Archive for June, 2015

Overcoming Chronic Ankle Instability

June 21st, 2015 by Blue Ridge Foot and Ankle

If you characterize yourself as having “weak ankles,” and find your ankle giving way or turning when you are walking, running, playing golf, tennis, basketball, or other sports, you may suffer from chronic ankle instability. At Blue Ridge Foot & Ankle Clinic, we frequently treat patients for this condition. Other symptoms of chronic ankle instability include persistent discomfort and swelling of the ankle, pain or tenderness, and just a general feeling that the ankle is wobbly and unstable.

Causes of Chronic Ankle Instability

Most often, chronic ankle instability is the result of an ankle sprain or sprains that have not healed completely or were not rehabilitated fully after initial injury. When you sprain your ankle, the ligaments (connective tissues around the ankle) are over stretched and sometimes even torn, leaving them like a rubber band that has lost its ability to snap back. Physical therapy and exercises to properly rehabilitate the muscles around the ankle are necessary to strengthen them and retrain the tissues that are responsible for balance. If this rehabilitation does not happen, the likelihood of spraining the ankle again is greatly increased. With each additional sprain, the ligaments get weaker and additional ankle problems can develop.

Surgical and Non-surgical Treatments

After a thorough exam, which may include digital x-rays at one of our central VA locations, Dr. Stewart M. Chang or Dr. Kevin P. Murray will determine the best treatment for your chronic ankle instability based on your test results and level of activity. Common non-surgical treatments include:

  • Bracing: An ankle brace can provide support and keep the ankle from turning and thereby prevent another sprain.
  • Physical therapy: Exercises and other treatments can strengthen the ankle and retrain your muscles resulting in an improved range of motion and balance.
  • Medication: Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to relieve pain and inflammation.

In severe cases, or if you are not responsive to non-surgical treatments, our board certified podiatrists many recommend surgery. If you are experiencing chronic ankle instability and would like more information about your condition, call our Charlottesville office (434-979-8116) or our Fishersville office (540-949-5150) to schedule an appointment or use our online appointment request form.

What is a Sesamoid Injury?

June 17th, 2015 by Blue Ridge Foot and Ankle

Sesamoid Injuries

Perhaps you have never heard of a sesamoid, but at Blue Ridge Foot & Ankle Clinic we see many people who are experiencing foot pain as a result of sports and leisure activities that put pressure on the ball of the foot, such as basketball, running, football, golf, tennis, or ballet, which can result in a sesamoid injury.

What are Sesamoids?

A sesamoid is a bone embedded in a tendon. In the foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. Sesamoids act as a pulley for the tendons, helping the big toe move normally and also providing necessary leverage for the big toe when it pushes off during walking and running. These sesamoids are also the weight-bearing surface for the long bone connected to the big toe, called the metatarsal bone.

Sesamoid Injuries

Sesamoid injuries can involve the bones, tendons, and/or surrounding tissue in the joint. There are three main kinds of sesamoid injuries:

  • Turf Toe: This injury of the soft tissue surrounding the big toe joint usually occurs when the big toe is extended beyond its normal range. You may feel a “pop” at the moment of injury and will usually feel a sharp pain, followed by swelling.
  • Fracture: A break in a sesamoid bone can either be acute–caused by a trauma or impact to the bone–which results in immediate pain and swelling at the site of the break; or chronic–due to repetitive stress or overuse–which is characterized by ongoing pain that increases with activity and is relieved with rest.
  • Sesamoiditis: This injury is a chronic inflammation of the sesamoid bones and tendons that is usually caused by overuse and activities that put increased pressure on the sesamoids. Its symptoms are a dull, longstanding pain beneath the big toe joint that usually worsens with particular activities or certain shoes.

Diagnosis and Treatment

Our board certified foot and ankle surgeons, Dr. Stewart M. Chang and Dr. Kevin P. Murray are experts in the central VA area in diagnosing sports related injuries. After a thorough examination of the foot and big toe area, the doctor may evaluate your walking and the wear pattern of your shoes. Digital x-rays, which can be done in either our Charlottesville or Fishersville office, may also be ordered. Once the diagnosis is confirmed, there are a variety of non-surgical treatments available, with surgery reserved for those people who do not respond to those treatments.

If you suspect you may have a sesamoid injury, contact one of our offices today to make an appointment.



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