Foot and Ankle Injuries

Foot and ankle injuries can be overwhelming for new sports medicine learners due to the complex network of bones, muscles, tendons, ligaments and joints. Dividing the anatomy into the ankle joint, hindfoot, midfoot, and forefoot can be helpful. Learning the intricate anatomy is the first step in understanding what structures are located where, making it easier to narrow down the differential diagnosis. Foot and ankle injuries are common in the majority of sports, and learners need to become familiar with common and not to be missed pathologies.

In this episode, Dr. Fahim Merali, sports medicine specialist at the Dovigi Orthopaedic Sports Medicine Clinic at Mount Sinai Hospital in Toronto discusses ankle and foot injuries seen frequently in various sports.

Listen to learn how to provide an accurate on field assessment to determine appropriateness to return to the game, when to have a player sit out and undergo more urgent assessments, how to investigate and manage subacute and chronic foot and ankle injuries and appropriate rehab protocols for various foot and ankle conditions.

As always, understanding the mechanism of injury is a key component and mastering the anatomy is the only way to know what structures are present in the region of pain, which leads to the differential diagnosis. Remember to always palpate and image the contralateral side for comparison.

For learning anatomy, practice palpating structures on your own foot and ankle, use an anatomy colouring book and review resources such as radiopaedia or the Sports Medicine Review videos linked below.

Additional resources:

1. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach

Halabchi, F., & Hassabi, M. (2020). Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World journal of orthopedics, 11(12), 534.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745493/

 2. Lisfranc injuries

Welck, M. J., Zinchenko, R., & Rudge, B. (2015). Lisfranc injuries. Injury, 46(4), 536-541.

https://pubmed.ncbi.nlm.nih.gov/25543185/

 3. Turf Toe: anatomy, diagnosis, and treatment

McCormick, J. J., & Anderson, R. B. (2010). Turf toe: anatomy, diagnosis, and treatment. Sports Health, 2(6), 487-494.

https://journals.sagepub.com/doi/pdf/10.1177/1941738110386681

 4. Anterior calcaneal process fracture (on differential for lateral ankle injuries)

https://radiopaedia.org/articles/anterior-calcaneal-process-fracture-1

 5. Sports Medicine Review – Foot Review

http://sportmedschool.com/sports-medicine-review-foot-review/