Soccer is the most widely played sport in the world. There are two good reasons for the popularity of youth soccer versus other American sports such as football. It is more appealing to female participants and there are far fewer traumatic injuries. However, there is still an abundance of soccer injuries. In particular, there is a higher incidence of shin splints and plantar fasciitis among women and a higher incidence of contusions among men. Podiatric physicians who treat sports injuries have also seen an abundance of posterior heel pain in children. With this in mind, let’s take a closer look at common soccer-related ailments and other injuries that can occur with these athletes. With this in mind, let’s take a closer look at common soccer-related ailments and other injuries that can occur with these athletes. • Ankle sprains are among the most common injuries sustained by soccer athletes. These injuries may occur: • when an athlete is running downfield and his or her foot hits an unexpected rut in the surface; • when the athlete is making a sharp turn; • when he or she challenges for a ball and gets a foot tangled with another player’s leg; or • when the player simply twists his or her ankle when coming down from a header or other jump. The majority of these injuries are inversion related. It is important to reduce the swelling immediately by using ice and compression wraps. Often, it is difficult, initially, to evaluate the injury. Obtaining X-rays can help detect an ankle fracture. Essential Insights For Ankle Sprains Typical treatment for an initial ankle sprain may include wrapping the foot in a soft cast such as a Jones compression wrap, including an Unna boot or compressive ankle taping. I prefer to keep the ankle mildly everted after a lateral ligament injury in order to restrict inversion while allowing dorsiflexion and plantarflexion. Using this “active rest” approach allows motion, which helps prevent stiffness and facilitates a faster recovery. However, one should emphasize limited ambulation with crutches. If there is a significant amount of ankle effusion or hematoma, then you may have to aspirate blood from the joint. During the first few days after the injury, the patient should be utilizing the crutches in a toe-touch type of walking pattern. Doing so promotes range of motion while ensuring limited weightbearing. After approximately three days, re-wrap the ankle again in order to limit inversion and allow for other motions. Allow weightbearing while emphasizing an increased intensity of the patient’s rehabilitation. Emphasize NSAIDs for the first week to help reduce pain and inflammation. After the first week, you may tape the ankle or wrap it with an Unna boot. However, an elastic wrap and Aircast-type stirrup are usually all that is necessary to keep the ankle mildly inverted, allowing the ligaments a chance to re-oppose and heal. Continue this course for approximately three weeks. However, be aware that, depending on the severity of the injury, some athletes return to activity much quicker. For those with residual pain and weakness, a corticosteroid injection may be necessary to further reduce areas of swelling and/or initiate a better healing response. How To Address Shin Splints Shin splints are more prevalent in women with higher quadricep angles (Q-angles). However, shin splints are also common among those athletes who are not in the best of shape when they begin a high level of activity. Shin pain at the medial and medial posterior surface of the tibia may occur due to a lack of flexibility and strain in the leg muscles. These muscles simply cannot keep up with the demands placed upon them and fatigue sets in, causing unwanted muscle strain. In addition, be aware of players with predisposing factors for shin pain. This includes those who may have knock-knees and excessive pronation. This is further aggravated by those who run with their feet out-toed, which may place undue tension on the medial soleus and posterior tibial muscles. In addition, the origin of these leg muscles may pull away from their attachment to the Sharpey’s fibers and periosteum of the tibia. Through chronic stress, this microtrauma can lead to a stress fracture within the tibia. After analyzing the soccer player’s alignment and running form, you should emphasize a strengthening program for the lower leg muscles and augment the soccer shoes with orthotic supports to improve his or her structural alignment.