Your child's sports injury: the foot

Ankle injuries are considered the most common type of athletic injuries. If your adolescent or teen has suffered an injury, the most likely cause is a sprain. The treatment for a sprain is RICE (rest, ice, compression and elevation) for the first 48 hours, followed by rehabilitation. However, here are a few lesser known injuries that may be to blame:



Stress Fractures
Metatarsal Stress Fracture
This is a small crack in one of the metatarsal (toe) bones, usually the 2nd or 3rd toe, and typically occurs in runners. There will be point tenderness over the area on examination. Treatment is rest for 6 weeks and using shoes with good arch support.

Navicular Stress Fracture
This is a tricky fracture of the upper bone in the foot called the navicular bone that occurs in athletes in running sports. They complain of vague, non-localizing pain at the dorsum (top) of the foot. These do not show up on imaging right away, so after a few weeks an MRI may be needed to make the daignosis. Treatment is casting and immobilization for 8 weeks

Calcaneal Stress Fracture
Fracture of the heel bone. Occurs in athletes engaging in running sports, and is characterized by pain in the heel with walking or running. Pain can be elicited on exam by squeezing the heel bone. Imaging may be needed to make the diagnosis, and treatment is 8 weeks of immobilization.



Sever Disease
Inflammation of the bottom of the Achilles tendon where it attaches to the heel bone (calcaneus). It occurs in prepubescent boys, during exercise, in both lower legs. The treatment is RICE and shoes with good arch support, and will heal in about 2 months.



Plantar Fasciitis
Athletes will report morning heel pain after several hours of rest or during the first few steps of the day. The treatment is rest, and pain is gone after about 6 months.