injury corner - November 27, 2013

Common foot injuries in soccer

You might be able to play soccer with a tight hamstring or even a pulled calf, but with a foot injury there is a bigger chance that you wont even be able even put any weight on your foot let alone be able to play soccer. This is largely down to the fact that your foot is key to helping you push off and land when running. Your foot is required to control both the forces that are created when your foot pushes off the ground as well as absorb shock from impact when your foot lands on the ground. A lot of common foot injuries are often caused by problems with one or both of these foot functions. For example if your the foot is stiff and cannot properly bear weight when your feet hit the ground can result in a tibial stress fracture. Another example would be if you have instability in your foot when your foot hits the ground, overtime you could get runner’s knee thanks to the additional shocks that can resonate up into your knee and damage them.

Understanding how the foot functions as well as knowing the ins and outs of the foot anatomy is key to preventing and treating foot injuries. In this article we will be looking at how the foot works, different foot conditions and types that can affect the foot function as well as the most common foot injuries.

Foot types

The feet are the supporting foundations for your whole anatomy. If your feet are misaligned or are not functioning how they should be then this can cause problems through out your body, More than 75% of people will have over pronation or abnormal supination of the feet, but despite this high number the majority of will be totally oblivious what sort of foot type we have and how this can affect our health and well-being.

Pronation is how our feet shift weight and absorb shock when we walk : any time your feet hit the ground the arch of your feet will flex downwards and should spread the impact force evenly across your foot.

Everybody pronates their feet when they walk! Despite what the majority of people think pronation of the feet is perfectly healthy and normal thing for your feet to do. However if your feet pronate too much when you walk then problems can arise. If the arch of your foot flexes inward to much or is too flat when you walk then this is called over pronation and should be avoided.

Over pronation

Individuals can suffer from varying degrees of over-pronation. In extreme cases of over-pronation a persons feet and
ankles may rotate as a result of the over pronation which can cause problems that don’t just affect the feet.

Who over pronates?

Over pronation is biomechanical imbalance and is very common and can affect a wide range of people with different foot types. Pronation is often believed to be something that only people with flat feet however this is not the case as those with both flat feet and arches can over pronate. Many of us will have always over pronated our feet since we were born, whilst other people may have developed over pronation due to factors such as ageing, sudden weight gain, or even just from constant standing for long periods on hard surfaces.

How do I tell if I over pronate?

You can tell if you over pronate your feet from distinct wear on the edges of your soles around the heel. To find out more accurately if you feet over pronate it is always best to see a podiatrists who will analysis your gait and and will be trained to spot over pronation and other biomechanical imbalances in your feet..
Why should I care about over pronation?

Over pronation can have an bad affect on your body’s skeletal alignment. Over pronation can result in the lowering of the longitudinal arch which can in could mean that the heel bone is pulled downwards. I the heel bone is pulled downwards this may causes rotation of the leg bones such as the Tibia, Fibula, femur as well as the rotation and tilting of the hips and pelvis, creating excessive pressure and strain on your lower limbs and back as a result.

Excessive strain on the lower limbs caused by pronation is known to cause a wide range of injuries such as Plantar fasciitis Achilles tendinitis, runners and jumpers knee and bursitis in the hip.

How to stop over pronation?

Off the shelf insoles are really good at correcting over pronation. Custom insoles should eb avoided because of the fact that these insoles support your feet in the the shape and position that is causing your over pronation and or biomechanical imbalances, whilst off the shelf insoles are designed to support and correct the function of the foot in a different and more natural position.

Excessive Supination

Supination is a natural foot function. Supination helps to propel your body forward by turning or rotating the foot outwards slightly when you lift your heel, your feet do this by means of putting weight onto the forefoot and your toes allowing you to then push off from the ground when you walk or run.

Is supination good for your feet?

Supination becomes a problem if your feet supinate when they are not meant to, or your foot supinates for too long or if the foot rolls outwards too much. If this happens then it is called excessive supination (some people call it under pronation).

If you suffer from excessive supination it means that the the foot rolls outward too much and distributes too much weight around the outside your foot and can cause the ankle bone to push outwards as well. Excessive supination often leads to strain on and around the ankle and the surrounding muscles and tendons. Supination can also restrict the ankle from flexing properly and can inhibit the foot’s capability at absorbing shock to the ankle and foot. Excessive supination can also mean that the littler toes are forced to work harder than the big toes when you feet push off from the ground, reducing the efficiency of the function of your feet when walking or running.

