The Achilles tendon is the strong band of tissue that connects the calf muscle to the heel bone. This lower leg tendon enables you to walk, jump, stand on your toes and climb stairs. You rely on it virtually every time you move your foot.
When the tendon is stretched beyond its normal capacity, a complete or partial tear may occur. Most Achilles tendon ruptures occur as a result of sport-related injuries when forceful jumping or sudden accelerations of running overstretch the tendon and cause a tear. Individuals with Achilles tendinitis -- weak and inflamed tendons -- are also more susceptible to tendon tears.
Signs of a torn Achilles tendon include:
- Sudden, sharp pain in the back of the ankle and lower leg
- Snapping or popping sensation at the time of the injury
- Swelling down the back side of the leg or near the heel
- Difficulty walking or rising up on the toes
The best treatment for a torn Achilles tendon is prevention. Avoiding this injury could save yourself months of rehab and extended time away from your game. Help prevent injury to your Achilles tendon by:
- stretching your calf muscles regularly
- limiting hill running and jumping activities that place excess stress on the Achilles tendons
- resting during exercise when you experience pain
- maintaining a healthy weight
- alternating high impact sports, such as running with low-impact sports, such as walking or biking
- wearing appropriate, supportive shoes with proper heel cushioning
If you suspect a ruptured Achilles tendon, visit our practice as soon as possible. Until you can seek professional care, avoid walking on the injured tendon and keep it elevated. Ice the affected area to reduce pain and swelling and, if possible, wrap the injured foot and ankle. For partial tears, swelling and pain may be less severe, but prompt treatment should still be administered.
Treatment for an Achilles tendon rupture can be surgical or non-surgical. Surgery to reattach the tendon is generally recommended, followed by rehabilitation, especially for individuals who want to return to recreational sports. Our pracitce can evaluate the severity of your tear and suggest the best treatment plan. With proper care, most people return to their former level of performance within six months.
A subungual hematoma is a collection of blood beneath the nail and is usually from trauma to the nail unit. This can be from obvious injuries like dropping something on the toe or stubbing it or it can occur from repetitive microtrauma. This is usually the case with runners or athletics when the toe is constantly and repetitively hitting the shoe. A small sore develops beneath the nail plate and bleeds under the nail. This then forms a blood blister beneath the nail which can be very painful and feel like there is a lot of pressure beneath the nail.
Treatment options vary depending on the injury and the amount of nail involved that has the hematoma. If there is any known injury, an Xray may be obtained to rule out a fracture to the underlying bone. If the hematoma encompasses a small area and the nail is not painful, the area can typically be left alone and the bruising will slowly grow out of the nail. If there is pain to the area and the hematoma involves a large portion of the nail, the pressure can be relieved by puncturing a small hole in the nail plate and allowing the fluid to drain or the nail is removed in its entirety and allowed to grow back. This is done under local anesthesia in the office.
If you experience this or any other foot and/or ankle issue, please call us at 972-542-2155 for more information.
Are you starting to notice your second toe rising up and crossing over your big toe? If so, you may be suffering from a plantar plate injury or pre-dislocation syndrome. This usually occurs with a bunion deformity in which the big toe sways over and points torward the lesser toes. The second toe has no where to go so it begins to rise up and cross over the big toe. This can also occur without a bunion deformity if there is injury to the plantar plate.
The plantar plate is a thick ligament on the bottom of your foot that connects the toe to the ball of the foot. You can develop micro tears in the plantar plate from injury or abnormal foot biomechanics. If you develop a small tear on portion of the ligament that is closer to the 3rd toe, the opposite portion of the ligament is now tighter and pulls the toe toward the big toe.
If you have a plantar plate tear, it will most likely be painful at the ball of the foot beneath the 2nd toe and will probably be worse with increased activity or walking barefoot. After a thorough lower extremity physical exam, an X-ray will be taken to ensure there is no bony pathology to the area. Sometimes when the plantar plate tears, it takes a small portion of bone that it was attached to with it.
Treatment of plantar plate tears begins conservatively and varies with orthotics, Non-Steroidal Anti-Inflammatory Drugs (NSAIDS such as Advil, Aleve) , walking boots, Injections and a special device to wear that holds your toe pointed downward to help faster healing. If conservative treatment fails and the area is still painful, the plantar plate may need to be surgically repaired. This is performed outpatient at a surgery center.
At Advanced Foot & Ankle Center, all of our providers have extensive experience with this condition. If you are experiencing this issue or any other foot or ankle disorder, please call us at 972-542-2155.
