Common Foot & Ankle Injuries
Achilles Tendon Rupture
The Achilles tendon is the largest tendon in the body, and it connects the calf muscles to the heel bone. It is used for walking, running, and jumping. The Achilles tendon is strong and can withstand a large amount of physical stress, but it is still susceptible to injury. An Achilles tendon rupture occurs when the tendon is torn to the point that it can no longer function properly. Although surgical repair is often needed because the tendon is critical for walking, non-surgical treatment may also be an option.
A sprain refers to an injury to a ligament, which is the tissue that connects bone to bone. The ankle ligaments hold the ankle bones in position and protect the joint from any abnormal movements, such as twisting or rolling. A sprained ankle is very common and is caused by a ligament being stretched beyond its normal position, as when the foot is planted on an uneven surface and the ankle is forced into an abnormal movement. Sprains can be mild to severe and treatment is calibrated accordingly. Options range from stretching and strengthening exercises for mild sprains to surgical reconstruction and physical therapy for severe sprains.
Stress Fractures of the Foot and Ankle
Stress fractures, which are minor bone cracks or bruises, are common in the foot and ankle. They typically are caused by overuse and repetitive activity and are especially common in sports that involve running such as soccer. Avoidance of the high-impact activity that led to the stress fracture is key to recovery, as resuming too soon can delay healing and increase the risk for a complete fracture. In most cases, recovery takes six to eight weeks, but more severe stress fractures can take longer to heal.
An ankle fracture, also known as a broken ankle, can occur in one or more of the bones that make up the ankle joint. The more bones involved in the fracture, the more unstable the ankle becomes. Ligaments, the tissue that connects bone to bone, may also be injured in an ankle fracture. Symptoms of an ankle fracture can be similar to an ankle sprain and include pain, swelling, and tenderness at the site of injury. If the ankle is stable, a physician may decide that it can be treated with a cast for several weeks. If the fracture is severe or creates an unstable ankle, then surgery may be necessary.
Pilon Fractures of Ankle
The tibia, or shine bone, is one of the bones that make up the ankle joint. Pilon fractures refer to a break at the bottom of the tibia. In most pilon fractures, the fibula, the smaller bone in the lower leg, is also broken. Pilon fractures are commonly caused by a high-impact crushing injury. Because of the force needed to break the bones in this manner, pilon fractures are accompanied by additional injuries in half of all cases. Like other fractures, patients experience pain, swelling, bruising, and tenderness at the site of injury. Most pilon fractures require surgery but if the bones remain stable despite the injury, nonsurgical treatments, such as splints or casts, may be used.
The talus is one of the bones of the ankle. A fracture, or break, of the talus is usually the result of a high-impact injury, such as a high-velocity fall. The talus is important for ankle movement, and a fracture generally results in the inability to move the ankle in addition to the pain, swelling, and tenderness typical of fractures. It is important that talus fractures be properly evaluated and treated because injuries that do not heal properly can lead to chronic pain. Most talus fractures require surgery in order for patients to make a complete recovery.
Lisfranc injuries, also called mid-foot injuries, result from either fractures or torn ligaments in the midfoot. This type of injury can be mild and simple or severe and complex, involving many bones, ligaments, and joints of the midfoot. It typically results from a low-energy abnormal movement, such as a twist and fall, and is commonly seen in athletes such as football or soccer players. A Lisfranc injury causes tenderness and swelling of the top of the foot, bruising, and pain that worsens when standing or walking. It is commonly mistaken for a simple sprain, but this type of injury is severe and can take many months to heal. Some cases may also require surgery for complete recovery.
Toe and Forefoot Fractures
There are many bones in the foot and toes that can be fractured, or broken, and lead to pain and difficulty walking. Fracture types include stress and complete fractures, and pain, swelling, and bruising are the most common symptoms of foot or toe fractures. If treatment is delayed, chronic pain, arthritis, or difficulty walking can develop. Treatment depends on the type and location of the fracture, but most forefoot and toe fractures do not require surgery. Common options include wearing a splint, walking cast, or rigid, flat-bottomed shoe.
Turf toe refers to a sprain in the main joint of the large toe, and is so named because it became a common injury in American football players after artificial turf was introduced. Artificial turf surfaces tend to be harder than grass and do not react the same way to force (e.g., when pushing off into a sprint). Although commonly associated with football players, turf toe results from a wide range of sports and activities. If severe, this injury can include total dislocation of the joint. Although treatment is based on the severity of injury, most cases do not require surgery. Surgery may be considered if the symptoms are persistent or they affect the physical ability of the patient.
Other Foot & Ankle Injuries
For more information about other broken bones and injuries related to the foot and ankle, review the American Academy of Orthopaedic Surgeons (AAOS) links listed below.