated by a specialist. It’s always best to err on the side of caution with these injuries as early diagnosis and treatment can prevent long-term instability, pain, and recurrent injuries.

Conclusion

While we can’t prevent all injuries from occurring, there are many strategies we can use to minimize your risk of being injured. Understanding the common types of injuries that occur with sport as well as their mechanism of injury can help you identify them early and prevent further injury. Be sure to speak with a healthcare provider if you have any questions or concerns about an injury you may have experienced.

Frequently Asked Questions

Q: How do I know if my ankle injury is a sprain or a fracture?

A: Most of the time sprains will involve swelling and bruising with the ability to still bear some weight on your foot. Fractures generally cause sharp bone pain around the injured area and are usually unable to be bear weight. Doctors will often utilize the Ottawa ankle rules to determine if an ankle X-ray is needed.

Q: Can I play sports with mild foot or ankle pain?

A: It’s best to err on the side of caution and take time off if you’re experiencing pain. Continuing to play through pain can cause further injury and delay your recovery time. Watch your symptoms for the next few days. If they persist or worsen you should seek care.

Q: What is the fastest way to recover from a sports injury to the foot or ankle?

A: Like I mentioned above, the best thing you can do is reduce your activity load and follow care instructions. Allowing the injury to heal with proper bracing/support and starting physical therapy early can help speed up recovery time. Following a structured rehab program and avoiding returning to sport too soon can help you recover faster and prevent re-injury.