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Stephan J. LaPointe, DPM, PhD, FACFAS

Featured Articles

Causes, Symptoms, and Treatment for a Broken Foot

The human foot has 26 different bones, and the foot is divided into three parts: the hindfoot, the midfoot, and the forefoot. Each section of the foot is composed of a different amount of bones. For instance, the forefoot is made up of 19 bones. The midfoot is composed of five smaller bones called the navicular, cuboid, and three cuneiform bones. Lastly, the hindfoot is made up of only the talus and the calcaneus. The feet tend to be vulnerable to slipping and twisting; consequently, fractured bones within the foot are common. When a bone gets crushed, bent, twisted, or stretched it may become broken.

Many foot fractures occur through an accident or trauma. More specifically, common causes for broken feet are car accidents, falls, missteps, or overuse. If you have a broken ankle or foot, you may have one or more of the following symptoms: throbbing pain, swelling, bruising, tenderness, deformities, and difficulty walking.

There are some factors that may put you at a higher risk of developing a broken foot. People who participate in high-impact sports are more likely to develop foot fractures because of the stresses, direct blows, and twisting injuries involved in gameplay. Additionally, those who suddenly increase their activity level are more likely to suffer a stress fracture.

Unfortunately, there are different complications that may arise because of a foot fracture. For instance, arthritis may be caused by fractures that extend into the joints. Bone infections are also possible in open fractures due to the bone being exposed to bacteria. However, there are ways you can help prevent yourself from breaking your foot. One way to avoid fractures is to wear proper footwear. If you plan on going on a run, you should wear running shoes. You should also replace your shoes if you notice that they are becoming worn out. For runners, it is best to replace shoes every 300 to 400 miles.

Treatment for foot fractures usually consists of rest, ice, elevation, and compression (RICE). If you plan on wrapping your foot, try not to wrap it too tightly because doing so may cut off blood supply in the foot. You should also avoid walking on the fractured foot.

If you suspect you have a broken foot, you should see your podiatrist right away. It is important that you have someone bring you to your doctor, since driving with a broken foot can be dangerous. You should especially seek urgent care if you are experiencing numbness, pain, or deformities in your foot.

Exercise for Your Feet

Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.

For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.

Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.

Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works the muscles.

Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet off of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.

In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis. It’s also important to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage. This encourages circulation in the feet as well as muscle relaxation.

Foot and Ankle Surgery

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

Stress Fractures of the Foot and Ankle

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

Diabetic Foot Care

Diabetes can cause two problems that can potentially affect the feet: Diabetic neuropathy and Peripheral Vascular Disease. Diabetic neuropathy occurs when nerves in your legs and feet become damaged, which prevents you from feeling heat, cold, or pain. The problem with diabetic neuropathy is that a cut or sore on the foot may go unnoticed and the cut may eventually become infected. This condition is also a main cause of foot ulcers. Additionally, Peripheral vascular disease also affects blood flow in the body. Poor blood flow will cause sores and cuts to take longer to heal. Infections that don’t heal do to poor blood flow can potentially cause ulcers or gangrene.

There are certain foot problems that are more commonly found in people with diabetes such as Athlete’s foot, calluses, corns, blisters, bunions, foot ulcers, ingrown toenails, and plantar warts. These conditions can lead to infection and serious complications such as amputation. Fortunately, proper foot care can help prevent these foot problems before they progress into more serious complications.       

Each day you should wash your feet in warm water with a mild soap. When you finish washing your feet, dry them carefully especially between your toes. You should also perform daily foot inspections to ensure you don’t have any redness, blisters, or calluses. Furthermore, if you are diabetic, you should always wear closed-toed shoes or slippers to protect your feet. Practicing these tips will help ensure that your feet are kept healthy and away from infection.

If you have diabetes, contact your podiatrist if you have any of the following symptoms on your feet: changes in skin color, corns or calluses, open sores that are slow to heal, unusual and persistent odor, or changes in skin temperature. Your podiatrist will do a thorough examination of your feet to help treat these problematic conditions.

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