Sprains & Fractures

Your feet and ankles are the reason you can walk upright. Together, they provide support and mobility to your body. Like any other body part, your feet and ankles can be injured. This article defines sprains and fractures, and the causes, symptoms, treatment and prevention of these injuries.

If you sprain your foot or ankle, you have injured the soft tissue. The most common type of sprain is the pulling, stretching, or tearing of the ligaments that connect bone to bone. Tendons and muscles can also be sprained. A fracture is a break or crack in the bones.

Causes

The most common cause of foot and ankle sprains and fractures are injuries. Spraining or fracturing often occurs during sports, especially during football, basketball, running, gymnastics and dancing. The impact of the running, jumping and landing can create stress fractures for runners, gymnasts, and dancers, while the quick pivots in basketball can lead to ankle sprains. Football players are susceptible to both sprains and fractures.

Another common cause of sprains and fractures in the feet is tripping or stumbling on uneven ground.

Symptoms

Several symptoms are common when you have a sprained or fractured foot or ankle. These include:

• Pain in the affected area
• Swelling
• Bruising
• Difficulty walking

Treating Sprains and Fractures at Home

Be cautious if you’ve hurt your ankle or foot. It’s better to over pamper your foot than risk exacerbating the injury. Use the acronym RICE to remember what to do:

Rest—Give your foot or ankle a break. Stay off the injured leg, and avoid walking, running, or playing sports until the ankle or foot is healed. Doing strenuous activities while injured can often make the injury worse.

Ice—Ice can decrease inflammation. Apply ice to the area as soon as possible. Leave the ice on for 15-20 minute intervals every three or four hours. Do this during the first 48 hours after the injury.

Compression—Wrap the ankle or foot with an elastic bandage, such as an Ace® wrap. The wrapping should be snug or tight, but not so tight that you cut off circulation to the foot. The compression provides additional support to the foot or ankle, but doesn’t mean you can pretend nothing is wrong while wearing the bandage.

Elevation—Use pillows or another soft, supporting object to elevate the affected foot or ankle. Try to keep your foot or ankle higher than your heart while elevating it (lay down and rest as mentioned above). Elevation of the foot and ankle decreases the swelling.

Podiatrist Care

Doctors who specialize in caring for and treating foot and ankle problems are called podiatrists. If you’ve injured a lower extremity, a visit to a podiatrist is an important step for returning to normal life (or getting back to the sport you love) as soon as possible. The podiatrist will diagnosis the seriousness and extent of the injury and create a plan of care best suited for your needs.

If you’ve been using the RICE method and are still experiencing increased pain, swelling, redness, bruising, or difficulty walking, or if it seems you aren’t healing as fast as you expected, it is imperative to visit a podiatrist.

Diagnosis and Treatment

When you visit your podiatrist, he or she will ask for a complete medical history, as well as carefully examining your feet and ankles. To determine the extent of your injury, tests will be ordered. These test may include an X-ray, ultrasound, or an MRI. X-rays are useful for finding fractures, as the fractures can be clearly visible on the X-ray. If nothing is visible on the X-ray, an ultrasound or MRI might be used to discover torn ligaments or other soft tissue injuries or stress fractures.

Once the type and extent of your injury is determined, the podiatrist will recommend treatment options. Fractures need to be reduced by lining up the ends of the bones so they will heal properly. Local anesthetic makes this a nearly painless process. If the fracture doesn’t stay in place after a reduction procedure, you may need surgery. During surgery, your podiatrist will use metal plates and screws to fix the broken bones.

If the injury is a stress fracture, immobilization of the foot and rest are the best treatment. Staying off the affected area, whether from sitting and resting or through the use of crutches or a cast or boot, will allow the bones to heal. The cast or boot will help immobilize the area.

Immobilizing the foot or ankle is also the treatment method for a sprain. You may be able to resume activity fairly quickly, but the extent of the injury determines how long you need to immobilize your foot or ankle. If the sprain is a serious one, a soft cast or special boot and crutches may be needed for a period of weeks.

Professional athletes may undergo surgery to repair torn ligaments.

To decrease swelling, inflammation, and pain, ibuprofen or other oral anti-inflammatory medication may be prescribed.

Prevention

To prevent ankle and foot sprains and fractures, be sure to warm up prior to physical activity. Pay attention to your surroundings to avoid tripping on uneven ground. Wearing proper shoes can also make a big difference. Athletes should talk to their podiatrist to determine which shoes are best for their sport. Reading the APMA’s footwear selection tips provides more information. Replacing athletic shoes every year is a good practice. Running shoes should be replaced every 300-400 miles.