Is excessive supination common?

Unlike over pronation Excessive supination not very common at all. Quite a number of people with excessive supination of the feet have had the condition since childhood however some people do develop the condition later on in life due to because of injury, or overuse of the feet or from instability in the ankle that could have been cause by an ankle sprain.

How do you check if your feet over supinate?

Some people believe that there feet supinate just because they have high arches, but the fact is having high arches doesn’t necessarily mean that your feet over supinate! Individuals who have got high arches can over pronate, and people who have low arches have just as much chance of over supinating.
Over supination can be caused by a number of different factors however the main causes are often because of an instability in the foot and ankle or from an injury to the ankle.
Excessive supination can be found in both feet or just one it doesn’t matter! Examining your shoes to see if your shoes are worn out around the edges of the soles can give you an indication as to whether your feet supinate or not however it is always best to see a podiatrists for a proper diagnosis.

Should you be concerned about excessive supination?

Having excessively supinating feet can bump up your risk of injuring your feet and lower limbs. Excessive supination can:

Prevents your feet from properly absorbing shock allowing this shock to damage your feet and lower legs.
Lessens the biomechanical efficiency of your feet meaning your feet have to work harder.
Creates problems with the alignment of your bones. Supination can cause the lower leg bones and hips to slightly rotate adding to pressure resulting in tilting of the pelvis.
Cause excessive strain and instability on your ankles. Increasing your chance of ankle sprains as well as problems with your lower legs and knees.

How can I stop my feet from supinating?

Wearing insoles that help to correct your foot function aswell as stabilizing your heel and ankles are a must for people with excessive supination and can really help. You should also wear shoes that have a firm and supportive heel counter.

What does it mean if you have Neutral feet

Having neutral feet is not very common as just under25% of the world population have what would be described as having neutral feet. Having neutral means that you have good ankle and foot alignment and the feet and ankles form a straight line when placed on the ground. Neutral feet evenly spread pressure across your foot and heel.

What is a neutral gait?

If you have neutral gait it means that you have perfect biomechanical function in your feet, legs and body. For example, your feet pronate and absorbs just about all shock when your foot hits the ground, and then supinate to create a lever for your foot to push-off.

If you examine your shoes and see that the wear on the soles of them is evenly distributed on them this can mean that you have neutral feet and gait.

Is a neutral gait good?

Having neutral feet can really help to improve your overall body alignment and reduce strain on the feet, ankles, knees and hips helping to reduce the risk of injury. Even if you have neutral feet and currently do not have any discomfort or problems with them you still have to look after your feet!

With time your foot type can easily change and you can go from having perfect neutral feet to having supinated or over pronated feet because of a number of things such as aging, weight gain or even through persistent shock and strain to feet through sport activities. Keeping your feet supported and minimizing shocks to the feet can help your feet stay healthy especially if you are an athlete or a runner!

If you have neutral feet and want to wear insoles to keep them healthy it is best to make sure that you do not wear insoles that are ill-fitted, have weak arch support, alters your gait or are too hard.

Our anatomy will tend to adapt to just about any gait so it really doesn’t matter if you have supinated, over-pronated or neutral feet because at the end of the day what really matter is if your gait is compensating for something in unhealthy and unbalanced way and is causing you discomfort or injury.

Medial Arch

Whenever a portraitist discusses the arch of the feet, more often than not they are talking about the medial longitudinal arch, which supports the main arch structure of your foot and stretches from the the heel of the foot to ball of foot, medial longitudinal arch is designed to is to absorb shock and spread body weight.
If you have low, High or collapsed arches then this can reduce the foot ability to properly shock absorption and from properly spreading weight evenly across your foot.
Typically Low or collapsed arches tend to be connected with over pronation, whereas having high arches is more commonly linked to over under-pronation (supination).
But it must be said that you may still develop over pronation even if you have high arches and you can still have under pronation even if you have low arches.

Transverse Arch

Sometimes podiatrists may talk about the transverse arch. This arch found in your foot spans perpendicular to your medial longitudinal arch along the mid-foot.

Injury to this arch will affect the forefoot and cause injuries such as hammertoe, bunions, pins and needles and will cause Pain which often will get worse with the flattening of the transverse arch. By supporting the transverse arch and increasing room around the arch can help to improve blood flow to nerves and blood vessels in the mid-foot and help ease these problems.


