Stege's Podiatric Topics
FOOT AND ANKLE INJURIES
Foot and ankle emergencies happen every day. Broken bones,
dislocations, sprains, contusions, infections, and other serious
injuries can occur at any time. Early attention is vitally important.
Whenever you sustain a foot or ankle injury, you should seek
immediate treatment from a podiatric physician.
That advice is universal, even though there are lots of myths
about foot and ankle injuries. Some of them follow.
- "It can't be broken, because I can move it."
False; this widespread idea has kept many fractures from receiving
proper treatment. The truth is that often you can walk with
certain kinds of fractures. Some common examples: breaks of the
thinner of the two leg bones; small "chip" fractures of either
foot or ankle bones; and the frequently neglected fracture of a
- "If you break a toe, immediate care isn't
necessary." False; a toe fracture needs prompt
attention. If X-rays reveal it to be a simple, displaced fracture,
care by your podiatrist usually can produce rapid relief. However,
X-rays might identify a displaced or angulated break. In such
cases, prompt realignment of the fracture by your podiatric
physician will help prevent improper or incomplete healing. Many
patients develop post-fracture deformity of a toe, which in turn
results in formation of a painfully deformed toe with a most
painful corn. A good general rule is: Seek prompt treatment for
injury to foot bones.
- "If you have a foot or ankle injury, soak it in hot
water immediately." False; don't use heat or hot water
if you suspect a fracture, sprain, or dislocation. Heat promotes
blood flow, causing greater swelling. More swelling means greater
pressure on the nerves, which causes more pain. An ice bag wrapped
in a towel has a contracting effect on blood vessels, produces a
numbing effect, and prevents swelling and pain. After seeing a
podiatric physician, warm compresses and soaks may be used.
- "Applying an elastic bandage to a severely sprained
ankle is adequate treatment." False; ankle sprains
often mean torn or severely overstretched ligaments, and they
should receive immediate care. X-ray examination, immobilization
by casting or splinting, and physiotherapy to insure a normal
recovery all may be indicated. Surgery may even be necessary.
- "The terms 'fracture,' 'break,' and 'crack' are all
different." False; all of those words are proper in
describing a broken bone.
Before Seeing the Podiatrist
If an injury or accident does occur, the steps you can take to
help yourself until you can reach your podiatric physician are easy
to remember if you can recall the word "rice."
- Rest. Cut back on your activity,
and get off your feet if you can.
- Ice. Gently place a plastic bag
of ice, or ice wrapped in a towel, on the injured area in a
20-minute-on, 40-minute-off cycle.
- Compression. Lightly wrap an Ace
bandage around the area, taking care not to pull it too tight.
- Elevation. Sit in a position
that you can elevate the foot higher than the waist, to reduce
swelling and pain.
- Switch to a soft shoe or slipper, preferably one that your
podiatrist can cut up in the office if it needs to be altered to
accommodate a bulky dressing.
- For bleeding cuts, cleanse well, apply pressure with gauze or
a towel, and cover with a clean dressing. It's best not to use any
medication on the cut before you see the doctor.
- Leave blisters unopened if they are not painful or swollen.
- Foreign materials in the skin, such as slivers, splinters, and
sand, can be removed carefully with a sterile instrument. A deep
foreign object, such as broken glass or a needle, must be removed
- Treatment for an abrasion is similar to that of a burn, since
raw skin is exposed to the air and can easily become infected.
Cleansing is important to remove all foreign particles. Sterile
bandages should be applied, along with an antibiotic cream or
- Wear the correct shoes for any event. Good walking shoes
provide more comfort and better balance.
- Wear hiking shoes or boots in rough terrain.
- Different sports activities call for specific footwear to
protect feet and ankles. Use the correct shoes for each sport.
Don't wear any sports shoe beyond its useful life.
- Wear safety shoes if you're in an occupation which threatens
foot safety. There are specific safety shoes for a variety of
on-the-job conditions. Be certain they are fitted properly.
- Always wear hard-top shoes when operating a lawn mower or
other grass-cutting equipment.
- Don't walk barefoot on paved streets or sidewalks.
- Watch out for slippery floors at home and at work. Clean up
obviously dangerous spills immediately.
- If you get up during the night, turn on a light. Many
fractured toes and other foot injuries occur while attempting to
find your way in the dark.
(c) Copyright 1996 - David C. Stege, DPM - All