Foot and Ankle Care
Common Foot and Ankle Ailments
Irritation and inflammation of the tendon that attaches to the back of the heel bone. Achilles tendinitis can be caused by improper warm up or over training. Can be treated with ice, rest, aspirin or anti-inflammatory medications. Chronic pain or any swelling should be professionally evaluated.
Misaligned big toe joints which can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery by a podiatric physician is frequently recommended to correct the problem.
A condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Selecting shoes and socks that do not cramp the toes will alleviate aggravation.
Growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel can later calcify to form a spur. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced.
Enlarged benign growths of nerves, most commonly between the third and fourth toes. They are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can create the condition as well. Treatments include orthoses (shoe inserts) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. A podiatric physician can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
Sometimes known as the "ball bearings of the foot," the sesamoids are two small bones found beneath the first metatarsal bones. They can inflame or rupture under the stress of exercise. Sesamoiditis can be relieved with proper shoe selection and orthoses.
Pain to either side of the leg bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching and corrective orthoses (shoe inserts) for pronation can help prevent shin splints.
One of the various types of fractures, stress fractures require vastly different treatment. Stress fractures are incomplete cracks in bone caused by overuse. With complete rest, stress fractures heal quickly. Extra padding in shoes helps prevent the condition. Note: Stress fractures left untreated may become complete fractures, which require casting and immobilization.
A fracture is a partial or complete break in a bone. In the ankle, fractures involve the far or distal ends of the tibia, the X-ray image of an ankle fracture fibula, or both bones. The tibia is the shinbone and is located on the inner, or medial, side of the leg. The fibula is located on the outer, or lateral, side of the leg. The distal ends of the tibia and fibula bones are also known as the medial and lateral malleoli, respectively.
An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the lateral or outside part of the ankle. This is an extremely common injury which affects many people during a wide variety of activities. It can happen in the setting of an ankle fracture (i.e. when the bones of the ankle also break). Most commonly, however, it occurs in isolation.
Arthritis of the Foot and Ankle
The pain and stiffness you feel in your feet and ankles as you grow older could be arthritis. If left untreated, this nagging pain can grow worse, eventually becoming so excruciating that you can no longer walk even short distances. Severe arthritis can restrict your mobility and limit your quality of life, but with proper treatment, you can slow the development of arthritis and lead a more productive life.
Chronic Lateral Ankle Pain
Recurring or chronic pain on the outer side of the ankle often develops after an injury such as a sprained ankle. However, several other conditions may also cause chronic ankle pain.
High Ankle Sprain
The high ankle ligaments are located above the ankle, as opposed to the more commonly injured ligaments on the outside of the ankle. These high ankle ligaments connect the tibia to the fibula. It is important to have stability between the tibia and fibula at this level because walking and running place a tremendous amount of force at this junction.
A high ankle sprain occurs when there is tearing and damage to the high ankle ligaments. These injuries are much less common than a traditional ankle sprain.
Insertional Achilles Tendinitis
This is a degeneration of the fibers of the Achilles tendon directly at its insertion into the heel bone. It may be associated with inflammation of a (retrocalcaneal) bursa or tendon sheath in the same area.
Osteochondral lesions, sometimes called osteochondritis dessicans or osteochondral fractures, are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. These injuries may include blistering of the cartilage layers, cyst-like lesions within the bone underlying the cartilage, or fracture of the cartilage and bone layers. Throughout this article, these injuries will be referred to as osteochondral lesions of the talus (OLT).
The peroneal tendons run on the outside of the ankle just behind the bone called the fibula. Tendons connect muscle to bone and allow them to exert their force across the joints that separate bones. Ligaments, on the other hand, connect bone to bone. Tendinitis implies that there is inflammation in the tendon. Tendinosis means there is enlargement and thickening with swelling of the tendon. This usually occurs in the setting of overuse, meaning a patient or athlete does a repetitive activity that irritates the tendon over long periods of time. This article will focus on peroneal tendinosis.
The tibia (shin bone) and the fibula are the bones of the lower leg. Pilon fractures are injuries that occur at the lower end of the tibia and involve the weight bearing surface of the ankle joint. The fibula may also be broken. These injuries were first described more than 100 years ago and remain one of the most challenging problems for orthopaedic surgeons to treat.
A sprained ankle means one or more ligaments on the outer side of your ankle were stretched or torn. If it is not treated properly, you could have long-term problems. You're most likely to sprain your ankle when you have your toes on the ground and heel up (plantar flexion). This position puts your ankle's ligaments under tension, making them vulnerable. A sudden force like landing on an uneven surface may turn your ankle inward (inversion). When this happens, one, two or three of your ligaments may be hurt.
A talus fracture is a broken ankle bone. The talus is the bone in the back of the foot that connects the leg and the foot. It Talus fracture seen on X-ray joins with the two leg bones (tibia and fibula) to form the ankle joint and allows for upward and downward motion of the ankle.
Common Ankle Issues
Achilles tendinitis implies an inflammatory response, but this is very limited because there is little blood supply to the Achilles tendon. More appropriate descriptions are inflammation of the surrounding sheath (paratenonitis), degeneration within the substance of the tendon (tendinosis) or a combination of the two.
When the Achilles tendon degenerates and become inflamed, the condition is called Achilles tendinosis. The tendon can swell and may cause pain. This condition is common in athletes, runners and patients who have calf tightness. Achilles tendinosis may occur in the middle of the tendon. This is known as midsubstance Achilles tendinosis. It may also occur at the point where the tendon connects to the heel bone. This is known as insertional Achilles tendinosis.
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