How Does Osteoporosis Affect Your Feet?

Almost one million Australians currently have osteoporosis, with one in four women aged over 75 years being affected. As this condition skyrockets your vulnerability to bone fractures and associated hospitalisations, it’s important to understand why and how osteoporosis develops and who is at risk. Today, our podiatrists have shared all of this and what you can do to help protect your bone health if you develop osteoporosis.

Osteoporosis: What Is It?

Osteoporosis is a condition that weakens the bones, making them fragile and more likely to break when placed under stress. The term literally means porous bones. It’s important to note that being diagnosed with osteoporosis does not mean that your bone health and mineral density has simply started to decrease – this is known as osteopenia. If you are diagnosed with osteoporosis, your bones have already become significantly thin and vulnerable, to the point that even a minor bump or accident – or at worst even a sneeze – may cause a broken bone.

Osteoporosis develops gradually over time, often over a number of years. For many, a broken bone will be their first indicator of osteoporosis, while others may develop back troubles associated with a forwards bent posture, and some may see early signs on a bone scan.

While a decrease in bone density is a normal part of ageing, for some this process is accelerated, placing them at a higher risk. This tends to occur commonly in women after the first few years of menopause, and is a greater risk in those that take steroids and other medications for a prolonged time, avoid regular exercise, have nutritional deficiencies, suffer from medical problems like inflammatory arthritis or hormone-related problems and have a low BMI, among many others.

If you’re unsure if you may be at risk, you can take the Royal Osteoporosis Society’s free risk test here.

Managing Osteoporosis

If your bone mineral density is decreasing but you haven’t yet developed osteoporosis, taking small steps to keep your bones healthy can reduce your risk of developing osteoporosis. This includes:

Exercising regularly – at least 30 minutes a day, 5 days per week. Brisk walking is a great start, and including weight-bearing exercise and resistance training is also an important part of improving bone mineral density
Calcium & vitamin D – as calcium is an important component of strong bones, you should get at least 700mg from your daily diet. This is found in dairy like yoghurt and milk, as well as green leafy vegetables, dried fruit and yoghurt. Calcium supplements are also available. Vitamin D is also important as it helps your body absorb calcium. It is found in oily fish, red meat, egg yolks and other sources, and is also available as a supplement if required
Lifestyle control – controlling lifestyle factors like smoking and drinking can also help reduce your risk of developing osteoporosis. Maintaining a healthy body weight, that is, not being either underweight or overweight, is a strong recommendation from the Royal Osteoporosis Society

Aside from the factors above, treating osteoporosis itself involves using medicine to strengthen the bones, as well as treating and preventing broken bones. Your doctor is your go-to for medical osteoporosis treatment.

As podiatrists, we help patients with osteoporosis by helping them feel comfortable and confident on their feet, reducing their risk of having a fall, and redistributing excess stress away from high-pressure areas in the feet and legs.We do this using:

1. Custom orthotics

We prescribe, design and create custom orthotics for the feet that, in osteoporosis, will help:

Shift pressure away from areas of the feet that are currently being exposed to high stress and are therefore vulnerable to breaks
Cushion the feet to better absorb shock
Promote a healthy gait pattern to reduce excess stress on the tibia and knees during walking
Improve stability to the feet to reduce the risk of falls

2. Footwear

Your shoes become the ground you walk on – and can either help you feel stable and confident, reducing your risk of falls, or exacerbate it. We’ll assess your shoes and make recommendations on the best footwear for your feet, with considerations to any foot problems, abnormalities and symptoms you may have.

3. Physical therapy & exercise physiology

Working together with our sister clinic, The Physio,and our fantastic exercise physiologist, Emily, we can help you with meeting your daily exercise needs safely to help improve your bone health. Aside from regular exercise, this includes hydrotherapy, pilates and more – giving you options even you currently struggle with performing simple exercises

Ready to take control of your bone health?

Our team of experienced podiatrists would love to help – we’ve been helping Toowoomba & Darling Downs care for their foot and leg health for over 20 years. Book your appointment online or call us on (07) 4638 3022

The bones at this Lisfranc joint are connected by a tough band of tissue (ligament) that keeps the bones aligned in the right place (instead of popping up and down whenever!). It also helps to strengthen this area of the foot, which is vital for arch stability and for walking.

