The Olympics are finally here and we‘re geared up for some exciting competition and performances by remarkable athletes from around the world. With the intensity of the training these athletes are doing, and the high level of competition they endure, they are susceptible to sport-related injuries just like you and I. One of the most common injuries Olympic athletes suffer (as well as weekend warriors) are foot and ankle sprains or strains.
The foot and ankle is a complex in that it contains nearly one fourth of the humans bones of the body, (26 bones to be exact), over 33 joints that help to distribute force and provide shock absorption to the body, and more than 100 ligaments, tendons, and muscles that can be strained, torn, or sprained.
The most common mechanism of injury for the foot and ankle involves the athlete rolling their ankle to the outside while the toes are pointed downward. This mechanism will create a tear in one or more of the 3 ligaments (1. Anterior Talofibular 2. The Calcaneofibular and 3. The Posterior Talofibular) that support the outside of the ankle. Physical therapists are well versed at diagnosing which ligaments or muscles are involved without the need for MRIs or X-rays. Physical therapists are a great resource to be consulted immediately following an injury to the foot and ankle.
The muscles of the foot and ankle are strong; therefore most injuries to the foot and ankle involve ligaments. A strain occurs when the muscle fibers are torn. A sprain occurs when ligaments are torn. Strains and Sprains that only involve 25% of the involved tissue are referred to as Grade I tears. Athletes can usually play through these injuries with the help of physical therapy, Platelet Rich Plasma (PRP) injections, and braces or tape. In fact you will notice many gymnastics and track and field stars during the Olympics wearing tape or braces to provide extra support to a previously injured body part.
Grade I sprains and strains can recover in 3 to 10 days.
Grade II tears mean that up to 50% of the muscle, tendon or ligament has been torn. These are more complicated injuries because they take longer to heal. but Grade II tears require anywhere from 2 to 6 weeks. Extensive rehabilitation is often required for patients to recover from Grade II tears. This is why most athletes travel with their medical team, so they can continue to perform their rehab as they prepare for their event. One athlete to pay close attention to this year is the World’s fastest man, Usain Bolt. He strained his hamstring during the Jamaican Olympic trials early in July. Reports suggest that is was only a grade I tear, however, he has only had 4 to 6 weeks to recover since this injury.
Grade III tears are often referred to as ruptures. They almost always require surgery. There are several gymnastic stars this year that have successfully recovered from grade III tears in the past.
Whether you are an Olympic athlete, weekend warrior, or just an accident prone individual, the treatment of foot and ankle injuries looks like this:
Days 0 to 3:
RICE: Rest, Ice, Compression, and Elevation. Following these simple steps will help to minimize swelling, reduce pain, and prevent further ligament or muscle damage. Often crutches are needed to avoid weight bearing on the joint, but this is dependent on the severity of the injury.
Days 3 to 14:
Balance, joint range of motion, and strengthening exercises should be implemented to help the foot and ankle regain its mobility, joint nutrition, and stability. Often the athlete with a grade I tear will be able to return to sport during this time frame but they will need tape or bracing.
Days 14 to 6 weeks:
During this phase the athlete will progress their running, jumping, agility and strengthening exercises as tolerated and as directed by their physical therapist. It is critical that re-injury does not occur during this phase of rehabilitation as this will lead to scar tissue, instability, and chronic foot and ankle pain.
We hope you enjoy the Olympics this year and we hope for a healthy Team USA! If you are suffering from foot and/or ankle pain or know of someone that is, share this article with them and ask them to contact our team to schedule an evaluation. Our team at VTFC looks forward to helping you get back to an active lifestyle and successfully overcome your foot or ankle injury!