Common Lower Extremity Injuries in Football

Published: Friday, November 20, 2020

Football season is in full swing, and we are seeing the usual onslaught of injuries common to this sport. Most injuries that occur in football are simple contusions and abrasions, but sometimes more severe injuries do occur. Many of these injuries are to the lower extremities caused during running, cutting, tackling, blocking and jumping involved in the sport. 

Hip Pointer 

A common injury to the hip is a hip pointer. This is caused by a blow to the outside of the hip. Some players experience this injury because of hip pads that are either worn too low or not worn at all. 

In a hip pointer, there is a contusion of the overlying muscle and a collection of blood around the edge of the pelvis bone. The player experiences severe pain and tenderness directly over the iliac crest on the side of the pelvis. There is pain with all movement, especially bending the torso to the side away from the injury. 

Radiographs are taken to rule out a fracture. Treatment includes rest and application of ice. A compression wrap applied to the area may limit swelling. When the athlete returns to contact sports, the area may need to be padded to prevent re-injury.  

MCL Sprain 

Another common injury in football players is a sprained medial collateral ligament (MCL) which is on the inner side of the knee. This injury usually occurs when a player’s foot is planted, and the outside of the knee receives a direct blow. There may be a pop in the knee at the time of injury.

Symptoms include pain on the inner side of the knee. There may be swelling and giving out of the knee. Radiographs are obtained to rule out a fracture.

In players who are still growing, it is especially important to rule out a fracture of the distal femur or thigh bone since ligaments are more resistant to tension stress than the growth plate of the femur. 

Treatment of an MCL sprain is usually nonsurgical. Icing and elevation can limit swelling. Wearing a brace and using crutches help with healing. A rehabilitation program should be started within a few days.  

Ankle Sprain 

The most common type of sprain in football is a sprain of the ankle. The most frequent way that an ankle sprain occurs is when the ankle rolls in and the ligaments on the outside of the ankle are damaged. Ankle sprains often occur when landing from a jump or when stepping on someone else’s foot. 

After a sprain, the ankle becomes swollen and tender to touch. There is usually stiffness and pain with movement. Radiographs to rule out fractures are usually obtained, especially if there is significant pain with weight bearing. Ankle sprains result in weakness of the ankle due to damage to both the ligaments and the muscles around the joint.

Treatment of ankle sprains starts with RICE: Rest, Icing, Compression, and Elevation.  This helps to limit the swelling in the joint and to hasten recovery from the injury.  Proper rehabilitation is the key to successful management.  Range of motion exercises should be started after a few days in most cases. Later, strengthening and balance exercises should be performed. 

During the recovery process, the ankle should have support with a brace.  Severe sprains may require immobilization in a cast or walker boot for a few weeks.  

Return to Play 

Determination of when an athlete can safely return to play is not based on a certain length of time since injuries can be of different severity. Return to play is allowed when the athlete has healed enough to play without causing damage. 

When the athlete has full pain-free motion of the joint, and is able to run, cut, and perform the activities of the sport without pain, then return to play is appropriate. 


About Sports Medicine

Specialized in treating sports-related injuries, our Sports Medicine team is dedicated to helping athletes return to the big game and the active lifestyle they know and love.

Dr. Primos will treat patients of all ages. He specializes in concussion management, elbow injuries, foot and ankle injuries, hand and wrist injuries, knee injuries, shoulder injuries and ultrasound guided injections.