Injuries at the Lisfranc joint can come in the form of sprains, fractures or dislocations. Thankfully, this type of injury isn’t all too common, but is definitely something that our podiatry team comes across from time to time and can be extremely debilitating for a patient if left untreated.

It should be noted that Lisfranc injuries can be overlooked or misdiagnosed if your practitioner is unfamiliar with this problem. All our clinical staff at The Podiatrist specialise in leg and foot function and injury, so know how to spot this problem and how best to help you recover.

So, how could I have sustained a Lisfranc injury?

Lisfranc injuries typically occur either directly or indirectly. Direct injuries are the most common, caused by excessive force being applied to the end of the foot. This tears the supporting ligaments and can dislocate or fracture a bone, examples of direct injury causes include:

A heavy object falling on the foot
Falling from a high height
Car accidents
Kicking a hard object, particularly if it’s stationary

Indirect injuries result from overloading (putting excessive pressure through) the midfoot, which often occurs through either twisting the foot abnormally, or from impact to the midfoot. Anything that twists and overloads the midfoot can cause a Lisfranc injury, like:

Running where twisting of the foot and falling occurs
Missing a step on a staircase

What do Lisfranc injuries feel like?

Painful! You’ll likely know that something has gone wrong quickly after sustaining the injury, and may start to feel:

Midfoot pain, tenderness or throbbing
Swelling or redness
Bruising on the bottom of the foot after a couple of hours
Pain on standing, weight-bearing and physical activity

How should these injuries be treated?

The first thing you want to do is reduce your pain and discomfort. We recommend using the PRICE (protection, rest, ice, compression, elevation) principles. Avoid any movements that cause pain, including walking on the injured foot, as much as possible. Ice, compression and elevation will help reduce your swelling, which will reduce your pain and help you feel more comfortable.

Your treatment will then depend on how severe the injury to your Lisfranc joint is – which we’ll be able to give you an idea of when you come in to get it assessed and diagnosed. Getting your foot seen to if you have midfoot pain is a must as there are many causes of midfoot pain, and different causes require diffrent approaches to treatment.

Your care will differ depending on whether you’ve sustained a ligament sprain, fracture or dislocation. Midfoot sprains do take significantly longer to heal than regular ankle sprains, so don’t put pressure on your recovery.

When standing, the midfoot supports approximately 2-3 times a person’s body weight, so reducing this pressure and minimising weight-bearing at the midfoot is a key part of your treatment. We’ll focus on isolating the damaged structures of the foot and giving them time to heal, then slowly re-introducing weight-bearing and strengthening. Your care may include:

A range of full and partial casts and boots
Crutches
Orthotics to offload pressure as the injury heals
Footwear assessment to ensure shoes are helping and not hindering recovery
Physical therapy as the foot heals to strengthen affected muscles

Severe injuries where the joint is unstable may require surgical intervention. There are a number of different surgical options and we can refer you for a consultation with a surgeon to discuss the best one for you.

What’s the verdict – how long will it take to recover?

If you’re going to take away one thing from reading this information, let it be this: Lisfranc injuries do take a while to heal and you are very susceptible to re-injury if you return to regular activities too early and end up overloading your midfoot again.

Conservative treatment may involve restricting the foot to a variety of boots for up to 3 months before switching to custom orthotics beyond this. Athletes may require a recovery period of 6-12 months before returning to competitive activity.

We understand how important it is to be able to walk and play without pain so if you’re worried about your feet or you’ve suffered an injury – whether it’s painful or not – we’d love to help. We’ve been helping our community in Toowoomba & Darling Downs for over 20 years. To book an appointment, call us on (07) 4638 3022 or book your appointment online here.

References:

[1]Seybold JD, Coetzee JC. Lisfranc injuries: When to observe, fix, or fuse. Clinical Sports Medicine 2015;34(4):705–23
[2]Baquie P, Fooks L, Pope J, Tymms G. The challenge of managing mid-foot pain. Australian Family Physician 2015;44(3):106–11
[3]Welck MJ, Zinchenko R, Rudge B. Lisfranc injuries. Injury 2015;46(4):536–41
[4]Seybold JD, Coetzee JC. Lisfranc injuries: When to observe, fix, or fuse. Clinical Sports Medicine 2015;34(4):705–23