Addressing Foot and Ankle Injuries

August 19, 2019

Staying active is a key factor in helping to stave off age-related conditions, but if you’re plagued with pain or discomfort in your feet or ankles it can be difficult to get your “steps” in. Swelling of the heel, arthritis, and plantar fasciitis are three common debilitating injuries that slow people down.

“Foot and ankle injuries are fairly common, but they range from problems that are considered quite mild—oftentimes not even requiring any specific medical care—to those that can become quite debilitating, causing issues with walking or standing,” says Dr. Zung Le, podiatrist and clinical professor at The George Washington School of Medicine and Health Sciences.

When to Seek Professional Help

Elite athletes are quite attuned to their bodies and when to seek medical intervention. That may not be as easily determined for the typical individual. According to GW podiatrist Dr. Julie Rosner, pain is a definitive indicator. “My rule of thumb with patients is once pain starts, that’s a warning signal something isn’t quite right,” she notes. “I recommend patients take a break if they're a ‘weekend warrior’ type—backing down on some activities.”

If pain persists despite taking conservative measures such as rest, ice, or an over-the-counter anti-inflammatory medication, or if individuals are experiencing difficulty with everyday functioning—basic walking, getting out of bed, doing things around the house—Dr. Rosner advises getting checked out.

Diagnosing the Injury

The initial examination consists of an in-depth history about everything the patient has been experiencing, a timeline of symptoms, and a comprehensive physical examination. “We’re checking all parts of the feet, and typically we compare one side to the other, not just the side that is troubling to the patient. That way we know what ‘normal’ is in comparison to what may be hurting them,” explains Dr. Rosner.

Depending on symptoms and physical assessment, patients may be sent for additional tests such as an x-ray.

Treatment Options

With plantar fasciitis being so common among foot and ankle injuries, treatment modalities have evolved with advancements in technology. But, the foundation of these therapies always returns to two practices: adequate shoe support and aggressive stretching. Some patients may achieve relief by using prefabricated shoe inserts and performing self-stretching exercises, while others may require custom-made orthotics and enlisting the help of a physical therapist.

For cases that tend to be more stubborn, a steroid injection may be necessary to relieve the pain. “With the current technology, there are also a few other new options now available. These options are usually reserved when standard treatment has failed,” says Dr. Le.

For ankle strains and sprains, treatment typically begins with the RICE principle (rest, ice, elevation, and compression) and some sort of brace to support the joint. “More severe injuries—almost as bad as breaking a bone without actually breaking one—would potentially require immobilization and a walking boot, and removal from physical activity,” adds Dr. Rosner. “Depending on how patients do with physical therapy, which is so key in recovering from these types of injuries, surgery to repair ligaments may become a possibility in the future.”

Why Podiatry?

While a primary care provider may be the first step in seeking help, a podiatrist has the specific knowledge and skills to get to the root of the problem—and move patients past lingering symptoms. Much like other medical fields, doctors of podiatry go through extensive training, and many complete a fellowship that further specializes or subspecializes in a particular field within foot and ankle surgery.

“This could be reconstructive surgery. It could be focused on, in some cases, trauma. It could be deformity correction. Many times, podiatrists seek out opportunities related specifically to complications of diabetic foot problems,” shares Dr. Le. “The profession of podiatry itself has undergone many changes over the last decade or two.”

Faculty members

Listen to the Podcast with our Podiatrists, Dr. Zung Le and Dr. Julie Rosner.


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