27. March 2017 06:21
Tibia and fibula of the leg join with the talus of the foot to form an ankle joint. A sudden blow to the ankle may hamper the normal positioning of these bones leading to a disturbed anatomic relationship. This condition is referred to as Ankle Dislocation and is generally associated with a fractured tibia or fibula.
Types of Ankle Dislocations –
- Posterior – Talus moves backward in relation to tibia
- Anterior- Talus is pushed in the forward direction
- Lateral- It occurs when the ankle gets inverted or everted
- Superior - The force moves the talus in the upward direction between tibia and fibula
- Twisting or rolling of the ankle
- Falling or tripping
- A sudden impact during a car accident
- Severe Pain
- Swelling and bruising
- Difficulty in bearing weight
- Ankle may seem to be out of place
The doctor may check the appearance of patient’s ankle and conduct a thorough physical examination to determine the abnormality in the joint. He may also evaluate sensations experienced in the foot. An imaging test such as an X-ray may be recommended for a clearer view of the condition.
Initial treatment of Ankle Dislocation is to apply R.I.C.E principles.
- Rest – Sufficient rest may allow the scar tissues to connect the muscles and heal the damaged ligaments we well as tendons.
- Icing – Applying ice after every 15-20 minutes may help to reduce inflammation.
- Compression - In order to reduce edema caused by deposition of fluid from damaged capillaries, compression may be suggested.
- Elevation – Keeping the injured feet elevated may help to reduce swelling and bruising.
The doctor may also prescribe certain anti-inflammatory medication and painkillers to alleviate pain. In case any dislocation has occurred due to a fracture, surgical treatment may be recommended. In this, the orthopedic surgeon may use screws and metal plates to restore the position and stability of the ankle joint. He may also ask the patients to wear casts and crutches to immobilize ankle and ensure fast recovery after surgery.
If you are looking for the treatment of Ankle Dislocation, visit Dr. Heier in Carrollton, TX. He is an experienced and board certified ankle specialist. To schedule an appointment with the orthopedic surgeon, you can call at (972) 492 – 1334.
26. October 2016 08:25
The heel bone, also known as calcaneus bone, bears constant pressure throughout the day due to various activities like standing, walking and running. It also acts a shock absorber and provides cushioning to the foot. When this bone receives excess pressure or strain due to repetitive activities, it may lead to a condition called Fat Pad Contusion. Commonly known as Bruised Heel, the injury requires medical attention by an orthopedic doctor.
- Improper Footwear: Wearing poorly cushioned or worn-out shoes may cause pressure on the heel bone.
- Excessive Body Weight: Being overweight may place additional strain on the heel bone, which increases the risk of developing Fat Pad Contusion.
- Age Factor: The bones tend to get brittle with increasing age, which makes elderly people more prone to bone-related injuries.
- Sports Injuries: Athletes involved in contact sports like football, rugby or basketball can suffer the injury due to heavy landings and falls. In addition, running on hard surfaces may also increase the chances of suffering from Fat Pad Contusion.
- Pain and swelling in and around the heel area
- Pain may increase while walking, running or jumping
- The affected area may be tender to touch
An orthopedic foot doctor may first perform a visual inspection of the injured foot. He may then ask the patient questions regarding the mode and time of the injury. Clinical examination such as palpation, X-ray as well as MRI may be conducted to confirm the condition. Accordingly, a treatment plan may be devised.
Conservative Treatment Methods
- RICE Therapy: This therapy may help to reduce swelling as well as pain. It may include:
- Rest: Adequate rest must be provided to the affected area. This may help to reduce swelling as well as pain.
- Icepacks: Applying ice packs at frequent intervals may be beneficial in alleviating pain and swelling.
- Compression: An elastic bandage may be used to reduce inflammation.
- Elevation: Keeping the foot above the level of heart may help to improve circulation.
- Supportive Shoes: Wearing cushioned shoes may provide support to the feet and relieve the pressure from the heel. It may help to stabilize the foot and decrease discomfort.
- Rehabilitation Exercises: The doctor may recommend specific exercises which may help to promote healing. These exercises can reduce stiffness and improve the range of motion.
- Medications: Non-steroidal anti-inflammatory medications may be prescribed by the doctor. In case of severe pain, cortisone injections may be administered.
For comprehensive treatment of Fat Pad Contusion, visit Dr. Heir. To schedule an appointment with the foot and ankle surgeon in Carrollton, you can call at (972) 492 – 1334.
