HEALTH & FITNESS
Fracture of the Talus Commonly Missed
By Marc R. Rizzardo B.Sc. P.T., M.P.E., B.P.E., Dip. Sports Physio
Chief Therapist 2007 Pan Am Canadian Medical Team
Metrotown Orthopedic & Sports Physiotherapy Clinic, Burnaby, BC (www.metrotownphysio.com)
A very common injury in soccer players that is routinely missed is a fracture to the talus, a bone in the foot.
The talus forms part of the talu-crual joint, which allows the foot to dorsiflex and plantarflex (go up and down). Typically what happens in soccer is that the player sprains his/her ankle. It is treated like a simple sprain, where one or more of the ligaments that support the ankle are stretched.
However, the player continues to experience a significant amount of pain in the front part of the ankle, where the foot moves up and down. The player also notices that the foot does not dorsiflex as far as it is necessary. Running is a problem, doing any type of landing after jumping is a problem, and simply doing stairs is a problem.
Treatment
If the talus has moved and it can be manipulated back into position, this clears the problem.
Continue flexibility, strength, and cross training exercises. For example, cycling, walking (once pain free), rowing, swimming, stair climbing, pool running (only if it's not a navicular stress fracture).However, if the pain persists, a bone scan and a CT Scan will be required to rule out a talar dome fracture. If this is confirmed, then surgery is required to correct the problem.
Proper rehabilitation is strongly recommended for any sprained ankle so that the therapist can determine if the talus or any other foot bone is aligned properly.
Rehabilitation is crucial following talar dome surgery so that the player can get full active range of motion, restore normal strength to all the muscles that surround the ankle, and improve the proprioception of the ankle.
