Suwanee Foot & Ankle Specialists

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• Achilles Tendonitis

  Achilles tendonitis (also tendinitis) is an inflammation of the Achilles tendon, the strong band of tissue that connects the calf muscle to the heel. This condition occurs when excessive stress is put on the tendon. Achilles tendonitis is usually a painful but short-lived condition. It not treated, however, Achilles tendonitis can increase the risk of Achilles tendon rupture, a serious injury requiring immediate medical attention. Most cases of Achilles tendonitis can be prevented by beginning an exercise regimen slowly, with preparation, and by increasing an exercise program gradually and with care. Causes of Achilles Tendonitis Achilles tendonitis is usually caused by excessive or repetitive strain on the tendon. It is frequently found in athletes who suddenly increase their activity level, or in middle-aged individuals who exercise intensely but irregularly. Older individuals are at increased risk of injuring the tendon because tendons weaken during normal aging. Movements that may put strain on the Achilles tendon include walking, running, jumping or pushing up onto the toes. Risk Factors for Achilles Tendonitis Apart from age and improper preparation for exercise, other risk factors for Achilles tendonitis include: Being male, being obese Having flat feet or tight calf muscles Wearing non-supportive footwear Exercising in very cold weather or on hilly terrain Having diabetes or hypertension Taking certain antibiotics, known as fluoroquinolones, such as Cipro and Levaquin, also puts individuals at greater risk of developing Achilles tendonitis. Symptoms of Achilles Tendonitis Typically, the pain of Achilles tendonitis initially manifests after engaging in a sports activity as a mild ache in the calf or above the heel. Other symptoms may include: Increased pain after running or climbing stairs Pain when walking General tenderness and swelling at the site Stiffness or tenderness upon awakening Lessening of pain with mild activity If a patient experiences severe pain or disability in the region of the Achilles tendon, a ruptured tendon should be suspected and medical attention should be sought immediately. Diagnosis of Achilles Tendonitis Achilles tendonitis is usually diagnosed through a combination of physical examination, including an assessment of flexibility, range of motion, reflexes, inflammation and alignment at the injury site, and one or more of the following imaging tests: X-rays MRI scan Ultrasound The chief purpose of these imaging tests is to rule out the possibility of a tendon rupture, a more serious injury that requires surgical intervention. Treatment of Achilles Tendonitis As with most injuries, conservative methods of treatment are normally tried first, but the initial treatment will depend, to some extent, on the patient‘s level of pain and dysfunction. Home Care Tendonitis usually responds well to self-care measures, including rest, ice application, and elevation of the affected area, in combination with over-the-counter pain and anti-inflammatory medication. Assistive Devices and Orthotics In order to relieve pain and accelerate healing by taking weight off the injured area, assistive devices, such as, walking boots, crutches or canes may be recommended and prescribed. Orthotics, or shoe inserts, may also be suggested to provide a cushion that diminishes pressure exerted on the Achilles tendon. Prescribed Medications When over-the-counter medications are insufficient, the doctor may prescribe stronger analgesics or anti-inflammatories. Physical therapy Physical therapy may be advised as an alternative method of treatment. Physical therapists are trained to instruct and assist in exercises the patient can use to stretch, strengthen and heal not only the Achilles tendon, but the adjacent, supportive region. They may also use laser, ultrasound and electrical stimulation as part of the rehabilitative process. Surgery If diagnostic tests have shown that the Achilles tendon is torn or ruptured, or if the patient doesn‘t show marked improvement after several months of conservative treatment, surgical repair of the Achilles tendon may be necessary. If surgical intervention is necessary, most patients will require physical therapy after the operation to regain maximum strength and flexibility.

  Link: Achilles Tendonitis

• Arthritis

  Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is a common form of arthritis caused by the wearing down of the cartilage that protects the bones of a joint. Rheumatoid arthritis is an autoimmune condition caused by an inflammation in the lining of the joints. Both forms of arthritis cause pain, tenderness, and swelling, and may result in loss of movement in the affected joints. Over time, joints affected by arthritis may become severely damaged. Arthritis occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of a joint or after an injury. It can however, affect people of any age, including children. In addition to rheumatoid arthritis and osteoarthritis, there are other types of arthritis, and depending on the cause, may affect people of different ages. Gout is a form of arthritis caused by a build-up of uric acid within the body, that causes painful, swollen, red and inflamed joints. Psoriatic arthritis affects people who have psoriasis, a skin condition characterized by red and scaly patches of skin. Psoriatic arthritis is considered an autoimmune disorder and causes joint inflammation, stiffness and pain. Diagnosis of Arthritis Arthritis is diagnosed through a physical examination, diagnostic tests and imaging exams to evaluate the affected areas of the body. Diagnostic tests may include: Blood tests Urinalysis Joint fluid testing X-rays MRI scans An arthroscopy may also be performed to assess damage within the joints. Treatment for Arthritis Treatment for arthritis varies based on the type and symptoms. Treatment may include medication to control pain, minimize inflammation and slow the progression of joint damage. Exercise and physical therapy may also be effective at keeping joints flexible. In severe cases, surgery may be recommended to repair tendons or replace damaged joints. In addition to medical treatment, some forms of arthritis may respond to lifestyle changes such as losing weight, eating a healthy diet and exercise. Heat and cold therapy may also relieve pain and swelling in joints and assistive devices such as canes or walkers may assist individuals with arthritis with mobility.

  Link: Arthritis

• Athlete’s Foot

  Athlete‘s foot (tinea pedis) is a common fungal infection that develops in the moist areas between the toes or on the soles of the feet. It causes itching, stinging and burning, and, if left untreated, can cause the skin to peel and crack, which, in turn, can lead to bacterial infection. Athlete‘s foot can also affect the toenails, palms and fingers. It is caused by a variety of fungi that belong to the group "dermatophyte," which also causes ringworm, diaper rash and jock itch (dhobi itch). Athlete‘s foot fungus thrives in a warm, moist environment. Fairly contagious, it is often spread in public areas such as swimming pools and locker rooms. It can spread from the feet to the hands or other body parts through physical contact, or from contact with contaminated objects such as rugs, linens, clothes or towels. Risk Factors for Athlete‘s Foot Susceptibility to athlete‘s foot increases with age, and men are more likely to contract it than women. Others at increased risk for athlete‘s foot include those who: Wear tight shoes Sweat a great deal Walk barefoot in moist public areas Share towels or other personal items Have weakened immune systems Have minor skin or nail injuries Having had athlete‘s foot in the past increases the chance of its reoccurring. Symptoms of Athlete‘s Foot Typically, the first symptom of athlete‘s foot is itching between the toes. Other symptoms, including red, itchy, stinging or burning skin, and oozing or crusty blisters, may develop in a short period of time. The skin may flake, crack or peel. If the fungal infection spreads to the nails, the nails may become discolored, and thicken or, possibly, decompose. Diagnosis of Athlete‘s Foot Usually, athlete‘s foot is diagnosed by simple physical examination. In cases in which laboratory confirmation is necessary, a skin culture is taken, or a test called a "KOH exam" is administered. During a KOH exam, a scraping of skin cells is deposited in potassium hydroxide (KOH), which destroys all but the fungal cells, making microscopic detection of the fungus much simpler. Treatment of Athlete‘s Foot Most athlete‘s foot cases, particularly those treated early, respond well (usually within 1 to 2 weeks) to over-the-counter remedies that include creams, lotions and sprays. During the treatment period, keeping feet clean and dry, especially between the toes, and avoiding contact with contaminated surfaces is essential. In some cases, when athlete‘s foot does not respond to treatment with over-the-counter medications, prescription medication may be necessary. Usually taken orally, this medication can have serious side effects, so is prescribed only when necessary. In order to avoid a recurrence of athlete‘s foot, patients are advised to air out their feet as much as possible; to wear clean, dry socks; to avoid wearing shoes made of plastic; to dust their feet frequently with antifungal powders; and to avoid areas that may be contaminated with athlete‘s foot fungus. If the patient has contracted a bacterial infection as a result of athlete‘s foot, topical or oral antibiotics may be prescribed.

