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Spine

Foot/Ankle



Ankle Sprain / Strain

A sprained ankle is a very common injury. Approximately 25,000 people experience it each day. A sprained ankle can happen to athletes and non-athletes, children and adults. It can happen when you take part in sports and physical fitness activities. It can also happen when you simply step on an uneven surface, or step down at an angle.

The ligaments of the ankle hold the ankle bones and joint in position. They protect the ankle joint from abnormal movements-especially twisting, turning, and rolling of the foot.

A ligament is an elastic structure. Ligaments usually stretch within their limits, and then go back to their normal positions. When a ligament is forced to stretch beyond its normal range, a sprain occurs. A severe sprain causes actual tearing of the elastic fibers.

Ankle sprains happen when the foot twists, rolls or turns beyond its normal motions. A great force is transmitted upon landing. You can sprain your ankle if the foot is planted unevenly on a surface, beyond the normal force of stepping. This causes the ligaments to stretch beyond their normal range in an abnormal position.

For detailed information about this injury and treatments please visit: AAOS Online Services Fact Sheet - Sprained Ankle
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Achilles Tendon Injuries

Achilles tendon injuries affect the back of your lower leg. It most commonly occurs in people playing recreational sports.

The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture). An Achilles tendon rupture can be partial or complete.

If you have an Achilles tendon rupture, you might feel a pop or snap, followed by an immediate sharp pain in the back of your ankle and lower leg that makes it impossible to walk properly. It almost feels like you've been kicked, or even shot.

Surgery is often the best treatment option to repair an Achilles tendon rupture.
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Bunions

If the joint that connects your big toe to your foot has a swollen, sore bump, you may have a bunion.

With a bunion, the base of your big toe (metatarsophalangeal joint) gets larger and sticks out. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. An advanced bunion may make your foot look grotesque. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Most bunions are treatable without surgery. If your bunion has progressed to the point where you have difficulty walking, or experience pain despite accomodative shoes, you may need surgery.

For detailed information about bunions and treament options please visit: AAOS Online Services Fact Sheet - Bunions
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Fusion (Arthrodesis)

If arthritis in the foot and ankle doesn't respond to nonsurgical treatment, surgical treatment might be considered. The choice of surgery will depend on the type of arthritis, the impact of the disease on the joints, and the location of the arthritis. Sometimes more than one type of surgery will be needed.

One surgery performed for arthritis of the foot and ankle is arthrodesis (or fusion of the joints). Arthrodesis fuses the bones of the joint completely, making one continuous bone.

The surgeon uses pins, plates and screws, or rods to hold the bones in the proper position while the joint(s) fuse. If the joints do not fuse (nonunion), this hardware may break.

A bone graft is sometimes needed if there is bone loss. The surgeon may use a graft (a piece of bone, taken from one of the lower leg bones or the wing of the pelvis) to replace the missing bone.

This surgery is typically quite successful. A very small percentage of patients have problems with wound healing. These problems can be addressed by bracing or additional surgery.

The biggest long-term problem with fusion is the development of arthritis at the joints adjacent to those fused. This occurs from increased stresses applied to the adjacent joints.

For detailed information about this procedure please visit: AAOS Online Services Fact Sheet - Arthritis of the Foot and Ankle
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Plantar Fasciitis / Heel Spur / Heel Pain

If you are experiencing pain under your heel, you may have one or more conditions that inflame the tissues on the bottom of your foot:

  • Stone bruise. When you step on a hard object such as a rock or stone, you can bruise the fat pad on the underside of your heel. It may or may not look discolored. The pain goes away gradually with rest.

  • Plantar fasciitis (subcalcaneal pain). Doing too much running or jumping can inflame the tissue band (fascia) connecting the heel bone to the base of the toes. The pain is centered under your heel and may be mild at first but flares up when you take your first steps after resting overnight. You may need to do special exercises, take medication to reduce swelling and wear a heel pad in your shoe. For detailed information about this injury and treatments please visit: AAOS Online Services Fact Sheet - Plantar Fasciitis

  • Heel spur.When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone. Your doctor may take an X-ray to see the bony protrusion, which can vary in size. Treatment is usually the same as for plantar fasciitis: rest until the pain subsides, do special stretching exercises and wear heel pad shoe inserts.

For detailed information about these injuries and treatments please visit: AAOS Online Services Fact Sheet - Total Knee Replacement
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Foot & Ankle Fractures (Tibia, Fibula, Talus, Metatarsal)

A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for three months. A fracture ankle can be caused by:

  • "Twisting" or rotating your ankle
  • "Rolled" your ankle
  • Tripping or falling
  • Impact during a car accident

Broken ankles affect all ages. Ankle fractures occur in 184 per 100,000 persons per year. During the past 30 to 40 years, doctors have noted an increase in the number and severity of broken ankles, due in part to an active, older population of "baby boomers." In 2003, nearly 1.2 million people visited emergency rooms because of ankle problems. For detailed information about ankle fractures please visit: AAOS Online Services Fact Sheet - Ankle Fractures.

Nearly one-fourth of all the bones in your body are in your feet, which provide you with both support and movement. A broken (fractured) bone in your forefoot (metatarsals) or in one of your toes (phalanges) is often painful but rarely disabling. Most of the time, these injuries heal without operative treatment.

See a doctor as soon as possible if you think that you have a broken bone in your foot or toe. Until your appointment, keep weight off the leg and apply ice to reduce swelling. Use an ice pack or wrap the ice in a towel so it does not come into direct contact with the skin. Apply the ice for no more than 20 minutes at a time.

For detailed information about toe and forefoot fractures please visit: AAOS Online Services Fact Sheet - Toe and Forefoot Fractures.Top