Ankle Injuries Archives - Orthopedic & Sports Medicine

Simple Ankle Fractures Explained

What Is an Ankle Fracture?

A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both.

Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.

Symptoms of an Ankle Fracture

An ankle fracture is accompanied by one or all of these symptoms:

Pain at the site of the fracture, which in some cases can extend from the foot to the knee.
Significant swelling, which may occur along the length of the leg or may be more localized.
Blisters may occur over the fracture site. These should be promptly treated by a foot and ankle surgeon.
Bruising that develops soon after the injury.
Inability to walk; however, it is possible to walk with less severe breaks, so never rely on walking as a test of whether or not a bone has been fractured.
Change in the appearance of the ankle—it will look different from the other ankle.
Bone protruding through the skin—a sign that immediate care is needed. Fractures that pierce the skin require immediate attention because they can lead to severe infection and prolonged recovery.

Diagnosis of an Ankle Fracture

Following an ankle injury, it is important to have the ankle evaluated by a foot and ankle surgeon for proper diagnosis and treatment. If you are unable to do so right away, go to the emergency room and then follow up with a foot and ankle surgeon as soon as possible for a more thorough assessment.

The affected limb will be examined by the foot and ankle surgeon who will touch specific areas to evaluate the injury. In addition, the surgeon may order x-rays and other imaging studies, as necessary.

Nonsurgical Treatment of an Ankle Fracture

Treatment of ankle fractures depends on the type and severity of the injury. At first, the foot and ankle surgeon will want you to follow the RICE protocol:

Rest: Stay off the injured ankle. Walking may cause further injury.
Ice: Apply an ice pack to the injured area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
Compression: An elastic wrap should be used to control swelling.
Elevation: The ankle should be raised slightly above the level of your heart to reduce swelling.

Additional treatment options include:

Immobilization. Certain fractures are treated by protecting and restricting the ankle and foot in a cast or splint. This allows the bone to heal.
Prescription medications. To help relieve the pain, the surgeon may prescribe pain medications or anti-inflammatory drugs.

When Is Surgery Needed?

For some ankle fractures, surgery is needed to repair the fracture and other soft tissue-related injuries, if present. The foot and ankle surgeon will select the procedure that is appropriate for your injury.

Follow-Up Care

It is important to follow your surgeon’s instructions after treatment. Failure to do so can lead to infection, deformity, arthritis and chronic pain.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Achilles Tendon Rupture

in Ankle Injuries

Article featured on Cleveland Clinic

The Achilles tendon is a thick band of tissue that attaches your calf muscle to your heel bone. It is the largest and longest tendon in your body and is built to handle a lot of stress. But you can rupture your Achilles tendon under extreme stress — like during a sudden start or stop, or if you fall. Sometimes it heals with rest and bracing, but many people need surgery to repair it.

What is an Achilles tendon rupture?

The Achilles tendon attaches the calf muscle to the heel bone. This thick band of tissue is very strong. In fact the Achilles tendon is the largest and strongest tendon in the body. The Achilles tendon gives your leg strength to walk, run and jump.

An Achilles tendon rupture is a full or partial tear of the Achilles tendon. This acute (sudden) injury occurs when the tendon stretches to its breaking point. It happens most frequently while playing sports. Tripping, falling or twisting your ankle can also cause an Achilles tear.

How common are ruptured Achilles tendons?

Achilles tendon ruptures are very common sports injuries. They occur most frequently in people ages 30 to 40 and are more common in men than in women.

People who are “weekend warriors” (usually adults who don’t train regularly, then exercise at a high intensity) are more likely to tear an Achilles tendon than younger, well-trained athletes.

Symptoms and Causes

What causes an Achilles tendon rupture?

Sudden movement that puts stress on the Achilles tendon can lead to a rupture. Typically, people tear the Achilles tendon while playing sports. The biggest culprits are sports with sudden stops, starts and pivots — such as soccer, football, basketball, tennis or squash. Achilles tendon tears aren’t always a sports injury. You can tear your Achilles tendon by tripping, missing a step when going downstairs or accidentally stepping into a hole and twisting your ankle. Some medications — including certain antibiotics and steroid injections in the area — can weaken the Achilles tendon. This can put you at a higher risk for a tear.

What are the symptoms of a torn Achilles tendon?

The classic sign of a ruptured Achilles tendon is feeling (and sometimes hearing) a pop or snap at the back of your ankle. People often mistakenly think something has hit them, but they’re actually feeling the tendon snap.

Other common symptoms include:

Sharp, sudden pain in the back of the ankle near the heel.
Swelling and bruising in the back of the ankle.
Pain when walking, especially upstairs or uphill.
Tenderness in the spot where the tendon is torn.

What are the complications of an Achilles tendon rupture?

A torn Achilles tendon is a traumatic injury that requires medical attention. Without treatment, an Achilles tendon rupture may not heal properly. This can increase your risk of rupturing it again.

Diagnosis and Tests

Your healthcare provider will physically examine your foot and ankle. They’ll check your ability to move it in various directions and see how you react to pressure on the area. They will also feel for a gap in the tendon that suggests it’s torn.

Your provider may also use imaging tests — such as ultrasound or MRI — to determine the extent of the Achilles tear.

Management and Treatment

How is a ruptured Achilles tendon treated?

Even before you seek medical help, you can reduce pain and swelling to the injured tendon by following the RICE (Rest, Ice, Compression, Elevation) method:

Rest, by staying off the injured leg.
Apply ice to the injured area.
Wrap your ankle to compress the injured area and prevent more swelling.
Elevate your leg at or above the level of your heart to reduce swelling.

