Posts for tag: ankle
The most common cause for a persistently painful ankle is incomplete healing after an ankle sprain. Other conditions that can lead to chronic ankle pain include an injury to the nerves that pass along the ankle joint, a torn or inflamed tendon,arthritis of the ankle joint, a fracture of bones around the ankle, inflammation of the ankle joint lining, or scar tissue buildup. These conditions can cause symptoms of pain on the outer side of the ankle, difficulty walking on uneven ground, difficulty walking in high heels, ankle instability,swelling, stiffness, tenderness, and repeated ankle sprains.
The first thing a doctor will evaluate is the history of your chronic ankle pain. This will help them determine the cause, as there are so many potential reasons for chronic ankle pain. Your doctor will also feel for tender areas and look for signs of swelling. They may have you move your foot and ankle to assess range of motion and flexibility. To test the sensation of the nerves, your doctor may administer a shot of local anesthesia. Your doctor may order x-rays of the ankle joint and foot to help view the bony alignment.
The podiatrists at Coastal Podiatry Associates will tailor your treatment plan to your needs. Conservative treatments include anti-inflammatory medications, physical therapy, braces, local steroid injections, and casts. If conservative treatment doesn’t bring relief, surgery may be needed. Most procedures are done on an outpatient setting with six to ten weeks of post-op rehabilitation. Surgical options include removing loose tendon fragments, cleaning the joint or joint surface, and ligament repair or reconstruction.
Coming soon.
Have you ever dropped a heavy box on the top of your foot? Have you ever stepped into a small hole, falling, and twisting your foot? These two common accidents can result in midfoot or Lisfranc fracture-dislocation. Lisfranc injuries (named from the French doctor that first described the injury) occur at the midfoot. This area is a cluster of bones and joints that form an arch on the top of the foot between the ankles and toes. In total, five long bones extend to the base of the toes meet four bones projecting towards the rear of the foot. These bones are held into position by ligaments that stretch across and down the foot. The bone extending to the second toe is extremely important as it acts as a stabilizing force in the area but lacks ligaments to secure it to the first long bone. These two long bones may shift, break, or dislocate in a twisting fall.
Lisfranc fracture-dislocations are often mistaken for sprains. The top of the foot may be swollen and painful with some bruising. If the injury is severe, you may not be able to place any weight on the foot. Lisfranc injuries are often difficult to see on X-ray and can have serious complications if left untreated. It is important to see a podiatrist if rest, ice, and elevation do not reduce the pain and swelling within a day or two. At the doctor’s office, a podiatrist will evaluate the foot through a detailed physical exam and image study. If initial x-rays do not show an injury, a CTor MRI may be needed.
Treatment for a Lisfranc injury depends on the severity of the injury. If the bones have are still in alignment, a cast is typically used in addition to not placing any weight on the foot for six weeks. Unfortunately, surgery is often needed to stabilize the bones and hold them in place after they have become dislocated. Pins, wires, or screws may be used to restore normal position. After surgery, a cast and non weight bearing to the foot for six to eight weeks is typical. In both situations, arch support and a rigid soled shoe are commonly used until all symptoms have disappeared.
It is important to seek appropriate medical advice when rest, ice, and elevation do not resolve pain. It is equally important to follow doctor’s orders and refrain from activities until instructed. The podiatrists at Coastal Podiatry Associates are trained in Lisfranc fractures and will help their patients return to normal activity as quickly as possible.
Ankle sprains are so common that many people never seek medical care. One simple misstep can cause the ankle to twist at just the wrong angle leading to pain for days. Two important questions to ask after spraining an ankle include; when is it appropriate to see a podiatrist and what can be expected during the visit?
During the most common ankle sprains, the outer ligaments of the ankle are injured due to an excessive stretching force. This can happen by awkwardly planting the foot while walking, stepping, or running. In these situations, the foot rolls in and forces the ankle to move away from the body. Ankle sprains can cause pain, swelling, bruising, and weakness. This pain intensifies with movement or touching of the ankle joint.
For mild sprains, the RICE principle should offer enough treatment. RICE stands for rest, ice, compression, and elevation. RICE combined with a reduction in activity and over the counter anti-inflammatory medications such as ibuprofen may offer full relief. If pain, swelling, and weakness last longer than a week, it is important to seek medical attention. The podiatrists at Coastal Podiatry Associates are trained to evaluate ankle injuries. They will examine the ankle to make sure that a serious injury, such as an ankle fracture has not occurred. In the office, they will evaluate the ankle’s range of motion, strength, and locate the area of maximum tenderness. They may use x-ray or MRI to ensure their diagnosis and check for bone or ligament damage. Depending on the severity of the sprain, a doctor might recommend a brace, splint, or crutches to keep pressure off the ankle joint. Physical therapy may be needed to help regain full range of motion and strength.
