Our Pueblo, Pueblo West, CO Podiatrists Can Help You Find Relief From Foot or Ankle Pain
If you, or someone you know has sustained an injury to the foot or ankle please contact our podiatry team at Pueblo Ankle and Foot Care , we will make every attempt to see you ASAP, usually the day you call.
HEEL PAIN - PLANTAR FASCIITIS - HEEL SPURS
The bottoms of things have, in general, been much maligned. The bottom of the barrel, bottom of the ocean, bottom of the slag-heap, and more bottoms are generally thought of as dark, dirty, or otherwise unpleasant places. But just think how important bottoms can be: the bottom of a ship, for instance, while sometimes sloshing with bilge-water, is nonetheless essential in a ship’s overall well-being. When its bottom fails, the ship goes down to the bottom of the ocean. Which is full of bottom-dwellers, as we well know.
The bottoms of feet are likewise very important. Think about it: all the weight of your body presses down on your poor, overworked feet. And towards the bottom of the foot is a band of tissue called the plantar fascia (a fascia is similar to a ligament) which connects to the bottom of your heel bone and fans out to the base of your toes. It helps support the structure of the bones at the bottom of your foot. Unfortunately, we don’t seem to appreciate what the plantar fascia does for us until it decides to go bottoms-up.
Like many tissues, the plantar fascia can become stretched over time, particularly in people with unusually high or low arches, or who are overweight, tend to do a lot of physical activity like running and jumping, wear shoes with little or no support, or have a tight Achilles tendon. Spending a lot of time on hard, flat surfaces (like a concrete floor) can also lead to problems. Plantar fasciitis may show up in either gender, although it most often affects people in late middle age (about 40 to 60).
When the plantar fascia stretches too far, it can develop small tears (or in extreme cases may even rupture). These tears make the plantar fascia irritated and inflamed, a condition known as plantar fasciitis.
Plantar fasciitis tends to manifest itself as pain at the bottom of the heel (although it can occur at any point along the arch of the foot) which is usually most severe when getting up in the morning (or in the afternoon if you like to sleep in a lot). The pain often subsides during the day as you walk around a little, although it may become worse again if you’re on your feet a great deal, or if you sit for awhile and then try to stand again. Many patients feel a searing or sharp pain when they first get on their feet after a period of rest. This may subside to a dull ache as the day goes on.
This condition tends to get worse over time, so you may start off with very little pain that gradually progresses to severe over a period of months. Your arches may also gradually flatten as the plantar fascia stretches out.
Additionally, you may develop a heel spur (a bone growth along the bottom of your heel bone). In the past, it was thought that the spur contributed to the pain, but, since many people with heel spurs experience no symptoms, this is no longer thought to be the case.
When you go in to see your podiatrist about the pain in the bottom of your heel, be sure to come prepared to answer questions (and ask questions of your own, of course). Your doctor will probably want to know a history of your symptoms and will perform a physical exam of your foot to check for swelling and redness. He or she may also check for tenderness on the foot to find out where the pain is coming from. You may need to get X-rays to check for other possible sources of your pain (such as stress fractures).
Getting your plantar fascia to feel better usually revolves around some conservative treatments. These may include anti-inflammatory medication (such as ibuprofen), ice (20 minutes on the foot over a thin towel, then 40 minutes off), doing exercises to stretch the calf muscle, wearing shoes that give better support to the foot (such as those with a slightly elevated heel and decent arch support), avoiding going barefoot, and giving your feet a rest by avoiding activities that stress them out (like certain sports or standing for long periods).
Persistent pain may need slightly more extensive treatment, such as the use of orthotics (custom-made shoe inserts), a walking cast to keep your foot immobile or a night splint to stretch the plantar fascia out. Your podiatrist may also suggest physical therapy (including extracorporeal shock wave therapy), padding and strapping (or taping) the foot to ensure things stay in their proper positions, and cortisone injections (although you don’t really want to have more than one of these, since repeated injections can weaken the fascia).
Although it’s rare, very persistent plantar fasciitis may need to be addressed with surgery if it fails to respond adequately to the above treatments. Surgery usually involves releasing the fascia from the bottom of the heel bone, although this may weaken the arch of the foot, and may have other complications, including as infection and nerve injury. Be sure to discuss all possible treatments with your foot doctor.