Full healing of a torn Achilles tendon typically takes about four to six months. Medical treatment for a ruptured Achilles tendon may include:

Brace or walking cast: Nonsurgical treatment for a torn Achilles tendon requires immobilizing the injured foot and ankle. Your provider will place your foot, ankle and calf in a brace or walking cast. Your foot and ankle flex downward so that the Achilles tendon can heal.
Surgery: Most providers recommend surgical repair of a torn Achilles tendon in people who are active and middle-aged or younger. During surgery, a surgeon stitches the two ends of the torn tendon back together. After surgery, you’ll need a cast on your lower leg to immobilize the tendon while it heals.
Physical therapy: You will need physical therapy to regain strength and mobility in your Achilles tendon, whether or not you had surgery.

Prevention

How can I prevent a torn Achilles tendon?

You can’t always prevent an accidental injury like tearing your Achilles tendon. But you can take steps to reduce the risk of an Achilles tendon rupture, including:

Doing warmup exercises before a workout or game.
Increasing the intensity of workouts gradually.
Regularly stretching your calf muscles and Achilles tendons.

Outlook/Prognosis

What is the prognosis (outlook) for people with an Achilles tendon rupture?

With proper treatment, most Achilles tendon ruptures fully heal within four to six months.

Having surgery to repair a torn Achilles tendon is usually the best option for younger, active people. After surgical repair, you can regain your Achilles tendon’s full strength and function.

When should I call the doctor?

You should call your healthcare provider if you experience:

A snap or pop at the back of your ankle during activity.
Sudden sharp pain at the back of your ankle.
Difficulty walking after an injury.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

Do I need surgery to repair my Achilles tendon?
How long will I need to wear a brace or cast?
When can I start exercising or playing sports again?
Am I at risk of tearing my Achilles again after it heals?

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Achilles Tendinitis

in Ankle Injuries, Foot Pain

Article featured on Mount Sinai

Achilles tendinitis occurs when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. This tendon is called the Achilles tendon. It allows you to push your foot down. You use your Achilles tendon when walking, running, and jumping.

Causes

There are two large muscles in the calf. These create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel.

Heel pain is most often due to overuse of the foot. Rarely, it is caused by an injury.

Tendinitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes.

Achilles tendinitis may be more likely to occur if:

There is a sudden increase in the amount or intensity of an activity.
Your calf muscles are very tight (not stretched out).
You run on hard surfaces, such as concrete.
You run too often.
You jump a lot (such as when playing basketball).
You do not wear shoes that give your feet proper support.
Your foot suddenly turns in or out.

Tendinitis from arthritis is more common in middle-aged and older adults. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling. Flat feet will put more tension on the tendon.

Heel pain can be a common problem. Though the cause is rarely serious, the pain can be severe and sometimes disabling.

Heel pain is often the result of overusing your foot. Causes may include, running, especially on hard surfaces like concrete, tightness in your calf, or from Achilles tendonitis (inflammation of that large tendon that connects your calf muscle to your heel), shoes with poor support, sudden inward or outward turning of your heel, or landing hard or awkwardly on your heel after a jump or fall.

Problems related to heel pain include bursitis (inflammation of the bursa at the back of the heel), bone spurs in the heel, and plantar fasciitis (swelling of the thick band of tissue on the bottom of your foot). Heel pain is something you can usually treat at home.

If you can, try resting as much as possible for at least a week. Apply ice to the painful area twice a day or so, for 10 to 15 minutes. If you need to, you can buy a heel cup, felts pads, or shoe inserts to comfort your heel.

You should call your doctor if your heel pain does not get better after two or three weeks of home treatment. But also call your doctor if your pain is getting worse, or your pain is sudden and severe, your feet are red or swollen, or you can’t put weight on your foot.

If you visit the doctor, you may have a foot x-ray. Your treatment will depend on the cause of your heel pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. To prevent future heel pain, we recommend you exercise.

Maintaining flexible, strong muscles in your calves, ankles, and feet can help ward off some types of heel pain. And do yourself a favor, trade those sleek high heels in for a comfortable, properly fitting pair of shoes.

Symptoms

Symptoms include pain in the heel and along the length of the tendon when walking or running. The area may feel painful and stiff in the morning.

The tendon may be painful to touch or move. The area may be swollen and warm. You may have trouble standing up on your toes. You may also have trouble finding shoes that fit comfortably due to pain in the back of your heel.

Exams and Tests

The health care provider will perform a physical exam. They will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes.

X-rays can help diagnose bone problems.

An MRI scan of the foot may be done if you are considering surgery or there is a chance that you have a tear in the Achilles tendon.

Treatment

The main treatments for Achilles tendinitis do not involve surgery. It is important to remember that it may take at least 2 to 3 months for the pain to go away.

Try putting ice on the Achilles tendon area for 15 to 20 minutes, 2 to 3 times per day. Remove the ice if the area gets numb.

Changes in activity may help manage the symptoms:

Decrease or stop any activity that causes pain.
Run or walk on smoother and softer surfaces.
Switch to biking, swimming, or other activities that put less stress on the Achilles tendon.

Your provider or physical therapist can show you stretching exercises or eccentric loading exercises for the Achilles tendon.

You may also need to make changes in your footwear, such as:

Using a brace, boot or cast to keep the heel and tendon still and allow the swelling to go down
Placing heel lifts in the shoe under the heel
Wearing shoes that are softer in the areas over and under the heel cushion

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can help ease pain or swelling.

