Ankle problems typically fall into two categories: sudden injuries or long-term deterioration. While both can cause much pain, treatment may not be the same.
Ankle injuries can be sprains or fractures, both of which might result in an appointment with a podiatrist like Dr. Elizabeth Barnica or Dr. Jared Stanton at Mercy Clinic Podiatry in Joplin and Carthage.
Ankle sprains are ligament tears and can range from mild to severe, depending on the number of ligaments involved and whether tears are partial or complete, according to Dr. Barnica. The most common causes are when people twist (invert) their ankle and it “rolls under them” such as when stepping off a curve awkwardly.
“Anytime you have an acute ankle injury and have difficulty putting weight on your foot, seek medical care immediately,” she said.
Another common acute ankle injury is a ruptured Achilles tendon, which is a complete tear of the strong, fibrous cord that connects muscles in the back of the calf to the heel bone. While the rupture is sudden, it’s usually the result of long-term overuse or chronic degeneration, Dr. Barnica said.
“Typical patients we see who have ruptured an Achilles tendon are in their 40s or older and resumed activity after many years or are ‘weekend warriors,’” she said. “In those cases, the tendon and tissue aren’t strong enough and rupture from increased stress.”
Treatment depends on the patient’s age, health, activity level and degree of the tear. Conservative treatment is to cast the ankle and allow it to reattach as it scars. Often, surgery is needed to reattach the tendon.
A partial tear of the Achilles tendon often is discovered when the patient develops tendonitis or pain. Treatment involves controlling pain and swelling with anti-inflammatory medicine like ibuprofen and applying cold therapy, resting the injury from aggravating activities and taping the tendon to reduce weight load when walking. Once swelling is reduced and the injury has healed enough, rehabilitation can move to stretching and strengthening exercises.
Non-acute ankle injuries usually can be treated at home using the RICE method of rest, ice, compression and elevation. Ice for no more than 15 minutes at a time, put on a compression sock or wrap, and elevate the ankle above the heart, if possible.
“In addition to ligaments, with severe sprains you can damage joints, cartilage and bones underlying the joints and cartilage,” Dr. Barnica said. “Those can be more subtle injuries where people tend to feel pain or movement inside the joint or the ankle locks up for no apparent reason.”
People who have sprained an ankle may be more prone to reinjure the ankle because it may not be as strong as before the injury.
“If that happens, it can lead to what becomes an unstable ankle,” she said. “We’ll evaluate that for possible bracing, physical therapy or surgery.”
Ankle problems also can be caused by degenerative issues such as arthritis and pain inside joints.
“We see patients with ankle and foot arthritis quite a bit,” Dr. Barnica said.
Treatment is similar to arthritis in other parts of the body and includes medication, injections, heat therapy and, in some severe cases, fusion surgery. Additionally, being active can improve the situation, Dr. Barnica said.
“The tendency is to be immobile as movement with arthritis usually means pain initially,” she said. “For most anyone with arthritis, the more active they stay, the better.”
Referrals are not required to make an appointment with Dr. Barnica at Mercy Clinic Podiatry in Joplin or Carthage, but some insurance coverage requires a referral for specialists.
For more information about Mercy Clinic Podiatry – Joplin, 100 Mercy Way, or Mercy Clinic Podiatry – Carthage on the Mercy Hospital Carthage McCune-Brooks Campus, 3125 Dr. Russell Smith Way, call 417-556-2278.