SERVICES

  • Achilles Tendonitis

  • Ankle Fractures

  • Ankle Joint Surface Defects

  • Ankle Pain

  • Ankle Sprains

  • Arthritis of the Foot and Ankle

  • Bunions, Hammertoe, and Other First Toe Disorders

  • Cartilage Injuries

  • Cerebral Palsy and Brain Injury Contractures

  • Chronic Lateral Ankle Sprains

  • Claw Toe

  • Clubfoot

  • Flat Feet

  • Foot Pain

  • Fractures of the Foot and Ankle

  • Heel Pain

  • High Ankle Sprain

  • Lisfranc (Midfoot) Fractures

  • Morton’s Neuroma

  • Neuromas

  • Osteochondral Defects and Fractures

  • Peroneal Tendinosis

  • Plantar Fasciitis

  • Rheumatoid Arthritis

  • Sesamoiditis

  • Sports-Related Injuries to the Foot, and Ankle

  • Stress Fractures

  • Tendon Ruptures

  • Traumatic, Post-Traumatic, and Degenerative Conditions of the Foot, and Ankle

 

 

Procedures:

  • Adult Reconstructive Surgery of the Foot and Ankle

  • Ankle Arthroscopy

  • Bone Spurr removal

  • Deformity Correction

  • Flatfoot Correction

  • Reconstruction of Complex Deformities of the Foot, and Ankle

  • Rheumatoid Reconstructions

  • Stem Cell Injections

  • Tendon Repair and Reconstruction including Achilles, Posterior Tibial and Peroneal

  • Ingrown Toenail Removal

  • Vascularized Bone Transport to Reconstruct Bone Loss and Chronic Non-Union

  • Wart, corns, removal

 

 
Achillies Tendonitis

Overview:   Achilles Tendonitis is a common injury in athletes and middle aged people who play sports.   It occurs in the band of tissue that connects calf muscles at the back of the lower leg to the heel bone. The  tendon becomes swollen and painful and in a severe Achilles tendon injury, too much force on the tendon can cause it to tear partially or rupture completely. To avoid Achilles Tendonitis, athletes should use caution when increasing the intensity or duration of their activity, especially running.  Wearing high heels can also cause the Achilles tendon to become swollen and painful. Other causes of Achilles Tendonitis include problems with feet, such as fallen arches or overpronation (feet pointed out), which stretches the muscles and tendons in an unnatural way. It also could be caused by muscles or tendons in the leg that are too tight. 

Symptoms:   Symptos include pain along the back of your foot and above the heel, tenderness, swelling stiffness, hearing a snapping or a popping noise during an injury.

 

 

Overview:    Ankle injuries are among the most common of the bone and joint injuries. Often, the degree of pain, the inability to walk, or concern that a bone may be broken is what might cause you to seek care in an emergency situation.

For the most part, your concern is the same as the doctor's: Is there a broken bone? It is often impossible to diagnose a fracture (broken bone) rather than a sprain, a dislocation, or tendon injury without X-rays of the ankle.

The ankle joint is made up of 3 bones coming together.  These 3 bones (tibia, fibula, and talus) make up the bony elements of the ankle joint. A fibrous membrane called the joint capsule, lined with a smoother layer called the synovium, encases the joint architecture. The joint capsule contains the synovial fluid produced by the synovium. The synovial fluid allows for smooth movement of the joint surfaces. The ankle joint is stabilized by several ligaments, which are fibers that hold these bones in place.

Causes:  When you stress an ankle joint beyond the strength of its elements, you injure the joint. If only the ligaments give way and tear, you have sprained the ankle. If a bone gives way and breaks, you have an ankle fracture.

  • Fractures can occur with simultaneous tears of the ligaments. You can do this in several ways:

    • Rolling the ankle in or out

    • Twisting the ankle side to side

    • Flexing or extending the joint

    • Applying severe force to the joint by coming straight down on it as in jumping from a high level

Ankle Fracture
 
Flat Feet
 

Overview:  Flat feet (pes planus) refer to a change in foot shape in which the foot does not have a normal arch when standing.

Causes:  Flat feet are a common condition and occur because the tissues holding the joints in the foot together (called tendons) are loose. In young children, the tissues tighten and form an arch as children grow older. This will take place by the time the child is 2 or 3 years old. Most people have correctly formed arches by the time they are adults. However, the arch may never form in some people. Aging, illness, or injury may harm the tendons and cause flat feet to develop in a person who has already formed arches. This type of flat foot may occur only on one side. Rarely, painful flat feet in children may be caused by a condition in which two or more of the bones in the foot grow or fuse together. This condition is called tarsal coalition. 

Symptoms: Most flat feet do not cause pain or other problems. Children may have foot pain, ankle pain, or lower leg pain. They should be evaluated by a health care provider if they have any regular pain.  Symptoms in adults may include tired or achy feet after long periods of standing or playing sports.