Other treatment include injections, such as platelet rich plasma or steroids, to reduce the inflammation. However, the tendon can become even weaker following injection and should be protected after the injections.

If these treatments do not improve symptoms, you may need surgery to remove inflamed tissue and abnormal areas of the tendon. If there is a bone spur irritating the tendon, surgery can be used to remove the spur.

Extracorporeal shock wave therapy (ESWT) may be an alternative to surgery for people who have not responded to other treatments. This treatment uses low-dose sound waves.

Outlook (Prognosis)

In most cases, lifestyle changes help improve symptoms. Keep in mind that symptoms may return if you do not limit activities that cause pain, or if you do not maintain the strength and flexibility of the tendon.

Possible Complications

Achilles tendinitis may make you more likely to have an Achilles rupture. This condition most often causes a sharp pain that feels as if you have been hit in the back of the heel with a stick. Surgical repair is often necessary. However, the surgery may not be as successful as usual because there is already damage to the tendon.

When to Contact a Medical Professional

Contact your provider if:

You have pain in the heel around the Achilles tendon that is worse with activity.
You have sharp pain and are unable to walk or push-off without extreme pain or weakness.

Prevention

Exercises to keep your calf muscles strong and flexible will help reduce the risk for tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Dance Injuries and Prevention Tips

in Ankle Injuries, Foot Pain, Joint Pain, Knee Injuries, Sports Related Injuries

Article featured on Johns Hopkins Medicine

Dance may look effortless, but it requires a lot of strength, flexibility and stamina. It also comes with a high risk of injuries. Whether you are a dancer, the parent of a dancer or a dance teacher, you should be aware of the most common dance injuries and learn how to avoid them.

Johns Hopkins performing arts physical therapists Andrea Lasner and Amanda Greene share valuable information about dance injury treatments and prevention tips. Lasner and Greene, both dancers, have turned their love for the art into a means of helping injured dancers.

What are some common dance injuries?

A few studies that looked into dance injuries found that injuries from using your joints and muscles too much (overuse injuries) are the most common in dancers. The majority of these overuse injuries involve an ankle, leg, foot or lower back. Some common dance injuries are:

Hip injuries: snapping hip syndrome, hip impingement, labral tears, hip flexor tendonitis, hip bursitis and sacroiliac joint dysfunction
Foot and ankle injuries: Achilles tendonitis, trigger toe and ankle impingement
Knee injuries: patellofemoral pain syndrome
Stress fractures: metatarsals, tibia, sesamoids and lumbar spine
Dancers are also likely to develop arthritis in the knee, hip, ankle and foot

Generally, dancers have a much lower rate of anterior cruciate ligament (ACL) injuries than other athletes. One explanation could be that dance training involves much more intense jumping from an earlier age than other sports, which helps improve muscle control.

How do I know if the pain is from an injury?

In most cases, the pain you experience after dancing is muscle soreness that usually subsides within 24 to 48 hours. Sometimes, it takes a few days for muscles to get sore, which is also normal. However, if you experience the following types of pain, you may have suffered an injury:

Pain that wakes you up at night
Pain that is present at the start of an activity
Pain that increases with an activity
Pain that makes you shift your weight or otherwise compensate your movements

If you experience such pain, consult with a medical specialist — preferably a physical therapist or physician with experience in treating dancers. They will be able to determine whether additional testing is needed and will formulate an appropriate treatment plan.

Why do dance injuries happen?

Dance is a physically demanding activity. Dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer leads to an increased risk of stress fractures and other injuries.

On top of the intensive training, many dancers get little time to recover between the sessions and have no “offseason.” Restrictive diets and unhealthy body weights may also contribute to dance injuries. Proper nutrition is important for dancers of all ages.

How do dancers get ankle sprains?

Ankle sprains are the number one traumatic injury in dancers. Traumatic injuries are different from overuse injuries as they happen unexpectedly. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and may experience tears. Ankle sprains often happen due to improper landing from a jump, misaligned ankles (when they roll in or out) or poorly fitted shoes. Torn ligaments never heal to their preinjury condition. Once you’ve sprained your ankle, you are at risk of doing it again. It’s important to build muscle strength to prevent further injuries.

Dance Injury Prevention

How can dance injuries be prevented?

The majority of overuse injuries and even some traumatic dance injuries can be prevented. Follow these guidelines to reduce your risk of injury:

Eat well and stay hydrated before, during and after class.
Get enough rest and avoid overtraining.
Do cross-training exercises to build strength and endurance in all parts of your body.
Always wear proper shoes and attire.
Always warm-up before training or performances.
Lead a healthy lifestyle and get to know your body.

When injuries happen, address them immediately and get advice from a doctor or physical therapist.

What are good cross-training exercises for dancers?

Core and hip strengthening exercises like Pilates and stability-based yoga are great for dancers. And so are aerobic and cardiovascular activities, such as running, swimming or biking. They get your heart rate up and help build stamina for long performances.

Many dancers don’t do enough cardio during their regular training. Just 30 minutes three to four times a week is usually enough to improve your endurance. As always, do this in moderation and in short intervals to avoid stressing your joints. Being screened by a physical therapist with experience treating dancers will help you identify individual areas of weakness to address with specific exercises.

How much rest should a dancer get?

While many experts stress the importance of proper rest, there are no specific guidelines on the frequency and amount of rest. However, we know that dancing five hours a day or longer is linked to an increased risk of injury. It is also known that intense activity leads to microdamage, which peaks in recovery 12 to 14 hours after a workout. So it would make sense to take the next day off after a high-intensity activity. Dancers should work at their highest intensity a couple of times per week and then take at least two days off, preferably in a row. Also, a three- to four-week period of rest after the season is ideal for recovery.

