Treatment Solutions For Common Soccer Injuries

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Calcaneal Apophysitis: An Emerging Trend Among Kids In Soccer?

Calcaneal apophysitis, a growth plate disorder, is characterized by a pain directly behind the heel in children. It has two probable causes. When bones grow faster than the soft tissues, there is an abnormal pull of the soft tissues away from the bone, which leads to a traction type of injury. Tight calves may have a similar effect although children usually have adequate flexibility.

Young soccer players typically play on grassy fields and I have noticed an increase in the incidence of calcaneal apophysitis during rainy stretches. After it rains, the field is softer and the foot is more vulnerable to excessive motions, whether they are toward pronation or supination. This excessive teeter-tottering of the heel and/or foot may cause irritation of the Achilles tendon against the heel bone near its insertion or of the plantar fasciitis near its origin. When treating this condition, you should focus on reducing the excessive motions of the heel and elevating the heel to reduce tension of the Achilles and plantar fascia at its attachments to the growth plate area.

Posterior heel straps and/or taping are extremely effective for limiting excessive heal motion. Adding heel lifts further reduces Achilles tension. Once you have reduced the initial pain, you should consider fabricating orthotic devices with a deep heel cup to help prevent recurrence.

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Above, you can see genu valgum in a soccer player with pes planus.
Here is the soccer player standing on orthotics. Orthotics can help realign the knee in athletes with genu valgum.
Here you can see a calcified ankle diastasis that resulted from a soccer player sustaining repeated contusions. Sometimes a routine ankle X-ray, perhaps one that you obtain while treating a sprain, can reveal this condition.
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Author(s): 
By Richard T. Braver, DPM

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.

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Anonymoussays: July 8, 2010 at 1:37 am

This was helpful! I am suffering from shin splints and had no idea my cleats could be causing that!

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