Foot & Ankle


Make an appointment to see how our board certified and fellowship trained Foot and Ankle expert can help you.

Ralph Napoli, DPM
Foot and Ankle

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At Active Orthopedics and Sports Medicine, we understand that pain or injury of the foot and ankle can severely impact the quality of your life.

Our board-certified, fellowship-trained physician and his team are renowned for their treatment of all sorts of foot and ankle disorders and focus on relieving pain so you can regain mobility and function.

We treat everything from the simple and routine problems like ingrown nails, warts, orthotics, bunions, hammer toes and sprained ankles, to diabetic foot care, severe sprains and fractures of the foot and ankle, heel spurs, tendon ruptures and more. We also offer pioneering treaments such as Tenex Health TX which is minimally invasive and helps remove damaged tissue and stimulate healing and even complex reconstruction and total replacement surgery.

Of course, whenever possible, our doctors always choose the most conservative care for patients first, such as physical therapy and pain management. Should surgery be necessary, we look at the most minimally invasive procedures first that will help with a more speedy recovery.

We believe that patient education is an important part of providing exceptional care. Below are some of the more common procedures we specialize in, so that our patients can learn about the causes, symptoms and treatment options for all types of foot & ankle injury:

Ankle Sprain
Achilles Tendon Injuries
Foot & Ankle Fractures


Ankle Sprain

What causes an ankle sprain?

A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside. An ankle sprain is an injury that causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint.

Sprains may be classified as mild, moderate, or severe.

Most sprains occur on the outside part of the ankle, but they can occur on the inside as well.

What are the symptoms of a sprained ankle?

– mild aching to sudden pain

– swelling

– discoloration

– inability to move the ankle properly

– pain in the ankle even when you are not putting any weight on it.

How is a sprained ankle diagnosed?

To diagnose a sprained ankle, the doctor will review how the injury occurred and consider your symptoms. He or she will examine your ankle carefully. X-rays may be taken of your ankle.

For additional information visit: AAOS Online Service Fact Sheet – Sprained Ankle



Achilles Tendon Injuries

What are some causes of Achilles tendinitis?

  • overuse of the Achilles tendon
  • tight calf muscles
  • tight Achilles tendons
  • lots of uphill running
  • increasing the amount or intensity of training, sometimes along with switching to racing flats, racing shoes with less heel lift
  • over-pronation, a problem where your feet roll inward and flatten out more than normal when walking or running
  • wearing high heels at work and then switching to a lower heeled workout shoe.
  • Violent stretching of the Achilles tendon can cause it to rupture.

What are some symptoms of Achilles tendinitis?

Achilles tendonitis causes pain and may cause swelling over the Achilles tendon. The tendon will be tender and may be swollen. You will have pain when you rise up on your toes and pain with stretching of the tendon. The range of motion of your ankle may be limited.

When it tears or ruptures, you may feel a pop. If there is a complete tear, you will be unable to lift your heel off the ground or point your toes.

For additional information visit: AAOS Online Service Fact Sheet – Achilles Tendinitis




What are bunions?

Bunions are painful swellings that occur at the base of the first toe on the inner side of the foot as a result of inflammation, and can lead to pain, tenderness and an altered position of the first toe.

What causes bunions?

Bunions tend to run in families, suggesting that the inherited shape of the foot may lead some people to develop this condition. Flat feet, which are often unstable, can also cause bunions as the uneven pressure on the foot may cause the toe to bend and deform. Bunions can also be caused by shoes that are too small or uncomfortable, and are much more common in men than in women.

What are some symptoms of bunions?

  • Large bump on the outside of the big toe
  • Swelling, redness or soreness around the big toe joint
  • Thickening of the skin
  • Corns or calluses
  • Pain
  • Restricted movement

As time goes on, bunions often grow larger and become more painful.

How are bunions treated?

Treatment for bunions depends on the severity of the condition, although early treatment is always considered most effective. Nonsurgical treatments such as changing shoes, applying ice, medication, orthotics and physical therapy can often help relieve symptoms of mild bunions.

More severe cases may require surgical removal, which is often successful in relieving pain, inflammation, deformities and stiffness.

For additional information visit: AAOS Online Service Fact Sheet – Bunions



Foot & Ankle Fractures

How do foot and ankle fractures occur?

With over 26 bones, the foot and ankle are common locations for bone fractures. A fracture is a break or crack in a bone that can cause pain and swelling in the affected area.

Foot and ankle fractures most commonly occur from injury, such as a fall or other event that places great force on the foot. Certain factors such as age and osteoporosis can increase a patient’s risk for fractures, and may also be a major cause, since bones begin to weaken and become brittle as we age.

There are several different types of foot and ankle fractures depending on which bone is affected and the severity of the fractures. A fracture may occur in the phalanges (toes), metatarsals, talus, calcaneus, tibia or fibula.

How are foot and ankle fractures treated?

Treatment for foot and ankle fractures depends on the type, severity and location of the fracture. Your doctor will often begin treatment with conservative methods such as rest, ice, immobilization and anti-inflammatory medication to see if the fracture heals on its own. If a fracture is not out of place and the bone remains stable, most can be effectively treated without surgery.

However, surgery may be required for some cases to set or realign the fracture and help promote healthy healing. Surgery may use a metal plate, rod or screws to realign the bone fragments and hold them in place while they heal.

For additional information visit: