Transcription:
Foot and Ankle Sprains and Injuries

Melanie Cole (Host): Ankle sprains and foot injuries are very common injuries. Around 25,000 people incur these types of injuries every day. My guest today is Dr. Marco Ucciferri. He’s a podiatrist at Summit Medical Group. Welcome to the show, Dr. Ucciferri. So, let’s first just talk about the most common injuries that you see of the foot and ankle all the time.

Dr. Marco Ucciferri (Guest): Sure, some of the common injuries I see in the office or in the hospital setting are ankle sprains or foot sprains, also a lot of lacerations in the summer time. Some patients either cut their feet or get foreign bodies in the bottom of the foot. They get things stuck inside their foot. So, those are the most common injuries we tend to find, and also fractures, of course. But, the most common ones tend to be ankle sprains.

Melanie: So then, let’s talk about ankle sprains. How do we know if we’ve sprained our ankle? Do we hear a pop? Is it just pain? What would we feel?

Dr. Ucciferri: When a patient typically tells me, in regards to their history and spraining their ankle, they typically tell me they feel some type of tear or a pop. Sometimes it’s audible. But, basically, they end up having an inversion type of injury, where their foot kind of rolls from underneath the patient and they end up having swelling and pain in that area immediately.

Melanie: Is this an emergent condition? Do we wrap it in ice and put it up or do we run off to see a doctor about this?

Dr. Ucciferri: The typical acronym is RICE- rest, ice, compression and elevation. So, I usually tell patients when something like this does happen outside or at home, you want to immediately take care of it. You want to address it as fast as you can so that it really reduces some of the post-injury type of swelling and pain. If it’s not resolving or feeling any better by the next day or so, I usually recommended patients to follow up with a physician, either at an urgent center or at the office.

Melanie: Is it okay to take an NSAID for the pain or swelling, or no? You don’t recommend that?

Dr. Ucciferri: It is okay if the patient can tolerate NSAIDs. Not everyone can do that depending on their health history but if they can tolerate an NSAID, it would be appropriate to do that to reduce some of the swelling and pain to the area.

Melanie: Does a sprained ankle predispose someone to arthritis of the foot and ankle?

Dr. Ucciferri: It can if it’s repetitively done. I do have patients that have “weak ankles” that repetitively sprain their ankles even on the slightest bit of irregular surface and those patients do end up having some kind of arthritic condition to the ankle. Sometimes they have chronic ankle instability with inflammation to the joint, almost like an early form of arthritis that could be limiting in their activity level.

Melanie: Is there a way to prevent ankle sprains, Dr. Ucciferri?

Dr. Ucciferri: I explain to patients, sometimes as a patient is older, sometimes there are injuries they sustained when they were younger, so giving proper support to an older patient, such as sneakers or bracing. Sometimes they may get Neoprene braces or sleeves that surround the ankle. So, if they’re very active and going out and doing sports or exercising, it makes sense to use some type of supportive device. Podiatrists do make custom-mold orthotics which is very helpful to stabilize the foot and ankle to prevent further injuries in the future. Also, making sure the surface you’re going to be on, for instance, if patients like to do trail-running or trail-walking versus walking on a straight surface, you want to be more careful in regards to where you’re going to be running based on your ability to have stability to the ankle. So, you don’t want to be running in the woods or in a grassy field if you know there’s going to be irregular surfaces that could make a patient prone to spraining their ankle.

Melanie: Do you hate high heels?

Dr. Ucciferri: I don’t hate high heels. I think some patients wear them and it’s appropriate to wear them but there are some patients who shouldn’t be wearing high heels. There is an issue regarding spraining the ankle and also causing further damage to the Achilles tendon and other parts of the foot. If they’re walking heavily in heels or using them almost every day, you can have issues long-term with high heels but, on average, use is not an issue at all.

Melanie: So then, you mentioned at the beginning about lacerations and stepping on things. That’s pretty common, especially in the summer. People are walking around in bare feet. What do you do when you step on something? Do you pull it out? Do you run off to the doctor? What do you do?

Dr. Ucciferri: Sure. So, if you step on something and you can visibly see it and get to it, I would say try to remove the portion that’s sticking out of the skin. If it’s deep in the skin, I usually tell patients not to try to dig it out or poke things in there to get that either splinter or foreign body out of the foot. I usually recommend they see either an urgent care center or physician as soon as possible so it can be done in a sterile way and make sure that you don’t have complications such as infection after removing the foreign body.

