Fractures

Nearly one-fourth of all the bones in your body are in your feet. A broken (fractured) bone in your forefoot or in one of your toes is often painful but rarely disabling. Most of the time, these injuries heal without operative treatment. Types of fractures include stress fractures and general bone fractures.

Stress fractures frequently occur in the bones of the forefoot extending from your toes to the middle of your foot. Stress fractures are like tiny cracks in the bone surface. They can occur with sudden increases in training (such as running or walking for longer distances or times), improper training techniques or changes in training surfaces.

Most other types of fractures extend through the bone. They may be stable, in which there is no shift in bone alignment, or displaced, in which the bone ends no longer line up properly. These fractures usually result from trauma, such as dropping a heavy object on your foot, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. Several types of fractures occur to the forefoot bone on the side of the little toe (fifth metatarsal).

An ankle-twisting injury may tear the tendon that attaches to this bone and pull a small piece of the bone away. A more serious injury in the same area is a Jones fracture, which occurs near the base of the bone and disrupting the blood supply to the bone. This injury may take longer to heal or require surgery. Symptoms include pain, swelling, and sometimes bruising.

Ankle Sprain

More than 25,000 people sprain their ankles every day, according to the American Orthopaedic Foot and Ankle Society.

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on the outside of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems.

Treatment includes resting the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury. More serious ankle sprains, particularly in competitive athletes, may require surgery to repair to tighten the ligaments.

Chronic Lateral Ankle Pain

Chronic lateral ankle pain is recurring or chronic pain on the outside part of the ankle that often develops after an injury such as a sprained ankle. Other conditions, however, may also cause chronic ankle pain.

Signs and symptoms include:

• Ankle instability.
• Difficulty walking on uneven ground or in high heels.
• Pain, sometimes intense, on the outer side of the ankle.
• Repeated ankle sprains.
• Stiffness.
• Swelling.
• Tenderness.

While ankle sprains are the most common cause of chronic lateral ankle pain, other causes may include:

• A fracture in one of the bones that make up the ankle joint.
• Arthritis of the ankle joint.
• Inflammation of the joint lining.
• Injury to the nerves that pass through the ankle. In this case, the nerves become stretched, torn, injured by a direct blow, or pinched under pressure.
• Scar tissue in the ankle after a sprain. The scar tissue takes up space in the joint, putting pressure on the ligaments.
• Torn or inflamed tendon.

Treatments for chronic lateral ankle pain include:

• Over the counter or prescription anti-inflammatory medications to reduce swelling. Consult your physician before taking any medications.
• Physical therapy, including tilt-board exercises, directed at strengthening the muscles, restoring range of motion, and increasing your perception of joint position.
• Ankle braces or other supports.
• Steroid medication.
• Immobilization to allow the bone to heal (in cases of fractures).

Osteochondritis

Osteochondritis Dessicans are lesions that usually cause pain and stiffness of the ankle joint and affects all age groups. Often, Osteochondritis usually follow a twisting type injury to the ankle.

Osteochondritis may cause swelling and ankle pain. When immobilization of the injury doesn't alleviate the problem, surgery is sometimes prescribed. The procedures usually involves removing the loose fragment of cartilage and bone from the ankle joint and placing small drill holes in the defect. The drill holes stimulate new blood vessels to fill the area and help form scar tissue to fill the defect.