Injury and Trauma to the Feet
Injury and Trauma to the Feet

Whether performing daily activities or participating in a sporting event, injury to the feet is a common occurrence. Injuries such as bone contusions (bruise of the bone), fractures, dislocations of a joint, tendon or ligament injuries should be addressed and treated in a timely manner.

Bone Bruise

A bone bruise usually results from either a direct and sudden force or from repetitive compressive forces that are not strong enough to break or fracture a bone. There are many ways one can suffer from a bone bruise.

Sports injuries - Bone bruises are a common type of sports injuries, especially in those which involve a lot of falling or getting into hard contact with objects or other players. The knees and the ribs are commonly affected, and it is always advisable to wear proper sports gear to avoid these injuries.

Twisting injuries - This can result in sprained ankles or knees, and these are usually accompanied by bone bruises. Twisting a joint causes the involved bones to collide with each other forcefully, leading to a bone bruise.

High velocity trauma to a bone - In general, any type of direct impact or high velocity trauma to a bone brought about by an incident such as a car accident, a high fall, or a blunt force can result in a hematoma, a contusion, or a bruise to the bone affected.

Treatments for Bone Bruise

After a traumatic injury, it is best to rule out a fracture by consulting a doctor who may request tests to be done. When a bone bruise is diagnosed with an MRI, one should rest the involved bone or joint and avoid any type of stress that could impede the healing process.

Immediately apply an icepack or ice wrapped in thin cloth over the injured area to prevent excessive swelling and pain.

Avoid placing more stress on the bruised bone area to allow adequate healing. A bone bruise heals more slowly than a soft tissue damage. To support and protect a bone near a joint from further trauma, it is advisable to wear a brace, such as a knee brace.

Experts also advise against using tobacco or nicotine, which can delay the healing process, since they constrict blood vessels, thus reducing blood flow to the area.

Fractures (Broken Bones)

A fracture is a broken bone. A bone may be completely fractured or partially fractured in any number of ways (crosswise, lengthwise, in multiple pieces).

Types of Fractures

Bones are rigid, but they do bend or "give" somewhat when an outside force is applied. However, if the force is too great, the bones will break, just as a plastic ruler breaks when it is bent too far.

The severity of a fracture usually depends on the force that caused the break. If the bone's breaking point has been exceeded only slightly, then the bone may crack rather than break all the way through. If the force is extreme, such as in an automobile crash or a gunshot, the bone may shatter.

If the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone, the fracture is called an "open" fracture. This type of fracture is particularly serious because once the skin is broken, infection in both the wound and the bone can occur.

Common types of fractures include

Stable fracture. The broken ends of the bone line up and are barely out of place.
Open, compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.
Transverse fracture. This type of fracture has a horizontal fracture line.
Oblique fracture. This type of fracture has an angled pattern.
Comminuted fracture. In this type of fracture, the bone shatters into three or more pieces.

Our Doctor's Examination

Our doctor will do a careful examination to assess your overall condition, as well as the extent of the injury. He or she will talk with you about how the injury occurred, your symptoms, and medical history.

The most common way to evaluate a fracture is with x-rays, which provide clear images of bone. Our doctor will likely use an x-ray to verify the diagnosis. X-rays can show whether a bone is intact or broken. They can also show the type of fracture and exactly where it is located within the bone.

Treatment

All forms of treatment of broken bones follow one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed. In many cases, the doctor will restore parts of a broken bone back to the original position. The technical term for this process is "reduction."

Broken bone ends heal by "knitting" back together with new bone being formed around the edge of the broken parts.

Surgery is sometimes required to treat a fracture. The type of treatment required depends on the severity of the break, whether it is "open" or "closed," and the specific bone involved. For example, a broken bone in the spine (vertebra) is treated differently from a broken leg bone or a broken hip.

Dislocation

A dislocation occurs when the bones that are usually be connected at a joint separate. You can dislocate a variety of different joints in your body, including your knee, hip, ankle, or shoulder.

Since a dislocation means your bone is no longer where it should be, you should treat it as an emergency and seek medical attention as soon as possible. An untreated dislocation could cause damage to your ligaments, nerves, or blood vessels.

Treating Dislocations

Our doctor’s choice of treatment will depend on the joint that you may have dislocated. It may also depend on how severe your dislocation is. According to Johns Hopkins University, initial treatment for any dislocation involves R.I.C.E.—Rest, Ice, Compression, and Elevation. In some cases, the dislocated joint might go back into place naturally after this treatment .

If the joint does not return to normal, naturally, your doctor may use one of the following treatments:

  • Manipulation or repositioning
  • Immobilization
  • Medication
  • Rehabilitation
Tendon or Ligament Injuries

Ligaments are cable-like structures, which hold your bones together and allow you to walk and move without failing apart. Ligaments are flexible, but they do not stretch very far. Injuries – such as when you sprain a ligament, twist a knee, take a bad fall, suffer a whiplash, or lift an object which is too heavy – can tear or fray these cable-like structures. These injuries set up a healing process called inflammation to repair the injured ligament. You know this process is happening when you feel the pain, heat, note swelling, and cannot move the injured joint.

Treatment and Prevention

There is a tendency to treat the muscle spasms as the primary cause of the problem and many medical treatments may be directed toward the muscle spasms, and not to the primary cause: the ligamentous strain. If the joint is slightly out of place because of the ligamentous laxity, it may respond to manipulative care. Such manipulative techniques will often give good relief and sometimes permanent relief.

If lax ligaments can lead to muscle spasm, loss of movement, and all sorts of painful sensations and feelings, what can be done? The only non-surgical treatment for this ligamentous strain or laxity problem is called prolotherapy. In order to understand prolotherapy, one must understand how the body heals ligament damage normally. This healing process is called inflammation.

Inflammation has several distinct phases: the acute inflammation phase, the granulation phase, and the remodeling phase. This "Healing Cascade" is basic to all injuries regardless of the site or tissue. These three phases each have their own cellular and chemical processes and changes. Each phase is dependent upon the previous phase for initiation of the next step.