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Foot & Ankle

Ankle Arthritis

What is Ankle Arthritis?

There are 33 joints connecting the 26 joints in the ankle and foot. The ankle is the largest joint, and is a hinge joint connecting the lower leg and the foot. These joints are lined with articular cartilage, the smooth, white tissue lining the ends of each bone, and can break down over time from injury or the natural aging process. This process is known as degenerative arthritis or osteoarthritis.

How do you know if you have Foot or Ankle Arthritis?

Symptoms can include ankle pain, inflammation and stiffness. X-rays are often needed to confirm the diagnosis of ankle arthritis.

What are the treatments for foot or Ankle Arthritis?

Nonsurgical options historically included rest, modified activities, weight loss, medication, and physical therapy. The definitive treatment for arthritis is a joint fusion or replacement surgery. Many patients are not ready for surgery and there are a number of strategies to help manage pain until you are ready or the disease is severe enough to warrant surgery.

The goal of treatment is to control the pain and often includes medication, bracing, therapy, and a cortisone injection. Dr. Sussman offers alternatives to surgery, including platelet rich plasma (PRP) injections, amniotic growth factor injections and stem cell injections. Learn more about the alternatives to surgery here.

Achilles Tendinopathy

(Tendonitis)

Tenex procedure with the needle (arrows) guided into the Achilles tendon
tear (arrow head) as the tendon inserts on the heel bone.

What is Achilles Tendinopathy?

The Achilles tendon connects the calf to the heel bone (calcaneus) and is the largest tendon in the body. Injury to the Achilles tendon is often not related to a specific incident. Most Achilles tendon injuries are a result of gradual wear and tear. Micro-damage over time can result in degenerative tears of the tendon and pain.

How do you know if you have Achilles Tendinopathy?

Symptoms can include pain and stiffness over the back of the heel. Pain often is worse in the morning or at the end of the day. There can be swelling of the tendon. X-rays can show bone spurs. A MRI is often not necessary to diagnose Achilles tendinopathy, but Achilles tendinopathy can be confirmed with diagnostic ultrasound.

What are the treatments Achilles tendinopathy?

Achilles tendon pain can be challenging to treat. Nonsurgical options historically included rest, ice, medication, and physical therapy.

In the past when these traditional conservative treatments failed, surgery was recommended. Dr. Sussman now offers alternatives to surgery for chronic tendinopathy including platelet rich plasma (PRP) injections, stem cell injections and percutaneous needle tenotomy (Tenex). Learn more about the alternatives to surgery here.

Plantar Fasciitis

What is Plantar Fasciitis?

Platelet rich plasma (PRP) procedure for chronic plantar fasciitis with the
needle (arrows) guided into the thickened and partially
torn plantar fascia (arrow head).

The plantar fascia is a strong band of tissue that connects to the heel, and supports the arch of the foot. Plantar Fasciitis often is not related to a specific injury. Most plantar fascia injuries are a result of gradual wear and tear. Micro-damage over time can result in degenerative tears of the fascia and pain.

How do you know if you have Plantar Fasciitis?

Symptoms can include pain and stiffness under the heel of the foot. Pain can be worse in the morning or at the end of the day. X-rays can show heel spurs, but typically the spur is not the cause of pain. A MRI is often not necessary to diagnose plantar fasciitis, but plantar fasciitis can be confirmed with diagnostic ultrasound.

What are the treatments Plantar Fasciitis?

Nonsurgical options historically included rest, ice, medication, and physical therapy. In the past, when these traditional conservative treatments failed, surgery was recommended.

Because the heel spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur. Dr. Sussman now offers alternatives to surgery for chronic plantar fasciitis including platelet rich plasma (PRP) injections, amniotic growth factor injection, stem cell injections, and percutaneous needle tenotomy. Learn more about the alternatives to surgery here.

Chronic Ankle Sprain or Instability

What is an ankle sprain?

Platelet rich plasma (PRP) procedure for chronic ankle sprain with the
needle (arrows) guided into the chronically torn AITFL ligament (arrow head).

The ankle joint is surrounded by ligaments that help stabilize the joint. A sprain occurs when these ligaments are stretched beyond the normal range of motion. Most sprains involve the ligaments on the outside of the ankle. Most sprains are minor, but in more severe cases the ligaments can be torn leading to joint instability.

How do you know if you have a chronic ankle sprain or instability?

When the ankle ligaments are loose the joint can move too much. This extra motion can results in pain, and ultimately cartilage damage and arthritis. Typically, if you sprain your ankle the ligaments will heal with conservative management.

If you have ongoing pain after an ankle sprain or recurrent sprains you may have ankle instability. A MRI may not recognize a partial tear of the ligament. Examining the ligament with ultrasound, and stressing the ligament may help identify partial tears or nonretracted complete tears.

What are the treatments for chronic ankle sprain or instability?

Nonsurgical options historically included rest, ice, medication, and physical therapy. In the past, when these traditional conservative treatments failed, surgery was the only option recommended. Dr. Sussman offers alternatives to surgery for chronic ankle sprain or instability? Regenerative injections, including platelet rich plasma (PRP) injections, have been shown to help with chronic partial ankle ligament tears. Learn more about PRP here.