The ankle joint is made up of 3 bones: the tibia, fibula, and talus. The ends of these bones are covered with cartilage and are connected by strong ligaments to form the ankle joint. Cartilage is the smooth surface that allows the joints in our body to glide and function. The ligaments surrounding the ankle joint assures proper alignment and proper function. When either of these components are damaged or worn out, this can lead to arthritis.
The most common cause of ankle joint arthritis is post-traumatic arthritis due to a prior injury such as an ankle fracture or ankle sprain, 2nd most common cause is primary osteoarthritis or wear and tear arthritis. Other less common causes include gout, rheumatoid arthritis, neuropathy, osteonecrosis, hemophiliac.
Symptoms of ankle joint arthritis include pain with weight bearing and decreased motion. Exam findings include joint effusion or swelling, pain with motion or loss of motion, crepitus or grinding with motion, and deformity. X-rays will show signs of arthritis including loss of joint space, sclerosis or increased density of the bone underlying the cartilage, cysts or pockets of bone loss to the bone under the cartilage, as well as angular deformity.
Treatment includes conservative as well as surgical options. Conservative options include activity modification, bracing to immobilize the ankle joint, injections, and NSAIDs for pain control. If conservative treatment fails then surgical options are explored. Surgical treatment options vary based on severity and symptoms. For less severe cases, an ankle arthroscopy may be performed to clean up the joint and remove any spurring surrounding the joint that may be causing pain. This may also be performed along with a new procedure called a subchondroplasty which is a minimally invasive procedure that has shown effectiveness in treating pain and preventing or delaying the need for more invasive surgical options. For more severe cases an ankle joint fusion or ankle joint replacement may be an option.
Ankle joint fusion involves removing the remaining cartilage within the ankle joint and placing screws and/or plates to fuse the joint. Fusing the ankle joint prevents any further motion and thereby any pain associated with arthritis. Despite the inability to move the ankle, many patients lead healthy and functional lives without the pain of ankle joint arthritis.
Ankle joint replacement involves a procedure similar to a knee or hip replacement. This involves replacing the joint with a metal implant and polymer spacer. The advantages of ankle joint replacement is the maintenance of joint motion and function. The disadvantages are that ankle joint replacements are a relatively new procedure. Recent 5-10 year studies of newer generation ankle joint implants have shown good to excellent results, but long term outcomes are still pending. As with any artificial joint, there is increased risk of failure and revision with patients that are younger, higher BMI, and higher activity level. These are compounded by the increased forces within the ankle joint and decreased surrounding muscle and soft tissue compared to the knee or hip.
Your foot and ankle specialist at Advanced Foot and Ankle Center in Mckinney and Prosper TX will perform a thorough examination along with x-rays and other imaging and recommend the best course of treatment. Call us today at 972-542-2155 to set up your appointment!
Look out for our next blog post about Peroneal Tendon injuries, and other related conditions.
How to Maximize Your Game with Good Foot Health
When it comes to exercise, your feet are one of the most overlooked parts of the body, enduring tremendous strain and stress during a hard workout. It's no surprise that an athlete's foot and ankle are prime candidates for injuries. According to the American Podiatric Medical Association (APMA), poor foot care during physical activity is a contributing factor to some of the more than 300-foot ailments.
The following tips may help prevent foot and ankle injuries to keep you in the game.
Get a check-up
Visit our practice and your regular physician before starting any sport or fitness activity. This should include a complete foot and physical exam. During a foot exam, a podiatrist can identify whether your previously injured ankle is vulnerable to sprains, and recommend supportive ankle braces for increased stability.
Pre-workout warm up and stretch
Jogging before a competition or workout can help reduce the risk for foot and ankle injuries by warming up muscles, ligaments and blood vessels. Proper stretching before beginning a workout is also important. When muscles are properly stretched, the strain on joints, tendons and muscles is greatly reduced.
Treat foot and ankle injuries immediately
It's possible to injure bones in the foot or ankle without knowing it. What may seem like a sprain at the time may actually be a fracture. See a podiatrist at the first onset of ankle pain. The sooner you start treatment, the better your chance of preventing long-term problems like instability, and the sooner you can get back in the game.
Wear shoes specific to your sport
Different fitness programs require different footwear. Wearing the appropriate type of athletic shoe for your unique foot type and needs can help prevent foot problems while keeping you at your best performance. Remember to replace old, worn shoes in order to ensure optimal stability and support.
Pay attention to what your feet are telling you and remember to rest and consult our office when you first notice pain. Exercising is a great way to stay energized and fit, but if you're neglecting the health of your feet, you may be setting yourself up for serious injury.
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