Inside Insights For Tackling Football Injuries

By Mark A. Caselli, DPM

   Studies to measure restriction of motion associated with an inversion ankle sprain both before and after 15 minutes of zigzag running found that taping did restrict these motions an average of 27 percent compared to the untaped control. While taping appears to have the potential to protect athletes from inversion sprains, the effectiveness of taping decreases during prolonged use.

   Further studies have shown that braces can offer similar resistance to inversion but with the additional advantages of reusability and adjustability during competition. Although athletes and coaches are sometimes concerned that using such devices may reduce performance, a study found such reductions were only 4 percent or less on several performance tests. Researchers also determined that among athletes with a history of prior ankle injury, a combination of ankle bracing and coordination training on an ankle disc could greatly reduce the incidence of re-injury. Among athletes with no history of ankle injury, neither a brace nor coordination training appears to reduce the risk of injury.

   Midfoot sprains are much less common than ankle sprains. While these injuries can be misdiagnosed as ankle sprains, a thorough physical examination can usually differentiate between the two. Players with lateral tenderness return to play sooner than those with medial or global tenderness, which tends to sideline the player for extended periods of time.

Achilles Tendon Injuries: What You Should Know

   Probably the most common injury that has plagued many a quarterback is an overuse injury to the Achilles tendon. Achilles tendon ruptures can be caused by the repetition of dropping back to throw the football. A quarterback may throw the football up to 50 times in a game and a few hundred times during practice.

   This repetition of dropping back, decelerating and planting the right foot for a right-handed quarterback can lead to Achilles tendinitis that can cause gradual degeneration of the tendon. The tendinitis weakens the tendon and makes it susceptible to tearing. The tendon can also tear from the trauma of a one-time violent deceleration and planting motion without any previous problems with the tendon.

   Diagnosing an Achilles tendon rupture is fairly easy with the Thompson test. In many cases, one can use palpation to detect a defect in the tendon. Surgery is usually the treatment of choice for Achilles ruptures among athletes.

How To Manage First MPJ Injuries

   Turf toe is a condition that involves injury to the first metatarsophalangeal joint (MPJ) complex. The use of lightweight, flexible shoes on hard artificial turf reportedly increases the frequency of this injury. In one study, 83 percent of the patients reported that their initial injury occurred on artificial turf. The usual mechanism is forced dorsiflexion of the first MPJ joint, which causes stretching of the plantar structures and impaction of the proximal phalanx on the dorsal metatarsal. This often occurs when a player falls on the posterior aspect of another player’s leg. Pain during push-off, swelling, decreased motion and tenderness at the dorsal or plantar aspect of the joint are typical symptoms with these injuries.

   One should evaluate radiographs to rule out associated fractures, including fractures of the sesamoids. One would grade injuries to this complex according to their severity. Grade I injuries are marked by local tenderness without swelling or ecchymosis. Grade II injuries have swelling and ecchymosis, and tenderness may be less well localized. Grade III sprains have more marked tenderness, primarily dorsally, and probably represent a spontaneously reduced first MPJ dislocation. The initial treatment for all grades of turf toe is rest, ice, compression dressings, elevation and nonsteroidal antiinflammatory drugs (NSAIDs).

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