FOOT & ANKLE

PAIN

www.tocdocs.com

LIFE OR SPORTS, WE GET YOU BACK IN THE GAME.SM

Fort Sanders Regional The Trustees Tower

501 19th Street, Suite 600Knoxville, TN 37916

Tel 865.524.5365 • Fax 865.673.8007

The Tower at Parkwest9430 Park West Boulevard, Suite 130

Knoxville, TN 37923 Tel 865.690.4861 • Fax 865.560.8525

Seymour11546 Chapman Highway

Seymour, TN 37865Tel 865.524.5365 • Fax 865.673.8007

Oak RidgePhysicians Plaza

988 Oak Ridge Turnpike, Suite 100 Oak Ridge, TN 37830

Tel 865.483.8478 • Fax 865.483.4194

Randall R. Robbins, MD961 Oak Ridge Turnpike

Oak Ridge, TN 37830(865) 483.1906 • Fax (865) 483.3807

Lenoir City576 Fort Loudoun Medical Center Drive, Suite 100

Lenoir City, TN 37771Tel 865.988.8667 • Fax 865.988.8837

SPINEKnoxville10321 Kingston PikeKnoxville, TN 37922

Tel 865.694.8353 • Fax 865.693.0338

Foot and Ankle Brochure Stiched.1-2 1-2 9/6/07 11:58:27 AM

We know that getting back to normal is important to you. That’s why patients at TOC are always seen quickly. For urgent needs you can receive same-day treatment at one of our Quick Care clinics. For orthopaedic problems relating to the foot and ankle, see our foot specialists at TOC.

When should you see a foot and ankle specialist?If your pain:

• is increasing

• is continuous or prolonged

• prevents you from enjoying and performing daily activities

• is non-specific and has failed to be diagnosed by previous exams

• is associated with diabetes and requires reconstructive surgery

What can a foot and ankle specialist do for you?

TOC’s foot and ankle specialist provides comprehensive therapy catered to the specific symptoms and needs of the patient. By following steps of treatment starting from the simplest to the most complex, TOC will give you a correct, accurate diagnosis appropriate for your specific orthopaedic condition.

TOC Foot and Ankle Specialist:E. Brantley Burns, MD

Tracy A. Pesut, MD

Foot and Ankle Brochure Stiched.3-4 3-4 9/6/07 11:58:30 AM

PLANTAR FASCIITIS

What is plantar fasciitis?Plantar fasciitis is an inflammation of the plantar fascia, which is tissue that extends from the heel to the base of the toes. The plantar fascia provides support for the arch and allows flexibility. Plantar fasciitis occurs when the tissue is either pulled or torn, which causes swelling and can pull bone away, resulting in a bone or heel spur seen with the aid of an X-ray.

What are its symptoms?Plantar fasciitis is most commonly associated with heel pain. This pain can be more severe in the morning or after a period or rest or inactivity. You may also experience swelling, redness or tenderness.

What causes it?Two million people each year suffer from plantar fasciitis. It can be caused by repetitive stress, obesity, middle age, a tight Achilles tendon, flat feet or high arches. Athletes are prone to experience it as a result of an acute injury caused by abrupt contact with a hard surface. Improper shoe wear, uneven walking surfaces or the presence of a heel spur can also be responsible.

How is it treated?Most cases of plantar fasciitis improve with rest. Medication can reduce the swelling or your doctor may recommend a shoe insert or other orthotic device for extra cushioning and support. If morning pain is severe, you may consider wearing night splints or casting to keep the plantar fascia stretched. Roughly 90% of patients improve with conservative treatment; however, if you continue to experience pain or the condition becomes disabling, surgery may be considered.

Your Foot & Ankle

Did you know that each step you take puts up to 1.5 times your bodyweight on your foot and ankle? With the average person traveling roughly 1,000 miles a year on foot, that’s a significant performance. It’s no wonder that the 26 bones and more than 30 joints in the foot and ankle can become sore, swollen, broken or torn.

