Treatment Solutions For Common Soccer Injuries

Start Page: 36

A Guide To Evaluating Soccer Shoes

It is important to evaluate proper shoe fit when treating soccer players. Soccer players want to feel the ball and often want the soccer shoe to feel like a tight glove. However, improper fitting shoes cause toenail problems.

To evaluate an athlete’s shoe fit, have him or her stand straight. Check to see that the tips of the toes are not protruding into the leather distally. There should be a small amount of room from the longest toe to the tip of the shoe. Check that the foot is not hanging over the edge of the sole of the soccer cleat, either too much laterally or medially. Here, instability can lead to sprain or stress injury.

If this is the case, then either recommend a different cleat or remove the inlay within the soccer shoe and replace it with a more stable orthotic device. You may need to rip out the inlay within the soccer shoe and, using a straight edge screwdriver, proceed to remove any unwanted foam material that still adheres. This allows you to insert an orthotic without crowding the foot and causing other problems.

Check that the heel counter is still firm. When a shoe is worn for a period of time and subjected to the elements of rain, mud, etc., the heel counter may weaken and no longer be supportive for the foot. A weak heel counter enables the foot to go through excessive motions that may aggravate conditions such as calcaneal apophysitis, plantar fasciitis and Achilles tendinitis.

Set the shoe on a countertop and make sure the upper portion of the shoe is still firmly mounted on the sole and the shoe does not have excessive eversion or inversion lean. Check the cleats of the shoe for excessive wear. When treating patients who have metatarsal pain, make sure there is no cleat protruding upward through the sole of the shoe, irritating the involved metatarsal area

Finally, check the tongue of the shoe, making sure it remains well cushioned and centered underneath the laces. Soccer players like to optimally strike the ball with the instep of their foot and if the tongue is no longer providing cushioning, this may cause irritation to the dorsum of the foot over a period of time.

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.
42
Author(s): 
By Richard T. Braver, DPM

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.
Shin pains may also be related to increased shock forces particularly present during off-field training, especially when the athlete trains on harder surfaces. However, he or she may also experience this pain on turf surfaces laid over concrete. In these situations, add a shock absorbing insert to the orthotic or soccer shoe. The insert should be a viscoelastic, polymer or other rubber-based product.

Treating Contusions, Muscle Spasms, Abrasions And Lacerations
Soccer players are notorious for chasing a ball down. However, when two players challenge for the ball at the same time, there is a good chance one player may accidentally kick the opponent’s leg while trying to strike the ball. While soccer players do wear shin guards, there are certain gray zones including the Achilles, just below the shin guard at the ankle and above the shin guards to the leg and thigh. Unfortunately, many pickup soccer games are played without protective padding and lower leg contusions occur.
During a routine ankle X-ray for a sprain in adults, it is not unusual to see calcifications within the diastasis between the tibia and fibula bones distally. This may be caused by older contusions to this area similar to myositis ossificans, which are soft tissue calcifications found more commonly in larger muscles such as the calf.
If typical therapeutic modalities such as electrical muscle stimulation, ice and heat packs do not adequately resolve the painful condition, it is often necessary to obtain a MRI to determine the extent of intramuscular or intratendonous injury. X-rays and/or bone scans may also be necessary to differentiate soft tissue versus bone injury.

Muscle spasms are a common sequella immediately following a contusion. In order to treat the spasms, one may opt for the spray and stretch method. Using ethyl chloride or another cold spray substitute and following up with stretching of the injured area may help reduce the spasm. One may also use a combination of electrical muscle stimulation and soft tissue mobilization. Once the surrounding spasm is reduced, one can better define the localized site of injury.
Leg abrasions are also common injuries. They usually occur when a player attempts to slide into the ball to push or kick it out of the way from the opponent. Some refer to this as a slide tackle. Unfortunately, the skin of the leg scrapes against the turf or irregular surface of a grassy field, which may have small rocks or other protruding objects. One should treat the resulting abrasion like an open wound or burn and include the use of antibiotic cream, especially Silvadine cream. When dealing with lacerations, you should clean them and use steri-strips or sutures as needed.

image description image description


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!

Reply to this comment »

Post new comment

  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

More information about formatting options

Image CAPTCHA
Enter the characters shown in the image.