This is a very common question. If you sustain a foot or ankle injury, you should seek immediate treatment from a podiatrist. However, you can take several steps to treat the injury until you can receive medical attention.
*Stop exercising or walking on the injured foot. The idea of "working through the pain" or "letting it resolve on its own" does not apply when it comes to foot and ankle injuries! Continuing to put pressure on an injured foot or ankle can be disastrous if there is a fracture or tendon rupture.
*Gently place a plastic bag of ice on the injured area for 20 minutes each hour. It helps to put a towel between the ice bag and the skin to prevent skin damage. Do not place the ice directly on the skin even if it feels numb and does not "burn." If there is nerve damage or a lot of swelling, you may not feel the normal sensations of the skin. So it's important to know this before an injury occurs so that you are well prepared if one does happen.
*Lightly wrap an elastic bandage around the area, taking care not to pull it too tight. If it's too tight, you will notice numbness or tingling sensations in the toes and color changes in the toes. If either of these occur, the bandage is too tight and will need to be removed and rewrapped.
*Elevate your foot so that it is higher than your waist. Ideally, elevate it so that it is level with your heart, but if you can't do that, then the waist is next best. What you want to avoid is more swelling, and keeping your foot dangling down will increase swelling and pain.
*For bleeding injuries, clease well, apply pressure with gauze or a towel and cover with a clean dressing. Just use basic first aid common knowledge here. But one thing you can do for your doctor is to not apply colored antiseptics that stain the skin, such as mercurochrome, to your wounds before arriving at your doctor's office. It makes it difficult for us to evaluate the skin when it's stained dark purple or hot pink!
*Put on a soft shoe or slipper that can accommodate a bulky dressing. Common sense, I know, but some patients have arrived at my office in the past with a swollen foot or ankle squeezed into a tight shoe, limping, and wondering why it hurts so much!
Most importantly, NEVER ignore a foot or an ankle injury, no matter how minor it may seem! The pain from an injury could cause you to favor the injured limb, resulting in permanent knee and back problems.
Thursday, April 23, 2009
Friday, April 3, 2009
Who Knew Madonna's Ankle Would Make the News?
It's no "Holiday" for Madonna today!
It has been reported that Madonna, 50, fell off of her treadmill that she had flown to Maslawi and sprained her ankle yesterday. She was "writhing in agony" so much so that she had to postpone her planned tour of African orphanages. She is resting and nursing her ankle at this time. Let's hope she has a great podiatrist in Africa who can x-ray her ankle to check for a fracture or a displacement!
We've all heard of RICE treatment for ankle injuries, right? If not, here is a quick crash course for you!
RICE THERAPY:
RICE stands for the most important elements of treatment for many injuries---rest, ice, compression, and elevation.
Rest:
Stop using the injured part as soon as you realize that an injury has taken place. Use crutches to avoid bearing weight on injuries of the foot, ankle, knee, or leg. Use splints for injuries of the hand, wrist, elbow, or arm. Continued exercise or activity could cause further injury, increased pain, or a delay in healing.
Ice:
Ice helps stop bleeding from injured blood vessels and capillaries. Sudden cold causes the small blood vessels to contract. This contraction decreases the amount of blood that can collect around the wound. The more blood that collects, the longer the healing time. Ice can be safely applied in many ways:
* For injuries to small areas, such as a finger, toe, foot, or wrist, immerse the injured area for 15 to 35 minutes in a bucket of ice water. Use ice cubes to keep the water cold, adding more as the ice cubes dissolve.
* For injuries to larger areas, use ice packs. Avoid placing the ice directly on the skin. Before applying the ice, place a towel, cloth, or one or two layers of an elasticized compression bandage on the skin to be iced. To make the ice pack, put ice chips or ice cubes in a plastic bag or wrap them in a thin towel. Place the ice pack over the cloth. The pack may sit directly on the injured part, or it may be wrapped in place.
* Ice the injured area for about 30 minutes.
* Remove the ice to allow the skin to warm for 15 minutes.
* Reapply the ice.
* Repeat the icing and warming cycles for 3 hours. Follow the instructions below for compression and elevation. If pain and swelling persist after 3 hours call our office. You may need to change the icing schedule after the first 3 hours. Regular ice treatment is often discontinued after 24 to 48 hours. At that point, heat is sometimes more comfortable.
Compression:
Compression decreases swelling by slowing bleeding and limiting the accumulation of blood and plasma near the injured site. Without compression, fluid from adjacent normal tissue seeps into the injured area.
To apply compression safely to an injury:
* Use an elasticized bandage (Ace bandage) for compression, if possible. If you do not have one available, any kind of cloth will suffice for a short time.
* Wrap the injured part firmly, wrapping over the ice. Begin wrapping below the injury site and extend above the injury site.
* Be careful not to compress the area so tightly that the blood supply is impaired. Signs of deprivation of the blood supply include pain, numbness, cramping, and blue or dusky nails. Remove the compression bandage immediately if any of theses symptoms appears. Leave the bandage off until all signs of impaired circulation disappear. Then rewrap the area--less tightly this time.
Elevation:
Elevating the injured part above the level of the heart is another way to decrease swelling and pain at the injury site. Elevate the iced, compressed area in whatever way is most convenient. Prop an injured leg on a solid object or pillows. Elevate an injured arm by lying down and placing pillows under the arm or on the chest with the arm folded across.
**The most important thing to remember with ankle injuries is to get to your podiatrist's office ASAP. Many patients think "it's just an ankle sprain; I don't need to go to the doctor. I can treat it myself." Then a few weeks to a few MONTHS later, those patients show up in our offices not understanding why their ankle is still painful and swollen. Often times there are fractures and other injuries associated with ankle sprains that can be overlooked by a family doctor or nurse practitioner.
