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Dealing with Stress Fractures of the Foot and Ankle
Stress fractures occur in the foot and ankle when muscles in those areas are weakened from too much or too little use. When this happens, they stop cushioning the foot and ankles from the impact of hitting the ground. Because there is nothing to protect them, the bones of the foot begin to absorb the full impact of each step someone takes. The added stress causes little cracks to form in the bones that are under the most pressure. These cracks are called stress fractures.
Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Individuals who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intensive high impact work out may get stress fractures. This is because their muscles are not strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.
The pain from these fractures will occur in the general area of the fracture. It may be intermittent or constant, and will cause sharp or dull pain along with swelling and tenderness. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture. This is a much more serious problem, and will probably prevent you from applying any pressure on the foot at all.
Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.
In order to avoid getting stress fractures, make sure to get plenty of calcium and Vitamin-D. They will help to keep your bones strong, and make them less likely to break under pressure. If your new exercise regimen is running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. For example, if you plan to walk every day, you could ride a bike on some days to take the stress off of your feet. Make sure to wear supportive shoes to better protect you feet.
If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms do not go away, see an orthopedic specialist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.
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Foot and Ankle Surgery
What Type of Footwear Should be Used After Surgery on the Feet
While it is fortunate that many foot-related illnesses and injuries do not require surgery, for those that suffer from conditions that do require surgery, understanding what kind of shoes to wear after surgery is vital to recovery. Also important to note is that podiatrists and foot surgeons should always be consulted post-operation, to determine the exact needs of your feet.
Surgeries that require orthopedic shoes tend to involve bone deformities or other illnesses for which no other option is available. Some of these conditions are Tarsal Tunnel Syndrome, bunions which deform the large toe bones and cannot be corrected with other methods, and ligament tears that require surgery to alleviate pain and restore mobility. Each of the surgical procedures that are used to treat these illnesses benefit greatly from special orthopedic footwear and in many cases they are required for recovery.
There are many variations on orthopedic footwear that are required after foot surgery, but the typical style remains the same, and a few standard, functional qualities to ensure the comfort and support of feet are employed. Typical orthopedic shoes offer a rubber sole to prevent any possibility of slipping while foot related balance and support is reduced post surgery. These shoes are meant to only be worn during the small post operative recovery window and accommodate the excess size of the foot and bandages. During this time, a wider toe area and a larger heel width is necessary. These shoes also typically come with raised heels and can be quite expensive if not covered by insurance.
For those surgeries that do not require special footwear, typical patients will often turn to comfortable athletic shoes to provide adequate support for their feet. A post operative patient must take special care when choosing their athletic shoes and their choices should closely mirror the design of orthopedics. Chosen shoes should have wider toe boxes and a firmer heel, with plenty of room for a swollen or bandaged foot. Your podiatrist should always be consulted regarding which brands are appropriate to wear, and can often recommend a specific line of shoes to provide comfort to various arch shapes and foot sizes.
For those who are required to wear dress shoes post operation, shoes with a heel should be avoided, as most dress shoes with heels provide undue strain to the foot. Consulting your podiatrist before wearing shoes that have not been explicitly approved is necessary.
Foot Rehabilitation for Athletes
It is hard to think of a sport in which the ankle and foot are completely safe from injury. Even simple activities such as darts and pool can cause injuries to the foot. When an athlete does suffer from a foot injury, he needs to find a way to get back on his feet right away. Immediate results may be desired, but they are not always possible.
Severe injuries require special attention. When the foot or the ankle gets injured, muscles surrounding the bones can weaken or atrophy through disuse. While the bones will heal on their own, it takes a more concentrated effort for an athlete to regain full use of his feet and ankles. A doctor may recommend that a person go through a course of physical therapy. The course of physical therapy treatment uses simple, repetitive isometric exercises. The use of the exercises will cause the body to rebuild the muscles and tendons in the area over time and restore the full range of movement.
When selecting ankle and foot rehabilitation services, an athlete needs to find a licensed sports therapist (other physical therapists work with more generalized conditions, and while these kinds of physical therapists are dedicated to their job, they do not necessarily understand the special demands of the athlete). A good sports therapist will take their time with a patient, and make sure that he or she understands the problem and the options available for treatment.As long as the doctor expects a person to return to the sport which he enjoys, the sports physical therapist will recommend the exact exercises a person needs to get back in the game.