In your feet you have 26 different bones, 33 different joints, and more than 100 different ligaments and muscles and make up the supporting foundations of the rest of your body and so put under immenese pressure and stress making it very easy to injure your feet!

Plantar fasciitis

Amongst all of the foot injuries you can get plantar fasciitis is by far the most common. Plantar fasciitis will mostly affect individuals who damage the arch of their feet whilst running, forget to properly stretch their Achilles heel before training, or simply overdo things.

Plantar fasciitis is when the plantar fascia which is a stretchy ligament that spans the length of your foot and connects your heel to your toes becomes torn. This tearing generally happens where the plantar fascia connects to the heel bone where pressure tend to build up the most, causing inflammation around the heel and arch of the foot. Due to the fact blood supply around the plantar fascia means that if tearing does occur it will take time for your body to full heal the torn plantar fascia. If pressure on the heel is what is causing your plantar fasciitis you might find that heel spurs could start to develop on your heel. Heel spurs which are small calcium growths that form on the side of your heel. Heel spurs develop as a response from your body to try to combat the pressure on your heel and stop it from further damaging you heel bone. Heel spurs are not painful, however if you have plantar fasciitis these spurs can cause aggravate the plantar fascia further.

Plantar fasciitis is caused by tears on plantar fascia which supports the arch of your foot and connects the heel and toes. Plantar fasciitis is most common in athletes as well as the elderly, individuals who are overweight who are overweight or those that spend long periods of time standing or on hard surfaces.

Foot and heel pain that is a result of having plantar fasciitis will usually worsen slowly over time, and is often most severe when you are taking your first steps of the day in the morning.

Causes of plantar fasciitis in soccer players

There are a number of different reason why a soccer player might get plantar fasciitis. All of the following things can cause cause extra strain on the arches of the feet that can over time cause micro tears to develop on the plantar fascia:

  • Over pronation (your foot to roll inwards excessively ) when walking or running.
  • You have high arches or flat feet.
  • Running on hard surfaces
  • Not properly stretching out the plantar fascia and lower legs before training.
  • Athletes and runners that wear improper running shoes shoes that do not correctly support their arches or push the feet into a position that is unnatural.
  • Being overweight (obesity places abnormal load on your arches that your feet are unable to support.)
  • Having a tight Achilles heel (because your Achilles heel is attached to the plantar fascia mean that if your Achilles is tight it will also pull back your plantar fascia and make that tight as well.)
  • Having Weakness in the muscles of foot (could mean that your feet are unable to properly support your arches).

Plantar fasciitis is caused by tears on plantar fascia which supports the arch of your foot and connects the heel and toes. Plantar fasciitis is most common in athletes as well as the elderly, individuals who are overweight who or those that spend long periods of time standing on hard surfaces.

Foot and heel pain that is a result of having plantar fasciitis will usually worsen slowly over time, and is often most severe when you are taking your first steps of the day in the morning.

Achilles tendinitis

The Achilles tendon is the biggest and strongest tendon that you will find in your body. The Achilles tendons connects your heel to your calf. The Achilles heel is designed to help propel your leg forward when running, much like your plantar fascia, the Achilles tendon may inflame if it is over stretched or strained, when this happens it means that you have Achilles tendinitis.

The foot plays a vital role in a number of different things such as:

  • Helping to absorb shock whilst we walk, run or jump
  • Provide support to the rest of our bodies
  • Giving us a stable platform for us to push off and propel ourselves forward when we walk.

The majority of the muscles, ligaments and bones found in your foot and help to control the way your foot moves are connected to other important muscles and bones in your leg such as the tibia and fibula bones. If stress and pressure is put on your feet this can trigger instabilities and imbalances in your legs as well, creating biomechanical problems. When biomechanical problems occur, it could cause considerable pain and restrict movement in your feet and legs.

Other Achilles tendon injuries

Pain and stiffness located on the back of your heel might be caused by Achilles tendinopathy.

The pain can generally be treated through rest, applying an ice pack to the back of the heel and taking painkillers. However it should be mentioned that Achilles tendinopathy can often take many months to fully heal. Wearing a supportive ankle support that uses compression technology to promote blood flow to the heel area can be used to speed up the healing process.

