Foot and ankle injuries are a commonly encountered during basketball play. Recently, stars like Stephen Curry and Kobe Bryant suffered injuries that can sideline players for weeks or the whole season. In fact, Stephen Curry injured his shinbone during a recent game against the Kings, resulting in a bone bruise.
A bone bruise is when the surrounding membrane of the bone called the periosteum can become injured and inflamed. Bone bruises can take up to six weeks to heal and feel better with active rest and icing techniques.
Another more common basketball injury is an inversion ankle sprain. This usually occurs when a player jumps and lands on another player’s foot, twisting his or her ankle. The lateral ankle ligaments on the outside of the ankle will then stretch and possibly tear, causing pain and instability. Patients usually require an initial X-ray to make sure there are no fractures or dislocations, and are then immobilized for one to two weeks. When the period is over, they are allowed to start early range of motion on the injured ankle to prevent stiffness and maintain strength. Most patients can return to play within four to six weeks if no other pathologies are identified.
Some inversion ankle sprains result in cartilage damage to the talus bone of the ankle joint. The talus sits on top of the heel bone, and along with the shinbone makes the ankle joint. Cartilage damage to this joint can result in pain and stiffness with possible continued disability. Patients can even develop arthritis of the ankle joint if left untreated.
A more common ankle joint problem with inversion sprains is ankle instability. A patient can stretch out the lateral ankle ligaments or even tear them resulting in a unstable ankle that no longer has the taut stabilizing ligaments to prevent it from rolling in. When this occurs, patients report a feeling of unsteadiness or instability when walking, especially on uneven surfaces or on tiptoes. Most patients respond to instability of the ankle with bracing and physical therapy to help rebuild ankle strength and range of motion. However, some ankles remain unstable and are fixed through surgery, enjoying a 92 percent success rate and return to sport.
Athletes can also injure their Achilles tendon. Kobe Bryant ruptured his Achilles tendon in 2013 requiring surgical repair. The Achilles tendon is the largest and strongest tendon in the body. A rupture can happen if there is previous micro trauma to the tendon and there is disruption in blood supply from chronic inflammation such as from Achilles tendinitis. If the athlete is not warmed up properly, the load to the tendon can exceed the tensile strength of the tissues and cause a rupture. Some tendon tears or ruptures can be treated non-operatively, but the chance of a rupture recurring is higher and the recovery period is longer. Newer technology has been developed to treat Achilles tendon ruptures with minimally invasive techniques that allow for earlier recovery and return to sport.
Plantar fasciitis, or heel spur syndrome, is another common injury incurred during basketball play. The plantar fascia is a big, broad ligament that is at the bottom of the foot, starting at the heel and stretching to the toes. It supports the arch and can become painful, most commonly at its insertion on the heel bone. Pain can be debilitating during play, so the initial treatment should include R.I.C.E.: rest, icing, compression and active rest. Athletes can be given custom orthotics to address the foot posture or shape as well, such as night-splint bracing to increase flexibility to the fascia and anti-inflammatory medicines to reduce swelling. Rarely does plantar fasciitis require operative treatment.
The main instigators of heel pain are usually heel cord inflexibility and foot posture. Athletes that have inflexible or tight heel cords (Achilles tendons) will stress the heel bone and cause tension on the bottom surface of the bone, where the plantar fascia ligament originates. A designed stretching regimen can be created for the athlete to help release tension on the heel bone and improve overall performance and flexibility. The constant tension can inflame the ligament. An athlete’s foot posture or shape can also play a roll. If an athlete’s foot rolls inward (flattens) or rolls outward (high-arched), strain can also be placed on the ligament, causing it to inflame. If necessary, a custom insert or orthotic that is specifically designed by a foot and ankle specialist to address the biomechanical issue the athlete is having can be made.