Worthing Physiotherapy & Sports Injury Clinic

 

 

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The Foot and Ankle

Lateral View of the Ankle

Because the foot bears the entire body's weight with each step and contains numerous bones and joints, you may expect the foot to be at high risk of sprains. However, sprains of the foot are fairly rare, except in people who participate in certain sports or occupations that subject the feet to abnormal twisting motions or bends.

●    Ankle Sprains

The most common site of sprains is the ankle. An ankle sprain can happen when you fall, when you suddenly twist your ankle too far, or when you force the joint out of it's normal position (for example, when you land awkwardly on your foot after jumping). Most ankle sprains occur during sports activities or when walking or running on an uneven surface.

 

●    Foot Sprains

When foot sprains occur, they usually involve one of two distinct areas:

Midfoot The midfoot is the central area that includes the arch of the foot. In athletes, midfoot sprains usually occur because of a sports-related fall, a collision or an isolated twist of the midfoot, particularly during snowboarding, windsurfing, horseback riding or competitive diving. Among female ballet dancers, midfoot sprains typically happen when the dancer loses her balance while en pointe (on her toes) and spinning or when she lands with her foot abnormally flexed or rotated after a jump. Among people who do not compete in high-risk activities, about one-third of midfoot sprains happen by accident, simply because of an odd twist of the foot during an ordinary stumble or fall. Less often, severe midfoot sprains are the result of high-impact trauma, especially trauma caused by a motor vehicle collision or a fall from a high place. This type of injury is likely to produce not only Grade III sprains, but also foot fractures and open wounds.

First metatarsophalangeal joint This is the joint at the base of the big toe. A sprain of this joint is called turf toe, and it is usually caused by hyperextension (extreme backward bending) of the big toe. The typical scenario involves either a football player or a ballet dancer who falls forward while the big toe is planted flat against the ground. In football, turf toe is most common in players who wear lightweight soccer-style shoes while competing on artificial playing surfaces. The relatively flexible soles of their shoes probably don't offer enough protection for the first metatarsophalangeal joint, increasing the risk of a turf toe injury. The situation is probably similar for ballet dancers, particularly males.

●    Shin Splints

While the term "shin splints" has been widely used to describe any sort of leg pain associated with exercise, the term actually refers to pain along the tibia or shin bone, the large bone in the front of the lower leg. This pain can occur at the front outside part of the lower leg, including the foot and ankle (anterior shin splints) or at the inner edge of the bone where it meets the calf muscles (medial shin splints).

Shin splints are primarily seen in runners, particularly those just starting a running program. Risk factors for shin splints include overuse or incorrect use of the lower leg; improper stretching, warmup, or exercise technique; overtraining; running or jumping on hard surfaces; and running in shoes that don't have enough support. These injuries are often associated with flat (overpronated) feet.

●    Achilles Tendon Injuries

A stretch, tear, or irritation to the tendon connecting the calf muscle to the back of the heel, Achilles tendon injuries can be so sudden and agonizing that they have been known to bring down charging professional football players in shocking fashion.

The most common cause of Achilles tendon tears is a problem called tendinitis, a degenerative condition caused by aging or overuse. When a tendon is weakened, trauma can cause it to rupture.

Achilles tendon injuries are common in middle-aged "weekend warriors" who may not exercise regularly or take time to stretch properly before an activity. Among professional athletes, most Achilles injuries seem to occur in quick-acceleration, jumping sports like football and basketball, and almost always end the season's competition for the athlete.

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  2008 Worthing Physiotherapy & Sports Injury Clinic: Chartered Physiotherapists in Worthing, West Sussex