Should you hear a “snapping sound” along with a sharp and serious pain on the back of your heel, then you might have torn your Achilles tendon.

It is best to seek out medical guidance immediately if you believe that you might have torn your Achilles tendon. Generally a torn Achilles tendon will be treated with wearing a plaster cast for a month or two to restrict movement in your Achilles for it to properly heal. In some cases Surgery might be needed.

Turf Toe

Turf toe is an injury that affects the big toe and develops due to persistent hyperextension of the big toe. Turf toe is often found in individuals that wear very flexible shoes or participate in sports which require repeated, forced hyperextension of the big toe such as jumping.

If you have turf toe you will often feel pain and tenderness around big toe, pain is usually worse when moving, pushing off or putting weight onto the big toe. Usually, doctors when diagnosing turf toe will require patients to have an x ray just to make sure that you do not have a fracture. To treat turf toe it is more often than not rest and applying ice to the affected area that will help he most. You can also use kinesiology tape that will help to control movement, promote blood flow through compression and support the big toe aiding the healing process and preventing further damage to the big toe.


A bunion is when you have a bony growth on your big toe which may be painful while wearing shoes and can more often than not make walking more difficult.

Bunions are really quite common, especially in women. Bunions are usually caused when the big toe pushed unnaturally towards the other toes causing the big toe joint to stick out. Usually the big toe is pushed inwards like this because of over pronation (Over pronation will often mean that when your as you walk your big toe will be used to push your feet off the ground instead of using your ball of the foot resulting in increased pressure and stress on the big toe) or from wearing shoes that are too narrow and do not fit properly.

Bunions can result in pain and tenderness around the big toe, bunions usually get worse if you wear shoes that have a toe box which is narrow or pointed.
Bunions could possibly get more serious if the bunion is not treated properly. If you have a bunion it is always best to see your doctor or podiatrist for advice.
To treat bunions you should apply ice onto the affected big tos to reduce inflammation as well as resting your feet to allow your feet time to heal. It is also a good idea to wear shoes that have a wider toe box. Bunion pads can also be used, bunion pads are placed onto the big toe and help prevent shock and pressure from further damaging the bunion.

Stress Fractures

A stress fracture can develop around the metatarsal area and are very common amongst soccer players and athletes. Stress fractures can be caused by persistent shocks to the bones of the feet. Having a poor diet can also cause stress fractures as a poor diet can effect bone regeneration. You will find two different types of bone cells which are used for bone regeneration. One group of bone cells will help to break bone down old bone whilst the other type of bone cells will help grow new bone. If the balance between these two different bone cells is upset, the amount of break down can overtake the rate of new bone growth causing the bones to become weak.

Stress fractures are most commonly found within the second and third toes.

If you have a stress fracture you will likely feel pain and tenderness around the metatarsal bones and have mild swelling around this area. Applying weight to the fractured area is often very painful painful. Usually x rays cannot detect stress fractures initially because of how small stress fractures are. Rest and decreasing shocks and pressure to the area with the stress fracture is best way at treating them.


Sprains and strains in the feet are a very prevalent in soccer and can lead to permanent damage to the muscles and ligaments in your feet and lower limbs. Sprains generally happen if you quickly change direction, fall and land wrongly on your foot, or your foot collides with something, for example when making a tackle in soccer.

A sprain is a result of your ligaments either twisting or stretching too much and becoming torn. Whilst strains result when your muscles have twisted or have been overstretched.

If you have a sprain or have strained your feet you will often encounter pain as well as swelling, and bruising where you have the injury, you also may not be able to walk or put any weight on the affected foot.

Sprains usually through resting of the feet will often heal with time.


Gout is a form of arthritis that is due to the accumulation of uric acid inside your joints. Gout can result in intense pain, swelling in the joint.

Gout will usually affect a joint for several days before going away and in the majority of cases affects the big toe joint. Gout is often very tricky to diagnose and can be misdiagnosed as being a severely inflamed bunion.

You can treat gout by applying ice to the affected area as well as taking anti-inflammatory drugs to reduce inflammation. It is also recommended to wear shoes that have plenty of room and support the feet properly to avoid pressure worseing the gout.


Verrucas are painful growths which can occur on the bottom of the feet.

Verrucas resemble little, flat white circles on the surface of the skin with a black dot in the middle.