  Link: Athlete’s Foot

• Bunions

  A bunion (hallux valgus ) is a common foot problem in which an abnormal bony bump develops at the joint of the big toe, causing the joint to swell outward and become painful. As a result of the enlarged joint, the big toe may become stiff and turn inward. The more deformed the joint becomes, the more it can lead to difficulty walking and to the development of ingrown toenails, corns and calluses. Although bunions are not usually a serious condition, they can be painful and unsightly. Left untreated, they will usually grow larger and more painful over time. Bunions can occur as a result of an inherited foot type, abnormal walking due to other foot problems, or shoes that do not fit properly, In some cases, bunions may develop because of injury, arthritis or neuromuscular disease. Although much less common, bunions can also occur on the small toe where they are referred to as bunionettes. Bunions are diagnosed through physical examination. X-rays are also administered to determine the type and extent of the bone deformity. Nonsurgical Treatment for Bunions Early treatment of bunions is usually considered most effective and there are several treatment options available for this condition. Depending on the severity of the condition, the following methods may be employed: Over-the-counter analgesics and anti-inflammatories (NSAIDs) Wearing roomier, low-heeled shoes Ice pack applications Taping or splinting the foot into a normal position Corticosteroid injections to further reduce inflammation Custom-made orthotics to reposition the foot Physical therapy Ultrasound therapy Whirlpool baths When these conservative methods are insufficient to provide relief and bunions interfere with the patient‘s everyday activities, surgical intervention may become necessary. Surgical Treatments for Bunions There are numerous surgeries that may be performed to treat bunions. The most common surgical procedure for bunions is a bunionectomy, during which the bony protrusion itself is removed. Other surgical procedures which may or may not be performed in conjunction with the bunionectomy, some of which may require the use of metal devices to hold bone structures in place as they heal, include: Realignment of the ligaments around the big toe joint Making small cuts to move the bones into a normal position Reshaping of the affected joint Fusion of the big toe joint Fusion of the joint at the mid-foot region (Lapidus procedure) Implant of all or part of an artificial joint Bunion surgeries are typically performed under local anesthetic, but general anesthesia may be administered if the procedure is particularly complex or if the patient requests it. Bunion surgery requires a lengthy recovery period from 6 weeks to 6 months, so the surgery should never be undertaken lightly. After surgery, most patients will require some type of supportive splint or cast and crutches or a cane for several weeks until they are able to put weight on the surgical site. Typically, patients will need to wear custom-made orthotics after surgery to maintain stability and to keep their foot in the correct position to avoid a reoccurrence of the problem. Risks of Bunion Surgery Like other operations, bunion surgeries include certain risks. In addition to the typical surgical risks of infection or adverse reaction to anesthesia or medication, possible complications include: Stiffness or limited mobility of the big toe Nerve damage leading to pain or numbness Persistent swelling Arthritis or poor circulation at the site Recurrence of the bunion. While a relatively substantial percentage of patients who undergo bunion procedures are not completed satisfied with the results, the majority experience relief of their symptoms and regain the ability to resume normal activities after surgery.

  Link: Bunions

• Chronic Ankle Instability

  Chronic ankle instability is a condition in which the outer portion of the ankle has a chronic sensation of weakness and constantly "gives way" during walking and other activities. While this condition commonly occurs during physical activity, it may even occur while an individual is standing still. Chronic ankle instability commonly affects athletes and is often caused by an ankle sprain that has not healed properly or by repeated ankle sprains. A sprained ankle tears or stretches connective tissues, affecting balance, and if not treated properly, chronic ankle instability and other ankle problems may occur. Symptoms of Chronic Ankle Instability The most common symptom of chronic ankle instability is a wobbly, unstable feeling within the ankle. Additional symptoms that may affect the ankle may include: Pain Tenderness Swelling and discomfort Some individuals with chronic ankle instability may experience a repeated turning of the ankle when walking or running on uneven surfaces. Diagnosing Chronic Ankle Instability Chronic ankle instability may be diagnosed through a physical examination, and a medical history review. Patients may be asked about past ankle injuries and recovery. Imaging tests, such as x-rays are often performed to detect any damage to the ankle bone and provide an accurate diagnosis. Treatment for Chronic Ankle Instability Most cases of chronic ankle instability are treated through conservative measures that may include: Physical therapy Anti-inflammatory medication Ankle bracing Severe cases of chronic ankle instability that do not respond to conservative treatment methods may require surgical correction. Surgery for chronic ankle instability involves repairing or reconstructing the damaged ligaments that cause symptoms. Recovery from surgery varies depending on the specific procedure that is performed.

  Link: Chronic Ankle Instability

• Corns And Calluses

  Corns and calluses are thickened layers of skin that develop on the feet as a result of the skin protecting itself from friction and pressure. Corns and calluses do not often cause serious medical problems, but they may be painful, especially when walking. Many people are also bothered by the appearance of these growths, as they appear as hard, raised bumps or thick, rough areas of skin. Symptoms of Corns and Calluses Both corns and calluses are troublesome conditions that may affect the feet and can be identified through different characteristics. Corns Corns usually have hard center and are surrounded by inflamed skin. They commonly develop on the tops of the toes, sides of the feet and toes, and even in between the toes. They may cause pain when any pressure is applied. Calluses Calluses may appear as rough, thickened patches of skin that usually develop on the soles, and heels of the feet. They can also develop on the palms of the hands and knees. They are often larger than corns, although they are rarely painful. Treatment of Corns and Calluses Home remedies and treatment for corns and calluses may include: Using medicated corn pads Moisturizing the skin Soaking feet in warm water Using salicylic acid Wearing shoe inserts to protect the affected areas Individuals who may be bothered by the inflammation and discomfort of corns and calluses on their feet should consult with a doctor for medical treatment. Doctors may examine the skin to see if any underlying factors are causing problems with the skin. Patients with diabetes may be at a higher risk of developing complications from these conditions and should seek immediate treatment. Medical treatment may include trimming excess skin, antibiotics, and in severe cases, surgery may be necessary. Prevention of Corns and Calluses Although not all corns and calluses can be prevented, the following recommendations may help prevent corns and calluses from developing: Wear shoes that fit properly and have plenty of room Wear felt pads, corn pads or bandages over areas that rub against foot wear Keep skin moisturized Using a pumice stone to rub off dead skin, may also be an effective method to prevent calluses from developing.

