BOSMC consists of a team of specialists who manage the full spectrum of foot and ankle disorders from the common to the complex.

Foot and ankle problems are quite common in sports and we are able to diagnose and treat a wide range of conditions.

COMMON DIAGNOSES

Ankle Sprains and Fractures

Initial management of acute sports ankle injuries is often undertaken by emergency departments and your physiotherapist. In some situations , radiological imaging will indicate a serious fracture or ligament injury. 

Acute swelling after an ankle rollover is best assessed early with examination by a clinician followed by imaging as required.

Many ankle ligament sprains can be managed by early rest , ice, compression followed by rehabilitation. It is rarely a good idea just to return to sport without adequate rehabilitation and strengthening.
 

Traumatic Midfoot Dislocations

These injuries are often not immediately detected and delayed diagnosis can lead to early onset osteoarthritis.

The typical mechanism involves the forefoot being twisted in relation to the hind foot. Another player may have stood on the forefoot anchoring it down. Midfoot pain and subsequent swelling can occur. Inability to be able to toe stand can occur.

Early imaging including weight bearing plain xray  and MRI is helpful.

This condition is usually treated seriously with immobilisation on crutches for several weeks or may require operative reduction and fixation.
 

Tendoachilles Rupture

The Achillles tendon is one of the strongest tendons in the body and is crucial to running and jumping.

The tendon can tear or rupture and high load but can also rupture in the middle age person and males are more commonly affected.

The typical injury occurs as a sudden event when the back of the leg gives way. Many people will look around to see who kicked them. 

Even though the ligament has ruptured , it is still possible to walk on the leg which can deceive the patient in to thinking that the injury is a minor one.

An experienced clinician will make the diagnosis on examination although an ultrasound will clarify the diagnosis.

In many cases this condition can be managed conservatively although operative repair will be advised sometimes.
 

Tendonitis

Tendons are the part of the body that attach the muscle to the bone. It is through tendons that our muscles of the foot and ankle act to allow us to perform the different motions necessary for walking. Injuries to tendons usually start with an inflammation of the lining of the tendon (paratendonitis) that lead to inflammation within the tendon (tendonitis). Both of these conditions commonly are initiated by overuse secondary to over activity or increased stress on the tendon. If left untreated, tendonitis can lead to a tear within the tendon or a complete rupture of the tendon. If properly treated early with rest, activity modifications, direct physiotherapy and proper medication, the problem can be resolved completely. If untreated, in addition to pain, long term structural abnormalities such as flat foot can result. Occasionally, surgery may be necessary in order to regain the normal pain free function of the foot and ankle.
 

Neuromas

A neuroma is an irritative process of a nerve branch. A neuroma in the foot usually occurs as the nerve courses between the metatarsal bones and into the toes. An inflamed, irritated nerve that supplies sensation to the third and fourth toes is called a Morton’s neuroma and is the most common neuroma. Numbness and burning are generally consistent findings. Pain may vary from mild to severe and is frequently precipitated by tight fitting shoe gear or hosiery or by trauma. Treatment frequently involves removing the irritating process, i.e. removing the narrow or high heeled shoes. Metatarsal pads, non-steroidal anti-inflammatories and cortisone injections are often treatment modalities. Surgical intervention is reserved for the recalcitrant cases, but can provide excellent symptom relief in properly selected individuals.
 

Fractures

A fracture is a broken bone. If not treated properly, a fracture can lead to long term disability. The bone may fail to heal (non-union) or it may heal in a poor alignment (mal-union). If a non-union or mal-union occurs, often times a surgical reconstruction is necessary.

The complex anatomical relationships of the multiple bones of the foot and ankle allow for pain free walking, running, jumping, etc. When a fracture of one of these 30 bones of the foot and ankle occurs it is essential to obtain a prompt evaluation for proper diagnosis and treatment. Techniques employed may be non-operative with casting and early foot and ankle physical therapy or surgical reconstruction of the broken bone(s) followed by a foot and ankle rehabilitation program. With early diagnosis, proper treatment, and correct rehabilitation, the goal of a healed fracture leading to a foot and ankle that functions without pain can be obtained.
 

Ingrown Nails

Ingrown nails most commonly involve the big toe, but can involve any of the toenails. The nail becomes ingrown when one or both sides grow into the skin of the toe. The skin then becomes red and swollen and causes pain. Sometimes the nail actually breaks the skin and causes a localised infection which may become more acutely painful and cause drainage from the side of the toe. They can become quite debilitating. Ingrown toenails are most commonly caused by shoe pressure, although some people may be born with a tendency to develop ingrown toenails. They inherit this directly from one or both parents who may suffer from the same problem. Other causes for ingrown toenails may be improperly trimmed nails, crowding of the toes within shoes, repeated trauma to the toes from abnormal activities, such as running, walking or certain sports.

Ingrown toenails can be prevented by cutting the toenails after bathing, when they are soft and making sure to cut the nails straight across, only slightly rounding the edges of the nails. Patients are not recommended to cut down into the borders of the nails, which often leads to infection along the side of the toe. After properly trimming the nails, the edge of the nails should be lightly smoothed with a file or emery board. Patients are also advised to wear well fitted shoes that are not restrictive in the toe area.

Patients who suffer from discomfort of ingrown toenails are advised to soak their feet in a solution of lukewarm water and soap, followed by applying an antiseptic or topical antibiotic and covering with a bandage. If this treatment is not successful in alleviating the patient’s discomfort the patient may need to seek a doctor’s care. Ingrown toenails that are infected usually require some minor surgery in order to remove the portion of nail causing the infection, followed by prescribing soaks and appropriate topical antibiotics to resolve the localized infection. Patients are advised to continue to properly care for their nails and wear properly fitted shoes in order to prevent more chronic problems with ingrown nails. Chronically ingrown toenails may be corrected with surgery by removing part of the toenail and the growth matrix to prevent the regrowth of the problem side of the nail. Patients who suffer from diabetes are particularly cautioned against cutting their nails improperly, since these individuals are prone to serious infections which often require a doctor’s care.

Please remember that medical information provided by Brisbane Orthopaedic and Sports Medicine Centre, in the absence of a visit with a physician, must be considered as an educational service only. The information contained in this web site should not be relied upon as a medical consultation. This web site is not designed to replace a physician’s independent judgement about the appropriateness or risks of a procedure for a given patient.