Knowledge Center

Follow the links below to Learn some of the most common FOOT PAIN, DISEASES and AILMENTS


Achilles Tendonitis

DESCRIPTION:

Inflammation of the Achilles tendon, the tough sinew that attaches the calf muscle to the back of the calcaneus or heel bone. The Achilles tendon is the largest and strong tendon in the body. It allows us to rise up on our toes, for everyday activities such as walking.

Achilles Tendonitis

PROBLEMS:

Achilles tendonitis causes pain and often swelling over the Achilles tendon. The tendon is tender and may be swollen. There is pain on rising up on the toes and pain with stretching of the tendon. The range of motion of the ankle may be limited. Repeated or continued stress on the achilles tendon could cause a rupture, leading to severe pain, or the inability to walk.

PAIN:

The causes of Achilles tendonitis include overuse of the tendon, overly tight calf muscles or Achilles tendons, excess uphill running, sudden increase in the intensity of training, sometimes along with switching to racing shoes, or wearing high heels at work and then switching to a lower heeled workout shoe. Exerting rapid stress on the Achilles tendon when it is inflamed can result in rupture of the tendon.

Arthritis

DESCRIPTION:

Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints. There are many forms of arthritis (over one hundred and growing). The forms range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an over-active immune system (such as rheumatoid arthritis). Together, the many forms of arthritis make up the most common chronic illness in the United States.

Achilles Tendonitis

PROBLEMS:

During the walking phase a persons foot joints are consistently moving to propel the foot. This movement of the arthritic joints aggravates the arthritis the most and pain is a result.

PAIN:

When it comes to feet it is very difficult to alleviate the pain of arthritis because its need for movement. It is possible to reduce the movement of the joints and still walk with ease. It is important to wear supportive shoes and not light weight flexible shoes. Shoes that bend will allow bones to move and cause more pain. An orthotic is also a benefit because of its ability to support the entire foot.

Bone Spur

DESCRIPTION:

Heel spurs are pointed bony outgrowths of the heel. They are attributed to local inflammation at the insertion of soft tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot. Heel spurs and plantar fasciitis can occur alone or be related.

Bone Spur

PROBLEMS:

Plantar heel spurs cause localized tenderness and pain made worse when stepping down on the heel.

PAIN:

DON’T WALK BARE FOOT. A shoe or a supportive sandal must be worn at all times. By supporting the arch it will decrease the amount of pressure the heel will have to absorb.

Bunion

DESCRIPTION:

Bunion Image 1

The common bunion is a localized area of enlargement of the inner portion of the joint at the base of the big toe. The enlargement actually represents additional bone formation, often in combination with a misalignment of the big toe. The normal position of the big toe (straight forward) becomes outward-directed toward the smaller toes (Hullux Valgus.) The enlarged joint at the base of the big toe (the first metatarsophalangeal joint) can become inflamed with redness, tenderness, and pain. A small fluid-filled sac (bursa) adjacent to the joint can also become inflamed (bursitis) leading to additional swelling, redness, and pain.

A less common bunion is located at the joint at the base of the smallest (fifth) toe. This bunion is sometimes referred to as a tailor’s bunion.

Bunion Image 2

PROBLEMS:

Pain located on the base of the 1st or 5th metatarsal. Pronation is related to most bunion cases. This inward walking motion will increase the deformity of the bunion and the big toe. Bunions are also aggravated when wearing tight fitting shoes. Narrow fitting shoes will usual cause pain and callouses in bunion areas.

PAIN:

Wear shoes that have extra depth toe box room. The foot will never regain its natural shape again without surgery. Not wearing the proper shoes will just accelerate the process of more deformity and pain. Propers shoes will decrease the pain and slow down further deformity and can even eliminate the callous formation.

It is important to keep the foot in a neutral position while walking. Reducing the pronation of the foot, achieved by an arch support, combined with a proper fitting shoe is the best solution for bunions. Together they can maximize foot comfort and minimize further deformity.

Cross Over Toes

DESCRIPTION:

Overlapping toes can occur in any of the toes and can cause extreme irritation if not corrected. Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. People of all ages can experience forefoot problems.