Dance Injury Treatment

Should I ice or heat after a dance injury?

If it’s a sudden injury, it’s best to apply ice first to reduce swelling and inflammation. RICE treatment is a common approach that involves rest, ice, compression and elevation. After a few days, you can switch to heat to increase blood flow to the area and promote healing. However, every person is different. If you feel that ice helps you better than heat, then there is nothing wrong with continuing to ice. But be careful not to ice before dancing or stretching, because you want those muscles to be warmed up to prevent re-injury.

What are my treatment options for a dance injury?

It depends on the type of injury, your level as a dancer and many other factors. For example, for traumatic injuries like ankle sprains, your doctor may recommend RICE, joint protection and physical therapy. For stress fractures you may need to limit weight on your foot by using crutches, wearing a leg brace or walking boots. Surgery is typically used as the last resort. It is best to discuss your treatment options with a doctor who specializes in dance injuries. And if you are working with a physical therapist, make sure he or she is experienced in treating dancers. A big part of physical therapy is correcting the training technique that led to the injury. Otherwise, you risk hurting yourself again by making the same mistake.

What should be in the first aid kit for dance injuries?

Your regular first aid kit might already have many of the essentials for handling a medical emergency. However, when it comes to common dance injuries, you may want to include a few additional items, such as:

Instant cold pack
Pre-wrap and athletic tape (if qualified providers are available to apply)
Elastic bandages (to be used only for compression, not support while dancing)
Crutches
Topical pain reliever

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Chronic Ankle Instability?

in Ankle Injuries

Article featured on Foot Health Facts

What Is Chronic Ankle Instability?

Chronic ankle instability is a condition characterized by a recurring giving way of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains. Usually, the giving way occurs while walking or doing other activities, but it can also happen when you’re just standing. Many athletes, as well as others, suffer from chronic ankle instability.

People with chronic ankle instability often complain of:

A repeated turning of the ankle, especially on uneven surfaces or when participating in sports
Persistent (chronic) discomfort and swelling
Pain or tenderness
The ankle feeling wobbly or unstable

Causes of Chronic Ankle Instability

Chronic ankle instability usually develops following an ankle sprain that has not adequately healed or was not rehabilitated completely. When you sprain your ankle, the connective tissues (ligaments) are stretched or torn. The ability to balance is often affected. Proper rehabilitation is needed to strengthen the muscles around the ankle and retrain the tissues within the ankle that affect balance. Failure to do so may result in repeated ankle sprains.

Repeated ankle sprains often cause—and perpetuate—chronic ankle instability. Each subsequent sprain leads to further weakening (or stretching) of the ligaments, resulting in greater instability and the likelihood of developing additional problems in the ankle.

Diagnosis of Chronic Ankle Instability

In evaluating and diagnosing your condition, the foot and ankle surgeon will ask you about any previous ankle injuries and instability. Then s/he will examine your ankle to check for tender areas, signs of swelling and instability of your ankle as shown in the illustration. X-rays or other imaging studies may be helpful in further evaluating the ankle.

Nonsurgical Treatment

Treatment for chronic ankle instability is based on the results of the examination and tests, as well as on the patient’s level of activity. Nonsurgical treatment may include:

Physical therapy. Physical therapy involves various treatments and exercises to strengthen the ankle, improve balance and range of motion and retrain your muscles. As you progress through rehabilitation, you may also receive training that relates specifically to your activities or sport.
Bracing. Some patients wear an ankle brace to gain support for the ankle and keep the ankle from turning. Bracing also helps prevent additional ankle sprains.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and inflammation.

When Is Surgery Needed?

In some cases, the foot and ankle surgeon will recommend surgery based on the degree of instability or lack of response to nonsurgical approaches. Surgery usually involves repair or reconstruction of the damaged ligament(s). The surgeon will select the surgical procedure best suited for your case based on the severity of the instability and your activity level. The length of the recovery period will vary, depending on the procedure or procedures performed.

Why choose a foot and ankle surgeon?

Foot and ankle surgeons are the leading experts in foot and ankle care today. As doctors of podiatric medicine – also known as podiatrists, DPMs or occasionally “foot and ankle doctors” – they are the board-certified surgical specialists of the podiatric profession. Foot and ankle surgeons have more education and training specific to the foot and ankle than any other healthcare provider.

Foot and ankle surgeons treat all conditions affecting the foot and ankle, from the simple to the complex, in patients of all ages including chronic ankle instability. Their intensive education and training qualify foot and ankle surgeons to perform a wide range of surgeries, including any surgery that may be indicated for chronic ankle instability.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Arthritis of the Ankle

in Ankle Injuries, Arthritis

Article featured on University of Michigan Health

Ankle arthritis occurs when there is a breakdown of cartilage in the ankle joint. It can result from a variety of causes, including trauma (such as a car accident), autoimmune diseases (such as rheumatoid arthritis) or infection. In most cases, ankle arthritis is due to the degeneration of the cartilage from an old injury.

If you have – or suspect you have – ankle arthritis, we can provide you with a complete diagnosis and a personalized treatment plan. Experience is crucial in treating ankle arthritis, and we see many patients with complicated foot and ankle conditions.

