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An Achilles tendon tear is a complete rupture or partial tear in the tendon running along the back of the lower leg that connects the calf muscles to the heel bone (calcaneus). Partial and full tears are most likely the result of activities that involve forceful bursts of jumping, pivoting, or running. The injury commonly occurs in individuals playing recreational sports. A tear can also be the result of direct trauma to the Achilles tendon as occurs in an accident or fall. The Achilles tendon may grow weak with age or prolonged inactivity and become even more susceptible to injury or rupture.
The Achilles tendon is the thickest and strongest tendon in the human body. A tough band of fibrous tissue, it is also known as the calcaneal tendon or heel cord. The Achilles tendon is formed as the gastrocnemius and soleus muscles (calf muscles) unite into one band of tissue at the low end of the calf. Its terminal insertion is at the back of the heel bone and is cushioned by fluid filled sacs known as bursae. Although the Achilles tendon has an extraordinary ability to withstand great stress from running, jumping, and all of the daily activities, it is also prone to injury from overuse, degeneration, and trauma.
The Achilles tendon has a massive job to do. As the calf muscles contract, the heel by way of this tendon, is lifted. This action allows one to point their foot and stand on tiptoe. It also produces the majority of force that allows the foot to push down, which is an essential component of every step whether it be for walking, running, jumping or any other related movement.
Although the Achilles tendon is quite strong, due to a limited blood supply and the massive demands placed on the tendon, it is susceptible to injury. When the Achilles tendon stretches beyond its biomechanical limits, it may tear. Most cases of involving a tear are the result of a sports activity. It is an especially common injury in middle–aged “weekend warriors” who participate in sports during their spare time. Older individuals, as well as those with a history of previous Achilles tendon injuries, certain illnesses, or taking certain medications, may have a weakened tendon and have a higher risk of suffering a tear.
Achilles tendon tears can range from micro-tears, with or without symptoms, to larger ruptures that cause significant pain, swelling and impairment. Additionally, a tear may occur suddenly or develop gradually over time.
Symptoms of a complete tear or total rupture may include:
In cases of a partial tear the symptoms may vary. The amount of tenderness, swelling, pain, stiffness and the degree of impairment depends on the severity of the tear.
Diagnosing a torn Achilles tendon begins with a thorough medical history and the performance of a physical exam. During the clinical examination the doctor will examine the foot, ankle, and calf, to check for signs of an Achilles tendon injury. Range of motion, the ability to perform certain movements, and muscle strength will be evaluated. Imaging tests may be also ordered to fully assess the damage.
Treatment depends on the severity of the rupture as well as an individual’s health and activity level. Options include both surgical and non-surgical approaches. For minor ruptures and for individuals who have medical conditions that preclude surgery, a non-surgical treatment may be suggested. In instances of a complete tear of the tendon, surgery is typically recommended.
There are 28 bones in the foot and ankle complex. These bones in partnership with 25 joints and supporting soft tissues are responsible for providing balance, supporting an individual’s body weight in an upright posture, and facilitating a diverse range of movements including standing, walking, running and jumping. As the foot and ankle work together to propel the body through movement at different speeds, they are able to sustain forces that are up to several times an individual’s body weight, as well as adapt to most types of surfaces that are underfoot.
However, supporting the body in all upright movements exposes the foot and ankle to constant physical stress. This is one of the reasons that a broken ankle or a broken foot is a common injury. Events such as a simple misstep, repetitive stress and overuse, and falling or tripping can all result in a fracture. In addition trauma that is sustained from a direct blow, from a crushing injury that occurs in an accident, or from the impact of a heavy weight dropped on the foot or ankle can also lead to broken bones in these areas. Bones in this region that have been weakened by disease processes such as osteoporosis or cancer may be more vulnerable to fracture.
An ankle or foot fracture is a painful and debilitating injury that impairs mobility and disrupts normal daily activities. These fractures can occur as either an isolated injury or in conjunction with other soft tissue injuries. The severity depends upon the location of the fracture, the degree and type of fracture, and the damage to the surrounding tissues. In some cases there may be signs of an obvious deformity, the skin may appear stretched over the underlying bone, or bone may actually be exposed. If not treated promptly these fractures can have dangerous complications and result in long lasting impairment.
