Sports medicine for the foot and ankle

You rolled an ankle, felt a pop, or have pain that isn’t settling after the game. It’s tempting to wait it out. Here’s why a prompt, accurate diagnosis matters. An ankle sprain is a stretch or tear of the ligaments that hold the ankle together, most often the ones on the outside of the ankle. It happens when the foot rolls inward, under the leg. But a few injuries hide behind a bad sprain: a fracture, a torn tendon, or damage to the cartilage inside the joint. Simple bedside checks, the Ottawa ankle rules, show who needs an X-ray, and we take X-rays in the office the same day. A sudden pop at the back of the ankle, as if you were kicked, can be an Achilles tendon rupture, and should be seen promptly. Stress fractures at the base of the fifth metatarsal and in the navicular bone heal poorly because of their limited blood supply. They need careful treatment, not walking it off. Turf toe, a sprain of the big-toe joint, ranges from a mild stretch to a complete tear, and the grade decides the treatment and the time away from sport. And deep ankle pain, swelling or catching that lingers after a sprain can mean an injury to the cartilage inside the ankle. For ordinary sprains, early, protected movement leads to a better recovery than keeping the ankle still. A guided exercise program speeds recovery, and bracing and balance training lower the chance of spraining it again. Returning to sport before the ankle is fully rehabilitated is the most common reason a sprain turns into chronic instability, an ankle that keeps giving way. Over time, that is linked with less physical activity and earlier arthritis in the ankle. Here, care starts with a hands-on examination and, when needed, X-ray or ultrasound in the office, so we know exactly what is injured. Then we protect the injury with a brace, a boot or taping when they help, and rebuild strength, balance and range of motion. Your return to sport is graded, based on how the injury is healing and what you can do, not only on how many weeks have passed. Get seen promptly for an injury you can’t put weight on, a bone that looks out of place, a sudden pop at the back of the ankle, or a foot that turns cold, pale or numb. In an emergency, call 911 or go to the nearest emergency department. Whether you compete every weekend or just laced up for your first 5K, a foot or ankle injury deserves an accurate diagnosis and a plan for a safe return to your sport. To arrange a visit, call the office or book online.

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