Overview and Epidemiology of Foot and Ankle Problems in Sports

  • John S. LewisJr.Email author
  • Mark E. Easley


Injuries of the foot and ankle are common among recreational and competitive athletes. Like most sports-related injuries, management typically entails a period of rest, aggressive rehabilitation and return to early competitive activity without compromising long-term functional outcomes. Timing of intervention and return to play is often a prime consideration with respect to sports, and thus particular emphasis is often given to early diagnosis and treatment in the athlete. A combination of intrinsic and extrinsic factors may predispose athletes to certain injuries in the foot and ankle. Common acute athletic injuries to the foot and ankle include ankle sprains, ankle fractures, turf toe, Lisfranc injuries, and overuse syndromes ranging from Achilles tendonitis to stress fractures. As in all of sports medicine, the goal of treatment and surgical decision-making is to ensure safe return to play and to reduce the risk of further or recurrent injury, aligned with the goals of coaches, teams, and the athlete.


Ankle Athlete Injury Overuse Stress fracture Sports 


  1. 1.
    Clanton TO, McGarvey M. Athletic injuries to the soft tissues of the foot and ankle. In: Coughlin MJ, editor. Surgery of the foot and ankle. 8th ed. St. Louis: Mosby; 2007. p. 1425–563.Google Scholar
  2. 2.
    Anderson RB, Hunt KJ, McCormick JJ. Management of common sports-related injuries about the foot and ankle. J Am Acad Orthop Surg. 2010;18(9):546–56.CrossRefPubMedGoogle Scholar
  3. 3.
    National Safety Council. Injury facts, 2004 edition. Itasca: National Safety Council; 2004. p. 130.Google Scholar
  4. 4.
    Saluta J, Nunley JA. Managing foot and ankle injuries in athletes. J Musculoskelet Med. 2010; 355–63.Google Scholar
  5. 5.
    Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977;5:241–2.CrossRefPubMedGoogle Scholar
  6. 6.
    Baxter DE. Traumatic injuries to the soft tissues of the foot and ankle. In: Mann RA, editor. Surgery of the foot and ankle. 5th ed. St. Louis: Mosby; 1986. p. 456–72.Google Scholar
  7. 7.
    Dick R, Agel J, Marshall SW. National Collegiate Athletic Association Injury Surveillance System commentaries: Introduction and methods. J Athl Train. 2007;42(2):173–82.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311–9.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Borowski LA, Yard EE, et al. The epidemiology of US high school basketball injuries, 2005–2007. Am J Sports Med. 2008;36(12):2328–35.CrossRefPubMedGoogle Scholar
  10. 10.
    Janda DH, Wild DE, Hensinger RN. Softball injuries: etiology and prevention. Sports Med. 1992;18:632–5.CrossRefGoogle Scholar
  11. 11.
    Janda DH, Wojtys EM, Hankin FM, et al. A three-phase analysis of the prevention of recreational softball injuries. Am J Sports Med. 1990;18:632–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Mueller FO, Blyth CS. North Carolina high school football injury study: equipment and prevention. Am J Sports Med. 1974;2:1–10.CrossRefGoogle Scholar
  13. 13.
    Powell KE, Kohl HW, Casperson CJ, et al. An epidemiological perspective on the causes of running injuries. Physician Sports Med. 1986;14:100–14.CrossRefGoogle Scholar
  14. 14.
    Walter SD, Hart LE, McIntosh JM, et al. The Ontario cohort study of running-related injuries. Arch Intern Med. 1989;149:2561–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Macera CA, Pate RR, Powell KE, et al. Predicting lower-extremity injuries among habitual runners. Arch Intern Med. 1989;149:2565–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Heckman DS, Gluck GS, Parekh SG. Tendon disorders of the foot and ankle, part 2: achilles tendon disorders. Am J Sports Med. 2009;37:1223–34.CrossRefPubMedGoogle Scholar
  17. 17.
    Bensel CK. The effects of tropical and leather combat boots on lower extremity disorders among US Marine Corp recruits. Technical report No 76-49-CEMEL, March 1976. Natick: Clothing, Equipment, and Materials Engineering Laboratory, US Army Natick Research and Development Command; 1976.Google Scholar
  18. 18.
    DeVan WT, Carlton DC. The march fracture persists: a report on 143 cases during a fifteen-month period at an infantry basic training center. Am J Surg. 1954;87:227–31.CrossRefGoogle Scholar
  19. 19.
    Simkin A, Leichter I, Giladi M, et al. Combined effect of foot arch structure and an orthotic device on stress fractures. Foot Ankle. 1989;10:25–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Kaufman KR, Brodine SK, Shaffer RA, et al. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med. 1999;27:585–93.PubMedGoogle Scholar
  21. 21.
    Torg JS, Quedenfeld T. Effect of shoe type and cleat length on incidence and severity of knee injuries among high school football players. Res Q. 1971;42:203–11.PubMedGoogle Scholar
  22. 22.
    Rowe ML. Varsity football: knee and ankle injury. N Y State J Med. 1969;69:3000–3.PubMedGoogle Scholar
  23. 23.
    Johnson GR, Dowson D, Wright V. A biomechanical approach to the design of football boots. J Biomech. 1976;9:581–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Barrett JR, Tanji JL, Drake C, et al. High- versus low-top shoes for the prevention of ankle sprains in basketball players: a prospective randomized study. Am J Sports Med. 1993;21:582–5.CrossRefPubMedGoogle Scholar
  25. 25.
    Ottoviani RA, Ashton-Miller JA, Kothari SU, et al. Basketball shoe height and the maximum muscular resistance to applied ankle inversion and eversion moments. Am J Sports Med. 1995;23:418–23.CrossRefGoogle Scholar
  26. 26.
    Ashton-Miller JA, Ottaviani RA, Hutchinson C, et al. What best protects the inverted weightbearing ankle against further inversion? Am J Sports Med. 1996;24:800–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Schindle MK, Endo Y, et al. Stress fractures about the tibia, foot, and ankle. J Am Acad Orthop Surg. 2012;20:167–76.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA

Personalised recommendations