Get Treatment for Foot Injuries Today

Rogue Valley Foot & Ankle Clinic, PC is certified to provide surgical procedures for feet and ankle injuries. If you been injured call 541-773-3338 to get an appointment.
Therapist helping patient with crutches - Foot & Ankle Clinic in Medford, OR

Proper Crutch Usage

It takes some coordination to get around on crutches. To make sure you use your crutches correctly, please read these instructions and follow them carefully.

Sizing Your Crutches
Even if you've already been fitted for crutches, make sure your crutch pads and handgrips are set at the proper distance, as follows:
  • Crutch pad distance from armpits: The crutch pads (tops of crutches) should be 1 / 2 " to 2" (about two finger widths) below the armpits, with the shoulders relaxed.
  • Handgrip: Place it so your elbow is flexed about 15 to 30 degrees enough so you can fully extend your elbow when you take a step.
  • Crutch length (top to bottom): The total crutch length should equal the distance from your armpit to about 6" in front of a shoe.

Begin in the Tripod Position
The tripod position is the position you stand in when using crutches. It is also the position you begin walking in. To get into the tripod position, place the crutch tips about 4" to 6" to the side and in front of each foot. Stand on your good foot (the one that is weight-bearing).

Walking with Crutches
(Non-weight-bearing) If your podiatric foot and ankle surgeon has told you to avoid ALL weight-bearing, it is important to follow these instructions carefully. You will need sufficient upper body strength to support all your weight with just your arms and shoulders.
  1. Begin in the tripod position and remember, keep all your weight on your good(weight-bearing) foot.
  2. Advance both crutches and the affected foot/leg.
  3. Move the good weight-bearing foot/leg forward (beyond the crutches).
  4. Advance both crutches, and then the affected foot/leg.
  5. Repeat steps #3 and #4.

Managing Chairs with Crutches
To get into and out of a chair safely:
  1. Make sure the chair is stable and will not roll or slide and it must have arms and back support.
  2. Stand with the backs of your legs touching the front of the seat.
  3. Place both crutches in one hand, grasping them by the handgrips.
  4. Hold on to the crutches (on one side) and the chair arm (on the other side) for balance and stability while lowering yourself to a seated position or raising yourself from the chair if you're getting up.

Managing Stairs without Crutches
The safest way to go up and down stairs is to use your seat, not your crutches.

To go upstairs:
  1. Seat yourself on a low step.
  2. Move your crutches upstairs by one of these methods:
  3. If distance and reach allow, place the crutches at the top of the staircase.
  4. If this isn't possible, place crutches as far up the stairs as you can, then move them to the top as you progress up the stairs.
  5. In the seated position, reach behind you with both arms.
  6. Use your arms and weight-bearing foot/leg to lift yourself up one step.
  7. Repeat this process one step at a time. (Remember to move the crutches to the top of the staircase if you haven't already done so.)

To go down stairs:
  1. Seat yourself on the top step.
  2. Move your crutches downstairs by sliding them to the lowest possible point on the stairway then continue to move them down as you progress down the stairs.
  3. In the seated position, reach behind you with both arms.
  4. Use your arms and weight-bearing foot/leg to lift yourself down one step. Repeat this process one step at a me. (Remember to move the crutches to the bottom of the staircase if you haven't already done so)

Follow These Rules for Safety and Comfort
  • Don't look down. Look straight ahead as you normally do when you walk.
  • Don't use crutches if you feel dizzy or drowsy.
  • Don't walk on slippery surfaces. Avoid snowy, icy, or rainy conditions.
  • Don't put any weight on your foot if your doctor has so advised.
  • Do make sure your crutches have rubber tips.
  • Do wear well-fitting, low-heel shoes (or shoe).
  • Do position the crutch hand grips correctly (see Sizing Your Crutches)
  • Do keep the crutch pads 12 " to 2" below your armpits.
  • Do call your podiatric foot and ankle surgeon if you have any questions or difficulties.
Wound at foot - Foot & Ankle Clinic in Medford, OR

Punctured Wounds

Puncture wounds and cuts are not the same. A puncture wound has a small entry hole caused by a pointed object - for example, a nail that you step on. In contrast, a cut is an open wound that doesn't produce a hole, but rather a long tear in the skin. Puncture wounds require different treatment from cuts because these small holes in the skin can disguise serious injury. Puncture wounds are common in the foot, especially in warm weather when people go barefoot. But even though they occur frequently, puncture wounds of the foot are among the most inadequately treated conditions. That's a big concern, because if not properly treated, infection or other complications can develop. Getting proper treatment within the first 24 hours is especially important with puncture wounds because they carry the danger of embedding the piercing object (foreign body) under the skin. Research shows that complications of puncture wounds could be prevented if the patient seeks professional treatment right away.

Foreign Bodies in Puncture Wounds
A variety of foreign bodies can become embedded in a puncture wound. Nails, glass, toothpicks, sewing needles, insulin needles, and seashells are some common offenders. In addition, pieces of your own skin, sock, and shoe can be forced into the wound during a puncture, as well as dirt and debris from the object. By their nature, all puncture wounds are dirty wounds because they involve penetration of an object that isn't sterile. Regardless of what the foreign body is, anything that remains in the wound increases your chances of developing other problems, either in the near future or down the road.