24. May 2016 06:30
The human foot comprises of 28 bones and 30 joints which enable it to move, stabilize the body and absorb external shocks. The bones are further supported by strong tendons, ligaments, muscles, cartilage and fluid filled lining called the synovium. Degeneration of the bones, cartilage and other constituent parts of the joint may lead to Ankle Arthritis. There are three main types of Arthritis that may affect the ankle joint.
- Osteoarthritis- It is a painful condition caused due to wearing out of the protective cartilage with age. It causes the bones to rub against each other and may lead to the development of bone spurs.
- Post-Traumatic Arthritis- injuries that cause severe damage to the joint surfaces may lead to the development of Arthritis over the years
- Rheumatoid Arthritis- It is a chronic condition which occurs when the immune system attacks the body’s tissues. It characteristically affects both the joints at the same time
- Genetic factors
- Infections that may lead to auto-immune disorders
- Direct injury or trauma to the joint
- Stretching or tearing of ligaments and tendons
- Post-surgical effects
- Ankle dislocation or fractures
- Pain which may aggravate during movement and weight bearing
- Visibly deformed joint
- Restricted range of motion
- Change in gait and posture
- The joint may feel tender when pressed
- Redness and warmth
- Detailed clinical evaluation of the affected joint
- Analysis of gait and range of motion
- Assessment of patient’s medical history and previous ankle injuries
- X-ray imaging may be done to check bone placement and structure
- CT scan and MRI may help diagnose soft tissue and ligament damage
- Blood tests may be recommended to diagnose the type of Arthritis
- Avoiding any activity that aggravates discomfort
- Performing exercises that strengthen the supporting muscles
- Anti-inflammatory medicines may be prescribed to relieve pain
- Physical therapy may help to improve flexibility of the joint
- Use of ankle-foot orthosis or a removable brace to provide support to the joint
- Walking stick may be used to avoid weight bearing
- Arthroscopic Debridement to remove bone spurs or damaged cartilage and synovium
- Arthroplasty- surgical replacement of the ankle joint with an artificial implant
- Arthrodesis or surgical fusion of the bones using pins, screws and rods to restrict movement between them and reduce pain
Dr. Heier provides complete diagnosis and treatment for Ankle Arthritis. To schedule an appointment with the foot and ankle specialist in Carrollton, TX, you can call at (972) 492 – 1334.
23. November 2015 12:53
Clubfoot (Talipes Equinovarus) is a foot deformity that affects nearly 1 out of every 1000 children in the USA. In the condition, the foot twists inwards and the toes point outwards. The tissues that connect the foot muscles to the bone are shorter than usual. Clubfoot can affect one or both feet and is usually congenital. It is recommended that the condition should be treated soon after the birth to avoid permanent foot deformities.
Clubfoot is idiopathic that is often the cause is not known. The abnormality may result due to following reasons:
- Drugs or smoking during pregnancy
- Spinal deformities or neuromuscular diseases
- Less amniotic fluid during pregnancy
- Top of the foot is twisted downward and inward
- Toes pointing downwards
- Tightening of the Achilles tendon
- Abnormal shape of the foot
- Rigidity in the foot
- Inability to move the feet
- The calf muscles remain underdeveloped
- Affected leg is shorter than the normal leg
- Tightening of the Achilles tendon
An orthopedic doctor may perform a physical examination to check for the symptoms. The shape and positioning of the infant’s feet may help the doctor to identify Clubfoot. He may also suggest X-ray and other imaging tests to confirm the disorder.
Clubfoot can be corrected surgically soon after the birth. The procedure involves moving the foot to the correct position and immobilizing it with the help of a cast. It is easy to reshape the foot soon after the birth, so there should not be any delay in the treatment. The surgeon stretches and casts the foot after regular intervals to improve the condition. Once the foot is in positioned, the child may have to wear special brace for a few months. If the Achilles tendon is tightened, the surgeon will release it surgically.
In case of bone deformity, the surgeon may perform osteotomy that involves cutting the bones and fusing them to stabilize them. The surgery is often done once the child is ten years old.
Physiotherapy is important as it can help in correcting the foot by simple manipulations and exercises.
For diagnosis and treatment of Clubfoot, consult Dr. Heier in Carrollton, TX. To schedule an appointment with the foot and ankle surgeon, you can call at (972) 492 – 1334 or visit 4780 N. Josey Lane, Carrollton, TX 75010.
