A Guide To Treating Common Soccer Injuries
In addition to standard radiographic views for ankle injuries (weightbearing AP, medial oblique and lateral ankle and foot), our office utilizes musculoskeletal ultrasound to aid in the diagnosis. We have found musculoskeletal ultrasound to be invaluable in the diagnosis of sports medicine foot and ankle injuries. Magnetic resonance imaging usually confirms ultrasound findings, especially when you cannot easily visualize or determine the degree of ligament tear. We will also use MRI when we suspect intra-articular, osteochondral lesions or when there is a history of ligamentous laxity due to chronic sprains in the absence of acute injury.
Podiatrists can manage minor acute lateral and medial ankle injuries conservatively with compression, analgesics, home exercises and time away from the playing field for a period of two to four weeks. For more severe injuries including anterior talofibular, calcaneofibular or deltoid ligament tears, or ruptures with or without intra-articular osteochondral defects, initial treatment will consist of immobilization and edema reduction. One may accomplish this by applying an Unna Boot soft cast for five days if the edema is severe. We will also use a CAM walker for immobilization for an additional four to six weeks. This will be followed by physical therapy twice a week for an additional six to eight weeks. Physical therapy, which includes proprioceptive coordinative training, helps with both injury prevention and rehabilitation, and is essential in returning injured players back to the field.11
The most common risk factor for ankle sprain in sports is history of a previous sprain.9 Our clinic dispenses an Air-Stirrup® Ankle Brace (Aircast) to soccer players suffering a moderate or severe sprain. They wear the brace during play for at least six months after an ankle injury. This simple treatment can mean the difference between patients being able to continue to play uninjured and having to withdraw from soccer entirely due to chronic, worsening instability or pain.
Conservative Care Tips For Tendon Strains And Plantar Fasciitis
We commonly see soccer strains of the posterior tibial tendon, anterior tibial tendon, peroneal tendons, Achilles tendon and plantar fasciitis. Again, in these cases, treatment is symptomatic and includes compression sleeves, rest, ice, compounded topical anti-inflammatories and modified activity.12 In more severe or chronic cases, immobilization, bracing and taping can be effective as well as physical therapy.
For taping, we instruct our players on how to use RockTape for injury prevention and rehabilitation. During the 2008 Summer Olympics, taping came to the forefront when Olympians competing in sports ranging from volleyball to water polo sported a brightly colored athletic tape called Kinesio Tape®. In 2009, Rocktape (www.rocktape.com ) became a major competitor to Kinesio. However, while one needs to be certified to promote and use Kinesio taping, this is not the case with Rocktape.
Rocktape has how-to videos on its Web site as well as a brochure packaged with each roll offering instructions on how to apply the tape. Rocktape also sells wholesale to podiatrists so patients can purchase this directly from your office rather than buying it somewhere else.
Rocktape primarily markets to athletes and our soccer players routinely respond favorably to this easy, inexpensive, treatment. Similar to Tensoplast® (formerly Elastoplast®), Rocktape is an elastic tape that one can use for support and compression. The best part is you can teach your patients how to do this themselves and the tape stays on for four to five days.