Posts for: October, 2020
Fall is officially here which means football season is underway! Football players can experience a wide range of foot and ankle injuries, ranging from turf toe to Lisfranc injuries, high ankle sprains to Achilles tendon ruptures. Let’s delve a little deeper into each of these injuries, including a look at their mechanism of injury and possible treatment options.
Turf toe refers to an injury to the ligaments surrounding the big toe joint. It often occurs from overextending the big toe during a “push off”
type motion, causing the ligaments to elongate or tear. This injury is especially common in football or soccer players due to the artificial turf
surface. Athletes may experience a popping sensation when the injury occurs or may feel stiffness and limited motion around the big toe. It is important to see a podiatrist if you experience any of these symptoms, and an x-ray will be performed to rule out any fractures or dislocations. Milder injuries to the joint can be treated with immobilization, compression, ice, and elevation. Athletic tape can also be utilized to stabilize the toe and minimize motion at the joint during the healing process. For more advanced injuries, a walking boot or cast may be necessary to eliminate all motion and allow the ligaments and damaged tissues to heal properly.
A Lisfranc injury refers to a strain in the midfoot, an area which is highly important in stabilizing the arch and the entirety of the foot. Lisfranc injuries range from purely ligamentous injuries to fractures in the midfoot bones. One common mechanism of injury in football players is a downwards force on a foot with toes flexed towards the ground. In essence, the toes buckle underneath the foot and there is strain or collapse at the midfoot level. It is not uncommon for players to experience immediate pain and swelling, with the inability to bear weight. Imaging is highly important in these injuries and may include x-rays, MRI, or CT scans. Treatment ranges from a walking boot or cast to surgical intervention. Recovery times can range from 4-6 weeks to several months for more complex fracture-dislocation injuries. Untreated injuries can lead to further instability and chronic pain.
High ankle sprains generally refer to an injury to the ligament complex above the ankle joint. This complex, referred to as the syndesmosis, is responsible for stabilizing the joint between the two long bones of the leg, the tibia, and the fibula. The mechanism of injury usually occurs from an external or outward rotation of the leg on a planted foot, especially when the foot and toes are pointing up (dorsiflexed) in relation to the ankle joint. Podiatrists can diagnose this injury by squeezing the two bones together at the lower leg, which will elicit pain. X-rays and MRIs can also aid in making this diagnosis. Conservative treatment options include immobilization in a walking boot, ice, compression, and elevation. In cases where the gapping between the two bones (referred to as the “diastasis”) is excessively wide, surgical treatment is indicated to stabilize the ankle joint. This can involve either screws or surgical anchors to support the two bones and decrease the gapping.
Achilles tendon ruptures are among the most common injuries to affect football players. A rupture refers to a complete tear of the calf tendon, either within the midsubstance of the tendon or, less commonly, when the tendon tears off the back of the heel bone. One possible mechanism of injury includes the forced planting of the foot on the ground with the majority of the player’s body weight pushing down. Any type of aggressive dorsiflexion of the ankle (when the foot and the toes pointing upwards at the ankle joint) can cause a “popping” sensation in the Achilles, which may be indicative of a partial or complete rupture of the Achilles tendon. If the tendon is torn, the patient will be unable to plantarflex (point their foot and their toes in a downward direction), and will likely be unable to bear weight on the affected extremity. Podiatrists will often feel a noticeable gap in the area of the tendon rupture on the back of the patient’s calf. Though clinical evaluation is often all that is needed to make the diagnosis, ultrasound or MRI imaging can be helpful in confirming a tendon rupture and informing the doctor of the gap that exists between the two torn tendon ends. TIn milder injuries, tendon ruptures can be treated conservatively with complete immobilization in a boot or cast. More often in the athletic population, surgical treatment and open repair of the tendon rupture is indicated, as this leads to a lesser chance of re-rupture. Surgical intervention includes an open end-to-end repair of the torn Achilles tendon, often using a heavy stitch (suture) material to reapproximate the tendon ends. It is important to note that these injuries have a long recovery period of rehabilitation and physical therapy, generally ranging from 9-12 months.
Recognizing any of the above conditions and seeing a podiatrist quickly after an injury can minimize the risk of complications or delayed diagnoses. Ultimately, it is both the patient and the physician’s goal to return to the sport in an efficient but safe manner!
- Pain at the ball of the foot near the big toe
- Pain when bending or straightening the big toe
- Pain that comes up gradually
How is sesamoiditis treated?
The good news is that this inflammatory condition can be treated with rest and home care designed to ease the inflamed tendon or muscle. At-home care for sesamoiditis looks like:
- Avoiding any activities that put pressure on the foot
- Taking a pain reliever such as ibuprofen to reduce pain and swelling
- Wearing supportive shoes with ample cushioning
- Applying ice to the foot for 10-15 minutes every few hours
- Avoiding shoes with pointed toes or high heels
If you are experiencing severe or persistent foot pain, you must seek podiatry care from a qualified foot and ankle specialist. Foot pain should not go ignored. Call your podiatrist today.
Clean Feet Daily
It’s easy for our feet, just like the rest of our bodies, to pick up bacteria and fungus. Washing your feet with soap and water every day can help to remove these germs to prevent infections. Just remember to always dry your feet off thoroughly after bathing to reduce your risk for fungal infections. While you can do this at any time of the night, bathing and washing your feet in the evening could help you relax prior to bedtime.
Keep Feet Moisturized
You may notice that as you get older your skin also gets drier. While staying hydrated will certainly help to keep skin supple and moisturized, it’s also a good idea to apply a moisturizer to your feet to prevent cracking or broken skin (which can lead to infection). Once you’ve applied moisturizer to the feet it’s a good idea to cover the feet with socks made from breathable material such as cotton.
Trim Nails Properly
If you neglect to trim nails regularly you may find that long nails are prone to fungal infections and ingrown toenails. If you are able to trim nails yourself you will want to trim them so they are level with the tips of the toes (any lower and you could risk an ingrown toenail). Always trim nails straight across, never curve the edges of the nails. If you are having trouble trimming your own nails you can turn to a podiatrist for proper foot care.
Wear Appropriate Footwear
With all the changes that occur to your feet as you get older, it’s particularly important that you wear the proper footwear that will provide additional support and cushioning. It’s also important that you have your feet properly measured (best done in the afternoon when feet are at their largest due to swelling) and shoes fitted by a specialist. If you are dealing with blisters, calluses, and sore feet then you’ll want to talk with your podiatrist about getting different shoes or about getting custom orthotics/arch support.
Fungal infections, bunions and ingrown toenails can appear almost instantly, so having a podiatrist that you can turn to for regular care and treatment can provide you with peace of mind. Talk with your podiatrist about how to keep your aging feet feeling young and healthy.