Your feet
and ankles are one of the most overlooked parts of your
body. When they are working well, it is easy to take them
for granted. But once they hurt, every step is a constant
reminder and can lead to knee, hip and back pain.
There are 28 bones and 48 joints that make up each
foot and ankle. They are connected by a series of ligaments
and muscles that work in a finely coordinated fashion.
The average person takes 4,000 steps a day. Three to
seven times your body weight is transmitted through
your feet with each step. Your feet are designed for
both strength and flexibility in order to support your
body in activities ranging from gentle walking to mountain
climbing. With today's increasing participation in sports,
more people than ever are sustaining injuries to their
feet and ankles.
Injuries to the foot and ankle may involve the bones,
joints, ligaments, tendons, nerves, or a combination
of these. They may also occur suddenly due to an acute
trauma or secondary to repeated stress or overuse of
a certain part. Some injuries even occur from compensation
or weakness or mal-alignment in another part of the
body.
By far, the most common injury is the ankle sprain.
This occurs when ligaments in the ankle joint are stretched
or torn, usually by a twisting injury. Depending on
the amount of damage to the ligaments, a sprain may
be mild, moderate, or severe. A sprained ankle is usually
accompanied by pain, swelling, bruising and difficulty
or inability to put weight on your foot.
Similarly, ankle fractures usually occur with a twist
or blow to the ankle. This may occur in an automobile
accident or when simply stepping off the curb wrong.
Instead of tearing the ligaments however, the bones
are broken. The symptoms are similar to an ankle sprain
with pain, swelling and bruising. Often the diagnosis
can only be made by x-ray.
Tendons may be inflamed or irritated anywhere in the
foot or ankle causing tendonitis. This may start gradually
from overuse or suddenly from a sudden strain. Pain
and swelling are seen along a specific tendon and worsen
with activity than at rest. The achilles tendon is the
prominent tendon at the back of the heel. It is essential
for walking and running and is frequently involved.
It may occasionally rupture if severe enough.
Treatments
Given that so many different injuries in the
foot and ankle have similar symptoms, the
key to appropriate treatment is in an accurate
diagnosis. This can usually be accomplished
by a thorough exam and possibly x-rays of
the involved area. Occasionally more sophisticated
tests such as CT or MRI are employed. Once
the diagnosis is made, treatments may be as
simple as rest, icing, compressive dressings
and elevation and anti-inflammatory medicines
for simple sprains or tendonitis. With increasing
severity, braces or casts may be employed
to allow healing to occur with maximal speed
and minimal discomfort. Exercises and stretching
are frequently necessary to promote healing
while maintaining motion. This may be performed
individually or under the supervision of a
therapist. Lastly, surgery may occasionally
be necessary to reduce or "set"
displaced fractures or unstable joints. The
treatments chosen are individualized to ensure
maximal healing with as rapid a return to
activities as possible. |
|
|
