Sprained Foot: Symptoms, Causes And Treatment

The foot is a major structure in the body that is needed for us to move from one point to another. Without the foot, moving around will be a pretty difficult thing to do.

A lot of injuries, however, can happen to the foot because of its functions in the body. This article will tell us all we need to know about a sprained foot and how it can be treated.

What Does It Mean To Have A Sprained Foot?

The feet

 

A sprained foot is an injury to any of the ligaments in the foot. These injuries could be an overstretching of the ligaments, a partial or full tear of the major ligaments in the foot.

The foot is made up of 26 bones and 33 joints. It is divided into three sections:

  • The forefoot which starts from our toes to the balls of our feet. The bones in the forefoot are the metatarsals and the phalanges.
  • The midfoot which starts from after the balls of our feet to just before the heel. The bones found in the midfoot are the cuboid, navicular and cuneiform bones
  • The hind foot is the heel. The bones in the hindfoot are the calcaneus bone and the talus bone.

These bones found in the foot are joined together to form joints by thick fibrous tissues called ligaments. These ligaments along with muscles support the foot as we use them to carry out our daily activities. An injury to a ligament is called a sprain.

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The major ligaments found in the foot are:

Plantar Fascia

This ligament joins the heel to the toes. It also provides support to the arches of the foot. This ligament connects the three sections of the foot.

Plantar Calcaneonavicular Ligament

This ligament joins the calcaneus (heel bone) to the navicular bone, found in the midfoot. It supports the medial longitudinal arch which bears more of the body weight. This ligament spans from the hind foot to the midfoot.

Calcaneocuboid Ligament

This ligament joins the calcaneal bone, which is found in the hind foot,  to the cuboid bone, which is found in the midfoot. This ligament spans from the hind foot to the midfoot as well.

Looking at these ligaments we can say that the most affected part of the foot that is usually sprained is the midfoot due to the number of ligaments that run around it.

How Can I Sprain My Foot?

Improper footwear

  1. Wearing the wrong shoes to carry out activities may sprain ligaments in the foot or weaken the ligaments in the foot. Imagine running in heels and missing a step or having to jump over an obstacle while running, the foot is not well balanced or supported in the heels and the ligaments are already stretched in them. The impact of running or landing on your foot in the unsupported position can cause a sprain to the ligaments in the foot.
  2. Athletes that train on uneven or rough playing surfaces are prone to getting their feet sprained.
  3. A sudden twist of the foot while running or jumping from a high place and landing awkwardly.

How Can I Be Sure It Is A Sprain?

  1. Pain at the foot which can either be at the arch or the heel of the foot
  2. Tenderness
  3. Swelling at the top of the foot
  4. Difficulty Walking or bearing weight on the affected foot

Diagnostic Tests

X-ray

An X-ray is usually recommended to ensure that the foot or ankle is not broken as they both have pain and swelling in common with a sprained foot.

CT scan

A CT scan may be done to ensure that the ligaments are actually injured and not the tendons and muscles.

How Is It Treated?

Physiotherapy for the foot

1. See A Doctor

This is very necessary as not every treatment will work for a sprained foot. The doctor will prescribe the necessary medications needed to relieve pain and swelling in the foot. An x-ray or CT scan is usually recommended to rule out other conditions that have similar symptoms mentioned earlier.

The doctor will also refer you to a physiotherapist to assess the foot and prevent any further injury to the foot.

2. Physiotherapy

A physiotherapist will assess the foot to ensure that there are no fractures or dislocations as they tend to have similar symptoms with a sprained ligament.

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Due to the close proximity of the foot to the ankle, the physiotherapist will also assess the ankle just in case there are some injuries around it. After the assessment, the physiotherapist designs realistic goals to get you back on your feet. Literally.

The first goal of a physiotherapist is to relieve pain which can be done through the use of ice or heat therapy or the use of electric stimulators.

Another goal will be to reduce swelling and protect the foot from further injury which may involve getting a foot brace or taping and a type of massage called Effleurage which helps to reduce swelling. Depending on the severity of the injury, crutches or bed rest may be commended to prevent you from bearing weight on the injured foot as it may lead to increasing the severity of the injury.

The main goal of physiotherapy treatment is to get you back to your pre-injury state. As mentioned in the signs to show that a foot is sprained, one of them is difficulty in walking. The physiotherapist will gradually train you back to walking properly. This can be done through exercises to strengthen the muscles and training your walking movement as the signs reduce and the ligament heals.

The RICE treatment is usually done and recommended by the physiotherapist.

3. R.I.C.E

R.I.C.E. treatment.

Rest – The foot should be left to rest which basically means that no weight should be placed on the foot. Taping and the use of crutches will help to rest the affected foot.

Ice – Ice has been shown to reduce swelling and relieve pain by making the affected area numb. This can be done by placing big chunks of ice into a bowl of water and placing your foot into the bowl for 15 minutes or crush ice in a damp towel and place around the painful part of your foot for 15 minutes.

Compression – Compression helps to reduce swelling by using an elastic bandage. This is wrapped around the foot, especially the swollen part, which will help to reduce the swelling.

Elevation – Elevation, with compression, reduces swelling. the foot should be elevated n a way that it is higher than the chest. This will help reduce swelling.

4. NSAIDs

Anti-inflammatory drugs are recommended to help reduce swelling and relieve pain. Ointments with analgesics as their major component are recommended by a physiotherapist. An ointment with methyl salicylate or a hot gel is NOT recommended in the first 3 – 5 days after the injury.

The ointments normally used are described as cold gels. These have Diclofenac, Ketoprofen, and Ibuprofen as their major analgesic component.

5. Surgery

Surgery is recommended when the ligaments are completely torn. A ligament repair or reconstruction injury is usually done to the ruptured ligament.

6. Exercises

Ligament stretches to the foot

Exercises are gradually introduced into the rehabilitation treatment as the injury heals. Muscles may waste due to inactivity as the foot sprain may affect your locomotion.

Some of these exercises include:

  • Place your feet on the floor and spread your toes. Hold this for 5 seconds and rest them
  • While lying or sitting, point your toes towards the ceiling and then to the ground. This can be done 5 to 10 times.
  • While sitting, roll a tennis ball under your foot back and forth to help relax the muscles and provide some form of massage
  • Place your heel on the floor and lift your forefoot and midfoot off the ground. Hold for 5 seconds and drop your entire foot to the ground.

How Long Does It Take To Heal?

Foot treatment

The time frame of healing for a sprained foot depends on the severity of the ligament injury. It also depends on how soon treatment and rehabilitation commenced after the injury.

All ligament injuries are graded from 1 to 3 and can only be identified by a doctor and a physiotherapist. These grades are:

Grade 1- In this grade of ligament injury, the ligaments are overstretched beyond their limit but they are not torn. This takes about 2 to 4 weeks to completely heal.

Grade 2 – The ligaments are partially torn but not completely. This takes about 6 to 8 weeks.

Grade 3 – In this grade, the ligaments are completely torn and often require surgery. This takes at least 2 months to heal.

How Can I Avoid Spraining My Foot?

  • Wear the right shoes or place a silicon insole in your flat shoes.
  • Check your training shoes and change them when due. Training shoes actually have a life span. If you overuse your trainers, they begin to wear out and may not provide as much balance for the foot. Also, your training shoes should be properly taken care of. A way to know when your shoes are wearing off is to compare your new walking shoes, for example with the old one.
  • Warm up and stretch before any activity. Warming up prepares the muscles in the legs for any sporting activity and helps prevent injuries.

What May Happen If The Sprained Foot Is Not Treated Well?

  • Severe pain at the ankle joint
  • Reoccuring swelling in the injured foot
  • Muscle weakness of the affected leg
  • Change in the normal walking pattern which may cause a domino effect of pain in the ankle and knee joints

A sprained foot may seem like a minor injury but if not well treated, it may stop you from performing your daily activities, especially if you are into sports and may go on to cause pain at the ankle and knee joints.

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Adekanmi Lipede, M.Sc, MPH

Adekanmi Lipede is a licensed physiotherapist with a Master's degree in physical activity and public health from Loughborough University. She joined 25 Doctors in 2018 and is passionate about educating people about the best steps to take when trying to be physically fit or when recovering from a mobility-related condition. For fun, she loves to exercise and read.
Adekanmi Lipede, M.Sc, MPH
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