Strut Your Stuff - Tips for Healthy Feet and Ankles

Foot and Ankle Problems Affect Most Americans

Approximately 75 percent of Americans have or have had a medical problem in their feet, according to the American Podiatric Medical Association. Women are four times as likely to have a foot problem than men, based on the fact that they wear high heels. Despite reporting pain in their feet, however, almost two-thirds of people did not see a doctor for treatment.

Improvements in medicines, preventive treatments, and footwear, along with a new, less-invasive surgical procedure, can make foot and ankle problems less of an issue for the average person.

Common Foot and Ankle Problems

Foot problems come in two broad categories: traumatic injuries, and issues that develop over time. These can include:

• Acute or recurrent Ankle Sprains
• Overuse injuries due to athletics and running
• Stress Fractures
• Plantar fasciitis
• Flat feet/fallen arches
• Osteochondral Lesion of the ankle
• Toe deformity
• Achilles tendon pain
• Fractures of foot/ankle bones due to falling or sports injury
• Foot/Ankle arthritis

Ankles Problematic Too

In addition to foot problems, the average person is susceptible to ankle issues, ranging from simple sprains to torn ligaments and breaks. These can occur not only from traumatic accidents but from repetitive stress, as well.

“Ankle sprains are actually the most common athletic injury in the United States—in fact, thousands occur across the US each day,” says Dr. Craig Haytmanek, an orthopedic surgeon at St. Alphonsus Medical Groups’ Coughlin Foot and Ankle Clinic in Boise. The vast majority of ankle sprains do not require surgery, according to the American Orthopaedic Foot & Ankle Society.

“After the initial injury, I recommend elevation and gentle compression with an ACE wrap,” says Dr. Haytmanek. “If swelling is severe—ice can help prevent a further increase in swelling. The elevation is needed for the first 24-48 hours, then becomes less important as the body begins to heal. NSAIDs (non-steroidal anti-inflammatories) should be avoided in the early healing stages as there is a suggestion in the medical literature that they interfere with the normal healing response and the inflammatory cascade needed for ligament repair. I recommend against the use of these medications for the first few days if possible, instead of using a medication such as an acetaminophen. NSAIDs are safe and effective starting 3-5 days after injury.” If pain persists after that time, a foot and ankle specialist can help diagnose the severity of an ankle injury, recommend the proper treatment.

A physician can check that there are no fractures which occurred at the time of injury—usually with an X-ray--and also check for variants of a standard ankle sprain such as a "high ankle sprain" which requires a different approach to physical therapy and return-to play-protocol, says Dr. Haytmanek. “If an athlete is not progressing as we expect—meaning the ankle sprain is healed in one or two weeks—it is important to see a physician ensure there is no damage to the cartilage in the ankle. This can be hard to detect on X-rays and can occasionally require an MRI to see the cartilage surface. The good news is that 85 to 90 percent of ankle sprains heal without future problems or needing an MRI.”

Taking Preventive Steps

While you might not think to have your feet and ankles checked out when they feel fine, it’s a good idea to visit a specialist any time you have pain for more than six to eight weeks, recommends Dr. Haytmanek. Many feet and ankle problems, when diagnosed early, can be treated with simple non-operative measures.

Visiting a physician can help a person determine whether he or she should wear orthotic devices or a specific type of shoe during athletics, exercise or everyday activities. A doctor might prescribe balance training or ankle supports for a patient prone to ankle sprains.

In addition, consumers should shop for and try on shoes before they have walked on their feet all day or when they have been in hot weather, which can cause feet to swell. This leads to purchasing a shoe that’s too big, which doesn’t provide proper support when the feet regain their normal size.

TENEX: New Treatment for Serious Problems

A recent breakthrough in treating foot and ankle issues, such as plantar fasciitis (a common and painful heel problem in active adults), involves a less-invasive surgical procedure. With the new TENEX surgical procedure, a doctor uses a small probe (about the size of a toothpick) to send ultrasonic waves into problem tissue, breaking it up, liquefying and then removing it with suction. The procedure might last 15 minutes under local, with recovery time based on the injury. Patients can weight bear (walk) right after surgery and typical recovery for plantar fasciitis is two to three weeks, according to Dr. Haytmanek.

What Kind of Doctor?

While a general practitioner can help detect and treat some common foot problems, an orthopedic surgeon has specialized training in the care of bones, joints, tendons, and ligaments. This specialized orthopedic training involves five years of additional training after medical school. Some orthopedic surgeons have received advanced training in foot and ankle surgery—spending an additional year of training learning how to treat this specific anatomic area and might be more likely to be aware of the latest practices, procedures, and treatments.

Better Safe Than Sorry

A person who has never had a specialist examine his or her feet and ankles should consider getting diagnosed before issues can develop that could lead to expensive surgeries and loss of mobility, recommends Dr. Haytmanek. "We have many options when treating foot and ankle pain, such as shoe recommendations, stretching and strengthening activities,” says Dr. Haymanek. “These simple steps can treat foot and ankle problems when caught early. If we can treat problems at an early stage, we can often avoid more invasive and expensive surgical options".