After receiving treatment, your plantar fascia should stop causing you so much pain. But really, the whole experience should make you appreciate the bottom of your foot that much more. And then you can thank it. From the bottom of your heart.
So, if you're suffering with heel pain, don't wait for it to become a chronic problem. Contact us today, and we'll get you back, to the activities you love, in no-time.
Whether the tendency is good or bad, human beings do have a propensity to take a bit of delight in destruction. Knocking over a tall tower of blocks, smashing through the carapace of a scuttling cockroach, watching as a wrecking ball brings down an abandoned office building, all give us the tiniest of thrills. But broken things aren’t always so exciting. In fact, some can as easily cause distress as delight. Broken dishes, broken hearts, broken fingernails-all ignite some degree of angst, some more than others, and broken bones are probably somewhere in the middle of the scale.
Bones really do a lot for us. They help us fight the good fight against gravity (giving structure and support to our bodies), provide anchors for our muscles, and offer us all something to shiver at when people hang skeletons from their trees in late October. So it’s hardly surprising that breaking a bone is often painful and can be extremely disruptive to the function of the foot.
Bone breaks (also known as fractures and cracks) are usually either caused by trauma (a sudden injury like a fall or car accident) or long-term stress to the bone. There are many different types of breaks. They include open fractures (where the bone has broken through the skin) and closed fractures (the skin over the bone remains intact). The break in the bone may be transverse (broken straight across the bone like a snapped twig), oblique (broken at an angle to the bone), spiral (the bone has been twisted apart) and stress fractures (small cracks in the bone). Stress fractures may not be as familiar (or as feared) as fractures caused by trauma, but they still may cause significant problems, particularly in patients with diabetes. Osteoporosis, being overweight, overuse of the foot, poorly fitting or unsupportive shoes, and certain bone disorders may all make one more susceptible to developing these fractures.
While any of the 26 bones in the foot could be broken, a few areas tend to see injury more than others. These include:
- Toes – Late-night stumbling into the corner of your bookshelf may snap the bones in your toe (so turn on the light or use a flashlight if you need to visit the bathroom the middle of the night). Don’t ever assume that doctors can do nothing for your toe. Some toe breaks may require surgery to get all the pieces back together, or your doctor may need to tape it up to make it heal properly, so be sure your podiatrist has a look at it.
- Metatarsals – Metatarsals are the long, thin bones that connect your toes to the rest of your foot. Breaks might occur at any point along their length (head, neck, shaft and base), and may occur to any one or all of the five. (Each metatarsal corresponds to and is numbered with the toe it connects to. So the first metatarsal connects to your big toe, and the fifth metatarsal connects to your pinky toe. You can probably work out the other numbers on your own.) Metatarsals are also particularly susceptible to stress fractures when overstrained.
- Ankle – The ankle is actually made up of several different bones: the tibia (your shin bone), the fibula (the thinner leg bone that runs along next to the tibia-the end of this bone forms the outside of your ankle), and the talus (a foot bone). Any one of these bones can break (or all of them in particularly horrid circumstances), although most breaks tend to occur in the fibula or tibia.
- Heel – The heel bone (also known as the calcaneus) generally breaks under major stress, such as a car accident or falling from a significant height. Breaks in this area can be particularly devastating, and often require surgery.
Some breaks (particularly those in the ankle) may be mistaken for sprains or other injuries. So, whenever you experience the symptoms of a break, it’s important that you get your foot checked out by a podiatrist in order to determine what’s really going on. Common symptoms of fractures include the following. (By the way, you may experience only some of the symptoms, since not all fractures produce the same symptoms.)
- Pain (likely to be sudden in the case of fracture caused from trauma, or if from a stress fracture will probably appear with activity and disappear during periods of rest)
- Tenderness to the touch
- An inability to walk on the foot (stress fractures may not have this symptom)
- Deformity (the shape of the foot has visibly changed)
A common misconception is that if you can move the bone, it can’t be broken. This is not true, particularly for breaks in the fibula, chip fractures, stress fractures, and broken toes. Get your injury checked by a doctor. It’s better to check and not have a broken bone than not to check and have an untreated fracture.
