Conditions / Procedures

• Achilles’ tendon injuries

  Overview:

  An Achilles tendon tear or tendinitis are the two main types of injury that affect the band of fibrous tissue linking the muscles in your calf to your heel.

  Symptoms may include:

  • pain at the back of the heel
  • stiffness
  • swelling
  • bone spurs on the heel bone
  • difficulty flexing the affected foot
  • popping sound along with a sharp pain

  Treatment/procedure options:

  Non-surgical treatments include rest, applying ice, orthotic shoes, wearing a cast, splint, or walking boot to promote healing, anti-inflammatory medications, and physical therapy. Chronic Achilles tendinopathy can benefit from surgery for recalcitrant cases, and surgery is also an option for acute Achilles tendon ruptures.

• Ankle Replacement

  Overview:

  When ankle joint pain and swelling become intolerable, ankle replacement surgery is a decision you and our orthopedic surgeons can discuss. Total ankle joint replacement involves implanting an artificial joint made of metal and plastic during a surgical procedure that requires general anesthesia. Similar to hip and knee arthritis, the benefit to an ankle joint replacement is that the patient is able to maintain his or her range of motion while significantly reducing pain.

  Symptoms may include:

  • inability to ambulate without pain due to the underlying cartilage wear
  • associated swelling

  Treatment/procedure options:

  Conservative treatment for end-stage ankle arthritis involves corticosteroid injections, custom bracing, activity modification, and anti-inflammatories. When this fails, surgical options include ankle fusion and ankle replacement surgery. While each have their advantages, ankle replacement surgery is a cutting-edge surgical option that our foot and ankle orthopedic surgeons are particularly adept at. Discuss this option with one of them at your next visit.

• Ankle Sprains

  Overview:

  A sprained ankle injury occurs when you roll, twist, or turn your ankle in an awkward way. The ligaments that are attached to and hold the ankle bones together can stretch or tear these tough bands beyond their normal range of motion causing pain and immobility. Generally, a sprained ankle involves the ligaments on the outer side of the ankle.

  Symptoms may include:

  • pain
  • tenderness
  • swelling
  • bruising
  • restricted range of motion
  • instability in the ankle
  • a popping sensation or sound at the time of injury

  Treatment/procedure options:

  Patients can utilize the R.I.C.E. (rest, ice, compression, elevation) approach for purposes of self-care while incorporating medications to manage the pain. In addition, orthotics are beneficial for those with foot and ankle malalignment, and physical therapy is often recommended to accelerate the rehabilitation process. Severe injuries may benefit from a brief period of immobilization with a boot. Chronic instability may benefit from an MRI and possible surgical stabilization.

• Bunions

  Overview:

  Usually described as a bony bump on the side of the big toe, a bunion is a deformity in the skeletal framework of the front part of the foot. The big toe bends towards the second toe, rather than pointing straight and thus produces the protrusion on the inside of the foot.

  Symptoms may include:

  • bulging bump on the outside of the base of your big toe
  • inflammation
  • redness
  • soreness
  • corns or calluses
  • limited movement
  • pain

  Treatment/procedure options:

  Non-surgical treatments include applying ice to relieve swelling, medication to reduce inflammation, padded shoe inserts to reduce pain and prevent progressive deformity, and changing your selection of footwear. Surgery is considered in severe cases to realign the toe and remove the painful prominence.

• Flat Feet

  Overview:

  Flat feet are a result of a fallen arch in the foot, allowing the entire sole of the foot to touch the floor when standing.

  Symptoms may include:

  • pain in the heel or arch area
  • ankle swelling
  • a tight Achilles tendon

  Treatment/procedure options:

  Non-surgical treatment includes orthotics to support the arch of the foot, supportive shoes, stretching exercises, physical therapy, rest, anti-inflammatories and weight loss to relieve some of the stress from the feet. Surgery is not usually necessary for this condition. Surgical treatment is complex may involve a variety of procedures to rebuild the arch and repair any damaged tendons or may require a fusion of multiple joints in severe cases.

• Foot and ankle nerve entrapment

  Overview:

  Nerve entrapment, commonly known as a pinched nerve, occurs when a nerve is under repeated pressure for an extended period. The nerve begins to degenerate causing fluid to leak in which leads to swelling and inflammation. Common nerve disorders depend on the affected principal nerve and its extending branches that supply sensation to different areas of the foot and ankle.

