High Ankle Sprain

The high ankle ligaments are located above the ankle, as opposed to the more commonly injured ligaments on the outside of the ankle. These high ankle ligaments connect the tibia to the fibula. It is important to have stability between the tibia and fibula at this level because walking and running place a tremendous amount of force at this junction.

A high ankle sprain occurs when there is tearing and damage to the high ankle ligaments. These injuries are much less common than a traditional ankle sprain. 

How to Care for Your Diabetic Feet

People with diabetes are at risk for foot problems. However, building regular healthy habits, practicing proper daily care, and carefully protecting the feet can go a long way towards avoiding more serious issues, like gangrene, infection, deformity, and amputation. Click the button below for a list of important care recommendations for people with diabetes.

Ingrown Toenail

An ingrown toenail (onychocryptosis) is a common condition, usually of the big toe, where the nail cuts into the surrounding nail bed causing an infection and pain. 

If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail. Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe. But this technique can cause your toenail to grow into the skin of your toe. The sides of the nail curl down and dig into your skin. An ingrown toenail also can happen if you wear shoes that are too tight or too short. Any of your toenails can get ingrown, but it's most likely with your big toes.

Insertional Achilles Tendinitis

Insertional Achilles tendinitis is a degeneration of the fibers of the Achilles tendon directly at its insertion into the heel bone. It may be associated with inflammation of a bursa or tendon sheath in the same area. 

Intoeing

Intoeing means that the feet curve inward instead of pointing straight ahead when walking or running. If your young child has intoeing, he or she probably will outgrow the condition naturally. You don't need special shoes, stretching exercises or other treatments. By age two most children walk with their feet pointing in the direction they are heading.

Lisfranc Injury

A Lisfranc injury involves the joints and/or the ligaments of the middle of the foot. The Lisfranc ligament is a ligament of the foot that runs between two bones called the medial cuneiform and the second metatarsal. The name comes from French surgeon Jacques Lisfranc de St. Martin (1790-1847), who was the first physician to describe injuries to this ligament.

There are a variety of causes for this injury such as a car accident, sports injury, or a simple slip and fall. Sometimes the injury can be mistaken for a foot sprain when X-rays do not show any broken bones. Delaying treatment can sometimes lead to more significant problems. The key for the treatment of a Lisfranc injury is proper diagnosis.

Metatarsalgia (Forefoot Pain)

Pain in the ball of your foot, the area between your arch and the toes, is called metatarsalgia (MET-ah-tar-SAL-gee-ah). The pain usually centers on one or more of the five bones (metatarsals) in this area under the toes.

Morton's Neuroma

Morton's neuroma is a thickening of the tissue that surrounds the small nerve leading to the toes. It occurs as the nerve passes under the ligament connecting metatarsal bones in the forefoot. 

Morton's neuroma most frequently develops between the third and fourth toes. It often occurs in response to irritation, trauma, or excessive pressure, and is more common in women.

Osteochondral Lesion

Osteochondral lesions, sometimes called osteochondritis dessicans or osteochondral fractures, are injuries to the talus (the bottom bone of the ankle joint) that involve both the bone and the overlying cartilage. These injuries may include softening of the cartilage layers, cyst-like lesions within the bone below the cartilage, or fracture of the cartilage and bone layers. Throughout this article, these injuries will be referred to as osteochondral lesions of the talus (OLT).

Peroneal Tendinosis

The peroneal tendons run on the outside of the ankle just behind the bone called the fibula. Peroneal tendinosis is enlargement and thickening with swelling of these tendons. This usually occurs with overuse, such as a repetitive activity that irritates the tendon over long periods of time. 

Pilon Fracture

The tibia (shin bone) and the fibula are the bones of the lower leg. Pilon fractures are injuries that occur at the lower end of the tibia and involve the weightbearing surface of the ankle joint. The fibula also may be broken. These injuries were first described more than 100 years ago and remain one of the most challenging problems for orthopaedic surgeons to treat. Common causes of pilon fractures are falls from a height and car accidents.

Plantar Fasciitis

If your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis, an overuse injury that affects the sole of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.

Plantar Fibroma and Plantar Fibromatosis

A plantar fibroma is a benign (non-cancerous) nodule that grows in the arch of the foot and usually appears between ages 20 and 60. It usually is slow-growing and often less than one inch in size. Some can grow faster and are considered plantar fibromatosis. A plantar fibroma or fibromatosis is a disease of the fibrous tissue that grows between the skin and the underlying fascia.

Plantar Warts

Plantar warts are a common viral skin infection on the bottom (plantar) side of your foot. About 10 percent of teenagers have plantar warts. Using a public shower or walking around a locker room in bare feet increase your risk for developing plantar warts.

Progressive Flatfoot (Posterior Tibial Tendon Dysfunction)

Tendons connect muscles to bones and stretch across joints, enabling you to bend those joints. One of the most important tendons in the lower leg is the posterior tibial tendon. This tendon starts in the calf, stretches down behind the inside of the ankle, and attaches to bones in the middle of the foot. 

The posterior tibial tendon helps hold up your arch and provides support as you step off on your toes when walking. If this tendon becomes inflamed, overstretched, or torn, you may experience pain on the inner ankle and gradually lose the inner arch on the bottom of your foot, leading to flatfoot. 

Rheumatoid Arthritis of the Foot and Ankle

Rheumatoid arthritis (RA) is a systemic disease that attacks multiple joints throughout the body. About 90 percent of people with RA eventually develop symptoms related to the foot or ankle. Usually symptoms appear in the toes and forefeet first, then in the middle and back of the foot, and finally in the ankles. Other inflammatory types of arthritis that affect the foot and ankle include gout, ankylosing spondylitis, psoriatic arthritis, and Reiter's syndrome.

The exact cause of RA is unknown but there are several theories. Some people may be more likely to develop RA because of their genes. However, it usually takes a chemical or environmental trigger to activate the disease. In RA, the body's immune system turns against itself. Instead of protecting the joints, the body produces substances that attack and inflame the joints.

Sesamoid Injuries

Sesamoids are bones that develop within a tendon. The one most people are familiar with is in the kneecap, however they most commonly occur in the foot and hand. Two sesamoids, each about the size of a corn kernel, typically are found near the underside of the big toe.

Stress Fracture

A stress fracture is a small crack in a bone. These fractures most often are a result of overuse and can occur with an increase in activity. Stress fractures most commonly occur in the weight­bearing bones of the legs. When a bone is subjected to a new stress, such as a new exercise routine, it may not be prepared for the increased workload, and as a result, may develop a stress fracture.

Talus Fracture

A talus fracture is a broken ankle bone. The talus is the bone in the back of the foot that connects the leg and the foot. It joins with the two leg bones (tibia and fibula) to form the ankle joint and allows for upward and downward motion of the ankle.

The talus (ankle bone) sits within the ankle mortise or hinge, which is made up of the two leg bones, the tibia and fibula. There are three joints:

  • the ankle, which allows the up-and-down motion of the foot with the leg
  • the subtalar joint, which allows for side-to-side movement
  • the talonavicular joint, which has a complicated biomechanical function that controls flexibility of the foot and the arch of the foot.

The talus has no muscular attachments and is mostly covered with cartilage, which makes injuries difficult to heal.

The Diabetic Foot and Risk

People with diabetes are at risk for foot issues, including the possibility of losing a leg. The risk increases when a person has diabetic neuropathy, a type of nerve damage that causes foot numbness, since problems can go unnoticed. Click the button below to learn how to reduce the risk by properly caring for diabetic feet and seeing a doctor as soon as possible if there is an issue.