Foot and Ankle
Containing more than 100 bones, tendons, muscles and ligaments and forming 33 joints, our feet and ankles play a major role in how we can (or can’t) move. A mild sprain or strain or even a broken toe can cause pain, limit our movement or possibly cause further injury in other parts of the body.
From bunions and heel problems to fractures and sprains, Orthopedic Associates’ fellowship-trained surgeons offer surgical techniques and non-surgical treatments for adults and children to eliminate or relieve many of these problems.
Trust our team of foot and ankle specialists to help you get back on your feet!
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Regenerative Cellular Therapies, or Concentrated Bone Marrow Aspirate, contains all of the healing and growth factors contained in PRP, with additional healing cells called pluripotent cells.
Bone marrow is the tissue that is found in the hollow spaces in the interior of our bones. It is known that significant sources of our body’s adult stem cells are contained within our bone marrow. It is also known that these have the potential of positively contributing to healing. Blood and tissue can be harvested from the several bones in the body, the most popular being the hip, tibia and calcaneus, in an outpatient setting via an aspiration device.
Similar to PRP, a centrifugation device is used to concentrate the platelets and growth factors, as well as the pluripotent (or stem) cells, creating an injectable product that is delivered directly to the site of injury, jump-starting the healing cascade.
Regenerative Cellular Therapies may be effectively used in the treatment of:
- Muscle Injuries
- Bicipital Tendonitis
- Ankle Sprain/Ligament Pain
- Painful Degenerative Tendon Conditions
- (i.e. Tendinopathies of the Hips, Rotator Cuff Tendons & Elbow)
- Plantar Fasciitis
- Elbow Pain
- Medial/Lateral Epicondylitis
- Ulnar Ligament Strains
- Chronic Neck and Low Back Pain
- Sacroiliac Pain
- Chronic Lateral Hip Pain
- Coccydynia or Tailbone Pain
- Osteitis Pubis
- Ankle Pain and Instability
- TMJ Dysfunction
A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus.
Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.
Anyone can get a bunion, but they are more common in women. Many women wear tight, narrow shoes that squeeze the toes together-which makes it more likely for a bunion to develop, worsen and cause painful symptoms.
In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe.
In addition to the visible bump on the inside of the foot, symptoms of a bunion may include:
- Pain and tenderness
- Redness and inflammation
- Hardened skin on the bottom of the foot
- A callus or corn on the bump
- Stiffness and restricted motion in the big toe, which may lead to difficulty in walking
A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. This type of fracture commonly occurs during a high-energy event-such as a car crash or a fall from a ladder-when the heel is crushed under the weight of the body. When this occurs, the heel can widen, shorten, and become deformed.
Calcaneus fractures can be quite severe. Treatment often involves surgery to reconstruct the normal anatomy of the heel and restore mobility so that patients can return to normal activity. But even with appropriate treatment, some fractures may result in long-term complications, such as pain, swelling, loss of motion, and arthritis.
Patients with calcaneus fractures usually experience:
- Heel deformity
- Inability to put weight on the heel or walk
With some minor calcaneus fractures, the pain may not be enough to prevent you from walking – but you may limp. This is because your Achilles tendon acts through the calcaneus to support your body weight. If, however, your calcaneus is deformed by the injury, your muscle and tendon cannot generate enough power to support your weight. Your foot and ankle will feel unstable, and you will walk differently.
A hammer toe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and require surgery.
People with hammer toe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Hammer toe results from shoes that don’t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and cannot stretch out.
Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when there is no confining shoe.
Every mile you walk puts 60 tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle.
A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people try to ignore the early signs of heel pain and keep on doing the activities that caused it. When you continue to use a sore heel, it will only get worse and could become a chronic condition leading to more problems. Surgery is rarely necessary.
If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail. Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe. But this technique may encourage your toenail to grow into the skin of your toe. The sides of the nail curl down and dig into your skin. An ingrown toenail may also happen if you wear shoes that are too tight or too short.