Symptoms of a broken ankle or foot may include:
Nerve and blood vessel injuries can cause additional symptoms including paleness, numbness, or an inability to move the ankle, the foot, or the toes.
Treatment of ankle fractures depends upon the type and severity of the injury. Some ankle fractures can be treated without surgery. If the bones are aligned, a period of immobilization with a splint or cast may be sufficient. In many cases an ankle fracture will require a surgical procedure to repair the bone along with any associated soft tissue related injuries. Similarly the treatment of a foot fracture depends upon the type and severity of the injury, which bone in the foot is broken, what part of the bone is broken, as well as where this bone is located in the foot. Foot fracture treatment can range from buddy taping an uncomplicated toe fracture all the way to complex surgical procedures designed to restore bone integrity, the surrounding soft tissues, and foot function.
The presence of ankle and leg deformities can be attributed to a variety of causes. They may be congenital (present at birth), the consequence of a dysplastic disorder, developmental, the result of injury, disease, tumor, or the failure to heal properly following an earlier trauma or procedure.
In many instances of ankle and lower limb abnormalities, both bone and soft tissue deformities are present. Because defects range from differences in appearance or uneven limb length to more severe disfigurement, pain, limited mobility, or even a complete loss of function, the treatment varies. Skilled care is essential. If left untreated, ankle and lower limb deformities can affect joint alignment and lead to more far-reaching musculoskeletal problems and pain.
Corrective care for an ankle or limb deformity may involve anything from casting, bracing, medications, and physical therapy to minor or major surgical procedures. It’s essential to keep in mind that growing children present different considerations in care from adults, and treatment may differ.
However, whatever the underlying cause and prescribed treatment may be, correcting these deformities requires precise planning, skilled execution, and focused care. This statement also applies to recovery and rehabilitation. As a trained and accomplished foot and ankle surgeon, Dr. J. Turner Vosseller performs all types of non-surgical and surgical procedures, including guided growth surgeries to address complex lower limb and ankle deformities.
More than an unsightly bump, a bunion is a deformity of the framework of the foot. It develops when the joint at the base of a toe becomes unstable, causing both the bone and soft tissues to move out of place. Most often seen at the base of the big toe, a bunion can also develop on the little toe. Although imperfect foot mechanics may be at play, factors such as your gait, footwear, injuries, occupations that put stress on the feet, and other conditions contribute to bunion formation.
Even though bunions tend to develop slowly, when left untreated, they become larger and more disfiguring over time. In addition to making it harder to find shoes that fit and feel comfortable, bunions lead to other foot problems. Furthermore, as they get bigger, bunions can affect your balance, reduce mobility, and impact other parts of your body.
In some cases, conservative treatment such as recommended footwear, padding, splinting, physical therapy, or taking medication provides relief. However, when non-surgical treatment fails to restore comfort and function, a surgical procedure may be recommended.
At the office of Dr. J. Turner Vosseller, we treat a comprehensive range of foot and ankle disorders and develop treatment plans that address individual needs. While we tailor the surgical approach to the requirements of each case, the following goals remain the same:
As a skilled specialist, Dr. J. Turner Vosseller provides expert guidance while providing the most advanced treatment to achieve healthy outcomes of care. He performs the leading-edge surgical techniques to get patients back on their feet and enjoying the activities they love.
Moving about with comfort and ease relies in large part upon the health and functional harmony of the 26 bones, 33 joints, and intricate network of muscles, tendons, and ligaments that make up each of your feet. If misaligned or unstable bones and joints are responsible for persistent discomfort, cartilage damage, arthritis, and impaired function, a foot or ankle fusion surgery may be indicated.
Fusion surgery involves connecting and permanently joining adjacent bones in the foot or ankle to prohibit motion and reduce instability. The goals are to alleviate pain, optimize weight-bearing capacity, and facilitate normal activities. It's performed when other treatment options fail to produce sufficient pain relief, stability, or function.
