Symptoms and Causes of Broken ankle/broken foot

You spend every day on your feet and put them through a lot. The foot is made up of 26 delicate bones, linking together with a network of tendons and muscles that connect to your ankle joints. With this many parts to the ankles and feet, there are many places where damage can occur.

Causes of a Broken ankle or foot

Broken bones are caused by an impact or sustained pressure that is more than the bone can take. Some common causes include:

  • dropping something heavy on the foot
  • hitting your toe against a piece of furniture or door frame
  • sports injuries
  • a severe twist or sprain
  • falling from a height, especially onto a hard surface

Symptoms of a broken foot or ankle

At first it can be hard to tell the difference between a bad sprain and a broken bone. You should always visit a doctor if you suspect a break. Some symptoms include:

  • sharp pain centered on the break or radiating through the foot
  • swelling
  • deep bruising
  • a grinding sound or sensation when you move the foot
  • physical deformation, especially for broken toes
  • inability to walk on the foot

For this last point, keep in mind that broken toes may be less painful and you may be able to walk on them.

How are broken ankles and feet treated?

Your doctor will probably order an x-ray to determine exactly what happened and where the break is. For a broken ankle, a splint may be used. If it’s a severe break, you may need reconstructive surgery. In the case of broken bones in the foot, you may be given a cast, walking boot, or wheelchair to help you keep pressure off the area as it heals. For broken toes, the doctor will most likely splint one to an adjacent toe.

What are Dislocated Shoulder Symptoms? 

A shoulder dislocation occurs when an injury causes the ligaments in the shoulder to separate and the upper arm bone pops out of the shoulder socket. Since the shoulder has such high mobility, shoulder dislocations can be a common occurrence. Emergency treatment is required for shoulder dislocations.

Pain Symptoms

Intense pain is likely to be the first symptom noticed during a shoulder dislocation. Patients can often feel the shoulder as it pops out of the socket. The majority of shoulder dislocations occur from falls with the arms outstretched or a direct impact to the shoulder. If the patient has pain in other areas caused by the injury, he or she may not initially realize shoulder dislocation has occurred. Along with pain, patients may feel weakness and numbness in the area surrounding the shoulder blade.

Change in Appearance

Aside from the pain, a shoulder dislocation causes bruising and swelling to appear at the site of the injury. When a shoulder is dislocated, an evident deformity can often be seen with the bone sticking out prominently from the skin. The deformity varies based on the direction that the dislocation has occurred. The three types of dislocation include:

  • Anterior
  • Posterior
  • Inferior

For an anterior dislocation, the upper arm bone pushes forward. The posterior dislocation means the bone goes toward the back. An inferior shoulder dislocation means the bone has moved downwards. Most shoulder dislocations are anterior while only a small percentage are posterior and inferior dislocations.

Never attempt to treat a dislocated shoulder at home. Self-treatment could inadvertently worsen the injury. Contact a physician to confirm shoulder dislocation and review treatment options available. Treatment options may include shoulder relocation, slings and orthopedic surgery.

Treatment of a Broken Finger 

A broken finger, though it might sound innocuous, can be a very painful, life-altering injury. By definition, a broken finger is a fracture or break of any one of the three bones that make up the finger.

Broken Fingers Are Common Injuries

A broken finger is a common injury, but one that merits a visit to the doctor. This is because when these breaks aren’t properly treated, they can heal out of alignment. This, in turn, can cause future pain and will look odd as well.

How Broken Fingers Occur

A finger injury can happen in a variety of ways. One of the most common is when the finger is crushed between two objects. A finger being struck by a ball or other fast moving item is another common cause.

Symptoms of a Broken Finger

The most common symptom of a broken finger is pain immediately after trauma. Sometimes, patients will notice a slight or significant deformation in their finger as well. A broken finger might still have some range of motion, which is a common misconception. Swelling and bruising often occur 5-10 minutes after the injury takes place. Numbness can also occur due to nerves being cut off as a result of swelling.

Treatment of a Broken Finger

The first step after a finger injury is determining the extent of said injury. To determine if the finger is displaced, fractured or broken, the finger must be X-rayed. Most broken fingers are simple fractures, that don’t include a displacement of bone. The treatment for this type of injury is a splint that will keep the finger immobilized while it heals, a process which typically takes between three and four weeks. Finger buddy taping might also be implemented.

When a broken fragment of bone is displaced, this is considered a more complicated fracture or break. This might also include a break in the bone in more than one location. In this instance, surgery is often the only treatment to ensure the finger heals properly. This type of surgery includes a surgeon pinning the two bone fragments together so they can heal properly.

Having a broken finger treated by a specialist is the best way to ensure it heals properly and doesn’t cause additional issues down the road. Make an appointment today to learn how we can help you.

What are the most common orthopedic surgeries?

Orthopedic surgery is a surgical procedure performed on the musculoskeletal system for the correction of injury or other conditions. The musculoskeletal system is made up of bones, joints, and soft tissues such as muscles, ligaments, and tendons. Any part of the musculoskeletal system can become impaired through injury/accident or caused by other degenerative conditions.


Orthopedic surgery can performed through traditional open surgery, or arthroscopically. Arthroscopy is a surgical procedure on a joint that is minimally invasive as treatment is provided using an arthroscope inserted into the joint through a small incision.

Most orthopedic surgeries are performed on the ankle, knee, hip, wrist, elbow, shoulder or spine. The most common procedures include:

  1. Soft tissue repair, for torn ligaments and tendons.
  2. Joint replacement, in which a damaged joint is replaced with a prosthesis.
  3. Revision joint surgery, in which a preexistent implant is changed with a new one.
  4. Bone fracture repair
  5. Debridement, during which damaged soft tissues or bones are removed.
  6. Fusion of bones, in which bones are fused with grafts.
  7. Spine fusion, during which the spinal bones (vertebrae) are joined together.
  8. Osteotomy, aimed at correcting bone deformities.


Dr. Marshall P. Allegra is a board-certified orthopedic surgeon with over 23 years experience treating patients in Monmouth County. Depending on the type of condition or injury, Dr. Allegra may recommend fixing a fracture with rods, plates, and screws that will hold the fracture together during healing. Contact the offices today for answers to any questions you may have or to schedule an appointment.

Adding Steps To Your Life

The warmer weather is a great time to start achieving your goal to become more active. It’s surprising how easy it is to add simple activities to your everyday life and increase how much you move throughout the day.

Regular exercise can help people of all ages and levels of physician ability lead a healthier life. Exercise helps to keep our bodies functioning better, and keeps heart disease, diabetes, and many other diseases at bay. Exercise is a key ingredient when it comes to losing weight.

Regular exercise can

  • Improve your chances of living longer and living healthier
  • Help protect you from developing heart disease and stroke or its precursors, high blood pressure and undesirable blood lipid patterns
  • Help protect you from developing certain cancers, including colon and breast cancer, and possibly lung and endometrial cancer
  • Help prevent type 2 diabetes
  • Help prevent the irreplaceable loss of bone known as osteoporosis
  • Reduce the risk of falling and improve cognitive function among older adults
  • Relieve symptoms of depression and improves mood
  • Prevent weight gain, promote weight loss, and help keep weight off after weight loss
  • Improve heart-lung and muscle fitness
  • Improve sleep

Try incorporating the following tips into your daily schedule:

Participate in activities that you enjoy doing! Activities such as gardening, walking, and even dancing can assist in your journey to becoming physically active and healthy. Develop a support group and have friends and family join you in your goal. Exercise can be a wonderful time to bond with a family member or a friend.

