Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

The human foot has 26 different bones, and the foot is divided into three parts: the hindfoot, the midfoot, and the forefoot. Each section of the foot is composed of a different amount of bones. For instance, the forefoot is made up of 19 bones. The midfoot is composed of five smaller bones called the navicular, cuboid, and three cuneiform bones. Lastly, the hindfoot is made up of only the talus and the calcaneus. The feet tend to be vulnerable to slipping and twisting; consequently, fractured bones within the foot are common. When a bone gets crushed, bent, twisted, or stretched it may become broken.

Many foot fractures occur through an accident or trauma. More specifically, common causes for broken feet are car accidents, falls, missteps, or overuse. If you have a broken ankle or foot, you may have one or more of the following symptoms: throbbing pain, swelling, bruising, tenderness, deformities, and difficulty walking.

There are some factors that may put you at a higher risk of developing a broken foot. People who participate in high-impact sports are more likely to develop foot fractures because of the stresses, direct blows, and twisting injuries involved in gameplay. Additionally, those who suddenly increase their activity level are more likely to suffer a stress fracture.

Unfortunately, there are different complications that may arise because of a foot fracture. For instance, arthritis may be caused by fractures that extend into the joints. Bone infections are also possible in open fractures due to the bone being exposed to bacteria. However, there are ways you can help prevent yourself from breaking your foot. One way to avoid fractures is to wear proper footwear. If you plan on going on a run, you should wear running shoes. You should also replace your shoes if you notice that they are becoming worn out. For runners, it is best to replace shoes every 300 to 400 miles.

Treatment for foot fractures usually consists of rest, ice, elevation, and compression (RICE). If you plan on wrapping your foot, try not to wrap it too tightly because doing so may cut off blood supply in the foot. You should also avoid walking on the fractured foot.

If you suspect you have a broken foot, you should see your podiatrist right away. It is important that you have someone bring you to your doctor, since driving with a broken foot can be dangerous. You should especially seek urgent care if you are experiencing numbness, pain, or deformities in your foot.

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.