The majority of verrucas usually gradually go away on their own over time. You can speed the healing of a verrucas by using special verruca creams, gels which can help. verrucas plasters can
also be used to protect the verrucas and prevent damage from making it worse.

Blisters, corns and calluses

If you wear poorly fitted loose shoes that cause your feet to move around in your shoes and rub against your shoes you may find that Blisters, corns and calluses form:

Blisters are small pockets of skin filled with fluid. Blisters usually form when the layers of your skin separate and become filled with fluid
corns and calluses is hard skin that forms to protect parts of your foot from damage and pressure. calluses are often yellowish in appearance.

Formation of blisters, corns and calluses might lead to pain and discomfort when walking.
The majority of blisters go away with time and shouldn’t call for medical attention. Putting on well-fitting shoes and heel grips to stop your feet from moving around and rubbing against your shoes can help to prevent blisters.

Corns and calluses usually don’t go away on their own and you might have to see a podiatrist to find out what is causing them and how best to get rid of them..

Morton’s neuroma

Morton’s neuroma is a problem which impacts the nerves in between the toes.

Fibrous tissue grows close to the nerve, that can become inflamed and compacted, which can result in extreme pain along the ball of the foot and around the toes.

Morton’s neuroma may develop on either one or both of your feet. Morton’s neuroma more often than not affects the nerve found around the third and fourth toes, however in some cases the nerves around the second and third toes can also become afflicted.

If you have Morton’s neuroma, it may help to wear shoes with more room for the toes. You can also take painkillers or have steroid injections to help ease the pain. If these treatments don’t work, surgery may be needed.


Metatarsalgia is very common amongst soccer players and is often diagnosed when you have pain in the front of your foot which gets worse when walking. Metatarsalgia can be cause
d by a number of different causes such as:

wearing poorly fitted shoes should be avoided as these sort of shoes will often push the ball of the foot into a unnatural position place the metatarsal bones under more pressure than they should be under
high-impact sports – sports such as soccer or rugby can also put the metatarsal bone sunder persistent shock and pressure which they may not be able to cope with.
Obesity can flatten the arch of the foot and place extra pressure on the metatarsal bones as a result
Having biomechanical imbalance such as having flat feet or high arches can place more pressure on the metatarsal bones and raise the likelihood of you developing metatarsalgia.
Suffering from joint and foot conditions – such as bunions and heel spurs can cause your shoes to become tighter than normal.
Ageing can also weaken the metatarsal bones making them more susceptible to pressure and shock

If you have this condition then anything which places additional strain or pressure on the ball of your foot should be avoided- such as, wearing shoes that are too tight or playing high impact sports.

Almost all metatarsalgia cases can be treated using what is known as PRICE which stands for protection, rest, ice, compression and elevation, also making sure that you wear shoes and insoles that have shock absorption and correct pronation of the feet can all help. You can also buy metatarsal pads which are designed to protect and support the metatarsal bone sand stop the injury from worsening.


Arthritis is very common amongst the elderly. osteoarthritis makes up the majority of cases of arthritis. osteoarthritis is caused by long-term wear and tear of the joints and can cause severe inflammation around the affected joint in the feet. If you notice frequent periods of foot pain and stiffness this might be a sign of a rapid deterioration of your joint caused by osteoarthritis.

Arthritis can be helped through putting on appropriate shoes to that help to prevent strain on your joints, insoles should also be worn to support your feet and to help absorb shock and spread pressure away from the arthritic joint to prevent further wear and tear. Individuals with arthritis may also take anti-inflammatory drugs to help ease the swelling and inflammation around the joint.

rheumatoid arthritis is a much less common form of arthritis found in the feet and is a result of the immune system destroying and inflaming the joints . rheumatoid arthritis will not just affect one joint but will affect joints through out your body, so if you have rheumatoid arthritis then foot pain will most likely not be the only symptom that you will have.


If you have any of the above foot injuries then it is best to seek advice from a medical professional.

Something else that you should consider doing is changing the insoles in your feet for a pair of orthotic instead!
Orthotic insoles are orthopaedic shoe inserts that are created using light-weight materials and are available in a variety of different shapes and sizes to suit different foot types and conditions.

Orthotics insoles are really good at helping to correct underling biomechanical issues that could be causing foot injuries. If you have a foot injury orthotic insoles will help you to regain your flexibility stability and foot function and help you to get back on your feet walking, running and jumping again by minimizing pain and reducing swelling.

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