6 Common Foot & Ankle Injuries
Posted by Jenn F. on Monday, July 15th, 2013
The NYC Center for Podiatric Care and Sports Medicine is one of the top facilities for injury care in the New York metro. Under the direction of Dr. Josef F. Geldwert, we specialize in advanced therapies and late-breaking treatments clinically proven to get individuals and athletes back to doing what they love as quickly as possible. Wait times are not long, but new patients may fill out this form prior to arrival to expedite their treatment even more. Here are six of the most common foot and ankle injuries we treat here at the center.
1. Broken Ankle
We have seen an increase in the number of cases and the severity of broken ankles in recent years, particularly due to the number of active baby boomers. On any given year, US emergency rooms see over a million visitors for broken ankles, in fact! The ankle is comprised of the tibia (shin), the fibula (lower leg bone) and the talus (anklebone). A fall, car accident or other type of trauma can snap any one of these bones — or, in some cases, all of them. It’s difficult for patients to tell a severe sprain from a break, so every injury should be examined by a doctor. X-rays are standard protocol. Swelling, bruising, tenderness, severe pain, deformity and inability to put weight on the foot are the symptoms of a broken ankle. “Clean breaks,” where there is a fracture without joint or ligament damage, can be treated with a leg cast or brace for about six weeks. It could take several months to return to a competitive level again. If ligaments are torn or bones become loose, surgery may be required. A program of rehabilitation and strengthening will then be required.
2. Talus Fracture
The talus (pronounced TAY-lus) connects the heelbone with the tibia and the fibula. It is shaped like a turtle. Talus injuries usually result from car accidents, falls from height or snowboarding tumbles. Acute pain, tenderness on the outer side of the ankle, severe bruising, swelling and the inability to bear weight are the usual symptoms of this injury. X-rays and CT scans will help pinpoint the location of the break and show whether the bones have shifted out of alignment or not. Nerve functioning and circulation will need to be assessed as well. It is essential to treat this type of injury properly — and right away. Otherwise, arthritis, chronic pain and bone collapse may develop later on. A well-padded splint around the back of the foot and leg from the toe to the upper calf is necessary. Ice and elevation are recommended. More often than not, surgery is needed and a six to eight week recovery is standard. We monitor these cases very carefully to make sure there are no complications.
3. Heel Fractures
It takes a lot of force to break the heel, but a car accident or fall from a height could do it. The heel doesn’t necessarily bruise as much as other breaks, but it does hurt very, very much and you will be unable to put any weight on it. Stiffness and swelling may follow. Often, the pain is centered on the outside of the ankle or the heel pad. Expect x-rays, a CT scan and nerve function analysis for diagnosis. You won’t need surgery if the bone is still aligned, but merely broken. A compressive dressing can hold the foot together while you heal in that case. Typical recovery is about six to eight weeks. If the bone has shifted, a metal plate and small screws will be needed to hold the bones in place. Healing could take a good 10 weeks and you will probably need a cane or special boot. Sometimes the foot is never the same as it was before the injury and a heel pad lift with special shoes is required.
4. Lisfranc Fracture
Lisfranc (midfoot) injuries can occur from a twisting fall or dropping something onto the foot. These injuries occur in the small cluster of bones that form the top arch between the ankle and toes. Like a sprain, this type of break will swell, bruise and hurt. The full extent of the damage can’t always be seen in an x-ray, so usually a CT scan or MRI is needed to confirm the diagnosis. Bones pushed out of position will be treated with a cast and rest for six weeks. Shoes with rigid arch support and foot exercises will be prescribed for recovery. Operations to stabilize the bones using pins, wires or screws are not uncommon. A cast will be needed for six to eight weeks, followed by a walking brace for several more weeks. People who try to return to regular activity too soon may suffer another injury, blood vessel damage, poor wound healing, or painful arthritis.
5. Stress Fractures
Stress fractures occur as the result of overuse or repetitive motion, so we see these in a lot of runners and athletes. Doing too much too soon is a common reason for a stress fracture, as is insufficient sports equipment or footwear. Tiny cracks in the bone develop when the surrounding muscles become fatigued and can no longer absorb the shock of impact. As we get older, these fractures could simply occur due to a weakening of the body. Symptoms include pain that increases with activity and diminishes with rest, swelling on the top of the foot or outside of the ankle, tenderness to the touch and bruising. A bone scan will detect this type of delicate break. Most stress fractures will heal in two to four weeks with protective footwear and reduced activity. Swimming and biking are allowable activities during recovery. Stress fractures on the outside of the foot take longer to heal — sometimes up to six or eight weeks.
6. Toe and Forefoot Fractures
Most of the time, broken metatarsals or toes are painful, but can heal without operations. There may be stress fractures from sudden increases in training or pounding the pavement, or there could be traumatic injuries from a twisting fall or dropping an object on the foot. Pain, swelling and bruising are signs of a broken toe or foot. X-rays are the standard way of diagnosing, but bone scans can identify smaller stress fractures too. Rest for three to four weeks is necessary. Buddy tape with gauze can mobilize a broken toe. Forefoot breaks may require a brace, short-leg walking cast or flat-bottom shoe to facilitate proper healing. A bone typically takes six to eight weeks to heal, but the doctor will monitor your progress. Surgery is rare, but successful when needed.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.