When you first have an ingrown toenail, it may be hard, swollen and tender. Later, it may get red and infected, and feel very sore. Ingrown toenails are a common, painful condition-particularly among teenagers. Any of your toenails can become ingrown, but the problem more often affects the big toe. An ingrown nail occurs when the skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. Redness, pain and swelling at the corner of the nail may result and infection may soon follow. Sometimes a small amount of pus can be seen draining from the area.
Ingrown nails may develop for many reasons. Some cases are congenital-the nail is just too large for the toe. Trauma, such as stubbing the toe or having the toe stepped on, may also cause an ingrown nail. However, the most common cause is tight shoe wear or improper grooming and trimming of the nail.
A stress fracture is a small crack in a bone, or severe bruising within a bone. Most stress fractures are caused by overuse and repetitive activity, and are common in runners and athletes who participate in running sports, such as soccer and basketball.
Stress fractures usually occur when people change their activities – such as by trying a new exercise, suddenly increasing the intensity of their workouts, or changing the workout surface (jogging on a treadmill vs. jogging outdoors). In addition, if osteoporosis or other disease has weakened the bones, just doing everyday activities may result in a stress fracture.
The weight-bearing bones of the foot and lower leg are especially vulnerable to stress fractures because of the repetitive forces they must absorb during activities like walking, running, and jumping.
Refraining from high impact activities for an adequate period of time is key to recovering from a stress fracture in the foot or ankle. Returning to activity too quickly can not only delay the healing process but also increase the risk for a complete fracture. Should a complete fracture occur, it will take far longer to recover and return to activities.
The most common symptom of a stress fracture in the foot or ankle is pain. The pain usually develops gradually and worsens during weight-bearing activity. Other symptoms may include:
- Pain that diminishes during rest
- Pain that occurs and intensifies during normal, daily activities
- Swelling on the top of the foot or on the outside of the ankle
- Tenderness to touch at the site of the fracture
- Possible bruising
A talus fracture is a break in one of the bones that forms the ankle. This type of fracture often occurs during a high-energy event, such as a car collision or a high-velocity fall.
Because the talus is important for ankle movement, a fracture often results in significant loss of motion and function. In addition, a talus fracture that does not heal properly can lead to serious complications, including chronic pain. For this reason, many talus fractures require surgery.
Patients with talus fractures usually experience:
- Acute pain
- Inability to walk or bear weight on the foot
- Considerable swelling, bruising, and tenderness
A tarsal coalition is an abnormal connection of two or more bones in the foot. The bones affected – called tarsal bones – are located toward the back of the foot and in the heel, and the connection of the bones can result in a severe, rigid flatfoot.
Although tarsal coalition is often present at birth, children typically do not show signs of the disorder until early adolescence. The foot may become stiff and painful, and everyday physical activities are often difficult.
For many children with tarsal coalition, symptoms are relieved with simple treatments, such as orthotics and physical therapy. If a child has severe symptoms that do not respond to simple treatments and continue to interfere with their daily activities, surgery may be recommended.
Many tarsal coalitions are never discovered because they do not cause symptoms or any obvious foot deformity. When symptoms do occur, they may include:
- Stiff, painful feet. The pain usually occurs below the ankle around the middle or back half of the foot.
- A rigid, flat foot that makes it difficult to walk on uneven surfaces. To accommodate for the foot’s lack of motion, the patient may roll the ankle more than normal, which may result in recurrent ankle sprains.
- Increased pain or a limp with higher levels of activity.
Learn About Our Advanced Technologies
We offer advanced treatment options for patients with special needs.
Before beginning any treatment, discuss your options with your foot doctor.
A small amount of a patient’s blood is drawn and then spun at high speed. The platelets are concentrated. This liquid is then injected around or near the area of injury being treated. The PRP at this stage contains three to five times the concentration of growth factors compared to normal human blood.
What Happens After a PRP Injection?
You may experience mild pain and irritation of the area for several days following the injection. Some doctors may ask patients to limit motion or weight-bearing activity immediately following the injection. The use of a brace, boot or cast may be recommended during the early post-injection course.
Three to seven days after the injection, you may gradually return to normal physical activities. The return to full activity is determined based on response to the therapy and the recommendation of your surgeon.