Vlog: Sports Injuries – Dr. Burk 2/22

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Video Blog Sports Injuries

Hey good morning, this is Dr. Roman Burk! I wanted to cover some injuries that happen a lot this time of year. Spring sports are on us, and thus spring sport injuries are as well. Kids especially, but athletes of any age tend to find that there are particular injuries that occur when playing grass sports or turf sports, so I wanted to cover how to prevent a few of these types of injuries today.

One of the more common injuries that we see in sports, especially on grass, is known as a Jones Fracture. A Jones Fracture happens on the outside of a person’s foot when they rotate the foot or when they supinate the foot and they end up with a lot of weight-bearing pressure on the outside part of their arch. That part of their mid-foot is really susceptible to injury. 

On a skeleton it looks like this. So here’s our foot. These are five bones called metatarsals and when a person has a tendency to turn or rotate their foot outward, it’s this part of the foot that receives the greatest amount of force and potential for injury. So this portion of the foot, this portion of the fifth metatarsal, is frequently broken or cracked during that process of an athlete rotating or turning the foot outward and in the process of that happening the bone breaks or cracks. This is a particularly difficult area to get to heal because the blood supply to that part of the bone is uniquely fragile. 

One of the big issues that you see especially in turf injuries is that the types of cleats that athletes are using can make a big difference in terms of how that injury occurs. Cleats that are more rounded or cleats that are very flimsy where the midsole of the shoe has a tendency to flex too far in one direction are going to contribute to that because it allows the foot to turn out too far and it allows a lot of force to be delivered right to that vulnerable area of the fifth metatarsal so starting with a really good cleat is an enormous game changer in terms of prevention. That’s clearly one of the most important steps in any type of sports injury is the right type of shoe gear and if you pick the wrong one unfortunately sometimes these injuries can end up being a real game changer for people in terms of losing their season and a lot of lost time.

Injury number two common injury number two is called turf toe and we hear this a lot in terms of coverage from sports that occur on television and radio notoriety is given a lot to that type of injury. Turf toe is frequently misunderstood but it usually involves our great toe. The big toe itself has two particular small bones on the bottom known as sesamoids, these two sesamoids are intended to be present in the bottom of our joint and they move they float they sit within a muscle and tendon group that attaches to our great toe and these two small little bones sit underneath the big toe joint they are the equivalent in our foot of being similar to our kneecap and our knee.

They float and move and are intended to help us as we propel forward unfortunately sometimes depending on the sport and we’re thinking like soccer, rugby, lacrosse, any of these spring sports that a lot of kids are going to be playing on turf. What will happen is that they’ll get themselves in a forced position where the foot is in a position called dorsiflexion or in other words where the big toe goes up and when that big toe goes up to a certain point it has an end there is a point where we should not go past it unfortunately sometimes in these types of sports a tackle a fall anything that can occur there that causes the big toe to dorsiflex more than it was intended to. It will draw these little sesamoid bones up further and cause them to split apart they normally move as a unit two of them simultaneously are tracking under the big toe and what happens is that when the foot is forced to dorsiflex the big toe joint too far it tears the ligament that holds these two bones together resulting in injury we call turf toe it makes it difficult for runners to push off to run fast or sprint after this type of injury and frequently takes a long time to recover this is again a classic example of where shoe gear plays an important role because a shoe that is too flimsy too flexible in the wrong spots is going to put undue strain on certain parts of the foot.

So prevention is really handled best by use of particular sport specific cleats that are well made and that have a firm midsole injury number three that frequently happens especially in these spring types of sports is known as a high ankle sprain sometimes you’ll hear about this in a variety of sports it happens a lot on turf in particular and what happens is that there are ligaments that help us to hold together our leg bone and the outside of our ankle these two bones when they touch one another at the level of our ankle joint are held together by ligaments those ligaments are what keep the two leg bones together so that they can form the ankle joint when the ligaments here above the ankle have been injured or sprained we call it a high ankle sprain. The more common ligament injuries are here below the ankle, called just the common ankle sprain that occurs when we invert the ankle too far and it forces the ligaments on the outside to tear in the case of a high ankle sprain. What will happen is that the foot will be planted and rotated and as you can see with my bone model it wants to tear this fibula away from our leg bone called the tibia and so what happens is that it’s typically a plant and rotate kind of injury. Sometimes these are bang-bang type of injuries that happen super fast without anybody even really being able to think about it or stop it from occurring,  it usually occurs when kids get in a pileup. Think rugby, think contact sports, like soccer where there’s going to be a lot of heavy pressure and body movement where the foot plants and then it turns or rotates which is going to force those ligaments apart causing them to tear an important part of this is that if you’re in a highly susceptible type of position for your team think midfielders or even defensive players on a let’s say like a lacrosse team they’re going to need to consider whether they have a history of injury there because sometimes using an ankle brace in those particular sports is a really good preventative method.

It’s also a really important thing to note that proper training and exercise to get dexterity and muscle movement in coordination with each other so that before a season a player is ready to go and doesn’t just pick up and try to play. That type of agility and ease of which they move is going to make a tremendous difference in terms of prevention of these types of injuries. In some cases you may not be able to stop it because it may happen due to another player’s impact on you but these are the good things that we can do to help us prevent these types of injuries from occurring before they ever start.

Thanks for watching!

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