Douglas Pacaccio, DPM
Thomas Nordquist, DPM
May 2020
Dealing with Stress Fractures of the Foot and Ankle
Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.
Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.
Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.
Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.
If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.
If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.
How to Care for Your Child's Feet
It is never normal for a child to experience pain in his or her feet. Foot pain that lasts more than a few days and limits a child’s ability to walk should be examined by a podiatrist. Many adult foot ailments originate in childhood and may be present at birth. Common foot issues that are experienced by children are pediatric flat foot, Sever’s disease, ingrown toenails, and plantar warts.
A child’s foot grows rapidly during the first year, allowing it to reach almost half of their adult foot size. Consequently, foot specialists consider the first year to be the most crucial point in the foot development process. There are ways you can help ensure that your child’s foot develops properly. One way is to carefully look at your baby’s feet. If you notice any deformities, you should immediately seek professional care. You should also loosely cover your child’s foot, since tight coverings may prevent movement and inhibit normal development. Another tip is to change the baby’s positioning throughout the day. If your baby lies down in one spot for too long, it may put an excess amount of strain on the feet and legs.
It is best that you try not to force a child to start walking. Children will begin to walk when they are both physically and emotionally capable to do so. You should also avoid comparing your child’s walking progress with other children because the age range for independent walking may range. When your child’s feet begin to develop, you may need to change both their shoe and sock size every few months to allow room for their feet to grow.
Kids are sometimes prone to splinters, cuts, and severe injuries because they tend to walk around barefoot. This also makes them more susceptible to developing plantar warts which is a condition caused by a virus that invades the sole of the foot through breaks in the skin. These ailments can be avoided by making sure your child wears shoes in unsanitary environments. You should also wash any minor cuts or scrapes on your child’s feet. It is a myth that exposure to fresh air will heal injuries; fresh air will only expose your child’s cuts to germs.
As a parent, you should ensure that your child’s feet are developing properly and are being properly maintained. Consequently, it is important that you perform routine inspections on his or her feet to detect any injuries or deformities in their early stages. Early detection and treatment will help to ensure that your child does not develop any serious foot conditions.
What are Achilles Tendon Injuries
The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.
The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.
An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.
Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.
Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health.
It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.
Cuboid Syndrome
Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome. This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.
Causes of Cuboid Syndrome
- Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
- Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
- Over-pronation can exacerbate the condition if not corrected.
Disagreements Amongst Podiatrists Regarding Cuboid Syndrome
- Some refer to it as the dislocation of the calcaneal-cuboid joint only.
- Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.
It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.
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