Topic Overview

At one time or another, everyone has had a minor toe, foot, or ankle injury that caused pain or swelling. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or an injury.

Toe, foot, or ankle injuries most commonly occur during:

• Sports or recreational activities.
• Work-related tasks.
• Work or projects around the home.

In children, most toe, foot, or ankle injuries occur during sports, play, or falls. The risk for injury is higher in sports with jumping, such as basketball, or sports with quick direction change, such as soccer or football. Any bone injury near a joint may injure the growth plate (physis) in a child and needs to be evaluated.

Certain athletes, such as dancers, gymnasts, or soccer or basketball players, have an increased risk of toe, foot, or ankle injuries.

Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength as they age. They also have more problems with vision and balance, which increases their risk of injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing.

Sudden (acute) injury

An acute injury may occur from a direct blow, a penetrating injury, or a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Your pain may be sudden and severe. Bruising and swelling may develop soon after your injury. Acute injuries include:

• Bruises (contusions). After an ankle injury, bruising may extend to your toes from the effects of gravity.
• Puncture wounds. Sharp objects, such as nails, tacks, ice picks, knives, teeth, and needles, can all cause puncture wounds. Puncture wounds increase your risk of infection because they are hard to clean and they provide a warm, moist place for bacteria to grow. The bacteria Pseudomonas is a common cause of infections when a puncture wound occurs through the sole of an athletic shoe.
• Injuries to ligaments that support your joints.
• Injuries to tendons, such as ruptured tendons in your heel (Achilles tendon). Children ages 8 to 14 may have a condition known as Sever's disease, which causes injury to the growing bone where the Achilles tendon is attached. This usually occurs during activity and is relieved with home treatment.
• Injuries to your joints (sprains). If a sprain does not appear to be healing, a condition known as osteochondritis dissecans may be present, causing persistent symptoms.
• Pulled muscles (strains). Muscles of the foot and ankle can be strained and can also rupture.
• Broken bones (fractures), such as a broken toe.
• A bone moving out of place (dislocation).
• A crushing injury, which can lead to compartment syndrome.

Overuse injuries

Overuse injuries occur when too much stress is placed on your joint or other tissue, often by "overdoing" an activity or repeating the same activity over and over. Overuse injuries include:

• Retrocalcaneal bursitis, which is inflammation of the bursa. This condition causes swelling and tenderness of the back of the heel and ankle. Pain usually gets worse while you are wearing shoes and during activity, and it improves during rest.
• Achilles tendinitis or tendinosis (tendinopathy), which is the breakdown of soft tissues in and around the Achilles tendon that connects the calf muscles to the heel bone.
• Stress fracture, which is a hairline crack in a bone.
• Plantar fasciitis, which is an inflammation of the plantar fascia, a broad, flat ligament on the bottom of the foot that extends from the front of the heel to the base of the toes and helps maintain the arch of the foot.
• Metatarsalgia, which is pain in the front (ball) of the foot.

Treatment

Treatment for your toe, foot, or ankle injury may include first aid measures (such as the application of a brace, splint, or cast), a special shoe (orthotic device), physical therapy, medicine, and, in some cases, surgery. Treatment depends on:

• The location, type, and severity of your injury.
• When the injury occurred.
• Your age, your overall health condition, and your activities (such as work, sports, or hobbies).