Ankle Arthritis Symptoms

Pain that may increase with activity
Stiffness or loss of mobility
Swelling
Deformity of the ankle

Ankle Arthritis Diagnosis

So we can understand your condition, during your office visit:

We will take a complete history and conduct a physical examination to assess skin changes, the presence or absence of pulses and nerve sensations, the range of motion in your ankle, and the areas of discomfort.
We will take X-rays to evaluate your degree of arthritis and any associated ankle problem.
We may order further testing, such as a CT scan or MRI if we are considering surgery as an option.

Ankle Arthritis Treatments

Your individualized treatment plan is based on any previous treatments you have had, your current level of disability, the presence of other medical conditions, and our findings from your health history, exam and X-rays.

Non-Surgical Treatments

We always look at non-surgical treatments first, especially if you have never received any other treatments. Treatments can include:

Ankle bracing – Either a custom-made or pre-fabricated ankle brace will stabilize your ankle joint and provide support for your ankle.
Cortisone injections – Cortisone injected into the ankle can reduce pain and swelling during a flare-up.
Activity modifications – Limiting high-impact activities, such as running, jumping or court sports, or switching out high-impact activities for low-impact options may be an option for you.
Ice and anti-inflammatory medications – We may give you these as needed to decrease symptoms.

Surgery

Surgery is only considered if all appropriate non-surgery treatments have failed. The types of surgeries we do include:

Ankle fusion (arthrodesis) – This procedure can be done either inpatient or outpatient, depending on your condition. Ankle fusion fuses together the two bones that make up the ankle joint – the tibia and talus – to make one solid block of bone. Fusion is an excellent pain-reliving procedure for arthritic joints. It involves removing the cartilage from a joint so it grows into one bone, eliminating the pain of bones rubbing against each other. Fusion of the ankle does result in loss of approximately 75% of ankle motion, but some motion is kept through the joints underneath the ankle and into the mid-foot.
Total ankle joint replacement (arthroplasty) – This ankle joint replacement treatment utilizes the newest implants (prosthesis) available. The surgery is only appropriate for certain patients with ankle arthritis, but for the right candidate, it can be very successful in preserving function and providing excellent pain relief. We are one of the few health care providers to offer total ankle replacement to our patients, and our surgeons are highly experienced in this procedure.
Bone spur removal (debridement) – Arthritis can cause bone spurs to develop on the ankle joint, and removal of these bone spurs, either through an open ankle incision or through an ankle scope (arthroscopy), may relieve pain and improve range of motion.
Distraction arthroplasty – This is a new joint restoration technique that uses an external frame (applied surgically) placed around the outside of the leg to spread the surfaces of the ankle joint, to encourage new cartilage growth. This procedure maintains ankle motion and relieves pain.

Our surgeons will be happy to discuss the pros and cons of surgery, and to let you know if they think surgery is the best option for you.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Prepare for Ankle Replacement Surgery

in Ankle Injuries

Article featured on WebMD

After you’ve scheduled your ankle replacement surgery, you need to take some steps to make sure the operation goes smoothly. First, set up some time with your doctors to make a plan and get yourself ready:

Your primary care doctor.

It’s a good idea to get a physical exam to make sure you’re healthy enough to have surgery. This is especially important if you have long-term health conditions, such as diabetes.

Your physical therapist.

They’ll measure how well your ankle works before surgery. This will help them check your progress as your joint heals and you start to move again. They can teach you how to use the crutches or walker you’ll need to get around after the operation, too.

Your anesthesiologist.

They are the doctor who will keep you pain-free during surgery. Usually you meet with them on the day of your operation. They’ll explain the type of anesthesia they’ll use and will ask you if you’ve had any bad reactions in the past.

Get Your Body Ready

You might need to do some things that will let you heal quickly:

If you smoke, stop. It hurts your heart and blood vessels and will make your recovery time longer.
Changes in medication . If you take blood thinners or anticoagulants, your doctor will discuss when to stop taking them before having surgery. These include anti-inflammatory pain relievers like aspirin and ibuprofen. They can cause extra bleeding if you take them too close to surgery.
Tell your surgeon about other prescription and over-the-counter drugs that you take. You might need to temporarily stop them or take an alternative treatment.
Watch for illness. If you get sick or have symptoms of infection in the week before surgery, let your doctor know right away.
Keep clean. Stick to any directions you’re given for showering or bathing before surgery. Your surgeon might ask you to wash with a special soap that kills the bacteria on your skin.

Prepare Your Home for Recovery

You won’t be able to walk for a period of time after surgery. Before you go to the hospital, you can make your home a safe place to recover by following these tips:

Prepare for “one-floor” living. If you have a multi-level home, make arrangements to spend your time on the first floor while you recover so you aren’t climbing stairs. This may mean moving furniture so you have a place to sleep.
Get rid of tripping hazards. Pack away throw rugs, and move any cords or other obstacles on the floor.
Bathroom changes. Get a chair for your tub or shower so you can bathe safely.
Keep must-have items handy. Throughout your home, put things you use often within easy reach. Set them in places where you don’t need to bend over or reach up to get to them.
Arrange for help. Make sure someone will be with you for at least the first few days after surgery. You’ll need to stay off your feet and keep your ankle elevated. Your surgeon will tell you how long.

Going to the Hospital

Don’t eat or drink after midnight the evening before your surgery.

Don’t wear any makeup or jewelry to the hospital. Pack a small bag to bring with you, though. Your surgeon might give you a list of suggested items to pack. These might include:

Insurance information
A copy of your advance medical directives and medical history
Medicines you regularly take
Personal care items, such as your toothbrush and hairbrush
Comfortable clothing to wear home, including shorts or pants that are very loose around the ankles

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Ankle Sprain Rehab Exercises to Get You Back on Your Feet

in Ankle Injuries

Article featured on verywellfit

One of the most common sports injuries, an ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn as the ankle joint and foot is turned, twisted, or forced beyond its normal range of motion.

