Sprains, Strains and Fractures

Your feet are wonderful—and wonderfully complicated.

Did you know, for example, that almost exactly one quarter of all the bones in your entire body are located in just your two feet? For most people it works out to 52 out of 206, to be precise.

And those are just the bones. They’re joined by well over 100 distinct soft tissue structures—muscles, tendons, ligaments, and fascia—that hold all the bones and joints together and allow you to stand, walk, run, and play!

These bones and tissues make up the “foot and ankle division” of what’s called your musculoskeletal system. And while they’re built to handle a whole lot of weight and force throughout a day (and a lifetime), they are not invincible.

Injuries to these structures tend to be classified as either sprains, strains, or fractures. Without prompt attention, they may cause lasting damage and discomfort to your feet.

Sprains

A sprain is any injury involving the stretching or tearing of ligaments. (These are tough connective tissues made of cartilage, and their job is to hold two or more bones together, stabilizing joints.)

Sprains are usually caused by a sudden hyperextension of a joint, when the bones are forced to stretch beyond their normal range of motion. Falls, slips, trips, and landing awkwardly after a jump are all common accidents that can cause sprains.

Sprains are classified as either Grade I, Grade II, or Grade III depending on their severity:

  • Grade I: Ligaments have been overstretched, but not torn. Moderate soreness, pain, and swelling are common.
  • Grade II: Ligaments are partially torn. Pain and swelling are more severe. You may not be able to put full weight on the joint. The joint may feel unstable when moved in certain ways.
  • Grade III: Ligaments have completely torn. Pain, swelling, and bruising may be severe. You probably won’t be able to put any weight on the joint (and you shouldn’t!), and it will feel significantly unstable.

As you probably guessed, the ankle is the most common joint affected by sprains. In fact, since there are several ligaments supporting the ankle joint, the term “ankle sprain” can apply to a few different specific injuries.

However, a sprain can technically occur in any ligament or joint. Another common location is at the base of the big toe. This injury is commonly known as turf toe.

Strains

Strains are very similar injuries to sprains. The difference is that strains are injuries to either muscle tissue or tendons, rather than ligaments.

(The main difference between tendons and ligaments is not so much their structure, but what they connect. While ligaments connect bones to other bones, tendons attach muscle to bones.)

Foot and ankle strains are common in and around the Achilles tendon, as well as the arches. They are more common in older adults and women who frequently wear high heels, although anyone can develop one.

In addition to pain and swelling, some characteristic symptoms of foot strains include muscle spasms and feelings of weakness. As with sprains, they may be graded from I to III, from mild overstretching to complete ruptures.

Fractures

Fractures involve damage to bones. There are many different types and classifications, some of which can overlap with one another:

  • Stress fractures. Rather than broken through, stress fractures are cracks that develop in the surface of bones due to repetitive stress. Without rest and treatment, they may deepen and develop into more significant breaks.
  • Stable fracture. Although the bone has broken clean through, the ends of the bones remain lined up properly and are only barely out of alignment (if at all).
  • Unstable fracture. Bones have shifted position after breaking, causing a visual deformity in the structure of the feet or ankle.
  • Avulsion fracture. A small fragment is “pulled” away from the rest of the bone at the site where a tendon attaches. This often happens at the base of the fifth metatarsal, along the outside middle of your foot.
  • Comminuted fracture. The bone shatters into three or more pieces.
  • Open fracture. Also known as a compound fracture, this happens when the bone pierces the skin. It is a highly dangerous situation that can cause significant blood loss and risk of infection.
  • Closed fracture. Any fracture that does not break the skin.

Fractures are usually the result of a sudden, high-impact incident—such as a car crash, falling from a ladder, or dropping something heavy on your foot. However, some fractures may develop through overuse—in particular stress fractures.

Common example of foot and ankle fractures include broken ankles, broken toes, calcaneal stress fractures, and Jones fracture (break of the fifth metatarsal).

Treating Sprains, Strains, and Fractures

Obviously, the best treatment for your musculoskeletal injury will depend, to a significant extent, on the type, location, and severity of your injury. A mild ankle sprain will not require the same treatment protocols as a severe open fracture.

However, one thing that these injuries have in common is that they should be taken very seriously. You should never attempt to “walk off” even a mild sprain, strain, or stress fracture. Doing so will likely only make the situation worse. Furthermore, sprains and strains that do not heal properly the first time can lead to the development of chronic weakness, instability, and arthritis in the affected area.

If you believe you’ve suffered a musculoskeletal injury to your feet and ankles, please give us a call to schedule an appointment at your earliest convenience. In the meantime, follow the RICE treatment protocol:

  • Rest: Take a break from activities that cause pain. Do not bear weight on a severely injured foot or ankle.
  • Ice: Use ice packs to control swelling. Only ice for 20 minutes at a time, no more than 3-4 times per day.
  • Compression. You may find that using a compression wrap also helps control pain and swelling. Make sure it is not so tight that it cuts off circulation to the feet.
  • Elevation. Prop your feet up—ideally above chest level—while sitting and sleeping.

When you come in for your appointment, we will conduct a full examination of your feet and ankles to get an accurate diagnosis of your condition. That may include taking an X-ray or ultrasound; it will also involve talking with you about your symptoms, your injury, and your goals for treatment.

From there, we put together a treatment plan customized for your needs. And whether that plan involves advanced laser therapy to accelerate healing, surgery, immobilization, new shoes, orthotics, or just plenty of rest and stretching at home, you can rest assured that you’re in good hands with the team at Heartland Foot & Ankle Associates.

To schedule your appointment with us, please call (309) 661-9975 today.