30 – 40% of injuries seen in clinics are foot and ankle related
Some of the reasons we are seeing more foot injuries in sports:
- Bigger athletes
- Stronger athletes
- The desire for lighter footwear to increase speed
- Faster athletes
- Increased mobility in footwear
However, Dr. Gauvain discusses the lack of research and evidence to confirm that lighter shoes are contributing to the growth in injury.
What are some of the troublesome foot and ankle injuries?
High-ankle sprain –
- separation of the tibia and fibula.
- We do not really get into the whole fix it after a week of rehab topic… but it is really controversial in the high school setting
Dr. Gauvain recommends the following for high ankle sprains:
- Treat each one individually
- adjust the plan to fit the need and injury
- in general non-weight bearing in a cast or boot for 6-8 weeks
- begin therapy for the mobility of joint
- after mobility of joint returns begin working on agility and return to sport activity
Jones Fracture –
- occurs at the base of the 5th metatarsal
- non-union occurs about 10% of the time
- Re-fracture rates are reported post-surgical intervention
Some have tried adjusting diet and increasing vitamin D
Plantar Plate / Turf Toe
- Sesamoid fracture complicates things…
- Some are born with bipartite bones
- We lack great fixation techniques because of the size of the bone.
- Mobility vs stability is a huge issue with plantar plate injuries.
- Finding the balance is always key
- Discuss the change in the mechanism of injury
- Roma arch configuration gives a great understanding of the importance
- orthotics may be partially to blame
How can ATs be more effective at collaborating with Doctors and diagnosing foot injuries?
- Always discuss with an athlete the injury and what you think.
- Tell them and write down what you would like to see
- weight-bearing films are crucial
- need bi-lateral comparison
- Plantar Bruising
- Dorsal Swelling
- Inability to return to practice after rehab
Do we have a window for getting films on a midfoot sprain?
Refer to the above clinical signs as well as a few missed practices.
A missed diagnosis can create long term debilitating arthritis.
If there is a suspected Bone Bruise then Dr. Gauvain likes to refer for an MRI to ensure there is not something being missed