If you suspect an ankle sprain, there are things you can do immediately after being injured to protect your ankle. Once the initial injury begins to heal, use exercises to rehabilitate your ankle and get back to the activities you love.

Ankle Sprain Causes and Grades

The most common cause of an ankle sprain in athletes is a missed step or a missed landing from a jump or fall. Ankle sprains vary in severity and are classified by the degree of severity:

Grade I: Stretch and/or minor tear of the ligament without laxity (loosening)
Grade II: Tear of ligament plus some laxity
Grade III: Complete tear of the affected ligament (very loose)

For immediate relief, you can use the R.I.C.E. treatment plan: rest, ice, compression, and elevation.1 While there is general agreement that the best approach to an ankle sprain is immediate rest, there is some conflicting advice about what comes next.

Until definitive answers are available, the following approach is still the most widely recommended:

Rest: Avoid weight bearing for 24 hours, or longer for a severe sprain. You may need to use crutches.
Ice: Apply ice (bagged, crushed ice wrapped in a thin towel) to the ankle joint. To avoid frostbite, ice should not be left in the area longer than 20 minutes at a time. Ice for 20 minutes every two hours for the first 24 hours to control swelling.
Compression: Wrap the ankle with an elastic bandage (start at the toes and wrap up to the calf) to help prevent swelling and edema.
Elevation: Raise the ankle above the hip or heart to reduce swelling.

If the swelling doesn’t subside in 48 to 72 hours, or if you are unable to bear weight on the injured ankle within 48 hours, seek medical treatment for a complete evaluation.

Ankle Sprain Rehab

After the initial 24 to 48 hours of rest and icing, slowly begin bearing weight over several days as tolerated. Avoid full weight bearing during this phase. Gradually progress to full weight bearing. Try to use a normal heel-toe gait.

Start doing rehabilitation exercises as soon as you can tolerate them without pain. Range of motion (ROM) exercises should be started early in the course of treatment. Gradual progression to other weight-bearing exercises should follow shortly after.

Assessment of the Ankle Joint

After an ankle injury, the joint should be assessed for misalignment or structural defects caused by the sprain. A physician will check the joint and test for weakness or deficits in soft tissues (tendons, ligaments, and cartilage).

Your injury may require taping or bracing. If a fracture or dislocation is suspected, an MRI or an X-ray will confirm the diagnosis and determine the most appropriate treatment.

Any ankle injury that does not respond to treatment in one to two weeks may be more serious. Consult a physician for a thorough evaluation and diagnosis.

Types of Rehab Exercises

Specific exercises are prescribed to help restore ankle stability and function. These exercises are progressive (they should be done in order) and are generally prescribed for range of motion, balance, strength, endurance, and agility.

Range of motion (flexibility) exercises
Progressive strength exercises
Balance (proprioception) exercises
Progressive endurance exercises
Agility (plyometric) exercises

The following exercises can be used to rehab a Grade I ankle sprain. If your sprain is more severe, you should follow the plan prescribed by your physician and physical therapist. Your physical therapist can design the best program for your specific injury and your limitations.

Flexibility and Range of Motion Exercises

As soon as you can tolerate movement in the ankle joint and swelling is controlled, you can begin gentle stretching and range of motion exercises of the ankle joint.

Towel stretch: The towel stretch is a simple and effective way to improve the flexibility of your calf muscles. While seated on the floor, simply wrap a towel around the ball of the foot and gently pull the towel so the toes and ankle flex up.
Standing calf stretch: Stretching your calf muscles is important to help loosen the muscles and prevent further injury. While facing a wall, place one leg behind. Lean toward the wall until you feel a slight stretch in the calf of your extended leg.
Achilles soleus stretch: Slowly stretching your Achilles tendon can help you prevent injury and keep the tendon flexible. To stretch your tendon, stand an arm’s length away from the wall and place one leg back. Keeping the leg slightly bent at the knee, slowly lean forward and press your heel to the floor.
Toe circles: Move your ankle through its entire range of motion—up and down, in and out, and in circles. Move only the ankle and not the leg.
Alphabet exercise: With your leg extended, try to write the alphabet in the air with your toes.

Strengthening and Endurance Exercises

Once you have a good range of motion, joint swelling is controlled, and pain is managed, you can begin strengthening exercises.

Step-ups: Begin on a short step and slowly step up in a controlled manner while focusing on contracting the muscles of the foot, ankle, and leg. Turn around and slowly step down in the same manner. Repeat 20 times, several times per day.
Towel curls: To perform a towel curl, you will need to be seated and barefoot. Place a small towel on a smooth surface in front of you. Grab the towel with your toes. Keep your heel on the ground and curl your toes to scrunch the towel as you bring it toward you. Let go and repeat until you’ve moved the towel to you. Then, do the action in reverse to push the towel away from you. Repeat 10 times, several times a day.
Isometric exercises: Gently push against an immovable object in four directions of ankle movement—up, down, inward, and outward. Hold for 5 seconds. Repeat 10 times, several times a day.
Tubing exercises: Use elastic tubing to create gentle resistance. Wrap the elastic band around the ball of the injured foot and resist the band as you move your ankle up, down, inward, and outward. These exercises incorporate the four movements of the foot: inversion, eversion, plantar flexion, and dorsiflexion. Perform three sets of 15 repetitions for each movement and repeat several times a day to build endurance.
Toe raises: Stand with your heel over the edge of a step. Raise up on the ball of your foot, hold for 3 seconds, and slowly lower your heel to the starting position. Perform 20 repetitions several times a day.
Heel and toe walking: Walk on your toes for 30 seconds. Switch and walk on your heels for 30 seconds. Build up to 1 minute on toes and heels alternating for 5 to 10 minutes. Perform several times per day.