But take it slow to avoid injury:

  • Plan to be physically active at a time when you are most energized. This allows you to fully benefit from the workout, and it prevents injuries that may occur if you are physically or mentally sluggish during your workout.
  • Warm up before you start. Jumping right into physical activity can cause injury and muscle strain. By adding five to ten minutes to your routine, you give yourself a chance to warm-up.
  • After being physically active, spend five minutes or so walking or moving around slowly until your heart rate goes back to normal. Cooling down helps to prevent an abrupt drop in blood pressure and may help prevent muscle stiffness.
  • Stretch after your muscles are warmed up. When stretching, don’t bounce. Instead, hold each stretch comfortably for 20 to 30 seconds.
  • Making sure your body has enough fluids is important to keeping your body temperature normal and lubricate your joints, especially in the summer. When dehydrated, you may feel fatigued, have headaches, become nauseated, or feel dizzy.
  • Pay attention to your breathing while being physically active. Rapid and shallow breathing can lead to shortness of breath and even cause dizziness or fainting. By breathing naturally and deeply, you will be able to be physically active longer and with less effort. During strength training, a common mistake people often make is holding their breath. Don’t hold your breath, but exhale when exerting your muscles and inhale when relaxing.
  • Listen to your body for warning signs. Be mindful of the differences between your body’s normal responses to physical activity and abnormal responses that should be warning signs to STOP and get medical help.

Using these tips to become more physically active will help you in achieving your goal of living a longer, healthier life.

Bone and Joint Problems Associated with Diabetes

November is American Diabetes Month, a time set aside to raise awareness about diabetes and its associated risk factors.

Did you know that if you are an individual living with diabetes, you are at higher risk for some bone and joint disorders?

Certain factors such as nerve damage (diabetic neuropathy), arterial disease and obesity may contribute to these conditions, but often the cause isn’t clear.

If you feel that you are experiencing any of these symptoms, talk with your endocrinologist or consult a board certified orthopedic physician who will take your medical history of diabetes into account when diagnosing your condition.

Charcot Joint
Charcot (shahr-HOK) joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage – a common complication of diabetes. Charcot joint primarily affects the feet.
Symptoms include numbness and tingling or loss of sensation in the affected joints. They may become unstable, swollen or deformed. If detected early, progression of the disease can be slowed. Limited weight bearing activities and use of orthotic supports to the affected joint and surrounding structures can help.

Diabetic Hand Syndrome

Diabetic hand syndrome, also called cheiroarthropathy, is a disorder in which the skin on the hands becomes waxy and thickened. Eventually finger movement is limited. What causes diabetic hand syndrome isn’t known but it is most common in people who have had diabetes for a long time.
Over time, individuals with diabetic hand syndrome become unable to fully extend their fingers or press their palms together flat. Better management of blood glucose levels and physical therapy can slow the progress of this condition.

Osteoporosis is a disorder that causes bones to become weak and prone to fracture. People who have type 1 diabetes have an increased risk of osteoporosis.
Osteoporosis rarely causes symptoms in the early stages. Eventually, when the disease is more advanced, individuals can experience loss of height, stopped posture or bone fractures. A healthy lifestyle, including weight bearing exercise such as walking, and eating a well-balanced diet rich in calcium and vitamin D – including supplements if needed – are the best ways to address this condition.

Osteoarthritis is a joint disorder characterized by the breakdown of joint cartilage. It may affect any joint in the body. People who have type 2 diabetes have an increased risk of osteoarthritis, likely due to obesity – a risk factor for type 2 diabetes – rather than to the diabetes itself.
Osteoarthritis may cause joint pain, swelling and stiffness as well as loss of joint flexibility or movement. Treatment involves exercising and maintaining a healthy weight, caring for and resting the affected joint, pain medication and, in some cases, surgery. Complimentary treatment such as acupuncture and massage can be helpful.

Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a hardening of tendons and ligaments that commonly affects the spine. DISH may be associated with type 2 diabetes, perhaps due to insulin or insulin-like growth factors that promote new bone growth.
Affected individuals may experience pain, stiffness or decreased range of motion in any affected part of the body. Treatment involves managing symptoms, usually with pain medication, and in rare cases may require surgery to remove bone that has grown due to the condition.

Dupuytren Contracture
Dupuytren contracture is a deformity in which one or more fingers are bent toward the palm. It’s caused by thickening and scarring of connective tissue in the palm of the hand and in the fingers. This condition is common in people who have had diabetes for a long time.
People affected by dupuytren contracture may notice thickening of the skin on the palm of their hand. Eventually, they may not be able to fully straighten one or more fingers. Steroid injections may help reduce inflammation. Surgery, injections and a minimally invasive procedure called aponeurotomy to break apart the thick tissue are other options if the condition prevents the ability to grasp objects.

Frozen Shoulder
Frozen shoulder is a condition characterized by shoulder pain and limited range of motion. It typically affects only one shoulder. Although the cause is unknown, diabetes is a common risk factor.
Frozen shoulder causes pain or tenderness with shoulder movement, stiffness of the joint and decreased range of motion. If started early, aggressive physical therapy can help preserve movement and range of motion in the joint.

Carpal Tunnel Syndrome
Carpal tunnel syndrome is caused by a constriction of the hand’s central nerve by a ligament that runs across the palm. Diabetes may account for between 5 and 16 percent of all cases of carpal tunnel syndrome. The link between diabetes and carpal tunnel syndrome may be that the ligament becomes thickened in response to collagen glycation so that it presses on the nerve. Another possibility is that diabetic neuropathy – nerve disease – damages the nerves in the hand, making them more susceptible to carpal tunnel syndrome.
Strengthening and stretching exercises under the direction of a physical therapist may be helpful. Steroids and a wrist splint can be an interim measure, and surgery may be needed eventually.

Rotator Cuff Injuries & Care

Rotator cuff tendonitis occurs when the tendons and muscles that help move the shoulder joint are inflamed or irritated. This condition commonly occurs in people who play sports that frequently require extending the arm over the head, such as tennis, swimming and pitching. Most people with rotator cuff tendinitis can regain full function of the shoulder without any pain after treatment.

Rotator cuff tendonitis affects the tendons and muscles that help move the shoulder joint. If you have tendinitis, it means that your tendons are inflamed or irritated. Rotator cuff tendinitis is also called impingement syndrome.

This condition usually occurs over time. It can be the result of keeping the shoulder in one position for a while, sleeping on the shoulder every night, or participating in activities that require extending the arm over the head. Sometimes, rotator cuff tendinitis can occur without any known cause.

Rotator Cuff Symptoms Worsen Over Time

The symptoms of rotator cuff tendinitis tend to get worse over time. Initial symptoms may be relieved with rest, but the symptoms can later become constant. Symptoms of rotator cuff tendinitis include:

  • Pain triggered by raising or lowering the arm
  • A clicking sound when raising the arm
  • Stiffness
  • Pain and swelling in the front of the shoulder and side of the arm
  • Pain that causes you to wake from sleep
  • Pain when reaching behind the back
  • A loss of mobility and strength in the affected arm

How Is Rotator Cuff Tendinitis Diagnosed?

Your orthopedic physician will begin by examining your shoulder to see where you’re feeling pain and tenderness. Your doctor will also test your range of motion and the strength of your shoulder joint. They may also examine your neck to check for conditions such as a pinched nerve or arthritis that can cause symptoms similar to rotator cuff tendinitis.

Your orthopedic physician may order imaging tests to confirm the diagnosis of rotator cuff tendinitis and rule out any other causes of your symptoms. An X-ray may be ordered to see if you have a bone spur. Your doctor may order an ultrasound or MRI to check for inflammation in the rotator cuff and to check for any tearing.

How Is Rotator Cuff Tendinitis Treated?

