Toe, foot, and ankle injuries: Overview
Everyone has had a minor toe, foot, or ankle injury that caused pain or swelling. Most of the time our body movements don't cause problems. But sometimes symptoms develop from everyday wear and tear, overuse, or an injury.
Toe, foot, or ankle injuries most often occur during:
- Sports or recreational activities.
- Work-related tasks.
- Work or projects around the home.
In children, most toe, foot, or ankle injuries occur during sports, play, or falls. The risk for injury is higher in sports with jumping, such as basketball. And it's higher in sports with quick direction change, such as soccer or football. Any bone injury near a joint may injure the growth plate (physis) in a child. It needs to be checked.
Certain athletes, such as dancers, gymnasts, and soccer or basketball players, have a higher risk of toe, foot, or ankle injuries.
Older adults are at higher risk for injuries and fractures. That's because they lose muscle mass and bone strength as they age. They also have more problems with vision and balance. These problems increase their risk of injury.
Most minor injuries will heal on their own. Home treatment is usually all that's needed.
Sudden (acute) injury
An acute injury may occur from a direct blow, a penetrating injury, or a fall. It can also happen if you twist, jerk, jam, or bend a limb abnormally. Your pain may be sudden and severe. Bruising and swelling may start soon after your injury. Acute injuries include:
- Bruises (contusions). After an ankle injury, bruising may extend to your toes from the effects of gravity.
- Puncture wounds. Sharp objects such as nails, tacks, ice picks, knives, teeth, and needles can all cause puncture wounds. These wounds increase your risk of infection because they are hard to clean. They also provide a warm, moist place for bacteria to grow.
- Injuries to ligaments that support your joints.
- Injuries to tendons, such as ruptured tendons in your heel (Achilles tendon). Children ages 8 to 14 may have a condition known as Sever's disease. It causes injury to the growing bone where the Achilles tendon is attached. This usually occurs during activity and is relieved with home treatment.
- Injuries to your joints (sprains). If a sprain doesn't seem to be healing, you may have a condition called osteochondritis dissecans (OCD). It causes lasting symptoms. In OCD, a piece of bone or cartilage (or both) inside a joint loses blood supply and dies. Symptoms include pain and swelling.
- Pulled muscles (strains). Muscles of the foot and ankle can be strained. They can also rupture.
- Broken bones (fractures), such as a broken toe.
- A bone moving out of place (dislocation).
- A crushing injury, which can lead to compartment syndrome.
Overuse injuries
Overuse injuries occur when too much stress is placed on your joint or other tissue. It often happens when a person "overdoes" an activity or repeats the same activity over and over. Overuse injuries include:
- Retrocalcaneal bursitis, which is inflammation of the bursa. It causes swelling and tenderness of the back of the heel and ankle. Pain usually gets worse while you are wearing shoes and during activity. Pain improves during rest.
- Achilles tendinitis or tendinosis (tendinopathy). This is the breakdown of soft tissues in and around the Achilles tendon, which connects the calf muscles to the heel bone.
- Stress fracture. This is a hairline crack in a bone.
- Plantar fasciitis. This is inflammation of the plantar fascia, a broad, flat ligament on the bottom of the foot. This ligament extends from the front of the heel to the base of the toes. It helps maintain the arch of the foot.
- Metatarsalgia, which is pain in the front (ball) of the foot.
Treatment
Treatment for your toe, foot, or ankle injury may include first aid (such as using a brace, splint, or cast), a special shoe (orthotic device), physical therapy, or medicine. In some cases, surgery is needed. Treatment depends on:
- The location and type of injury, and how bad it is.
- When the injury occurred.
- Your age, your overall health, and your activities (such as work, sports, or hobbies).
Caring for a minor toe, foot, or ankle problem
Try the following tips to help relieve toe, foot, or ankle pain, swelling, and stiffness.
- Clean a skin wound as soon as you can.
This will help prevent infection, scarring, and tattooing of the skin from dirt left in the wound.
- Check your feet every day.
Take a look at your feet to see if you have pressure spots, redness, or blisters.
- Remove all jewelry.
Remove rings, anklets, and any other jewelry that goes around your leg, ankle, or toe. It will be hard to remove the jewelry after swelling starts.
- Rest.
It's important to rest and protect the affected area.
- Use ice.
Put ice or a cold pack on the affected area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake).
- Wrap the affected area.
Compression, or wrapping the area with an elastic bandage (such as an Ace wrap), will help reduce swelling. Don't wrap it too tightly, because that can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, and swelling in the area below the bandage.
- Elevate the affected area.
Try to keep the area at or above the level of your heart to help reduce swelling. Prop up the area on pillows while you apply ice and anytime you sit or lie down.
- Stop, change, or take a break from any activity that causes your symptoms.
- Avoid "running through the pain." It may increase damage to your foot.
- Try changing your exercise routine if you think running or another high-impact sport is causing your foot pain. Switch to a low-impact exercise activity for a while. Try things like cross-country skiing, stair-climbing machines, biking (regular or stationary), rowing, and swimming.
- Use sensible sports-training techniques. For example, wear the right shoes, and stretch before activities.
- Avoid more swelling.
For 48 hours, avoid things that might increase swelling. These things include hot showers, hot tubs, hot packs, and drinks that contain alcohol.
- Apply heat.
- After 2 or 3 days, you can try applying heat to the area that hurts. Types of heat therapy include microwavable packs and disposable heating patches.
- Apply heat for 10 to 20 minutes at a time.
- You might also try switching between cold and heat.
- Take care of blisters.
Try using a donut-shaped moleskin pad. Leave the area over the blister open. Home treatment for blisters depends on whether the blister is small or large and whether it has broken open.
- Try massage.
Gently massage your feet to reduce discomfort, relax your feet, and promote circulation.
- Choose your footwear carefully.
- Wear comfortable and supportive shoes and socks. Look for roomy footwear, and avoid high heels.
- Try using an orthotic shoe device, such as an arch support. It may help relieve your foot pain.
- Do foot exercises.
Try heel-cord exercises to increase your strength and flexibility, if your heel or heel cord (Achilles tendon) is tight and painful. Try a standing calf stretch, towel scrunch, or seated calf stretch using a towel. These may help relieve your heel pain.
If you need to use a wrap for more than 48 hours, you may have a more serious injury that needs to be checked by a doctor.
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