Foot and ankle

Ankle Sprains, Plantar Fasciitis, Tarsal Tunnel Syndrome

ANKLE SPRAINS:

An ankle sprain is an injury to one or more of the ligaments in the ankle. The ligaments are structures that control excessive movement of the joint.

The most common type of ankle sprain occurs when the foot is inverted (turns inward). When this occurs, the outer ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) are stretched too far.

Common symptoms associated with an ankle sprain are pain, swelling and bruising. The degree of symptoms tends to correlate with the extent of the damage to these ligaments:

  • Grade I sprain: The ligaments are often over-stretched and slightly damaged. The ligament damage occurs without any significant instability of the ankle developing.
  • Grade II sprain: The ligaments have been significantly damaged and partially torn but there is no significant instability.
  • Grade III sprain: This indicates that the ligament has been significantly damaged, and that instability has resulted. A grade III injury means that the ligament has been torn.

 

PLANTAR FASCIITIS:

Plantar fasciitis is the most common cause of heel pain. The plantar fascia is the flat band of tissue that connects the heel bone to the toes. It supports the arch of the foot.  If the plantar fascia is injured, it can become swollen and irritated.

Plantar fasciitis is caused by straining the ligament that supports the arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if:

  • Feet pronation (rolling too much inward) when walking
  • Having high arches or flat feet
  • Decreased mobility of the big toe
  • Walking, standing, or running for long periods of time
  • Being overweight
  • Wearing shoes that don’t fit well or are worn out
  • Having tight Achilles tendons or calf muscles

Most people with plantar fasciitis have pain when they take their first steps, get out of bed or sit for a long period of time.  Stiffness and pain usually improve after taking a few steps.

 

TARSAL TUNNEL SYNDROME:

Tarsal Tunnel Syndrome (TTS), also known as posterior tibial neuralgia, is a compression mononeuropathy.  It is a painful foot condition in which the tibial nerve is compressed as it travels through the tarsal tunnel.  This tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). The posterior tibial artery, tibial nerve, and the tendons of multiple ankle and foot muscles travel in a bundle through the tarsal tunnel.

Common causes of TTS include:

  • Direct trauma
  • Pressure on the nerve for a long period of time causing entrapment
  • Flat feet

Symptoms of TTS may include:

  • Sensation changes in the bottom of the foot and toes including pain, numbness and tingling, burning or other abnormal sensations.
  • Weakness of ankle, foot, and toe muscles
  • Inability to curl the toes, push the foot down, or twist the ankle inward
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