What is an Ankle Replacement?

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Article featured on Mercy Health

What is an ankle replacement?

Arthroplasty — or ankle joint replacement surgery — is a procedure doctors offer to patients who suffer from arthritis in the ankle. The surgery replaces the ankle joint with an artificial one. This preserves range of motion while reducing pain.

Your doctor may recommend an ankle replacement if other conservative treatments aren’t working. Surgery is usually the last option because it has risks and requires a long recovery. Before opting for surgery, your doctor may try bracing, physical therapy, steroid injections or anti-inflammatory medications.

What to expect from ankle replacement surgery

Ankle joint replacement surgery is a major surgery that requires a hospital stay of two to three days or more. It may take longer for you to be able to walk on crutches or with a walker.

You’re either completely asleep under general anesthesia or numb from an injection during the surgery. Your doctor makes an incision in your skin above the ankle and moves soft tissues out of the way to get to the bone.

The surgeon cuts and removes the bottom of the tibia and the top of the talus. Screws attach the artificial joint in place. Your doctor will realign bones or correct deformities while working on your ankle if necessary.

After surgery, your doctor closes the incision with stitches or staples. Then he puts your ankle in a cast.

Recovery takes several weeks. Avoid putting weight on your ankle until your doctor confirms with x-rays that you’ve healed enough. You can work with a physical therapist to strengthen your muscles and improve range of motion.

Common conditions ankle replacement surgery

Doctors use ankle joint replacement surgery to treat arthritis in the ankles. Your ankle joints have cartilage between the bones that act as a cushion. Arthritis causes the cartilage to wear down. This causes the bones to rub against each other. Other reasons cartilage might wear out and cause your joints to fail are:

  • Infection
  • Wear and tear
  • Ankle fractures
  • Trauma to the ankle

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

Causes of Ankle Popping and Clicking

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Article featured on Orthopedic Institute of Pennsylvania

No matter your age, you might have heard a crackle or pop in your joints when sitting down, standing up or simply walking. Luckily most popping cases are not detrimental to your physical health. However, if left untreated, they could cause mobility complications.

Medically, popping in your joints is known as crepitus. If you’re experiencing a bout of crepitus, it could be from overworking your joints through exercise or stiffness in the joints after a long period of inactivity. While these causes may sound contradictory, it’s how our bodies adapt to certain stimuli — or lack thereof.

Why Does My Ankle Keep Popping?

Ankle popping on its own is very common. If your popping ankle isn’t painful, it is likely caused by a gas release or tendon rubbing. However, if it is accompanied by pain or swelling, there may be an underlying cause.

The most common causes of ankle clicking or popping include:

  • Gas release: Every time your ankle moves, the joint capsule filled with lubrication fluid is stretched. The fluid in the capsule can contain bubbles of nitrogen that can pop when you move, causing a loud popping sound — similar to when you pop your knuckles in your hand. Tight muscles can also contribute to gas buildup in the fluid, especially after inactivity like sleeping or binging a TV show. This is normal and does not signify an underlying cause.
  • Tendon slip: The peroneal tendons in the lower outside of your leg work to stabilize the ankle joint. Sometimes, these tendons slip from the muscle surrounding them, resulting in a snapping sound or feeling. A recent ankle injury could increase the ankle popping frequency. This is also common and not a cause of concern unless it is painful.

Less common reasons that may signify an underlying health condition include:

  • Tendon dislocation: The peroneal muscles surrounding the tendons can be pushed from their usual location, causing popping and snapping sounds in your ankle every time you move. This can happen during an ankle sprain. The inflammation, swelling and pain that occurs will need medical attention.
  • Osteochondritis dissecans: This condition causes a small segment of bone to separate and causes the cartilage in the ankle joint to wear away. This cracking sound could be painful after a lot of movement, like walking or running.
  • Osteochondral lesion: Lesions can form on the cartilage on the ends of your joint bones. Clicking and locking the ankle can occur, limiting the range of motion and causing swelling.
  • Ankle osteoarthritis: Osteoarthritis refers to a joint deterioration similar to osteochondritis with the wearing down of joint cartilage over time. While most common in the knees, it can also occur in the ankle.
  • Peroneal tendon injury: The peroneal tendons that may slip to make a cracking noise can also become injured.

Prevention and Remedies of Ankle Popping and Cracking

You can do several exercises at home to strengthen your popping ankles. These stretches both prevent ankle popping and reduce cracking sounds that already exist.

Ankle Circles

Performing ankle circles can warm up your joints and increase mobility. You can do this exercise from a seated or lying position:

  1. Sit or lay with your legs stretched out front. Prop your leg on a stable surface with the ankle hanging off the edge.
  2. Rotate your foot in clockwise circles 10 times with your ankle.
  3. Switch to counterclockwise circles 10 more times.
  4. Swap feet and repeat with the other ankle.

Towel Stretches

Relieve tight ankles with these simple towel stretches you can do at home:

  1. Sit on a flat surface with your legs straight out in front of the body.
  2. Loop a towel horizontally around the sole.
  3. Gently pull the towel ends toward the body, stretching the foot.
  4. Hold this position for 20 seconds.
  5. Repeat as needed.

Calf Raises

Strengthen your calf muscles to reduce pressure on the ankles in motion.

  1. Stand on the edge of a platform or the bottom stair step with the heels hanging off.
  2. Slowly rise onto the toes, driving the body fully upward with the calves.
  3. Let the heels gently fall, stretching slightly below the ledge.
  4. Repeat 10 times.

When to See a Doctor

When your ankle popping begins to cause discomfort or pain, consider getting a proper diagnosis from a doctor. They may order tests like an MRI or CT scan to look inwardly at the bone and cartilage.