Proprioception Exercises

After you are able to place your full weight on the injured ankle without pain, you may begin proprioceptive training to regain balance and control of the ankle joint.

One-leg balance: Try to stand on one leg for 10 to 30 seconds. Increase the intensity by doing this with your eyes closed.
One-leg squat: Stand on the affected leg with your foot pointing straight ahead and the knee of the other leg slightly bent. Extend your arms for balance if necessary. Lift the non-supporting foot slightly off the floor and lower to a squat position.
Balance board ball toss: While balancing on a wobble board, balance board, or BOSU, catch and toss a small (5-pound) medicine ball with a partner.
Balance board with half-squats: While balancing on a wobble board, perform 10 slow, controlled half-squats.
Step up onto balance board: Place a balance board (or soft pillow or foam pad) 6 to 8 inches higher than your starting point. Step up 10 times.
Step down onto balance board: Place a balance board (or soft pillow or foam pad) 6 to 8 inches lower than your starting point. Step down 10 times.
One-leg squat and reach: Stand on the affected leg and raise the other leg slightly. As you squat, reach toward the floor with the hand opposite your standing leg.

Agility Exercises

Once you have regained balance, strength, and control, you can begin working on agility.

Lateral step up and down: Step up sideways to a step bench and then step down sideways.
Plyometric exercises: These can include single-leg hops (hop forward and concentrate on “sticking” the landing), single-leg spot jumps (hop from spot to spot on the floor), or reactive spot jumps (place numbered pieces of tape on the floor and as a partner calls out a number, hop to that number).
Sport-specific skills and drills: Sport-specific drills can be added as long as return to sports guidelines are followed.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Recovery from an Ankle Sprain

in Ankle Injuries

Article featured on Harvard Health Publishing

All it takes is a simple misstep, and suddenly you have a sprained ankle. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. Many people try to tough out ankle injuries and don’t seek medical attention. But if an ankle sprain causes more than slight pain and swelling, it’s important to see a clinician. Without proper treatment and rehabilitation, a severely injured ankle may not heal well and could lose its range of motion and stability, resulting in recurrent sprains and more downtime in the future.

Anatomy of an ankle sprain

The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle — the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. (Ligaments are bands of fibrous tissue that connect bone to bone; see illustration.)

Ankle ligaments

ankle-ligaments

Less common are sprains affecting the ligaments of the inner ankle (medial ankle sprains) and syndesmotic sprains, which injure the tibiofibular ligaments — the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle. Syndesmotic sprains, which occur most often in contact sports, are especially likely to cause chronic ankle instability and subsequent sprains.

The severity of an ankle sprain depends on how much damage it does and how unstable the joint becomes as a result. The more severe the sprain, the longer the recovery (see “Grades of ankle sprain severity”).

Grades of ankle sprain severity
Severity	Damage to ligaments	Symptoms	Recovery time
Grade 1	Minimal stretching, no tearing	Mild pain, swelling, and tenderness. Usually no bruising. No joint instability. No difficulty bearing weight.	1–3 weeks
Grade 2	Partial tear	Moderate pain, swelling, and tenderness. Possible bruising. Mild to moderate joint instability. Some loss of range of motion and function. Pain with weight bearing and walking.	3–6 weeks
Grade 3	Full tear or rupture	Severe pain, swelling, tenderness, and bruising. Considerable instability and loss of function and range of motion. Unable to bear weight or walk.	Several months

Immediate ankle sprain treatment

The first goal is to decrease pain and swelling and protect the ligaments from further injury. This usually means adopting the classic RICE regimen — rest, ice, compression, and elevation. If you have severe pain and swelling, rest your ankle as much as possible for the first 24–48 hours. During that time, immerse your foot and ankle in cold water, or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15–20 minutes three to five times a day, or until the swelling starts to subside.

To reduce swelling, compress the ankle with an elasticized wrap, such as an ACE bandage or elastic ankle sleeve. When seated, elevate your ankle as high as you comfortably can — to the height of your hip, if possible. In the first 24 hours, avoid anything that might increase swelling, such as hot showers, hot packs, or heat rubs. Nonsteroidal anti-inflammatory drugs such as ibuprofen can help reduce pain and swelling and may also speed recovery.

Ankle sprain medical evaluation

Unless your symptoms are mild or improving soon after the injury, contact your clinician. He or she may want to see you immediately if your pain and swelling are severe, or if the ankle feels numb or won’t bear weight. He or she will examine the ankle and foot and may manipulate them in various ways to determine the type of sprain and the extent of injury. This examination may be delayed for a few days until swelling and pain improve; in the meantime, continue with the RICE regimen.

X-rays aren’t routinely used to evaluate ankle injuries. Ligament problems are the source of most ankle pain, and ligaments don’t show up on regular x-rays. To screen for fracture, clinicians use a set of rules — called the Ottawa ankle rules, after the Canadian team that developed them — to identify areas of the foot where pain, tenderness, and inability to bear weight suggest a fracture. A review of studies involving more than 15,000 patients concluded that the Ottawa rules identified patients with ankle fractures more than 95% of the time.

