Course

Foot

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17 Lessons

Football is one of the most popular sports in the world and one in which the feet are most exposed to injury. Statistics show that between two and 9.4 football players suffer an injury to their feet per 1,000 hours of exposure. Of these injuries, we most commonly find sprains, fractures and torn ligaments as well as various blows and bruises. The type of foot is considered to be an intrinsic factor when taking the injury into consideration, while at the same time the football boot is considered an extrinsic factor.

A higher proportion of foot injuries in football occur as the result of foul play and involve direct contact with the injured foot. The majority of foot injuries are caused by tackles from the side involving lateral or medial forces on the foot that create an inversion or eversion force. The weight-bearing status of the injured foot is an important consideration. The severity of injury where the athlete is weight-bearing is generally higher that that observed for the non-weight-bearing foot.1-3

In this module, we aim to tackle the most common foot injuries in football along with practical aspects of skin, footwear, alignment problems and rehabilitation.

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Learning outcomes

By the end of this topic, you should:

  • understand the characteristics of the equipment used in football and their relationship to injury
  • be able to conduct a history and examination of a football player presenting with foot pain
  • be able to arrange appropriate investigations to assist with the diagnosis of foot pathology
  • understand how common football-related foot injuries are managed and be able to initiate their treatment
  • know when to refer foot injuries for further assessment and treatment

Tasks

  • Read the relevant section in the FIFA Medical Manual and other required reading.
  • Review the suggested reading.
  • View, or listen to, any relevant multimedia content.
  • Complete the course quiz.

Suggested Reading

Brukner & Khan’s

Clinical Sports Medicine – 4th Edition

Chapter 40 (pages 844-877)

References

  1. Giza E., Fuller C., Junge A., Dvořák, J. (2003) Mechanisms of foot and ankle injuries in soccer. Am J Sports Med 31(4): 550-554
  2. Fuller C., Smith G., Junge A., Dvořák, J. (2004) The influence of tackle parameters on the propensity for injury in international football. Am J Sports Med 32(1)/43S-53S
  3. Andersen T., Floerenes T., Arnason A., Bahr R. (2004) Video analysis of the mechanisms for ankle injuries in football. Am J Sports Med 32(1): 69S-79S
  4. Taylor S., Fabrikant P., Khair M., Haleem A., Drakos M. (2012) A review of synthetic playing surfaces, the shoe-surface interface, and lower extremity injuries in athletes. Phys Sportsmed 40(4): 66-72
  5. Williams S., Hume P. (2011) A review of football injuries on third and fourth generation artificial turfs compared to natural turf. Sports Med 41(11): 903-23
  6. Bentley J., Ramanathan A., Arnold G., Wang W., Abboud R. (2011) Harmful cleats of football boots: a biomechanical evaluation. Foot Ankle Surg 17(3): 140-44
  7. Ford K., Manson N., Evans B., Myer G., Gwin R., Heidt R., Hewett T. (2006) Comparison of in-shoe foot loading patterns on natural grass and synthetic turf. J Sci Med Sport 9(6): 433-40
  8. Ekstrand J., Nigg B. (1989) Surface-related injuries in soccer. Sports Med 8(1): 56-65.
  9. D’Hooghe, Kerkhoffs (2014) The ankle in football (Springer Verlag book) chapter 21: 253-268
  10. Cain L., Nicholson L., Adams R., Burns J. (2007) Foot morphology and foot/ankle injury in indoor football. J Sci Med Sport 10(5): 311-19
  11. George E., Harris A., Dragoo J., Hunt K. (2014) Incidence and risk factors for turf toe injuries in intercollegiate football: data from the national collegiate athletic association injury surveillance system. Foot Ankle Int 35(2): 108-115
  12. Anandan N., Williams P., Dalavaye S. (2013) Turf toe injury. Emerg Med J 30(9): 776-77
  13. Brophy R., Gamradt S., Ellis S., Barnes R., Rodeo S., Warren R., Hillstrom H. (2009) Effect of turf toe on foot contact pressures in professional American football players. Foot Ankle Int 30(5): 405-9
  14. Childs S. (2006) The pathogenesis and biomechanics of turf toe. Orthop Nurs 25(4): 276-80
  15. Allen R., Flemming D., Sanders T. (2004) Turf toe: ligamentous injury of the first metatarsophalangeal joint. Mil Med 169(11): xix-xxiv
  16. Watson T., Anderson R., Davis W. (2000) Periarticular injuries to the hallux metatarsophalangeal joint in athletes. Foot Ankle Clin 5(3): 687-713
  17. Michell L., Smith A., Bachl N., Rolf C., Chan K. (2001) Team physician manual (FIMS, Lippincott Williams and Wilkins Asia ltd ) chapter 17: 406-427
  18. Sikka R., Hunkele T., Sugarman E., Myerson M., Fetzer G., Boyd J. (2012) Dorsal dislocation of the great toe in a professional football player: case report. Foot Ankle Int 33(9): 798-802
  19. Ekstrand J., Van Dijk C. (2013) Fifth metatarsal fractures among male professional footballers: a potential career-ending disease. Br J Sports Med 47(12): 754-8
  20. Meyer S., Callaghan J., Albright J., Crowley E., Powell J. ( 1994) Midfoot sprains in collegiate football players. Am J Sports Med 22(3): 392-401
  21. Hatem S., Davis A., Sundaram M. (2005) Your diagnosis? Midfoot sprain: Lisfranc ligament disruption. Orthopedics 28(1): 75-77
  22. Nunley J., Vertullo C. (2002) Classification, investigation and management of midfoot sprains: Lisfranc injuries in the athlete. Am J Sports Med 30(6): 871-78
  23. DeLee J.C., Evans J., Julian J. (1983) Stress fracture of the fifth metatarsal. Am J Sports Med. 11(5): 349-53
  24. Dimitriou R., Tsiridis E., Giannoudis P. (2005) Current concepts of molecular aspects of bone healing. Injury 36(12): 1392-404
  25. Ebraheim N., Haman S., Lu J., Padanilam T., Yeasting R. (2000) Anatomical and radiological considerations of the fifth metatarsal bone. Foot Ankle Int 21(3): 212-15
  26. Ekstrand, Torstveit (2012) Stress fractures in elite male football players. Scand J Med Sci Sports 22: 341–46
  27. Fazzalari N. (2011) Bone fracture and bone fracture repair. Osteoporos Int 22(6): 2003-6
  28. Hens J., Martens M. (1990) Surgical treatment of Jones fractures. Arch Orthop Trauma Surg. 09(5): 277-79
  29. Kaeding C., Miller T. (2013 ) The comprehensive description of stress fractures: a new classification system. J Bone Joint Surg Am 95(13): 1214-20
  30. Kaeding C., Yu J., Wright R., Amendola A., Spindler K. (2005) Management and return to play of stress fractures. Clin J Sport Med.15(6): 442-7
  31. Lee S., Anderson R. (2004) Stress fractures of the tarsal navicular. Foot Ankle Clin 9(1): 85-104
  32. Kubitz E. (2003) Athletic injuries of the first metatarsophalangeal joint. Am Podiatr Med Assoc 93(4): 325-32
  33. Orchard J. (2004) Is it safe to use local anaesthetic painkilling injections in professional football? Sports Med 3’(4): 209-19
  34. Kadakia A., Molloy A. (2011) Current concepts review: traumatic disorders of the first metatarsophalangeal joint and sesamoid complex. Foot Ankle Int 32(8): 834-39