 

Heel Pain
 

Heel pain could be associated with several things. Plantar Fasciitis  is usually the main culprit. The plantar fascia attaches to the bottom of the heel bone and extends to the ball of the foot. The plantar fascia helps to maintain the arch integrity of the foot. Pain in the the heel occurs from the strain of the fascia attaching to the heel bone. The calf muscle applies a powerful force to the arch of the foot forcing the arch to collapse. This increase force on the fascia applies force to the nervous tissue of the bone called the periosteum leading to pain. The plantar fascia itself can have decreased blood flow which causes deterioration of the fascia which could progress to fascia rupture. The leading deforming force is caused by overactive calf muscles that limit range of motion in the ankle. Evaluation by  a healthcare provider can lead to treatment and resolution of pain. Heel pain could also be caused by nerve impingement, or stress fracture of the heel bone, or in rare cases a bone tumor. For more information about Heel Pain, go here.

 
Hammertoes and Bunions

Hammertoes are created from a muscular imbalance involving the muscles
on the top of the foot and the bottom of the foot. As we age, the
ankle joint has limited range of motion which also leads to hammertoe
deformities. The toe has two joints, which can be rigid and painful.
The joint which connects the toe to the rest of the foot can become
severely contracted which causes the toe to pop up. Because of the
pull of the muscles, the toe buckles and it eventually is fixated in
that position leading to pain. 

Hammertoes and bunions can be unsightly deformities of the foot which are acquired overtime between ages 20 and 50.

 

A bunion is a notable bump on the side of the big toe as well as outside of the fifth toe.

These can form due to two common causes. One cause is due to ankle equinus (more commonly known as tight calf muscles). As the calf muscle limits the range of motion of the ankle joint, the person will angle their feet out to allow them to walk without having to put the ankle through full range of motion. This makes walking easier; however the adverse effect is that the ground is pushing to the side of the big toe which forces the big toe

up and out. The Adductor Hallucis and the Abductor Hallucis are two muscles that work together on the big toe.  The Adductor Hallucis pulls the big toe towards the second toe while Abductor Hallucis should counter that pull.  When the ground pushes the big toe up and out, this gives the Adductor Hallucis mechanical advantage pushing the big toe towards the second toe. This also crowds the second toe forcing the second toe up. This creates a floating toe which eventually progresses into a hammered second toe.

 

Hammertoes also form because of muscular imbalance. The tendons on the top of the foot and the bottom of the foot compete. In addition, the small muscles that move the toes side to side also compete and eventually the tendons on the top and bottom

overcome and force the toe to buckle. Toes naturally grip to gain stability as a person is walking. Over time, that gripping action becomes rigid and painful in which the toe cannot be straightened.

Ankle Sprains
 

Why are ankle sprains so painful and debilitating? Ankle sprains are very common among sports injuries, casual joggers, or even just in daily movement. Ankle sprains can range from tender to incapacitating due to the injury of ligaments and/or bone structures in the ankle.

An ankle sprain feels like a “stretching” or partial dislocation of the ankle joint as it bowstrings out of alignment. There are many ligaments, tendons and bones of the ankle and foot which can be injured. One of the most common ligaments injured is called the anterior talofibular ligament, located on the outside of the ankle joint. This ligament is usually the first of many ligaments which can be torn, stretched or even completely ruptured. Typically when a ligament is injured there is localized swelling over the outside of the ankle which also becomes very tender to touch. When the ankle is injured it is difficult to walk and the patient ends up limping for the next several days. There are multiple other structures which can be injured including another ligament called the calcaneofibular ligament which is located on the outside of the ankle as well. These first two ligaments are the most common ligaments which can be ruptured or damaged.

 

Ligaments are not the only structures which can be injured.  Tendons, such as the peroneal brevis and longus, on the outside of the ankle, can be damaged or torn. The peroneal brevis tendon can be stretched, or even torn. In severe cases it can be torn away from the bone with can cause fracturing or breakage of the bone as well. 


In a severe ankle sprain the inside bone of the ankle joint called the talus can actually rub up against the ankle walls where  the tibia and fibula are located. This forces an erosion of the cartilage of the talus and/or tibia. The bones of the ankle are involved in the most severe ankle sprains. The most common fracture is of the fibular bone located on the outside of the ankle which can (depending on the severity of the ankle sprain) lead to a non-displaced or displaced fracture. An additional fracture can also occur on the inside of the ankle joint of the tibia. In severe trauma of the ankle such as falling from a height the heel bone can be broken into multiple pieces including the ankle joint.


In a severe ankle sprain it is imperative that the injury be evaluated by a foot and ankle specialist to identify the type of injury and the best type of treatment. Severe ankle sprains with potential fracture of the ankle may require surgery to fix and stabilize the fracture.
In some cases ankle trauma can lead to loss of sensation of the ankle and foot, loss of movement, and loss of blood flow. This is a medical emergency and would require immediate intervention to restore sensation and blood flow to the foot. This is called compartment syndrome in which the neurovascular structures are compressed with acute swelling preventing blood flow to the foot.


With less severe ankle injuries it is ideal to be evaluated by a foot and ankle specialist to determine the type of injury and best action of treatment.
With any ankle injury if proper treatment does not occur this can lead to laxity of the ankle joint and chronic pain.

© 2015 by Foot & Ankle Specialists of Idaho,

Phone:  208-346-7443 

Fax: 208-346-7442

Office Cell: 208-917-FOOT

2116 E 25th St,  Idaho falls ID 83404