26. October 2015 13:32
Achilles tendon is the largest tendon in the body that connects the calf muscle at the back of lower leg to the heel bone. Achilles Tendinitis occurs due to overuse or degeneration of this tendon. Athletes who participate in sports activities such as running, gymnastics, football, tennis etc. are at higher risk of developing this condition.
- Strenuous activities
- Bone spurs
- Tightening of calf muscles
- Wearing high heels
- Pain along the back of the foot
- Difficulty pointing your toes
The doctor may perform X-rays to determine the severity of the condition. He may also conduct an MRI scan to check for any tear in the Achilles tendon.
- Rest: A doctor may recommend the patient to take rest to provide relief from pain. He may also advice to avoid any vigorous activities such as running, jumping etc. until the condition improves.
- Ice: Applying ice at regular intervals on the affected area may help in reducing the swelling.
- Compression: Using an elastic bandage can provide support and help in minimizing inflammation.
- Elevation: Elevating your leg using a pillow may also help in the fast recovery of the condition.
- Medication Anti-inflammatory medicines may be prescribed by the doctor to reduce pain and swelling.
- Inserts: Wearing inserts in shoes can help your Achilles tendon from further stretching and help in fast recovery. Orthotics devices such as heel lifts reduce the strain on this tendon.
- Strengthening Exercises: A physical therapist may recommend some specific exercises to increase flexibility and strength of the muscles.
In severe cases of Achilles Tendinitis, the doctor may recommend any of the following surgical procedures to repair the damaged tendons:
- Gastrocnemius Recession: The procedure involves lengthening of the calf muscles with the help of small incisions using an endoscope. This surgery is performed to treat patients who have difficulty in flexing their feet. It is done to provide flexibility to the ankle.
- Debridement and repair: In this method, the surgeon removes the damaged Achilles tendon and repairs it with stitches.
- Reduce uphill running as it can pressurize the Achilles tendon
- Wear shoes with good support
- Increased the intensity of exercises gradually
- Avoid exercising, if you feel pain at the back of your calf
22. May 2015 13:25
Ankle joint consists of the three bones, the tibia, fibula and the talus, which are held together by ligaments. Ankle injuries are quite common specially among athletes and sportspersons, can occur at any age and are usually painful.
- Sprains and strains: Strains in the ankle are caused due to excessive stretching or tearing of muscles and tendons. However forceful twisting or bending of the ankle can also cause sprains.
- Arthritis: Ankle Arthritis causes inflammation in the joint, pain and swelling. The condition may eventually result in deformity, loss of joint function and disability in walking.
- Gout: Gout is a complex form of Arthritis and is characterized by severe pain, tenderness and redness in the ankle joint.
- Fracture: A broken bone can be caused due to a hard fall or bad landing from a jump. People suffering from weak bones are more prone to fractures of the ankle.
- Achilles Tendon Rupture: Achilles Tendon is the thickest tendon in the human body present in the back of the leg. A rupture or tear in this tendon can cause ankle pain.
- Burning pain
- Numbness or tingling
- Disability in walking
- Popping sound
The orthopedic surgeon physically examines the ankle to determine the extent of the condition. He may also recommend certain imaging tests like an X-ray to rule out the possibility of a fracture.
The orthopedic surgeon diagnosis the extent of the condition and accordingly devises a treatment plan.
- R.I.C.E. therapy: In order to treat sprains and strains the orthopedic surgeon can recommend R.I.C.E. therapy, which is rest, applying ice, compressing by wrapping the injured ankle with a bandage and elevating the foot. This therapy can be helpful in treating mild ankle pains.
- Medical assistance: Anti-inflammatory medication can also be helpful in managing ankle pain. These help relieve pain and also reduce swelling.
- Physical therapy and exercise: Stretching exercises can help in improving the flexibility of the ankle, helping in the treatment of ankle pain.
- Surgical Treatment:In severe cases like fractures, surgical assistance may be required to regain movement in the ankle.
Ankle pain can be mild and severe depending upon the severity of the injury. However it is recommended to consult an orthopedic surgeon for prompt diagnosis and treatment of the condition.
21. November 2014 04:42
The Calcaneus, also known as the heel bone, is a large bone located at the back of the foot. It is responsible for shifting weight bearing strengths from the ankle to the ground while walking, standing or running activities. Performing certain actions, such as rolling the ankle or landing from a height, can put stress on the Calcaneus bone. When this stress is sudden and beyond the tolerance level of the bone, a break may occur which is termed as a Calcaneus Fracture.
The main cause of a Calcaneus Fracture is a sudden weight bearing force on the foot such as falling from a ladder or landing from a height on the heel. Other causes may include sports injuries or automobile accidents.The Calcaneus bone may also sustain stress fractures due to overuse associated with a prolonged marching or running activity.
- Sudden and intense pain in the heel
- Unable to bear weight on the injured heel
- Bruising and discoloration on the heel and ankle
- Visible deformity in the heel
- Difficulty in walking
- Pain increase while touching the ankle or walking
- Numbness or tingling sensation in the toes, foot or ankle
To diagnose and evaluate a Calcaneus Fracture, the foot and ankle doctor will physically examine the heel bone and ask the patient about how the injury occurred. He may also recommend an X-ray or certain other imaging test to analyze the severity of the damage and the nature of the injury.
Treatment options for Calcaneus Fractures depend upon the type and level of the injury. Non-surgical options for mild to moderate injuries may include:
- RICE: Taking proper rest helps the fracture to heal and ice eases pain and swelling. Compression with an elastic bandage while keeping the foot elevated above the heart level also helps to restore the foot’s normal functioning.
- Immobilization: The patient may also be recommended to use a cast or brace to hold the foot in position and prevent the fractured bone from moving. Crutches can help to avoid putting weight on the foot while walking.
In severe cases, the ankle surgeon might suggest the patient to undergo surgical treatment in order to reconstruct or fuse the joint. However surgery is always kept as the last resort.
For consultation regarding the treatment options for Calcaneus Fractures in Carrollton, TX, contact Dr. Heier. To schedule an appointment with the foot and ankle specialist, you can call at (972) 492 - 1334.
22. September 2014 09:02
Plantar Fasciitis (PF) is a painful foot condition which is a common cause of heel pain in adults. It is an overuse injury that causes severe pain in the foot. Planar Fasciitis is a small band of tissue stretching from the heels to middle foot bones that helps in absorbing shock and provides cushioning to the arch of the foot. The ligaments in Plantar Fasciitis can get injured due to wear and tear of the foot and too much pressure can result in damaging the ligaments.
Plantar Fasciitis is commonly caused by wear and tear which can be due to:
- It can be caused due to excessive pressure on the feet while walking, running or standing.
- Wearing shoes that have poor cushioning or poor arch support.
- Repetitive impact activities like sports can impact the feet negatively resulting in plantar fasciitis.
- People who are overweight or obese can put extra pressure on their feet.
- Pregnant women can also experience plantar fasciitis during late pregnancy.
- People who have active jobs that involves being on feet like factory workers or a restaurant server may also develop this condition.
- People suffering from foot problems like high arches or flat feet can also develop this condition.
Plantar Fasciitis is accompanied with pain and stiffness in the bottom of the heel. Some other symptoms include:
- Pain in the foot develops gradually and can affect one or both feet.
- The pain can be dull or sharp, with burning sensation or ache at the bottom of the foot extending outwards from the heel.
- Severe pain in the foot when you take first steps in the morning or when no weight is placed on the foot for long periods of time.
- Great pain after exercising or any physical activity.
A foot and ankle surgeon will examine the feet and check for symptoms of Plantar Fasciitis. The doctor will carefully examine the feet for tenderness and high arches. The doctor may also ask you to flex your foot while pushing the Plantar Fasciitis to see if flexing worsens the pain. Signs of swelling and inflammation are also noticed and if the cause of pain still remains uncertain, diagnostic tests like X-Rays and MRI scans help in determining the exact cause behind the pain.
The pain caused due to Plantar Fasciitis is generally self-limiting and subsides with time. If the ligaments have been injured it may take several months to heal. However, conservative treatment methods are also beneficial in providing relief from the pain. Resting the affected area and avoiding all activities that strain the foot can help in reducing the pain. Rubbing ice helps in easing the inflammation and relieves pain and anti-inflammatory medicines prescribed by your foot surgeon can also help in reducing the pain and inflammation. Physical therapy helps in easing the tight muscles in feet and calves which also reduces the pain. Heel pads help in providing support to the feet by elevating and cushioning the feet.
Surgery may be required if the pain continues to occur after non surgical treatment. The surgical procedure for planar fasciitis involves separating the plantar fascia where it connects to the bone although surgery is considered as a last resort.
For diagnosis and treatment of Plantar Fasciitis, visit Dr. Heier in Carrollton, TX. To schedule an appointment, you can call at (972) 492-1334.
22. August 2014 11:51
Our feet are prone to a lot of wear and tear. Since they bear the whole weight of our body, they are susceptible to a number of problems related to feet, ankles, hips and spine. These can slowly turn into more serious disorders like arthritis, nerve and circulatory disorders. Wearing shoes that are too tight, loose and don’t have proper support can be detrimental in the long run. Therefore, it is important to understand the importance of finding the right shoe fit in order to keep your feet in good shape.
According to foot and ankle doctors, shoes that are selected for daily use should be of proper size that provides comfort from long periods of standing or walking. Below are some tips that can help in selecting the right shoe size:
- It should not be assumed that you can fit into the same size of shoes as the previous ones. Even if the shoes are from the same company and model, they should be tried before purchasing to see if they are comfortable.
- To ensure that the shoes fit properly, they should be bought towards the end of the day as your feet swell up to 8% throughout the day.
- While shopping for shoes, you should spend adequate time in making the choice. They should not be bought in a hurry. Since most outlets have a few shoes of the many shoes in the market, it is not compulsory to buy shoes from the first shop itself.
- Shoes should be tried on both feet to check for comfort. You should walk a few steps on a hard floor and even try a larger size to decide on the best fit.
- Comfort should be the only criteria while purchasing shoes. The shoes that feel good right away are the right shoes for you.
- If possible, shoes that have different widths should be tried. Shoes that are wide enough allow for fitting the ball of the foot in the widest part of the shoe.
- If the foot needs to be stretched by a salesperson, it should not be bought.
- Pointed shoes cause discomfort causing the toes to crowd. Square and round shape toe box have more room and comfort, allows the toes to lay flat. Therefore, these shapes should also be kept in mind before buying any kind of shoes.
- There should be ½ inch space between the longest toe and shape of the shoe. Wearing shoes that are too long can cause blisters as the foot keeps moving towards the shoe front.
The material of the shoe should be considered to see if it is comfortable against the skin. One should not tell you which shoes are right for you. You should try several pairs to see which shoes are the best and provide cushioning to your feet. Choosing the right shoes can keep a lot of foot problems away and also provide support to other parts of the body. If you want any consultation regarding foot and ankle problems, please contact Dr. Heier at (972) 492-1334.
21. July 2014 08:31
Ankle sprain is one of the most common orthopedic problems that people suffer from these days. Ankle sprains make walking difficult and the swelling thus incurred may even make it difficult to stand on one's feet. It is estimated that ankle sprains have the potential to cause more chronic problems and this is why they must be treated before they become severe.
Ankle sprains may be caused when the ankle joint is twisted beyond its ability to withstand force causing the outer ligament of the ankle to tear. It also happens when the whole weight of body presses down on it while playing or running. Sprains may occur due to -
- Running/Walking on rough or uneven surfaces
- Falling awkwardly
- Sudden impacts like car crash
- Colliding with another person while playing
- Sudden change of direction
- Wearing high heels
An ankle sprain usually causes a sudden pain, with a sound of “pop” if it is a severe sprain. The affected area becomes too tender to touch and causes acute pain in the ankle. Symptoms associated with ankle sprain are -
- Mild or severe pain in ankle
- Swelling of the foot
- Bruise development
- Ankle feels unstable
- Inability to move the ankle
- Difficulty walking
The foot and ankle surgeon first determines the severity of the sprain by checking your foot, knee and leg to see if some damage to some other bones has occurred too. To determine if you have broken a bone somewhere the doctor may suggest an x-ray.
- An ankle sprain is treated depending on the severity of the injury. Some sprains require a little time to heal, while others may need rigorous treatment.
- The first and foremost treatment for a minor ankle sprain is R.I.C.E. which is short for Rest, Ice, Compression and Elevation. Rest prevents further injury and stress to the ankle while ice helps to reduce the pain and decreases swelling. Compression helps prevent inflammation and by elevating the ankle at a height above heart level, the body absorbs the fluid that has leaked into the tissue.
- Severe sprain cases have to be treated by immobilizing the ankle with a cast or a splint which may need to be worn for certain duration as determined by the orthopedic ankle surgeon.
- Anti-Inflammatory pain killers on doctor's recommendation can help to reduce the swelling and the doctor may advise strengthening and stretching exercises to return the range of motion to the ankle.
It is advised to complete the rehabilitation program that fully recovers the injury or else the sprain may become chronic. Minor injuries to ankle must be attended promptly before they become severe. Effective treatment and following your doctor's advice with adequate rest can make a sprained ankle as good as new in a few weeks time.