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Treated Foot & Ankle Conditions

Daniel L. Peterson, DPM, FACFAS is a board certified, fellowship-trained foot and ankle surgeon and the head of the Foot and Ankle Team at Sheridan Orthopedic Associates. This team is one of the most respected in all of Wyoming and combines decades of experience in both non-surgical and surgical treatments for conditions of the foot and ankle. The Foot and Ankle Team at Sheridan Orthopedic Associates collaborates on each patient’s diagnosis to establish the most effective treatment plan.

Appointments & Contacts
Foot Conditions:
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Bunions

Bunions are a condition that affects the big toe at the joint at the base of the toe and occurs when the big toe is forced inward toward the second and third toes causing a bump to form at the first metatarsophalangeal (MTP) joint. The MTP joint is important, as it is the joint that is required to flex every time we take a step. As the joint weakens or become stiff, walking and standing can become painful. Over time, the toe can become deformed and begin to overlap the second or third toes.

When consistent pressure is applied to the toe over a long period of time the tissue underneath the toe at the joint rubs together and grows thicker. This tissue may also become trapped between the joints of the toe and become irritated and is the source of the pain in the toe. This pressure is often a result of shoes that are too tight, poorly fitting or high heels.

Signs and symptoms of Bunions may include:
● Pain in the toe
● A bunion on the toe
● Deformity of the toe
● Pain when wearing shoes
● Pain when walking
● Sensitivity to touch

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Hammer Toe

Hammer Toe is a visible deformity in which one or more of toes of the foot becomes deformed and overlaps the other toes. This condition is especially common in women who often wear high heels.

High-heeled shoes or footwear can force the toes into a space that does not allow them to lie flat. This forces the toes to become bunched and compacted into a small space causing the toes to curl. This can alter the joints and tendons of the toe causing this curled position to persist even when barefoot.

In some instances, an injury including stubbing or breaking the toe can cause Hammer Toe.

Signs and symptoms of Hammer Toe may include:
● Visible deformity of the toe
● Permanent curled position of the toe
● Pain in the affected toe
● Corns or calluses

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Morton's Neuroma

A Morton’s Neuroma is a growth, usually between the third and fourth toes, that causes pain in the foot. Many patients describe this condition to be similar to having a pebble in your shoe.

The neuroma is a result of the thickening of the tissue around the nerves of toes. As this tissue becomes thickened it begins to compress the nerves of the foot causing sharp pain. It also may cause a burning or stinging sensation in the toes.

Morton’s Neuromas are often seen in those who often wear high heeled shoes, as these shoes may cause increased pressure on the joints, tissue and nerves of the foot. Athletes are also susceptible to Morton’s Neuroma if they engage in sports the cause repetitive trauma to the foot or do not wear properly fitted shoes during sports.

Signs and symptoms of Morton’s Neuroma can include:
● The feeling of having a pebble in your shoe
● Pain or burning in the ball of the foot or toes
● Numbness or tingling in the toes

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Plantar Fasciitis

Plantar Fasciitis is a painful condition that is the result of a thick band of tissue at the bottom of the foot called the “plantar fascia”. This tissue connects the heel bone to the toes provides stability and support to the foot. The most common cause of this condition is repetitive micro traumas that create small tears in the tissue. Over time, these tears can become inflamed and extremely painful. Those who spend multiple hours of the day standing on a hard surface can be at increased risk for developing Plantar Fasciitis.

Signs and Symptoms of Plantar Fasciitis can include:
• Sharp pain at the bottom of the foot
• Pain that is worse in the morning

Ankle Conditions:
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Ankle Sprains

An ankle sprain is one of the most common medical ailments with almost 25,000 occurring each day. These injuries often occur during sports but can also occur around the house as a result of uneven ground or missing a stair. Ankle sprains occur when the ligaments responsible for keeping the ankle in line are overstretched or torn due to rolling, twisting or turning the ankle. These motions force the ligaments to extend past their natural range of motion. Some patients note hearing a “pop” when the injury occurs. While most sprained ankles do not require immediate medical attention, it may be necessary to treat the injury in an effort to avoid compensatory or secondary injuries to a sprained ankle. The restricted mobility and soreness of the ankle may force an altered stride or gait they can damage the shins, knees and hips, when left untreated.