Despite having probably knocked over his or her share of block towers as a toddler, your podiatrist takes no delight in broken bones. However, he or she is an expert at diagnosing and fixing them. When you go in to see your foot doctor about your injury, he or she will likely inquire about symptoms you’ve experienced, may make a physical exam of your foot, and (unless he or she has superpowers and can see through your skin) will almost certainly use some sort of imaging technology to find out what’s going on with your bones. X-rays are probably the most commonly used imaging tool in fracture diagnosis, although your podiatrist may also suggest CAT scans or MRIs.
Treating a broken bone can be a tricky business, simply because each fracture is different. Depending on the type of fracture and on which bone is broken, treatments may be conservative or can go all the way up to extensive surgery. Whether the treatment is conservative or not, healing broken bones generally revolves around keeping them immobilized so they have a chance to knit back together again. The difference is that conservative treatments immobilize from the outside, while surgery immobilizes from the inside.
Your podiatrist may accomplish external immobilization with a splint, removable boot, or a cast. You’ll likely also find relief from pain by employing the RICE method (Rest, Ice, Compression, and Elevation). Also, whatever you’ve heard, it is not a good idea to soak your broken bone in hot water. Doing so increases blood flow, which will also increase swelling and pain.
However, if the bones aren’t stable, or the break is severe enough (and there are lots of little pieces of bone involved), your podiatrist may suggest surgery to correct the break and avoid arthritis in the future. Surgery may use pins, screws and plates to secure bones in their proper places.
In general, healing from a broken bone usually takes several weeks to several months, although the time needed for healing can vary greatly depending on the type of fracture and your overall health. (Diabetics, for instance, may experience a longer healing time than other patients.) On occasion, bones may not knit back together (non-union), or may knit together incorrectly (mal-union). In such circumstances, your podiatrist can recommend further treatment methods, which may include surgery.
It isn’t always possible to mend broken things (like a very expensive vase, for instance). But the beautiful thing about the body is that, with a little help, it usually does a great job of putting everything back together. So, with enough time and care, your broken bones should be nice and whole once again.
ANKLE SPRAIN - ANKLE PAIN
Ankles can be a pretty delicate part of the body. If youve ever stepped off of a curb and sprained your ankle, have twisted your ankle while skating, or live with chronic ankle pain like gout or arthritis, youre pretty aware of that fact.
Probably the most common type of ankle pain is a sprain, which is a stretching or tearing of the ligaments that connect bones together and move your ankle around. This tearing can occur when an ankle rolls over, either on the outside or the inside of the foot, thus stretching the ligaments more than they can bear. However, sprains arent the only type of injury that can result in ankle pain: fractures in the ankle bone might be the problem, or perhaps the ankle is unstable. Pain might be coming from gout (a buildup of uric acid crystals in the joint), arthritis, tendonitis (inflammation of tendons), tarsal tunnel syndrome (when nerves get compressed), misalignment of the bones of the foot, or an infection. Thats a lot of different causes to think about. Fortunately, your foot doctor is well-versed in ankle problems and will be able to determine what is causing your poor ankle such distress.
Ankle pain is often accompanied by inflammation in the area, which means that the ankle will likely appear puffy and swollen, reddened, and will feel warmer than skin in other areas. The pain is also likely to be more severe while standing on the ankle or moving it, although this is not always the case.
Your podiatrist is the best person to determine treatment. However, using the RICE method (Rest, Ice,
Compression, Elevation) is likely to help the pain associated with inflammation. Your doctor may also prescribe or suggest anti-inflammatory drugs, such as ibuprofen or may give the area a shot of cortisone. Some ankle problems may require physical therapy, and some may require surgery.
Schedule an appointment immediately with Pueblo Ankle and Foot Care to be evaluated and to learn more about all of your treatment options.
ACHILLES TENDINITIS - TENDON INJURY
Anyone who has read up on their Greek mythology knows that an Achilles Heel isn’t necessarily a good spot to rely on. However, most of us rely on our Achilles tendon to a tremendous degree: we use it when jumping, running, walking – pretty much any time we use our foot. Despite its mythological association with weakness, the Achilles tendon (a thick, cord-like bunch of tissue that attaches the calf muscle to the back of the heel bone) is actually the strongest and largest tendon in the body. Unfortunately, it’s also susceptible to injury, since the muscles that pull on it exert more force than any other in the leg. To make matters worse, blood circulation to the tendon is relatively poor, which means that it generally isn’t able to heal quickly when injured.