I hope it helps, and I hope Madonna is reading!!! :)
Dr. Michele Colon, DPM, MS
It has been reported that Madonna, 50, fell off of her treadmill that she had flown to Maslawi and sprained her ankle yesterday. She was "writhing in agony" so much so that she had to postpone her planned tour of African orphanages. She is resting and nursing her ankle at this time. Let's hope she has a great podiatrist in Africa who can x-ray her ankle to check for a fracture or a displacement!
We've all heard of RICE treatment for ankle injuries, right? If not, here is a quick crash course for you!
RICE THERAPY:
RICE stands for the most important elements of treatment for many injuries---rest, ice, compression, and elevation.
Rest:
Stop using the injured part as soon as you realize that an injury has taken place. Use crutches to avoid bearing weight on injuries of the foot, ankle, knee, or leg. Use splints for injuries of the hand, wrist, elbow, or arm. Continued exercise or activity could cause further injury, increased pain, or a delay in healing.
Ice:
Ice helps stop bleeding from injured blood vessels and capillaries. Sudden cold causes the small blood vessels to contract. This contraction decreases the amount of blood that can collect around the wound. The more blood that collects, the longer the healing time. Ice can be safely applied in many ways:
* For injuries to small areas, such as a finger, toe, foot, or wrist, immerse the injured area for 15 to 35 minutes in a bucket of ice water. Use ice cubes to keep the water cold, adding more as the ice cubes dissolve.
* For injuries to larger areas, use ice packs. Avoid placing the ice directly on the skin. Before applying the ice, place a towel, cloth, or one or two layers of an elasticized compression bandage on the skin to be iced. To make the ice pack, put ice chips or ice cubes in a plastic bag or wrap them in a thin towel. Place the ice pack over the cloth. The pack may sit directly on the injured part, or it may be wrapped in place.
* Ice the injured area for about 30 minutes.
* Remove the ice to allow the skin to warm for 15 minutes.
* Reapply the ice.
* Repeat the icing and warming cycles for 3 hours. Follow the instructions below for compression and elevation. If pain and swelling persist after 3 hours call our office. You may need to change the icing schedule after the first 3 hours. Regular ice treatment is often discontinued after 24 to 48 hours. At that point, heat is sometimes more comfortable.
Compression:
Compression decreases swelling by slowing bleeding and limiting the accumulation of blood and plasma near the injured site. Without compression, fluid from adjacent normal tissue seeps into the injured area.
To apply compression safely to an injury:
* Use an elasticized bandage (Ace bandage) for compression, if possible. If you do not have one available, any kind of cloth will suffice for a short time.
* Wrap the injured part firmly, wrapping over the ice. Begin wrapping below the injury site and extend above the injury site.
* Be careful not to compress the area so tightly that the blood supply is impaired. Signs of deprivation of the blood supply include pain, numbness, cramping, and blue or dusky nails. Remove the compression bandage immediately if any of theses symptoms appears. Leave the bandage off until all signs of impaired circulation disappear. Then rewrap the area--less tightly this time.
Elevation:
Elevating the injured part above the level of the heart is another way to decrease swelling and pain at the injury site. Elevate the iced, compressed area in whatever way is most convenient. Prop an injured leg on a solid object or pillows. Elevate an injured arm by lying down and placing pillows under the arm or on the chest with the arm folded across.
**The most important thing to remember with ankle injuries is to get to your podiatrist's office ASAP. Many patients think "it's just an ankle sprain; I don't need to go to the doctor. I can treat it myself." Then a few weeks to a few MONTHS later, those patients show up in our offices not understanding why their ankle is still painful and swollen. Often times there are fractures and other injuries associated with ankle sprains that can be overlooked by a family doctor or nurse practitioner.
I hope it helps, and I hope Madonna is reading!!! :)
Dr. Michele Colon, DPM, MS
Thursday, March 26, 2009
Carpal Tunnel is Everywhere! What about Tarsal Tunnel?
What is Tarsal Tunnel Syndrome?
Tarsal Tunnel Syndrome is a compression of the tibial nerve, due to inflammation or other impingement, as it passes from the leg to the foot. This compression interferes with nerve impulses, causing pain and other neuropathy in the foot.
It is less common than carpal tunnel and is often times misdiagnosed.
What causes Tarsal Tunnel Syndrome?
There are many possible causes, inluding flatfeet, ganglion cysts, tumors, varicose veins, tendonitis, bone spurs, rheumatoid arthritis, diabetes, obesity, ankle injuries (ankle sprains, fractures, dislocations).
Treatment
Treatment includes rest, ice, anti-inflammatory medications, and immobilization. Physical therapy may be indicated as well. For more serious cases that do not respond to conservative treatment, injections, bracing, and/or surgery may be required.
Tarsal Tunnel Syndrome is a compression of the tibial nerve, due to inflammation or other impingement, as it passes from the leg to the foot. This compression interferes with nerve impulses, causing pain and other neuropathy in the foot.
It is less common than carpal tunnel and is often times misdiagnosed.
What causes Tarsal Tunnel Syndrome?
There are many possible causes, inluding flatfeet, ganglion cysts, tumors, varicose veins, tendonitis, bone spurs, rheumatoid arthritis, diabetes, obesity, ankle injuries (ankle sprains, fractures, dislocations).
Treatment
Treatment includes rest, ice, anti-inflammatory medications, and immobilization. Physical therapy may be indicated as well. For more serious cases that do not respond to conservative treatment, injections, bracing, and/or surgery may be required.
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