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Management Of Foot and Ankle Injuries In Soccer Players

Soccer places large physical demands on players, especially on their feet, ankles and legs. This is due to intense running, sudden direction changes, tackling impacts, and frequent kicking. As a result, soccer players are prone to traumatic and overuse injuries. Podiatrists play an important role in treating these injuries to keep players staying on the field and performing at their best. We will run through common injuries that we see in the clinic, and detail the importance of their assessment and management for best results in return to play.

Common Toe, Foot, and Ankle Injuries in Soccer Players

Toe Injuries

  • Turf Toe: Turf toe is a sprain of the main joint of the big toe, often caused by hyperextension – forcibly bending our joint all the way up or down. It commonly occurs on artificial turf where the foot can stick, forcing the toe into this extreme position. Symptoms include pain, swelling, and difficulty putting pressure through the toe. Due to the nature of kicking in soccer, injuries here can be debilitating as it limits a players ability to change direction & kick well.
  • Broken Toes: Soccer players are commonly prone to fractures in their metatarsal bones & their toes, most often from direct trauma – whether that’s tackling another player, getting stepped on during the game, or even kicking the ball. These fractures can range from hairline to more severe breaks. Fractures cause pain, swelling, and difficulty walking. It also unfortunately means a couple of weeks on the sideline to let that bone heal fully & to ensure there’s no further damage on return to sport.
  • Toenail Issues: Ingrown toenails and subungual hematomas (blood and bruising under the nail) are frequent among soccer players, often a result from kicking the ball or the player. Ingrown toenails, which are frequently seen with boots that are too tight, can lead to pain, swelling, and infection. Subungual hematomas, usually resulting from trauma, cause intense pain and black or blue colouring under the nail. Both of these conditions often make any form of kicking quite painful due to the nature & location of the condition.

Foot Injuries

  • Stress Fractures: Repetitive stress on the foot, especially from running, can lead to stress fractures, which are small cracks in the bones. Symptoms include pain that worsens with activity and swelling. Stress fractures require rest and sometimes immobilisation to heal properly. This can mean wearing a moon boot during this time. Stress fractures, while more commonly seen on players using artificial pitches, are a common issue in soccer due to the high intensity & volume of running in the game. They can however be best avoided by wearing proper boots with some extra support and cushioning, to help reduce the forces acting on our feet when we run.
  • Plantar Fasciitis: Plantar Fasciitis is an injury of the plantar fascia, a band of tissue on the foot’s underside, often resulting from overuse. Often we see that increased training, calf muscle tightness, poor biomechanics, and improper footwear contribute to this condition. Heel pain is often felt in the morning, and can lead to long-term discomfort and gait changes. Preseason is a common time for heel pain to arise, as players go through extra training. However, with proper management, including volume control, strengthening, and correcting foot posture, returning to sports is completely achieveable.
  • Lisfranc Injuries: These complex injuries involve the bones, ligaments and joints in the midfoot. They can result from a fall or a significant twist of the midfoot, often forced by external pressure such as landing from a jump, or getting caught in a tackle. Symptoms include pain, swelling, and inability to bear weight through the foot. Proper diagnosis and treatment are crucial to ensure the foot is supported & offloaded for healing as early as possible, but to avoid long-term issues.

Ankle Injuries

  • Ankle Sprains: Ankle sprains are among the most common injuries in soccer, typically resulting from twisting or rolling the ankle. They vary in severity from mild to severe, involving stretching or tearing of the ligaments. Symptoms include pain, swelling, and instability in the ankle, with severe sprains causing some difficulty weight bearing. In mild-moderate cases, these conditions tend to only take up to 6 weeks to heal & players can make a full recovery without any concerns.
  • Achilles Tendonitis: This condition involves inflammation of the Achilles tendon.Achilles pain is most commonly caused by overuse and sudden increases in training intensity. Symptoms are pain and stiffness along the tendon, particularly in the morning and after rest. Depending on the site of pain in the Achilles, these issues are often managed with a combination of muscle strengthening, correcting biomechanical issues & reducing pressure in the achilles, and anti-inflammatory management to help reduce pain & swelling.

The Role Of Podiatrists In Treatment

 

  • Biomechanics Assessments: Efficient biomechanics are essential in preventing injuries. Poor biomechanics can lead to overuse injuries and imbalances that predispose soccer players to injuries.
  • Gait and Foot Assessments: Podiatrists perform comprehensive gait analyses and assess foot mechanics to identify any abnormalities or imbalances. This involves observing a player’s walking and running pattern, assessing pressure under foot when moving and adjusting running styles to decrease pressure and optimise movement patterns.
  • Custom Orthotics: Benefits of Custom Orthotics: Custom orthotics are specially designed shoe inserts that provide support for sore or injured feet. For soccer players, orthotics can help alleviate pain, distribute pressure more evenly, and improve foot function. Together, this reduces both pain and future injury risk. Orthotics provide cushioning, enhance foot mechanics, and improve overall foot alignment.
  • Importance of Proper Footwear: Wearing the right soccer shoes and boots is important for performance and injury prevention. Proper footwear supports the feet, offers appropriate traction, and reduces the risk of blisters, sprains, and other injuries.Podiatrists assist players in choosing the best shoes based on their foot type and position demands.
  • Initial Assessment and Diagnosis: Accurate diagnosis is needed for treating foot conditions effectively. Podiatrists use physical assessments, X-rays, gait analysis, and biomechanical testing to evaluate injuries’ severity and plan treatment accordingly. This approach ensures tailored treatment plans that address the root cause of pain rather than just alleviating symptoms.
  • Non-Surgical Treatments: Shockwave therapy can assist in reducing painful symptoms by increasing blood flow and healing to the injured area. Other treatments include dry needling, massage, joint mobilisation and strapping to provide pain relief. Your treating Podiatrist will assess and advise on the best care for you and your injury.

Conclusion

In soccer, the health and function of the feet, toes, and ankles are key to a player’s performance. Podiatrists play an essential role in preventing and managing injuries to ensure that players can maintain their foot health and continue to compete at their best. Through assessments, custom orthotics, footwear recommendations, and hands on treatment strategies, podiatrists help soccer players navigate the physical demands of the game and recover from injuries well. Include Podiatry care in your health team now to perform at your very best!

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