Foot & Ankle Injuries / Pain

Foot & Ankle Injuries: Preventing Injuries & Getting You Better Fast!

 

Many, if not most people will experience a foot or ankle pain in their lifetime. The difference between getting your life back and being stuck immobile can be based on the type of care you get and how fast you get it.

 

we always say, no injury is better than any other kind of injury, which is why preventative education is important. However, accidents happen and you need to understand how your recovery plan will get you back to your normal life as quickly and painlessly as possible.

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 A. Causes of Foot & Ankle Injuries:

 

There are many different causes of foot or ankle injuries. Some of the most common causes include ill-fitting shoes, falling, or a sports injury.

 

We see these injuries every day.

 

Injuries are often overlooked while some think it will get better with time, it almost never does! It's important to utilize technology, such as X-rays or ultrasound to diagnose the problem so doctors can devise an effective treatment plan. 

B. Common Foot & Ankle Injuries:

i. Achilles Tendonitis

 The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. It is also the most frequently ruptured tendon.

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Events that can cause Achilles tendinitis may include:

  • Hill running or stair climbing.
     

  • Overuse resulting from the natural lack of flexibility in the calf muscles.
     

  • Rapidly increasing mileage or speed.
     

  • Starting up too quickly after a layoff - Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.

 

Symptoms of Achilles Tendonitis - Achilles tendinitis often begins with mild pain after exercise or running that gradually worsens. 

  • Recurring localized pain, sometimes severe, along the tendon during or a few hours after running.
     

  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.

  • Mild or severe swelling.
     

  • Stiffness that generally diminishes as the tendon warms up with use.

Treatment for Achilles Tendonitis includes:

  • A bandage specifically designed to restrict motion of the tendon.
     

  • Non-steroidal anti-inflammatory medication.
     

  • Orthotics- devices to help support the muscle and relieve stress on the tendon
     

  • Rest, and switching to another exercise, such as swimming, that does not stress the tendon.
     

  • Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors.

  • In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.

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 ii. Posterior Tibial Tendonitis

 

Tendonitis in the foot is a common problem because we use our feet continuously. It is a common example of an overuse injury. One of the most frequently affected tendons is the posterior tibial tendon, a structure that is normally hard at work, helping to hold the arch up and prevent over-pronation or rolling in of the foot. This is a major cause of adult flat foot.

The posterior tibial tendon (below) runs behind the inside bump on the ankle (the medial malleolus), across the instep, and attaches to the bottom of the foot.

The symptoms of tendonitis of the posterior tibial tendon include pain (below) in the instep area of the foot and swelling along the course of the tendon. The patient may also experience pain and swelling right behind the inner ankle bone. There is pain upon palpation along the course of the posterior tibial tendon behind the inner ankle.

 

There may also be burning, shooting, tingling, stabbing pain, because the nerve is inflamed inside the tarsal tunnel. Patients experience significant pain when walking, steadily worsening toward the end of the day. There is significant pain when the patient inverts his/her foot, as well as pain upon passive stretching of the posterior tibial tendon, and on eversion or flattening of the foot.

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Signs and symptoms of posterior tibial tendon dysfunction include:

  • Gradually developing pain on the outer side of the ankle or foot.

  • Loss of the arch and the development of a flatfoot.

  • Pain and swelling on the inside of the ankle.

  • Tenderness over the midfoot, especially when under stress during activity.

  • Weakness and an inability to stand on the toes.


In some cases, the tendon may actually rupture or tear, due to weakening of the tendon by the inflammatory process. Rupture of the tendon leads to a fairly pronounced flatfoot deformity that is easily recognizable.

iii. Ankle Sprains

More than 25,000 people sprain their ankles every day. Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on the outside of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems.

An ankle sprain is a common injury and usually results when the ankle is twisted, or inverted. The term "sprain" signifies injury (below) to the soft tissues, usually the ligaments, of the ankle. 

How Do You Know It's an Ankle Sprain and Not Broken?

The diagnosis of an ankle sprain is usually made by examination of the ankle and x-rays to make sure that there is no fracture of the ankle. If there is a complete rupture of the ligaments suspected, your doctor may order stress x-rays (below) as well. These x-rays are taken while someone twists or "stresses" the ligaments.     

  

Treatment for an Ankle Sprain - The treatment for ankle sprains depends on the severity of the case. usually treatment will begin with RICE-rest, ice, compression, elevation. It is never recommended to try to walk on a sprained ankle, even if it not confirmed. Depending on the severity of the sprain, your doctor may recommend a CAM walker or crutches.
· Elevation will help control the swelling
· Gentle compression and ice will control swelling
· Mild pain relievers will help with the pain
· Crutches and braces to limit or prevent weight bearing

Should I Wear a Cast? Casts have fallen out of favor, and as treatment progresses, early weight bearing has been shown to be beneficial. Braces that can be worn to support the ankle - but still allow weight bearing are the most popular treatment method today. Healing of the ligaments usually takes about 6 weeks. The swelling may be present for several months. A physical therapist may be suggested to help you regain full function of your injured ankle.

If conservative treatment does correct the ankle, surgery may be suggested to completely heal the ankle. Your podiatrist will be able to determine the correct treatment for your situation.

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 iv. Fractures:

 

Nearly one-fourth of all the bones in your body is in your feet. A broken (fractured) bone in your forefoot or in one of your toes is often painful but rarely disabling. Most of the time, these injuries heal without operative treatment. Types of fractures include stress fractures and general bone fractures.

Common Foot Fractures:

1. Stress Fractures: Stress fractures frequently occur in the bones of the forefoot extending from your toes to the middle of your foot. Stress fractures are like tiny cracks in the bone surface. They can occur with sudden increases in training (such as running or walking for longer distances or times), improper training techniques or changes in training surfaces.

2. Foot Fractures: Most other types of fractures extend through the bones in the foot or toes. These fractures usually result from trauma, such as dropping a heavy object on your foot, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. Several types of fractures occur to the forefoot bone on the side of the little toe (fifth metatarsal).

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Ankle Fractures: 

 

An ankle-twisting injury may tear the tendon that attaches to this bone and pull a small piece of the bone away. A more serious injury in the same area is a Jones fracture, which occurs near the base of the bone and disrupting the blood supply to the bone. This injury may take longer to heal or require surgery. Symptoms include pain, swelling, and sometimes bruising.
 

Treating Foot & Ankle Injuries:
 

There are many different treatment options available for foot and ankle injuries. Our office will devise a custom treatment plan based on your specific injury and lifestyle. We have a wide array of technologies to help get you better, faster. We believe in treating most injuries conservatively before we will recommend more invasive options.