  Link: Corns And Calluses

• Diabetic Foot Problems

  Patients with diabetes have an elevated risk of serious foot problems. There are several reasons for this since diabetes involves: poor circulation, a damaged immune system and the possible development of nerve damage (neuropathy). Blood circulation in the feet is weaker than elsewhere in the body to begin with because of distance from the heart and the force of gravity. Further impaired circulation in diabetic patients may slow healing to a dangerous level. Causes of Diabetic Foot Problems Poor circulation makes for slow healing and immune deficiencies allow infections to develop. In addition, diabetic nerve damage may keep patients from sensing heat or injury, and retinopathy which impairs their visual acuity, making detection of injury more difficult. These factors combine to make patients with diabetes highly susceptible to complications from foot problems. Diabetic neuropathy results from blood sugar levels that are elevated for a long period of time. Nerve damage may sometimes result in pain, but more often results in tingling, numbness, burning, or the inability to experience normal sensation. Diabetics frequently miss the sensory signals, such as extreme temperature or pain, designed to alert the body to possible injury. Diabetics need to take precautions such as: not walking barefoot, wearing properly fitted shoes, inspecting their feet daily, and carefully treating small injuries, like blisters or calluses, as soon as they appear. It is very important for patients with diabetes to have regular medical and podiatric examinations. Because even minor abnormalities or injuries may lead to serious complications in patients with diabetes, diabetics need to pay close attention to any and all of the following: Blisters Ingrown toenails Corns Bunions Hammertoes In diabetics, seemingly inconsequential wounds can quickly become infected or develop into ulcers. Ulcers are wounds that destroy tissue and do not heal on their own. Because patients with diabetes may have poor circulation and skin that is excessively dry, they are more prone to injury. Furthermore, because of nerve damage, they may not feel irritations, such as those caused by ill-fitting shoes, that may lead to such injury. This is why daily inspection of the feet is so important. Treatment of Diabetic Foot Problems For patients with diabetes, it is necessary to treat wounds, even small ones, as soon as they are detected. Such wounds often appear on the bottom of the feet, particularly susceptible because they are weight-bearing. Diabetic wound treatment usually follows a protocol that includes: Relieving pressure on the affected area Cleansing the area thoroughly Removing dead skin cells, a process known as debriding Applying medication Dressing the wound If a wound is severe, it may be necessary for the patient to wear specially designed footwear, a brace or other device in order to alleviate pressure and promote healing. Complications of Diabetic Foot Problems Without proper treatment, diabetic foot problems can have grave consequences, including serious infection of skin or bone tissue. Once tissue becomes necrotic, gangrene can development. If gangrene sets in, amputation may be necessary. Risk Factors for Diabetic Foot Problems Apart from the disorder itself, risk factors for diabetic foot problems include: Having kidney or eye complications of diabetes Having poorly regulated blood glucose Having peripheral neuropathy Smoking Drinking alcohol Being overweight While diabetic foot problems are common, patients with diabetes can usually avoid serious complications through vigilance and early intervention.

  Link: Diabetic Foot Problems

• Flat Feet

  Flat feet (pes planus) are extremely common. While usually just a normal anatomical variation that does not result in any serious difficulties, this condition, which causes the feet to lean inward, or pronate, can cause problems over time. Infants feet are naturally flat because of the pad of "baby fat" at the instep. As they grow and begin to walk, their feet normally develop arches. For some children this does not happen and their feet remain flatter than average. While this condition is usually inherited, there are many individuals who have normal arches as children and young adults, but develop flat feet, or "fallen arches," over time. These individuals are said to have acquired flat foot deformity (AFFD). Risk Factors for Problematic Flat Feet Apart from heredity, there are several risk factors that predispose certain individuals to developing flat feet that are troublesome and may require medical intervention. These risk factors include wear and tear due to aging or obesity, disease conditions such as rheumatoid arthritis, traumatic injuries, and dysfunctions of tendons or ligaments. The most serious of the latter is posterior tibial tendon dysfunction in which the primary tendon that supports the arch gradually becomes lax. Types of Flat Feet There are two basic types of flat feet: rigid and supple. If the medial longitudinal arch (MLA) is not visible whether the patient is either seated of standing, the condition is called rigid MLA. If, on the other hand, the MLA is present when the patient is seated or standing up on the toes, disappearing only when the patient stands, the condition is known as supple MLA. The latter condition is less serious and can most often be alleviated with the use of arch supports or orthotics. Symptoms of Flat Feet Many individuals with flat feet have no discomfort at all because of the condition, but some may experience foot fatigue and pain, Some, particularly as they age, develop pain in the heel or arch area, or swelling along the inside of the ankle. When the condition of an individual with flat feet deteriorates, the person may suffer from pain or aching not only in the foot, but in the ankle, knee, or back. It is also common for such people to develop bunions, arthritis, or another foot or ankle deformity. In such cases, medical intervention may become necessary. Diagnosis of Flat Feet While flat feet are diagnosable through simple physical examination, diagnostic imaging tests may be used to detect anatomical abnormalities, soft tissue injuries, such as those affecting the tendons, and any arthritis that has developed in the area. Such imaging tests include: X-rays CT scan Ultrasound scan MRI scan These tests are often necessary to determine whether treatment is necessary and, if so, what type. Treatment of Flat Feet For children with flat feet that trouble them, walking barefoot, particularly on soft terrain like sand, is recommended. There is some evidence that this may assist them in developing normal arches. Wearing supportive shoes and orthotic devices can be helpful to individuals of any age. Other treatments for pain or fatigue resulting from flat feet include over-the-counter anti-inflammatory medication, applications of ice packs, stretching exercises and physical therapy. When flat feet have resulted in, or a have been caused by, more serious foot abnormalities, such as bone spurs or tendon ruptures, surgery may be required. Depending on the patient‘s condition, this may involve removing a bone spur, repairing a tendon or ligament, or fusing one or more bones of the foot.

