Treatment for Ankle Sprain – San Francisco Podiatrist Union Square CA
Dr. Bill Metaxas discusses the symptoms, causes and treatments for Sprain Ankle.

http://www.footankleinstitutesf.com

SPRAINS
Injuries to the outside of the ankle associated with rolling of the foot are known as ankle sprains.
The ankle ligaments provide stability to the ankle by helping to hold the ankle bone within the ankle joint. The ankle ligaments usually involved in an ankle sprain are also known as the lateral collateral ligaments of the ankle. The lateral collateral ligaments of the ankle are comprised of the anterior talofibular ligament, the calcaneofibular ligament and the posterior talofibular ligament.
The lateral ligaments provide stability to the ankle throughout the gait cycle as the foot bends up and down. Therefore total lateral stability of the ankle is provided by these three ligaments.
The most anterior (front) and most frequently injured of these ligaments is the anterior talofibular ligament. This ligament is intracapsular, or blended and contiguous with the lining of the anterior lateral aspect of the ankle capsule (joint). It can be seen as a fibrous thickening of the lining of the joint and courses from the front of the fibula to the front of the lateral surface of the talus.
The main function of the anterior talofibular ligament is the prevention of axial or rotational instability of the ankle. During gait as the heel is coming down, the foot is held in a dorsiflexed (up) position. Essentially the foot is pivoting on the edge of the heel only. Any irregularity in the ground, or laterally directed force, will cause the foot to twist in or out depending on the orientation of the force. Similarly, when we push off, the foot is in a plantar flexed (down) position. As the foot is plantar flexed, the position of the foot increases the long axis of the leg and increases the torque on the ankle region. Any ground irregularity or laterally directed force will cause the foot to twist in or out depending of the orientation of the force.
Classification of Injury
Rolling in of the foot (inversion), with the sole of the foot towards the opposite leg, is defined as a lateral ankle sprain. There are several classifications of this injury. A simple definition of injury breaks the injury down in terms of physiologic injury: sprain, strain or rupture which define the extent of stretching and A second classification of injury of the lateral collateral ligaments of the ankle is known as Grades 1, 2, or 3. This classification describes the functional loss of the ankle and the resultant grade or level of injury.
The end result of injury of one or more of the lateral collateral ligaments of the ankle is ankle instability. This instability can show up initially as a result of the severity of the injury or later as a result of chronic ankle instability.
During the moment of injury, due to the instability caused by the injury, movement and twisting of the Talus (ankle bone) in the ankle joint resulting in bone to bone compaction and twisting of other ligaments, tendons and nerves may occur. Injuries beyond the level of the ligaments themselves can occur and will occur depending of the level of injury. MRI, CT scans, bone scans and electro-diagnostic testing may be recommended to evaluate for these secondary injuries.
Chronic Ankle instability occurs much later than then original injury. Once the lateral collateral ankle ligaments are injured, they no longer provide the ability to stop ankle twisting and to hold the Talus within the ankle joint. As you walk or run with an unstable ankle, the talus can twist within the joint and partially come out of the joint. This movement is unnatural and abnormal and redirects force to the outside of the joint. With an increase in joint load to the outside, the foot will roll to the inside producing further tearing of the ligament and further injury.
Treatment
Conservative treatment for this condition depends on the necessity to stabilize the foot to restore the anatomical position of the ankle ligaments. The often noted RICE formula (rest, ice, compression elevation) is the standard initial treatment. Any treatment provided is to allow the ligaments to heal in the correct position and at the correct length. Depending on which ligaments are injured and to what degree the ligaments are injured, your doctor can provide you with the best ankle brace to stabilize your ankle.
Supplemental treatment for secondary injuries incurred at the time of injury will be diagnoses and treated at the same time as the treatment for the ankle ligaments.
Surgical Treatment
Surgical treatment of the ankle ligaments or associated injury conditions are performed when instability develops later or the injury is severe enough initially that stabilization must be done to allow for proper healing.

