How did it happen?
Ankle sprain is usually caused by improper shoe gear, gait instability, or trauma. Individuals with a cavus foot type (supinated foot), are inheritably prone to inversion ankle sprains. However, their risk for ankle sprain increases if they wear shoes that exaggerate the condition (e.g. supinated shoes). Gait instability is seen more commonly in older individuals or in individuals who are recovering from trauma (e.g. car accident, stroke, etc.).
An ankle sprain is an injury of the ankle joint. At the time of injury, the foot is most commonly in an inversion position. When the foot is in that position, the lateral collateral ligaments (ligaments on the outside of your ankle) can be damaged. It is important to note that repetitive ankle sprains can lead to ankle instability, ankle synovitis, and osteochondral lesion.
Tendinitis is the inflammation of a tendon secondary to overuse. This usually happens in individuals who are active or stand/walk a lot for work. Posterior tibial tendon, peroneal tendons, and Achilles tendon are most commonly affected.
Metatarsalgia occurs when pain is present on a certain location of your foot secondary to an existing foot condition. The most commonly seen location is under the second metatarsal head. In other words, pain under the balls of the feet. Sub second metatarsal head pain can be caused by a short first metatarsal, hallux limitus, or elevated first metatarsal.
What are my options?
Acute ankle sprains should be treated aggressively so your return to activity will not be delayed. Keep in mind that if you cannot walk or see severe bruising along your ankle or foot, you should see a doctor immediately to rule out any fractures. Also, try your best to not walk on that limb to prevent further injury.
If you can still walk with minimal pain and no bruising is noted, you can try RICE at home. RICE therapy focuses on Rest, Ice, Compression, and Elevation. RICE helps reduce the swelling which in turn help with the pain. RICE is recommended for two weeks with limited activities. If pain fails to improve at the 2 weeks mark, it is highly recommended that you see a doctor for further evaluation.
Recurrent ankle sprains are problematic as they can affect your daily life activities and cause more issues down the line. The most common result of recurrent ankle sprain is ankle synovitis (a condition in which the soft tissue lining of the ankle joint becomes inflamed), which can cause ankle pain, and osteochondral lesion (a defect in the cartilage of a joint and the bone underneath). An osteochondral lesion can also cause ankle pain. With this condition, the longer it goes untreated the more damage it can create which can eventually lead to surgery.
Tendinitis responds very well to conservative treatment. Conservative treatments include but not limited to immobilizing, bracing, limiting activities, aqua roll therapy, MLS laser therapy, physical therapy, EPAT shockwave therapy, and orthotics.
If the condition is chronic and fails to improve with conservative treatments, advanced imaging is needed. Successful treatments for this chronic condition depend on the results of the physical exam and advanced imaging.
Metatarsalgia can be effectively treated by custom insert to accommodate for the deformity. Surgical treatment is usually not necessary.