EP #9: Unwrapping the Intricacies of Ankle Sprains: Identifying and Treating Sudden Foot Pain

Ever found yourself hobbling around after a deceivingly simple misstep? We can relate to that sudden ankle pain that ambushes you mid-run. In our latest episode, I'm joined by my co-host Jeremy Wolf where we peel back the layers on the often overlooked world of ankle sprains and foot injuries. We discuss everything from the alarmingly easy ways we can overstretch our ligaments during everyday activities to the tell-tale signs that distinguish a sprain from more serious conditions like fractures or complete ligament tears.

Navigating the complexities of our foot's connective tissues, Dr. Lauren enlightens us on the precautions and timely medical interventions crucial for those unexpected ankle twists. As avid runners and sports enthusiasts, or simply someone curious about their foot health, you'll find our chat filled with actionable advice. We cover the significance of pain duration as a red flag, the role of diagnostic tools like x-rays and ultrasounds, and the various levels of ligament sprains. So strap on your health-conscious hats, and tune in – your joints will thank you for it.

To learn more, visit: LMDpodiatry.com or contact (954) 680-7133

Transcript

Speaker 1: 0:01

Welcome to the LMD Pediatry podcast. Trust us to get back on your feet. Here's your host, Dr Lauren Devakarov.

Jeremy: 0:15

Hello everyone. We are back your co-host here, Jeremy Wolfe, with Dr Lauren Good. To see you again, Dr Lauren Good morning.

Jeremy: 0:24

Good morning. So thanks everyone for tuning in. You know we have a running theme going here, pun intended, and it's my running journey. You know I was running the other day and out of nowhere I just started getting some pain in my ankle and kind of the lower arch of my foot and it got me thinking about how I'm getting old and I'm breaking down real quickly. But got me thinking about ankle sprains and I don't really know what that is exactly. So can you maybe explain what a sprain is and how it differs from other foot and ankle injuries?

Dr. Lauren: 1:01

Sure. So what is a sprain? Right, there's. So you have ligaments. Right, we have hundreds of ligaments throughout our whole body and what ligaments do is they hold down bone to bone. So every little joint in your body is held together or anchored with the ligament. And a ligament is just made from this fibrous connective tissue and it's just supposed to stabilize the joint and hold it together. When a sprain happens, in your case an injury, what happens is those ligaments, they stretch. So, like a regular, boring grade one sprain is that you take that ligament and then, instead of it being nice and parallel and smooth, all of a sudden it stretched out a little. You know, you can have a grade one, grade two, grade three sprain and you could have a partial tear of your ligament. You have a complete tear. So all those it's basically nothing is holding the joint anymore.

Jeremy: 2:04

So and this could just come, obviously, because I feel like I didn't even do anything to create the injury this could come from just repetitive motion, doing the same activity, and I probably stretching, as we always talk about, would help that.

Dr. Lauren: 2:17

Well, you could have like a like if you were running. In your case you were running or you're, you know, the stair master or biking, or playing tennis, golf, any of those like repetitive things, pickleball for example if you, if your foot's not very stable when you do that motion, if it's not held well in a shoe, for example, or your entire shoelace is enough, so you know eventually that you know that that ligament will overstretch and that's kind of that's probably why you might not have like a pure sprain. But you know, the ligament probably was like the joint was a little unstable when you're running and it's overstretched a little bit and that's why your ankle is hurting. So that's kind of you know, basic way to explain it.

Jeremy: 3:07

So how can I, or someone who's listening, differentiate between because I'm just assuming at this point that maybe, maybe a lot of times, you tweak your ankle, you're like, oh, I just sprained it. But how can you differentiate between a sprain and something more serious that could actually require some immediate tension, like a fraction of a fracture or like a ligament tear?

Dr. Lauren: 3:27

So it usually depends how long the pain takes to go away, right.

Jeremy: 3:31

So how long? How long should it take then? Because it's been like a week or so. I can't. I still get it when I run.

Dr. Lauren: 3:36

So. So if it's been a week, you should see here your local local foot doctor.

Jeremy: 3:42

Okay, you got to get me in on the calendar. I got to come see you.

Dr. Lauren: 3:45

So that's when. That's what happens. When patients have a trauma, they you know they have a trauma, they have pain. If it doesn't go away within a week or two, then they come in to get evaluated. I always get an x-ray to make sure nothing's broken and then, if the x-ray is broken, if nothing's broken on the x-ray, I do a quick ultrasound and the ultrasound will show me if there's a ligament, you know, if there's a ligament sprain. If there's a tendon sprain, you know your tendons can over stretch your ligaments, your ligaments can over stretch. Lots of different things can happen. The most common thing I see in your case for a runner, you guys usually get a capsular a spring. A capsular spring is like the second joint underneath the pad of your foot.

Dr. Lauren: 4:33

That one is where you land all the time when you run. So a lot of times if you guys are not protecting the area, you can have a little sprain or a tear there.

Jeremy: 4:43

Yeah, I felt a lot of the pain in this comfort. Again, out of nowhere, I was just running and all of a sudden it was around the lower ankle area, into the arch of the foot, and I kept going because I was like, oh, I can get past this. And then I got done and now I'm getting ready for a 5k, I think next weekend.