  Symptoms may include:

  • numbness
  • a tingling sensation similar to when your foot has fallen “asleep,”
  • sharp or burning pain
  • weakness in the foot, toes and ankle

  Treatment/procedure options:

  Although surgery may be necessary in severe cases, treatments include icing, massage, physical therapy, orthotics, anti-inflammatory medication, cortisone injections.

• Foot and Ankle Reconstructive Surgery

  Overview:

  The foot and ankle involve many musculoskeletal parts that may require surgery should they become compromising to a patient’s quality of life. This can range from torn ligaments and tendons to stress fractures and trauma, all of which can be treated by our specialists with their expertise in quality care.

  Symptoms may include:

  • pain
  • inflammation
  • swelling
  • tenderness
  • instability
  • joint stiffness
  • restricted range of motion

  Treatment/procedure options:

  Both non-surgical and surgical management is aimed at addressing the underlying pathology causing the patient pain. Thus, conservative treatment can involve custom orthotics, anti-inflammatories, corticosteroid injections, braces, and physical therapy. When surgery is required, reconstructive surgery commonly involves tendon repairs/transfers, bony realignment procedures, fusions, and other involved procedures. The goal of the reconstruction is always to restore anatomy and structure so as to improve the patient’s quality of life.

• Hammertoe

  Overview:

  Hammertoe is an abnormal bend of one or both joints in the small toes usually caused by an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. This type of physical deformity may result from the type of shoes you wear, foot structure, trauma, and certain disease processes.

  Symptoms may include:

  • toe may be flexed and/or stiff or swollen
  • toe may develop painful corns or calluses

  Treatment/procedure options:

  Acute pain can be addressed through a combination of various treatments including gentle massage, strengthening/stretching exercises to maintain flexibility, selecting appropriate footwear, custom-made shoe inserts, and medication to reduce inflammation. In severe cases, an outpatient surgical procedure may be recommended. Common surgical techniques, such as fusion, tendon transfer, or joint resection, may be chosen depending on the level of deformity and specifics of the patient’s case.

• Ligament and tendon tears

  Overview:

  Ligament and tendon injuries can occur from acute tears or chronic overuse injuries. They can present with pain, swelling, instability or weakness in different areas of the foot and ankle depending upon the injured structure. Without treatment, these injuries may not properly heal and become debilitating.

  Symptoms may include:

  • pain
  • swelling
  • instability
  • weakness along the associated tendon or ligament

  Treatment/procedure options:

  Treatment includes rest, physical therapy, nonsteroidal anti-inflammatories, ice, and supportive shoes or orthotics. Surgical treatment options include debridement, repair, and reconstructive options which may include tendon transfers or tendon grafts.

• Midfoot & Ankle Arthritis

  Overview:

  The surfaces between the bones in our foot and ankle lined by cartilage that helps create a smooth motion as we are propelled forward in walking or running. The significant amount of force that crosses these joints during normal daily function can wear the cartilage out and cause pain and inflammation as bone begins to rub against bone. When this affects the midfoot or ankle joints, this is known as midfoot or ankle arthritis.

  Symptoms may include:

  • tenderness when you touch the joint
  • pain in the joint
  • trouble walking or putting weight on the foot
  • joint stiffness
  • warmth
  • swelling

  Treatment/procedure options:

  Non-surgical treatment includes orthotics, activity modification, stretching exercises, anti-inflammatory medications, joint injections, and assistive devices such as orthotics or a cane or walker.

• Plantar fasciitis

  Overview:

  Plantar fasciitis, commonly called jogger’s heel, is characterized by pain and stiffness in the ligament that connects your heel to the front of your foot. This tissue runs along the bottom of your foot and supports the arch of the foot.

  Symptoms may include:

  • pain on the bottom of the foot near the heel, particularly in the morning with the first few steps after getting out of bed

  Treatment/procedure options:

  Treatment includes rest, applying ice, nonsteroidal anti-inflammatory medication, cortisone injections, supportive shoes or orthotics, night splints, physical therapy, and extracorporeal shockwave therapy. Surgical procedures include gastrocnemius recession, which lengthens the calf muscles to relieve stress from the plantar facia, and a plantar fascia release where the ligament is partially cut to relieve tension in the tissue.