Foot Sprains and Strains

Both foot sprains and foot strains are very common injuries, occurring as a result of sports accidents, falls, or other traumas. The difference between the two types of injuries is that sprains affect the ligaments, the thick strands of cartilage attaching one bone to another, and strains affect the muscles or the tendons, thick bands attaching muscle to bone. In both cases, the patient with the injury usually experiences pain (particularly upon movement), swelling, tenderness, bruising, weakness or muscle spasms. Foot sprains, the more serious injury, may also cause possible instability of the joint, most frequently the ankle. Depending on where on the foot the injury occurs, patients may be unable to bear weight until healing takes place.

Causes of Foot Sprains and Strains

Typically, foot sprains occur in the ankle or midfoot as an abnormal twisting during an athletic event or accident. When a sprain occurs in the big toe, rather than midfoot, it is referred to as turf toe. This injury is the result of an awkward twisting or hyperextension of the affected appendage. Foot strains, on the other hand, happen as the result of a sudden tear or pull of the affected muscle, usually because of overstretching or over contraction.

Diagnosis of Foot Sprains and Strains

Foot sprains and strains are routinely diagnosed through physical examination of the patient and an evaluation of the circumstances of the injury as well as its resulting symptoms. X-rays may also be taken to confirm the diagnosis and to rule out other problems, such as bone fractures. When diagnosed, both sprains and strains are graded as I, II or III, depending on severity of injury, pain level and lack of function. For both sprains and strains, the categories are designated mild, moderate and severe.

Treatment of Foot Sprains and Strains

Mild foot sprains and strains can normally be successfully treated through the usual remedies of rest, ice, compression and elevation (RICE). Over-the-counter anti-inflammatory medication is typically administered to reduce swelling and alleviate pain. In some circumstances, mild stretching exercises may be helpful.

While severe sprains may require complete immobilization with a cast, with lesser sprains and strains the patient may be able to walk with a bandage or brace, aided by a cane, or may not require any assistance. Most patients heal gradually from mild or moderate sprains in approximately 2 to 8 weeks, depending on the severity of the injury.

In the case of severe sprains or strains, a surgical repair may be necessary, in which case the recovery period may stretch to 3 months. After immobilization for a lesser injury or after surgery for a more severe one, a period of physical rehabilitation is necessary.

Ankle Fracture

An ankle fracture, commonly known as a broken ankle, involves any type of break or crack in the tibia, fibula, or talus. Common causes of an ankle fracture may include a sports injury, a motor vehicle accident or a fall. An ankle fracture can include injury to one or more of the bones that make up the ankle joint. The more bones that are broken, the more complicated and severe the fracture is. Treatment for a broken ankle depends on the type and severity of the individual fracture, but may include wearing a cast or brace, applying ice and taking anti-inflammatory medication. Stable fractures can usually heal on their own within a few weeks, while more complicated ones may require surgery to reposition the broken bone.

Symptoms of an Ankle Fracture

Individuals with an ankle fracture may experience difficulty walking or putting weight on the affected ankle. Additional symptoms may include:

  • Pain
  • Swelling
  • Bruising
  • Tenderness
  • Physical deformity

Because the ankle and foot may become very swollen, it may be difficult for some people with a broken ankle to put shoes on.

Diagnosis of an Ankle Fracture

An ankle fracture is diagnosed through a physical examination and diagnostic imaging tests that may include:

  • X-ray
  • CT scan
  • MRI scan

A bone scan may also be performed to determine which parts of the bone have been damaged.

Treatment of an Ankle Fracture

Treatment for an ankle fracture varies depending on the type and severity of the individual fracture. Medication may be prescribed to control inflammation and treat pain. Resting, applying ice and elevating the ankle, are all methods that can contribute to the healing of the fracture. In most cases, a cast or brace will be used while the ankle heals. In severe cases, surgery may be necessary to reposition the broken bone.

Although the methods used to treat ankle fractures vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the ankle and help the patient return to all usual activities. After the ankle bone has healed from the initial treatment for the fracture, and patients can bear weight on the joint, a physical therapy regimen is implemented to strengthen muscles and increase mobility. Without proper rehabilitation, complications such as chronic pain, inflammation and weakness, may cause difficulty walking and performing physical activities.

Ankle Dislocation

An ankle dislocation can occur when a significant amount of force is placed on the joint, resulting in an abnormal flexing that shifts the bones in the ankle from their normal positions. An ankle dislocation is often the result of a sports injury caused by physical contact or by quick pivots to change direction. Prompt medical attention to determine whether the blood supply to the foot has been compromised is essential.

The symptoms of a dislocated ankle typically include intense pain at the joint, which may radiate up the leg, and an inability to place weight on the associated foot. Swelling, tenderness and a sensation of numbness around the ankle are also common.

Treatment of an ankle dislocation generally begins with rest, ice, compression and elevation (RICE) to help reduce inflammation and prevent further damage to the joint. A surgical procedure to reposition the bone and hold it in place with screws and plates may be necessary. The ankle is then put in a cast or boot to stabilize and protect it as it heals.

Ankle Strain

An ankle strain is an injury to a muscle or tendon in the ankle. An ankle strain is a common injury that occurs when the ankle muscle is stretched or torn. A strain is caused by twisting or pulling of the muscle or tendon and may be caused by playing sports, lifting heavy objects or an injury that causes the foot and ankle to twist inward.

Symptoms of an ankle strain may include pain, muscle spasms, swelling and bruising. The affected ankle is often difficult to move, making it difficult to walk and put pressure on the foot. An ankle strain may be diagnosed through a physical examination and X-rays may be performed to rule out the possibility of a fracture or dislocation. Most ankle strains can be treated through conservative methods such as:

  • Resting the ankle
  • Applying ice
  • Using compression bandages
  • Elevating the ankle
  • Taking anti-inflammatory medication
  • Going to physical therapy

Ankle strains usually heal within 2 to 6 weeks, and most individuals can resume physical activity at this time. Surgery is not usually required to treat an ankle strain. Taping or bracing can help protect the ankle after injury and also helps prevent future injuries from occurring. It is important to take extra precautions after an ankle injury, as some patients may be susceptible to recurring injuries.

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