Melanie: Do you recommend--suppose our child steps on something, as children do--do we use Neosporin and then wrap it up? Do you like those kinds of analgesics?

Dr. Ucciferri: Yes, you can do Neosporin. There are all types, depending on the patient’s ability to tolerate some of the medication. There are some people that are allergic to certain, even topical antibiotics. But, an antibiotic type of solution that the patient can tolerate, be it like a Neosporin, or Bacitracin, or Betadine ointment and bandaging it to take some of the pressure off until they can see a physician.

Melanie: What about tetanus because we used to hear a lot about that: “Oh, if you step on a nail or something rusty, you have to get a tetanus shot.” Is that still what’s being done?

Dr. Ucciferri: Yes, if there’s any type of history, I think at this point in the medical profession, most patients have a good tetanus prophylaxis at this point where they don’t need to get a tetanus shot or a booster but it would be best to check with your physician, making sure that your tetanus booster is up to date and that, if you need one, you should probably get one immediately after stepping on something, even if it’s wood or glass or metal.

Melanie: Okay. So, it’s definitely something that they’re still checking on. What do you want us to be cautious or look for if something isn’t right?

Dr. Ucciferri: Obviously redness, feeling sick, sometimes patients get fevers or chills from sometimes an infection, redness and also purulent drainage from the area. Basically, any type of signs of infection to the area, you want to be aware and typically the pain. When patients step on something, if they don’t get the whole piece out or the piece doesn’t come out, it’s typically painful to still put weight on it and to me that’s really the biggest alert sign to make sure you follow up with a medical professional is that if you’re still having some discomfort when you step on the foot.

Melanie: So, doctor, give us some advice on proper foot care and what you want us to do in the summer. Women have cut little toenails, we’re wearing sandals, and what do you want us to know about good, healthy feet in the summer?

Dr. Ucciferri: As far as good, healthy feet in the summer, I explain to patients you should definitely keep moisture to the skin. A lot of women tend to wear flats that are open, or sandals, or walk barefoot and their skin tends to dry out and callous and can cause some pain or even issues with integrity of the skin. I explain to patients that they should moisturize the skin. Make sure they bathe regularly, keep the area clean and then, when there’s the ability to wear a supportive shoe, it makes sense, especially now there are summer fairs going on and people are out and about doing activities outside. It makes sense to wear a supportive shoe to care for the foot and make sure there’s no further damage or possibility of stepping on something or spraining your foot or ankle, twisting it based on not having good, supportive shoes when you’re out and about.

Melanie: If someone does have weak ankles, as it were, and they like to play tennis or they like to golf and they have to step down into the sand, do you recommend wrapping or bracing?

Dr. Ucciferri: Yes. There are different braces and wraps you can either purchase or have made that give support to the foot and ankle. There are also cases when that is actually surgically repaired. There are patients that have chronic ligament damage that there’s a lack of support, so even with bracing and with taping or wrapping of the ankle and foot, they continue to have issues with sprain and instability. In those cases, we usually do further examination with an MRI and x-ray to evaluate for possible treatment and that can be corrected, actually, so that they don’t need to wear as many braces or as frequently to be out and about. But, yes, if you’re going to be in an area where there’s going to be irregular surfaces like sand or beach or you’re prone to spraining your foot or ankle, it makes sense to wear some type of brace or tape up or wrap up the ankle and foot.

Melanie: In just the last few minutes, Dr. Ucciferri, give us your best advice for healthy feet, ankle sprains and foot injuries, lacerations, and what you really want people to know and why they should come to Summit Medical Group for their care.

Dr. Ucciferri: Sure. So, basically during the summer, everyone’s out and about, doing their thing. I want patients to know that if there’s any type of injury sustained, whether it’s a sprain, a laceration, a foreign body in the foot, make sure you clean it and take care of it right away. You want to address these things right away, not just keep walking and ignore them. If they’re not improving in a day or so and patients are feeling worse with something they’ve incurred, an injury of some sort, they should call Summit Medical Group. We’re very able to see them and make sure that they’re treated appropriately and so they can get back to their summer activities as soon as possible with no pain.

Melanie: Thank you so much. It’s great information. You’re listening to SMG Radio. For more information, you can go to SummitMedicalGroup.com. That’s SummitMedicalGroup.com. This is Melanie Cole. Thanks so much for listening.