Archive for April, 2012

Common Ankle/Foot Injuries

Sunday, April 8th, 2012

All of the joints in the body are very important, and if they are not working properly, it can throw off the entire structural integrity of the body. However, it is especially crucial to take care of the ankle joint because it supports the weight of the body.  And if you are an active person/athlete, ankle injuries can hugely affect your mobility.  Living in Salt Lake City, Utah, there are plenty of active people; being that we live in an outdoor mecca.

Ankle injuries are defined by the kind of tissue — bone, ligament, or tendon — that’s damaged. The ankle is where three bones meet — the tibia and fibula from your leg and the talus from your foot. These are held together at the ankle joint by ligaments, which are elastic bands of connective tissue. These keep the bones in place while stretching to permit normal motion. There are also muscles and tendons that protect the ankle joint, do the work of making the foot move, and help hold the joint in place. The illustration below (left) shows the bone components of the ankle.  Next to it, an articulation of the muscles, ligaments and tendons.









Here are some of the more common injuries of the ankle and how to treat them in an acute phase:

ANKLE SPRAIN-  An ankle sprain is the most common injury to the ankle. Most people have “twisted” an ankle sometime in their life.  But if your ankle becomes swollen and painful after you twist it, you have most likely sprained it. Basically this means you have stretched and possibly torn the ligaments in your ankle.  Often times a sprained ankle is not that serious, but unfortunately the long term consequences is a common cause of chronic ankle pain.

The most common type is the Inversion Ankle Sprain, in which the ankle rolls outward and the foot turns inward.  When this occurs, the ligaments on the outside of the ankle stretch out and possibly will tear.  I have personally experienced this type of sprain.  A few years ago, during the holidays, I was snow-sledding at a park with some friends.  As I was sledding down one particular steep slope, I instinctually put one foot out to help slow my speed.  At the time, it seemed like a good idea, but I quickly realized it was not.  My foot did assist in slowing me down, but only by rolling under the sled.  This was a classic Inversion Ankle Sprain, and I believe it stretched out one or more lateral ankle ligaments.

There are 3 lateral ankle ligaments called the Anterior Talo-Fibular Ligament, Posterior Talo-Fibular Ligament, and the Calcaneo-Fibular Ligament.

During the acute phase of an ankle sprain, I suggest using the RICE method to assist in healing the injury. REST, ICE, COMPRESSION, ELEVATION.  And the first 48 hours is a crucial time to use this treatment.  It can affect how chronic and painful the condition becomes later.  Once the swelling and pain has subsided, the ankle greatly benefits from specific injury massage treatments.

PLANTAR FASCIITIS-  Plantar Fasciitis is inflammation of the thick tissue on the bottom of the foot. This tissue is called the plantar fascia. It connects the heel bone to the toes and creates the arch of the foot. Plantar Fasciitis occurs when this thick band of tissue on the bottom of the foot is overstretched or overused. It is one of the most common orthopedic complaint. I usually see this dysfunction in those who are constantly on their feet, namely waitresses and athletes.  Plantar Fasciitis is also often a symptom of obesity.  This ailment can cause intense pain and/or stiffness in the feet, especially during the first few steps you take in the morning.  Swelling can occur, and usually worsens as the day goes by.  Most of my clients who suffer from Plantar Fasciitis see most of their swelling at night which forces them to stay off of their feet. Another very common symptom of Plantar Fasciitis is heel pain, caused by a tight Achilles Tendon, (the tendon that connects the calf muscles to the heel) Pictured below.

The best way to remedy your symptoms and heal the Plantar Fascia is, of course, rest.  The constant repetition of walking will only worsen the inflammation.  If you must be on your feet, try to rest as much as you can.  Ice is the next best treatment – twice a day for at least 15 minutes. Stretching your heels everyday and wearing shoes with good support are also helpful.

FRACTURE-  A fracture occurs when there is a break in one or more of the bones.  Generically, it is referred to as a broken ankle.  As mentioned before, the 3 bones (tibia, fibula, and talus) make up the bony elements of the ankle joint.  A crack or break to any of these bones is considered a fracture.  This type of injury typically needs medical attention.  Go to your doctor to treat it, then use the RICE method at home.  Again, once the injury has healed, some injury massage is helpful to loosen up potential scar tissue and encourage blood flow.  This promotes further healing to the chronic injury.

ANKLE TENDONITIS-  Tendonitis is simply inflammation to a tendon. Ankle tendonitis is caused by excess stress being placed on the Posterior Tibialis Tendon. Those most at risk of developing the condition are people involved in sports that involve a lot of stopping, starting and sharp movements. Sports like basketball, squash, baseball, tennis and football put a lot of strain on the ankles.  Also, anyone who may be starting a new workout routine often can develop tendonitis.

Pain, tenderness, swelling and a “hot” feeling around the area are common symptoms of Tendonitis.  In most cases of ankle Tendonitis, the pain will develop around activity and subside a short time afterwards.  The best remedy for Tendonitis in the ankle is the RICE method.  Also, you will want to discontinue the activity that is causing the pain; at least for a short while.  Then, ease back into the activity slowly once you have rested the injured area.

ACHILLES TENDON RUPTURE-  The Achilles tendon is the strongest and thickest tendon in the body, connecting the strong calf muscles to the heel of the foot.  When the calf muscles contract, the Achilles tendon is tightened, pulling the heel. This allows you to point your foot and it is vital to such activities as walking, running, and jumping. An Achilles tendon rupture is a complete tear through the tendon, which usually occurs about 2 inches above the heel bone.  This injury tends to occur in middle-age, especially in males.  Weakening and thinning of this tendon occurs with age.  Injury often occurs during recreational sports that require bursts of jumping, pivoting, and running. Most often these are tennis, racquetball, basketball.  To prevent an Achilles rupture, stay active and stretch it out regularly.

It is easy to care for your ankles by keeping the joint, muscles, ligaments and tendons surrounding it, strong.  Remember that the body is built for movement and without it, the body will weaken.  This leaves us prone to injury, and later in life, chronic pain and possibly arthritis.  If you are suffering from any of the previous injuries mentioned, call today to see if sports injury massage might work for you.  Schedule an appointment in Salt Lake City at 801.349.3934.