Cross Over Toes

PROBLEMS:

The main cause of overlapping toes is bunions. As a bunion progresses it can cause the big toe to start to rest under the second toe. Other causes of overlapping toes are improper footwear, rheumatoid arthritis, hereditary factors and injury to the toes. Many additional disorders can affect the joints in the toes including arthritis, autoimmune diseases, trauma, congenital deviations, hammertoes, etc.

PAIN:

Any problems that cause pain or discomfort in the toes should be given prompt attention. Ignoring the symptoms can aggravate the condition, and lead to infection or a breakdown of tissue.

Conservative, non-surgical treatment of overlapping toes begins with accommodating the disorder with extra depth shoes. Shoes with a high, broad toe box (toe area) are recommended to keep the top of the toes from rubbing against the shoe.

Forefoot supports such as gel toe straighteners, gel toe caps and toe combs are often recommended to keep overlapping toes apart. These effective devices are designed to reduce friction to help relieve the discomfort.

Flat Feet

DESCRIPTION:

A condition of the feet in which the arch of the instep is flattened and the entire sole touches the ground.

All babies have flat feet because their arches are not yet built up (and their feet tend to be plump). This condition may persist into adulthood, or an arch may form as the child grows.

Flat feet can also be acquired, as in jobs that require a great deal of walking and carrying heavy objects.

Flat Feet

PROBLEMS:

The normal arch is made up of bones and joints which are held tightly together in a precise relationship. In order for the arch to flatten out, the ligaments and tendons which hold the bones and joints together must be more flexible than normal. This abnormal flexibility may be a result of: the genes we inherit from our parents, the weakening of muscles and ligaments caused by advancing age, neuromuscular diseases, or injury. Injuries may include one severe trauma, or years of standing for long periods of time in the wrong types of shoes (those with high heels or those with poor support). This flexibility of the bones, joints, and soft tissues is what causes the foot problems which are related to flat arches or feet.

PAIN:

We know that flat feet are cause by the foot’s dysfunction to uphold the weight applied to it. Therefore, it makes sense that the support to up hold the arch must be strong enough to endure a person’s body weight. For this reason soft arch supports and flexible shoes will not help.

Shoes must be stiff and non-flexible through out the arch area to the ball of the foot. This stiffness will help keep the bones from misaligning like walking barefoot. Reinforced heal counters are also very important for stabilization.

Arch supports need to made strong enough to support a person body weight. An arch support must fit the entire length of the longitudinal arch without sharp rises. Arches normally found just have a small lump in the middle which would hurt those with a flat foot. The pressure to increase the arch needs to be spread out and have a gradual rise.

Fat Pad Atrophy

DESCRIPTION:

When a person natural protective tissue is minimized to the point of literally skin over bone.

Fat Pad Atrophy

PROBLEMS:

Feet with little to no fat pad on the bottom will experience more pain, callouses, and foot sores. Without the extra padding every bony spot, spur, and callous will be more painful.

PAIN:

It is important to wear shoes all the time. Walking barefoot will be painful and damaging to the foot. Shoes with extra padding like depth shoes that have 1/2″ cushioning are excellent way of replacing the fat pad. In cases of bony areas, an orthotic can dispense weight differently to decrease the pressure it that area. Combination of depth shoes and custom made orthotics is ideal for those with extreme fat pad atrophy.

Gout

DESCRIPTION:

Gout in the foot can cause hard deposits of uric acid crystals to form a lump at the inner side of the base of the big toe.

Gout

PROBLEMS:

Depending on the size of the deposit, there can be abrasion and even ulceration from the shoe. The joint can inflame with swelling and redness. There is pain when the big toe moves or is touch by a shoe.

PAIN:

Normally deeper and wider shoes are helpful. Even running shoes are effective because they have a rocker toe. This slight rock reduces the about the big toe has to move while walking. This reduction in movement helps the pain. When running shoes are not wide enough the depth shoes are soft and give more room.

An orthotic will also help offload the joint affected by the gout. By added arch support the affected joint will endure less body weight increasing the likelihood of relieving pain and irritation.

Haglund Deformity

DESCRIPTION:

A bony enlargement of the upper/back portion of the heel. This enlarged bone rubs on the Achilles Tendon, just above its attachment to the heel, causing inflammation and pain.

