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Foot & Ankle Sports Injuries in Teenagers – Alex’s Story

We look at understanding the significance of sports injuries in young people – read more about Alex, an 18-year-old keen amateur footballer.

A write-up originally from Nuffield Health about Mark’s care of Alex North 

For budding young athletes who get injured whilst participating in sports activities, it is important to know when they can get back to full function and how long it might take.

For Alex North, an 18-year-old keen amateur footballer, it was particularly significant; he would have struggled to get back to full function without an intervention from Nuffield Health Leeds Hospital. 

Alex has been playing since he was six years old, and this Sherwood Colliery FC centre forward was no stranger to football injuries. As he progressed from the junior and senior teams, he was prone to suffering from foot and ankle pain.

However, the injury that Alex suffered two years ago was uncommon and unusual, hence he ended up being treated at the Nuffield Health Leeds Hospital.

Although a first team player, Alex had been drafted to play for the reserves and it was during a match he suffered an unfortunate tackle on the inside of his foot. As tackles go, it wasn’t particularly bad, it was the position of the impact, on the inside of his left ankle that caused the unusual injury. 

In pain and with considerable swelling that didn’t seem to subside, Alex’s father, Steve, made an appointment with ex-Mansfield Town FC physiotherapist, Barry Statham.

Steve North says: “Obviously as a football physiotherapist, Barry knew quite a bit about the game and sports injuries, he helped Alex two years prior to this accident when he broke his pelvis.

“Having examined the foot, he initially thought to give it a couple of weeks of treatment and see how it goes but something worried him, and he suggested Alex go to a hospital in Nottingham for an MRI scan. 

“The results showed there was an entire range of issues around the deltoid and spring ligaments that were affecting the stability of Alex’s foot.” 

Although many / most sports injuries in young athletes will heal if treated correctly and generally do not lead to further problems, it was clear in Alex’s situation that an intervention was likely to be needed. 

It was at this point, because of Alex’s previous foot injuries, the North family were advised to meet with Mr Mark Farndon, who had in the past, taught on emergency medical courses for the Football Association and looks after players from many local football teams including Leeds United. 

Nuffield Health Leeds Hospital is also one of very few independent hospitals in the north that can treat children and adolescents and it is easily accessible for patients to travel from across the north and Midlands.

“The unusual thing in Alex’s case was the severity of the injury to the deltoid and spring ligaments, situated on the inside of the ankle.”

“Ankle sprains are very common. When most people hurt their ankle this usually involves injuring the ligaments on the lateral (outer) side and in the vast majority of cases usually settles really well. Nearly everybody in the country will have experienced this type of injury at some stage in their life,” Mr Farndon said. 

“It is relatively uncommon however to injure the deltoid on the inner side of the ankle to the extent that it ruptures. This generally doesn’t need to be treated surgically unless there is a complete rupture. If it extends to involve the spring ligament below, which contributes significantly to stabilising the arch of the foot, patients can develop a flat foot quite quickly if unrecognised / untreated.”

Steve North says: “Mr Farndon was superb. He spent time talking and listening to Alex, gathering information on how the injury occurred, how he had been before the injury and since.”

“This was all before he touched or examined the ankle. He sat for 10 minutes looking intensely at the X-rays not saying anything. He was really focused looking at the absolute detail before he was prepared to say what he thought he should do.”

“It was clear there was too much play and not enough support in Alex’s foot, and it was at this point Mark told me to look at it. As Alex stood up, I could clearly see his left ankle was sagging to one side.”

If Alex were to get back to football as soon as possible then an operation was needed.

Picking up the story, Mr Farndon explains: “Rather than having normal alignment, the foot becomes quite flat very quickly. It is uncommon and in Alex’s case credit must go to Barry, his physiotherapist, that he was worried about the significance of the injury and picked it up quickly. 

“It would be unusual for someone in Alex’s age group for the rupture to be treated without surgery, so we imaged the ankle and the MRI scan confirmed what I suspected.”

The next step was to stress test and examine the injury whilst Alex was asleep under anaesthetic. Mr Farndon put the ankle through its paces on the agreement that if he felt absolutely convinced it was going to be unstable, he would repair it. 

The process proved to be quick and successful. Alex North had his initial consultation in December and the day surgery in January. He then wore a surgical boot for six weeks and by March was playing football again this time for South Normanton FC.

Steve North comments: “What I liked about Mr Farndon was his ability to listen and gather information. His interpersonal skills are immaculate. He chatted with Alex in one way and discussed his findings with me in a separate way. He knew how to communicate at various levels. 

“He put everything in remarkably simple terms so I could understand and get my head around the procedure. He also took a real interest in Alex’s A Level studies and recommended a medical summer school that Alex might attend. 

Alex has now applied to read for a Chemical Engineering degree at Manchester University, and if successful, intends to continue with his football career representing his university. That is amazing and his current projected grades for Maths, Chemistry, and Biology are A, A, and A**.

For the North family, the process was daunting as the country was emerging from lockdown, but they had confidence with Nuffield Health Leeds Hospital because the clarity of information was so good. “We were also impressed with how the medical teams led the surgery during the pandemic. We felt safe and secure. 

“Nothing was rushed, everything was done at our pace. Even the nurse who came into fit him for his crutches and only left when Alex was 100% happy with the fitting. 

Consultants are highly intelligent and brilliant at what they do. However, the ‘soft skills’ are vital and the ability to communicate, show empathy and listen are so important and Mark has these skills in abundance. 

“I was confident in the entire process because of the ability to listen, make connections, empathise, and pitch scenarios at the right level. 

“I would highly recommend Mr Mark Farndon and Nuffield Health Leeds Hospital.”

Contact Mr. Farndon