Benefits of Below Knee Cast

A recent study in The Lancet shows that treatment of severe ankle sprains with a below the knee cast is more effective than a compression bandage. A total of 584 participants with severe ankle sprains from eight emergency departments were included in a study to evaluate different treatment methods. Patients were placed in a below-knee cast, an Aircast brace, a Bledsoe boot (walking boot) or a tubular compression bandage. Patients were evaluated at three months and nine months.

Those who received a below-knee cast had significant improvement in pain, symptoms and the quality of ankle function compared with the tubular compression bandage. Those placed in an Aircast brace experienced an improvement in the quality of ankle function, but had no difference in pain or symptoms in comparison to the compression bandage. Those placed in the Bledsoe boot had no benefit over the tubular compression bandage at three months. When the patients were evaluated again at nine months, there were no significant differences between the tubular compression bandage and other treatments (1).

DR'S RESPONSE:  This might seem obvious, but any kind of conservative treatment that limits or prohibits motion in an area of injury would be the best treatment option.  The important point to decipher is that regardless of treatment, at 9 month follow-up, there were no significant statistical differences noted.  Thus, one must measure cost with effectiveness when treating injuries.

Central Florida 
Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Running in the Dark

  Well yesterday I was running in the dark on my street. As I was merging into my friend's front lawn, he has this little bump on the perimeter of his lawn, you can’t even really consider it a curb since it is barely seen and black. Anyways, I did not see it running onto the grass and landed on my ankle incorrectly after somewhat tripping over this bump.

 I went to sleep with what was a mild ankle pain at the time. I could normally walk, but with some discomfort. Now as I just woke up, there is no swelling in the ankle, maybe some minor inflammation. BUT, I can barely walk, I mean it really hurts to put pressure on that foot.

 This is my first injury of this type, should I seek professional care or just do the standard home treatment (Ice it, and rest)

 I would get it checked out by a doctor, even if it is just a sprain it's better to get it looked at by a professional. If it's just a sprain take Advil to bring down the swelling in the joint (there's swelling even if you can't see it) and ice it for periods of 10 minutes on and then 10 minutes off.

DOCTOR'S RESPONSE:  Any kind of tripping, twisting, or sprains normally doesn’t require a visit to the doctor.  However, any time you are “barely able to walk” after an injury should ring alarm bells that something is possibly amiss.  There could be a variety of injuries.  I recommend that you make an appointment with your local podiatrist, a physician with specialized training for problems in the foot and ankle. 

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Listen to your feet!

Your feet are not supposed to hurt. If your feet hurt – they are telling you something is wrong. Many people who experience foot pain have a neuroma. A neuroma is a painful condition that is sometimes referred to as a pinched nerve or a nerve tumor in your foot. It is a benign growth of nerve tissue frequently found between the third and fourth toes, bringing pain, burning sensation, tingling, or numbness between the toes and in the ball of the foot. The principal symptom associated with a neuroma is pain between the toes while walking. At times, the pain is described as pain similar to having a stone in the shoe.

Causes and Treatments

The exact cause of the condition is unclear, but the following factors can contribute to the formation of the neuroma: high arch or flat feet, trauma to the nerve, improper footwear, repeated stress or occupational injuries. Treatment options vary with the severity of each neruroma. Identifying the neruroma early in its development is important to avoid surgical intervention. If left untreated, neuromas tend to get worse.  Examinations include x-rays as well as an echograms in order to ensure the correct diagnosis. The most common modalities utilized to treat the neuroma are: 1. anti-inflammatory medications that can be prescribed for acute pain, 2. special padding orthotic devices 3. cortisone injections 4. revolutionary neurolytic injections (series of 4 to 7 injections) that are reported to have as high as 87% efficacy rate in making the symptoms subside or go away.

Surgical options are usually a last resort, but may become necessary when the earlier mentioned treatments fail and the neuroma progresses pass the threshold for these options. The procedure, which consists of decompression or removal of the inflamed and enlarged nerve, can usually be conducted on the outpatient basis. Recovery time is often just a few weeks and in the majority of cases patients can walk immediately after the operation.

Pain is Not Normal

Remember that foot pain is not normal, and any disruption in foot function limits your freedom and mobility. It is important to schedule and appointment with one of your podiatrists at the first signs of pain or discomfort in your feet. After being treated for a foot condition such as a neuroma, it is important to follow proper maintenance guidelines to assure that the health of your feet continues to improve. You will need quality patient care with access to state of the art diagnostic equipment, such as ultrasound and digital x-rays. Treatments may also include new revolutionary injections that eliminate the necessity of surgical intervention in the majority of the cases. Most podiatric surgeons have been trained specifically and extensively in the diagnosis and treatment of all manners of foot conditions. This training encompasses all the intricately related symptoms and structures of the foot and lower leg including neurological circulatory skin and the musculoskeletal systems which include: bones, joints, ligaments, tendons, muscles, and nerves. If you or someone you know is experiencing foot pain, your podiatric physician will be more than happy to thoroughly examine you and recommend the treatment that is appropriate for your condition.

Central Florida
Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com