Foot and Ankle Sports Medicine

Sports medicine injuries occur commonly in the foot and ankle from a variety of activities. We are seeing more of these type injuries occurring even in older patients now as they try to remain active doing a variety of activities such as pickleball and golf.

Ankle sprains are still one of the most common injuries that occur. Inversion ankle sprains are the most common that occur when the foot inverts underneath the ankle and the anterior talofibular ligament is torn. When these injuries occur, icing, anti-inflammatories, and immobilization typically in a Cam walker boot is necessary until the inflammation and swelling go down. Physical therapy is an important part of rehabilitation, and we use this commonly to work on balance and proprioceptive training exercises.

When patients suffer a high ankle sprain, this means that the syndesmosis, which holds the tibia and fibula together, is also injured. Depending on the severity of this, this injury can still be treated conservatively but minimally invasive surgical options are also an option to try to return patients to their sport more quickly.

If the ankle becomes chronically unstable after you suffer one of these types of ankle sprains and the ligaments do not heal correctly, this can also be addressed relatively minimally invasively through arthroscopy of the ankle and ligament repairs as necessary.

Achilles tendon injuries are probably the second most common sports medicine injury in the foot and ankle. Achilles tendinitis can be a challenge to treat, because it can often linger for patients and set them up for an Achilles tendon rupture. Icing, anti-inflammatories, and eccentric Achilles tendon stretching exercises are typically the first treatments used for Achilles tendinitis. Formal physical therapy can also be helpful to treat this to try to return patients to activity with less pain.

If you suffer an Achilles tendon rupture and are relatively active and healthy patient trying to return to sport, surgical repair is typically recommended. The goal of the surgery is to restore the appropriate tension on the Achilles tendon, and there are now more minimally invasive ways to have this procedure done as well. Cast immobilization with the foot in plantar flexion is an option to treat this. However, patients that have this treatment typically are not able to regain complete pre-rupture strength, so the pros and cons of conservative versus surgical treatment for this need to be weighed individually with patients.

Another common ligamentous injury in the foot and ankle that we see is a plantar plate sprain or rupture. The plantar plate is a ligament that stabilizes the second metatarsal phalangeal joint at the base of the second toe in the ball of the foot. This ligament has a relatively poor blood supply, so it does not heal very well when it is injured. Overload of this ligament can also be caused from mechanical abnormalities in the foot such as a bunion, a long second metatarsal, or an elevated first metatarsal. We can try to treat this area of pain that typically causes capsulitis over the second metatarsophalangeal joint with anti-inflammatories or cortisone injections and orthotics with a metatarsal pad. If conservative therapy fails there are also surgical options to decrease the pain and allow patients to get back to the activities that they enjoy doing.

If you are suffering from any foot and ankle pain or have an injury or fracture, the expert foot and ankle surgeons at Foot and Ankle Institute of Colorado are here to help you. All of our podiatrists and staff try to treat every patient with an individualized plan that is best for them. Call us today at 719-488-4664 so we can help!

Author
Dr. Matthew Hinderland Board Certified Podiatrist and Foot and Ankle Surgeon

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