School is back in session which means athletes are back on the field ready to kick off their Fall sports seasons! This time of year we start to see a spike in athlete injuries like football, soccer, and volleyball. So, what are some of the things to look for in potential injuries an athlete may endure? Here is how to know how severe the injury may be and when to seek care.
Just like anywhere else on the body, your foot may have a bruise or a contusion of the foot. What is a contusion? It is just that, a bruise on your bone. The most common occurrences we see is when a player gets kicked, stepped on, or cleated in the ankle, foot, or lower areas of the leg. Majority of athletes can continue playing their sports when having a contusion, however they may not be feeling 100%. Many of times the ability to play is due to the adrenaline rush that keeps the athlete going and not feeling the pain in the moment. After the game, when the athlete gets a break or time to rest then they start to realize that there may be a potential injury. One strategy we recommend before seeking care is to use the RICE method listed below.
Rest, rest, rest!
Ice is a good pain reliever and lowers inflammation.
Compression applied with ace helps with swelling while providing stability.
Elevate the injury to relieve swelling and limit the amount of bruising.
You must give the injury enough time. It is a battle of pressure and wanting to get back on the field, but what the body really needs is the adequate amount of time to rest up and heal. If the athlete is still experiencing pain and struggling to walk, it is time to seek a professional for care.
How to know if it is a contusion? With a contusion, the athlete can usually pinpoint the focal area that is causing pain. The foot may be showing signs of mild swelling but overall, the athlete can still put weight on the foot and wear a shoe.
What’s the next step? Getting an x-ray will show that the athlete is negative with a contusion. They will be put in a boot to let them simmer down and weight bare in the boot. Next, an evaluation will be taken in 1-2 weeks to ensure there’s no more concerning injury shown. In most cases, the athlete can extricate themselves from the boot in just a couple of weeks. If they are doing well walking in the boot with no pain after a few days, the boot will be removed, and they will be allowed to start walking on the field starting with low impact exercises, in hopes to return to playing shortly after.
More severe cases:
When there is a more severe injury things become a bit more complicated. With athletes, these cases may be caused by someone falling on the leg, a pile up in football, or the athlete falls and rotates their ankle or foot. The athlete will have an immediate out from their game followed by trouble walking. Many players will come in under their own power likely needing crutch assistance. They are usually seen quickly after the injury because of the level of pain. The swelling is much more considerable and there is usually bruising involved (bleeding from the inside). These patients will need an x-ray to see if the damage is severe enough for a surgical repair. The x-ray shown is an example of a serious ligament and bony Lisfranc injury.
What injuries specifically? Usually, a fracture or ligament injury will fall into this category. Regarding the ankle, many rotational injuries can result in an ankle fracture (Is it sprained or broken blog). If the athlete experiences a lot of swelling in the ankle and the inability to walk it is very important to get an x-ray and check to make sure there is no fracture or the need for surgery.
Regarding the foot, the most common and concerning injury is a Lisfranc injury. This is an injury that goes back to a general in Napoleon’s army that noticed people were twisting their feet in stirrups and these injuries were devastating often leading to amputation. The concern here is the injury from twisting is severe and most come on strong directly through the foot, which we would call an axile loading type injury.This occurs when you’re standing on the ball of your foot and a load goes straight through the long axis of the foot (as seen in the picture). These injuries may be severe and will likely require surgery.
What to look for with these injuries and when to be concerned it’s a Lisfranc injury? Bruising on the bottom of the foot is the best tell-tale sign (as seen in the photo). If the foot is at all twisted the athlete will be experiencing severe pain in the middle of the foot. The injury will be very painful in the first few days to a week but, if the athlete doesn’t seek care, sometimes the pain will diminish, and they may not be as concerned about the injury. It is important to get these injuries checked out because that slight sign of improvement can give a false sense of optimism or hope that the foot will heal, which may lead to collapse and arthritis down the road.
Rolling of the ankle due to un-even ground: