Book Now

Tag: ankle pain

Broken Ankle vs Sprained Ankle: Symptoms, Treatment, and Recovery Explained

Posted on by admin

sprained ankle vs broken ankle

So, you injured your ankle, and you are wondering if it is a sprained ankle vs a broken ankle. Injuring your ankle is a common occurrence, whether during sports or everyday activities. Both ankle sprains and fractures can lead to pain and swelling, affecting the ankle joint and overall mobility. This blog aims to differentiate between an ankle sprain and an ankle fracture, discussing symptoms, treatment options, and recovery times to help individuals understand whether they are dealing with a sprained or broken ankle.

What is an Ankle Sprain?

An ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn. The ligaments that surround your ankle are important for stabilizing the ankle joint. This common ankle injury often happens when the foot twists or rolls awkwardly during activities. The severity of the injury can vary, with grade I being a mild stretch, while grade III involves a complete tear of the ligaments. When a grade III occurs, aggressive treatment is necessary because the long-term consequence can be a more unstable ankle. Common causes include sports activities and uneven surfaces. Knowing how to identify a sprain can help in seeking medical attention promptly.

grades ankle sprain anderson podiatry center

Symptoms of Ankle Sprain

Symptoms of a sprained ankle often include pain and swelling around the affected area. Individuals may experience limited range of motion, making it difficult to bear weight on the injured foot and ankle. Bruising may also develop as blood vessels break. Understanding these symptoms can help individuals determine whether they should seek medical attention for further assessment.

What is an Ankle Fracture?

An ankle fracture refers to a break in one or more ankle bones, often resulting from high-impact activities or falls. When you injure your ankle severely, you may hear a cracking sound, indicating a potential fracture. The types of fractures can be classified as stable, where the bone remains in place, or unstable, where the bone may shift. Recognizing the signs of a broken ankle is crucial for appropriate treatment.

Symptoms of Ankle Fracture

Common symptoms of an ankle fracture include intense pain and swelling around the ankle bone. Individuals may notice deformity in severe cases, and there may be difficulty bearing weight on the affected foot and ankle. In some instances, bruising may also occur. If these symptoms are present, it’s imperative to undergo physical exams and imaging tests to confirm the diagnosis. Remember: just because you can walk on the foot or ankle, does not mean it is not broken.

Diagnostic Procedures for sprained ankle vs broken ankle

Both ankle sprains and fractures are diagnosed through physical exams and imaging tests, such as X-rays or MRIs. X-rays are used to evaluate the bones of the ankle and MRI is used to evaluate the tendons and ligaments. These procedures help determine the extent of the injury and whether surgical intervention is necessary. Accurate diagnosis is essential for effective treatment, ensuring that individuals receive the appropriate care for their ankle injury.

Treatment Options for Ankle Sprain

Treatment for ankle sprains primarily involves the RICE method: rest, ice, compression, and elevation. This approach helps reduce pain and swelling while promoting healing. Over-the-counter pain relief medications, such as NSAIDs, can also be effective. In more severe cases, physical therapy may be required to restore range of motion and strengthen the ankle joint. Individuals should monitor their symptoms and seek medical attention if they do not improve.

Treatment Options for Ankle Fractures

For ankle fractures, treatment options depend on the type and severity of the break. Non-surgical options may include casting or immobilization to allow the broken ankle to heal. However, unstable fractures often require surgical intervention, where screws or plates may be used to secure the bones. Follow-up care is crucial to monitor the healing process and incorporate physical therapy to regain strength and mobility.

Recovery and Rehabilitation

Recovery times for ankle sprains typically vary from a few days to several weeks, while broken ankles may take longer, often requiring several months for full recovery. Rehabilitation exercises are vital for both types of injuries to restore strength and range of motion. Failing to properly rehabilitate can lead to long-term complications, emphasizing the importance of adhering to a structured recovery plan.

Long-term considerations for an ankle sprain versus a broken ankle

Ankle Sprains:

When ankle sprains are chronic or you have a grade III that was treated inappropriately, this can lead to chronic ankle instability. A foot specialist may recommend the following:

  • Custom-made orthotics: Custom-made orthotics can help reduce the risk of ankle sprains as it always gives the foot and body the feedback as to the positioning of the foot
  • Surgery: There are procedures that can reinforce an ankle joint that is unstable by utilizing tendons in the adjacent area or ligaments to help support the ankle better.

Ankle Fractures:

When an ankle fracture occurs, there could be greater incidence of arthritis in the ankle joint in your lifetime. This is because the alignment of the bones that form the joint may be less than perfect. This can cause earlier wear and tear of the cartilage on the joint.

Custom-made orthotics: this may help slow down the degenerative joint disease
Surgery:

  • Ankle-scope surgery if there is inflammation of the joint or when the DJD is in its early stages, cleaning the joint out by using ankle arthroscopy can be very useful.
  • Joint denervation surgery – this procedure is not well-known, but we have had great success using this technique to avoid or delay the need for an ankle replacement surgery or ankle fusion surgery. The surgery involves cutting specific nerve branches and burying the nerve in the muscle in the lower leg. This type of procedure blocks messages going to the brain signaling the pain from the arthritic joint. These nerves do not supply muscles, so your muscular strength remains intact while greatly eliminating the pain. There is minimal layup after surgery, patients are ambulating within a week.
  • Ankle fusion/replacement surgery – these surgeries are the last resort if your ankle sprain has led to eventual ankle arthritis. There is significantly longer recovery period with these procedures.

Conclusion

In summary, understanding the differences between ‘sprained ankle vs broken ankle’ can be crucial for effective treatment. If you suspect an ankle injury, especially if you hear a cracking sound or experience severe pain and swelling, it’s vital to seek medical attention. Proper diagnosis and treatment can ensure a full recovery, allowing individuals to return to their normal activities without the risk of re-injury.

 

 

 

 

Frequently Asked Questions (FAQs)

1. What are the key differences between a sprained ankle and a broken ankle?

A sprained ankle involves the stretching or tearing of ligaments, while a broken ankle refers to a fracture in one or more bones in the ankle. The severity of pain and the type of injury are typically the distinguishing factors.

2. How can I tell if my ankle is sprained or broken?

Symptoms of a sprain include swelling, bruising, and pain, often without an obvious deformity. A broken ankle usually presents with more intense pain, swelling, difficulty moving the foot, and may include visible deformities or a crackling sound at the time of injury.

3. What are the treatment options for a sprained ankle vs a broken ankle?

A sprained ankle typically requires rest, ice, compression, and elevation (R.I.C.E.), along with possible physical therapy. A broken ankle may require a cast, splint, or even surgery, depending on the severity of the fracture.

4. How long does it take to recover from a sprained ankle compared to a broken ankle?

Recovery from a sprained ankle usually takes a few weeks to a few months, depending on the severity. A broken ankle often requires a longer recovery period, typically 6 to 8 weeks or more, and may involve rehabilitation.

5. Can I walk on a sprained ankle or broken ankle?

Walking on a sprained ankle is generally possible but should be avoided to prevent further injury. Walking on a broken ankle, however, is not recommended, and weight-bearing should be minimized until properly treated by a healthcare professional.

 

Book Now

What Could It Be That’s Causing Your Ankle Pain Without Injury?

Posted on by admin

ankle pain without injury

The ankle joint is a very important joint that allows you to have proper mobility. When it starts hurting for no apparent reason and it’s slowing you down, you’re very likely feeling frustrated. You’ll start to wonder what I did and what can be done about it. In this blog I’ll give you some incites as to what the pain could be coming from. In many situations its it could be related to overuse but in other situation it may not be. This is why we think there should be a discussion about “ankle pain without injury?”, because this may stop a person from getting back to regular activities due to lingering joint issues.

The ankle joint– The ankle joint is one of the most important joints in your feet and ankles for normal ambulation. It’s the primary joint in the foot that allows the foot to move up and down which is very important for walking, running, and a multitude of activities. It has various ligaments and tendons around it that help to stabilize the joint and support your weight on the joint. The primary foot bone that sits inside the ankle between the tibia and fibula is called the talus. It is thought to be the hardest bone in your body. Why? Because all your body weight has to be placed on this small surface area of bone. Imagine how much wider your knee joint is compared to your ankle joint and you’ll begin to appreciate the strength of this bone inside the ankle joint.

Common causes of ankle pain

Problems associated with overuse or trauma

Osteoarthritis – another name for this is degenerative joint disease. This can occur for two reasons

  • Overuse – from years of activities that can cause damage to the joint, the wear and tear that will come over time
  • Trauma- old ankle injuries which may include a history of multiple ankle sprains. Every time you sprain your ankle there is the potential for damage to the cartilage inside the ankle joint. This repeated damage over time can create osteoarthritis state. This can then create joint pain.
  • Ankle fractures – If you have a history of an ankle fracture this can increase the likelihood of arthritis in the joint. In some cases, surgery may have been performed to reposition the bones in proper alignment and because of this the joint alignment may not be as precise as it was before surgery, and this may lead to more wear and tear to the joint cartilage over time.
  • Flatfeet – The type of foot you’re born with may also lead to ankle pain. If you have a foot that overpronates, flattens, this may also cause pain in the ankle joint. A flatfoot can lead to more wear and tear on the ankle. It may also lead to other problems including Achilles tendon pain which would cause pain behind the ankle. Achilles tendonitis would make the tendon painful to touch and may cause swelling. Another tendon that helps support the foot and ankle is called the posterior tibial tendon. It is located around the inside of the foot and ankle and may also get overused because of the flatfoot. This can cause pain and swelling on the inside of the ankle joint.

Problems not caused by overuse and trauma

  • Gout – Sudden ankle pain without injury can be from gout. The pain from gout can be very severe and can come on very quickly for no apparent reason. The ankle will become swollen, and heat and redness will be associated with it. The affected ankle will feel warmer to touch than the opposite ankle and will look more red. Gout can often be mistaken for an infection. Gout occurs as a byproduct of protein metabolism. Uric acid is a byproduct of that metabolic process. When Uric acid gets into a joint it’s recognized as being foreign to the body’s immune system. So, your body’s immune system begins to attack these uric acid crystals in the joint as if the crystals were bacteria. A medication called Indocin is frequently used to treat acute attacks. If the gout attacks keep returning further workup may be necessary to see if there is a related medical cause and potentially the use of medication to lower Uric acid levels in the body may be recommended.
  • Autoimmune disease – These may include rheumatoid arthritis and Lupus. An autoimmune disease will create inflammation to the ligaments and joint capsule around the ankle joint. This may also cause damage to these soft tissue structures leading to less support for the join and ultimately damage to the joint cartilage. With an autoimmune disease your body’s immune system will attack and damge these soft tissue structures. Medications are frequently needed to treat these conditions.
  • Ganglions – This is soft tissue fluid filled sacs that may originate from the ankle joint or from tendons sheaths around the ankle. If painful these are treated with aspiration of the fluid from the sac or surgical removal.

What can be done about ankle pain without injury?

If you find yourself experiencing ankle pain, consider some of the following suggestions.

  • If it’s very sudden and your ankle feels hot and looks red get immediate medical attention as most likely this may be a gout attack.
  • If there is no redness of heat consider RICE, rest, Ice, compression and elevation. You may also consider using non-steroidal anti-inflammatories NSAID, which may help.
  • If you have flat feet you may want to consider more support shoes or consider over the counter arch supports.
  • If the pain persists with your attempts, then consider seeing your podiatrist

What will a podiatrist do?

It starts with a good medical history from you as this can give us good insight into what it may be. X-rays and diagnostic ultrasound to look at the joint and the soft tissues around the joint may be needed. Examination of the foot and ankle by itself can tell us a lot simply by the appearance and location of the ankle pain without injury.

Options we consider

  • Orthotics– custom made arch supports may be recommended especially if the problem is related to flatfeet. Also, this treatment can be helpful if the joint is getting osteoarthritis from previous trauma, overuse or autoimmune diseases.
  • Regenerative medicine treatments- this involves using what is now referred to as human cellular tissue products. Currently we use umbilical cord or placenta cell products. These are injected into the joint in a clinic setting. Minimal down time is needed and there is minimal discomfort. This is usually a one-time treatment and we have had great success in helping with pain and prevent ankle surgery.
  • Laser treatment- MLS laser treatment can also help reduce the pain and inflammation in joint and surrounding soft tissues.
  • Surgery – This usually involves ankle scope surgery. Two small incisions are made to access the joint and through these incisions the joint and its structures can be visualized and damaged cartilage or soft tissue removed. Usually, you can get your foot wet within a few days and can bear weight within a few days. You can return to full activity relatively quickly with this technique. It’s also useful to have this done early if ankle arthritis is severe enough that ankle replacement surgery could be a consideration in the future.

I hope this blog eliminated some of the confusion that can happen when your ankle hurts without an injury.

Regenerative Patient Testimonial Video

Ankle Scope Patient Testimonial Video

CJ’s Story: Chronic Tendon Pain (The Power of Regenerative Medicine)

Posted on by admin

CJs testimonials chronic tendon pain

The new year is here, and for many of us that means it’s time to focus on our health, and address some of those lingering issues we’ve been putting off.

Today, I will share a success story of a patient who was dealing with chronic joint and tendon pain for several years. My goal is to help instill hope in many of you who have been experiencing similar pain, and have perhaps given up on finding a solution. So, here we go.

52, Healthy and Active

This patient is a 52 year-old female, who was healthy and active. We will call her CJ. She came into my office with a variety of foot complaints. The primary issue was chronic joint and tendon pain in her right foot and ankle, and this had been going on for several years.

Seven years prior, a horse stepped on her foot and she was diagnosed with a “hairline fracture” and wore a cast for three months. Once she was out of the cast, she could get back to activity with little pain. However, over the next five to six years, she started having more and more pain in the area that began to significantly limit her activity. This gradually led to weight gain, which only made the problem worse.

Plantar Fasciitis, Arthritis and Tendon Pain

When I first saw CJ, she was planning on having gastric bypass surgery, but was concerned that she would not be able to exercise properly after the surgery because of her foot and ankle pain. She had previously been treated for plantar fasciitis by another doctor.  She had steroid injections and wore a night splint, but neither treatment seemed to give her any relief.

During her initial exam, her X-rays showed that the old injury had been more than just a hairline fracture. She had evidence of post-fracture arthritis in two joints in the middle of her foot. The fracture had healed, but left joint damage behind. Her other main issue of ankle pain was diagnosed as a partial tendon tear. This had likely been aggravated by compensating for the joint pain.

Regenerative Medicine + Surgery

Many times, when patients present with arthritis, tendon pain, or plantar fasciitis, we use regenerative medicine therapy to help stimulate healing and avoid surgery altogether. But, in CJ’s case, we needed to use several different treatments to help address all the issues that had been accumulating for all these years.

We performed surgery to repair the tendon tear and used regenerative injections to help heal the joint damage. To better support the damaged joints, we fitted her for custom orthotics. She then began physical therapy to improve her strength, balance, and flexibility.

Ten Weeks Later

CJ was on crutches for four weeks after the tendon repair. But, once we cleared her to start walking, she progressed quickly. She was highly motivated and committed to her therapy and post-operative rehab. Ten weeks after surgery and regenerative therapy, she was already back to walking and elliptical workouts daily. She still has the occasional sore muscles, but no longer has anywhere near the pain she did before. CJ is still considering gastric bypass surgery. But, she now feels she will be able to lose the weight without it since she can exercise without pain.

So, if you or someone you love is struggling with daily foot or ankle pain, please don’t wait any longer to address it. Call today to make an appointment, and we can discuss treatment options with you.

2018 can be your last year to deal with chronic pain. It’s time to get on the path to healing, together.

Chronic Foot Pain: Why Am I Still in Pain?

Posted on by admin

It’s never fun to suffer an injury of any kind. There is always the initial pain and limitations. But, what happens when the pain doesn’t go away even when the injury is “healed?”

Does it just need more time? Are you doing something wrong? In many cases, the injuries look completely healed on X-rays or MRI, but the pain continues. So what do you do next?

I’d like to tell you a story about a patient who had just this problem. We will call her Alice.

The Ankle Fracture that “Healed”

Alice is a 32 year-old female patient. She came to see me for severe daily pain in her foot and ankle, which initially started after she fractured her ankle. Alice fell on her ankle and heard/felt a pop. She was evaluated in the ER and properly diagnosed, and subsequently had surgery to repair the fracture. The repair went as planned and after six weeks her X-rays showed a completely healed fracture.

She was then allowed to start walking on it again. That was when her pain really started. After surgery, she had experienced the normal post-op pain, but it wasn’t until she was out of a cast that she began having constant ankle and foot pain that was not relieved by much of anything. It hurt when she walked and it hurt when she didn’t walk. The pain woke her up and kept her awake.

Time to Put on My Detective Hat

Alice was at the end of her rope, and was even considering possible amputation if the pain could not be relieved. With any patient in this much pain, my first impulse was to throw the kitchen sink at her problem to try to find some way of getting her relief. However, in order to help these patients, I know I have to put on my detective hat, do a thorough review of their injury, treatment, and health history, and then put together a step-by-step plan to hone in on the primary cause of the pain.

A Painful Scar

Alice had pain throughout her foot and ankle, but the majority of the constant pain was along the inside of the ankle and down into the foot. This area was so sensitive that any light touch would send pain up and down her leg. She was especially sensitive along a surgical scar from her ankle fracture repair.

She had mentioned this to the surgeon who fixed her ankle and he assumed it was simply a painful scar and would improve with time but instead the pain grew steadily worse. An X-ray showed the screws and plates in the bones did not appear to be causing any problem and the scar itself did not appear thickened or contracted. However, the location of the incision was right over one of the main nerves in the leg, and I considered the possibility that the nerve had been damaged or cut during the fracture repair.

Testing the Theory

A simple way to test this theory was to perform a diagnostic nerve block of the nerve higher up the leg with a long-acting local anesthetic and a small amount of steroid. This will decrease inflammation and reduce sensitivity of the nerve for 2-3 days after the injection.

If the patient’s symptoms significantly improve for a few days after the injection, then it is a good bet that the nerve itself is the source of the pain and not just the messenger. If it only feels better while it is numb, then it’s time to head back to the drawing board. Alice had significant improvement for 3-4 days after the block before the pain returned. This is normal and expected because you can only use this injection for diagnosis, not treatment.

The Source of the Pain

Once we knew the nerve was the source of her pain, it was time for treatment. In this case, I recommended a procedure called a neurectomy of the nerve. This involves making a small incision over the nerve, farther up the leg than the damaged portion. I then locate the nerve, and cut it to shut off the pain signals. It’s kind of like throwing a breaker on an electrical outlet.

Although this might sound drastic, it is a much safer and effective option than other chronic pain management options (opiates or a spinal stimulator for example). For Alice, it worked very well. Once the nerve pain was eliminated, she was finally able to participate in physical therapy to address the other tendon pain and weakness that had developed from how she was compensating for the pain.

Finally, Pain Free

At Alice’s last follow up, she was pain free. She still had a bit of residual limp that will continue to improve with therapy. I present Alice’s story as an example of the complex diagnostic work-up often involved with post-traumatic chronic pain.

No two patients are the same and no two injuries are the same. What worked on one may not work on the other. As a doctor, when I see patients with chronic pain, I have two goals in mind.

1. Identify the primary problem.

2. Do not aggravate the pain any further with unnecessary treatments.

Once we identify the root of the issue, we can then proceed with the appropriate treatment to relieve the patient’s pain.

If you are experiencing chronic injuries or unresolved pain, please come see us! We can help. Come visit your podiatrist in Fort Collins or Broomfield for further consultation.

To learn more about our treatment options, click here.

Book your appointment here.