Ultrasound-Guided Therapy for Soccer Players

Soccer players with posterior ankle impingement can return to athletic activity quickly with the use of a sonographically guided injection of steroids and an anesthetic, according to a recent study.

The study, conducted at Leeds Teaching Hospitals (Leeds, UK), consisted of 10 professional soccer players between the ages of 22-30, with no previous posterior ankle pain who underwent magnetic resonance imaging (MRI) and ultrasound-guided injection for clinical posterior impingement.

According to the study, in spite of rehabilitation with resolution of anterior and lateral symptoms after an initial inversion injury, all players developed posterior pain that was resistant to conservative therapy three to four weeks after the precipitating injury. The pain limited the athletes' ability to sprint and hit the soccer ball and prevented them from returning to competition.

"In our practice, we see many professional athletes with this condition, and we found that the majority of them were showing excellent response to this treatment,” said Philip Robinson, M.D., and lead author of the study. "We decided to analyze the imaging features and injection results more rigorously for publication.”

All players underwent MRI scanning of the ankle after clinical examination by a foot and ankle surgeon. The ultrasound-guided injection was then performed into the posterior capsule abnormality. Posterolateal capsule thickening and synovitis involving an intact posterior talofibular ligament (ligament located in the back of the foot) were present in all 10 patients.

According to the study, all players tolerated the injection procedure with no immediate or delayed complications. All patients observed a striking decrease in symptoms and stiffness immediately after the injection of bupivacaine (an anesthetic). "For patients, the results of this study mean that they should have a faster recovery time and may not require arthroscopy. It also demonstrates that ankle impingement syndromes which appear predominately soft tissue based can respond to image guided injection treatment,” said Dr. Robinson.

The study was published in the July 2006 issue of the American Journal of Roentgenology.



Related Links:
Leeds Teaching Hospitals