Ankle injuries in football players: Challenges, prevention and the role of physiotherapy

The ankle joints are complex anatomical structures that play a key  role in locomotion and cushioning when running, jumping and  changing direction. For football players who are exposed to  intense loads and sudden movements, ankle joint injuries are  among the most common injuries. 

Types of injury 

Sprains: Represent the most common type of ankle joint injury,  resulting from overstretching or tearing of ligaments. They  manifest as pain, swelling, restricted mobility and often bruising.  They mainly affect ligaments, including the anterior talofibular  ligament (ATFL). Sprains can range in severity from mild strains  to complete ruptures. In addition to the ATFL, the posterior  patellofemoral ligament (PTFL) and calcaneofemoral ligament  (CFL) are also frequently injured. 

Dislocations: Occur less frequently but are more serious and  involve complete displacement of joint surfaces. In addition to  pain and swelling, they are accompanied by instability of the joint. 

Fractures: These can involve the ankle bones or the shinbone and  tibia forming the joint, or avulsion fractures (detachment of a bony  fragment with an attached ligament). They require immobilisation  and often surgical treatment.

Tendonitis: Arises from overloading the tendons of the muscles  that flex or straighten the foot. It manifests itself as pain,  tenderness and restricted mobility. 

An inadequate warm-up and cool-down are often risk factors. At  the same time, failure to adequately prepare muscles and joints for  exercise increases the risk of injury. The next risk is inappropriate  footwear: shoes with inadequate cushioning or a poor fit can lead  to excessive strain on the ankle joints. 

What can we do to play safely?  

The basics are a proper warm-up before training and a cool-down after training: The warm-up should include  dynamic and static exercises, and the cool-down should include static stretching  of the muscles. Additionally the right footwear is important: Shoes should fit the foot and provide adequate cushioning. If possible, avoid  playing on uneven or hard ground. If the joint is weakened or recovering after an injury, an orthosis can provide additional support. 

Treatment and the role of physiotherapy 

– As a physiotherapist, I am particularly interested in working with  football players for several reasons. Firstly, I played football  myself for more than 10 years, at junior level and the Polish IV  league, which allowed me to understand the specifics of the sport  and the typical injuries that players face. This personal experience  motivates me to continue my adventure in football as a  physiotherapist, where I can use my knowledge and passion to  help other athletes and, above all, to continue working in the sport. 

– says physiotherapist Kacper Zarosa from the Physiomed  physiotherapy clinic in Powiśle Elektrownia in Warsaw. 

His work with football players at Polonia Warsaw as an intern was  an extremely inspiring experience for Kacper. What he liked most  about this job was the opportunity to directly influence the health  and fitness of the players, which translates into their success on the  pitch. Each case is unique and requires an individual approach,  which makes his job rewarding and challenging. How do you treat  injuries most effectively and what is the role of physiotherapy  here?  

The treatment of ankle injuries in football players depends on the  type and severity of the injury. Physiotherapy is an integral part of  the patient’s comprehensive rehabilitation. With it, the patient has  

the chance to improve function, reduce pain medication and  improve quality of life. For sprains and tendonitis, conservative  methods such as rest, cooling, compression, elevation of the limb  (RICE), painkillers and anti-inflammatory drugs and  physiotherapy are usually used. Physiotherapy plays a key role in  recovery from an ankle injury. An experienced physiotherapist  will develop a personalised exercise programme to help with: 

– Relieving pain and swelling 

– Restoring the mobility of the joint 

– Strengthening the muscles 

– Improving proprioception and balance 

– Preventing the recurrence of an injury

In the case of fractures or dislocations, surgical treatment may be  necessary. Physiotherapy is also important after surgery to help  you return to fitness and full range of movement.