  Link: Flat Feet

• Foot Sprains And Strains

  Both foot sprains and foot strains are very common injuries, occurring as a result of sports accidents, falls, or other traumas. The difference between the two types of injuries is that sprains affect the ligaments, the thick strands of cartilage attaching one bone to another, and strains affect the muscles or the tendons, thick bands attaching muscle to bone. In both cases, the patient with the injury usually experiences pain (particularly upon movement), swelling, tenderness, bruising, weakness or muscle spasms. Foot sprains, the more serious injury, may also cause possible instability of the joint, most frequently the ankle. Depending on where on the foot the injury occurs, patients may be unable to bear weight until healing takes place. Causes of Foot Sprains and Strains Typically, foot sprains occur in the ankle or midfoot as an abnormal twisting during an athletic event or accident. When a sprain occurs in the big toe, rather than midfoot, it is referred to as turf toe. This injury is the result of an awkward twisting or hyperextension of the affected appendage. Foot strains, on the other hand, happen as the result of a sudden tear or pull of the affected muscle, usually because of overstretching or over contraction. Diagnosis of Foot Sprains and Strains Foot sprains and strains are routinely diagnosed through physical examination of the patient and an evaluation of the circumstances of the injury as well as its resulting symptoms. X-rays may also be taken to confirm the diagnosis and to rule out other problems, such as bone fractures. When diagnosed, both sprains and strains are graded as I, II or III, depending on severity of injury, pain level and lack of function. For both sprains and strains, the categories are designated mild, moderate and severe. Treatment of Foot Sprains and Strains Mild foot sprains and strains can normally be successfully treated through the usual remedies of rest, ice, compression and elevation (RICE). Over-the-counter anti-inflammatory medication is typically administered to reduce swelling and alleviate pain. In some circumstances, mild stretching exercises may be helpful. While severe sprains may require complete immobilization with a cast, with lesser sprains and strains the patient may be able to walk with a bandage or brace, aided by a cane, or may not require any assistance. Most patients heal gradually from mild or moderate sprains in approximately 2 to 8 weeks, depending on the severity of the injury. In the case of severe sprains or strains, a surgical repair may be necessary, in which case the recovery period may stretch to 3 months. After immobilization for a lesser injury or after surgery for a more severe one, a period of physical rehabilitation is necessary.

  Link: Foot Sprains And Strains

• Hallux Rigidus

  Hallux rigidus, meaning "stiff big toe," is a type of degenerative arthritis affecting the joint located at the bottom of the big toe (the metatarsophalangeal joint). This condition causes the joint to stiffen and become painful, eventually making it difficult to walk, stand up, bend, squat or run. Hallux rigidus may occur as a result of structural abnormalities, heredity, traumatic injury, or underlying disease conditions, such as rheumatoid arthritis or gout. As in other forms of arthritis, the affected joint becomes inflamed and may be more painful in cold, damp weather. Hallux rigidus is often accompanied by a bunion on the top of the foot, making shoes uncomfortable to wear. As the condition worsens, patients may experience aching or pain in the knee, hip of lower back. Hallux rigidus is diagnosed through the taking of a medical history, physical examination and X-rays. Nonsurgical Treatment for Hallux Rigidus There are several treatment options for hallux rigidus, depending on the severity of the condition and the patient‘s mobility issues. Nonsurgical treatments include: Avoiding activities that cause pain, such as running Wearing roomier or customized shoes Wearing shoe pads to limit the motion of the big toe Wearing orthotics Taking over-the-counter anti-inflammatory medications Engaging in physical therapy Receiving corticosteroid injections When these conservative methods are insufficient to provide relief, surgical intervention may become necessary. Surgical Treatment for Hallux Rigidus In situations where refraining from designated activities is impossible long term, as in the case of professional athletes, and in cases where conservative methods are not sufficient to reduce pain and inflammation, surgery will be necessary. There are a few surgical procedures that may be performed to relieve hallux rigidus, depending on individual circumstances. These include: Cheilectomy, shaving the bone spur Osteotomy, cutting bone to realign the big toe Arthroplasty, grafting donor tissue Arthrodesis, joint fusion One or another of these surgeries may be more appropriate for particular patients because of the severity of their condition or because of their need to regain full mobility of the affected joint as well as to relieve pain.

  Link: Hallux Rigidus

• Hammertoes

  A hammertoe is an abnormally crooked, contracted toe that takes the shape of an inverted "V." This condition develops when a muscle or tendon imbalance causes the toe to buckle and eventually become stuck in a bent position. Hammertoes may occur for a number of reasons, including hereditary abnormalities, rheumatoid arthritis, traumatic injury, or the wearing of poorly fitted or high-heeled shoes. Risk Factors for Hammertoes Individuals with poor circulation or nerve damage in their feet, such as diabetics, stroke survivors, or those with peripheral artery disease, are more at risk for hammertoes than the general population. Women are more prone to hammertoes than men, presumably because they wear less comfortable shoes with smaller toe boxes. Other risk factors for hammertoes include increasing age and having a second toe longer than the big toe. Symptoms of Hammertoes A patient with a hammertoe may experience pain, swelling, redness and stiffness in the affected toe, usually the toe next to the big toe. It may be difficult or painful to move the hammertoe and it is common for patients to develop corns and calluses as a result of the condition since deformed toes are more likely to be impacted by shoes. Treatment of Hammertoes Treatment for hammertoes depends on the severity of the condition, but simple measures like wearing roomier shoes, custom orthotics or padded inserts to relieve pressure or taking anti-inflammatory medication to relieve pain may provide relief. Certain exercises to stretch and strengthen the feet and toes may also be helpful. Toes may also be taped to correct their position and sometimes corticosteroid injections are administered to alleviate swelling and pain. Only when hammertoes are severe is surgery recommended. When necessary, such surgery may be performed one of three ways: removing a small section of bone from the affected joint (arthroplasty), releasing the tendon that is keeping the toe from lying flat, or fusing the bones of the affected joint to keep the toe straight. Fusion surgery requires the use of a metal pin to hold the toe in position as it heals. Recovery from Surgery for Hammertoe Correction Should surgery be necessary, recovery may take up to 3 months during which time the patient is required to wear comfortable shoes and to do some rehabilitative exercises. The home remedies recommended for postsurgical care are easily remembered by using the acronym RICE, standing for: rest, ice, compression and elevation.

  Link: Hammertoes

• Heel Spurs

  A heel spur is an outgrowth of bone, known as a bone spur or osteophyte, on the heel of the foot. Bone spurs form as the body attempts to repair damage caused by constant physical irritation, pressure or stress, and may form in various regions of the body. They develop in the heel for a variety of reasons. In many cases, the long ligament that runs across the bottom of the foot, called the plantar fascia, gets pulled too tightly and an inflammation known as plantar fasciitis results. As the body tries to repair the damage, a heel spur may form. Causes of Heel Spurs Plantar fasciitis is the most common reason for a heel spur to develop, but there are many other possible contributing factors. Normal aging causes cartilage and ligaments to wear down and bones to rub together and the body may create a bone spur in response. Activities like dancing, running and jumping can exacerbate the irritation, as can being overweight or wearing ill-fitting or high-heeled shoes. Having flat feet, naturally tight calves or very high arches, or standing or walking for prolonged periods also puts individuals at greater risk for developing heel spurs. Symptoms of Heel Spurs A patient with heel spurs experiences sharp heel pain when weight is put on the affected foot. Pain may also be felt along the arch of the foot or on the back of the leg during walking. The pain is most intense when the patient stands after sitting or lying for an extended period. Severe pain upon arising after sleep is a frequent complaint. While it is the plantar fasciitis, not the heel spur, that is usually causing the pain, the heel spur, which can be seen on X-ray, demonstrates that the foot damage is of relatively long-standing. Treatment of Heel Spurs Treatments for plantar fasciitis and heel spurs begin with rest, stretching exercises and anti-inflammatory medications, such as ibuprofen, to alleviate pain. Corticosteroid injections at the site may be administered as well. Certain lifestyle adjustments, such as weight loss and wearing well-fitted shoes and appropriate orthotics, may help to keep the condition from becoming chronic. When these conservative methods do not provide relief, extracorporeal shock wave therapy at the site, or night splints to stretch the calf and arch during sleep, may be considered. In severe cases heel spurs may necessitate surgery.

