Category: Services

Ankle Sprain

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.

Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising.

Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.

To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercising, stretching, and wearing well-fitted shoes.

Chronic Lateral Ankle Pain

Chronic Lateral Ankle Pain

Chronic lateral ankle pain is recurring or chronic pain on the outside part of the ankle that often develops after an injury such as a sprained ankle.

Signs and symptoms include:

• Ankle instability.
• Difficulty walking on uneven ground or in high heels.
• Pain, sometimes intense, on the outer side of the ankle.
• Repeated ankle sprains.
• Stiffness.
• Swelling.
• Tenderness.

Although ankle sprains are the most common cause of chronic lateral ankle pain, other causes may include:

• A fracture in one of the bones that make up the ankle joint.
• Arthritis of the ankle joint.
• Inflammation of the joint lining.
• Injury to the nerves that pass through the ankle. In this case, the nerves become stretched, torn, injured by a direct blow, or pinched under pressure.
• Scar tissue in the ankle after a sprain. The scar tissue takes up space in the joint, putting pressure on the ligaments.
• Torn or inflamed tendon.

Treatments for chronic lateral ankle pain include:

• Over the counter or prescription anti-inflammatory medications to reduce swelling. Note: Please consult your physician before taking any medications.
• Physical therapy, including tilt-board exercises that focus on strengthening the muscles, restoring range of motion, and increasing your perception of joint position.
• Ankle braces or other supports.
• Steroid medication.
• Immobilization to allow the bone to heal (in cases of fractures).

Osteochondritis

Osteochondritis is a lesion that usually causes pain and stiffness of the ankle joint and affects all age groups. Osteochondritis is caused by a twisting-type injury to the ankle. Symptoms include swelling and ankle pain.

Immobilization of the foot and ankle for a period of time usually resolves the problem. In more severe cases, however, surgery may be prescribed. During the surgery, loose fragments of cartilage and bone are removed from the ankle joint and, in some cases, small drill holes are made in the defect to stimulate new blood vessels and help form scar tissue that will fill the defect.

Achilles Tendonitis

The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.

Events that can cause Achilles tendonitis may include:

• Hill running or stair climbing.
• Overuse, stemming from the natural lack of flexibility in the calf muscles.
• Rapidly increasing mileage or speed when walking, jogging, or running.
• Starting up too quickly after a layoff in exercise or sports activity, without adequately stretching and warming up the foot.
• Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort, such as in a sprint.
• Improper footwear and/or a tendency toward overpronation.

Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include:

• Recurring localized pain, sometimes severe, along the tendon during or a few hours after running.
• Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.
• Sluggishness in your leg.
• Mild or severe swelling.
• Stiffness that generally diminishes as the tendon warms up with use.
   

Treatment normally includes:

• A bandage specifically designed to restrict motion of the tendon.
• Taking nonsteroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.
• Orthotics, which are corrective shoe inserts designed to help support the muscle and relieve stress on the tendon. Both nonprescription orthoses (such as a heel pads or over-the-counter shoe inserts) and prescribed custom orthotics may be recommended depending on the length and severity of the problem.
• Rest and switching to exercises that do not stress the tendon (such as swimming).
• Stretching and exercises to strengthen the weak muscle group in front of the leg, calf, and the upward foot flexors, as well as massage and ultrasound.

In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.

Peroneal Tendon Dislocation/Dysfunction

Peroneal tendons support two important foot muscles (Peroneus Brevis and Peroneus Longus) that originate on the outside of the calves. These two muscles allow you to roll to the outside of your foot while standing.

Peroneal tendons are also called stirrup tendons because they help hold up the arch of the foot. The two muscles are held in place by a band of tissue, called the peroneal retinaculum. Injury to the retinaculum can cause this tissue to stretch or tear. When this happens, the peroneal tendons can dislocate from their groove on the back of the fibula. The tendons can be seen to roll over the outside of the fibula, which damages the tendons.

Skiing, football, basketball, and soccer are the most common sports activities leading to peroneal tendon dislocation. In some cases, ankle sprains also have caused this condition. Patients usually have to use crutches after such an injury, in order to allow the retinaculum tissue to heal and the tendons to move back to their natural position on the fibula. Sometimes a splint or compression bandage is applied to decrease swelling. Anti-inflammatory medications and ice are often part of the treatment. Note: Please consult your physician before taking any medications.

In moderate to severe cases of injury, when the peroneal retinaculum is torn or severely stretched and susceptible to dislocation, surgery may be required.

Xanthomas of the Achilles Tendon

Xanthomas are cholesterol deposits that appear in the Achilles tendon. High cholesterol levels can cause the formation of these cholesterol deposits, which appear as small lumps. Aside from treating the underlying cholesterol problem, treatment for xanthomas may require taking a biopsy of the lesion but leaving the nodules intact.

General Statistics

Foot and ankle problems usually fall into the following categories:

• Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
• Arthritic foot problems, which typically involve one or more joint.
• Congenital foot problems, which occur at birth and are generally inherited.
• Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
• Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
• Traumatic foot problems, which are associated with foot and ankle injuries.

The top foot problems are:

• Bunions – misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem.
• Hammertoe – a condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Selecting shoes and socks that do not cramp the toes will alleviate aggravation.
• Heel spurs – growths of bone on the underside, forepart of the heel bone. Heel spurs occur when the plantar tendon pulls at its attachment to the heel bone. This area of the heel can later calcify to form a spur. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced.
• Ingrown nails – toenails whose corners or sides dig painfully into the skin. Ingrown toenails are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity and poor foot structure. Women are much more likely to have ingrown toenails than men. Ingrown nails can be prevented by trimming toenails straight across, selecting proper shoe style and size – not too tapered or shallow – and paying special attention to foot pain.
• Neuromas – enlarged benign growths of nerves, most commonly between the third and fourth toes. They are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Treatments include orthoses (shoe inserts) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.
• Plantar fasciitis (heel pain) – usually caused by an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
• Sesamoiditis – inflammation or rupture of the two small bones (sesamoids) under the first metatarsal bones. Proper shoe selection and orthoses can help.
• Shin splints – pain to either side of the leg bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching and corrective orthoses (shoe inserts) for pronation can help prevent shin splints.
• Stress fractures – incomplete cracks in bone caused by overuse. With complete rest, stress fractures heal quickly. Extra padding in shoes helps prevent the condition. Stress fractures left untreated may become complete fractures, which require casting and immobilization.

A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

• Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
• Removal of corns and calluses on the foot.
• Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
• Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
• Exercises to maintain joint mobility and prevent stiffness or arthritis.
• Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.

Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising.

Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.

To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercising, stretching, and wearing well-fitted shoes.

Falls Church Foot and Ankle Center offers a full array of Podiatric services to help you maintain healthy feet. You can read more on this page about specific services.

Achilles Tendon Ankle Instability Ankle Sprains Arthritic Foot & Ankle Care Athletes Foot Bunions Calluses Corns Crush Injuries Diabetic Foot

Flat Feet Fungus Toenails Geriatric Foot Care Hammertoes Heel Spurs Ingrown Toenails Injuries Neuromas Plantar Fasciitis Warts

Ankle Sprains
Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on the outside of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems.

Bunions
Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes.

Flat Feet
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches.

Hammertoes
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery.

Diabetes and Your Feet
With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal.

Heel Spurs
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.

Corns
Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet.

Athlete’s Foot
A chronic infection caused by various types of fungus, Athlete’s foot is often spread in places where people go barefoot such as public showers or swimming pools.