common foot and ankle injuries: you don’t have to suffer!
DESCRIPTION
Join us for a lecture on common foot and ankle injuries, diseases, and conditions, including skin lesions/soft tissue masses, fungal nails, plantar fasciitis, bursitis, hammertoes, bunions, tendonitis, ankle sprains, and arthritis. In addition to discussing causes, the lecture will focus on treatments that can help you get back on your feet!TRANSCRIPT
Foot and Ankle Injuries: You Don’t
Have to SufferWarren A. Chiodo, DPM
Summit Medical Group- Berkeley HeightsBensley Pavilion, 2nd Fl.
Understand what a Podiatrist is and how they can help you
Understand that painful feet and ankles are not normal and can indicate/lead to bigger issues
Understand why you are having foot and ankle pain
Understand what treatment options are available to resolve your foot and ankle pain
Objectives
Dermatological◦ Plantars warts◦ Fungal nails and
Athlete’s feet◦ Melanomas and
other cancerous lesions
Biomechanical Bunions and
hammertoes Heel pain Flat Feet and High
arches
Categories of Foot and Ankle Issues
Sports Medicine and Trauma◦ Ankle Sprains◦ Achilles Tendonitis◦ Ankle Fractures◦ Foot fractures
Pediatrics◦ Clubfoot◦ Flat feet◦ Calcaneal
Apophysitis (heel pain)
◦ Foreign bodies
Categories of Foot and Ankle Issues
Systemic Problems◦ Diabetes Mellitus
Peripheral Vascular Disease
Neuropathy
◦ Rheumatoid Arthritis◦ Gout
Categories of Foot and Ankle Issues
Plantar Warts◦ Caused by virus◦ Can be found in
gyms, locker rooms, pools, salons
◦ Can be painful if on weight bearing surface of foot
Dermatological Issues
Treatments◦ 1st Visit: Biopsy and
topical treatment◦ Subsequent Visits:
Debridement and repeat applications of topical treatments
◦ Possible surgical excision, oral anti-viral, or topical anti-viral as needed
Dermatological Issues
Onychomycosis◦ Fungal infection of
nails Generally occurs after
any microtrauma to nail plate that exposes nail bed
Athlete’s Foot (Tinea pedis)◦ Fungal infection of
skin
Dermatological Issues
Onychomycosis Tinea Pedis◦ Prescription topical
anti-fungal solutions, gels, creams, lotions
◦ Over-the-counter creams and powders
◦ Soak in tea tree oil or tanic acid (black tea)
Dermatological Issues
Melanomas and Other Cancerous lesions
Benign Skin Lesions
Dermatological Issues
PUNCH BIOPSY!!
May require surgical intervention or referral for further oncological workup
If benign, can continue to observe or excise
Dermatological Issues
Bunions and Hammertoes
Biomechanical Issues
Bunions and Hammertoes◦ Conservative Care
Injection therapy Toe sleeves Alternative shoe gear Custom Molded Orthoses
◦ Surgical Intervention Generally considered the only long-term treatment
for symptomatic bunions and hammertoes
Biomechanical Issues
Bunion surgery
Biomechanical Issues
Heel Pain a.k.a Plantar Fasciitis◦ Caused by excessive strain on the ligament on
bottom of foot◦ May develop a heel spur◦ Generally worst when getting up from rest or
after long periods of activity◦ Pulling, sharp pain in bottom of heel or
throughout the arch
Biomechanical Issues
Plantar fasciitis◦ Injection therapy
1-3 injections
◦ Stretching Daily
◦ Icing Frozen bottle of water
◦ Custom Molded Orthoses
◦ Night splint◦ Physical Therapy
Biomechanical Issues
Plantar fasciitis◦ 90% of people get
resolution of symptoms with conservative care
The unlucky 10% have minimally invasive options◦ Radiofrequency◦ Platelet rich plasma◦ Shockwave therapy◦ Fasciectomy with or
without heel spur resection
Biomechanical Issues
Ankle Sprains◦ Generally caused by
twisting ankle towards outside (inversion)
◦ Can damage ligaments and tendons
◦ Common in sports or when you least expect it
Sports Medicine and Trauma
X-rays Ambulatory cast
CAM Walker Gameday Brace REST, ICE,
ELEVATION Physical Therapy
Sports Medicine and Trauma
Ankle Sprains◦ Generally 4-6 week
recovery◦ Should see steady
improvement◦ If no improvement,
may need an MRI
Sports Medicine and Trauma
Achilles Tendonitis◦ Pain at insertion on
posterior heel or lower leg
◦ Due to overuse and/or excessive tightness
◦ Could lead to rupture if chronic degeneration of tendon
Sports Medicine and Trauma
Achilles Tendonitis◦ Immobilization with
heel lift◦ Stretching and icing◦ Prolotherapy
Injection therapy◦ Night Splint◦ Physical Therapy◦ Surgical Intervention
Sports Medicine and Trauma
Ankle Fractures Foot Fractures
Sports Medicine and Trauma
Foot Fractures If no displacement, can try conservative care
If displaced or unstable, requires surgical intervention
Complications: non-unions, mal-unions, post-traumatic arthritis
Sports Medicine and Trauma
Clubfoot◦ Typically 1st born
child◦ Requires serial
casting ASAP◦ May require surgical
intervention
Flat Feet◦ All foot bones are
not developed until 6 yrs of age
◦ Can be flexible or rigid
◦ If rigid, may require CT or MRI
Pediatrics
Flat feet◦ Normal ligamentous
laxity◦ How do I know if my
child’s flat foot is a problem or normal?
◦ If rigid Coalition- abnormal
joint fusion Tendon spasm
Stretching Physical Therapy Orthotics
Surgical Intervention??
Pediatrics
Calcaneal Apophysitis◦ Heel pain in children◦ Generally seen in
active children during activities
◦ May occur in overweight children
Pediatrics
Foreign Bodies◦ Splinters, needles,
glass
May be taken out and irrigated in office◦ Aftercare may
include soaking and topical antibiotic vs. oral antibiotic
May require surgical procedure if deep
Pediatrics
Diabetes Mellitus◦ Routine foot
examinations◦ Vascular studies◦ Nerve conduction
studies◦ Wound Care◦ Diabetic Shoes and
Insoles
Systemic Diseases
Rheumatoid Arthritis◦ Leads to foot
deformity Custom molded
orthoses Injection therapy for
pain Possible Surgical
intervention
Gout◦ Uric Acid causing
inflammation of joint◦ Generally seen in
big toe joint◦ Treated with
injection therapy or anti-inflammatories
Systemic Diseases
Thank you!!!
Any Questions???
The End!