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Joint Injuries: Knee, Ankle and Foot Injuries

Between each vertebra in the spine there are soft tissue "discs" that help cushion the spine and add mobility to what would otherwise be a rigid structure. The problem starts when a disc becomes injured or damaged in someway. This can lead to disc degeneration, a disc protrusion, and even disc ruptures. All of these separate injuries can result in similar types of back pain and are often difficult differentiate with out the use of special imaging studies like X-rays or MRIs.

Disc injuries come in many different the two most common of which are disc herniations and degenerative discs.

Common knee problems can include:

    •    Pain, soreness, or tenderness
    •    Swelling or bruising around the knee
    •    Instability of the knee; where the knee can give way or won’t support your weight
    •    Stiffness, limited movement, or locking of the knee
    •    Clicking, popping, or grinding sounds with movement

Injuries are the one of the most common cause of knee problems. However, it may be difficult recall a specific injury, especially if your symptoms began gradually or during everyday activities.

    •    Overuse injuries (such as bursitis, tendonitis, or patellofemoral pain syndrome) often happen with repetitive activities or repeated or prolonged pressure on the knee. These can include activities such as stair climbing, bicycle riding, jogging, or jumping which stress joints, eventually leading to irritation and inflammation
    •    Sudden (acute) injuries may occur from a direct blow to the knee or from excessive bending or twisting of the knee.

Acute injuries include:

    •    Sprain
    •    Strain
    •    Torn ligaments. The medial collateral ligament (MCL) is the most commonly injured ligament
    •    Torn meniscus fractures
    •    Dislocated knee

The pain, bruising, or swelling from an acute injury may be severe and develop within a few minutes of the injury. Nerves or blood vessels can be pinched or damaged during the injury. The knee or lower leg may in turn feel numb, weak, or cold leading to tingling; or may look pale or blue.

Problems not necessarily the direct result of an injury may occur in or around the knee. A previous insult or injury, or increased activity may have caused the problem, either directly or indirectly.

    •    Osteoarthritis (degenerative joint disease) may cause knee pain that is increased in the early part of the day and improves during the latter part of the day. It often develops at the site of a previous injury or problem. There are other types of arthritis, such as rheumatoid arthritis, gout, and lupus, that can also affect the knee
    •    Osgood-Schlatter disease common in boys ages 11 to 15 causes pain, swelling, and tenderness in the front of the knee below the kneecap
    •    A popliteal (or Baker’s) cyst is a common cause swelling in the back of the knee
    •    Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can lead to pain and restricted knee movement. One sign of this is that the skin over the knee may be red, swollen or hot, pus may be present, or you may have a fever or chills
    •    A problem elsewhere in the body, such as a pinched nerve in the low back or a problem in the hip, can occasionally cause knee pain

Treatment for knee injuries may include first aid measures, knee braces, crutches, physical therapy, exercises, chiropractic manipulation, medication, or even surgery. Treatment options will depend on the age and health condition of the patient, the severity of pains and symptoms, and the type of injury (if an injury occurred).

Toe, Foot and Ankle Problems

Achilles tendon: back (posterior) view:

    •    Achilles tendinitis or tendinosis
    •    Stress fractures

Fractures of the foot:

    •    Plantar fasciitis

Plantar fascia ligament:

    •    Metatarsalgia

Joint problems:

Toe joints are more likely to develop problems than other joints in your feet.

    •    Heat, pain, redness, swelling, and extreme tenderness that comes on quickly in your big toe joint may be caused by gout. Similar symptoms can occur with an infection
    •    If you have swelling or a bump at the base of your big toe, you may have a bunion

Bunion (hallux valgus):

    •    If you have a bump on the outside of your little toe, you may have a bunionette
    •    If your toes, other than your big toes, bend in an odd position, you may have hammer toes, mallet toes, or claw toes. See an illustration of toe joint deformities.
    •    Joint pain, stiffness, and swelling are common when you have bursitis, arthritis, lupus, or gout

Pain:

You may develop pain in the front (ball) of your foot (metatarsalgia) or in your heel. Heel problems commonly occur when you overuse calf muscles, wear shoes with high heels, or participate in activities, such as running, that cause repeated pounding of your heels.

    •    Sharp pain on the bottom of your heel may be caused by plantar fasciitis
    •    Pain in the back of your heel and ankle may be caused by Achilles tendinitis or tendinosis or retrocalcaneal bursitis
    •    Pain that is worse before or after exercise but improves during exercise may be caused by a stress fracture of a bone in your foot (usually a metatarsal bone)
    •    Small bony growths under your heel bone may be a heel spur
    •    Pain in the midfoot may be caused by fallen arches or being flat-footed

Numbness or tingling:

Many conditions may affect the nerves of the foot which can result in numbness, tingling, and burning.

Nerves of the foot

    •    Pain, burning, tingling, or numbness that occurs between your toes, especially the third and fourth toes, and in the ball of your foot may be caused by a growth around the nerves (Morton’s neuroma)
    •    Pain, numbness, and tingling that begins in your back or buttocks, moves down your leg and into your foot may be sciatica, caused by a pinched nerve (nerve root compression)
    •    Foot and ankle pain that occurs with numbness and weakness in your foot may be caused by a pinched nerve in your ankle (tarsal tunnel syndrome) or back (sciatica)
    •    Burning, numbness, or lack of feeling in the feet may be caused by poor circulation, especially in people who have diabetes or peripheral vascular disease. The circulation problem can lead to nerve damage (peripheral neuropathies). Foot problems are more likely to develop in people who have these conditions

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