Are You Wondering “Do I Need Ankle Surgery?” These Noninvasive Treatment Methods Could Help You Avoid Foot or Ankle Surgery
Posted by Jenn F. on Wednesday, December 9th, 2015
One of the reasons people put off coming to see sports medicine doctors is that they worry: “Do I need surgery?” However, the push has been toward more minimally invasive, nonsurgical treatments that you needn’t be afraid of. Learn how we can help your sprained ankle, injured tendon, or plantar fasciitis without resorting to surgery.
RICE Treatment and Physical Therapy for Sprained Ankles
If you’ve played sports, chances are you’ve probably twisted an ankle at some point. Sometimes a sudden movement or awkward turn tears one or more of the ligaments holding the ankle bones together. The level of severity ranges from overstretching to complete tearing. Prompt evaluation using MRI is recommended to assess the extent of the damage and determine the right type of immobilization.1http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348693/ There are all different kinds of wraps and boots we could put you in until the ligament heals. Most of the time, conservative care with rest, ice, compression, and elevation (RICE treatment) is enough to fix an ankle sprain. Sometimes anti-inflammatory medication is used to take down chronic swelling and physical therapy is used to enhance range of motion and prevent stiffness. Most patients are healed within eight weeks of conservative treatment.
So, do I need ankle surgery? Surgery may be required in severe cases of complete tears, but grade III sprains can also often be treated with casting instead.2http://www.aofas.org/education/orthopaedicarticles/ankle-sprain.pdf In cases where bracing is impractical (such as diabetics with skin problems, people with work issues, or among dancers), surgery may be a better option. Individuals who have suffered recurrent sprains with daily activities may also be candidates for surgery. Return to a sport is usually delayed 4-6 months following surgery.
Platelet Rich Plasma for Achilles Tendon Injuries
The Achilles is the body’s longest and strongest tendon responsible for jumping and acceleration movements, but it can still fray or tear when excessive force is placed on it, or it’s severely overused. These injuries are especially common among weekend warrior runners and pro football players. Not every podiatrist offers it, but we’ve been using platelet rich plasma (PRP) injection therapy here at The Center for Podiatric Care and Sports Medicine for over five years. Along with functional bracing, PRP therapy improves outcomes by stimulating the body’s natural healing processes with growth factors concentrated from a small amount of your own blood. One study published in the Journal of Bone and Joint Surgery found that nonoperative treatment with functional rehab had the same recovery time and outcomes as surgery.3http://health.usnews.com/health-news/news/articles/2012/12/28/surgery-may-not-be-needed-for-ruptured-achilles-tendon
When is surgery needed? When functional rehabilitation is not an option, surgery may be necessary. If you are in a position for sports or work where you need to get back to your routine fast, you can shave about 19 days off your recovery with surgery. If the Achilles tendon is particularly shredded or scarred from past injuries, then surgery is also warranted.
New Shoes and Custom Orthotics for Plantar Fasciitis
Many of our patients are amazed that the answer to their debilitating heel pain was nothing more than a new pair of shoes or a pair of insoles that redistributes the pressure of their soles. Plantar fasciitis occurs when the tissue connecting the heel bone to the toes becomes stretched and moved out of alignment due to repetitive stress or foot trauma. Fitness runners and people who work on their feet all day are our most typical patients. Most cases resolve with rest, ice, and stretching, but recovery can take months. We find that changing to properly fitted, shock absorptive shoes with good arch support aids significantly in the recovery process. We have the technology in our Manhattan and Westchester podiatry offices to fit you with the latest custom orthotics, formed to your unique feet. Another advanced-technology option we offer for plantar fasciitis sufferers is Extracorporeal Shockwave Therapy.
Does this condition require surgery? Only about 5% of cases require surgery. We consider surgery in cases where the inflammation is chronic, pain is severe enough to interfere with regular daily activities, and the patient’s condition does not improve over the course of six months with conservative therapy.
Get Help for Your Feet in NYC!
Our NYC foot care professionals are board-certified podiatrists, podiatric surgeons, physical therapists, and sports medicine doctors. We have two offices — one in Manhattan near Central Park, and another in Westchester. We work with anyone who wants to remain active despite foot and ankle issues, as well as professional sports teams, marathon runners, and Olympic-level athletes. Contact us for more information.
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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.