  Link: Heel Spurs

• Ingrown Toenails

  Ingrown toenails are toenails that have grown into the skin of the toe, causing pain, swelling and, frequently, infection. Usually, it is the corner of the big toe that is affected by this condition, although the smaller toes can also develop this problem. Ingrown toenails may occur as a result of tight-fitting shoes, a curved growth pattern of the nail itself, an injury, or improper toenail cutting. If left untreated, an ingrown toenail is likely to develop an infection and may even require surgery to remove the nail. Symptoms of Ingrown Toenails Ingrown toenails present with pain, swelling and redness. Many ingrown toenails, particularly when they first develop, can be treated at home by soaking the foot in warm water, keeping the area clean, applying antibiotic cream to the area and wrapping the toe in gauze or bandages. If there are signs of active infection, such as pus, however, or if the patient has diabetes or another disorder that interferes with proper circulation or immune response, a physician should be promptly consulted. Treatment of Ingrown Toenails The doctor may place a piece of cotton under the nail to separate it from the skin that it is growing into, encouraging growth above the edge of the skin. For more severe or recurrent cases, part of the nail and the underlying tissue may have to be removed in order to remove the infection. Removal of an ingrown toenail may be partial or complete and is performed under local anesthetic. The procedure can be done surgically or using chemical or laser techniques. Patients can prevent ingrown toenails by protecting their feet from trauma, using extreme care when cutting their toenails, and by wearing comfortable, well-fitting shoes. Patients with diabetes and other underlying conditions that put them at greater risk for infection or complications should take special precautions and visit a podiatrist at regular intervals.

  Link: Ingrown Toenails

• Morton’s Neuroma

  Morton‘s neuroma is a painful condition in which excess fibrous tissue accumulates around a nerve in the ball the foot, usually between the third and fourth toes. Patients may experience pain, burning, tingling or numbness in the foot, radiating into the toes, and often report feeling as if they are walking on a pebble. Pain may be soothed by taking weight off the foot or by massaging the area. The pain of Morton‘s neuroma is likely to worsen over time, becoming more severe and more persistent. The condition is found more frequently in women than in men. Risk Factors for Morton‘s Neuroma The specific cause of a Morton‘s neuroma is unknown, but the condition begins a nerve in the forefoot is compressed by the long bones called the metatarsals. This occurs when these bones move abnormally or when there is a traumatic injury to the area. Risk factors for a Morton‘s neuroma include: Flat feet or high arches Bunions, hammertoes, or other foot deformities Ill-fitting or high-heeled shoes Repetitive trauma caused by running or other sports Injury resulting from previous surgery Diagnosis of Morton‘s Neuroma Morton‘s neuroma is normally diagnosed by a physical examination, an MRI and a high-resolution ultrasound. X-rays or electromyography (EMG) may be administered to rule out other conditions that cause similar symptoms, such as arthritis, stress fractures, tendon inflammation or neuromuscular disorders. Treatment of Morton‘s Neuroma Home remedies for Morton‘s neuroma include resting the foot, applying ice packs and massaging the area to relax the foot muscles. Taking anti-inflammatory medications, wearing roomier shoes, and padding or taping the area may also be helpful. Medical interventions include nerve-blocking medications and corticosteroid injections to reduce inflammation. Physical therapy and custom-made orthotics can help to correct abnormal metatarsal movement. If none of these more conservative treatments relieves the symptoms, a surgical procedure may be required. One minimally invasive procedure sometimes used is cryogenic neuroablation. Exposing the nerve to freezing temperatures can disrupt the transmission of pain signals from the nerve, but it is a temporary solution. Another option is decompression surgery, in which the structure pinching the nerve, often a ligament, is removed. In some cases, relief will only be provided by a procedure to remove the thickened nerve tissue itself. If the nerve is permanently damaged, it can be removed, either through chemical destruction or surgical excision. While most operations for Morton‘s neuroma are successful, a small percentage of patients continue to experience pain even after surgery.

  Link: Morton’s Neuroma

• Mucoid Cyst

  Mucoid cysts are fluid-filled sacs that usually develop on or near the joints of the fingers, although the toes can be affected. Typically benign, they feel like firm, rubbery lumps, and are usually not painful unless they grow large enough to put pressure on nerves. Mucoid cysts are also referred to as mucous cysts, ganglion cysts, myxoid cysts, synovial cysts, periarticular fibromas and mucinous pseudocysts. Signs of Mucoid Cysts A mucoid cyst presents as a small raised lump that is filled with gelatinous fluid. A mucoid cyst usually develops in the proximal nail fold, which is just above the cuticle, or at the distal interphalangeal (DIP) joint, which is the first joint from the tip of the finger. A mucoid cyst can appear suddenly or develop over time, and may indicate osteoarthritis in the joint near which it appears. Treatment for Mucoid Cysts Treatment is not required for the majority of mucoid cysts. If, however, treatment is recommended, digital mucoid cysts may be: Punctured, aspirated and drained Injected with steroids or sclerosing alcohol Scraped with a curette and then compressed Surgically removed After aspiration alone, fluid in the cyst often comes back. Surgical excision is appropriate for aesthetic reasons, or if the cyst is large enough to cause pain or to interfere with the function of the nail or hand.

  Link: Mucoid Cyst

• Plantar Fasciitis

  Plantar fasciitis is an inflammation of the plantar fascia, a band of fibrous connective tissue that runs along the bottom of the foot from the heel to the base of the toes. This band normally supports the muscles and the arch of the foot, functioning as a shock absorber, but if, after repeated stretching, it tears, inflammation and severe heel pain, exacerbated by standing or walking, result. Plantar fasciitis is the most frequent cause of heel pain and a common reason for the development of outgrowths of bone, called heel spurs, as well. It is more common in women and tends to occur as people age. Risk Factors for Plantar Fasciitis Although plantar fasciitis can occur in any individual, certain risk factors predispose people to developing the condition. Some people are at an anatomical or physical disadvantage because of they have: Flat feet and excessive pronation Extremely high arches Tight Achilles tendons or calf muscles Legs of uneven lengths An abnormal gait Some individuals increase their chances of developing plantar fasciitis by: Being overweight Walking, standing, or running for long periods Beginning or intensifying exercise without proper preparation Wearing poorly fitted, worn-out, or high-heeled shoes Plantar fasciitis, while more common as people in patients between 40 and 60 years of age, may occur in younger individuals who spend a great deal of time standing or running, like athletes or soldiers. Arthritis may be a factor in the development of the condition. Symptoms of Plantar Fasciitis Patients with plantar fasciitis have sharp pain in the heel which may extend to the arch of the foot or to the back of the leg during walking. The pain is usually worst in the morning when the patient first steps down on the affected foot. It may subside somewhat and then recur when the patient rises to a standing position after sitting or lying down. Stair climbing may be especially difficult. Plantar fasciitis does not usually cause foot pain at night. Diagnosis of Plantar Fasciitis In order to diagnose plantar fasciitis, the doctor does a thorough examination of the patient‘s feet that includes observing the patient stand and walk. A medical history is also taken, including information concerning what time of day the patient‘s feet hurt most and what types of physical activities elicit pain. If the doctor suspects an anatomical problem with the bones of the foot, or another type of injury, such as a stress fractures, an X-ray may also be taken. Treatment of Plantar Fasciitis As with other medical conditions, the simplest remedies are typically the first treatments tried. These include: Rest Application of ice to the heel Over-the-counter pain medications and anti-inflammatories Exercises that stretch the toes and calves Purchase of more supportive shoes Wearing orthotics (shoe inserts) If these preliminary treatments don‘t work, the doctor may advise the wearing of splints during the night or the administration of corticosteroid injections directly into the site. While most patients find relief within several days or weeks, some will not experience complete recovery for many months. If recovery doesn‘t occur after 6 to 12 months, surgical intervention may be necessary.