During a fusion procedure, the damaged cartilage is removed, and the adjacent bones are moved together and stabilized with surgical screws or plates. When needed, a bone graft gets placed to support healing while promoting a stronger and more durable fusion.
It's essential to bear in mind that complex foot and ankle issues require the skilled and experienced care of a specialist. As a trained and experienced foot and ankle surgeon, Dr. J. Turner Vosseller is well equipped to perform all types of foot and ankle fusion procedures. He provides expert care using the most advanced technology and sophisticated treatment methods to alleviate discomfort and restore optimal function.
Consisting of some 26 bones and an intricate framework of muscles, tendons, and ligaments, each foot is exquisitely designed to allow you to stand, walk, run, jump and absorb the tremendous forces that get generated every time the heel hits the ground. If any of these interdependent parts are damaged, disfigured, or not working in perfect harmony, your ability to move about and function with comfort and ease can be compromised.
Foot deformities are common problems that can arise for a variety of reasons. They may be hereditary, a congenital problem, the result of an injury, produced by ill-fitting footwear, or the consequence of a medical condition that affects the bones and tissues of the foot. In addition to being a source of local pain and discomfort, these deformities can impair function and progress to create more far-reaching issues that extend upwards through your feet, legs, hips, back, and beyond.
As a skilled and experienced orthopedic foot and ankle surgeon, Dr. J. Turner Vosseller treats a comprehensive range of foot deformities. He offers advanced non-surgical and surgical solutions to reconstruct normal anatomy, improve alignment, alleviate discomfort, and restore optimal function.
Some of the most common foot deformities he treats include:
Dr. J. Turner Vosseller expertly evaluates every case to determine the precise nature and extent of the deformity and the best way to correct it. He customizes every step in care from the initial diagnosis to the provision of treatment and follow-up care, including prescribing a physical therapy program, rehabilitation, and returning to daily activities.
As part of the musculoskeletal system, a well-designed network of strong, fibrous connective tissue attaches the muscles to the bones. Known as tendons, these bands transfer the action of the muscles to the bone, to move various body parts.
The tendons in the foot and ankle are particularly active. They not only support your movements as you walk, run, jump, or stand, but they also provide your feet with balance and stability. While healthy tendons allow you to function with comfort and ease, traumatic injuries, overuse, medical conditions, and degenerative changes can damage these tendons. An injured tendon can cause you significant pain while also impairing your mobility and function.
When a tendon gets torn, treatment depends on the severity of the rupture as well as the individual’s overall health, activity level, and lifestyle. While minor, partial tears may respond to non-surgical treatment, a severely torn, or completely ruptured tendon often requires surgery.
The goal of tendon repair and reconstructive surgery is to alleviate discomfort, restore function, re-establish range of motion, and sufficiently improve foot and ankle strength to allow the resumption of normal activities. During surgery, the damaged tissue is removed, and then sutures are precisely placed to repair the tendon. A graft or tendon transfer may also be required to supplement and support the repair and reconstruction.
Treating foot and ankle injuries requires the skilled care of a specialist. As a trained and experienced foot and ankle surgeon, Dr. J. Turner Vosseller performs the most advanced procedures to repair and reconstruct damaged tendons. In addition to offering comprehensive treatment for a wide range of foot and ankle disorders, he provides a customized, well-planned rehabilitation program to support optimal recovery.
One of the most common toe deformities seen by our office is a hammertoe. Most often attributed to wearing ill-fitting, tight footwear or high-heeled shoes that squish the toes into a bent position, a hammertoe can also be influenced by genetic factors, the result of a bunion, or caused by arthritis in the toe joint.
Just as the name implies, a hammertoe resembles a "hammer" with the toe bending at the middle joint into a claw-like deformity. While hammertoes usually affect women, men can develop them as well.
Hammertoes can cause discomfort while walking, and even when you try to move or stretch your toes. You may also develop corns or calluses on the top of the toe and the ball of the foot and have difficulty fitting into your shoes. While in its early stages of development, the involved joint still feels flexible, if left untreated, your hammertoe will become more rigid and less responsive to conservative modes of care.
