Sports Podiatry

The Most Frequent Sports Injuries


The foot structure comprises bones, joints, ligaments, muscles, and other tissues. Some injuries are typical of sports activities, being acute or chronic. Overload may sometimes contribute to the development of fractures, as traumas affect the soft tissues, bringing about severe complications.


Blisters and Calluses


Movements involving friction and stress may produce blisters and calluses, of which all athletes know a lot. When the skin layers are forced to separate by friction, a fluid-filled vesicle appears. The colour of the liquid is very important. Normally it is clear, though sometimes it can be dark which signifies containing blood. Blisters often hamper athletes in their activity, producing pain and discomfort. Large blisters need draining and padding to avoid further friction and new wounds. When drawing off the fluid, it is advisable to leave the overlying skin intact till the new skin grows below, to reduce the risk of infection. If a blister bursts open, it should be cleaned, otherwise it may get infected.

Antibacterial lotions and antibiotic ointments should be applied to a blister, followed by protecting the area with a sterile dressing. Drained blisters should be treated carefully to avoid possible complications.


Toe Injuries


Toes get injured in sports activity as well. When being trodden on, the toes may suffer nail lifting or a subungual hematoma, collection of blood under the nail. This condition can be extremely painful, so decompression is recommended to relieve the pain and the pressure to the area.

Poor footwear, too narrow or too small, also contributes to flattened toenails with blood collecting underneath. Besides, it may cause the in-growing of toenails, the big toe being most commonly affected.





Sprains are wrenching injuries to the ligaments reinforcing synovial joints. Depending on the forces involved there may be mentioned three types of sprains:


1.  First degree sprains

Least serious. Some functional disorder, minor pain or swelling can be present. Ligaments are hurt to a minimal extent.

2. Second degree sprains

More serious, causing more damage to the ligaments and more discomfort. Functional disorder is more evident. Swelling seems more pronounced, as the abnormal mobility is observed. Such injuries tend to be chronic.

3. Third degree sprains

Most serious. The ligaments are torn. The damage, the pain, the swelling, and the hemorrhage are severe. Considerable joint stability loss.




These are injuries to muscles, tendons, or muscle-tendon units.

Muscle-tendon strains are the most common, their etiology still being unknown. Just like sprains, strains may have various degrees of importance. According to SNAI (Standard Nomenclature of Athletic Injuries), there exist three strain degrees:


1. First degree strains

Minimal damage to the muscle-tendon structure. Pain may be intense when trying to employ the affected area. Slight swelling or muscle spasms may be present.

2. Second degree strains

Imply a more substantial damage to the soft tissue structures concerned. The pain, the swelling, and the spasms are more significant. Functional loss is moderate. Such injuries are associated with excessive strain, too much physical effort, or a muscle synergy failure.

3. Third degree strains

The most serious ones. Imply having torn completely the soft tissue structures concerned. May develop in different areas, such as tendon to bone attachment (avulsion fracture), muscle-tendon unit tissues, or muscle tissues. The swelling is considerable, as the trauma is obvious. Functional loss is very important.




Fractures and luxations (dislocations) are injuries to bones and articulations. However ordinary such injuries might be for any kind of activity, they are more typical of collision sports with great forces involved. Fractures can be closed or open (compound). Compound ones are potentially more dangerous, as open wounds may easily get infected. Depending on the importance and the location of the wound, it may be necessary to control the hemorrhage. Acute fractures in sports occur seldom.


Stress Fractures


Fatigue fractures, unlike traumatic ones, are almost exclusive to sports, developing over a long period of time. They are caused by subjecting a bone to a repeated or prolonged stress surpassing its recovery capability. The bone gets weaker and finally yields to the pressure. Keeping in mind that stress fractures need time to develop, their signs and symptoms can be easily confused with those of the minor lesions. Although such fractures may occur in any part of the body, the majority develops in the lower extremities. Weight and bad shape influence the development of stress fractures. However, athletes in great physical shape may suffer a fatigue fracture too, having intensified their training abruptly.

The symptoms may be imprecise, though normally there may be present some common stress fracture factors: pain, tenderness, no visible signs, repetitive and prolonged nature of the injury.




Importance of the lesion defines the luxation type. Subluxation implies partial dislocation of a bone in a joint, while luxation indicates that the bone has been dislocated completely. Nevertheless, any luxation should be treated as a kind of sprain.

Sprains, as mentioned above, affect articulation tissues (i.e. ligaments, capsules). Luxation signs and symptoms are similar to those of a sprain, including joint disfunction and the feeling of the joint having been forced out of its normal position. Athletes often report having heard a sharp snapping sound.


Ankle Injuries


Sprains are some of the most common sports injuries to the lower part of the leg and the ankle. Abnormal forces applied to the ligaments cause damage that may vary depending on a particular case. Sprains develop in the ankle ligaments following the direction of the foot, when ligaments suffer the impact of an abnormal force, and the foot subsides to the pressure, shifting aside.


1. First degree lateral ankle sprains

Pain, difficulty moving, tenderness, limited joint mobility, mild swelling or its absence.

2. Second degree lateral ankle sprains

Pain, difficulty moving, tenderness, functional loss, abnormal mobility, mild to moderate swelling.

3. Third degree lateral ankle sprains

Intense pain, inability to move, tenderness, functional loss, abnormal joint mobility, moderate to considerable swelling.


Achilles Tendon Lesions


Long-distance runners, basketball and tennis players have their calcaneal tendon injured rather frequently. Tendinitis, or tendon inflammation, begins slowly in long-distance runners. In basketball and tennis players it develops rapidly, pushed by a great number of quick, sharp movements and jumps. Discussion on the exact etiology of tendinitis continues. Achilles tendon connects gastrocnemius and soleus muscles to the heel bone. Both tendon sheath and dorsal subcutaneous bursa may become inflamed, contributing to the Achilles tendinitis development.

Most researchers agree that athletes dealing with hard, uneven or sloping surfaces and increasing notably their running distance or the duration of trainings are predisposed to have this type of tendinopathy. Apparently, this condition makes the affected part hot and tender to touch. The pain is usually confined to a small area and intensified by movement, especially after a period of rest. The tendon seems thicker. These signs and symptoms may be observed over a long period of time (days to weeks) or during a couple of days only. Early detection of the problem accelerates the recovery and the athlete’s return to sports activity and competition.

Traumatic injuries to the Achilles tendon develop as a result of explosive movements and jumps, or any impact that causes tendon straining or tearing.


Plantar Fasciitis


Plantar fascia, the thick inelastic fibrous tissue on the sole of the foot, attaches at the heel bone and runs forward to the base of the toes. Overstraining may produce tears at the attachment point, complicated by the inflammation of the adjacent tissues, including the bone. Changing footwear or a training technique, or an activity type may trigger the fasciitis development. This problem has a higher incidence in people who exercise seldom. A detailed medical history is of vital importance for a correct diagnosis. Medial plantar pain as well as morning pain coming with the first steps is typical of the plantar fasciitis.                        




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