Definition and Overview
The feet are a perfect example of body parts that are most prone to strain, and, at one point or another, the strain can lead to foot injuries, which may affect any part of a foot, such as the toe, ankle, or sole. While most of these injuries cause pain and swelling, and can heal on their own, some can progress or worsen and cause other symptoms such as bleeding or infection. It is for this reason that each foot injury is treated differently depending on the cause, symptoms, and severity.
Cause of Condition
Foot injuries are caused by a wide variety of factors, such as:
- Wear and Tear
- Wrong type of footwear
- Ill-fitting shoes
- Work-related tasks
- Old age
Most athletes, especially gymnasts, basketball players, soccer players, and dancers face the highest risk of foot injuries, closely followed by older adults who have lower bone strength and muscle mass.
Foot injuries may affect a person in different ways and may cause different symptoms. The symptoms tend to differ depending on whether the injury is acute or chronic.
Acute injuries may cause:
- Bruises or contusions
- Injured ligaments
- Injured tendons or ruptured heel tendons
- Sprains or injured joints
- Strains or pulled muscles
- Fractures or broken bones
- Dislocation or when a bone in the foot moves out of its place
- Puncture wounds – These are caused by sharp objects such as nails, knives, needles, and so on. These are considered as more serious injuries because of the risk of infection, especially if the sharp object is dirty or rusty. The open wound also makes it easier for bacteria to enter the body.
- Compartment syndrome due to a crushing injury
Chronic injuries or those that develop over time due to wear and tear or overuse can lead to the following conditions:
- Plantar fasciitis or when the plantar fascia, a flat ligament at the bottom of the foot, becomes inflamed, causing pain in the arch area
- Metatarsalgia or when the front ball of the foot becomes painful
- Stress fracture or a crack in a bone
- Achilles tendinitis or when the soft tissues surrounding the Achilles tendon break down
- Tendinosis or tendinopathy
- Retrocalcaneal bursitis or when the bursa becomes inflamed, causing pain in the ankle and the back of the heel especially during certain activities
Who to See and Types of Treatments Available
Injuries that are minor usually heal on their own and do not require any professional treatment. Most of the time, home treatment methods are enough to relieve symptoms and speed up the body’s natural healing process. However, there is a fine line between foot injuries that can heal without treatment and those that require medical attention. It is important to know when to use home remedies and when to see a doctor. If the injury seems severe, it is best to perform first aid treatment and then arrange to see a doctor.
The best treatment for a foot injury depends heavily on the severity of the condition, but is also influenced by the location of the injury, the reason and time it occurred, the patient’s age and condition, and his activity level.
Minor injuries can be treated with first aid measures, such as putting a brace, cast, or splint to keep the foot steady and prevent further injury, while serious foot injuries may require orthotics devices, physical therapy, pain medications, or surgery. These treatments are provided by health professionals specializing in orthopedics and physical therapy.
First aid measures include:
- Controlling bleeding
- Removing any jewellery before the swelling intensifies
- Freeing the foot if trapped
- Bandaging the affected area
- Using rest, ice, compression, and elevation or R.I.C.E. to relieve pain and swelling
- Protecting the skin with a soft padding like felt or foam
- Cleaning a skin wound
- Encouraging blood flow by gently massaging the affected area, but only if doing so does not cause a lot of pain
While recovering from a foot injury, it is best to avoid activities that may worsen the swelling, like hot tubs, hot packs, or alcohol. Once the swelling has subsided, doing gentle foot exercises may help restore the foot’s strength and flexibility. Exercise should be done by following the MSA process, which stands for movement, strength, and alternate activities.
Movement exercises help the foot regain its full range of motion at the soonest possible time and shorten the downtime caused by the injury.
Strength exercises, on the other hand, help strengthen the injured area, but these should be done only when the swelling has subsided and the foot has achieved its full range of motion again.
Alternate activities means doing regular exercises, activities, or sports without straining the injured area. When the pain is completely gone, balance and control exercises may be added to the regime.
Other types of exercises include:
Range-of-motion exercises – These can be done gently right after the injury while ice is still being applied. Even simply keeping the feet flat on the floor and moving the knee gently from side to side can help.
Stretching exercises – These should be started within 72 hours after the injury, and should be focused on the Achilles tendon. There are many ways to do this, such as the towel or calf stretch. The towel stretch is ideal for when the patient is unable to stand; it is done by looping a towel around the ball of the foot and slowly pulling on the towel for up to 30 seconds until the calf begins to stretch. A calf stretch, on the other hand, should be done when the patient is capable of standing on his own and without support. This is done by facing a wall and placing the hands on the wall at the same level as your shoulder, then placing your injured foot behind the other while keeping the heels down. The patient then has to slowly bend the front knee until the calf in the back leg begins to stretch. These stretching exercises should be repeated a couple of times every day until the injury is fully healed.
If the foot injury does not seem to respond to home treatment or no improvement is observed, it is best to seek medical treatment. When preparing for an appointment, the patient may expect to answer questions regarding his symptoms, the cause of the injury, any limitations caused by it, and the initial treatment that has been done.
As with all injuries, prevention is still better than treatment. Some tips to help prevent foot injuries include:
- Wearing the most appropriate and most comfortable footwear
- Changing running shoes often
- Wearing a supportive brace or wrapping the foot and ankle when engaging in heavy activities
Exercising the feet often
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LeCursi N. Sports shoes and orthoses. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 115
Molloy A, Selvan D. Ligamentous Injuries of the Foot and Ankle. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 116