Treatment for a hammertoe depends upon the severity of the toe deformity, level of toe flexibility, existing medical conditions, and other factors. In the case of mild deformities, or for individuals with complex medical histories, conservative treatment may be recommended. A non-surgical plan may include strategically placed foot padding, wearing shoes with a roomy toe box, custom orthotics, splinting, or taking anti-inflammatory medication as needed to reduce pain and inflammation. However, severe toe deformities and joint rigidity warrant surgery. Also, a combination of surgical procedures may be recommended when other foot deformities accompany a hammertoe.
The goal of corrective hammertoe surgery is to re-establish normal anatomy while restoring comfort and function. During a surgical procedure, the toe is straightened, and the joint between the involved bones stabilized. While healing, the newly realigned bones fuse, thereby permanently maintaining the toe in a straighter and healthier position.
As experts in foot anatomy, health, and function, Dr. J. Turner Vosseller uses the most advanced surgical techniques to achieve outstanding results of care. Also, the success rate of hammertoe surgery is quite high, and the risks of complications are low. While hammertoe surgery is often performed as an outpatient procedure, treatment and delivery of care are tailored to address each patient's unique requirements.
Sometimes hammertoes and a bunion go hand-in-hand. When that's the case, both deformities can get surgically corrected at the same time.
Whether it's the treatment of hammertoes, or any other issue affecting foot health and function, you can rely on our office for skilled and experienced care. Dr. J. Turner Vosseller maintains an unwavering commitment to excellence and is dedicated to providing patients with the most effective options in care.
A Lisfranc injury occurs in the midfoot, where the five long metatarsal bones that extend back from the base of your toes meet the small tarsal bones that sit in front of your ankle area. It includes a range of injuries and encompasses any combination of sprained ligaments, fractures, or dislocations affecting the Lisfranc joint complex.
The degree of discomfort and debilitation produced by a Lisfranc injury depends upon the extent of the damage and number of ligaments, bones, and joints involved. Because the midfoot endures up to 2-3 times a person’s body weight while stabilizing the arch and transferring force from the lower leg muscles to the front of the foot, a Lisfranc injury can have significant consequences.
A Lisfranc injury may be caused by anything from a twist and fall to sports-related trauma, an automobile accident, or something heavy landing on the foot. Besides the various combinations of bone, joint, and ligament disruption, a Lisfranc injury can damage the cartilage covering the bones.
Signs and symptoms of a Lisfranc injury include the following:
Since a Lisfranc injury might be mistaken for a simple sprain, it’s essential to see a skilled and experienced foot and ankle surgeon for a precise diagnosis and care. Stable injuries without fractures or dislocations that only involve stretched or partially torn ligaments may get treated non-surgically. However, more complex Lisfranc injuries with ligament damage, fractures, and dislocations typically require surgical intervention to realign the bones, reattach any pieces of bone, and repair the ligaments.
As an orthopedic surgeon specializing in the treatment of foot and ankle disorders, Dr. J. Turner Vosseller offers the latest and most effective methods of care to address a Lisfranc injury, alleviate pain, and restore optimal function.
Between the base of the toes and the ankle in each of your feet sit five metatarsal bones. Long and strong, these bones give your foot its arch and serve as a natural springboard to cushion and support all manner of movement. Although your feet will adapt to most surfaces while bearing the weight of your body and helping you maintain balance, the metatarsals are vulnerable to fracture from either repetitive stress or acute trauma.
Metatarsal fractures account for 5 to 6% of all fractures and are among the most common injuries to the foot. While acute metatarsal fractures are the immediate result of direct trauma such as a heavy object dropping on the foot, getting stepped on, kicked, landing awkwardly from a jump, or twisting the foot and ankle, stress fractures tend to develop as the result of overuse and emerge over a more extended period of time.
A traumatic fracture of a metatarsal bone typically exhibits the following signs and symptoms:
However, stress fractures typically feel a bit different. Although initially, your discomfort may be intermittent, diffuse, and alleviated with rest, the pain gradually becomes more localized and continuous. If left untreated, a hairline stress fracture can significantly worsen, progressing to a full-thickness fracture.
