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Ask the Doctor: foot and ankle injuries

Ask the Doctor: foot and ankle injuries
Ask the Doctor: foot and ankle injuries

Dr. Carr Vineyard specializes in orthopedic surgery, ankle replacement surgery and foot and ankle disorders. Below he answers questions relating to foot and ankle issues.

What is the most common cause of ankle injury?

The most common cause of ankle injury is a twisting motion to the ankle leading to what is commonly called an ankle sprain or rolled ankle. This can occur from a sporting activity such as basketball or from stepping off a curb while walking down the street. The twisting can result in an injury to the ligaments around the ankle (a sprain) or a fracture to one of the bones in more severe cases. Typically patients report pain and a popping sensation around the outside of the ankle and then have a variable amount of swelling and bruising. Sometimes the swelling can be impressive, approaching the size of a baseball.

What is the typical treatment and prognosis?

If someone has sustained an injury like this to the ankle, I recommend immediate rest, ice, compression and elevation of the ankle with use of anti-inflammatory medication such as ibuprofen or Aleve to help with pain. If the pain is severe and you are not able to walk on the injured ankle, I recommend evaluation by an orthopedic surgeon as soon as possible. Typically if the pain and swelling have improved after two to three days, you can return to normal sporting activities as long as you can run and jump without pain. Some severe injuries can take several months to completely resolve. The prognosis for someone with an ankle sprain is excellent, but it may take longer than they want for the pain and swelling to completely go away. It is not unusual to have some mild pain and swelling for up to six weeks after a sprain.

Is it okay to continue playing sports with a sprained ankle? At what point should I make a decision to rest?

You can participate in sports when there is no pain or feelings of instability in the injured ankle. When you do return to play, I would recommend using an ankle brace that laces up in the front to stabilize the ankle and help prevent repeat injuries. These braces are easy to use and can be purchased at most sporting goods stores. If you are still having pain, feelings of instability or significant swelling in the ankle when you attempt to return to sports, I would recommend you rest the ankle for several more days and try again, or go for evaluation by an orthopedic surgeon.

What types of temporary foot pain relief treatment do you recommend?

Rest, ice, compression and elevation are the first line treatment for most types of foot pain. Anti-inflammatory medication such as ibuprofen or Aleve can be helpful as well. I also recommend that anyone having foot pain try changing their shoes to see if they can find something more comfortable. Good quality tennis shoes can frequently help decrease pain.

What is your background and experience with flat feet or bunions? Are these serious issues?

A large portion of my training and clinical practice involves patients with flat feet and bunions, so I have a great deal of experience in treating patients with these problems. These are very complex issues, and no two patients are exactly alike in their deformity or pain. A patient’s treatment should be personalized to their deformity, pain level and lifestyle. This is one of the many reasons I find these problems fascinating and is part of what helped get me interested in the field of orthopedic foot and ankle surgery. Bunions and flat feet can be very serious. If you have a painless flat foot or bunion, no treatment is necessary. If you have pain in the foot associated with flat feet or bunions, then evaluation by an orthopedic foot and ankle surgeon is recommended. Your problem may not require surgery, but there are other treatment options to help decrease pain and prevent worsening deformity over time.


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