Ankle Sprain
A sprain is the stretching or tearing of ligaments. Ligaments connect adjacent bones and provide stability to a joint. An ankle sprain is a common injury that occurs when you suddenly fall or twist the ankle joint, or when you land your foot in an awkward position after a jump.
Achilles Tendon Rupture
The Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. The Achilles tendon ruptures most often in athletes participating in sports that involve running, pivoting and jumping.
Plantar Fasciitis
Plantar fasciitis refers to the inflammation of the plantar fascia, a thick band of tissue that is present at the bottom of the foot. It runs from the heel bone to the toes and forms the arch of your foot.
Ankle Fractures
Ankle injuries are very common in athletes and individuals performing physical work; often resulting in severe pain and impaired mobility. Pain after ankle injuries can either be from a torn ligament (ankle sprain) or broken bone (ankle fracture).
Ankle Instability
The joints of the ankle are held in place and stabilized by strong bands of tissue called ligaments. Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains, which are injuries to the ligaments.
Nail Bed Injuries
Nail bed injuries such as crush and avulsion injuries commonly occur when the nail bed gets compressed between the hard nail on top and the toe bone below it.
Lisfranc (Midfoot) Fracture
A midfoot fracture is characterized by pain and inability to bear weight. The appearance of bruises and swelling on the bottom of the midfoot are commonly observed symptoms.
Turf Toe
Turf toe is an injury to the ligament at the base of the big toe. It is a painful condition that usually results from jamming the toe into the ground or excessive backward bending of the toe. As it is more common in athletes playing on artificial turf, especially those involved in field sports such as football, baseball, and soccer, it is known as turf toe.
Foot and Ankle Trauma
Foot and ankle trauma refers to injuries that most commonly occur during sports, exercise or any other physical activity. Trauma may be a result of accidents, poor training practices or use of improper gear. Injuries may also be caused when an individual is not medically fit or because of insufficient warm-up and stretching exercises.
Ankle Ligament Injury
An ankle ligament injury, also known as an ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. When stretched beyond its limit, the ligament may partially or completely tear.
Foot and Ankle Arthritis
Arthritis is the inflammation of joints as a result of degeneration of the smooth cartilage that lines the ends of bones in a joint. This degeneration of the cartilages leads to painful rubbing of the bones, swelling, and stiffness in the joints, resulting in restricted movements.
Bunion
A bunion is a bony protuberance that appears on the outer surface of the big toe when it angles toward the adjacent toe. It is an extra bone and a fluid-filled sac that grows at the base of the big toe.
Congenital Deformity and Clubfoot
Congenital deformities of the lower limbs are developmental disorders that are present at birth, causing alterations in the shape and appearance of the legs. Several factors such as genetics, teratogenic drugs, and chemicals can cause congenital deformities.
Ingrown toenail
An ingrown toenail is a common and painful condition of the toe. It occurs when the side or corner of the nail grows inwards and penetrates the skin of the toe. Pain is often accompanied by swelling and redness. The big toe is affected most often.
Sesamoid Fracture
A sesamoid fracture is a break in the sesamoid bone. Sesamoids are two small, pea-shaped bones located in the ball beneath the big toe joint at the bottom of the foot. Sesamoid bones are connected to muscles and other bones by tendons that envelop these bones.
Stress Fractures of Foot and Ankle
A stress fracture is described as a small crack in the bone which occurs from an overuse injury of a bone. It commonly develops in the weight-bearing bones of the lower leg and foot.
Achilles Tendinitis
Inflammation of the Achilles tendon is known as Achilles tendinitis or tendonitis.
The Achilles tendon is a tough band of fibrous tissue that runs down the back of your lower leg and connects your calf muscle to your heel bone. The tendon is used when you walk, climb, jump, run and stand on your tip toes.
Stiff Big Toe (Hallux Rigidus)
A stiff big toe, also called hallux rigidus, is a form of degenerative arthritis affecting the joint where the big toe (hallux) attaches to the foot. The toe typically becomes stiff at the base and is sometimes called a “frozen joint”.
Tarsal Tunnel Syndrome
The tarsal tunnel is a narrow passageway that lies on the inside of your ankle and runs into the foot. It encloses arteries, veins, tendons and nerves that supply the foot. The tunnel holds very limited space as it is formed between bones and overlying fibrous tissues.
Flatfoot Deformity
Flatfoot, also known as “fallen arches” or Pes planus, is a deformity in children’s feet where the arch that runs along the sole of the foot collapses to the ground or is not formed at all. Flatfoot is normal in the first few years of life as the arch of the foot usually develops between the age of 3 and 5 years.
Bunionectomy
A bunionectomy is a surgical procedure to remove a bunion. A bunion, also called a hallux valgus, is an enlargement of bone or soft tissues around the joint at the base of the big toe that results in the formation of a bump. The bone that joins the big toe with the first metatarsal bone thickens and enlarges, tightening the tendons, which in turn causes the base of the big toe to angle out resulting in a painful bony deformity.
Foot Injections
Foot injections are steroids that are injected into your foot to relieve pain and inflammation. Cortisol is a hormone that is produced in the human body and functions to reduce stress and inflammation. Steroids are synthetic drugs that resemble cortisol and are used in treating joint pain.
Foot Reconstruction
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness. Ideally, any foot surgery for reconstruction is done to improve the appearance and function of the foot so that you can maintain your quality of life.