  Link: Plantar Fasciitis

• Posterior Tibial Tendon Dysfunction

  Posterior tibial tendon dysfunction occurs when the posterior tibial tendon of the foot becomes torn or inflamed. Commonly referred to as flat foot, this condition often results in the inability to provide support for the arch of the foot. The posterior tibial tendon is the tendon that attaches the calf muscle to the bones on the inside of the foot and ankle, and is responsible for creating the arch in the feet. This tendon provides the support that normally holds up the arch of the foot while walking. As the tibial tendon tears, individuals often experience pain as the foot gradually rolls inward and flattens. Over time, the supporting ligaments in the foot begin to stretch and tear as well. Causes of Posterior Tibial Tendon Dysfunction Posterior tibial tendon dysfunction may be a condition that some people are born with. Other causes may include: Stretched or torn tendons Nerve problems Fractured or dislocated bones in the leg or foot Posterior tibial tendon dysfunction often occurs in athletes such as basketball and tennis players who may have tears in this tendon from repetitive use. This condition is also more common in women, people who are obese and people with diabetes. Symptoms of Posterior Tibial Tendon Dysfunction Some people with this condition may not experience any symptoms at all, however, others may experience: Pain along the inside of the foot and ankle Swelling Limited flexibility Pain that intensifies with activity Pain on the outside of the ankle The shape of the foot may also change in individuals with posterior tibial tendon dysfunction, as the heel may tilt outwards and the ankle may roll inwards, as the arch of the foot collapses. Diagnosis of Posterior Tibial Tendon Dysfunction Tibial tendon dysfunction is diagnosed through a physical examination and a review of symptoms as well as diagnostic tests that may include X-rays, CT scans or MRI scans. Treatment of Posterior Tibial Tendon Dysfunction Initial treatment for posterior tibial tendon dysfunction may include conservative methods that may include: Rest Applying ice to the affected area Anti-inflammatory medication Immobilization through a short cast or walking boot Physical therapy Additional treatment for this condition may also include orthotic devices or braces to support the joints of the foot. In severe cases that do not respond to conservative methods, surgery may be required to cut or realign the bones and correct the deformity. Surgery often involves an osteotomy, which cuts and shifts the heel bone in order to transfer another tendon to be used in place of the torn tibial tendon. Other surgical methods may also include lengthening of the achilles tendon or a fusion of the joints in the back of the foot. Most patients have successful results from surgery. Left untreated, posterior tibial tendon dysfunction may cause arthritis in the foot and ankle and limitations to physical activity.

  Link: Posterior Tibial Tendon Dysfunction

• Stress Fracture

  A stress fracture is a very thin crack in a bone that can result from repetitive stress. Playing sports or performing other activities that put repeated pressure on bones are often causes of stress fractures. Although they can happen to anyone, stress fractures are more common in athletes such as runners, dancers, gymnasts, and basketball or tennis players. Stress fractures can also be caused by diseases that weaken bones. Symptoms of Stress Fractures Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Rarely, they occur in the forearm. At first, pain caused by a stress fracture may be barely noticeable, but it tends to worsen with time. There may also be swelling or bruising around the site of the injury. Definitive diagnosis of a stress fracture is made through diagnostic imaging tests such as X-rays, MRI scans and bone scans. Risk Factors for Stress Fractures Although athletes, especially track and field athletes, have increased susceptibility to stress fractures, they can occur in anyone, particularly those who take up a new sport or begin a period of extreme exercise. Military recruits, who are abruptly required to engage in prolonged periods of intense exercise, frequently suffer stress fractures. Other risk factors for stress fractures include the following: Abnormal or absent menstrual periods Flat feet or high arches Bones weakened by osteoporosis, bone cancer or other diseases Bones can also become weak from long-term use of corticosteroids and other medications. Treatment of Stress Fractures Treatment of a stress fracture depends on its location and severity, but usually consists of resting the affected bone, applying ice, reducing weight-bearing activity, and immobilizing the injured area with tape, a cast or a splint. For leg or foot stress fractures, patients often use canes or crutches during recovery. In some cases, surgery may be necessary to hold the bone in position (internal fixation). Surgery is more common if the fracture is in a region in which blood circulation is poor, or if the patient has experienced more than one such fracture. When surgery is necessary, metal pins or screws may be needed to hold the bone in place as it heals. Physical rehabilitation is necessary after surgery, and patients should resume physical activity only gradually.

  Link: Stress Fracture

• Toe Fracture

  A toe fracture, though very painful, is not usually a serious injury. Nonetheless, it must be appropriately treated to ensure proper healing. In most cases, a toe fracture, particularly of one of the small toes, can be treated nonsurgically, frequently by home remedies. At times, however, if the fracture is more severe, greater immobilization or surgery maybe required to prevent permanent damage. Causes of a Toe Fracture There are many possible causes of a toe fracture. The injury may be caused be stubbing the toe, dropping something on it, or bending it out of position. A stress fracture, also known as a hairline fracture, may be the result of a sudden increase in the intensity of simple exercise, like walking or running. Symptoms of a Toe Fracture There are several symptoms that may indicate a toe has been fractured, including one or more of the following: Severe pain increased by touch or movement Inability to move the toe Swelling Dark bruising Deformity (abnormal positioning) Sometimes when a toe, or any bone, is fractured, a popping sound is heard at the moment of impact. Diagnosis of a Toe Fracture In order to diagnose a toe fracture, after a physical examination, the foot is X-rayed to assess the damage. During the physical examination, the doctor looks for swelling, dark bruising, the location of the worst pain, and any abnormality in positioning. The X-ray shows whether there is actually a fracture, as well as its precise location and severity. Treatment of a Toe Fracture Usually, in the case of a minor toe fracture of one of the small toes, home remedies are all that is necessary. These include rest, application of ice, and elevation of the affected foot. In many cases, the injured toe is simply taped to an adjacent toe to protect it from further injury and promote healing. This is known as "buddy taping." When a toe is buddy-taped, soft padding is placed between the toes to prevent chafing. There are situations in which buddy taping is not possible, such as if the patient has diabetes or peripheral arterial disease, either of which impair circulation, or if the procedure increases the patient‘s pain level. When buddy taping is administered, it is generally left in position for 2 to 4 weeks. The fractured toe usually heals within 4 to 6 weeks. In rare instances, when the fracture is severe, the toe may require full immobilization to protect it from further injury. This may take the form of a splint, brace, or short leg cast. Surgery is sometimes necessary, most often when the big toe is the one fractured. Without treatment of a severe fracture, there may be serious consequences, such as limited mobility, deformity of the toe in question, and long-term pain.

