Your feet and ankles move and flex in many ways, as the base of your ability to stand, walk or run; whichever your sport calls for, we can help.

Two of the most common sports injuries that affect the ankle and foot are Achilles tendon tears and stress fractures. We treat these and other common foot and ankle issues, including:

  • Chronic exertional compartment syndrome (CECS), which occurs when leg muscles swell and create pain and pressure, causing numbness in the foot, cutting off vascular supply and impeding movement.
  • Ankle sprains, which usually occur when the ankle is twisted and ligaments are injured or torn, causing inflammation and bruising.
  • Plantar fasciitis, an inflammation of the tissue at the bottom of the foot, making it painful to walk.
  • Tendonitis, the inflammation of a tendon due to repeated use, causing pain and soreness around a joint.

Achilles tendon tear

The Achilles tendon connects your heel bone to muscles in your calf. Every time you run and jump, you use this tendon. A tear can happen when you push off your feet, break into a run or make a stop-and-start move.

Symptoms include:
  • Bruising or swelling around your foot or leg
  • Feeling of being kicked or stabbed in the back of the ankle
  • Difficulty walking or climbing stairs
  • Inability to stand on your toes
  • Sharp pain in your ankle or your leg

Stress fracture

Another common foot and ankle sports injury is a stress fracture. Sports that involve a lot of running and jumping, like basketball, soccer and track and field result in overuse injuries of the leg, foot and ankle. This can often lead to a small crack in bones, especially the shinbone (tibia) and bones in the foot called the metatarsals.

Symptoms include:
  • Pain that becomes more severe with activity and less severe with rest
  • Pain and swelling when supporting weight
  • Tenderness in the bone

Nonsurgical Treatments

Nonsurgical treatments

Nonsurgical treatments

Injection Therapy

Your physician may use musculoskeletal ultrasound to diagnose conditions such as an Achilles tendon tear. Musculoskeletal ultrasound improves accuracy when treating you with steroid injections in the office, and it is used for deeper joints, joints with poor anatomic landmarks and joints with little to no joint space. This technique uses sound waves to create images of the joint and to identify the needle used to inject the joint helping the physician guide it to the affected area. This technique is done in the office and does not expose you to any radiation.

Intramuscular Manual Therapy

Dry needling is an alternative pain relief technique that physical therapists may administer for muscle pain. It involves the insertion of a small, solid filament into a stressed muscle’s site of spasm and pain, also known as a trigger point. By doing so, the muscle relaxes and blood flow increases into the area, alleviating pain and improving motion.

Trigger points are often the result of an injury to a different part of the body, because other muscles overcompensate for imbalances and weakness in the injured area. Because of this overcompensation, muscle spasm occurs, causing discomfort and pain in the muscle.

Once dry needling resets the tone of muscle, your physical therapist works on correcting strength and mobility deficits in the muscle, which allows healing and prevents injury.

  • Results can be immediate or take up to 72 hours
  • One to five treatments is the expected course
  • Rehab exercises are part of the treatment


Lifestyle Modification

Depending on the risk assessment of your injury, you may be able to heal by backing off on activity, reducing the intensity of training and using healing aids. Immobilization with a splint or protective boot or the use of crutches can be effective for Achilles tear and certain stress fractures.

Surgical Treatments

Surgical treatments

Surgical treatments

Achilles Tendon Surgical Repair

There are two types of surgery for Achilles tendon tears. One involves reconnecting the tendon through an incision made in the back of your leg. The other involves sewing the tendon back together through various small incisions. A cast, walking boot or similar device is usually worn after surgery for about six to eight weeks. Full recovery can take up to six to nine months.

More than 80 percent of people who have Achilles tendon surgery are able to return to pre-injury activities, including sports. Factors like rehab and physical therapy can make a big difference in the speed and success of healing.


Achilles Tendon Tear Risks

It is possible for the Achilles tendon to re-tear, but the risk of re-injury is greater with nonsurgical treatment. It is also possible that the tendon will not be as strong as it once was. Risks associated with surgery include:

  • Infection (a common risk associated with surgeries)
  • Complications from anesthetic or other medicines (also a common risk associated with surgeries)
  • Nerve injury (in the surgical area)
  • Decreased range of motion
  • Wound healing problems (a common risk associated with surgeries)

Stress Fracture Surgery

Surgery may be necessary to correct problematic foot stress fractures. Special orthopedic devices are used in this procedure to support the affected bones. Screws, or pins, and plates hold the small foot and ankle bones together for them to heal.

After surgery, a gradual return to activity can be initiated once your stress fracture has healed. Resuming activity too quickly can lead to more significant stress fractures that will take even longer to heal. If reinjured, the stress fracture may never properly heal.

Rehab and physical therapy can help you avoid traumatizing the affected area and experiencing a repeat injury. But the best treatment of all is prevention. A consultation with our specialists can lead to early detection of a stress fracture, and initiating a rehabilitation program can keep you active, on the field and injury-free.

Needle Manometry

Surgeons use needle manometry – a needle fixed with a pressure gauge – to monitor the pressure created with chronic exertional compartment syndrome. Once the condition is diagnosed, the surgical procedure to release the pressure involves making a slit in muscle casing to give the muscle more room to expand when activity demands it. This relieves the pressure and helps restore blood flow, which diminishes foot numbness and allows you to resume regular activity.

Why Ohio State?

Why choose The Ohio State University Wexner Medical Center for treatment of sports-related ankle and foot injuries?

Diagnostic expertise: Our medical specialists published the first-ever system for diagnosing and classifying stress fractures that physicians at other institutions refer to.

Expert Care: Our surgeons have extensive experience repairing Achilles injuries. With in-depth focus on their area of specialty, our highly skilled surgeons offer comprehensive treatment that leads to better and faster results for you. We offer fellowship-level physician care and physical therapy, which means our providers have completed up to two years of intense, specialized experiential training in the field. 

Experience: As the sideline care providers for more than 5,000 central Ohio competitors and performers, including Ohio State’s athletes and varsity teams, we have the experience to help maintain better health and athletic performance.

Patient Success

Korban's Story

Korban was a track and field athlete at The Ohio State University from 2010-2013, and currently competes professionally in long jump. Here he discusses his foot injury and his treatment at Ohio State Sports Medicine.

Dr. Tim Miller discusses a typical approach to caring for a sprained ankle, a common injury that can range from a simple stretching injury to a complete tear of the ligaments.

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