As we discussed in this previous blog article, the feet and ankles play a significant role in keeping us active. So acute injuries or chronic conditions can greatly impact our ability to play sports, participate in outdoor activities, or keep up with our fitness regimens.

Our new orthopedic foot and ankle surgeon, Dr. Gregory Kirwan, provides an overview of three foot and ankle conditions that are common in active adults.

Achilles Tendon Injuries

Achilles tendon injuries can be characterized as acute or chronic. Acute injuries include Achilles tendon strains, partial tears, or acute ruptures. These types of injuries typically occur during strenuous physical activities or sports-related movements, especially sports that require a lot of jumping, pivoting, or cutting such as tennis, racquetball, and basketball. Certain occupations that require strenuous pushing or pulling could also cause an acute rupture.

Signs of an acute Achilles tendon rupture include:

  • Sudden and sharp severe pain in the back of the ankle or calf that may feel like you’ve been hit by a rock or kicked in the back of the leg
  • Hearing an audible “pop”
  • Feeling a tearing sensation
  • Swelling
  • Bruising
  • Difficulty walking and/or pointing the toes

One of the most important factors in treating an Achilles tendon rupture is being evaluated as soon as possible by an orthopedic physician. Early treatment can lead to better outcomes. Typically, all that’s needed to diagnose an Achilles tendon rupture is a physical evaluation of the injury by an orthopedic physician. Treatment can be nonsurgical using a cast and remov

able boot or a

surgical repair of the tendon may be recommended.

Chronic Achilles tendon conditions include tendinitis or tendinopathy. These result in pain, swelling, and sometimes a burning sensation around the Achilles, often after repetitive physical activity. People with these chronic conditions may also feel a nodule in the Achilles tendon that is painful to the touch or when stretched in certain positions.

Chronic Ankle Instability

On the outside of your ankle there are three major ligaments (highlighted in yellow above), which are usually the ligaments injured in a common ankle sprain. Treatment for an ankle sprain typcially includes a short period of immobilization and R.I.C.E. (rest, ice, compression, and elevation). Once the pain and swelling have improved, gentle range of motion exercises are started.

Two of the main causes of ongoing ankle pain or chronic instability are not properly rehabbing a sprain and suffering from multiple sprains. Therefore, it’s important to have ankle injuries evaluated by an orthopedic physician and to complete any recommended formal physical therapy programs. If chronic ankle instability does develop, it can often be treated through physical therapy. If conservative treatments don’t alleviate symptoms, surgery can be an option to repair the damaged ligaments.

Bunion and Hammertoe Deformitites

Forefoot deformities, such as bunions or hammertoe, affect the alignment or position of the toe joints or toes themselves. Hallux valgus – the technical term for a bunion – is when the first toe is misaligned so that it points in the direction of the smaller toes. Usually a bump is present on the inside of the foot at the base of the big toe joint. The bump doesn’t actually grow, but it can become more prominent as the toe alignment gets worse. The bump can cause significant pain and problems with shoe wear. Hammertoe deformity of the smaller toes often develops with a bunion.



Non-operative treatments for forefoot deformities:

  • Shoe modification
  • Activity modification
  • Occassionaly, anti-inflammatories

It is not recommended to surgically treat forefoot deformitites just for cosmetic reasons. Surgery can be an option if the condition causes significant pain or irritation that leads to other forefoot deformities, wounds, or ulcers. Recovery from a bunion repair surgery usually requires a two-week period of non-weight bearing followed by a period of limited weight bearing using a protective post-op shoe or boot. Normal activities are usually allowed by about eight weeks after surgery with a return to light exercise by 12 weeks.




 Dr. Kirwan is now seeing patients! Call 920-430-8113 to make an appointment.