  Link: Toe Fracture

• Ankle Fracture

  An ankle fracture, commonly known as a broken ankle, involves any type of break or crack in the tibia, fibula, or talus. Common causes of an ankle fracture may include a sports injury, a motor vehicle accident or a fall. An ankle fracture can include injury to one or more of the bones that make up the ankle joint. The more bones that are broken, the more complicated and severe the fracture is. Treatment for a broken ankle depends on the type and severity of the individual fracture, but may include wearing a cast or brace, applying ice and taking anti-inflammatory medication. Stable fractures can usually heal on their own within a few weeks, while more complicated ones may require surgery to reposition the broken bone. Symptoms of an Ankle Fracture Individuals with an ankle fracture may experience difficulty walking or putting weight on the affected ankle. Additional symptoms may include: Pain Swelling Bruising Tenderness Physical deformity Because the ankle and foot may become very swollen, it may be difficult for some people with a broken ankle to put shoes on. Diagnosis of an Ankle Fracture An ankle fracture is diagnosed through a physical examination and diagnostic imaging tests that may include: X-ray CT scan MRI scan A bone scan may also be performed to determine which parts of the bone have been damaged. Treatment of an Ankle Fracture Treatment for an ankle fracture varies depending on the type and severity of the individual fracture. Medication may be prescribed to control inflammation and treat pain. Resting, applying ice and elevating the ankle, are all methods that can contribute to the healing of the fracture. In most cases, a cast or brace will be used while the ankle heals. In severe cases, surgery may be necessary to reposition the broken bone. Although the methods used to treat ankle fractures vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the ankle and help the patient return to all usual activities. After the ankle bone has healed from the initial treatment for the fracture, and patients can bear weight on the joint, a physical therapy regimen is implemented to strengthen muscles and increase mobility. Without proper rehabilitation, complications such as chronic pain, inflammation and weakness, may cause difficulty walking and performing physical activities.

  Link: Ankle Fracture

• Ankle Ligament Reconstruction

  An ankle sprain is a common injury that occurs when the ankle is twisted or turned, and results in torn ligaments within the joint. This injury often causes pain, swelling and bruising, and if it does not heal properly, it may lead to chronic ankle instability or repeated ankle sprains. Ankle ligament reconstruction is a procedure commonly performed on patients experiencing chronic ankle instability and repeated ankles sprains. It is effective in repairing torn ligaments, tightening loosened ligaments and improving the overall stability of the joint. The Ankle Ligament Reconstruction Procedure The ankle ligament reconstruction procedure is performed on an outpatient basis while the patient is sedated under general anesthesia. Different techniques may be used by the surgeon, depending on the condition of the ankle. During the procedure, torn ligaments may be repaired with stitches or sutures, two ligaments may be reattached, or part of a lateral tendon around the ankle may be used to repair the torn ligament. After the procedure is complete, a splint or cast is applied to the ankle. This procedure may take up to 2 hours to perform. Risks of Ankle Ligament Reconstruction As with any surgery, there are possible complications associated with ankle ligament reconstruction which may include: Reaction to anesthesia Nerve damage Infection Bleeding After surgery, blood clots within the veins of the legs may also occur. Recovery from Ankle Ligament Reconstruction After surgery, patients will use crutches for up to two weeks. After this time, they may begin walking in a removable walking boot. Physical therapy is a crucial part of the healing process, and usually begins after about six weeks. Physical therapy treatments focus on improving range of motion without putting excessive strain on the healing tendons. Muscle-stengthening exercises and range of motion exercises may all be used to increase movement and mobility. Most patients fully recover from ankle ligament reconstruction after three to four months, and at that time they can resume all regular activities including running and exercise.

  Link: Ankle Ligament Reconstruction

• Diabetic Foot Care

  Because of their distance from the heart and because of the force of gravity, the feet and legs are more at risk for difficulties with circulation and healing than other parts of the body. In patients with diabetes, these risks are exacerbated by the disease since diabetes can lead to: impaired circulation, nerve damage (neuropathy), and a damaged immune system. Not only is the diabetic patient less able to fight off infection, but is also frequently unaware of injuries because of neuropathy and impaired vision. Daily Regimen Since patients with diabetes are at high risk for developing problems with their feet, it is extremely important for them to establish a healthy routine of foot care. An effective daily regimen should include: Thoroughly inspecting the feet every day Washing the feet in temperate water daily Keeping the feet dry, especially between the toes Changing socks daily Taking careful care of nails, corns, calluses Applying moisturizer to dry skin, but not between the toes Not walking barefoot Wearing properly fitted shoes Carefully monitoring blood glucose levels Diabetic patients should also make sure to take care of their general health in order to avoid potentially serious problems with their feet. In addition to having regular medical checkups, they should have regular appointments with a podiatrist to make sure of proper foot care and the detection of any injuries or abnormalities. A healthy lifestyle is especially important for patients with diabetes. This includes maintaining an appropriate weight, engaging in gentle exercise such as swimming or biking, avoiding smoking and not drinking alcohol, and keeping cholesterol levels under control. Following these directives considerably lowers the probability of the development of diabetic foot problems and lowers the risk of the serious consequences of neglect.

  Link: Diabetic Foot Care

• Physical Therapy For Ankle Conditions

  The ankle is the joint that connects the shinbone, or the tibia, to the upper bone of the foot. When part of the ankle has been damaged, it can affect other parts of the ankle and foot, leading to chronic ankle instability and other ankle problems. Certain ankle conditions may affect the joints of the ankle, causing stiffness and pain, and difficulty walking. Individuals with chronic ankle problems may undergo rehabilitation to regain strength in the ankle, increase flexibility, or relearn how to perform tasks such as walking. Rehabilitation may be helpful in treating patients who may suffer from: Osteoarthritis of the ankle Ankle impingement Chronic ankle instability Ankle sprain Although the initial methods used to treat ankle problems may vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the ankle and help the patient return to all usual activities. Without proper rehabilitation, complications such as chronic pain, inflammation and weakness may cause difficulty walking and performing physical activities. Physical therapy treatments may include: Muscle-strengthening exercises Gradual weight-bearing activities Range-of-motion exercises Balance training Depending on the patient‘s physical job requirements or athletic activities, a physical therapist may create a tailored treatment plan. Recovery times vary for each patient, and in severe cases, a physical therapy program may be on-going to ensure full mobility is restored to the ankle.

