Acute Injuries
more information on
types of acute injuries
Achilles Tendinitis
The spot where the Achilles tendon attaches to the heel bone is called the Achilles insertion, and it can be the location of pain for many patients. The pain usually comes about increasingly over time in the back of the heel. A tight calf muscle can accelerate these symptoms. In some cases, physical therapy to stretch the calf muscle can relieve the symptoms of insertional Achilles tendinitis. In other cases, if left unchecked, it can develop into a bony prominence on the back of the heel, called a Haglund’s deformity, which can be very painful and cannot be treated with physical therapy.
Ankle Sprain/Rolled Ankle
An ankle sprain is mild to severe tearing of the ligaments in the ankle. They are most commonly caused by “rolling” the ankle joint, and can cause a significant amount of pain and swelling. There are predisposing factors that can increase the likelihood of ankle sprains, including high arches and a tight calf muscle. People who have had an ankle sprain in the past are also more likely to sprain their ankle again. Most ankle sprains will get better with proper rest and time, however, some sprains are so severe that they need to be repaired surgically.
Painful Flat Foot (Sinus Tarsi Impingement Syndrome)
Sinus tarsi impingement commonly occurs along with an ankle sprain, or with chronic high arches. With an ankle sprain, the lateral ankle gets stretched, and the medial ankle gets compressed. The compression on the medial side can cause pain in the sinus tarsi, which is the area where the heel bone meets the talus bone in the medial ankle. High arches can also cause impingement of the sinus tarsi.
Heel Pain (Plantar Fasciitis)
Plantar fasciitis is one of the most common disorders that can affect people from all walks of life. Common characteristics include pain in the heel and bottom of the foot, and increased pain with the first step out of bed. Common causes of plantar fasciitis include restrictive foot wear and a tight calf muscle. Most cases of plantar fasciitis can be resolved with less-restrictive footwear and physical therapy to stretch the calf muscle.
Lateral Plantar Nerve Compression (Baxter's Nerve)
Causes – compression of the first branch of the lateral plantar nerve (Baxter nerve, branch to the abductor digiti quinti); common in running athlete or anyone who has had prior surgery on the heel. This tiny nerve becomes compressed between fascia of abductor hallucis longus and medial side of quadratus plantae.
Treatment – usually operative (surgery to cut a layer of soft tissue called “abductor hallucis fascia”
Ankle Wear & Tear/Arthritis (Anterior Ankle Impingement Syndrome)
Anterior ankle impingement is more of a chronic issue that develops over time. Anterior ankle impingement commonly causes bone spurs to develop in the anterior ankle joint, which can cause decreased range of motion. Unfortunately, physical therapy cannot fix those bone spurs, and if they are bothersome, the only way to get rid of the pain they cause is to move them surgically.
Pain at the Ball of the Foot (Lesser-ray Transfer Metatarsalgia)
There are five long bones in our feet called metatarsals, and when working properly, weight-bearing forces are shared between all of them. The largest of these five metatarsals, the first metatarsal, is the one connected to the big toe. It is the largest of the five metatarsals, and handles a significant portion of the weight-bearing forces.
Fractures/Broken Bones
There are 26 bones in the foot and ankle, and any one of them can break. Some fractures can heal on their own with immobilization, rest, and time. Others need to be realigned surgically in order for them to heal with proper alignment.
Ligament/Tendon Tear (Soft Tissue Injuries)
There are more than 100 muscles, tendons, and ligaments in the foot and ankle. Tendons connect muscles to bone, and ligaments connect bone to bone. Ligaments and tendons can be partially or completely torn, and depending on severity, can be treated surgically or non-surgically.
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