Whatever the case may be, it's essential to contact our office for care. Proper diagnosis and treatment from an experienced foot and ankle surgeon are required to restore alignment, promote optimal healing, protect the foot from further injury, and reestablish healthy function.
Treatment of a fractured metatarsal depends on the type and extent of the break. Once diagnosed and evaluated, many cases can be treated with a walking cast or rigid shoe to correctly immobilize the hard and soft tissues in the foot to allow healing. However, in certain situations, a surgical procedure may be required. If the fracture occurs in an area where the blood supply is poor, or the bones are displaced, surgery often provides the best course of care.
Whether it's a matter of a period of rest and immobilization or surgery, our foot and ankle surgeon is with you every step of the way. In addition to providing detailed instructions on how long to keep weight off your foot, and follow-up care, we'll also recommend the appropriate physical therapy, exercises, and rehabilitation to help ensure a healthy return to your daily activities.
The plantar fascia is a band of connective tissue that runs along the bottom of your foot. It extends from your heel to the base of your toes. Trauma, overuse, or prolonged wear and tear on the heel can strain this band, causing damage, inflammation, and pain. Pain under the heel is most frequently associated with a condition known as plantar fasciitis.
According to statistics, plantar fasciitis affects 1 in 10 people at some point during their lifetime. It affects both athletic and less active individuals and may be triggered by several factors and activities that overload or overstretch the plantar fascia. Risk factors for plantar fasciitis include foot arch problems, a tight Achilles tendon, and tight calf muscles. Additionally, specific sports, exercises, being overweight, and worn or poorly constructed shoes may contribute to the problem. Plantar fasciitis is common among athletes who run and jump a lot. Runners, in particular, often complain of plantar heel pain.
Symptoms of plantar fasciitis can occur suddenly or gradually and can be quite painful. The most common symptom is pain and stiffness in the bottom of the heel. While an individual with plantar fasciitis may experience dull or sharp pain, sometimes aching or burning on the bottom of the foot is felt. In many cases, a heel spur is also present.
Most cases of plantar fasciitis respond to conservative and non-operative approaches to care. Non-surgical treatment may include physical therapy, orthotics, night splinting, casting, or corticosteroid injections, and other medications. However, there remains a small percentage of people who do not experience sufficient relief. When symptoms are disabling and persist even after an extended course of conservative therapy, a surgical procedure to release a tight or contracted plantar fascia may be indicated. Plantar fasciitis surgery offers a high success rate and is typically performed as an outpatient procedure.
If a heel injury or persistent heel pain and associated symptoms are keeping you from participating in your daily activities, it’s time to contact a trained foot and ankle surgeon for an evaluation and care. At the office of Dr. J. Turner Vosseller, we provide the highest quality of skilled and experienced state-of-the-art care.
Healthy feet and ankles are naturally built to bear the weight of your body, absorb the forces of impact each time your feet strike the ground, and propel your body from place to place. However, they are not impervious to injury. Sudden trauma, repetitive strain, and overuse can damage the soft and hard tissues in the feet and ankles, causing discomfort, impairing function, and limiting participation in daily living activities.
With all of the running, jumping, pivoting, twisting, turning, and other movements involved in sports, overuse and acute injuries to the feet, ankle, and lower limbs are common. While injuries to the feet and ankle are often seen in many contact sports or activities like gymnastics and running, even weekend warriors and people who enjoy certain activities only once in a while can experience these injuries.
Even though there’s a long list of sports-related injuries to the foot and ankle, the most common ones involve sprains and strains, fractures, dislocations, and issues affecting the Achilles tendon. Keeping in mind that some injuries cannot be foreseen or avoided, some factors such as inadequate training, insufficient warm-up exercises or stretching, improper footwear, and the lack of appropriate protective equipment can contribute to the risk.
It is recommended that individuals who have sustained an injury seek treatment in a timely manner and refrain from continued stress to the affected site. With prompt attention and care further trauma and the onset of other complications can be prevented.