Initial treatment of rotator cuff tendinitis involves managing pain and swelling to promote healing. This can be done by:

  • Avoiding activities that cause pain
  • Applying cold packs to your shoulder three to four times per day
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen
  • Additional treatment may include physical therapy and steroids

If nonsurgical treatment isn’t successful, your orthopedic physician may recommend surgery. Most people experience full recovery after having rotator cuff surgery. The most noninvasive form of shoulder surgery is accomplished via arthroscopy. This involves two or three small cuts around the shoulder, through which your surgeon will insert various instruments. One of these instruments will have a camera, so your surgeon can view the damaged tissue through the small incisions.

Home Care for Your Shoulder

There are several things you can do to help reduce pain from rotator cuff tendinitis. These techniques can also help prevent rotator cuff tendinitis or another flare-up of pain.

Shoulder self-care includes:

  • Using good posture while sitting
  • Avoiding lifting your arms repetitively over your head
  • Taking breaks from repetitive activities
  • Avoiding sleeping on the same side every night
  • Avoiding carrying a bag on only one shoulder
  • Carrying things close to your body

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Men and Osteoporosis

Osteoporosis is a disease that causes the skeleton to weaken and the bones to break. While most people think of osteoporosis as a woman’s disease, it poses a significant threat to millions of men in the United States.
There are many lifestyle habits that put men at increased risk of osteoporosis, yet few men recognize the disease as a significant threat to their mobility and independence.
Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs. It develops less often in men than in women because men have larger skeletons, their bone loss starts later and progresses more slowly, and they have no period of rapid hormonal change and bone loss. However, in the past few years the problem of osteoporosis in men has become more recognized, particularly in light of estimates that the number of men above the age of 70 will continue to increase as life expectancy continues to rise.
Bone is constantly changing. Old bone is removed and replaced by new bone. During childhood, more bone is produced than removed, so the skeleton grows in both size and strength. For most people, bone mass peaks during the third decade of life. By this age, men typically have accumulated more bone mass than women. After this point, the amount of bone in the skeleton typically begins to decline slowly as removal of old bone exceeds formation of new bone.

Men in their fifties do not experience the rapid loss of bone mass that women do in the years following menopause. But by age 65 or 70, men and women are losing bone mass at the same rate, and the absorption of calcium, an essential nutrient for bone health throughout life, decreases in both sexes. Excessive bone loss causes bone to become fragile and more likely to fracture.
Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Perhaps because such fractures tend to occur at older ages in men than in women, men who sustain hip fractures are more likely than women to die from complications.
In addition to age-related bone loss, there are many lifestyle behaviors, diseases and medications that can hasten bone loss in men. These include:
• Chronic diseases that affect the kidneys, lungs, stomach, and intestines, or alter hormone level
• Regular use of certain medications, such as glucocorticoids
• Undiagnosed low levels of the sex hormone testosterone
• Unhealthy lifestyle habits: smoking, excessive alcohol use, low calcium intake, and inadequate physical exercise
• Age. The older you are, the greater your risk
• Race. Caucasian men appear to be at particularly high risk, but all men can develop this disease.
Osteoporosis can be effectively treated if it is detected before significant bone loss has occurred. An orthopedic physician can order a medical workup to diagnose osteoporosis, including a complete medical history, x-rays, and urine and blood tests. The doctor may also order a bone mineral density test to determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment.
In men, osteoporosis is often not diagnosed until a fracture occurs or a man complains of back pain and sees his doctor. This makes it especially important for men to inform their doctors about risk factors for developing osteoporosis, loss of height or change in posture, a fracture, or sudden back pain.
Once a man has been diagnosed with osteoporosis, his orthopedic physician may prescribe medications as well as a treatment plan including nutrition, exercise, and lifestyle guidelines for preventing bone loss.
Other possible prevention or treatment approaches include calcium and/or vitamin D supplements and regular physical activity.
Experts agree that both men and women should take the following steps to preserve their bone health:
• Avoid smoking, reduce alcohol intake, and increase physical activity
• Ensure a daily calcium intake that is adequate for your age
• Ensure an adequate intake of vitamin D
• Engage in a regular regimen of weight-bearing exercises in which bones and muscles work against gravity. This might include walking, jogging, racquet sports, climbing stairs, team sports, weight training, and using resistance machines
• Discuss with your doctor the use of medications that are known to cause bone loss, such as glucocorticoids
• Recognize and seek treatment for any underlying medical conditions that affect bone health