Ankle injuries can occur to anybody and may be tricky to treat. Many times a sprain will initially get better but fail to completely heal or even start to become painful again. People with conditions outside of the ankle that have not been diagnosed or treated properly are at an increased risk for recurrent ankle injuries. Many of these conditions are difficult to assess on initial exam and often fail to be diagnosed immediately following injury. Persistent inability to bear weight or bear weight without pain, persistent swelling, clicking or popping, feeling of instability, or pain that doesn’t decrease are all reasons to see a podiatrist for a physical exam and treatment. Ankle sprains can commonly be classified into several different types. These types include bone, cartilage, and soft tissue injuries and are all treated differently.
Bone injuries include fractures, stress fractures, and contusions. Several common fracture patterns occur with ankle sprains. If pain or swelling persist at a particular area of the foot or ankle, it is essential to see a physician. They may take x-rays or order an MRI to further evaluate the area and start treatment.
Cartilage injuries such as scuffs to the joint surface within the ankle may result in increased swelling or pain after activity. Commonly the pain and swelling improves with rest but then returns once normal activity is resumed.
Soft tissue injuries come in many forms. If a frayed ligament associated with the sprain heals in the joint, a catching sensation can cause pain or instability. Premature return to activity may allow poor healing of ligaments and cause weakness or instability. Muscles and tendons that stabilize the ankle may be damaged in a sprain. This results in pain, weakness, and/or unsteadiness. Nerve damage can occur in a sprain leading to weakness, numbness, or pain to the ankle or foot.
Seeking a podiatrist treatment plan is important to improving the long-term outcome of a sprain. Communication with the physician about the pain and how treatment is progressing is essential, especially if symptoms are not becoming better. Treatment plans depend on the extent of the sprain and tissues involved and may consist of immobilization, casting, physical therapy, or surgery.
By Dr. Scott Hamilton of Coastal Podiatry Associates, Myrtle Beach SC.
One of the most common injuries of the foot is an ankle sprain. Most of the time ankle sprains are thought of as a sports injury, they can be caused by daily activities such as walking off a curb, stepping on a rock, or missing a step. The ankle joint is unique in the body as it is composed of three bones built to bear and stabilize about ½ of the body's weight while still being fairly mobile. To help understand the injury, some background anatomy is needed.
There are two bones in the lower leg and one in the foot that make up the ankle joint. The two bones in the foot run together from the knee to the ankle. The inner and larger bone is called the tibia. This bone supports ½ of the body's weight above it. The smaller and outside bone is called the fibula. This long skinny bone serves as an attachment point for muscles and tendons. The tibia and fibula are joined just above the ankle joint by the distal tabiofibular ligament. The bone in the foot is called the talus. This bone fits into the space between the tibia and fibula. The talus pivots in this space allowing movement between the foot and leg. On the inside of the ankle joint the talus and tibia are connected by a group of ligaments called the deltoid ligament. On the outside, the talus and fibula are connected by three ligaments: anterior talofibular ligament, calcaneofibular ligament, posterior talofibular ligament. The last thing to talk about is the two broad ligaments that wrap around the entire joint. These are called the flexor retinaculum and extensor retinaculum and help stabilize and keep all of the parts of the ankle joint together.
Now that some of the anatomy is clear it's time to read about the different types of ankle sprain, how they are caused, and graded. The term "sprain" is used when a ligament is damaged or ruptured. The three basic types of ankle sprains are inversion, eversion, and syndesmosis or high-ankle sprains. The most common is an inversion sprain. This occurs when the foot is pointed toward the floor and the foot rolls inward placing the body weight over the outside of the foot and ankle. An inversion sprain usually happens by stepping or landing on uneven ground or making a cutting motion. These sprains damage the ligaments on the outside of the ankle with the anterior talofibular ligament most commonly damaged. Eversion ankle sprains require a large amount of force to occur. The most common way they occur is when an athlete has a foot planted and there is a blow from the side of the planted leg. The syndesmosis or high-ankle sprain is a stretch of the distal talofibular ligament. This occurs when the talus bone twists between the tibia and fibula, forcing the two leg bones unnaturally apart. This injury is most common when the foot is planted and the body twists over the planted foot.
During the diagnosis of a joint sprain, doctors may use the following scale. This helps them categorize the degree of damage to the joint and develop a treatment plan.
Grade 1: The joint has mild pain with little to no swelling. Minor tears and stretching of the ligament have occurred. There is only minimal loss of function and stiffness of the joint. Expected recovery is a few days.
Grade 2: The joint has moderate to severe pain with swelling. A partial tear of ligaments and moderate loss of function has occurred to the joint. Joint is also experiencing stiffness. Full recovery is within 2-3 months.
Grade 3: Initially there is severe joint pain but afterwards little or no pain. The joint becomes very stiff with large amounts of swelling. Ligaments are completely ruptured and joint has complete loss of function. Full recovery can take up to 4 months.