Common Athletic Injuries: Sprains, Shin Splints & Stress Fractures
by Robert D. Teasdall, MD
Professor of Orthopaedic Surgery
Wake Forest Baptist Health
Are foot and ankle athletic injuries common among athletes?
Foot and ankle injuries are relatively common among active people of all ages. The demands made on our feet and lower limbs can lead to a range of injuries, including sprained ankles, shin splints and stress fractures. Sprained ankles are perhaps the most common sports-related injury we see.
What causes ankle sprains?
Ankle sprains result from a twisting action of your feet. They are associated with activities that require a lot of running, jumping and quick changes of direction. A sharp twist or turning of the ankle can stretch and even tear the ligaments that hold the ankle joint in place.
How serious are ankle sprains?
With proper treatment ankle sprains are rarely cause for major concern, but they may develop into long-term problems if not correctly diagnosed and treated. Sprains are graded based on their severity. A first-degree sprain involves minor stretching of one of the ankle ligaments. Symptoms include some bruising, swelling and pain, but patients are usually able to walk without much discomfort. A second-degree sprain is the result of stretching and tearing of two of the ankle ligaments. A third-degree sprain involves a complete tear or rupture of all three of the ligaments that make up the ankle joint and causes severe swelling and pain.
What's the best way to treat an ankle sprain?
If you have a swollen ankle and are not able to put weight on your foot without pain, it's wise to see your doctor for an examination and X-ray, if necessary.
If there is no fracture, R (rest) I (ice) C (compression), and E (elevation) therapy is the most effective treatment. Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen or Tylenol will help ease the discomfort and reduce swelling. Your doctor may also prescribe crutches and/or a brace. After about 10 days, moving the joint within the range of pain tolerance is important. Your doctor may suggest physical therapy to increase range of motion and build strength. You should be back to normal in about six weeks although some swelling and mild pain can last for three months or more.
If pain continues to interfere with your normal activities, it's important to consult an orthopaedic doctor. Serious ankle sprains may require surgery to repair the ligaments.
Do shin splints necessitate a break from playing sports?
Shin splints shouldn't interrupt a sports season, but it's important to take a few steps to make sure the splints don't develop into a more serious problem such as stress fractures. Shin splints often affect athletes who ramp up their exercise without gradually conditioning their bodies. They involve the muscles and tendons of the lower leg. Running on hard surfaces and athletic shoes that don't provide sufficient cushioning, as well as inadequate conditioning, can all contribute to shin splint development.
Symptoms include tenderness around the shinbone. The pain usually develops gradually with exercise and subsides with rest. Most cases of shin splints can be treated with rest, ice and NSAIDs and a switch to a low-impact exercise such as biking or swimming until the shin splints heal.
It's never a good idea to run through the pain. If left untreated, the pain can intensify until it persists while walking or even at rest. Then it's definitely time to see an orthopaedic doctor.
What is a stress fracture?
A stress fracture is a small crack in the bone that occurs when the muscles that support the bone become fatigued and can no longer absorb the shock of an activity. It is a common injury among long distance runners and athletes who quickly escalate the intensity of their exercise. It can occur in any bone but it most commonly affects the foot (metatarsal) or shin (tibia) bones.
Unlike injuries to soft tissue, stress fractures are not associated with swelling or redness on the skin overlying the area of pain. Stress fracture pain may appear gradually or quite suddenly. You may feel a nagging pain as you walk or run. The area will also hurt if you press on it from above or below with your finger. Stress fractures usually heal by themselves, but a physician should evaluate any lingering pain.
It may take six to eight weeks for a stress fracture to heal, and during that time you should refrain from exercise that stresses the leg or foot. Swimming is a good alternative. For relief from pain, apply ice packs and take NSAIDs.
You should gradually introduce high-impact exercise back into your routine. Good supportive footwear and shoe inserts that absorb shock may help avoid future stress fractures.
Dr. Robert Teasdall is an orthopaedic surgeon with specialties including Sports Medicine, Foot and Ankle Surgery and Rehabilitation.
Request an appointment online or call 888-716-WAKE.