Texas Foot Doctor's Blog
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Medical Myths: The Truth Uncovered #1
There’s Nothing You Can Do About A Broken Toe: True or False?
There is often a delay in treatment for toe fractures because most people think there isn’t a treatment for them anyway. This is FALSE! Toe fractures are treated like any other fracture in the body. If it’s not displaced (separation between fracture pieces), then immobilization is the typically treatment. If there is separation of fracture pieces, sometimes a surgical procedure is necessary. If not immobilized properly (i.e. wearing one of those stylish black Velcro boots), there can be a delay in healing or the fracture may not heal at all. This can lead to long lasting pain and even deformity. Kids who fracture their toes through the growth plates can have long lasting deformity as well if not treated appropriately. The picture shown is of a female patient that broke her toe through the growth center and did not seek treatment. The growth plate closed prematurely resulting in a shortened digit. Moral of the story? If you injure a toe and think it might be broken, seek treatment! There IS something you can do about it!! The doctors at Academy Foot and Ankle Specialists treat all conditions of the foot and ankle. If you are experiencing foot, ankle or toe pain, contact us today for an appointment. 817-424-3668.
What is the Os Trigonum?
The os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is connected to the talus by a fibrous band. The presence of an os trigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence when one area of the talus does not fuse with the rest of the bone, creating a small extra bone. Only a small number of people have this extra bone.
What is Os Trigonum Syndrome?
Often, people don’t know they have an os trigonum if it hasn’t caused any problems. However, some people with this extra bone develop a painful condition known as os trigonum syndrome.
Os trigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players and other athletes.
For the person who has an os trigonum, pointing the toes downward can result in a “nutcracker injury.” Like an almond in a nutcracker, the os trigonum is crunched between the ankle and heel bones. As the os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn and the area becomes inflamed.
Signs and Symptoms of Os Trigonum Syndrome
The signs and symptoms of os trigonum syndrome may include:
- Deep, aching pain in the back of the ankle, occurring mostly when pushing off on the big toe (as in walking) or when pointing the toes downward
- Tenderness in the area when touched
- Swelling in the back of the ankle
Os trigonum syndrome can mimic other conditions such as an Achilles tendon injury, ankle sprain, or talus fracture. Diagnosis of os trigonum syndrome begins with questions from the doctor about the development of the symptoms. After the foot and ankle are examined, x-rays or other imaging tests are often ordered to assist in making the diagnosis.
Treatment: Non-surgical Approaches
Relief of the symptoms is often achieved through treatments that can include a combination of the following:
- Rest. It is important to stay off the injured foot to let the inflammation subside.
- Immobilization. Often a walking boot is used to restrict ankle motion and allow the injured tissue to heal.
- Ice. Swelling is decreased by applying a bag of ice covered with a thin towel to the affected area. Do not put ice directly against the skin.
- Oral medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
- Injections. Sometimes cortisone is injected into the area to reduce the inflammation and pain.
When is Surgery Needed?
Most patients’ symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the os trigonum, as this extra bone is not necessary for normal foot function.
Contact one of the doctors at Academy Foot and Ankle Specialists if you are experiencing foot or ankle pain for a full exam today!
When you take a step, your foot typically hits the ground heel first and rolls toward your toes, flattening the arch slightly. As you push off the ball of your foot, your arch springs back and does not touch the ground. That's how normal feet are supposed to work. Unfortunately, many feet aren't normal. Overpronation occurs if your foot rolls too much toward the inside. This can cause arch strain and pain on the inside of the knee. Underpronation occurs if your foot rolls too much to the outside. Underpronation can lead to ankle sprains and stress fractures. You can relieve foot pain by compensating for these tendencies, but first you need to determine which way your feet roll.
One method for determining which kind of pronation you have is the watermark test: Put your feet into a bucket of water, then make footprints on a piece of dark paper.
If your footprint looks like an oblong pancake with toes, you pronate excessively or may have flat feet. Try molded-leather arch supports, which can be purchased in many drug stores. And when shopping for athletic shoes, ask a sales clerk for styles with "control" features—soles designed to halt the rolling-in motion. If arch supports or sports shoes don't help, please contact our office for a custom-molded orthotics.
If there's little or no connection in your footprint between the front part of the foot and the heel, you under-pronate or have a high arch. This means a lot of your weight is landing on the outside edge of your foot. Ask for "stability" athletic shoes, which are built with extra cushioning to remedy this problem. If you are prone to ankle sprains, wear high-top athletic shoes that cover the foot and ankle snugly to minimize damage from twists.
What is Turf Toe?
Turf toe is a sprain of the big toe joint resulting from injury during sports activities. The injury usually results from excessive upward bending of the big toe joint. The condition can be caused from either jamming the toe, or repetitive injury when pushing off repeatedly when running or jumping. Although this injury is most commonly reported in football players, participants in soccer, basketball, wrestling, gymnastics and dance also are at risk.
The name “turf toe” comes from the fact that this injury is especially common among athletes who play on artificial turf. When playing sports on artificial turf the foot can stick to the hard surface, resulting in jamming of the big toe joint. There has also been some indication that less-supportive flexible shoes worn on artificial turf are also to blame.
The signs and symptoms of turf toe can include pain, swelling, and limited joint movement.
If turf toe is caused by repetitive actions that cause injury, the signs and symptoms will usually begin slowly and can gradually worsen. Turf toe can also be caused by a direct injury leading to damage of the bone beneath the cartilage. If direct injury is the cause, the signs and symptoms may begin suddenly and get worse over a 24-hour period.
To arrive at a diagnosis, the foot and ankle surgeonwill obtain your medical history and examine your foot. X-raysare typically ordered to rule out any broken bone. Other advanced imaging studies may also be helpful for proper diagnosis.
Initial treatments include rest, ice, compression, and elevation. (RICE), as well as a change to less-flexible footwear. Operative treatment is reserved for individuals with severe cases and prolonged pain.
“Shin splints” is a term to describe pain and swelling in the front of the lower legs. The pain usually appears after and is aggravated by repetitive activities such as running or walking. Contributing causes are flat feet, calf tightness, improper training techniques, worn out or improper shoes/sneakers, as well as running or walking on uneven surfaces. The inflammation in the shin results from the repeated pull of a muscle in the leg from the shin bone (tibia).
This condition usually occurs bilaterally (both legs) and can be alleviated by rest, use of non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, icing, a change in training habits, stretching exercises, and properly fitted shoes. A foot and ankle surgeon can treat the condition, recommend proper shoe gear, and evaluate whether orthotics are needed. If not treated, shin splints may eventually result in a stress fracture of the shin bone.
If you suffer from shin splints, make an appointment today with one of our Foot and Ankle Specialists for a complete exam, diagnosis, and treatment plan!
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