Injuries tend to happen to the Achilles tendon when we overuse it, resulting in inflammation (aka tendonitis). This can happen most frequently with individuals whose activity suddenly increases or changes, such as those who are active only on weekends or who suddenly become active (yes, we’re looking at you, weekend warriors). However, tendonitis may also result from putting consistent strain on the Achilles tendon. Athletes (particularly those involved in running or jumping sports), or those whose jobs cause them to overuse their feet or ankles will likely be the ones to fall into this category.
Age may also play a factor, since tendons tend to lose flexibility as a person grows older. The tendon’s inflexibility may also be exacerbated by the wearing of high-heeled shoes, which can cause the tendon to be shortened. Fortunately, stretching properly before exercising or engaging in periods of high activity may help to reduce the chance of injuring your Achilles tendon. (And you thought stretching was useless, didn’t you?)
Over time, if the tendon is misused enough, it gets pretty messed up. Achilles tendonitis may progress to Achilles tendonosis, or full-on degeneration of the tendon, in which it becomes more likely to experience tears or, in rare cases, a rupture (which is not a pretty injury). Tearing that comes with the tendonosis is usually microscopic (except in the case of a rupture, of course) and tends to show up about 2 inches (or 6 cm) above where the tendon is inserted into the heel bone.
If you have the misfortune of developing Achilles tendonitis or tendonosis, you’ll likely notice swelling, tenderness, and warmth on the Achilles tendon, or sometimes on your leg above the heel, anywhere from the back of the heel to the bottom of the calf muscle. You may also be able to feel with your finger, or even notice visually that your tendon has gotten thick. Walking will probably be uncomfortable and somewhat difficult, since your tendon will be painful and weak, and if the problem is severe enough, it might completely prevent you from running around. Squeezing the sides of the tendon is likely to be quite painful, although oddly enough, pushing on the back of the tendon will be less painful.
When the tendonitis progresses to tendonosis, the symptoms will be more severe. The tendon will become even more enlarged, with funky little nodules in the damaged areas.
When you go in to see your podiatrist about your painful Achilles tendon, he or she will likely feel the tendon to check for bumps, and will probably push it to see where it hurts. (This may be uncomfortable for you, but it’s
necessary to determine what the problem is.) He or she may also observe and ask questions as you walk or stand on your tiptoes, to see when the pain occurs.
Because your podiatrist is awfully clever, he or she will likely be able to diagnose Achilles tendonitis or tendonosis from a physical examination of the area. However, to make sure the diagnosis is correct, X-rays may be ordered to rule out arthritis or other causes of pain, and an MRI might be necessary to check the area if a rupture or partial rupture is suspected.
Treating Achilles tendon problems may mainly focus on reducing the inflammation of the area, allowing the tendon time to heal without adding to the injury it has already sustained. This will probably be best accomplished by letting the area rest by immobilizing it, either by a cast or a boot. You can also try putting ice on the tendon (on for 20 minutes, off for 40 minutes), although for pity’s sake, wrap the ice in a thin towel. You should never put ice right on your skin. (Seriously – you don’t want to cause frostbite – just reduce the swelling.)
Your podiatrist may also suggest anti-inflammatory medications, such as ibuprofen, or steroid treatments such as cortisone. Physical therapy might be used to strengthen the muscles around the tendon and prevent further injury, or used to soothe the tendon and accompanying inflammation by use of ultrasound therapy or stretching, or it might simply consist of teaching you how to use your foot properly during the activities you so love to do. Like walking.
If these treatments don’t work, or if the injury to your tendon is severe enough, then surgery might be the best option to help your Achilles tendon. Your surgeon may remove the damaged part of the tendon and stitch together the remaining healthy portions. If the injury is pretty severe, the surgeon may have to grab a tendon from another part of your body in order to repair the damaged area. Schedule an appointment today with Pueblo Ankle & Foot Care for a comprehensive evaluation.