If you recently had an ankle injury, rest is a major proponent of healing. A doctor may recommend anti-inflammatory medications to help with the pain and swelling.

A doctor can stabilize the ankle with a brace or orthotic to promote faster healing for more serious conditions. Physical therapy also works alongside any stabilization devices to slowly get your ankle back to regular functioning. If necessary, surgical options are available, including arthroscopy and total joint replacements.

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

Joints That Are Most Commonly Affected by Arthritis

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Article featured on Healthgrades

Arthritis is a long-term (chronic) condition that causes joint inflammation. When you’re living with arthritis, a simple task, such as tying your shoe or buttoning your shirt can become a challenging one. Not only does the swelling and aching interfere with work and daily living activities, it can also be painful and sometimes debilitating.

There are more than 100 different types of arthritis, but the most common include rheumatoid arthritis (an autoimmune disease) and osteoarthritis (a “wear-and-tear” condition related to aging, injury or obesity). Both cause joint stiffness, pain and decreased range of motion, and can affect many different joints throughout the body.

1. Knee

The knee is one of the most common joints affected by osteoarthritis. This happens when there’s a breakdown of cartilage, which cushions the ends of the bones where they meet the joints. Symptoms of knee arthritis include stiffness, swelling, and pain, which can make it hard to walk and get in and out of chairs and bed. In severe cases, osteoarthritis in the knees can lead to disability.

2. Hand

When you have arthritis in your hands, it usually includes aching, stiffness or numbness in the fingers or at the base of the thumb joint, making it difficult to pinch or grip items. Small, bony knobs may appear on the middle or end joints (those closest to the fingernails) of the fingers, which can become enlarged and gnarled. This type of arthritis in the hands seems to run in families.

3. Hip

The hip is also a common arthritis site. You may have pain and stiffness in your hip joint, but some people also notice pain in the groin, buttocks, lower back, or front or inner thigh. Or they may have pain in only one of these areas. This type of hip arthritis can affect your ability to move or bend, and make daily activities a challenge.

4. Spine, Neck and Back

Arthritis in the spine usually results in stiffness and pain in the neck or lower back, but in some cases, it may not lead to any pain at all. Arthritis changes can also cause pressure on the nerves where they exit the spinal column, leading to weakness, tingling or numbness of the arms and legs. Since these symptoms can often seem like other health conditions, always check with your doctor for a diagnosis.

5. Foot and Ankle

Arthritis can also cause swelling and pain in the foot and ankle. It most often affects the joint at the base of the big toe, which can make walking difficult. The swelling can also lead to bunions on the toes, which can sometimes make the pain and deformity of the foot worse. With rheumatoid arthritis, the same joints on both sides of the body (such as both feet or both ankles) are usually affected.

6. Elbow

Joint inflammation can also be to blame for elbow pain or loss of function. Rheumatoid arthritis is the most common type of arthritis in the elbow, and if one elbow is affected, the other likely will be, too. While elbow osteoarthritis is more common in weight-bearing joints, such as the knee and hip, it can also occur in the elbow, and is often the result of overuse or an injury, such as in the case of a tennis or baseball player.

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

Foot or Ankle Fractures & Dislocations

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Article featured on Mercy Health

Causes of foot or ankle fractures or dislocations

A foot or ankle fracture or dislocation can be caused by a variety of factors. Some of these include:

  • An acute injury caused by direct force like a fall, car accident or a sporting accident
  • Overuse or repeated movements that wear down the musculoskeletal tissues

Risk factors for foot or ankle fractures and dislocations

Risk factors for fractures and dislocations are:

  • Foot or ankle fractures and dislocations are most common in high impact or extreme sports such as downhill skiing, football, basketball, soccer or rugby
  • Jobs and sports (such as running) that require repetitive movements lead to a higher risk for stress fractures

Symptoms of foot or ankle fractures or dislocations

The most obvious symptoms of a foot or ankle fracture or dislocation are severe pain, swelling and bruising.

Other symptoms of foot or ankle fractures and dislocations include:

  • Misaligned foot or ankle
  • Numbness to the impacted area
  • Loss of use of the injured area
  • Muscle spasms around the injured area

Not all fractures or dislocations will cause the person to lose mobility. Contact your orthopedic physician if you suspect you have a fracture or dislocation or you have several of the above symptoms. The longer you wait to see a physician, the longer the healing process will be.

Stress fractures are more challenging to self-diagnose because they can be caused by minor injuries and can be mistaken as a sprain or a strain .  If the pain does not subside in 3 – 5 days after a minor injury, schedule a consult with your physician.

Visit the emergency room immediately if the injury is severe and multiple body parts have been impacted.

Diagnosis of foot or ankle fractures or dislocations

A foot or ankle fracture or dislocation is diagnosed under the care of your orthopedic or sports medicine provider.

Typically, the physician will order an x-ray to identify the fracture. In more severe cases, your orthopedic physician will order an MRI (magnetic resonance imaging) or CT (computed tomography) scan.

Treatment for foot or ankle fractures or dislocations

After suffering a fracture or dislocation apply pressure to the impacted foot or ankle, splint the area, and call for a medical appointment as soon as possible.

  • Surgical realignment
  • Splint/Brace
  • Cast

Recovery from foot or ankle fractures or dislocations

Recovering from a fractured or dislocated foot or ankle can take anywhere from 6 weeks to more than a year depending on the severity of the injury. Staying off the ankle and rest are crucial in allowing you to heal as quickly as possible.

It is important to follow your physician’s recommendations for recovery including follow up visits and x-rays of the injured area.

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

Simple Ankle Fractures Explained

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Article featured on Foot Health Facts

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

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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

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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

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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?

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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

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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