Dr. Lauren: 5:01

That sounds like a tendonitis, jeremy. Yeah, you have the posterior tibial tendon. It courses through the inside of your ankle, attaches into your arch and what happens with that is that is the main tendon that holds up your arch. So if you're wearing shoes or insoles that aren't giving you enough support, and then you're a runner, so that that repetitive motion probably made your tendon tired and that's why it probably hurts worse at the end of the day.

Jeremy: 5:33

Yeah, I mean it just depends right. When I walk around barefoot it starts to hurt, but when I have the shoes on and I walk it doesn't hurt as much. But if I start running, inevitably after a few hundred yards I start feeling a little bit of pressure on the bottom and it just gets worse.

Dr. Lauren: 5:49

Right. So, just like I kind of analyzed from where your pain was, I'm assuming that. But that's why you should always come in, because it could be anything and each thing is obviously the best is rest, but each thing is treated very differently. So if it's just like a tendonitis or you have like an inflamed tendon that's tired, the best, you know, for example, the best thing to do is just rest it and ice it and compress it for like two, three weeks and then if you do have like a serious sprain, that usually requires some sort of immobilization for up to six weeks.

Dr. Lauren: 6:31

So you know, wearing a brace or something like that, a lot of people get ankle sprains. You know, I always recommend wearing a brace for six weeks because you know it takes that long for your body to lay down the foundation for the ligament to repair itself. So you know again, there are so many types of injuries and they all act differently. They all need to be treated a little differently. So that's why it's really important to you know, if you suspect some pain hint hint, jeremy, if your pain's not going away after a week or two, no matter what you do, it's best to come in and get some imaging and, you know, have an examination by your local podiatrist. Hint, hint me, so we make sure that your pain's free.

Jeremy: 7:20

I'm glad I know a good podiatrist, because I think a lot of people suffer from what I do, which is to say I think it's probably an ego thing, more for men. I get a little pain and I think in my mind like, oh, I'm sure it's nothing, like I don't need to go to the doctor, I'm gonna, I can walk it off, and then it maybe it isn't something that's that severe, and you keep putting pressure on it and then all of a sudden that turns into a more severe injury and then you're out of commission for a while. So yeah, I think.

Dr. Lauren: 7:48

I had. I've been having patients that they've been living with their pain for over a year, year and a half. And then when I do an exam and I see you know all the stuff I look on the inside. Guess what? They're like full of scar tissue and it's like harder to repair, that they're less likely to respond to basic treatment. You know what I mean. So you know. When you pain is like a really big indicator by your body like please do something about me, so a lot of people think that just because you know it'll go away, it'll go away and then when it doesn't go away, they don't want to do anything about it because they know they have to keep walking and they can just keep walking on the injury.

Dr. Lauren: 8:27

So that makes it worse. Yeah, you know, do your stuff to everyone out there and podcast lands. You know good neighbors, you know, don't ignore your pain because it can be. It could be something simple and then it could be something severe, so you don't want it to end up in some type of complication.

Jeremy: 8:48

All right. Well, I am definitely going to schedule a time to come see you to get this looked at, and I actually haven't haven't been to a podiatrist and I can't even remember the last time I've been in, so it's probably a good idea to get a little bit of a check up. So you'll be hearing from me, for sure.

Dr. Lauren: 9:08

Do you want to know anything else about springs, or did we cover everything?

Jeremy: 9:12

I think I got a pretty good handle, unless there was anything else that you wanted to share.

Dr. Lauren: 9:18

No, I mean it's, it's pretty basic. You know, just it's important to protect your feet with wearing the right shoes, right inserts, and if you have an injury and want to keep going, there are ways to, just you know, wrap your ankle and wrap your feet, back, your toes.

Jeremy: 9:35

I'm going to take a CO tape, right? Yeah, I'm going to tape it. That's what I'm going to do. I'm going to tape it after I see you. If you give me, if you give me the green light to run the 5k, I'll tape that, tape that puppy up.

Dr. Lauren: 9:46

Yeah, it's so. It's so versatile how we treated there's. Like you know, medicine is so advanced today. They didn't have an easier state 100 years ago, when people kept walking on their injuries and we didn't have the shoes that we had, you know, 100 years ago. So everything is really different. I would say that the most common cause of everybody's injuries today is because the shoes today are made for foot size and not for foot type, whereas 100 years ago they were fitted for the foot. Every person had their own custom shoe.

Jeremy: 10:17

You had to go see a cobbler to fit you for a pair of shoes Exactly, and everyone needs to bring back the cobbler.

Dr. Lauren: 10:24

Let's go. I went to like a museum and I saw like all these like shoes and you can tell like each person had a unique shape to their shoe, as do all we today, but all the shoes today are like massively produced. Yeah, we've made for cheap, cheaper material, materials that we're out very frequently and a lot of you know, a lot of people just aren't aware about that. I have no idea and they don't know why they get all these aches and pains.

Jeremy: 10:51

I mean, it kind of makes sense right, we spend quite a bit of time on our feet makes sense to have a pair of shoes that supports them properly, and obviously, yeah, it's hard to come by.

Dr. Lauren: 11:01

you know I do lots of shoe education in my office, so so keep your, keep your feet, you know, protected everyone.

Jeremy: 11:11

All right, sounds good. Thank you everyone for joining us and we will catch you all next time. Everyone, have a wonderful day and take care.

Speaker 1: 11:25

Thank you for listening to the LMD podiatry podcast. For more information, visit LMD podiatrycom. That's LMD podiatrycom or call 954-680-7133.