Although the professional athlete needs a trained sports therapist, an amateur athlete or the weekend player can benefit from foot rehabilitation services for athletes as well. An ankle or foot injury does not have to cause a person go give up the game he loves entirely, so long as he or she seeks out a sports therapist.
Physical therapy can not always perfectly heal certain injuries, but it will more quickly and effectively help the afflicted person get better. Less severe injuries may only take a person out of his favorite sport just for a little while, if he or she sees a sports therapist. As long as the doctor the athlete sees thinks a full recovery is possible, it is worth it to check out ankle and foot rehabilitation services.
Playing sports with foot injuries
There are many types of foot injuries common among athletes such as plantar fasciitis, overpronation, strains, turf toe, heel spurs, and stress fractures of the foot. Plantar fasciitis is when the thick ligament in the base of the foot becomes swollen, and causes pain. Overpronation is excessive movement of the foot during gait. Pronation would be normal movement of the gait, but when movements become excessive, it leads to a variety of areas becoming painful due to the overpronation. The most common complaint is a burning sensation or inflammation under the arch of the foot, often called strain or arch pain. Heel spurs are growths of the bone in the heel where soft tissues and tendons connect. Turf toe comes from upward bending of the big toe outside of the normal range of motion. It most commonly occurs in athletes that play on artificial surfaces because a shoe grips the surface and forces and athletes weight forward causing the upward bending of the large toe. This causes damage by stretching the ligaments under the toe. Stress fractures could be caused by overuse due to muscle fatigue in the foot, preventing the muscles and ligaments from absorbing the shock and trauma.
Many athletes continue to play with mild foot injuries. You should remember to properly stretch before any activities, focusing on their calves to prevent injuries and reduce reoccurring pain. It is also common to wear braces to protect the areas that commonly become overstretched and use shoe inserts such as heel pads. It is important to remember to wear proper footwear and replace shoes when needed.
There are many kinds of treatments required to keep the injury from becoming serious. Most commonly an athlete should immediately ice the injury to take down swelling and inflammation. Applying a compression bandage and resting will also reduce pain and stress on the foot. Rest could include using crutches to keep weight off of the injury to allow proper healing, for instance. For plantar fasciitis, make sure calves are properly stretched and refrain from hills or speed work. One should try wearing an arch strap to add support. Those with heel spurs should also try arch straps to reduce strain and ice often. The best remedy would be heel pads. Aside from that, one would need a podiatrist or orthopedic specialist. It may require surgery. Those who are suffering from overpronation or turf toe should invest in a quality shoe to reduce motion. There are special insert and braces for the big toe, as well as shoes with firm soles to prevent bending. Stress fractures usually require rest, so an athlete may participate in lower impact activities to allow rest and healing. Most importantly, one should seek medical advice if pain does not go away or recurs frequently.
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Systemic Diseases of the Foot
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
Nerve Disorders of the Foot and Ankle
Similar to well known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.
Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.
Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.
Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.
If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition. If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.
Heel Pain
Heel pain is a stressful condition that affects day to day activities. Running and walking causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.
One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.
Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.
A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.
Treatments for heel pain are easy and effective as long as problems are addressed quickly. The most common solution is simply taking stress off the feet, particularly off of the heel. This will ease the pain and allow the tendons and ligaments to relax. In the case of both plantar fasciitis and Achilles tendonitis, icing will reduce swelling of any part of the foot and anti-inflammatory medication is highly recommended. Properly fitting your shoes and wearing heel pads or comfort insoles will also reduce the risk of developing heel pain. Stretching before and after exercises such as running will help the foot muscles prepare for stress and lower the chances of inflammatory pain. In extreme cases, relieving heel pain might require surgery. Always make sure to discuss these symptoms and treatment options with your podiatrist to keep yourself active and pain free.
Keywords: Heel pain, Achilles Tendonitis, Plantar Fasciitis, Heel Spur, Heel Pain Treatment, Stress on the Foot, Foot Tissue Tear, Foot Inflammation
What Is A Podiatrist?
The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.
To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.
When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.
Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise and referrals will be made to specialists that handle the greater health problems.
Some podiatrists have their own solo small private practices or clinics where they have a small staff and administrative personnel but many work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals or visiting patients in nursing homes. They typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Some other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.
Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that result from the effects of physical trauma or diabetes.
