Mechanisms of foot and ankle injuries in soccer

BACKGROUND: Although player-to-player contact is a risk factor in the majority of soccer injuries, the mechanisms leading to these injuries have not been analyzed. PURPOSE: To assess the relationships between foot/ankle injuries and foul play and tackle type, and to identify the position of the foot and ankle at the time of injury. STUDY DESIGN: Prospective cohort study. METHODS: Team physicians prospectively recorded each injury in four world soccer competitions, and the videotaped incident leading to the injury was retrospectively analyzed. RESULTS: Of 76 foot and ankle injuries (52 contusions, 20 sprains, 4 fractures), direct contact occurred between players in 72. Significantly more injuries involved a tackle from the side and a lateral or medial tackle force. The injured limb was weightbearing in 41 and nonweightbearing in 35 of the incidents. Significantly more injuries resulted in time lost from soccer when the limb was weightbearing. The most common foot and ankle positions at the time of injury were pronated/neutral in the sagittal plane for weightbearing limbs, and plantar flexed/neutral in the coronal plane for nonweightbearing limbs. The most common foot and ankle rotations at the time of injury were external (23) and eversion (28). CONCLUSIONS: The majority of injuries were caused by tackles involving lateral or medial forces that created a corresponding eversion or inversion rotation of the foot or ankle. The weightbearing status of the injured limb was a significant risk factor.