Signs and symptoms of an Ankle Sprain may include:
• Pain when putting weight on the ankle
• Swelling
• Sensitivity to touch
• Bruising

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Chronic Ankle Instability

Chronic Ankle Instability is characterized by a recurring feeling of the ankle “giving out” or rolling when walking or other activities. In most cases, it is the result of repeated ankle sprains, which can weaken the ligaments of the ankle. Each time the ankle is sprained, the ligament is weakened.

Signs and Symptoms of Chronic Ankle Instability may include:
• Repeated rolling of the ankle
• Persistent pain or swelling
• A feeling of the ankle being weak or unstable

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Achilles Tendon Tear

The Achilles tendon is the longest tendon in the body and extends from the heel to the calf and provides the motion needed for walking and running. An Achilles Tendon Tear occurs when this tendon becomes torn due to overexertion or hyperextension. This is one of the more common injuries in soccer, football, basketball, baseball and other sports.

Achilles Tendon Tears often occur in athletes as a result of a hyperextension or sudden impact such as:
● Rolling the ankle to one side
● Stepping into a hole or uneven ground
● Improper landing when jumping
● Repetitive strain
● A sudden change of direction
● A sudden stop while running
● Direct force to the tendon such as from a foot or helmet

If the Achilles Tendon is torn it may no longer be able to provide support while walking or during activity. If you suspect that an Achilles Tendon injury has occurred it is important to seek medical attention as soon as possible. Continued activity on the injured tendon may exacerbate the injury and increase the severity of the injury.

Signs and symptoms of a Achilles Tendon Tear may include:
● Hearing a “popping” sound at the moment of injury
● Swelling within 24 hours
● Pain at the outside or back of the hell
● Inability to point the foot downward
● Inability to stand on your toes of the injured leg
● Weakness in the lower leg or foot

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Achilles Tendonitis

The Achilles tendon is the longest tendon in the body and extends from the heel to the calf and provides the motion needed for walking and running. Achilles Tendonitis occurs when this tendon become inflamed or irritated and is most often caused by repetitive stress or strain. Achilles Tendonitis is also a very common injury among runners who suddenly increase their running regimen or go from running on one surface to another. Other cases of Achilles Tendonitis are caused by a bone spur that forms on the back of the heel and irritates the tendon. Achilles Tendonitis pain is generally a gradual and may progress from intermittent aches to persistent and chronic pain. One of the most effective ways to avoid this condition is to adequately stretch the muscles of the calf before any activity.

Signs and symptoms of Achilles Tendonitis can include:
● Pain or stiffness along the Achilles tendon
● Pain that worsens with activity
● Swelling
● Thickening of the tendon
● Bone spurs
● A protrusion along the back of the hell

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Ankle Fracture

An Ankle Fracture (more commonly referred to as a “broken ankle”) occurs when one or more of the bones of the ankle become damaged. Ankle fractures can range from mild hairline fractures to fractures that cause the bone to protrude from the skin. Not all ankle fractures are the result of a traumatic injury. In many instances, smaller hairline fractures weaken the ankle over time until the bone becomes completely broken. Those with conditions such as arthritis and osteoporosis may be more prone to ankle fracture.

The ankle is comprised of three separate bones and a break in one or more of these bones can comprise an ankle fracture.

● Tibia – shinbone
● Fibula – small bone in the lower leg
● Talus – a small bone that rests between the heel bone and the tibia and fibula

Ankle fractures can be caused by a variety of incidents including:
● A trip and fall
● Rolling the ankle
● Sports injury
● Direct force to one or more of the bones
● Chronic overuse of a weakened ankle

Signs and symptoms of an Ankle Fracture may include:
● Hearing a “snapping” sound at the moment of injury
● Swelling within 24 hours
● Immediate pain and/or throbbing
● Bruising of the foot ankle
● Pain that increases with activity
● Inability to bear weight on the injured foot
● Tenderness of the foot