The Foot & Ankle: What you need to know about caring for our bodie's foundations

1. The Foot & Ankle What you need to know about caring for our bodies’ foundations

2. Foot & Ankle Overview • The foot and ankle are part of one of the most complex systems in the human body. They are comprised of bones, joints, muscles, tendons and ligaments - playing an essential role in weight bearing activities • The primary functions of the feet and ankle are to allow specific actions such as walking, running and jumping .These motions are made possible by the Achilles Tendon , which is a fibrous tissue connecting the calf muscle to the heel bone • When walking, the foot and ankle adapt to any type of surface to get you to your next point • The foot is classified into three subdivisions: rearfoot, midfoot and forefoot.

3. Anatomy of the Foot • As mentioned, the foot is subdivided into three classifications: • Forefoot – comprised of 5 phalanges (toes) and 5 longer bones known as metatarsals • Midfoot – group of bones, including the navicular, cuboid and three cuneiform bones, which make up our feet arches • Hindfoot/Rearfoot – made up of the ankle & heel bone. Begins below the ankle joint, ending at the Chopart joint • Because our feet are our bodies’ foundations, they are subject to a host of conditions such as plantar fasciitis, bunions, diabetic foot complications and hammertoe

4. Anatomy of the Ankle • The ankle is the joint connecting the foot and lower leg, allowing for downward and upward motion • The ankle is comprised of three joints: • The ankle joint (also known as talocrural joint) • The Subtalar Joint • Inferior tibiofibular joint • These joints are held together tightly by ligaments surrounding the joints and when these ligaments stretch too far or tear, it can result in an ankle sprain

5. What Causes Ankle Joint Pain? • Ankle pain is common for a lot of individuals. Some causes for ankle pain include nerve damage, sprain, blockage in the blood vessel or joint inflammation • Additionally arthritis could be a cause of ankle pain – causing inflammation, swelling and pain in the joints • Tarsal tunnel syndrome may also be the source of ankle joint pain. This syndrome occurs when the posterior tibial nerve is compressed • While most common foot and ankles can be healed with conservative treatment options, there are some cases and conditions that may require surgery. Consult your podiatrist or orthopedic surgeon

6. Podiatrist vs. Orthopedic Surgeons • When you’re dealing with foot and ankle pain, you have the option to consult a podiatrist or an orthopedic surgeon. While there are a lot of similarities, there are also a few differences between the two fields • Both podiatrists and orthopedics can treat a range of foot and ankle conditions such as arthritis, Achilles tendon injuries, hammertoe, fractures, sprains, calluses, corns and diabetic foot complications • Podiatrist undergo 4 years of undergraduate education, 4 years of school at a podiatric medical institution, 3-4 years of surgical residency training focusing on only the foot and ankle. Orthopedic surgeons undergo 4 years of undergraduate education, 4 years of school at a medical institution, 5 years of residency training in orthopedic surgery, in addition (in some cases), one year of fellowship training dedicated to foot & ankle conditions • Foot and ankle orthopedic surgeons have experience treating all of the body’s bones and joints with surgery, while podiatrists focus only on conditions affecting the lower extremities – providing you with more specialized care.

7. Should You have Foot & Ankle Surgery? • Your podiatrist will first try a number of conservative treatment methods to diagnose and care for your foot and ankle condition. If you’re not responding to the treatment, surgery may be recommended • Some reasons an individual might need foot and ankle surgery could include: • A severe injury which might be caused due to a sprain, broken bone, fracture, etc. • Individuals who have a pre-existing medical conditions such as diabetes which can impact the feet • Individuals who have tried conservative treatment options, such as bracing, modifying the footwear, custom orthotics or medication, with no relief

8. Total Ankle Replacement Surgery – When is it Recommended? • Total ankle replacement surgery, also referred to as ankle arthroplasty, is performed to replace the damaged bone and cartilage in ankle joint • Typically performed to treat ankle arthritis and its symptoms • Recommended after conservative options, such as anti-inflammatories and physical therapy, have failed. • During the total ankle replacement procedure, the patient is put under anesthesia and the surgeon removes the damaged bone and cartilage and in turn replaces it with metal or plastic components to essentially replace the ankle joint

9. Ankle and Foot Surgery Recovery • The recovery time from ankle or foot surgery depends upon certain parameters such as: • Complexity of surgery • The patient’s age • General health condition • The recovery time could also be influenced with the quality of rest the patient undergoes post surgery. It can take around 3-4 months to recover if there is significant swelling. In more complicated cases, recovery can span a year or more • In most of the cases, the patients who have undergone foot and ankle surgeries would require rest for at least 2 weeks post surgery. In most cases, weight-bearing activities should be as limited as possible

10. General Guidelines to Post-Operative Foot & Ankle Care • Keep foot elevated to avoid swelling for the first few days post surgery • Use ice to reduce pain - 20 minutes on and then 20 minutes off. Repeat for the first 2-3 days • Patients will commonly be prescribed medications to manage pain and prevent infection, including muscle relaxants, blood thinners and antibiotics • Your diet plays an important role during post surgical care for foot and ankle surgery. Avoid fatty and fried foods to prevent inflammation. It is also recommended to increase your daily water consumption

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