Toe, Foot, And Ankle Injuries

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Topic Overview

At one time or another, everyone has had a minor toe, foot, or ankle injury that caused pain or swelling. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or an injury.

Toe, foot, or ankle injuries most commonly occur during:

• Sports or recreational activities.
• Work-related tasks.
• Work or projects around the home.

In children, most toe, foot, or ankle injuries occur during sports or play or accidental falls. The risk for injury is higher in sports with jumping, such as basketball, or sports with quick direction change, such as soccer or football. Any bone injury near a joint may injure the growth plate (physis) in a child and needs to be evaluated.

Certain athletes, such as dancers, gymnasts, or soccer or basketball players, have an increased risk of toe, foot, or ankle injuries.

Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength (osteopenia) as they age. They also have more problems with vision and balance, which increases their risk for accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing.

Sudden (acute) injury

An acute injury may occur from a direct blow, a penetrating injury, a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Your pain may be sudden and severe. Bruising and swelling may develop soon after your injury. Acute injuries include:

• Bruises. After an ankle injury, bruising may extend to your toes from the effects of gravity. See a picture of a bruise (contusion) .
• Injuries to ligaments that support your joints. See a picture of a ligament tear .
• Injuries to tendons, such as ruptured tendons in your heel (Achilles tendon). Young boys between 8 and 14 years old may have a condition known as Sever's disease, which causes injury to the growing bone where the Achilles tendon is attached. This usually occurs during activity and is relieved with home treatment. See a picture of the Achilles tendon .
• Injuries to your joints (sprains). If a sprain does not appear to be healing, a condition known as osteochondritis dissecans may be present, causing persistent symptoms. See a picture of a sprained ankle .
• Pulled muscles (strains). Muscles of the foot and ankle can be strained and can also rupture.
• Broken bones (fractures), such as a broken toe.
• A bone moving out of place (dislocation).
• A crushing injury, which can lead to compartment syndrome.

Overuse injuries

Overuse injuries occur when too much stress is placed on your joint or other tissue, often by "overdoing" an activity or repeating the same activity over and over. Overuse injuries include:

• Retrocalcaneal bursitis, which is inflammation of the bursa. This condition causes swelling and tenderness of the heel. Pain usually gets worse while wearing shoes and during activity and improves during rest. See a picture of the back of the heel and ankle .
• Achilles tendinitis or tendinosis (tendinopathy), which is the breakdown of soft tissues in and around the Achilles tendon that connects the calf muscles to the heel bone.
• Stress fracture, which is a hairline crack in a bone. See a picture of stress fractures of the foot .
• Plantar fasciitis, which is an inflammation of the plantar fascia, a broad, flat ligament on the bottom of the foot that extends from the front of the heel to the base of the toes and helps maintain the arch of the foot. See a picture of the plantar fascia .
• Metatarsalgia, which is pain in the front (ball) of the foot. See a picture of metatarsalgia .

Treatment

Treatment for your toe, foot, or ankle injury may include first aid measures (such as the application of a brace, splint, or cast), a special shoe (orthotic device), physical therapy, medicine, and in some cases surgery. Treatment depends on:

• The location, type, and severity of your injury.
• When the injury occurred.
• Your age, your overall health condition, and your activities (such as work, sports, or hobbies).

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

Last updated:	October 27, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	Kathleen Romito, MD - Family Medicine, Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer