Summer: The Season to Take Care of your Feet
By Dr. Jon Robinson
Summer here in Bozeman, our community awakens and takes full advantage of what nature has to offer in terms of outdoor recreation. This, of course, means hiking, biking, trail running,and fishing. Unfortunately, with an increase in outdoor activity, comes an increase in injuries, including those to the foot and ankle. Walking or running on uneven surfaces like trails or a river bottom increase the risk of ankleinjuries involving tendons, ligaments, or bones
As a foot and ankle specialist here in the Gallatin valley, I see ankle injuries on a daily basis. These injuries affect all age groups and are often result of “rolling” the ankle with sports activity or even stepping wrong. Two of the most common ankle injuries are ligament injuries (sprains)and bone injuries (fractures).
It is important to note that ankle sprains are common. According to the American Academy of Orthopaedic surgeons, about 25,000 ankle sprains occur every day! That is a lot of sprains and most of us aren’t even exactly sure what an ankle sprain really is.
The ankle jointis held in place by fibrous structures called ligaments. These ligaments hold the ankle bones in position and keep the ankle stable for activities. When an abnormal motion (twisting or rolling) occurs at the ankle, the ligaments are stretched beyond their limits and a tearing of the fibers occurs. In a severe sprain, the ligaments can be completely torn and sometimes a popping sound or feeling is noted. As you can imagine, tearing of ligaments is a pretty severe injury! Ask any one who has had a major ankle sprain. They are swollen and painful. Often times there is enough pain that crutches are needed to get around.
It is important to see your doctor to diagnose your ankle sprain. The diagnosis is made by physical exam of the ankle and your doctor may even order an x-ray to rule out a fracture. Treatment of an ankle sprain includes rest,ice, compression, and elevation (Abbreviated to R.I.C.E.). In addition to RICE, your doctor may prescribe physical therapy. Physical therapy helps to decrease pain and swelling, prevent chronic ankle problems,and helps you get back to normal activity ASAP. While your ligaments are recovering, you may need some help getting around. Crutches, ankle braces, or removable cast boots can be very helpful at keeping you mobile while recovering. Most ankle sprains, if treated, will resolve in about 6 weeks. If symptoms persist beyond 6 weeks, your doctor may recommend a MRI to look for other injuries. Sometime persistent instability results from an ankle sprain and requires surgical repair.
Fractures about the ankle, although less common than sprains, are still very common injuries. Just like an ankle sprain, an ankle fracture results from a twisting injury. Unlike and ankle sprain, this type of rotational injury causes the ankle to twist further than the joint architecture allows, which leads to fracturing of the ankle bones. If you have a painful swollen ankle after an injury, your doctor may recommend and x-ray to rule out a fracture. The ankle can be fractured in many ways but usually involves one or more of three bones: the medial malleolus, the lateral malleolus, or the posterior malleolus. Treatment of ankle fracture varies from immobilization in a walking cast boot to surgical repair.
According to the American Orthopaedic Foot and Ankle Society, the best way to prevent ankle injuries is to maintain good strength, muscle balance and flexibility. Additionally, they recommend warming up before vigorous activities. Pay attention to the surface you are walking on i.e. beware of rocks, ice, and debris. Wear good shoes. Lastly pay attention to you body and slow down when you are fatigued or in pain. Hopefully, by following a few simple rules you will have safe and exciting summer with healthy ankles.
Dr. Jon Robinson, M.D.
Fellowship Trained inFoot and Ankle Surgery