3 Common Foot & Ankle Injuries in Active Populations

 

Foot & Ankle Injuries in Active Populations


When you live in an area with an active population, you have a tendency to see certain types of injuries. And while the population at large will see similar injuries in terms of volume, in places like Vail and Summit County, we certainly see these "active people” foot injuries even more.

Here are three of the most common foot & ankle injuries in active populations (in no particular order).

Stress Fractures (Foot & Ankle Injuries)

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#1 on our list of common foot injuries in active populations is stress fractures. A stress fracture is a tiny crack in the bone caused by repetitive overload. Ankles and feet are the most common sites of stress fractures.

People who suddenly begin a serious walking or running program without gradually building up to it are prime candidates for stress fractures. So are people who quickly increase the intensity or distance of their exercise or who switch from running on soft surfaces to hard surfaces.

As with other types of fractures, pain and swelling are common, but the symptoms develop more gradually and are less severe than with a fracture due to a direct blow. Some additional points to remember:

  • The pain gets worse as you put weight on your feet, and is relieved by rest.

  • Your physician will generally diagnose a stress fracture with a physical exam.

  • Casts are not usually required for stress fractures, although your physician will likely recommend a slow progression of return to activity and intensity to allow your body to heal.

Plantar fasciitis (Foot Injuries)

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Plantar fasciitis is one of the common foot injuries, affecting the bottom of the foot. It is a common cause of heel pain and is sometimes called a heel spur. Plantar fasciitis is usually just on one side. In about 30 percent of all cases, both feet are affected. Plantar fasciitis can develop from a number of underlying causes. Finding the precise reason for heel pain is sometimes difficult.

How Does Plantar Fasciitis Occur?

As you can imagine, when the foot is on the ground a tremendous amount of force (the full weight of the body) is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body. This leads to stress on the plantar fascia where it attaches to the heel bone. Small tears of the fascia can result. These tears are normally repaired by the body.

As this process of these foot injuries repair repeats itself over and over again, a bone spur (a pointed outgrowth of the bone) sometimes forms as the body tries to firmly attach the fascia to the heel bone. Bone spurs occur along with plantar fasciitis but they are not the cause of the problem.

As we age, the very important fat pad that makes up the fleshy portion of the heel becomes thinner and degenerates (starts to break down). This can lead to inadequate padding on the heel.

What are the symptoms Plantar Fasciitis foot injuries?

The symptoms of plantar fasciitis foot injuries include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot. This is usually most pronounced in the morning when the foot is first placed on the floor.

Prolonged standing can also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the toes back toward the face can be very painful.

Most patients get better with the help of nonsurgical treatments. Stretches for the calf muscles on the back of the lower leg take tension off the plantar fascia. A night splint can be worn while you sleep. Supporting the arch with well-fitted arch support (or orthotic) may also help reduce the pressure of these foot injuries. Shock wave therapy is a newer form of nonsurgical treatment. It uses a machine to generate shock wave pulses to the sore area.

When Do You Need Surgery for Plantar Fasciitis?

Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on one of the following: removing the bone spur (if one is present); releasing the plantar fascia (plantar fasciotomy); releasing pressure on the small nerves in the area.

Suggestions that may help prevent suffering from plantar fasciitis in the first place include wearing sturdy shoes with good arch support for athletic activities; avoid running to lose weight, especially if you've recently gained over a short period of time (start with walking and be sure to stretch your feet and calves thoroughly, then progress to faster walking and running); resting from your activity if you experience pain in the heel. If your pain persists, be sure to see an orthopaedic specialist.

Ankle Sprain - Common Foot and Ankle Injuries #3

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On to the third injury on our list, ankle sprains. Spraining your ankle usually occurs when you overstretch or injure the ligaments that support the ankle. The ligaments on the outside of the ankle are most commonly injured when the foot is turned inward... usually when making an awkward step.

Symptoms include a tender and swollen ankle. You'll most likely have trouble moving your ankle, putting weight on your foot, and walking.

How do you treat an ankle sprain? We recommend the RICE method. RICE stands for Rest, Ice, Compression, and Elevation. (Rest: stop the further activity and keep the injured area in a relaxed and horizontal position. Ice: apply ice to the injured area to prevent or slow swelling. Compression: apply pressure and wrap the injured area. Elevation: raise the injured area to minimize swelling.)

Depending on how bad the sprain is, you may need to begin rehabilitation a few days after the injury, when the swelling has gone down. The goals of this rehabilitation are to restore motion and flexibility and to restore strength and balance.

Generally, you can return to sports after you have the full range of motion in all directions, good strength in the muscles all around the ankle, good balance, and no pain or swelling with exercise or activity.