Orthopedic Injuries Rise with Hoverboard Popularity

Hoverboards, one of the hottest gifts for both kids and adults this past holiday season, are also becoming a popular reason for visits to the emergency room.
An item that is a mixture of a skateboard and a Segway, a hoverboard allows the rider to stand on a platform that will accelerate and move freely in the direction of the rider’s weight. While fun and perhaps exhilarating, hoverboards are also putting some riders at risk.
Orthopedic physicians are seeing an uptick in injuries to bones and joints, wrist and ankle injuries, and fractures. Other injuries associated with hoverboards include spinal fractures, facial lacerations, head trauma with concussion, and contusions. Some injuries are more serious because of the height and speed behind the fall.
Riders need to have good balance on the devices, which don’t have a handle. The faster riders go, the higher the injury risk. Hoverboards can speed up to 12 miles per hour.
To avoid and prevent serious injury from hoverboards, follow these safety tips:
* Wear a helmet
* Wear wrist guards, elbow pads and knee pads
* Practice and become familiar with the hoverboard in an open, soft flat field
* Be mindful of vehicles and other forms of traffic and impediments (stay off the roads)
Supervise children using hoverboards and take the same precautions as you would for using a scooter, bicycle or roller blades, especially wearing a certified safety helmet.
When it comes to hoverboard safety for children and adults alike, start slow and make sure you have something stable to hold on to while you’re getting a feel for the hoverboard.

Lifestyle Changes To Manage Arthritis Pain

What you do or don’t do every day can have a major impact on your joints and the level of arthritis pain you experience. Arthritis is a leading cause of pain and disability worldwide.

Whatever your condition, you can work to stay ahead of your pain by:

  • Talking to your orthopedic physician about your symptoms, arthritis related or not. Sometimes seemingly unrelated problems are connected. Your doctor will know for sure.
  • Give your orthopedic physician complete information about your medical condition and medications, including over the counter medications and supplements.
  • Ask your orthopedic physician for a clear definition of the type of arthritic you have.
  • Find out whether any of your joints are already damaged.

Arthritis affects about 36 percent of obese American adults, according to the Centers for Disease and Prevention. A healthy body weight is important to your body’s overall health, including your joints. Joints that are stressed by bearing the burden of excess pounds show more wear and tear, inflammation and stiffness, leading to arthritic pain.

Consider making these changes to help reduce your arthritis pain:

  • Exercise for at least 20 minutes every day to keep the pounds off and reduce arthritis pain and stiffness.
  • Eat a healthy diet of low-fat, low-calorie foods and plan your meals and snacks to be sure you are getting lots of fruits and vegetables through your diet.
  • Get plenty of vitamin C to help manage joint inflammation. Studies have shown that vitamin C may be helpful in managing inflammation, so dig into an orange or have a glass of grapefruit juice.
  • Manage your weight. Even a few extra pounds can worsen your arthritis pain, so talk to your doctor to determine your healthiest weight. Focus on that number as your goal, and track your weight loss until you reach it.
  • Quit smoking. Smoking causes stress on connective tissues, which leads to more arthritis pain.
  • Avoid alcohol. Don’t medicate yourself with alcohol to manage pain; it will only create more problems and add calories to your diet.

Schedule an appointment with a board certified orthopedic physician to get tips on exercise and other common concerns when coping with arthritis symptoms and arthritis pain.