  Link: Physical Therapy For Ankle Conditions

• Reconstructive Foot Surgery

  Disorders of the foot develop from a wide range of causes, many of which can be treated with reconstructive foot surgery. Reconstructive surgery can help repair congenital defects, diseases and injuries, often alleviating aesthetic concerns at the same time as it relieves serious medical symptoms and restores normal function. While conservative treatments are frequently the first response to foot disorders, in many cases, reconstructive surgery may be the best available option. Most often, reconstructive foot surgery can be performed outpatient, with minimally invasive techniques, sometimes right in the doctor‘s office. Reasons for Reconstructive Foot Surgery Reconstructive foot surgery can be used to treat a wide range of foot problems which, while they may result from physical trauma to bone or muscle, may also stem from disorders of various body systems that interfere with circulation, tissue health or locomotion. Patients may require reconstructive foot surgery because of: Hereditary or traumatic deformity Vascular disease Metabolic disorder Tumor Infection Arthritic disease Surgery can involve any part of the foot and may involve skin, tendon, bone, joint, ligament or muscle repair. Screws, pins, wires and plates may be required to help the foot heal and ensure full recovery. Common Types of Reconstructive Foot Surgery The type of surgical procedure performed depends on the type and severity of the problem, but, regardless of type, the surgical goal is to alleviate pain and restore weight-bearing stability, function and normal appearance. Types of reconstructive foot surgery commonly performed include: Hammertoe repair Bunionectomy Endoscopic plantar fascia release Fasciotomy Open ankle fusion Ankle replacement (arthroplasty) Toe or ankle amputation Tumor removal Removal of ganglion cyst Recovery time varies, depending on the specific surgical procedure performed. For most varieties of reconstructive foot surgery, the patient‘s foot will have to be immobilized with a bandage or cast for a period of several weeks to many months and the patient may require crutches until the foot can bear weight. After surgery, a program of physical therapy will be necessary to assist the patient in regaining full strength and range of motion.

  Link: Reconstructive Foot Surgery

• Rehabilitation After Ankle Fracture

  An ankle fracture, commonly known as a broken ankle, involves any type of break or crack, often caused by a sports injury or a fall, in the tibia, fibula, or talus. This injury can include injury to one or more of the bones that make up the ankle joint. The more bones that are broken, the more complicated and severe the fracture is. Treatment for a broken ankle depends on the type and severity of the individual fracture, but may include wearing a cast or brace, applying ice and taking anti-inflammatory medication. Stable fractures can usually heal on their own within a few weeks, while more complicated ones may require surgery to reposition the broken bone. Although the methods used to treat ankle fractures vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the ankle and help the patient return to all usual activities. After the ankle bone has healed from the initial treatment for the fracture, and patients can bear weight on the joint, a physical therapy regimen is implemented to strengthen muscles and increase mobility. Without proper rehabilitation, complications such as chronic pain, inflammation and weakness may cause difficulty walking and performing physical activities. Nonsurgical Rehabilitation for Ankle Fracture If the ankle fracture does not require surgery, it is often treated with a cast or removable brace, and patients are typically advised not to put any weight on the ankle for about 6 weeks. A physical therapist will help the patient to walk safely using crutches or a walker, or another assistive device. Once the cast or brace has been removed and patients can begin moving the ankle, physical therapy and home exercise are extremely important for a full recovery. Physical therapy treatments may include: Muscle-strengthening exercises Gradual weight-bearing activities Range-of-motion exercises Balance training Depending on the patient‘s physical job requirements or athletic activities, a physical therapist may create a tailored treatment plan. Recovery times vary for each patient, but most individuals can return to all normal activities within 3 to 4 months. Rehabilitation After Ankle Fracture Surgery Rehabilitation after ankle fracture surgery is often a slow and cautious process. After surgery, the ankle is put in a cast or set in a brace for about 6 weeks. A physical therapist works with the patient to make sure that he or she is using crutches safely. The patient may not be able to bear weight on the ankle for up to 12 weeks. Initial physical therapy treatments may focus on controlling pain and swelling with the use of ice or electrical stimulation treatments. Massage may also be used to ease muscle pain. Physical therapy exercise treatments focus on improving range of motion without putting excessive strain on the healing bone or ligaments. As the ankle heals, muscle-stengthening exercises, range-of-motion exercises and balance training may all be used to increase movement and mobility. Full recovery after ankle fracture surgery may take up to 6 months.

  Link: Rehabilitation After Ankle Fracture

• Rehabilitation For Foot Conditions

  Although the methods used to treat foot injuries vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the foot and ankle and help the patient return to all usual activities. After the foot has healed from the initial treatment and patients can bear weight on the joint, a physical therapy regimen is implemented to strengthen muscles and increase mobility. Rehabilitation often takes three forms: Pain management to decrease discomfort Physical therapy to increase strength and mobility Occupational therapy to help perform day-to-day activities Without proper rehabilitation, complications such as chronic pain, inflammation and weakness may cause difficulty walking and performing physical activities. Nonsurgical Rehabilitation If the foot injury does not require surgery, it may be treated with a removable brace, and patients are typically advised not to put any weight on the foot for about 6 weeks. If necessary, a physical therapist will help the patient to walk safely using crutches, a walker, or other assistive device. Once the brace has been removed and patients can begin moving the foot and ankle, physical therapy and home exercise are extremely important for a full recovery. Physical therapy treatments may include: Muscle-strengthening exercises Gradual weight-bearing activities Range-of-motion exercises Balance training A physical therapist may create a tailored treatment plan, based on the patient‘s physical job requirements or athletic activities. Recovery times vary for each patient, depending on the severity of the injury. Rehabilitation After Surgery Rehabilitation after surgery is often a slow and cautious process. After surgery, the foot is put in a cast or set in a brace for about 6 weeks. A physical therapist works with the patient to make sure that he or she is using crutches safely. The patient may not be able to bear weight on the ankle for up to 12 weeks. Initial physical therapy treatments may focus on controlling pain and swelling with the use of ice or electrical stimulation treatments. Massage may also be used to ease muscle pain. Physical therapy exercise treatments focus on improving range of motion without putting excessive strain on the healing bone or ligaments. As healing progresses, muscle-stengthening exercises, range-of-motion exercises and balance training may all be used to increase movement and mobility. Full recovery after surgery may take up to 6 months.

  Link: Rehabilitation For Foot Conditions

• Sports Medicine

  Sports medicine is a subspecialty of orthopaedics that deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate injuries so patients can quickly return to their athletic activities. Participating in sports places wear-and-tear on the body, and can lead to orthopaedic injuries. Athletes are susceptible to injuries that include stress fractures and chronic pain, as well as tearing or stretching of internal structures. Treatment for these conditions can involve surgery, orthotics, physical therapy and rest. Specialized Care in Sports Medicine Many physicians work together to help a patient regain maximum use of an injured limb or joint. A sports injury is typically treated by a physician, orthopaedic surgeon, rehabilitation specialist, athletic trainer and physical therapist, all of whom have specialized training in the diagnosis, treatment and prevention of sports injuries. Common injuries treated in sports medicine include: Anterior cruciate ligament (ACL) tears Compartment syndrome Fractures Heat exhaustion Muscle contusions (bruises) Muscle cramps Shin splints Sprains and strains Stress fractures Torn tendons and ligaments Sports injuries are often repairable with arthroscopy, which is a minimally invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and disease through small incisions in the skin. Prevention of Injuries in Sports Medicine In order to prevent sports injuries, it is important for athletes to take care of themselves before, during and after physical activity; this helps to ensure long-term athletic health. Some of the most effective injury prevention tips include the following: Staying hydrated Taking time to rest Not working out on an empty stomach Warming up before exercising Increasing activity levels only gradually Seeking proper medical care at the first sign of a sports injury is imperative because continued activity can lead to even more damage.

  Link: Sports Medicine