All About Broken Ankles

Broken ankles are a very serious injury which, if not properly treated, can lead to continuous pain and an inability to walk. An ankle is made up of at least three major bones--the tibia, fibula, and talus. The tibia and fibula are the two bones that connect to your knees. They sit directly upon the talus bone, protected by a fibrous membrane that allows slight movement in our ankle joint. When the ankle is broken, it is because the foot rolled under or twisted too far, causing one or more of these three bones to break.

An ankle sprain occurs when ligaments are ripped or torn but no bones were broken. A sprain can be very severe, causing severe bruising of the foot and an inability to hold weight. In the case of broken ankles, the bones broken in this region could be numerous. If a person cannot stand their own weight on their ankle then it is most likely a broken ankle. The best thing to do if you suspect you have a broken ankle is to get an x-ray to determine the severity of the break immediately. The longer you wait to be diagnosed, the longer the healing process will take.

The most common cause of a broken ankle is when the foot has rolled over on itself, usually while engaged in exercise, physical activity, or sports. Another common cause is from a jump of great height. It is most important to seek medical treatment if one suspects they have broken ankles. A doctor can determine if surgery is needed in order to heal correctly. Without medical assistance after such an injury, a person may suffer severe arthritis and pain later in life. In some cases, an operation may be the only option to ensure the ability to walk properly again.

Broken ankles will cause severe pain. It will help to elevate the feet above your head to reduce blood flow to the injured area, as well as applying ice to the ankles to help decrease swelling. If surgery is required, it usually means an ankle cast for at least three months and then rehabilitation. Rehabilitation can be painful, using atrophied muscles and building tendon strength.

It is important to determine if surgery is needed as a broken ankle can become more severe than you realize. If not professionally treated, the broken ankle bones will inhibit your ability to walk properly.

Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.

Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain conditions and should therefore be well informed about problems that may arise and what they can do to properly avoid or treat them.

Some of the most common problems are foot ulcers, ingrown toenails, fallen arches, and fungal infection. A foot ulcer is an open sore on the foot and  can be a result of decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal infection is a condition that results in deformed and discolored toenails.

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a doctor for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier and between your bones and the ground as well as giving the skin on the foot a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. They also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.      

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also called tibial nerve dysfunction, is an uncommon form of misfiring peripheral nerves in the foot. Peripheral nerves are the nerves that carry signals from the brain and spinal cord to the other parts of the body. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee, or trauma to the tibial nerve can result in tarsal tunnel syndrome. Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome. However, tarsal tunnel syndrome can appear without an obvious cause in some cases.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of affected leg, with primary problems occurring on the bottom of the foot. The foot muscles, toes and ankle become weaker, and curling toes or flexing the foot becomes difficult. If the condition worsens, the person may develop infections and ulcers on the affected foot because of the lack of sensation. The affected foot can become permanently deformed, and sensation loss, particularly in the toes, is sometimes permanent.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition.

Occasionally, a person with tarsal tunnel syndrome can recover without specific treatment, but over the counter pain medication is still used to reduce the discomfort associated with the condition. Treatments for more severe tarsal tunnel syndrome focus on regaining sensation and strength in the affected toes and foot. Patients may receive physical therapy and prescription painkillers if the pain isn't managed by over the counter pain relievers. A surgery designed to lessen pressure on the tibial nerve can help in some cases. The surgeon enlarges the patient's tarsal tunnel, a ligament and bone structure in the foot that the tibial nerve passes through, relieving some of the pressure on the tibial nerve.

How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. Several common injuries can occur due to running. When the back of the kneecap starts wearing away and starts causing pain in the knee, this is commonly referred to as runner’s knee. Runner’s knee can occur because of decreased strength in the quadricep muscles or shoes that do not offer proper support to the inside of the forefoot. Runner’s knee usually is treated with strengthening exercises focusing on the quad muscle and sports orthotic. To prevent runner’s knee, efforts should be focused on hip strengthening. Physical therapy is also beneficial in helping to learn the best exercises to heal runner’s knee. To prevent runner’s knee, strengthen the quad muscles to keep the kneecap aligned.

Overtraining is one cause of a common running injury called iliotibial band syndrome, which occurs when the iliotibial band gets irritated, causing pain and discomfort to the outside knee area. Another common running injury is known as plantar fasciitis, which occurs when the bone in the foot becomes inflamed and irritated. This injury primarily causes pain in the foot. Causes can include a high arch, incorrect footwear, tight muscles and flat feet. The best way to avoid plantar fasciitis is stretching and proper footwear.

Stress fractures are a common injury for runners. These fractures can occur because of overtraining, lack of calcium or running style. In runners, it is common for stress fractures to occur in several locations including the inner bone of the leg, the thighbone, the bone at the base of the spine and the toe bones in the foot. The best approach to preventing stress fractures are proper footwear maintenance and running on a surface with enough “give” to absorb some of the shock produced during running.

Besides overtraining, other causes of these common running injuries are poorly fitting footwear, irregular biomechanics, and lack of flexibility and strength. The best way to avoid running injuries is to prevent them. Fortunately, each of these common running injuries can be prevented. To avoid running injuries it is highly recommended to wear only footwear that fits properly and that suits your needs. Running shoes are the only protective gear that runners have to safeguard them from injury; therefore, choosing the correct footwear for running is important. It is important, too, to think about other aspects of your running routine like training schedules, flexibility and strengthening, and tailor them to your needs in order to minimize the possibility of injury. Regular stretching before and after running should be considered also when trying to avoid running injuries. Stretching keeps muscles limber resulting in greater flexibility.

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New England & Ankle Specialists

(781) 944-4044
30 New Crossing Road Suite 311 Reading, MA 01876