More than 12 million physician visits per year are the result of foot and ankle complaints. Some people simply try to treat the condition or injury themselves, which only worsens the problem.

The most common foot and ankle problems include:• Achilles Tendonitis

• Ankle Injuries

• Plantar Fasciitis

Foot and Ankle Brochure Stiched.5-6 5-6 9/6/07 11:58:32 AM

ACHILLES TENdONITIS

What is Achilles tendonitis?The Achilles tendon is the largest and strongest tendon in the body. It attaches to the heel bone and connects the leg muscles to the foot. Achilles tendonitis is a painful inflammation of the tendon. This inflammation is a result of either insertional or non-insertional tendonitis. Insertional tendonitis is common in older, non-athletic, overweight or sedentary individuals. Non-insertional tendonitis is found among athletes who use repetitive foot and ankle motions that cause a high amount of stress on the tendon, such as jumping, pushing or cutting.

What are its symptoms?Achilles tendonitis is associated with pain in the back of your leg during or following an activity. As the condition worsens, your pain can occur earlier in your activity, with decreased activity or at rest. You may also have swelling, redness, hotness or a hard knot or tightening of the tendon on the back of your leg. If left untreated or without sufficient rest and recovery, a partial or complete tendon rupture can occur, which will make walking virtually impossible.

What causes it?The elderly are prone to develop Achilles tendonitis since the arch in the foot tends to flatten with age, which strains the Achilles tendon. Achilles tendonitis can also be the result of a single incident that causes significant stress or a series of small, repetitive tears that accumulate over time. Suddenly changing your activity level, training on unleveled surfaces or wearing inappropriate footwear contribute to the cause. Achilles tendonitis has also been linked to the use of certain medications and steroids.

How is it treated?You will need to discontinue any strenuous, weight-bearing activities for 3 to 4 weeks. Non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen may be recommended to help with the pain and swelling. Your doctor may also suggest physical therapy as a way to stretch and strengthen the calf muscles and tendon. Orthotics, heel lifts or gel cups can be used to ensure good body alignment and support after the injury. Sometimes a cast may be needed to ensure rest. If the symptoms do not get better after about 4 to 6 months, surgery may be necessary.

ANKLE INjURIES

What are ankle injuries?Ankle injuries can be the result of an ankle sprain, strain or fracture. A strain occurs when a muscle or tendon surrounding the ankle overstretches. A sprain occurs when the strong connective tissue (ligament) that connects one bone to another become overstretched. When the ligament tears and pulls a fragment of bone with it, that’s a fracture.

What are their symptoms?Ankle injuries often result in swelling or tenderness. Usually the differences (or grades) of a sprain, strain and fracture can be determined by how much weight – if any – the ankle can bear.

What causes them?Most ankle injuries involve a sudden, unexpected loss of balance that causes a sharp turn, twist or roll in the ankle, causing the ankle’s tissue to stretch beyond its normal range.

How are they treated?The most useful and easiest treatment to remember is RICE:

• Rest: Stay off the ankle as much as possible.

• Ice: Apply ice to the ankle for 20 minutes every hour to reduce the swelling.

• Compression: Firmly wrap an elastic bandage, stocking or gel wrap around the ankle to support the ankle and foot. Do NOT wrap the ankle too tightly.

• Elevation: Keep the foot above heart level as much as possible during the first 48 hours after the injury to minimize bruising and swelling.

Anti-inflammatory drugs such as ibuprofen will help reduce the pain and swelling.

If your doctor has decided to immobilize the ankle for a significant time, physical therapy will be required to restore full muscle balance and strength. In rare cases, surgery will be required to reattach ankle ligaments, stabilize the ankle, or remove bone fragments, scar tissue or damaged cartilage.

Foot and Ankle Brochure Stiched.7-8 7-8 9/6/07 11:58:32 AM