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Department of Orthopaedic Surgery
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Items filtered by date: June 2014 - Foot Associates of NY
Tuesday, 24 June 2014 19:37

Ankle Sprains

Ankle sprains can be quite the painful experience. Often times the injured person will experience limited mobility, swelling, and, depending on the severity, discoloration of the skin. This type of injury takes place when the ligaments are torn or stretched beyond their limits. Although this can occur in various areas of the body, the ankle is the most common site for a sprain.

There are multiple ways that the ankle can become injured like this. However, the simple act of walking may cause a sprain. If footing is lost or the person is walking on uneven terrain, local damage may occur. This may be especially so for athletes that continually push their limits, or for the person who has suffered from a previous accident involving the lower extremities.

In the majority of cases, medical attention is not required for a sprained ankle. Remedies for self-care at home include propping the ankle up, applying ice packs as needed, and remaining off your feet. Some may also find that wrapping with an ACE bandage and taking over-the-counter pain relievers are helpful. One of the most important things is to avoid further stress to the affected area.

Although rare, complications may arise and obtaining medical treatment may become necessary. A severe sprain can actually tear the ligament and even damage the muscle. When this occurs, the person may have to be off their feet for a prolonged period of time. Depending on the severity and nature of the damage, surgery and physical therapy may be required. Seeking out a podiatrist will help in making these decisions.

Sprained ankles are painful in nature, but those with severe unrelenting pain may have sustained a worse injury than previously thought. If walking becomes too painful for the person to take more than a few steps, swelling becomes too severe, or if numbness or tingling is present, immediate medical attention should be sought. Mild to moderate bruising is common with a sprain but redness of the skin or worsening of the discoloration should not persist either.

One of the best treatments for an ankle sprain is to prevent it in the first place. Wearing appropriate shoes for the occasion, stretching before exercises and sports, and knowing your limits can aid in prevention. Those that have suffered from a previous sprain may want to consider additional support, such as a brace and regular exercises to strengthen the ankle.

Tuesday, 17 June 2014 15:31

Plantar Fasciitis

Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be inaffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one time out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.

Stress fractures in the foot and ankle happen when muscles become weak due to too much or too little use. Stress fractures cause the muscles to stop cushioning the foot and ankles from the impact of hitting the ground. Since there is nothing to protect the bones of the foot, they absorb the full impact of each step you take. This additional stress causes little cracks, or stress fractures, to form in the bones that are being pressured.

Stress fractures are common in highly active people, especially athletes. Basketball, tennis or and gymnastics are activities where stress fractures occur more frequently. However, anyone can receive a stress fracture. Normally sedentary individuals who suddenly begin an intensive high impact work out may incur a stress fracture. This is because their muscles are not resistant enough to handle and cushion the intensity of the activity. Osteoporosis patients may also suffer stress fractures because the disease weakens the victim’s bones, making it easier for them to wear and tear.

Pain from stress fractures occurs in the site area of the fracture. It may be either constant or intermittent, causing sharp or dull pain accompanied by swelling and/or tenderness. Engagement in any kind of high impact activity will only exacerbate the pain. In fact, it can even cause a full fracture, especially when the area is not fully healed. Full fractures are much more serious, and can prevent you from using your foot at all.

Treatment varies depending on the patient and the degree of his or her injury. The most important treatment is to rest the injured foot. Some fractures may heal quicker with brief rest, while others need a longer rest period and utilizing crutches. In some cases surgery is required to install support pins around the fracture to aid healing.

To prevent stress fractures, be sure to get plenty of Calcium and Vitamin-D in your diet. This helps keep your bones strong and fortifies their resistance. If you begin a new regimen that involves high impact activity, set incremental goals on a weekly basis so you can build up the proper muscular strength. For example, if you wish to walk every day, you could ride a bike on some of those days to take stress off your feet. Also, make sure to wear supportive shoes that provide adequate protection.

If you experience any symptoms of stress fractures, you should stop exercising and rest. If these symptoms do not go relieve themselves, consult with an orthopedic specialist. Taking these measures can help prevent stress fractures to your foot and ankle, and allow you to continue the activities  you enjoy.

 

Monday, 02 June 2014 00:00

What to Know About a Broken Toe

Although most people try to avoid foot trauma such as banging, stubbing, or dropping heavy objects on their feet, the unfortunate fact is that it is a common occurrence. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break (fracture). Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, when the injured person experiences fever or chills throughout their body, and when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe with the affected foot elevated on pillows. Swelling can be alleviated by placing an ice pack on the broken toe for 15 minutes every two hours during the first two days after the fracture. The broken toe should be immobilized by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time.

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Foot Associates of New York


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an affiliate of:
Department of Orthopaedic Surgery
Columbia University Medical Center