Severity of Wounds
There are different ways of determining the severity of a puncture wound. Depth of the wound is one way to evaluate how severe the wound is. The deeper the puncture, the greater the likelihood that complications, such as infection, will develop. Many patients cannot judge how far their puncture extends into the foot. Therefore, if you've stepped on something and the skin was penetrated, seek treatment as soon as possible. The type and the cleanliness of the penetrating object also determine the severity of the wound. Larger or longer objects can penetrate deeper into the tissues, possibly causing more damage. The dirtier an object, such as a rusty nail as opposed to a sewing needle, the more dirt and debris are dragged into the wound, which may increase the chance of infection. Another thing that can determine wound severity is whether you were wearing socks and shoes or were barefoot. Particles of socks and shoes can get trapped in a puncture wound.

Treatment of Puncture Wounds
The key to proper treatment is this: A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications. Even if you have gone to an emergency room for immediate treatment of your puncture wound, see a foot and ankle surgeon for a thorough cleaning and careful follow-up. The sooner you do this, the better, within 24 hours after injury, if possible. The foot and ankle surgeon is trained to properly care for these injuries and will make sure your wound is properly cleaned and no foreign body remains. He or she may numb the area, thoroughly clean inside and outside the wound, and monitor your progress. In some cases, x-rays may be ordered to determine whether something remains in the wound or if bone damage has occurred. To treat or prevent infection, antibiotics may be prescribed.

Once you return home, be sure to carefully follow the foot and ankle surgeon's instructions to prevent complications (see Puncture Wounds: What You Should Do?).

Avoiding Complications
Infection is a common complication of puncture wounds that can lead to serious consequences. Sometimes a minor skin infection evolves into a bone or joint infection, so you should be aware of signs to look for. A minor skin infection may develop in 2 to 5 days after injury. The signs of a minor infection that show up around the wound include soreness, redness, and possibly drainage, swelling, and warmth. You may also develop a fever. If these signs have not improved, or if they reappear in 10 to 14 days, a serious infection in the joint or bone may have developed. Other complications that may arise from inadequate treatment of puncture wounds include painful scarring in the area of the wound or a hard cyst where the foreign body has remained in the wound. Although the complications of puncture wounds can be quite serious, early proper treatment can play a crucial role in preventing them. ï€ Puncture Wounds:

What You Should Do?
  • Seek treatment right away.
  • Get a tetanus shot if needed (usually every 5 years).
  • See a foot and ankle surgeon within 24 hours.
  • Follow your doctor's instructions:
  • Keep your dressing dry.
  • Keep weight off of the injured foot.
  • Finish all your antibiotics (if prescribed).
  • Take your temperature regularly.
  • Watch for signs of infection (pain, redness, swelling, fever).
  • Call your doctor if you have any of these signs.
Fracture - Foot & Ankle Clinic in Medford, OR


The structure of your foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in your foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A podiatric foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.

What Is a Fracture?
A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures. Traumatic fractures (also called acute fractures) are caused by a direct blow or impact -like seriously stubbing your toe. Traumatic fractures can be displaced or nondisplaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated). Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required. Signs and symptoms of a traumatic fracture include:
  • You may hear a sound at the time of the break.
  • Pinpoint pain (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
  • Deviation (misshapen or abnormal appearance) of the toe.
  • Bruising and swelling the next day.
  • It is not true that if you can walk on it, it's not broken.

Evaluation by the podiatric surgeon is always recommended.

Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. Or they may be caused by an abnormal foot structure, deformities, or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored, because they will come back unless properly treated. Symptoms of stress fractures include:
  • Pain with or after normal activity
  • Pain that goes away when resting and then returns when standing or during activity
  • Pinpoint pain (pain at the site of the fracture) when touched
  • Swelling, but no bruising Sprains and fractures have similar symptoms, although sometimes with a sprain, the whole area hurts rather than just one point. Your podiatric surgeon will be able to diagnose which you have and provide appropriate treatment. Certain sprains or dislocations can be severely disabling. Without proper treatment they can lead to crippling arthritis.

Consequences of Improper Treatment
Some people say that the doctor can't do anything for a broken bone in the foot. This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example:
  • A deformity in the bony architecture which may limit the ability to move the foot or cause difficulty in fitting shoes
  • Arthritis, which may be caused by a fracture in a joint, or may be a result of angular deformities that develop when a displaced fracture is severe or hasn't been properly corrected
  • Chronic pain and long term dysfunction
  • Non-union, or failure to heal, can lead to subsequent surgery or chronic pain.

Treatment of Toe Fractures
Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options:
  • Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe.
  • Splinting. The toe may be fitted with a splint to keep it in a fixed position.
  • Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned.
  • Buddy taping, the fractured toe, another toe is sometimes appropriate, but in other cases it may be harmful.
  • Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins.

Treatment of Metatarsal Fractures
Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges. For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Since the big toe is used so frequently and bears more weight than other toes, arthritis in that area can make it painful to walk, bend, or even stand. Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone. It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your podiatric surgeon is an expert in correctly identifying these conditions as well as other problems of the foot.

Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include:
  • Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone.
  • Avoid the offending activity. Because stress fractures result from repetitive stress, it is important to avoid the activity that led to the fracture. Crutches or a wheel-chair are sometimes required to offload weight from the foot to give it time to heal.
  • Immobilization, casting, or rigid shoe. A stiff-soled shoe or other form of immobilization may be used to protect the fractured bone while it is healing.
  • Surgery. Some traumatic fractures of the metatarsal bones require surgery, especially if the break is badly displaced.
  • Follow-up care. Your podiatric foot and ankle surgeon will provide instructions for care following surgical or non-surgical treatment. Physical therapy, exercises and rehabilitation may e included in a schedule for return to normal activities.