Foot and Ankle Injuries & Conditions

Considering the average American takes between 5,000 and 10,000 steps a day, a foot or ankle injury can make walking a real pain. Many people don’t realize that foot and ankle injuries run across a broad spectrum can be effectively treated by an orthopedist.

From ankle sprains to bunions, orthopedic treatment can help you put your best foot forward. Learn more about foot and ankle conditions and find treatment options to put the spring back in your step.

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ANKLE SPRAINS

Ankle sprains can happen to anyone at any age. When the ligaments that support the ankle are stretched too far and tear, the result is a sprained ankle. Sprains can be mild or severe, depending on how badly the ligaments have torn.

You should see your doctor if you experience any of the following:

A very swollen ankle
Pain when you walk
Difficulty putting any weight on your ankle

Left untreated, a more severe sprain could weaken your ankle and make it more susceptible to future injuries. With proper treatment and rehabilitation, you also can avoid more serious problems such as chronic ankle pain, arthritis and ongoing instability. By seeking treatment and following doctor’s instructions, most patients can expect a successful outcome for an ankle sprain.

Symptoms

You can’t ignore an ankle sprain. It’s painful and tender to touch. You also may notice swelling, bruising and even instability of the sprained ankle, which happens if the ligament is completely torn or the ankle joint is dislocated.

Treatments

Your treatment plan will depend on the severity of the sprain. The good news is that most ankle sprains can be treated without surgery, even in more severe cases. Treatment includes three phases:

Rest, protect, and reduce swelling
Restore range of motion, strength and flexibility
Perform maintenance exercises to help you gradually return to activities that do not require turning or twisting the ankle.

For minor sprains, treatment may last only two weeks. More severe injuries could take up to 12 weeks to complete all three phases. When treatment is complete, you’ll be able to gradually resume activities that require sharp turns such as tennis, basketball or football.

If the sprain if very severe and requires surgery, options may include arthroscopy or reconstruction. Your doctor also may use a cast or protective boot to immobilize and protect your ankle. After surgery, rehabilitation is essential to help restore strength and range of motion so you can return to normal activities.

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BUNIONS

A bunion is a painful price that is often paid for wearing the wrong shoes. Anyone, including adolescents, can develop the bony bump, but they are more common in women and mostly the result of tight, narrow shoes. Other causes of bunions include heredity or inflammatory conditions, such as rheumatoid arthritis.

Bunions develop slowly on the inside of the foot at the big toe joint as pressure on the joint pushes the big toe toward the second toe. Eventually, the bone structure changes and results in the bunion. Bunions become worse over time and can make walking or even wearing shoes painful. The condition also can lead to bursitis, chronic pain and arthritis.

Symptoms

Symptoms of a bunion may include:

Pain, tenderness, redness and inflammation
Hardened skin on the bottom of the foot
A callus or corn on the bump
Stiffness and difficulty moving the big toe

While your doctor will likely be able to diagnose your bunion by its appearance and your symptoms, he or she will also order an X-ray to check the alignment of your toes and for joint damage.

Treatments

Most bunions are treated without surgery by simply switching to properly fitting shoes that don’t pinch the toes together. Although this will not eliminate the bunion itself, it can help reduce pain and prevent the bunion from becoming worse. Other nonsurgical treatment options include:

Protective pads to help cushion the painful area over the bunion
Shoe inserts (orthotics) or toe spacers
A splint to move the big toe to a straighter position
Applying ice and using anti-inflammatory, non-steroid medications

If you’ve tried non-surgical treatment options and still have pain and difficulty walking, your doctor may recommend bunion surgery to bring the toe back to the correct position. Most procedures can be done in one day without hospitalization, but a lengthy recovery is common.

Surgical Procedures

Bunionectomy

A bunion is a “bony bump” or deformity to the joint at the base of the first or “great” toe. Bunions can cause significant pain, skin irritation and swelling. An orthopedic surgeon can perform a bunionectomy to help remove the bunion and restore normal alignment to the foot.

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ANKLE FRACTURES

An ankle fracture or “broken” ankle occurs when one or more of the bones that make up the ankle joint are broken. The condition can range from a simple break in a bone that doesn’t prevent you from walking, to multiple fractures that may leave you on crutches for a few months. The ligaments of the ankle that hold the ankle bones and joint in place also may be damaged.

People of all ages can be affected by a broken ankle. In recent decades, doctors have noticed an increase in broken ankles due to active, aging “baby boomers.” Broken ankles can be caused by a number of reasons, including twisting or rolling your ankle, tripping or falling, or as a result of impact from a car accident.

Symptoms

It’s hard to tell the difference between a severe ankle sprain and a broken ankle. That’s why it’s important to see a doctor for any ankle injury. Symptoms for a broken ankle include:

Immediate and severe pain
Swelling, bruising and tenderness
Inability to put weight on the injured foot
Abnormal appearance

Treatments

If your doctor suspects an ankle fracture, he or she will order tests, usually X-rays, to determine the extent of your injury. The type of treatment will depend on the extent of the injury. While some patients may be allowed to put weight on their ankle right away, others may have to wait for weeks.

As the fracture heals, your doctor may recommend protection ranging from a high-top tennis shoe to a short leg cast. Your doctor also will recommend regular, repeated X-rays to ensure that your ankle is healing properly.

If your ankle is unstable or the broken bone is out of place, you may need surgery to realign bone fragments and hold them together with screws or metal plates. More serious fractures may require bone grafting. Left untreated, an ankle fracture can lead to cartilage damage and the development of arthritis.

Regardless of how your fracture is treated, rehabilitation is very important for recovery. It may take several months, but if you do your exercises regularly and follow your doctor’s instructions, then you can eventually get back to your regular activities limp-free.

Surgical Procedures

Fracture Care

When a bone is broken is it called a fracture. Orthopedic surgeons can work to realign the broken bones and secure the bones in place. The goal is to restore proper alignment and stabilize the bone ends to allow healing. This can be accomplished through a variety of surgical techniques including open and minimally invasive methods such as plate and screws, “nailing,” or “pinning”.

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MORTON'S NEUROMA

Morton’s neuroma occurs when the tissue surrounding the nerve that leads to the toes becomes thickened. While the condition is seldom visible, it can cause persistent pain in the ball of the foot, most often between the third and fourth toes.

Women are more likely than men to have Morton’s neuroma. Causes for the condition include irritation, trauma or excessive pressure to that area of the foot.

Symptoms

The symptoms of Morton’s neuroma have been described as a “burning pain” in the ball of the foot that may radiate into the toes. The pain generally becomes worse with activity or wearing shoes.

The pain may radiate into the toes or they may feel numb or ache. Putting pressure on the ball of the foot, such as wearing high-heeled, tight, or narrow shoes will worsen the condition. Night pain is uncommon.

To diagnose the condition, your physician will feel for a mass or apply pressure between the bones. He or she will also look for calluses or evidence of stress fractures in the bones. To rule out other conditions, such as arthritis, X-rays may be required.

Treatments

Nonsurgical treatments provide relief in over 80 percent of patients. Options include:

Switching shoes – Shoes with low heels and cushioned soles will help bones to spread out and relieve pressure on the nerve.
Orthotics – Shoe inserts and pads that lift and separate the bones can help reduce pressure on the nerve.
Medication – When injected, corticosteroid medication may help relieve pain by reducing swelling and inflammation.

If nonsurgical treatment does not relieve your symptoms, surgery may be an option. You can usually expect a quick recovery.

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