The North Shore Podiatry Group Patient Information Series
Sports Injuries
Achilles Tendonitis
Achilles tendonitis is an overuse syndrome that occurs with
repetitive microtrauma, or from a larger, sudden stress to the Achilles tendon
(Figure 1). The condition usually presents with pain and swelling of the
tendon, close to its insertion into the heel bone. It can coexist with a bursitis,
or with a protrusion of the heel bone posteriorly called Haglund’s deformity or
retrocalcaneal exostosis.
Treatment begins with rest, stretching, icing, and oral
anti-inflammatory medications like Advil. Add a quarter inch heel lift to the
shoes to make it easier for the Achilles to propel the foot forward. Be sure to
add the lift to both shoes to maintain hip balance. Specially designed sport
orthotics (custom supports) decrease the torque on the Achilles tendon during
walking and running. If the condition persists, a sports podiatrist should be
consulted.
Ankle Sprains
The most common ankle
sprain is the “inversion” sprain, in which the sole of the foot turns inward.
In this injury, the ligaments connecting the leg to the foot are stretched,
partially torn, or in severe cases, completely ruptured (Figure 2). Ankle
sprains most commonly occur in basketball and volleyball players who land
improperly from a jump and roll over the outside of the foot. Sprains can occur
in any sport when an athlete falls or stumbles while in motion.
Proper treatment necessitates an accurate assessment of the
degree of ligament damage. The injury usually consists of a stretch or partial
rupture of a single ligament. This can be treated with rest, icing,
anti-inflammatory medicines like Advil, and compression with an ankle splint or
brace. The doctors of the North Shore Podiatry Group use splints that often
allow the athlete to return to their sport.
More severe ankle sprains that involve more than one ligament,
or where a ligament has ruptured will need more aggressive treatment. This
means immobilization with pneumatic, removable “casts,” or surgery to repair
the ligaments. Physical therapy plays a role in the rehabilitation of most
ankle sprains.
Hallux Rigidus (Traumatic
arthritis of the big toe joint)
Jamming of the big toe joint is the most common way Hallux
rigidus develops. Initially, the joint will be swollen and tender. As the
condition worsens, pain increases and joint motion becomes limited as bone
spurs and other arthritic changes develop in the joint.
In the early stages, a cortisone injection is usually
effective. Stiff soled shoes should be worn to decrease bending at the big toe
joint. Orthotics (custom supports) reduce pressure on the joint and encourage
normal joint motion.
In later stages, or if the patient does not respond to
conservative care, surgery is indicated to remove the damaged portions of the
joint.
In athletic children and adolescents, posterior heel pain
may be caused by Calcaneal Apophysitis (posterior heel pain in children and adolescents).
Stress Fractures
A stress fracture is a subtle crack in the bone, rather than
a full break. Stress fractures are most likely to occur when the sport activity
is new to the athlete or particularly strenuous, such as running a marathon.
The athlete with a stress fracture will have sudden onset of pain and swelling.
Metatarsals, the long bones behind the toes, are the foot bones that are most
prone to developing stress fractures. Because the fracture is a subtle crack,
it is usually not visible on x-ray, initially, and the diagnosis can be missed.
After two to three weeks, the body lays down bone around the fracture to splint
it, and this can be seen on x-ray (Figure 3, Arrow).
Treatment of stress fractures of the foot requires about
four weeks in a removable pneumatic cast. The patient may continue walking in
the cast.
Shin Splints
Shin splints is an overuse injury of the muscles of the leg
that control the foot. Symptoms include pain and soreness in the leg muscles.
It is important to treat shin splints, because shin splints are a precursor of
tibial stress fracture, an injury that can sideline an athlete for months.
Anterior shin splints affect the muscles that lie in the front of the leg near
the edge of the shin bone (tibia). These muscles are responsible for bringing
the foot and toes upward. Anterior shin splints are common in race walkers and
tennis players. Treatment involves exercises to strengthen the anterior leg
muscles.
Posterior shin splints affect the muscle group inside and
behind the shin bone (tibia). These muscles are responsible for resisting
pronation (flattening) of the foot. Treatment begins with arch supports to help
the muscles support the foot. If arches do not resolve the condition, custom
orthotics are indicated.
If you have questions or would like to discuss the treatment of Sports Injuries, please contact The
North Shore Podiatry Group.
The North Shore Podiatry Group Glenview · Lake Forest · Gurnee Phone: (847) 729-9580 · Fax: (847) 729-9480
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