Foot & Ankle

Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle.

There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.

Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.

Symptoms

The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:

• Pain with motion
• Pain that flares up with vigorous activity
• Tenderness when pressure is applied to the joint
• Joint swelling, warmth, and redness
• Increased pain and swelling in the morning, or after sitting or resting
• Difficulty in walking due to any of the above symptoms

Ankle injuries are the most common sports-related injury. An ankle fracture is a break in one or more bones that make up the ankle joint. Sometimes ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accident, rolling or twisting of ankle, and by tripping or falling. People participating in sports such as basketball, football, soccer, and skiing are at a high risk of developing ankle fractures.

Common symptoms of an ankle fracture include pain and swelling around the ankle, bruising, tender to touch, inability to walk on the leg, and deformity if the ankle is dislocated.

Following an ankle injury it is important to have the ankle evaluated by your doctor for proper diagnosis and treatment. Diagnosis is made based on the history of injury and physical examination of the ankle. In addition, the surgeon may order X-ray of the ankle to determine the extent of the injury.

Treatment varies with the type and severity of the injury. The common method of treatment of ankle fractures is adequate rest, ice application, leg elevation, and medications to reduce swelling and pain. A short leg cast or a brace may be applied over the fractured ankle to provide support. If there is severe injury, excessive swelling or severe pain, you should seek immediate medical treatment.

Some ankle fractures are treated with a splint, which is placed on the ankle for few days until the swelling subsides. Once the swelling decreases a cast may be placed on the ankle to hold the broken bone in a specific place. Surgery may be needed to realign the bones before placing the splint. During surgery, your doctor may place metal screws, plates, or rods to hold the broken bone intact until the healing happens. In some cases, crutches may be used to prevent the ankle from bearing weight.

It is important to use proper fitting shoes for the particular sports activity to reduce the chances of injury.

A sprain is stretching or tearing of ligaments, which connect adjacent bones in a joint and provides stability to the joint. An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular. Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle.

The diagnosis of an ankle sprain is usually made by asking the history of injury and physical examination of the ankle. X-ray of your ankle may be needed to confirm if a fracture is present.

The most common treatment recommended for ankle sprains is rest, ice, compression, and elevation (RICE).

• Rest: You should not move or use the injured part to help to reduce pain and prevent further damage. Crutches may be used to help with walking
• Ice: An ice-pack should be applied over the injured area up to 3 days after the injury. You can use a cold pack or crushed ice wrapped in a towel. Ice packs help to reduce swelling and relieve pain. Never place ice directly over the skin
• Compression: Compression of the injured area helps to reduce swelling and bruising. This is usually accomplished by using an elastic wrap for few days to weeks after the injury
• Elevation: Place the injured part above heart level to reduce swelling. Elevation of an injured leg can be done for about 2 to 3 hours a day

The doctor may also use a brace or splint to reduce motion of the ankle. Anti-inflammatory pain medications may be prescribed to help reduce the pain and control inflammation.

You may need to use an ankle brace or wrap to support and protect your ankle during sports activities. Avoid pivoting and twisting movements for 2 to 3 weeks.

To prevent further sprains or re-injury you may need to wear a semi-rigid ankle brace during exercise, special wraps, and high-top tennis shoes. A program of ankle exercises will also help to prevent re-injury by making the ankles strong and flexible.

Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to heel bone. It is used when you walk, run, and jump. When the Achilles tendon becomes thin, weak, or if it is not used, it may be susceptible to injury or damage. Achilles tendon rupture occurs most often in middle-aged athletes participating in sports that involve running, pivoting, and jumping. Recreational sports that may cause Achilles rupture include tennis, racquetball, basketball, and badminton.

If Achilles tendon is ruptured you will experience severe pain in the back of your leg, swelling, stiffness, and difficulty to stand on tiptoe and push the leg when walking. A popping or snapping sound is heard when the injury occurs. You may also feel a gap or depression in the tendon, just above heel bone.

Your doctor diagnoses the rupture based on symptoms, history of the injury, and physical examination. Your doctor will gently squeeze the calf muscles, if the Achilles tendon is intact, there will be flexion movement of the foot, if it is ruptured, there will be no movement observed.

Achilles tendon rupture is treated using nonsurgical method or surgical method. Nonsurgical treatment involves wearing a cast or special brace which is changed after some period of time to bring the tendon back to its normal length. Along with cast or brace, physical therapy may be recommended to improve the strength and flexibility of leg muscles and Achilles tendon. Surgical procedure involves opening the skin and suturing the torn tendon together. Surgery helps to decrease the recurrence of the Achilles tendon in comparison to the nonsurgical treatment.

To help prevent an Achilles tendon injury, it is a good practice to perform stretching and warm-up exercises before participating in any activities. Gradually increase the intensity and length of time of activity. Muscle conditioning may help to strengthen the muscles in the body.

Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.