Ankle Joint Replacement
Ankle joint replacement, also known as total ankle arthroplasty, is a surgical procedure performed to relieve pain and immobility due to severe end-stage arthritis that has not responded to non-surgical treatments. The goal of ankle joint replacement surgery is to eliminate your pain and increase the mobility of your ankle joint.
Ankle Arthroscopy
Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.
Treatment of Foot and Ankle Sports Injuries
Injuries during sports are common. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. Injuries to the foot and ankle are common while playing sports such as football, hockey, skating and in weekend athletes.
Flatfoot Reconstruction
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.
Achilles Tendon Repair
The Achilles tendon is often injured during sports activities, resulting in an inflammatory condition called tendonitis, which is characterized by swelling and pain. In some cases, severe injury results in a tear or rupture of the Achilles tendon, requiring immediate medical attention.
Ankle Arthrodesis
Ankle arthrodesis is the surgical fusion of bones that form the ankle joint. The ankle joint is formed by the tibia, talus, and the fibula bones.
Ankle Ligament Reconstruction
Ankle ligament reconstruction may be performed arthroscopically under general anesthesia. Your surgeon will make small incisions in your ankle. A tiny camera and a few special instruments are inserted through the incisions to repair and strengthen the ligaments.
Ankle Instability Surgery
Ankle instability surgery is performed to treat an unstable ankle and involves the repair or replacement of a torn or stretched ligament.
Complex Foot and Ankle Surgeries
Complex foot and ankle surgeries are procedures employed to treat foot and ankle structures with deformities, injuries, structural issues, and damage from diseases like diabetes or arthritis.
Shockwave Treatment for Plantar Fasciitis
Shockwave treatment, also known as Extracorporeal Shock Wave Therapy (ESWT), is a conservative procedure to treat plantar fasciitis of the foot, where shockwaves are passed through the heel to stimulate healing of the inflamed plantar fascia tissues.
Tendon Transfer
In a tendon transfer procedure, a healthy tendon is transferred to replace the damaged tendon and restore the normal movement of the foot.
Foot & Ankle Deformity Correction
Foot and ankle deformity is the structural abnormality caused by misalignment of the bones of the foot and ankle.
What is the Normal Anatomy of the Foot and Ankle?
The foot and ankle form complex joints that are involved in movement and providing stability and balance to the body. The foot and ankle consist of 26 bones, 33 joints, and many muscles, tendons, and ligaments.
Bones of the Ankle
The ankle joint connects the leg with the foot and is composed of three bones: the tibia, fibula, and talus. The tibia or shinbone and fibula or calf bone are bones of the lower leg, which articulate with the talus or ankle bone, enabling up and down movement of the foot.
Three bony bumps present on the ends of the tibia and fibula form parts of the ankle joint:
- The medial malleolus, formed by the tibia, is found on the inside of the ankle.
- The posterior malleolus, also formed by the tibia, is found at the back of the ankle.
- The lateral malleolus, formed by the fibula, is found on the outer aspect of the ankle.
Bones of the Feet
The foot acts as a single functional unit, but can be divided into three parts: the hindfoot, midfoot and forefoot.
The hindfoot forms the ankle and heel, and is made up of the talus bone and calcaneus or heel bone. The heel bone is the largest bone in the foot.
The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones. The navicular bone is found in front of the heel bone, and the cuneiform and cuboid bones are arranged in front of the navicular bone.
These bones are connected to five metatarsal bones of the forefoot that form the arch of the foot for shock absorption while walking or running. The forefoot is also made up of the toes or digits, formed by bones called phalanges - three in each toe, except the big toe, which has only two phalanges. The big toe has two additional tiny round sesamoid bones in the ball of the foot, which helps in upward and downward movements of the toe.
Ankle and Foot Joints
There are 33 joints in the ankle and foot. They include:
- Hinge joints in the ankle, which allow flexion (bending) and extension
- Gliding joints found in the hindfoot, which allow gliding movements
- Condyloid joints found in the forefoot and toes, which allow the flexion (bending) and extension, adduction, and abduction (sideward movement).
The joints of the foot and ankle provide stability and support the weight of your body, helping you to walk or run, and adapt to uneven grounds.
Soft Tissues of the Ankle and Foot
Our feet and ankle bones are held in place and supported by various soft tissues such as cartilage, ligaments, muscles, tendons, and bursae.
The joint surface of all the bones of the ankle and foot are lined by a thin, tough, flexible, and slippery surface called the articular cartilage, which acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables smooth movement of the bones.
Ligaments are tough rope-like tissue that connect bones to other bones, and hold them in place, providing stability to the joints. The plantar fascia is the largest ligament in the foot, originating from the heel bone to the forefoot, it extends along the lower side of the foot and is involved in maintaining the arch of the foot. The plantar fascia ligament stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot.
The foot is made up of 20 muscles that help in movement. The main muscles include:
- Anterior tibial muscle, which allows up and down movement of the foot
- Posterior tibial muscle, which supports the arch
- Peroneal tibial muscle, which controls movement on the outside of the ankle
- Extensors, which enable the ankle to raise the toes just before stepping forward
- Flexors, which stabilize the toes against the floor
- Smaller muscles that help the toes to lift and curl
Tendons are soft tissues that connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneal and anterior and posterior tibialis.
Bursae are small fluid-filled sacs that decrease friction between tendons and bone or skin. They contain special cells called synovial cells that secrete a lubricating fluid.
