Ankle pain in soccer players typically occurs after a sprain, which accounts for about 20 percent of injuries to soccer athletes. Pediatricians Chris G. Koutures and Andrew J.M. Gregory reported in the journal “Pediatrics” that ankle injuries are the most common injuries among youth players, accounting for between 16 to 29 percent of injuries. The pain is the body’s way of noting strain to the ligaments of the ankle. Ankle fractures are less common. A study of amateur soccer players in South Africa found two ankle fractures and 37 ankle sprains during a 3½-year period.
The ankle joint consists of the ends of the tibia and fibula, two shin bones, and the talus. A series of ligaments that resemble thick rubber bands hold the bones together. A sprain involves a stretching or partial or complete tearing of the ligaments. The ankle joint allows the toes to point up, in a motion called dorsiflexion, and down, in plantarflexion; the latter is essential for a powerful soccer kick off the laces of the shoe. Below the ankle joint is a ball-and-socket joint that allows inward and outward motion, respectively called inversion and eversion. Most soccer ankle sprains occur when the ankle and foot roll inward, notes.
The prevalence of ankle injuries that result from poor tackling by opponents led FIFA, the international governing body of soccer, to penalize unsafe tackles with an automatic red card and dismissal from the game. Illegal tackles involve contacting the player before the ball and striking the player with a raised upper leg after contacting the ball with the lower leg. Sports medicine researcher Roald Bahr of Norway also suggests that red cards should be considered for late slide tackles. Given the greater chance of ankle injury on wet or uneven ground, the goal area during corner kicks also can create risks for ankle injuries. Bahr suggests that coaches try to warn players to be extra careful during corner-kick practices to avoid injuries.
During powerful soccer kicks, the ankle joint is in a position of full extension or plantarflexion, as if pressing on an accelerator pedal. The borders of the tibia and talus can strike each other in this position, as well as during the full push-off motion of running. Repeated trauma to the joint can cause “footballer’s ankle,” where bony growths develop on the tibia and talus bones within the joint. Surgical removal of bony growths may be necessary.
Pain from a sprained ankle can be managed using the RICE protocol -- rest, ice, compression and elevation. Get the player to the sideline immediately so that he can rest the injury. A coach or parent can help carry the player off the field. Apply ice to the injured area but not directly to the skin; wrap an ice bag in a towel and place it on the ankle. Compress the ankle by using elastic tape, and elevate the ankle above the heart to prevent blood from pooling in the ankle. Mild sprains need overnight treatment, while moderate or severe sprains may require splinting or casts for two to three weeks.