By far the most common sports related ankle injury is the ankle sprain. There are 25,000 ankle sprains every day. Sprains are caused by stretching and/or tearing of the ligaments around the ankle joints.
More than 50% of ankle sprains leave patients with residual symptoms. While you can accommodate for the ankle injury, activity levels are affected, especially cutting and twisting motions required for most sports. Bracing and surgery are two options that can return you to better function.
Achilles Tendon Rupture
The great Greek warrior Achilles symbolizes the problems we have with our heel andAchilles tendons. Even with great conditioning, Achilles tendons can rupture seemingly without warning. Sometimes tendons undergo silent degradation. After at least 50% of the tendon degenerates, it will suddenly pop with an eccentric loading force. A rupture causes a sharp pain in the back of the leg. When this happens, most people turn around and look for the person that kicked them in the back of the leg. Surgical repair of this tendon permits a more rapid and likely return to pre-injury functional levels, but like every surgery, it carries risk. Non-surgical casting treatment can heal the tendon as well but, strength is diminished in some studies and re-rupture rates are higher.
Plantar Fasciitis is characterized by pain in the bottom of the foot. It is an overuse injury to the tough band of tissue connecting the heel to the toes. The degenerative tearing of the tissue on the bottom of the heel hurts when weight is applied. Plantar fasciitis generally hurts with the first steps in the morning and after getting out of a chair during the day. The problem that is most often overlooked with plantar fasciitis is the nerve compression on the inside of the heel. Plantar fasciitis will resolve in over 90% of cases with adequate rest to the tissue. However, once the nerve pain develops, it rarely improves without injections and occasionally surgery.
Stress fractures are overuse injuries to the bone. They are caused by repeated physical activity in an abnormally shaped foot, abnormal muscle and tendon length, or in abnormal bone biology. Sometimes it is from too much forced activity. We find this in athletic programs without adequate rest and in the military. Too tight of a calf muscle can cause all sorts of overload injuries. A Vitamin D deficiency because of inadequate exposure to sunlight slows bone turnover and can delay healing of stress fractures in any bone. The best treatment begins with defining which problems caused the stress fracture, be it biomechanical or biologic, and then addressing each one individually. Getting the fracture to heal is worthless if the true cause is not discovered; and the problem will just recur.