Foot and Ankle

Turf Toe

Turf toe is a common athletic injury usually caused by jamming your big toe into a hard surface or from excessive pushing off such as from repeated track starts.

Symptoms include pain around the base of the big toe as well as swelling and/or redness.

Although true turf toe only involves the soft tissue that surrounds the toe joint, it can be very painful and significantly limit your ability to walk or run.

Treatment may include ice and rest, supporting the toe with tape or brace during activity and increasing the rigidity or stiffness of your athletic shoes.

Plantar Fasciitis

Plantar fasciitis is an inflammation of the supportive soft tissue structures of the arch that line the bottom of the foot from the heel to the base of the toes.

These structures become irritated from overuse or prolonged weight bearing and cause symptoms that include localized pain around the heel and bottom of the foot and pain with weight bearing.

Symptoms are often more severe in the morning when first weight bearing and may decrease once the tissues have been sufficiently stretched. It often returns after 10-15 minutes of inactivity or with prolonged activity, however.

Plantar fasciitis is usually seen in middle-aged men and women, but is not uncommon in an athletic population or among runners.

Treatment may include:

  • Stretching activities
  • Using ice to help control inflammation
  • Wearing a night splint to hold the foot in a stretched position
  • Wearing proper supportive footwear, possibly with orthotics

Ankle Sprain

One of the most common orthopaedic injuries in athletics, an ankle sprain is the tearing or stretching of the tissues connecting your foot to your lower leg.

The majority of ankle sprains occur on the outside part of the foot, however sprains to the inside part of the foot are not uncommon.

Most ankle sprains occur when you step on an uneven surface or obstacle which forces your foot to one side or the other, usually inward for a lateral ankle sprain.

Symptoms include pain, swelling and discoloration around one or both sides of the ankle.

You may have localized pain at the time of injury, but the pain may be more general within a few hours. You may feel ankle stiffness within a few minutes and have significant pain with weight bearing.

Severe sprains usually involve more than one structure and may need X-rays to check for possible fractures in the surrounding bony structures.

Treatment usually includes:

  • Ice, compression and elevation to reduce swelling
  • Gradually increasing range of motion as tolerated
  • Strengthening exercises
  • Balance activities
  • A progressive return to activity

Although an ankle sprain is a common injury that usually resolves without complications, improper treatment or incomplete rehabilitation can result in an increased risk of re-injury.

Frequent ankle sprains can result in more permanent conditions such as chronic ankle instability or arthritic changes to the joint.

Lisfranc Injury

Often called a "fracture dislocation," a Lisfranc injury involves multiple bones that make up a joint in the midfoot.

This area is just above the arch where the long bones from the big and second toes meet with several smaller bones in the midfoot.

Lisfranc injuries may be caused by direct trauma or an axial load through the joint such as when you are on your toes with a heavy weight or force applied through your shoulders.

Symptoms of a Lisfranc injury include pain, swelling and tenderness in the midfoot. Pain often increases with weight bearing especially in a heel raise position.

Some deformity may be seen in the top of the foot, but is not always obvious depending on the severity of the injury and amount of swelling.

Posterior Tibial Tendon Dysfunction (PTTD)

Posterior Tibial Tendon Dysfunction (PTTD) is an overuse injury. Symptoms include:

  • Pain on the inside part of the ankle joint extending from just behind the ankle bone down into the arch of the foot
  • Associated weakness of the posterior tibialis (a muscle that pulls the foot down and inward)

Pain often increases with activity, especially during mid-stance and push off, and you may not be able to fully perform a single leg heel raise.

Treatment for PTTD usually includes:

  • Wearing shoes that support the arch of the foot
  • Stretching activities for the calf
  • Strengthening of the muscles that support the ankle
  • Eccentric strengthening of the calf and posterior tibialis
  • Applying ice to control inflammation

Because of the posterior tibial tendon's role in helping support the arch of the foot, untreated PTTD can result in the permanent condition of Adult Acquired Flat Foot.

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