Ankle Sprains

With the Kansas City Chiefs season still under way and the AFC Championship (Lamar Hunt Trophy) on the line, I will continue with the sports medicine theme. Ankle sprains are one of the most common sports injuries in the National Football League (NFL) and sports in general. In fact, Tom Brady of the New England Patriots played his way to Super Bowl XLIX with a sprained ankle, and Patrick Mahomes hobbled off the field in the NFL Playoff game last week with what looked like an ankle injury. Luckily for Chiefs fans, Mahomes is too determined to take Kansas City to Super Bowl LIII to be hobbled for more than a minute or two.

Two million people sprain their ankle every year in the United States, resulting in 30% of all sports injuries. They can be classified on a spectrum from minor to traumatic. You may have heard the phrase “you would have been better off breaking it” in reference to severe ankle sprains.

It is important to be evaluated by a foot and ankle specialist (podiatrist) after ankle sprains so we can diagnose the severity and any possible additional injuries that may be associated. What looks like an ankle sprain may be a tendon rupture or break in the bone. These injuries are treated differently.

As foot and ankle surgeons, we have a variety of treatment options for ankle sprains. It may be as simple as icing, elevating, and staying off your foot. However, recent studies show that dysfunction can persist in up to 40% of patients for as long as 6 months following the injury. Therefore, foot and ankle specialists are treating sprains more aggressively with range of motion exercises or even physical therapy referrals in certain cases. Bad sprains not treated with appropriate rehab may be at increased risk of developing ankle arthritis and/or an unstable ankle later in life.

If you are dealing with a sprain or have other foot and pain, contact Jayhawk Foot & Ankle Clinic.

Dr. Michael Johnson

Achilles Tendon Injuries

With the Kansas City Chiefs season off to a hot start, it feels appropriate to discuss a lower extremity injury well-known in the National Football League (NFL). Our own Eric Berry has dealt with this painful issue, which involves the Achilles tendon. 

Achilles tendon injuries take on a variety of forms, which fall under the umbrella terms “traumatic” or “non-traumatic.” Traumatic translates to Achilles tendon rupture in most cases, but many people may experience non-traumatic Achilles pain caused by years of repetitive exercise. Achilles tendinosis is a common non-traumatic Achilles problem and is considered an overuse injury.  

Running is the main cause of Achilles tendinosis, although it can occur in any sport. One is more likely to acquire it if one has postural problems such as flat feet or very high arches. Poor shoe quality also contributes, so it is important to buy new running shoes every 300 miles. A less common yet more serious contributing factor called “inflammatory arthropathies” may contribute. These include conditions like psoriatic arthritis, gout, rheumatoid arthritis, etc.  

It is important to be evaluated by a foot and ankle specialist if you experience pain in the back of your heel consistent with Achilles injury. A podiatrist will be able to decipher between paratenonitis, insertional Achilles tendinosis, non-insertional Achilles tendinosis, retrocalcaneal bursitis, Haglund’s deformity, Achilles tendon tear, or the list goes on. As you can see, heel pain could be one of many different conditions (and sometimes even several conditions occurring together).  

Depending on the pathology, your podiatrist can treat your heel pain using simple modifications to your training regimen, stretching protocol, NSAID medications, orthotics with a specially designed heel lift to decrease the tension on your Achilles tendon, among a variety of other treatments. Likewise, a benefit of going to a foot and ankle specialist like us at Jayhawk Foot and Ankle Clinic, is that we know which treatments to specifically avoid in this region. For example, steroid injections are commonly used for pain secondary to inflammation; however, steroid injections in the Achilles tendon are known to lead to Achilles ruptures and should be avoided.  

Your doctor will work with you to find a treatment that is aggressive enough to treat the injury yet sensitive to your specific circumstance. For example, a high-end athlete may resort to surgical treatment to avoid losing function of the Achilles whereas an older patient may opt for minimal treatment to control the inflammation while modifying his or her activity level. Regardless, it is important to seek treatment before further degeneration of the tendon occurs, which ultimately can lead to rupture.  

What is a Podiatrist?

I regularly get asked what I do for a living. When I tell them that I am a podiatrist, I usually get the same look you might see when someone passes by a stinky dumpster; or, from people who are more in touch with their facial expressions, the raised eyebrows.  I get it.  When you think of a podiatrist, what do you think of?  Gargoyle toenails? Foot fungus? While these things are a small part of being a foot doctor, you could compare it to your Family Practice physician treating a perirectal abscess (Google it if you’re not familiar… but make sure not to click the “image” tab!)… yikes, OK, it’s not really THAT bad.  The fact is that there is so much more to being a podiatrist than these things that you initially think of. Generally, the definition is that we are a physician specializing in medical and surgical treatment of all ailments of the foot and ankle. That means that we treat everything involving the foot and ankle with the expertise of someone who has trained greater than a decade to treat just that…the foot and ankle.  We treat the NFL running back that ruptures his Achilles tendon, down to your grandma whose rheumatoid arthritis is so advanced that she cannot fit her toes in her shoes; from ankle replacements to ingrown toenails. So, if you are having foot or ankle pain, an injury, an infection, or even Gargoyle toenails, Dr. Young and I are more than happy to do what we are passionate about: help our patients. Dr. Brian Schmidt