Treatment for a foot and ankle injury depends on the extent and severity of the damage. Care may include conservative methods such as orthotics, braces, casting, immobilization, physical therapy or medications. However, surgery may be necessary to correct alignment, alleviate discomfort, and restore function.
After reviewing the patient’s history, performing a clinical exam, and obtaining diagnostic tests as needed, Dr. Vosseller determines the best options in care. In addition to providing treatment to repair damaged tissue, alleviate discomfort, and restore mobility, he will recommend treatment to reduce the risk of re-injury.
Dr. J. Turner Vosseller provides the latest advanced non-surgical and surgical methods of care to help patients back on the road to health and back in the game.
The feet support the weight of your body every step of the way. With the average person taking approximately 8,000 to 10,000 steps a day, and athletes putting in even more mileage while enduring more wear and tear to their feet daily, it’s hardly surprising that stress fractures are a common problem.
Unlike a broken bone that occurs as the immediate result of a traumatic injury, a stress fracture develops slowly over time in response to repeated stress. For people with healthy bones, stress fractures in the foot and ankle are typically associated with high-impact, repetitive activities such as running, gymnastics, tennis, soccer, football, and other types of contact sports. Beginning a new activity or increasing the level of an existing one, in which the feet recurrently strike the ground, also elevates the risk of a stress fracture.
Sometimes, a foot deformity or even poorly fitting, non-supportive shoes can change the distribution of forces associated with walking, jumping, standing, or running to increase the likelihood of a stress fracture. For someone with a medical condition that weakens the bones, even low-impact activities can cause a stress fracture.
Because a stress fracture can develop slowly over time, it may not be immediately apparent that one is present. However, being mindful of the signs and symptoms can help prevent further damage.
Common symptoms of a stress fracture in the foot and ankle include:
If you suspect you may have a stress fracture, it’s essential to contact our office for care. Left untreated or ignored, a stress fracture can progress to a complete break causing more significant damage. At the office of Dr. J. Turner Vosseller, we provide skilled and compassionate care to address a wide range of disorders affecting the foot and ankle, including the treatment of repetitive stress and overuse injuries.
Once a complete assessment is performed, and the diagnosis gets confirmed, our office will recommend the best options in care to relieve your pain, prevent further damage, allow your fracture to heal, and get you back to your daily activities. While many stress fractures respond to nonsurgical treatment, some cases require a surgical procedure to heal properly.
You can rest assured your treatment is in the best of hands at the office of Dr. J. Turner Vosseller. From diagnosis to treatment, follow-up care, recovery, and rehabilitation, we’re with you every step of the way.
Enjoying comfortable and easy movement relies in large part on healthy feet. While all your toes bear your body's weight when walking and help you move faster when running, your big toe plays the most significant role in maintaining your balance and supporting your body weight.
When direct trauma or overuse subjects the main joint of the big toe to excessive force that causes it to bend upward more than normal, it can result in an injury known as "turf toe." More commonly seen in athletes who play sports on hard, less shock-absorbent surfaces like artificial turf, this injury can also happen in other sports and activities if the toe is suddenly jammed or repeatedly stressed when pushing off to run or jump.
Turf toe symptoms reflect the severity of the injury. When the tissues comprising the "plantar complex," which is the main joint in the big toe, are only slightly stretched, it produces localized tenderness and swelling. However, when partial or complete tears, which involve more significant damage to the joint complex, occur, they produce more extensive swelling, discomfort, and tenderness.
In addition to inflammation and pain, turf toe injuries to varying degrees also impair joint movement and limit mobility. Although in cases of repetitive stress, the symptoms emerge slowly, direct trauma produces immediate discomfort and damage.
Treatment depends on the precise diagnosis and assessment of the injury. For this reason, it's essential to see a skilled professional for care. Many turf toe injuries respond to conservative, non-operative modes of care, including RICE, orthotics, less-flexible footwear, or immobilization. However, more severe cases with evidence of severe tears, fractures, or cartilage damage may require a surgical procedure to alleviate pain, promote healing, and restore function.
At the office of Dr. J. Turner Vosseller, we specialize in the treatment of foot and ankle issues and provide skilled and experienced care to treat Turf Toe injuries.
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