Duncan, BC

Dr. Alexander Anzarut, M.D.

Ankle and Foot

This is categorized under:

Foot and ankle disorders include:

  • Achilles tendinitis
  • Bunion
  • Hammertoe

Treatments vary by the condition. Generally speaking, ankle and foot conditions may require surgeries to repair the small bones and tendons of the foot and ankle. Simple lifestyle changes, such as choosing well-fitting shoes, may also treat some conditions.

Achilles Tendinitis

The Achilles tendon, which pulls up the back of the heel, is the largest tendon in the body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured tendon. Both professional and weekend athletes suffer from Achilles tendinitis, a common overuse injury and inflammation of the tendon.

Signs and symptoms of tendinitis include:

  • Mild pain after exercise or running that gradually worsens
  • A noticeable sense of sluggishness in your leg
  • Episodes of diffuse or localized pain, sometimes severe, along the tendon during or a few hours after running
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone
  • Stiffness that generally diminishes as the tendon warms up with use
  • Some swelling

Treatments include:

  • Ice
  • Cold compression therapy
  • Wearing heel pads to reduce the strain on the tendon
  • An exercise routine designed to strengthen the tendon
  • Applying light to medium compression around ankles and lower calf by wearing elastic bandages throughout the day
  • Non-steroidal anti-inflammatory drugs, such as ibuprofen
  • Ultrasound therapy
  • Manual therapy techniques
  • A rehabilitation program
  • Application of a plaster cast (in rare cases)

Seeing a professional for treatment as soon as possible is important, because this injury can lead to an Achilles tendon rupture with continued overuse. Steroid injection is sometimes used, but must be done after very careful, expert consideration because it can increase the risk of tendon rupture. Severe cases may require surgery from an orthopedic surgeon or pediatric surgeon.

Achilles tendinitis can be prevented by following appropriate exercise habits and wearing low-heeled shoes. A physical therapist or athletic trainer can prescribe safe exercise methods.

Bunion

A bunion is a firm, fluid-filled pad overlying the inside of the joint at the base of the big toe (metatarsophalangeal joint). The pad (bursa), which may get larger and stick out, can become inflamed and painful.

Bunions may run in families, but many result from wearing tight shoes. Nine out of 10 bunions are developed by women. Nine out of 10 women wear shoes that are too small.

Tight shoes also can cause other disabling foot problems like corns, calluses and hammertoes.

The skin over your big toe may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful. Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. If this condition gets severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.

Bunions may be treated with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice, and medications. These treatments address symptoms more than they correct the actual deformity.

Surgery may be necessary if discomfort is severe enough or when correction of the deformity is desired.

Hammertoe

A hammertoe is a deformity of the second, third or fourth toes in which the main toe joint is bent upward like a claw. Initially, hammertoes are flexible and can be corrected with simple measures. Left untreated, they can become fixed and require surgery.

Hammertoe results from shoes that don't fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and can't stretch out.

With this condition, the toe is bent at the middle joint, resembling a hammer. If you have hammertoe, you may have corns or calluses on the top of the middle joint or on the tip of the toe. You also may feel pain in your toes or feet and have difficulty finding comfortable shoes.

In many cases, treatment consists of physical therapy and new shoes with soft, spacious toe boxes. In more severe or longstanding cases, orthopedic surgery may be necessary to correct the deformity. Toe exercises that can be done at home to stretch and strengthen the muscles may also be prescribed. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. One can also put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.