With only 1 more week of games to be played before the AFL finals series, now more than ever, the health of your team’s list is vital. Often team’s with the best availability in terms of personnel tend to fare better in the finals series, rather than those limping over the finish line.
Returning from injury is always a challenging scenario for both the players, coaches and the medical staff. Rush a player back too early, they run the risk of further injury, or playing underdone without adequate match fitness. But hold them out too long, and their absence may detriment the team’s dynamic.
As we look forward to an exciting finals series (regardless of what state the games will be played in) let’s take a look at some of the foot injuries to key players for some of the contending teams.
GEELONG- TOM STEWART- LISFRANC INJURY
Last week, Geelong defender Tom Stewart injured his foot in a training drill. Reports have said he will undergo surgery on Monday for a Lisfranc injury and has a slim hope of returning to play before the end of the finals series.
The Lisfranc (midfoot) injury results when the bones of the midfoot are broken or the ligaments that support the midfoot are torn. Trauma to this area results in a fracture/dislocation between the small bones that form the midfoot region. Often this injury is sustained with a twist and fall motion, especially if the foot is flexed downwards at the point of impact/falling.
Symptoms may include pain and swelling (especially at the top of the foot), bruising (particularly visible on the sole of the foot) and pain that worsens with walking, standing or when trying to propel (push off) the injured foot.
Treatment for a lisfranc injury may include-
- Immobilisation (crutches and/or Moon Boot) for a period of about 4-6 weeks
- Oral medications such as ibuprofen may benefit to reduce pain and inflammation.
- Rehabilitation is required to build up the strength of the foot.
- Changes to casual and sports footwear to ensure appropriate support for the feet
- Orthotic devices to support and align the foot and help to prevent further injury
- Surgery- to repair the injured ligament and stabilise the joint.
GREATER WESTERN SYDNEY- STEPHEN CONIGLIO- TOE
GWS Captain Stephen Coniglio is currently sidelined with an injury to his big toe. Coniglio injured his ankle and big toe earlier this year, and has undergone surgery for both. He returned to play in July but reported soreness in the big toe area, and has since been kept sidelined. Medical reports say that Coniglio had a torn medial ligament of the big toe, which is also commonly referred to as “Turf toe”.
Turf toe is when the big toe joint is forcibly bent up into hyperextension and the ligament of the big toe joint is strained or torn.
Symptoms may include: pain, swelling and difficulty moving the big toe with a feeling of the big toe being unstable. Our big toe plays such an important role in stabilizing our entire foot and helping us push (propel) forward. Without good strength and mobility through the big toe joint, you won’t be able to run or jump with any force or speed.
Treatment for Turf toe may include:
- Rest, Ice, Compression and elevation (RICE)
- Turf toe Taping techniques
- Oral medications to aid in pain relief and inflammation
- Immobilisation of the big toe- using a moon boot, or specialised insert into the shoe to limit movement of the big toe.
- Footwear changes: such as utilising rocker sole footwear to reduce load through the big toe when walking
- Orthotic devices to minimise loading through the big toe joint
- Rehabilitation to restore movement and strength to the foot and toe
- Surgery to repair the torn ligament and to restore joint motion.
SYDNEY- CALLUM MILLS- ACHILLES
Sydney Swans midfielder Callum Mills has been nursing an Achilles injury for the majority of the season. He has recently missed the last few games for the Swans as they look to secure their position in the top 8.
Most injuries require a period of rest for the player to recover and return to play, however Mills’ Achilles tendonitis is a particular injury which actually gets worse with prolonged rest. The Achilles tendon is a thick band of tissue that connects your calf muscle to your heel bone. Tendonitis is when the tendon becomes degenerated, inflamed and/or torn when it is subjected to overload. Tendons do not like prolonged rest, and research has shown that to effectively treat tendon problems, you need to progressively load them as part of their management. Effectively, you need to build up the tendon’s tolerance to load to avoid it breaking down again. If you rest it, it will weaken and get worse.
Mills was one of the Swans players who had to be pulled out of the Swans vs GWS game a few weeks ago as they were exposed to a Covid-19 hotspot and were required to isolate for 14 days. As a result he missed 2 weeks of training, which meant he wasn’t able to get the load through the tendon that was required to continue rehabilitation. This rest period, has unfortunately set the injury backwards in terms of it’s recovery, hence why he has missed a few games of late.
Symptoms of Achilles tendonitis include:
Pain at the back of the heel or lower leg which may increase with running, jumping, stairs or hills. Stiffness in the back of the ankle, especially in the morning, with swelling and thickening of the tendon is also possible.
Treatment for Achilles tendinitis may include
- Load management- reducing the load on the tendon (but not complete rest)
- Oral medications to reduce pain and inflammation
- Shockwave therapy
- Footwear changes and modifications
- Orthotic devices to decrease the overload that may be occurring in the tendon due to biomechanical abnormalities.
- Injection therapy (such as Cortisone or PRP)
- Strengthening and loading program
- Surgery for severe cases
Whilst we often hear more about AFL players’ soft tissue injuries (the Calf and Hamstring are prime examples), the foot when combined with the ankle is the most common body part where injury is sustained within the AFL playing group.
Podiatry has a significant role in not only injury management within the AFL, but more importantly injury prevention. Pre-season biomechanical screening and correct footwear prescription are just some of the ways Podiatrists are involved within elite sporting teams. Many AFL players would also utilise orthotic devices (shoe inserts) as a way to reduce their injury risk and improve performance.
This same rule should apply across all levels of sport, not just at the elite level. At Sole Podiatry, we are passionate about sport and keeping people of all ages active. We can assist with any foot and/or ankle injury management, as well as pre-screening/biomechanical assessments for any potential injury risks.