Badminton injuries / Uncategorized

Foot fractures: A guide for badminton players

Hey guys, my apologies for not updating for a while. I’ve been out of badminton since early February with a foot injury. There are 26 bones in the human foot and ankle and over 100 muscles, tendons and ligaments. I’ve fractured one of the bones and torn one of the ligaments. I was initially shy to share the details for fear that I’d write the wrong medical term or identify the incorrect bone. Since then I’ve discussed it that many times with health professionals,  I can narrate it without scrambling for a medical dictionary. So here’s my story…

The story of my foot fracture

On a hot summer night two weeks ago I dragged myself out to play badminton. I was exhausted from teaching and arrived late to the social session. I wasn’t in the mood to play, so no warm-up was needed (I thought).

During the game, I moved around the court to try cover my weaker doubles partner. I served then jumped back to reach the shuttle and collided with him.

I landed on his foot and my left foot inverted. I crashed to the floor and my foot instantly swelled up. I pulled off my shoe and lay there transfixed in pain until ice was brought. I couldn’t walk. After half an hour of icing and elevation, I thanked my friends for their help, hopped in the car and drove home. It was exquisitely tender during the first 24 hours.

Two days later, I saw my GP and had an X-Ray. I was diagnosed with an avulsion fracture of the talus, one of the strongest bones in the mid-foot. It was a Grade III sprain. It probably occurred when I’d jumped back and landed. One of the arms of the calcaneofibular ligament (a Y-shaped ligament attached to the talus) had torn and displaced a tiny piece of bone from the talus.

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The X-Ray of my left foot shows a tiny avulsed fragment above the talus on the right hand side

What are avulsion fractures?

An avulsion fracture is a fracture caused by a tendon or ligament pulling off a tiny piece of bone. Since the tendon or ligament can bear more force than the bone, the bone pulls off instead and a tiny fragment of bone gets displaced. An ankle avulsion fracture shows very similar symptoms to an ankle sprain and it’s hard to tell the difference without an X-ray or MRI scan.

What causes an avulsion fracture?

An avulsion fracture happens when there’s a sudden forceful pull on a muscle, tendon or ligament while the bone is moving in the opposite direction. With mid-foot injuries, when the foot is twisted, a tendon pulls the foot in one direction while the twisting force acts on the foot in the opposite direction.  This causes the bone to crack at the point where the tendon attaches to the bone. This can occur during a traumatic fall, walking on an uneven surface or while playing sports.

Bone healing

The good news is that these fractures almost always heal with rest and time. I didn’t use crutches or a moon boot but I took time off to rest in the first week (Day 1-7). I used RICE (Rest, Ice, Compression and Elevation) to reduce the swelling and bleeding. I took 2 x Voltaren 25 or Panadol Osteo sparingly to manage the pain and inflammation.

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Within the first few days of injury, I was virtually immobilised. I used a conservative treatment involving Rest, Ice, Compression and Elevation.

It’s currently day 13 and the inflammation has gone down, I’m walking with less pain and the purple bruising has virtually disappeared. I’ve regained about 50% normal range of movement and I’m following the rehabilitation plan set by my physiotherapist. My exercises include proprioception and balance exercises, using a theraband for wrist and forearm strengthening, and floor workouts for the core. My physio also recommended activities such as swimming or cycling that avoid putting direct pressure on the foot.

Over the next few weeks, I’m 100% focused on doing what I need to do to support the bone-healing process, which includes proper nutrition and exercise. Maintaining at least some conditioning will hopefully smoothen the transition back into badminton. The plan is in Week 4 I’ll start running again to build up my strength and cardio. In Week 5 I’ll get an X-Ray to confirm whether the bone is mended, then I’ll be able to slowly come back to badminton in week 6, wearing an ankle guard and playing conservatively. It’ll be about just getting back the footwork and timing. That’s the rough plan but we’ll see.

The bad news is that this kind of injury increases the risk of osteoarthritis and increases the risk of serious re-injury if I fall again. The best way to mitigate the risks, my physio advised, is to maintain low body weight, have strong muscles throughout the body, and develop good awareness of the body’s position in space (good proprioception). Unfortunately for me, this will take time as the balance fibres have been destroyed.

Key Points

  • You’re not alone: Sharing your story is a powerful part of healing and will keep you connected with your friends and family. An injury does not make you weak. How you cope and what you learn from the experience shows your strength.
  • Maintain a positive mental outlook:  My self-esteem is on a roller coaster and I feel dismayed at having gained 1-2 kg since last year. I’m dealing with an array of feelings (hurt, frustration and grief). But I know that when I come through this adversity, I’ll be mentally stronger. I’ve caught up with family and friends and I’ve kept in touch with a close group of badminton friends. Sharing is caring.
  • Get it checked out: At the time I was injured, my coach said it wasn’t the worst thing, he’d already sprained his ankle seven times and I’d probably just need four weeks off. My GP also thought it was a sprain but referred me to get an X-Ray just in case. When the physio saw my X-Ray film, he advised this type of mid-foot injury was rare and was amazed that I was walking. Which leads me to my next point… 
  • Prevention is better than cure: Ankle and foot injuries are so common in badminton that many players take a laid-back approach to it. Most sprains heal well but poorly managed avulsion fractures can lead to long-term instability. Treating an avulsion fracture is similar to treating a sprain, but rehabilitation exercises must be chosen to improve proprioception and avoid tearing the soft bone callus.

Conclusion

I mistakenly thought getting injured meant I was a failure. But writing this has given me fresh perspective. The truth is that injuries and accidents happen to even the most well-trained people. I was upset when I was told that it would take 6 weeks to recover. But all things considered, it’s not that long. What matters most now is my long-term health, resilience and making a solid recovery. Hopefully I’ll keep you posted!

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2 thoughts on “Foot fractures: A guide for badminton players

  1. Pingback: Under the spotlight: Sports writing | Sydney Social badminton

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