The foot and ankle are complex structures consisting of numerous bones, the joints between them, the ligaments that keep them stable, and the muscles that generate your strength and motion. Your foot and ankle take a lot of stress in a given day from standing, walking, running, or going up and down stairs. The muscles within the foot help the bones provide structure and support, and your foot is the base of support for your entire body. If the alignment of your foot is off because of weakness or structural issues it can cause many problems to occur up your entire leg. Foot or ankle problems can be caused by overuse, traumatic injury, and/or changes that occur naturally in your body.
Suffering from foot and ankle pain? Contact us to learn about treatment options.
How Your Foot and Ankle Works
The foot consists of three parts: the forefoot, midfoot, and hindfoot. The forefoot is made up of your toes and metatarsals, or the long bones that many of us think of as our “foot”. There are five metatarsals, each made up of two bones. The midfoot consists of five small bones called the navicular, cuboid, and 1st, 2nd, and 3rd cuneiform bones. The hind foot is made up of the heel bone (calcaneus) and the talus bone which sits on top of the heel bone. The talus meets the two bones of the lower leg (tibia and fibula) to create the ankle joint.
Bones are connected to other bones by ligaments which help provide stability. There are many ligaments that go between each of the bones in the foot. Each of these can be injured and cause pain and instability of the foot. The ankle has three main ligaments on the outside of the ankle and one broad band of ligaments on the inside of the ankle, all of which connect the two leg bones to the foot. There is also a ligament in the ankle, which connects the shinbone (tibia) to the outside lower leg bone (fibula). When this ligament is injured, it is referred to as a high ankle sprain.
Within the foot, there are many muscles that help flex and extend each of the toes. Some of these muscles have tendons that travel up the ankle and attach on the tibia or fibula, others remain entirely in the foot. The ankle has a series of muscles that allow the ankle to move in, out, up, and down. The Achilles’ tendon attaches to the heel and turns into the calf muscles ending behind the knee.
Evaluating Foot and Ankle Pain
Evaluation for foot and ankle pain starts with you giving us a history of your problem: when and how it started, how it currently feels, and which treatments you have tried so far. We also ask you about other medical conditions that may contribute to your pain. We do a physical exam to test the structures of your foot and ankle. Then we check your foot or ankle’s range of motion, strength and do special tests that can uncover specific problems.
Based on the findings of your physical exam, we may use a cortisone injection as both a clinical test and treatment for your pain. The numbing medicine mixed in the injection helps us determine the source of your pain, whereas the cortisone medication of the injection can provide pain relief. Sometimes we order tests such as x-rays or MRIs to visualize your bones and soft tissues. X-rays can show us things like fractures, spurs, and changes from arthritis. MRIs can show us more detail of the bones, as well as soft tissue damage like tears of the ligaments or muscles.
Whatever the cause of your foot and ankle pain, we are dedicated to helping you find the best treatment. Request an appointment today.
Causes of Foot Pain
- Less common causes– infection, tumors, or nerve problems
Treating Ankle and Foot Pain
Treatment of ankle and foot pain is specific to the diagnosis and severity of your symptoms.
Lifestyle modifications include: resting your ankle and foot, changing your daily activities to avoid painful situations, gentle motion exercises to smooth and polish the ankle joint, and doing exercises to strengthen weak muscles.
Medications can help with some conditions. Non-steroidal medications (NSAIDs) such as ibuprofen or naproxen can relieve inflammation. If the inflammation is severe, then a short burst of a steroid medication may be an option. Medications like acetaminophen (Tylenol) can help to control your pain.
Cortisone injections are used to target a specific location in your foot or ankle using a powerful anti-inflammatory medication. Numbing medications mixed in the injection help us know if the spot injected is the source of your pain.
Physical therapy is a form of treatment that focuses on getting your foot and ankle muscles and joints to properly work together as you stand and walk. Even if you are very strong and active, you may have muscle imbalances, which can cause pain. Physical Therapists can identify and address these muscle imbalances through corrective exercises. They may give you a series of take-home exercises to help return you to regular activities pain-free.
Braces are available to help with a variety of conditions of the foot and ankle, including braces to help increase the stability of the ankle (lace up and hinged braces) or braces to stabilize the foot and ankle (post-operative shoes and CAM walker).
Surgery may be an option for certain foot and ankle conditions if all other treatment options have been exhausted. Although many surgeries can be done through small incisions using a special camera to see inside the body (arthroscopy), some may still require a traditional open surgery.