Common Injuries
of the Foot and Ankle
Sprain

Definition: A sprain is a stretch or
tearing of one or more ligaments of the
ankle. Sprains are generally graded on
a scale of I to III depending on their
severity.

Grade I: slight stretching of ligaments,
may have some pain, no significant
swelling or discoloration.

Grade II: moderate stretching of
ligaments, some swelling and
discoloration, orthopedic tests will reveal
a “soft” endpoint.

Grade III: fibers of the ligament are
completely torn, usually severe and
immediate swelling, orthopedic tests will
reveal no endpoint
Inversion Sprain
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Most common mechanism for ankle
sprains.
Involves one or more of the lateral
ligaments of the ankle
Eversion Sprain
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Not that common due to strength of the
deltoid (medial) ligament and bony
structure.
Severe sprains often are accompanied by
fractures of the fibula.
Sprain
Treatment:
 The immediate treatment for any
degree of sprain is rest, ice,
compression and elevation.
 NSAID’s may be taken for pain and
swelling.
 Doctor referral if fracture is
suspected.
Achilles Bursitis

Definition: A bursa is a fluid-filled
membrane that lubricates between
areas of friction(bone-to-tendon or
bone-to-ligament). Bursitis is occurs
when the bursa becomes inflamed.
Achilles Bursitis
S/Sx:
 Point tenderness over attachment of
Achilles to the heel.
 Swelling may be present.
 Usually has a gradual onset
Achilles Bursitis
Achilles Bursitis
Treatment:
 Heat before activity
 Ice after activity
 NSAID’s
 Gentle stretching of Achilles tendon
 Lingering cases should be referred
to a doctor.
Achilles Tendonitis

Def: Inflammation of the achilles tendon

MOI: may be from a single incident but
more often from an accumulation of
smaller stresses
Achilles Tendonitis
S/Sx:
 Usually gradual onset of S/Sx
 Early on, pain occurs only during
activity and slowly progresses to
pain all of the time
 Point tenderness over tendon
 Swelling may be present
Achilles Tendonitis
Achilles Tendonitis
Treatment:
 Rest, ice and NSAID’s
 Gentle stretching of tendon
 Heat before activity/Ice after activity
 Taping and/or heel lift
 Ultrasound
 Possible doctor referral
Heel Contusion



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Bruise to the heel
MOI: stop and go activities or jumping
movements
S/Sx: Severe pain on bottom of heel, pain
with weight-bearing
Tx: RICE, taping, donut pad, ultrasound,
whirlpool
Turf Toe


Def: Sprain of the 1st MP joint
MOI: kicking object, stubbing toe,
dropping heavy object on it, fields with turf.
Occurs as foot is planted and the foot and
ankle is dorsiflexed. As the shoe grasps
the playing surface, body weight and
forward momentum force the 1st MP joint
into hyperextension.
Turf Toe
Turf Toe


S/Sx: pain during push-off phase of gait,
active joint motion or manual resistance.
Pain when attempting quick stops . Point
tenderness over MP joint, limited ROM
Tx: RICE, NSAIDs,
ultrasound, tape
Medial Tibial Syndrome


Def: Shin splints: a general term applied to a
variety of conditions that seasonally plague
many athletes
MOI: factors that may lead to an increase
incidence of shin splints are:
 Biomechanical factors
 Change in intensity, duration, or frequency
of workouts
 Improper or worn footwear
 Change in surface
 Improper warm-up and cool-down
 Change in type of workout
Shin Splints

S/Sx:
 Grade I: pain after activity
 GradeII: pain before and after activity
not affecting performance
 Grade III: pain before, during and after
activityand affecting performance
 Grade IV: pain so sever that
performance is impossible
Shin Splints

Tx: varies by individual
 Constant heat (whirlpools and US) with
taping
 NSAIDs
 Ice massage before or after
 Stretching of anterior and posterior
structures
Fractures
Definitions:
 Fractures of the foot and ankle can
occur in any number of places.
 The fibula is a non-weightbearing and
can be fractured by a direct blow.
 Fractures of the tibia are often
accompanied by a fracture of the fibula.
Fractures
S/Sx:
 Fractures of the fibula may not display
any gross deformities. There will be
point tenderness and a positive
percussion test. The person may be
able walk.
 Tib/Fib fractures will have a gross
deformity. The athlete will not be able to
bear weight.
Fractures
Treatment:
 For a suspected fibular fracture, the
athlete should be immobilized and
referred to a doctor.
 For a Tib/Fib fracture, try to calm the
athlete down and monitor for signs of
shock. Check for pulse and sensation
distal to the injury site. Splint and send
immediately to a hospital (or call 9-1-1)
Tib/Fib fracture at moment of
impact