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February 1, 2011 > Get Back on Your Feet!

Get Back on Your Feet!

Seminar Explains Treatment Options for Ankle Problems

The ankle joint is a complex structure. It's where the ends of your two lower leg bones (the tibia and the fibula) are connected to the uppermost bone of the foot (the talus) by three groups of strong fibers called ligaments. Bands of inelastic tissue known as tendons connect muscles to the bones, while flexible cartilage provides a cushion between the bones.

When you consider the fact that ankles have to support 1.5 times your body weight when you walk and up to eight times your body weight when you run, it's not surprising that ankles are prone to a variety of injuries and other problems. To help you learn about treatment options for ankle problems and how to prevent them from recurring, Washington Hospital is sponsoring a free Health & Wellness seminar featuring podiatrist Dr. Joshua Van Gompel on Tuesday, February 8 from 1 to 2:30 p.m. The seminar will be held in the Conrad E. Anderson, M.D. Auditorium at 2500 Mowry Avenue in Fremont.


Ankle Sprains and Instability

"The most common ankle problem is a sprain, which is a stretch or tear in a ligament," says Dr. Van Gompel. "Ankle sprains occur frequently in people who are active in sports - especially sports like basketball or soccer where the players make rapid shifting movements. Some foot types - such as feet with higher arches - also make people more prone to sprains."

With a mild sprain, your ankle might be swollen and tender, but you may still be able to walk on it without too much pain. If you get a bad sprain and it's so painful you can't walk on it, you should get it checked out by a doctor.

In many cases, people with mild ankle sprains can treat themselves at home, using the "RICE" approach of rest, ice, compression and elevation.

"In general, 'rest is best' when dealing with ankle sprains," Dr. Van Gompel advises. "That means staying off the injured ankle, using crutches if you need to get around. Icing the ankle for 10 to 20 minutes every hour or two and using compression wraps can help the swelling go down. Elevating your ankle above the level of your heart for a couple of hours a day also helps."

Dr. Van Gompel notes that since compression wraps such as ACE bandages don't keep the ankle immobile, it may be necessary to use an ankle boot or brace to rest the ligament.

"Don't try to 'walk it off' because when a ligament doesn't heal properly it can lead to recurring sprains, ankle instability and chronic pain," he says. "When a patient suffers ankle instability, we generally would try to treat it first with an ankle brace and physical therapy, but if the ankle is still unstable after rehab, it may be necessary to repair the ligament surgically. Ankle instability often doesn't go away without surgery to tighten the ligament back together. The success rate of such surgery, though, is well over 90 percent."


Heel Spurs and Achilles Tendon Problems

Strictly speaking, heel spurs aren't really "ankle" problems. They are calcifications or bony growths projecting from the back or underside of the heel that often make walking uncomfortable. Yet heel spurs can contribute to ankle pain by causing problems with the Achilles tendon that connects the calf muscle to the heel bone.

"Inflammation of the Achilles tendon - called tendonitis - or tiny tears in the tissue in and around the tendon can cause a lot of pain and reduce your strength and range of motion," says Dr. Van Gompel. "Treatment for tendinitis usually would include anti-inflammatory medications such as ibuprofen and immobilizing the tendon with an ankle boot or sometimes a cast. For severe problems such as a torn or ruptured tendon, treatment might also include surgery."

Even in mild cases, it may take several weeks or even months for the Achilles tendon to repair itself. "Immobilizing the ankle can result in a loss of muscle tone, so the patient may need physical therapy to strengthen the muscles afterward," he notes.


Ankle Arthritis

Some people also experience pain in their ankles due to arthritis. Osteoarthritis - sometimes called "wear-and-tear" arthritis - is most common in joints that bear weight, including the ankles.

"In osteoarthritis, the cartilage in a joint breaks down, either through normal wear and tear or following a trauma injury to the ankle," Dr. Van Gompel explains. "As the cartilage wears away, it doesn't cushion the joint as well, resulting in pain when the joint moves. Osteoarthritis accounts for about 90 percent of arthritis problems in the ankle, but rheumatoid arthritis, which is an autoimmune disease, can cause ankle pain, too."

As with tendonitis, treatment for ankle pain due to arthritis usually begins with anti-inflammatory medications. "If anti-inflammatories don't work, we can use cortisone shots, up to two or three times a year," he says. "In some cases, we can use arthroscopic ankle surgeries to clean up bone spurs or repair cartilage damage due to arthritis."


Plantar Fasciitis and Other Ailments

At the seminar, Dr. Van Gompel also will discuss plantar fasciitis, another condition that causes heel pain. "Plantar fasciitis is an inflammation of the ligament along the bottom of the foot that attaches to the heel," he says. "Millions of people get this problem, which generally causes bad pain when you first get out of bed and step on the floor. The pain eases up as the day goes on, but it becomes worse again by the end of the day."

In addition, he intends to divulge his "secret" remedy for plantar warts - painful warts that grow on the soles of the feet. When asked to explain what that entails, he chuckles and replies, "If you want to know about my treatment for plantar warts, you'll have to come to the seminar!"


Get Back On Your Feet!

Learn more about new treatment options for ankle problems. The free lecture will take place on Tuesday, February 8 from 1 to 2:30 p.m. at the Conrad E. Anderson M.D. Auditorium, located at 2500 Mowry Avenue (Washington West) in Fremont. Register online at www.whhs.com

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