Visit our website: http://www.footankleinstitutesf.com

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Exercise 5 ankle rehab

Duration : 0:0:59

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ANKLE FRACTURE ,Educational animation video describing the anatomy the injury the diagnosis and treatment of ankle fracture
ankle fracture are single malleolar bimalleolar trimalleolar
syndesmodic injuy is diagnosed and the ankle is fixed to reduce the talus under the dome of the tibia
any lateral shift will increase the stress by 40 to 50 percent and accelerate arthritis
this ankle fracture video is uploaded by the univresity of toledo orthopedic surgeon

Duration : 0:5:21

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The top of the foot consists of many bones, ligaments, tendons, nerves, and muscles. The function of the foot is produced by all of these components and each component is relatively small and complex. For the majority of people, the foot is used more than any other body part. Feet consistently bear the entirety of a person’s weight in almost all sports. Needless to say, feet take a beating and are often injured.
Tendons on the top of the foot are responsible for pointing the toes towards the sky (dorsiflexion), and therefore most of the time tendonitis on top of the foot is due to inflammation caused by this action being repeated many times under stress. Activities like running (especially on an un-even grade), hill training, sport that causes frequent change of direction, or even running in poorly fit shoes, can all cause tendonitis of these tendons.
Other causes of pain on the top of the foot include cysts, bones jamming due to fallen arches, stress fractures from trauma, bone spurs due to arthritic conditions, or even pinched nerves. Typical treatment of these conditions includes R.I.C.E. (rest, ice, compression, and elevation) after activity, orthotics, being correctly fit for shoes, or various inserts. Many times strength training of the calves can help to relieve stress.
KT Tape provides excellent support without sacrificing range of motion, as well as increasing blood flow and taking stress off of inflamed tendons. Regardless of the source of pain, these benefits can help to promote the healing process as well as significantly reduce pain. Reducing pain will help you to avoid compensation injuries that all too often follow foot pain.

Duration : 0:2:39

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g” align=”left”/>Tips for Bunion Sufferers:

Who ever named it a bunion? Probably the same person who named an enlarged thyroid a goiter, but seriously, bunions are the common description of a bump on the side of the big toe. Really they are much more than that. Bunions are known in medical terms as Hallux Abducto Valgus which in English is a crooked big toe joint with a bump on the side.

This is actually a progressive misalignment of the big toe joint which starts with a slight leaning of the big toe toward the second and then gradually produces the characteristic bump and joint symptoms.

In the late stages of progression, the big toe actually can overlap or underlap the second and cause reactive hammertoes (contracted) of the other toes. Even though they are extremely common, most people wait until they have significant symptoms and deformity before they seek medical attention. Often they have had pain in shoes and with activity for years when they finally come into the office. This is due to the misconception that they always require surgery for treatment.

What causes bunions? No, its not always the shoes! (But, they dont help) Bunions are caused by the faulty biomechanics of your foot structure that you inherited. Couple that with high heeled shoes or even just shoes that crowd your toes (listen up guys who wear cowboy boots!) and you are prone to the formation of bunions.

Symptoms of bunions are the prominent bump with redness from rubbing in shoes, grinding of the joint, pain, swelling, burning and occasionally even numbness.

Diagnosis of a bunion is done by x-ray findings together with physical exam. A bump is not necessarily always Hallux Abducto Valgus, so a complete podiatric exam including x-rays should be done to evaluate your condition. Many people actually have arthritis of the big toe joint or even just a cyst overlying the joint and think they have bunions.

Treatment includes shoe gear modification, an orthotic device to control the abnormal biomechanics, padding, anti-inflammatories or injection therapy to decrease inflammation, and at the later stages, surgery.

When is surgery needed for bunions? If you have pain every day, in every pair of shoes you own (including your athletic shoes) and you have treated your condition with conservative therapy without any relief; its time to discuss bunion surgery. Surgery should never be contemplated without pain and activity limitations. There are many advances in bunion surgery and varied procedures depending on your foot type, the stage of your deformity, your activity level, your medical history, and your age. Make an appointment to discuss surgery with your podiatric foot and ankle surgeon if you have progressing symptoms.

The American College of Foot and Ankle Surgeons cites a survey that showed 96% satisfaction after bunion surgery with a board-certified foot and ankle surgeon. 96% of the survey respondents identified pain relief as a desired outcome of the surgery, and 86% also said they hoped to improve their walking and increase their physical activity following surgery. On a scale of 1 to 10 with 10 representing much pain, the survey respondents averaged a score of 7 when assessing their pain before surgery, and the average score dropped to 2 when they assessed their pain six months after the operation. 92% said they were able to increase their physical activities — walking, running, golf, tennis, exercise — and 90% said they would recommend bunion surgery to others. This is great news! Many people fear the surgery more than pain every day in their shoes! Obviously, this fear is unwarranted!

Fear of surgery should not keep you out of the office because 80% of patients who come in asking for bunion surgery leave with a conservative treatment plan. Call or contact your podiatric foot and ankle surgeon for an appointment today to get your questions answers. Dont live with the pain of bunions for one more day.

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