The winter sports season is in full swing, and along with all that jumping and running often comes an increase in foot and ankle injuries.
Ned Amendola, MD, head of the UI Sports Medicine Center at University of Iowa Hospitals and Clinics, has these comments:
What size of increase in the number of foot and ankle injuries do you typically see this time of year?
We see a significant rise in those injuries, mainly because of the winter sports that people engage in, in particular the indoor sports such as basketball, volleyball, indoor running activities, because those sports are all weight bearing activities. There's a lot of deceleration, change of direction, twisting involved with those sports, so there's a significant increase in the acute injuries that we see in terms of sprains, strains, and fractures around the foot and ankle.
In addition, as people increase their endurance activities, doing a lot of treadmill running or working on the stepper to maintain their condition, we see a significant rise in overuse injuries around the foot and ankle, in particular, tendonitis, around the ankle and overload of the heel and the plantar surface of the foot with plantar faciitis and heel pain.
And so we get an increase in both the acute and the chronic injuries that we see around the foot and ankle in the winter season. If you look at those sports, it probably comprises about a quarter to a third of all the injuries that we see in those sports.
What kinds of injuries do you see?
Ankle sprains can be mild to severe, but fractures can also be associated with sprains. You can pull off a piece of bone with the ligament when you sprain it, and that's the bones around the ankle like the fibula or the tibia or one of the metatarsals.
With the twisting mechanism like an ankle sprain, instead of spraining your ankle, you can twist your midfoot, or midfoot sprains, that you hear a lot about in football. You get this torsional and loading of the foot. It can happen in those winter sports as well.
The other injuries include overuse injuries, heel pain plantar faciitis, are areas where there is very high stress around the foot and ankle when you load it. During walking, for example, maybe two to three times your body weight goes through the plantar fascia or the Achilles' tendon, then when you increase that to jogging or running, it's probably four to five times your body weight. If you're doing a half-hour to an hour on a treadmill everyday or using a stepper everyday, the load on those soft tissue structures is significant and so tendonitis is very common in those areas.
We've mentioned basketball and volleyball, any other winter sports that come into play where you see these types of injuries?
Specifically if you're asking about the winter sports, foot and ankle injuries in skiing aren't common because the ski boot protects the foot so knee injuries are more common in skiing.
But in snowboarding, there is a higher incidence of foot and ankle injuries because your body is twisted on the board. Your feet are pointed perpendicular to the direction that the board is moving, and then with the twisting action, there is a high incidence of ankle and torsional injuries of the subtalar joint, the joint below the ankle. There have been some fractures that are specifically associated with snowboarding, and there's one specifically of the talus that's called the snowboarder's fracture, that we see in the wintertime.
How can athletes reduce their risk for foot and ankle injuries?
The best thing they can do is be aware that ankle injuries are common in those types of jumping and running sports like volleyball and basketball and should have appropriate shoe wear. It's been shown that if you wear high-top shoes, it can prevent the risk of ankle sprains. If you wear a covering on your ankles, like a soft slip-on type of brace, it has been shown very clearly that those types of things help improve the neurosensory reception around the ankle to help you prevent those ankle sprains.
In terms of the chronic injuries, I think the most important thing is wearing good, shock absorbing, well-fitting shoes so that your foot is not slipping around in the shoe, back and forth, to increase the shirr and the stress on those soft tissues that are prone to overuse injury.
If foot injuries or ankle sprains occur, what is the best immediate treatment?
The best thing is to reduce the pain and swelling, put a wrap around it, ice the area. Generally speaking, if you're able to put weight on the foot or ankle and it doesn't hurt too much, that usually means that there's not a fracture associated with it. If you can't put any weight on it because it's very painful and it's significantly swollen, then you may be at risk that something is broken and it's probably worthwhile going to the emergency department and getting an x-ray to make sure that that's not the case.
Are people with foot and ankle injuries more susceptible to repeating the experience?
That's an interesting question. One of the common injuries is the ankle sprain. It has been shown very clearly that if you have one ankle sprain, you're prone to getting more ankle sprains. So even if you rehabilitate it and get it back to feeling normal, it's probably wise to wear some protection around the ankle, either an ankle brace or something to prevent that recurrent injury from happening. |
