Between every day activities and occasional high impact sports, almost anyone can suffer a foot or ankle injury. Our lower extremities bear the weight of our entire body and any sudden misstep can cause a significant injury.
At Mid-Tennessee Bone and Joint, Dr. Randy Davidson is our foot and ankle specialist. He has over 25 years of experience in treating a variety of orthopedic conditions. According to Dr. Davidson, he routinely sees patients who are suffering from trauma or overuse injuries, while other cases are congenital or developmental in nature.
“I also see patients who have foot and ankle pain that stems from poor choices in shoe wear,” he said. “High heels, flip flops, and worn out running shoes can all cause problems.”
The ankle is made up of three types of tissue: bones, ligaments, and tendons. Ligaments connect bone to bone, and tendons connect the muscles to bones which is important for movement. The foot and ankle have 28 bones, each of which can be fractured or injured in a variety of ways. Treatment is based on the bone that is broken and the alignment of the fracture. Many can be treated with bracing or casting while some require surgery.
With a suspected fracture or sprain, you’ll experience pain and swelling. For these types of injuries, there’s a simple acronym to remember: R.I.C.E. That stands for Rest, Ice, Compression, and Elevation. After trying these techniques, you can slowly start to put more weight on your foot or ankle based on pain. If the pain and swelling haven’t improved in a few days, you should seek medical attention.
Other than a fracture or sprain, there are many other reasons why someone might have foot pain. Plantar fasciitis is the most common cause of heel pain. The pain is along the bottom of the heel and is worse when you first get up in the morning or with prolonged walking. Other sources of pain can include tendonitis, bunions, or nerve pain such as Morton’s neuroma.
For every patient, Dr. Davidson creates an individualized treatment plan with the main goals of increasing function and decreasing pain. Typically, his first line of treatment will be a variety of nonsurgical methods, including the judicious use of injections. Other nonsurgical options include bracing, shoe modification or orthotics, anti-inflammatories, and occasionally physical therapy.
When the diagnosis calls for surgery, Dr. Davidson is highly experienced in performing a variety of procedures. His most common surgeries are bunion and hammertoe surgery, Achilles tendon repair and reconstruction, and ankle arthroscopy and ligament reconstruction. Arthroscopy is a less invasive form of surgery that allows the surgeon to evaluate the ankle by putting a small scope in the joint. It is used most often in young patients with intraarticular fractures or ligament injuries.
For patients who have significant arthritis in the ankle, an emerging trend is to perform a total ankle replacement. In the past these patients had to have an ankle fusion which severely limited their motion. Dr. Davidson recently performed this surgery on a patient at MTBJ, Dennis Edwards of Pulaski, and his progress so far has been very encouraging. Instead of having to be in a cast for three months, he was able to transition from a cast to a brace after two weeks. Physical therapy is required to maximize the motion and function after this procedure. For now, fusions are still the best option for young patients or those with multiple medical problems.
There are some important guidelines to remember after foot or ankle surgery. The first few weeks after surgery should be devoted to rest and recuperation. It may be helpful to have family members or friends on call to assist with most daily tasks, although the patient should be able to handle personal care.
Because the foot and ankle are under significant stress when we bear weight, most procedures require some time with restricted weight bearing after your surgery, with or without immobilization. All procedures will involve some swelling after surgery, which is one of the main reasons patients have to wait a while before they can wear shoes again postoperatively.
All procedures require some type of exercise program as part of the recovery process. Sometimes this is done in the home while in other cases formal physical therapy is required. An underwater treadmill is particularly helpful for foot and ankle patients because it allows exercising in a weight protected environment. Mid-Tennessee Bone and Joint offers this technology in our fully staffed physical therapy department. If coming here is inconvenient, we always work with our patients to ensure their physical therapy is scheduled at convenient locations and times.
If you’re experiencing foot or ankle pain that keeps you from being active and enjoying life, don’t wait to get it checked out. Knowing what to expect with any injury or other condition is important, and our physicians are available to guide you in making your critical health related decisions.