The foot and ankle consist of:
- Numerous bones
- The joints between them
- The ligaments that keep them stable
- The muscles that generate strength and motion
Your foot is the base of support for your entire body. If your foot’s alignment is off because of muscle weakness or structural issues, it can cause problems up your entire leg. Causes of foot pain include:
- Arthritis
- Fractures
- Instability
- Weakness
- Inflammation
- Less common causes – infection, tumors, or nerve problems
Suffering from foot and ankle pain? Contact us to learn about treatment options.
How Your Foot and Ankle Work
The foot consists of the forefoot, midfoot, and hindfoot.
- The forefoot is made up of your toes and five metatarsals, each made up of two long bones.
- The midfoot consists of five small bones – the navicular, cuboid, and first, second, and third cuneiform bones.
- The hindfoot is made up of the heel bone (calcaneus) and the talus bone, which sits on top of the heel bone.
- The talus meets the two lower leg bones (tibia and fibula) to create the ankle joint.
Ligaments go between the bones in the foot and help provide stability. When they’re injured, that causes pain and instability.
Three main ligaments on the outside of the ankle and one broad band of ligaments on the inside of the ankle connect the two leg bones to the foot. A ligament in the ankle connects the shinbone (tibia) to the outside lower leg bone (fibula). When this ligament is injured, it’s called a high ankle sprain.
Many muscles within the foot help flex and extend the toes. Some muscles have tendons that travel up the ankle and attach on the tibia or fibula; others remain entirely in the foot.
Muscles in the ankle help it move in, out, up, and down. The Achilles tendon attaches to the heel and turns into the calf muscles ending behind the knee.
Foot and Ankle Surgery
Some foot and ankle conditions may require surgery, especially if conservative treatments haven’t been successful.
For example, a torn Achilles’ tendon often needs repair so you can regain strength in your calf muscle. Tendon or cartilage injuries may need surgery to remove or repair damaged tissue and keep the ankle from catching or locking.
Ankle surgeries for tendonitis and impingement can be done with an arthroscope, which causes less harm to healthy tissues and greatly reduces recovery time compared to traditional surgery. Arthroscopic ankle surgery can often address multiple conditions at one time.
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Conditions Where Surgery May be Necessary
Your ankle joint is where the tibia and fibula meet your talus bone. These bony surfaces are covered by smooth, hard cartilage. A cartilage defect can damage healthy tissue in your ankle and cause a painful catch or click, limiting ankle motion and making it hard to walk – like walking with a rock in your shoe.
Relatively small defects can sometimes be polished and smoothed with gentle motion exercises, though surgery may be required for severe damage.
Repeated ankle sprains can cause soft-tissue fraying or scar-tissue buildup, causing pain, popping, and a feeling of instability. Tissue can also get flipped up and stuck, causing the ankle to lock.
An ankle arthroscopy can smooth damaged hard cartilage and clean up scar tissue or soft-tissue fraying. After this procedure, you’re often placed on crutches and can wean from them at your own pace. Your surgeon will detail your post-surgery restrictions.
The Achilles tendon, the thick band on the back of your ankle, connects the calf muscle to the foot. Your body relies on this connection to propel yourself forward while walking or jumping – even stepping on the gas pedal while driving. Your Achilles can tear with cutting and explosive activities like jumping or sprinting.
An Achilles-tendon repair is an outpatient procedure done with a general anesthetic (to put you to sleep) in conjunction with a nerve block (to provide initial pain relief after surgery). Your surgeon makes an incision on the back of your ankle, locates the two ends of the tendon, and ties them together using a strong suture. Your surgeon closes the sheath that surrounds your Achilles tendon to help it glide more smoothly, and then closes the incision.
After this procedure, you’re placed in a CAM boot and on crutches, not placing any weight on the ankle until you come back for your first post-operative visit. The tendon needs to heal without extra stress, so it typically takes at least six weeks until you can bear full weight on your leg. Your surgeon will outline your post-surgery restrictions.