Taking care while staying active: understanding foot and ankle conditions

By Mr Martin Klinke, consultant orthopaedic surgeon at Chiswick Medical Centre, The Lister Hospital and HCA UK at The Shard

 

As an orthopaedic surgeon of almost 20 years, I have certainly treated all manner of foot and ankle conditions.

 

This is true at Chiswick Medical Centre where I regularly meet patients who need minor care and treatment for ankle sprains or more complex injuries which require intricate surgery.

 

The one fact connecting all of my patients is the detrimental effect any foot and ankle injury can have on everyday life if not cared for properly.

The term ‘sprain’ is so widely used within the vernacular of common injuries, people will regularly self-diagnose without visiting a specialist.

 

Ankle sprains are responsible for 40 per cent of all sports injuries around the world, with each one offering different degrees of severity. Often dismissed as a simple ligament injury, they typically occur when you twist or turn your ankle awkwardly – stretching or tearing the ligaments around your ankle as a result. There are a number of symptoms associated with an ankle sprain to be aware of:

 

• bruising and/or swelling
• pain and/or tenderness
• stiffness
• skin discolouration
• inability to put weight on the injured ankle.

If you, or family member, experiences any of the above contact the Chiswick Medical Centre. We will be able to examine and test your ankle and, if necessary, perform an X-ray or MRI scan to provide a rapid diagnosis and initiate the correct ankle treatment. 

 

If an ankle sprain is diagnosed, a period of rest is essential for your ligaments to heal. For more severe cases, we will also provide you with a protective boot and physiotherapy as part of your rehabilitation process.

The Achilles tendon is the largest tendon in our body. It connects the bones and muscles from our calf to our ankle, thus playing a vital role in assisting with the movement and flexibility of our foot and ankle. Achilles injuries, such as a rupture or tendinopathy are particularly common in impact sports including tennis, running and football – with the likes of David Beckham a particularly famous example of a footballer rupturing his Achilles tendon.

 

When the Achilles tendon ruptures, patients will often feel as if they have been kicked in the back of their ankle. The tendon essentially comes apart and patients feel a strange popping or pulling sensation – often occurring when starting to run or landing awkwardly.

 

Patients who have an ongoing pain in their Achilles tendon (Achilles tendinopathy) may feel persistent pain or stiffness in the back of their ankle and calf. This is because of the natural wear and tear process which can develop over time from continued over-exertion of the tendon.

 

If you do experience an Achilles tendon injury, I strongly advise visiting Chiswick Medical Centre as soon as possible. An initial consultation and ultrasound scan will be organised and we’ll be able to diagnose the severity of your condition, before providing you with a treatment plan to help aid your recovery.

Compared to ankle sprains and ligament damage, plantar fasciitis is perhaps one of the lesser known foot and ankle conditions – although no less painful.

 

If you feel a pain on the bottom of your heel, particularly when you first walk after sleeping, it is likely you may have plantar fasciitis. Ironically, the pain can actually improve during gentle exercise, but then increase after playing sport or walking for a prolonged period of time. Fortunately, this is a condition where patients can take great steps (literally) to ease the pain themselves, by carrying out simple measures including:

 

• stretching your calf and foot muscles
• massaging your foot with a golf, tennis or even spiky ball
• wearing comfortable shoes with a heel raise and soft sole
• avoiding impact exercise, but undertaking gentler exercises including cycling and swimming
• wearing a night splint.

In addition to the above, shockwave therapy can be a particularly beneficial treatment option for ongoing chronic Achilles tendon pain and plantar fasciitis. The procedure involves sending shockwaves to the area of pain in order to irritate the tissue, forcing it to react and self-heal of its own accord.

 

Be assured, shockwave therapy is a very safe treatment with almost no side-effects, and normally only requires three to five sessions, scheduled one week apart to allow for the tissue to strengthen each time.

There are certain preventative measures you can take to limit the chances of incurring a foot and ankle injury - the most obvious being the use of suitable footwear when engaging in sport or physical activity.

 

Depending on the activity and your individual biomechanics, there will be certain shoes or trainers that are best suited to your feet. Orthotics might further help to protect both your feet and ankles during exercise. This includes a soft ankle support when returning to impact sports after an injury.

 

It is also worth remembering if you regularly walk in high heels, try to wear shoes where the heels and toe box is wider to limit the amount of stress applied to your feet and ankles when walking.

For patients requiring more comprehensive care Chiswick Medical Centre combines the expertise of our leading orthopaedic consultants, with state-of-the-art technology to ensure you’ll receive a swift and precise diagnosis for any foot and ankle condition. A thorough clinical examination and, if necessary, further imaging will allow us to find the correct diagnosis and provide you with the best available treatment. While we do not carry out surgical operations at Chiswick Medical Centre, patients can be referred directly to any HCA Healthcare UK hospital for the most clinical operative treatment. This may include:

 

• correction of bunions and other forefoot deformities
• ankle arthroscopy
• ligament repair
• fixation of broken bones
• repair of ruptured tendons
• ankle joint replacement.

At Chiswick Medical Centre we understand the importance of offering our patients exceptional care at a local level. This is why myself, and all of my colleagues within Chiswick’s orthopaedic unit take great pride in tailoring all care to the needs of each individual. This includes taking a multidisciplinary approach to each patient’s condition, meaning when necessary we work closely with other specialist departments within the centre to provide you with a treatment plan that assists your full recovery.

 

If you, or any one of your family members is experiencing foot and ankle problems, or indeed any orthopaedic-related injuries, please do get in touch to ensure you receive the highest standards of care.

 

For more information please contact Chiswick Medical Centre, part of HCA Healthcare UK on 020 8712 1806.