Your feet and ankles are subject to a large amount of stress -- first by bearing your body weight, and secondly by absorbing the full impact of landing from an airborne position while running and jumping. Ligaments are tissues that connect bone to bone and provide stability to the joints. While the ligaments are elastic, an overstretching of the ligament can result in a partial or full tear, affecting joint stability and movement.
Types of Ligament Tears
An overstretched or torn ligament is a common injury that may be caused by excessive, repetitive movements or a sudden trauma or fall. The overstretching can be classified based on the severity of the injury. A grade one strain is an overstretching of the ligament. A grade two strain is a partial tear. A complete tear is considered a grade three injury and may be subject to surgery. The extent of the ligament injury can be determined by the use of magnetic resonance imaging, or MRI.
Medial and Lateral Ligaments
The ligaments connecting your lower leg to your foot are located on the sides of your ankles. Three major ligaments are on the outside, and several stronger ligaments are located on the inside of your ankles. The less stable outside ligaments are prone to rolling movements that can result in overstretching or tearing. Initial treatment is geared toward reducing pain and swelling. This treatment may consist of rest, ice, pain medication and immobilization. Physical therapy can be introduced as soon as pain and swelling is diminished. For severe tears requiring surgery, physical therapy may be delayed.
Lisfranc Ligaments
The Lisfranc ligament is located in the metatarsal, or mid-foot, area between your toes and your ankle. This ligament is tight and limits joint movement. Overstretching or ligament tears are generally due to sudden trauma, falls or twisting of the middle of the foot. Initial treatment consists of immobilization and reduction of pain and swelling. This may last between four to six weeks. Rehabilitation in the form of physical therapy generally begins after the initial treatment has been successful.
Plantar Fasciitis
Plantar fasciitis is a condition characterized by inflammation of the ligament located on the bottom of your foot connecting the toes to the heel. In severe cases, the ligament can be partially or completely ruptured or torn. Common causes are repetitive stresses on the foot, arthritis, inadequate footwear and structural problems such as high arches and flat feet. Initial treatment consists of rest, ice and pain medication to reduce pain and swelling. The second treatment phase consists of physical therapy in the form of ultrasound and gentle stretching. Phase three consists of strengthening exercises and the use of orthotics. Athletes may progress through the phases more quickly than sedentary individuals.
References
- American Academy of Podiatric Sports Medicine; Plantar Fasciitis: Treatment Pearls; Douglas Richie, Jr. D.P.M.
- American Academy of Orthopaedic Surgeons; Sprained Ankle; March 2005
- University Foot and Ankle Institute: Ankle Ligament Tear/Ankle Instability
- Duke Orthopaedics: Ligament and Tendon Injury
- "American Family Physician"; Lisfranc Injury of the Foot: A Commonly Missed Diagnosis; Kevin E. Burroughs, M.D., et al.; July 1998
- Plantar Fasciitis Organization: Plantar Fasciitis, Heel Spurs, Heel Pain
