Common Foot and Ankle Injuries in Older Adults

Introduction

Foot and ankle injuries are common in older adults and occur in the feet or ankles of individuals aged 65 years or older. These injuries range from minor sprains and strains to more serious fractures and dislocations. Various factors, like decreased flexibility and balance, reduced bone density, and underlying medical conditions like arthritis, diabetes, and nerve damage, cause the injuries. Foot and ankle injuries impact an older adult's ability to walk, balance, and perform daily activities, and they also increase the risk of falls and cause other serious health complications.

What Factors Increase the Risk of Foot and Ankle Injuries in Older Adults?

Factors that contribute to the risk of foot and ankle injuries in older adults include:

• Reduced Bone Density: With age, bones become weaker and more prone to fractures, particularly in the feet and ankles.

• Chronic Conditions: Conditions such as arthritis, diabetes, and nerve damage can also increase the risk of foot and ankle injuries in older adults.

• Decrease in Strength and Coordination: As people age, the muscles and joints become weaker and less flexible, decreasing balance. This decrease in strength increases the risk of falling and sustaining foot and ankle injuries.

• Poor Vision: It increases the risk of falling and results in foot and ankle injuries.

• Certain Medications: Medications that cause drowsiness, dizziness, or lightheadedness, impairing an individual's ability to maintain balance, can increase the risk of foot and ankle injuries in older adults.

What Are the Common Foot and Ankle Injuries in Older Adults?

Several types of foot and ankle injuries occur in older adults, including the following.

• Sprains: It is an injury to the ligaments, which are the tissues that connect bones. Sprains can occur in the ankle, foot, and toes and are often caused by twisting or turning the joint.

• Strains: An injury to muscles or tendons, fiber-like tissue that connects muscles to the bones. Minor injuries cause overstretching, whereas severe injuries cause partial or complete tearing of these tissues.

• Fragility Fractures: Fragility fractures in older adults are breaks in bones that occur due to minimal trauma or everyday activities. Fractures like these are frequently related to osteoporosis, a medical condition that diminishes bone strength and elevates the risk of fractures. Risk factors for fragility fractures in older adults include:

  • Bones are weaker in older adults. A combination of falls and weaker bone has a higher chance of fracture.

  • Females have less estrogen hormone level after menopause which makes the bone thinner.

  • Low body weight.

  • Family history of fractures.

  • Individuals who have experienced a fragility fracture in the past have a doubled risk of experiencing another fracture in the future.

• Dislocations: A dislocation occurs when a joint's normal position is disrupted, forcing a bone to shift out of place. Dislocations can occur in the ankle, foot, and toes and are often caused by falls, trauma, or sports injuries. Dislocation usually occurs in the shoulders and fingers. Joint dislocation can occur to anyone. However, older individuals are more prone to joint dislocation, particularly if they have limited mobility or cannot avoid falls.

• Plantar Fascitis is an inflammation of the plantar fascia (a band of tissue that runs along the bottom of the foot). It is a common cause of heel pain in older adults and is often caused by overuse or poor foot biomechanics. Pain is usually seen in the center or inner side of the heel.

• Osteoarthritis: It is a type of arthritis that results from the breakdown and eventual loss of cartilage in joints. It is a degenerative disease commonly seen in older individuals that causes pain, stiffness, and reduced joint mobility. The most commonly affected joints are the hips, knees, hands, and spine. A combination of aging, injury, genetics, and obesity causes it. Arthritis in older age can cause foot injuries. Arthritis can cause joint instability, loss of range of motion, and muscle weakness, increasing the risk of falls and other foot injuries.

• Tendinitis is a tendon inflammation, usually caused by overuse, repetitive motions, and underlying health conditions. It can occur in the ankle, foot, and toes and is often seen in individuals who participate in sports or physical activities. Tendonitis in older age can be due to decreased flexibility, reduced blood flow, and weakened tendons. It can cause pain and discomfort in the affected area and limit mobility.

How Can Foot and Ankle Injuries in Older Adults Be Diagnosed?

The following steps can diagnose foot and ankle injuries in older adults:

• Medical History: The doctor will inquire about the individual's symptoms, past injuries, and medical conditions to better understand the cause of the injury.

• Physical Examination: The doctor will examine the injured foot and ankle, assessing the location and severity of pain, swelling, and range of motion. They may also perform specific tests to check for instability, weakness, or deformity.

• X-Rays can help the doctor determine if there are any fractures or changes in the bones. In addition, X-rays help diagnose conditions such as osteoporosis, which can cause bones to become more delicate and vulnerable to injury.

• MRI (Magnetic Resonance Imaging) Scan: MRI is a non-invasive imaging technique that provides detailed images of soft tissues like ligaments, muscles, and tendons. MRI diagnoses soft tissue injuries, including sprains and tears.

• CT (Computed Tomography) Scan: CT scans utilize a combination of X-rays and advanced computer technology to generate detailed images of bones and soft tissues. CT scans are particularly useful for diagnosing fractures, especially those that may not be visible on X-rays.

• Ultrasound Scan: Ultrasound uses high-frequency sound waves to visualize soft tissues and diagnose conditions such as tendonitis, bursitis, and plantar fasciitis.

In some cases, the doctor may also order additional tests, like blood tests or nerve studies, to rule out other conditions that could be causing the symptoms.

How Are Foot and Ankle Injuries of Older Adults Treated?

The treatment choice depends on the type and severity of the injury and the individual's overall health status. Treatment of foot and ankle injuries in older adults may involve a combination of the following steps:

• Rest and Immobilization: This involves avoiding activities that may worsen the injury and using crutches or casts to immobilize the affected area.

• Physical Therapy and Exercises improve flexibility, strength, and balance, reducing pain and swelling. Exercise programs are often tailored to an individual's specific needs and include stretching, range-of-motion, and weight-bearing activities.

• Medications: Pain relievers such as Acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs) can help manage pain and reduce inflammation.

• Orthotic Devices: Braces, shoe inserts, or other orthotic devices can help offload pressure from the affected area, reduce pain, and improve mobility. Purchase a brace under a doctor's guidance.

• Injections: In some cases, injections such as corticosteroids or hyaluronic acid can reduce pain and swelling.

• Surgery: In severe cases, surgery may be required to repair the damaged tissues, correct structural problems, or remove bone spurs or other obstructions.

A doctor will work with the patient to create a personalized treatment plan that meets their needs and objectives.

Conclusion

Foot and ankle injuries are a common concern among older adults. Proper care and attention will help in preventing these injuries effectively. Regular exercise, appropriate footwear, and regular checkups with the healthcare professional can maintain overall foot health and reduce the risk of injuries. Make sure to seek medical attention if an injury occurs, as timely intervention and treatment can ensure a full recovery and improve mobility in older people.