Monday Medical: Be kind to your feet and ankles
November 22, 2015
With 26 bones, 33 joints and dozens of tendons, ligaments and muscles, the foot is complex. Add the ankle, plus the never-ending work of moving around 100-plus pounds, and it's no wonder injuries happen.
"The foot is a very complicated piece of equipment and a tremendous amount of pressure and load is put through your feet," said Dr. Michael Sisk, a Steamboat Springs orthopaedic surgeon. "It is extremely hard-working."
When a foot or ankle injury strikes, it can be debilitating. But treating injuries quickly can make for a faster and easier recovery.
"So many people don't realize how important their feet are until they're not working," Sisk said. "It can really impact your ability to work, play and take care of your kids."
Some of the most common foot and ankle issues Sisk encounters include sprained ankles or damage to one of the ligaments in the ankle, common which are common to playing sports and hiking.
• Plantar fasciitis, or inflammation of the ligament along the bottom of the foot, is especially painful where the ligament inserts on the heel bone.
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• Toe problems, including bunions and a stiff big toe, which can make walking difficult.
• Tendonitis, especially in the Achilles tendon, which also can tear or misfire.
• Fractures to the bones in the foot, which can happen in a mountain bike fall or a slip on a log while chasing an elk.
Acting quickly is critical to treating foot and ankle injuries. Sometimes, that's hard to do: Some of these injuries are only mildly painful at first, and athletes especially can have a hard time taking a break from activity.
"What's unfortunate is some of these issues are not disabling enough to keep people from training," Sisk said. "It's very common for people to push through the pain."
A mild Achilles tendonitis that could have been treated with brief immobilization, ibuprofen and physical therapy can soon become chronically inflamed and weak, requiring surgery.
"If we see the problem rather quickly, some pretty simple treatments can be successful," Sisk said. "The longer the problem sits in there and simmers, it causes damage to the tissue that's more difficult to rectify."
For instance, if plantar fasciitis is caught early, a round of physical therapy, calf stretches, heel cups and possibly a steroid injection can help keep the issue from becoming chronic.
Treatment continues to advance. For instance, arthritis of the big toe can now be addressed by replacing and resurfacing the joint, an option that wasn't available a few years ago.
Another treatment is platelet-rich plasma therapy, or PRP, in which a patient receives an injection of his or her own concentrated platelets to heal a range of injuries, from fractures to tendonitis, more quickly.
With options from video gait analysis to custom orthotics, physical therapy is "an indispensable weapon" in recovering from foot and ankle injuries, Sisk said.
To avoid injuries, Sisk recommends wearing high-quality shoes with good arch support. That also means not stuffing toes into pointy shoes, no matter how nice they look.
He also recommends using common sense to treat even mild injuries quickly; rest, ice, compression and elevation can go a long way in healing your hard-working feet.
"People tend to put up with a lot, but there comes a time when everyone reaches their limit," Sisk said. "Coming in sooner rather than later is definitely going to better your outcome and hasten your recovery."
Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.