Ankle sprain functional treatment

To recover from an ankle sprain fully, you’ll need to restore the normal range of motion to your ankle joint and strengthen its ligaments and supporting muscles. Studies have shown that people return to their normal activities sooner when their treatment emphasizes restoring ankle function — often with the aid of splints, braces, taping, or elastic bandages — rather than immobilization (such as use of a plaster cast). Called functional treatment, this strategy usually involves three phases: the RICE regimen in the first 24 hours to reduce pain, swelling, and risk of further injury; range-of-motion and strengthening exercises within 48–72 hours; and training to improve endurance and balance once recovery is well under way.

Generally, you can begin range-of-motion and stretching exercises within the first 48 hours, and should continue until you’re as free of pain as you were before your sprain. Start to exercise seated on a chair or on the floor. As your sprained ankle improves, you can progress to standing exercises. If your symptoms aren’t better in two to four weeks, you may need to see a physical therapist or other specialist.

Exercises to help restore function and prevent injury

Range-of-motion, stretching, and strengthening: First 1–2 weeks

Flexes. Rest the heel of the injured foot on the floor. Pull your toes and foot toward your body as far as possible. Release. Then point them away from the body as far as possible. Release. Repeat as often as possible in the first week.

Ankle alphabet. With the heel on the floor, write all the capital letters of the alphabet with your big toe, making the letters as large as you can.

Press down, pull back. Loop an elasticized band or tubing around the foot, holding it gently taut (A). Press your toes away and down. Hold for a few seconds. Repeat 30 times. Tie one end of the band to a table or chair leg (B). Loop the other end around your foot. Slowly pull the foot toward you. Hold for a few seconds. Repeat 30 times.

Ankle eversion. Seated on the floor, with an elasticized band or tubing tied around the injured foot and anchored around your uninjured foot, slowly turn the injured foot outward. Repeat 30 times.

Ankle inversion. Seated on the floor, cross your legs with your injured foot underneath. With an elasticized band or tubing around the injured foot and anchored around your uninjured foot, slowly turn the injured foot inward. Repeat 30 times.

Stretching and strengthening: Weeks 3–4

Standing stretch. Stand one arm’s length from the wall. Place the injured foot behind the other foot, toes facing forward. Keep your heels down and the back knee straight. Slowly bend the front knee until you feel the calf stretch in the back leg. Hold for 15–20 seconds. Repeat 3–5 times.

Seated stretch. Loop an elasticized band or tubing around the ball of the foot. Keeping the knee straight, slowly pull back on the band until you feel the upper calf stretch. Hold for 15 seconds. Repeat 15–20 times.

Rises. Stand facing a wall with your hands on the wall for balance. Rise up on your toes. Hold for 1 second, then lower yourself slowly to the starting position. Repeat 20–30 times. As you become stronger, do this exercise keeping your weight on just the injured side as you lower yourself down.

Stretches. Stand with your toes and the ball of the affected foot on a book or the edge of a stair. Your heel should be off the ground. Use a wall, chair, or rail for balance. Hold your other foot off the ground behind you, with knee slightly bent. Slowly lower the heel. Hold the position for 1 second. Return to the starting position. Repeat up to 15 times, several times a day. This exercise can place a lot of stress on the ankle, so get your clinician’s go-ahead before trying it.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

Treating Ankle Injuries

in Ankle Injuries, Foot Pain

Article featured on UCSF Health

Ankle sprains are the most common ankle injury among regular athletes and weekend warriors. The top orthopedic complaint, sprains occur in an estimated 27,000 Americans a day.

Many athletes, however, who suffer from ankle sprains tend to play right through their injury, which can lead to lifelong problems with recurring sprains, unstable joints, arthritis-like pain or other complications like tendon or cartilage damage. And the earlier in life a sprain occurs, the higher the chance of recurrence. Therefore, it’s important to properly treat initial sprains, especially in young athletes.

If you sprain your ankle and it hurts to run, you should sit out the rest of the game. Once a sprain has occurred, follow these three steps to help you recover:

Step 1: RICE

Follow the instructions represented by the acronym RICE as often as possible for three days. RICE stands for rest, ice, compression (with an elastic ankle wrap) and elevation (toes above the nose). For significantly swollen ankles or if limping persists for more than three days, you should see a doctor.

Step 2: Rehabilitation

To prevent permanent damage to the ankle, take steps to achieve better range of motion (flexibility), balance and strength. Many of these exercises can be done at home.

Range of motion exercise

Place one foot on a stairway step. Allow the back heel to stretch downward over the edge of the step. Hold each foot in this position for 30 seconds.

Balance restoration exercise

Stand on one leg with your eyes closed. Gradually build up to standing 30 seconds on each leg. Repeat three times.

Strength exercise

Lie on your side on the sofa, with the upper leg hanging over the edge. Place the top of your foot through the handles of a plastic shopping bag filled with one to two pounds of weight (one or two cans of soup). Slowly lift your toes toward the ceiling and hold for three seconds. Repeat 10 times.

Step 3: Supportive devices

When back to playing sports, previously injured athletes should probably wear an ankle brace, no matter how much they have rehabilitated their ankle or how good their sneakers. An injured ankle will never have the same support again, so a brace should be considered.

Step 4: If pain continues

For ankle pain and significant instability that persists despite adequate rehabilitation or physical therapy, you should see a doctor for further evaluation. You may have injured the cartilage or tendons in your ankle, which may require special testing.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm