Foot and ankle surgeons offer tips for athletes of all levels.  
 

The 2024 Summer Olympics have arrived, and according to foot and ankle surgeons from the American College of Foot and Ankle Surgeons (ACFAS), intense play performance throughout the games can cause an increased risk for foot and ankle injuries.

From plantar fasciitis to Lisfranc injuries to ankle sprains and stress fractures, Olympic athletes have dealt with their fair share of injuries as they prepared for and now compete in the Summer Games.

According to Maryland foot and ankle surgeon and Fellow member of ACFAS, Timothy Swartz, DPM, FACFAS, “One of the most common athletic foot injuries, plantar fasciitis, is a painful injury that is most commonly found in those who are on their feet a lot, like athletes. It can be caused by abnormally high or low arches, insufficient support in footwear or simply putting too much strain on one’s feet.”

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.

Plantar fasciitis is often treated conservatively with a period of rest, physical therapy, anti-inflammatory medications, orthotics and stretching.

While plantar fasciitis is considered a heel injury, a Lisfranc injury occurs in the midfoot region, where the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The Lisfranc ligament is a tough band of tissue that joins two of these bones. This is important for maintaining proper alignment and strength of the joint. Injuries to the Lisfranc joint most commonly occur in athletes, such as runners, horseback riders, football players and participants of other contact sports, or can occur from something as simple as missing a step.

Although plantar fasciitis and Lisfranc injuries don't have a lot in common, what they do have in common is that they can be chronically symptomatic, and it may be difficult to get an athlete back to his or her previous level of activity in a short period of time. A Lisfranc injury can also be mistaken for a foot sprain, but when not diagnosed and treated early, it can lead to more serious complications in the long run. Lisfranc injuries may occasionally be treated with immobilization and rest, but most require surgery to stabilize the joints. “The specific midfoot joints that are stabilized depend on the ligaments that are injured and may vary somewhat on a case by case basis,” Swartz said.

Other common injuries seen in athletes are ankle sprains and stress fractures. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

Stress fractures, on the other hand, are tiny, hairline breaks that can occur in the bones of the foot. According to Dr. Swartz, they can be caused by overtraining or overuse, improper training habits or surfaces, improper shoes, flatfoot or other foot deformities and even osteoporosis. These tiny breaks in the bones of the feet can lead to a complete break if left untreated.

Athletes of all levels can benefit from these injury prevention tips from the American College of Foot and Ankle Surgeons to help keep them at the top of their game:

• Wear supportive shoes. Shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma or a thickening of the nerve tissue. Never wear flip flops or leisure shoes for athletic activities.
• Remember to stretch after warming up as well as following rigorous playing to increase blood flow to the muscles and allow for more flexibility so injuries can be avoided.
• And remember, just because you can walk on it doesn’t mean it’s ok to do so. Stress fractures may take days to appear in the form of bruising or swelling.
• If injured, athletes should remember RICE: Rest, Ice, Compression and Elevation and make an appointment with their local foot and ankle surgeon if the injury does not improve after a few days.