Inside Insights For Tackling Football Injuries

By Mark A. Caselli, DPM

   Few would argue that football is one of the most popular sports in the United States. There are an estimated 1.5 million high school and junior high school players, and 75,000 college and university athletes who play the sport. Football also has one of the highest injury rates among high school sports. The number of football-related injuries is estimated at 600,000 per year.    The care of football injuries occupies a unique place in sports medicine in the United States. Given the relatively small number of games in each season and the potential for college scholarships (and financial rewards for professional athletes or those on the verge of becoming pro athletes), there is perhaps greater pressure on the sports medicine clinician to return the athlete to competition than in any other sport.    As podiatric physicians, we must not only know the common injuries that occur in this sport and the types of footwear used, we also need to have a familiarity with the large number of specialized positions in the sport. Each position requires a wide variety of skills including throwing, catching, running, blocking and tackling. Each of these positions requires certain athletic skills and a specific training regimen. Each position also predisposes the athlete to different types of injury, which may have different requirements for rehabilitation and a subsequent return to play (see “A Guide To Common Lower Extremity Injuries At Different Positions” below).

How To Differentiate Between Ankle Injuries

   Ankle injuries are the second most common injury in football and rank just behind knee injuries when it comes to the amount of time lost from playing. Most of these injuries are sprains that players sustain when cutting and changing directions. They usually involve supination of the foot that causes injury to the lateral ligament complex. Another common mechanism involves pronation with external rotation of the talus. This may occur when the athlete’s body is twisted away from the injured side or when another player falls on the posterior aspect of a downed player’s leg.    Differentiating between a lateral ankle sprain and a “high” ankle sprain or syndesmosis injury is important. Syndesmosis sprains require much longer rehabilitation time. If radiographs suggest widening of the syndesmotic space, this may indicate the need for surgical treatment.    Treatment for lateral ankle sprains includes protection, rest, ice, compression and elevation. One should initially protect severe, acute ankle injuries with a posterior splint. When treating a grade 1 or 2 sprain, clinicians should replace this splint with a functional brace to allow early rehabilitation. If one suspects a serious fracture, apply an “L and U” (sugar tong) splint for transport to the hospital. Rehabilitation should include strengthening and proprioception exercises. Upon an athlete’s return to play, he may use braces, taping and high-top shoes for protection. Reserve surgical reconstruction for those with symptomatic chronic ankle instability.

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