Foot & Ankle Conditions
There are 28 bones and more than 30 joints in the foot. The ankle is comprised of three large bones and a complex ligament network. An acute injury to the ankle or foot can be simple or complex. In many cases, treatment for acute foot and ankle injuries can be accomplished through non-operative/conservative means. These types of concerns often include pain, swelling, and decreased function for a period of time. If conservative treatment fails to alleviate the symptoms or the condition, then surgical intervention can often be very helpful. Our experienced orthopaedic surgeons can develop a customized treatment plan that addresses your unique anatomic needs.
For more information about common foot and ankle conditions, please follow the links below to learn more.
- Achilles Tendinitis
- Ankle Sprain
- Bunion/Hallux Abductovalgus
- Flatfoot/Pes Planovalgus Deformity
- Hallux Limitus/Rigidus
- Heel Pain
- Midfoot/Lisfranc Sprain
- Nerve Abnormalities/Injuries
- Osteochondral Injuries
- Plantar Fasciitis
- Ruptured Achilles
The Achilles tendon is the strongest and one of the most important tendons in the entire body. The Achilles tendon is critical to running, jumping, walking, standing, and assists in overall balance.
Tendinitis is the most common condition that affects the tendon. It is a condition of irritation and inflammation in the back of the ankle. It can also involve swelling and thickening of the tendon, and could lead to further degeneration of the tendon resulting in a complete tendon rupture or tear.
The ankle is the most commonly sprained joint in the entire body. Ankle sprains usually occur when one inverts and plantar flexes (rolls) their foot relative to the leg. Typically, the lateral (outside) ligament structures stretch, partially tear, or completely tear. The degree of ankle sprain usually determines the extent of treatment required.
Arthritis is a term that broadly refers to a number of different conditions. It literally, however, means “pain within a joint.” Although there is no cure for arthritis, there are many treatment options available. There are different types of arthritis that may affect your foot and ankle. Osteoarthritis is known as the degenerative, or “wear and tear” arthritis. It is a common problem for many people after they reach middle age. The cartilage becomes worn or frayed, which results in pain, inflammation, and swelling surrounding the joint. Post-traumatic arthritis is very common in the foot and ankle. It occurs after an injury and it may develop years after a fracture, dislocation, severe sprain, ligament injury, or crush injury.
A bunion is a deformity characterized by lateral deviation of the hallux (great toe) toward the second digit. Hallux abductovalgus involves several pathologies of the first metatarsophalangeal joint. There is an enlargement of the medial (inner) first metatarsal head and range of motion often becomes restricted. The position of the great toe often continues to deviate more laterally over time, which can lead to arthritic changes of the first metatarsophalangeal joint. Bunions can be genetic or caused from faulty mechanics and are often associated with chronic use of high-heeled or ill-fitting footwear.
Flatfoot/Pes Planovalgus Deformity
Flatfeet, commonly known as fallen arches, can affect as much as 50% of the population. A flatfoot is due to excessive pronation. Pronation allows the foot to adapt and react to the ground. When there is excessive pronation, the foot splays (widens), the arch drops, and excessive stress and strain occur to many of the ligament and tendon structures supporting the foot and ankle. Flatfeet can lead to many painful conditions such as heel pain, tendinitis, arthritis, and difficulty with walking, running, and/or standing. Flatfeet can affect both children and adults. A child with excessive hyperpronation could possibly develop chronic foot pain or permanent biomechanical imbalances. Treatment for flatfeet include orthotics, pain relieving measures such as anti-inflammatory medication, proper shoe wear, and physical therapy. An adult-acquired flatfoot can be a very debilitating condition. Typically it is caused by a breakdown or tear of the posterior tibial tendon and could often lead to significant faulty mechanics of the foot, ankle, and lower extremity.
A broken bone, or fracture, of the foot or ankle is a common injury that can affect individuals of all ages. Fractures can be simple or complex. If the bone is misaligned (displaced) or the joint is dislocated, more advanced treatment may be necessary. Fractures of the foot or ankle often occur during sports or other recreational events, but they can also occur as a result of a work injury, repetitive use (stress fracture), osteoporosis, or some types of cancer. Sudden, sharp pain, swelling, and bruising are common with a fracture or dislocation, although gradual, growing discomfort may be a sign of a stress fracture or more complex concern.
Hallux limitus is the most common form of arthritis in the foot. It occurs at the base of the big toe. Arthritis of the big toe joint can be very problematic. The condition presents as a stiff joint. It can become chronically painful and cause difficulty in walking and particularly running. Hallux rigidus often progresses in spite of conservative treatment.
When one or more toes (typically excluding the big toe) appear to contract toward the foot in a claw formation, this is known as hammertoe. This condition is caused by an imbalance of the tendons and soft tissue of the affected areas. Discomfort when wearing shoes as a result of pressure on the curled toes and irritation of the knuckle skin is common. A progressive concern, hammertoe will worsen over time without treatment, and increasing pain may be felt in the toes and ball of the foot.
Heel pain has many causes. It can affect the posterior (back near the Achilles tendon), or plantar aspect (bottom) of the heel. Pain in the heel is generally a result of faulty biomechanics (walking or running gait abnormalities). Excessive stress is placed on the heel, which leads to chronic irritation and inflammation.
A more uncommon injury than other sprains or fractures, the Lisfranc sprain is a displacement of the bones or joints in the midfoot where they meet the forefoot. The Lisfranc joint is also known as the tarsometatarsal joint complex, and it includes several smaller joints. One or more joints, tissues, or bones can be affected, depending on the type and severity of the injury.
The nerves of the lower extremities help muscles to function and provide sensation to the skin and tissue. The most common examples of nerve abnormalities include neuropathy, neuroma, and a version of carpal tunnel that affects the ankle called tarsal tunnel. The cause of tarsal tunnel is not fully understood; however, injury, compression, and varicose veins are thought to be contributing factors. Compression, pinching, or abnormal biomechanics of the foot could be a sign of Morton’s neuroma, a thickening of tissue around the nerves in the foot. Complications related to diabetes can also lead to nerve abnormalities, which often feel like tingling, numbness, a burning sensation, pain, and/or weakness, depending on how advanced the condition is. Tingling and numbness may also be a sign of sciatica, typically resulting from a pinched or compressed nerve in the spine.
Osteochondral injuries most often occur after a significant or grade 3 ankle sprain (the most severe type). An osteochondral injury usually occurs when there is an abrasion to the cartilage of the talus (the bone connecting the foot to the leg). If the cartilage injury is severe, it can cause the joint to lock, feel unstable, and may lead to painful joint motion.
Plantar fasciitis occurs when inflammation develops in the band of the fibrous connective tissue along the plantar surface of the foot. The plantar fascia spans from the heel to the ball of the foot. Fasciitis is a common ailment experienced amongst athletes, runners, and those whose profession requires chronic repetitive standing or walking. Plantar fasciitis is by far the most common inflammatory condition experienced in the foot.
A ruptured Achilles tendon often can be very debilitating and, in many cases, surgery is required to repair the tendon directly. The Achilles is the most commonly injured tendon in the foot. It is located on the back of the leg and is a thick, fibrous piece of tissue that connects the calf to the heel bone. Injury most often happens as a result of playing sports, although other causes are possible. Four to six weeks of casting and physical therapy are mainstays of treatment after a complete Achilles tendon tear.
If you have questions about any of the above information, or if you would like to schedule a consultation with one of our experienced physicians, please contact us today.