If your foot and ankle doctor determines you have a sprained foot, you may be wondering how severe it is and if surgery will be necessary. In this blog, we will discuss foot sprains and possible treatments, including surgical solutions.
How Foot Sprains Happen
Foot sprains occur when the ligaments in the midfoot (the area between the toes and shin bone) become overstretched or torn. The midfoot has five long metatarsal bones as well as ligaments which compose what podiatrists call the Lisfranc complex.
If you have sustained a sprained foot, the ligaments of the Lisfranc complex will be involved. Most often, sprained feet of varying severity occur when a rapid twisting motion exerts extreme force on the midfoot and tearing occurs. Sometimes, fractures of the metatarsal bones accompany foot sprains, and if so, surgery is the most likely treatment of choice.
Symptoms of foot sprains include:
- Tenderness to the touch
- Limited ability or inability to bear weight on the affected limb
Diagnosing and Grading Foot Sprains
Mild foot sprains can respond well to at-home rest, icing, use of an elastic bandage for compression and elevation of the limb above the level of the heart. However, when symptoms are more severe and persist, or even worsen, then you should see a foot and ankle doctor for an accurate diagnosis and grading of the injury.
Your podiatrist will X-ray the affected foot, and possibly do an MRI or CT scan for the clearest possible imaging. They will also ask you about the circumstances surrounding the injury and perform some hands-on tests. Be sure to tell the podiatrist if you fell, were struck, or twisted your foot stepping down from a curb or other elevation. The details surrounding the injury help your podiatrist use the right assessments to reveal the problem, manage the symptoms and treat immediate and long-term effects.
For instance, the foot and ankle surgeon may perform a “piano key” test in which each toe is grasped and moved up and down. Or they may gently grasp the heel and rotate the midfoot and toes. Finally, you may be asked to stand, if possible, on the affected foot and slowly elevate yourself on your tiptoes.
With the results of imaging and these innovative tests, the podiatrist can grade your sprain and confirm or rule out any fractures of the metatarsal bones. Foot sprains are graded as one, two or three, with three being the most severe and likely to need surgery for best long-term relief of symptoms, prevention of arthritis and return to optimal weight-bearing and flexibility.
Is Surgery Necessary for My Foot Sprain?
Our podiatrists hear this question frequently. Thankfully, most foot sprains do well with physical therapy, rest and bracing and/or crutches.
However, the more severe cases do need surgery to stabilize the forefoot and to prevent the arch of the affected foot from collapsing under use. Your foot and ankle surgeon will tell you if an operation is your best treatment option. Usually, it is the optimal choice when severe sprains are
accompanied by one or more bone fractures in the Lisfranc complex in the midfoot.
With these severe foot injuries, your foot and ankle surgeon may install plates,screws, and other stabilizing hardware. Also, the soft tissues will be tightened for better midfoot and arch support.
Severe foot sprains require some time to heal. Physical therapy—whether you have surgery or not—is a must have so you can regain strength, flexibility, balance, and gait stability. Therapy helps you manage postoperative discomfort, too, helping to you rely less on pain medications.
Sprained Foot Treatment in Rhode Island and Massachusetts
At the Foot & Ankle Institute of New England, our three board-certified podiatrists are Drs. Criscione, Rogers and Gallucci. They are experts in all kinds of podiatric treatments, including surgeries which repair injuries and correct acquired and congenital deformities of the lower extremities.
If you sustain a foot injury, such as a sprain, be sure to contact one of our three offices for an evaluation and treatment plan. We are located in Warwick and Middletown, Rhode Island and in Dartmouth, Massachusetts. You may also request your appointment here. We look forward to serving you!