May Articles 2015

Ankle Sprains

Ankle sprains can be a serious injury that should be given immediate attention and care, despite not being as severe as a broken ankle. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by swelling and discoloration of the skin, which occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes them a very common injury for anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others, including athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough to warrant rushing to the hospital. There are many at-home treatment options available to you, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over the counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough to warrant going to the hospital and possibly having surgery done. Even after the surgery, the recovery process can be long, involving rehabilitation sessions administered by a podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, non-stop pain is occurring over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs might show that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

While not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.


Athlete’s Foot

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athletes foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow, thrive, and spread, this is the most commonly affected area, but it is known to grow in other places. However, for obvious reasons, the term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as obviously the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. On top of this, the extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. While it is hard to completely avoid, you can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, as these are not desirable conditions for tinea to grow. If you do happen to get athlete’s foot, treating it with topical  medicated creams, ointments or sprays will not only help eliminate it but also prevent it from coming back.

Blisters on the Feet

Blisters are a common ailment of people who wear shoes that are either too tight or rubbed up against their feet in the wrong way while wearing them. In order to better understand how they are formed and what treatment should be used for them, you have to start with the basics of what a blister actually is.

A blister on the foot, or any other part of the body for that matter, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery like fluid that should not cause any concern. However, blisters can fill up with blood if they are deep enough and even pus if they have become infected with bacteria.

Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time for example, or when your shoes simply do not fit you properly. They also form faster and easier if your feet are moist, so keeping them dry and clean is a preventative step you can take to avoid getting blisters.

Preventing infection should be the number one concern when treating blisters, as well as alleviating the pain they can cause. Using a band aid to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop, or you can take a pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics might need to be taken in order to completely eliminate the bacteria inside the blister, and that needs to be prescribed by a doctor.

However, one of the best ways to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a band aid to an area you think might get a blister before one pops up is another way you can prevent them.

Nerve Disorders of the Foot and Ankle

Similar to well known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.

Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.

Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.

Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.

If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition.  If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.