Haglund Deformity

PROBLEMS:

If the posterior-superior portion of the heel has an abnormally large bony prominence protruding from it (called a Haglund’s Deformity), in some instances it may rub against the Achilles Tendon. When this occurs, the bursa between the bone and the tendon, will become inflamed, swollen, and painful. This condition is called Retrocalcaneal Bursitis. The presence of a Haglund’s Deformity does not insure that these problems will occur. In order for these problems to occur, the heel and foot must be tilted in such a way as to actually force this bony prominence into the bursa and tendon.

PAIN:

In order to eliminate abnormal heel tilt, the foot must be re-balanced. This is best accomplished by correcting the foot to a neutral position with the use of an orthotic.

Shoes with soft and padded heel counter are more comfortable to wear. A running style shoe give good support with heel padding.

Hammer Toes

DESCRIPTION:

A hammer toe is a toe that is contracted at the PIP joint (middle joint in the toe), potentially leading to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Hammer toes may occur in any toe except the big toe. There is often discomfort at the top part of the toe due to rubbing against the shoe.

Hammer toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

Hammer Toes

PROBLEMS:

Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes.

PAIN:

Changing the type of footwear worn is a very important step in the treatment of hammer toes. When choosing a shoe, make sure the toe box (toe area) is high and broad, and can accommodate the hammer toes. A shoe with a high, broad toe box will provide enough room in the forefoot area so that there is less friction against the toes.

Other conservative treatments include using forefoot products designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer toe and provide relief to the forefoot. Gel toe shields and gel toe caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication.

Hallux Valgus

DESCRIPTION:

The big toe (the hallux) that is bent outward (valgus) so it crosses over into the 2nd toe. A bunion is a localized painful swelling at the base of the big toe that can accompany hallux valgus. It is frequently associated with inflammation. It can be related to inflammation of the nearby bursa (bursitis) or degenerative joint disease (osteoarthritis).

Hallux Valgus

PROBLEMS:

This deformity causes weight to be dispensed uneven. As the deformity worsens, the great toe will go under the second, causing it to hammer. This makes fitting shoe difficult.

PAIN:

It is important to stop the pronation that is making the bunion and hallux valgus worse. An orthotic can achieve this goal by offering longitudinal arch support. Supportive shoes are also recommended to support the orthotic. Together they with slow down further deformity of the bones. The foot will never restore it natural shape again without surgery, but without treatment it is surely going to get worse faster.

Ingrown Nails

DESCRIPTION:

When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

The most common cause of ingrown toenails is improper trimming. Cutting your nails too short encourages the skin next to the nail to fold over the nail. Another cause of ingrown toenails is wearing shoes that are tight or short. Certain nail conditions are often associated with ingrown toenails. Narrow toe boxes or misfitted shoes are the second most common cause of ingrown toe nails.

Ingrown Nails

PROBLEMS:

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

PAIN:

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk, for example, diabetes, nerve damage in the foot, or poor circulation.

If you don’t have an infection or any of the above conditions, you can soak your foot in room-temperature water (add Epsom’s salt if you wish), and gently massage the side of the nail fold to help reduce the inflammation. Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon.

Shoes with extra depth are more comfortable to wear when you have an ingrown toe nail. Also they will prevent future recurrences of it.

Metatarsalgia

DESCRIPTION:

Metatarsalgia is a common overuse injury described as pain in the forefoot associated with increased stress over the metatarsal head region. Metatarsalgia often is referred to as a symptom, rather than as a specific disease. Common causes of Metatarsalgia include inter-digital neuroma, metatarsophalangeal synovitis, vascular necrosis, sesamoiditis, and inflammatory arthritis; however, these causes often are diagnosed separately.

Metatarsalgia

PROBLEMS:

The primary symptom of Metatarsalgia is pain at one or more of the metatarsal heads. Diffuse forefoot pain and mid foot pain are often present in athletes with combinations of high-impact inflammatory conditions.

  • Pain typically is aggravated during the mid stance and propulsion phases of walking or running.
  • A history of gradual chronic onset is more common than acute presentation. Chronic symptoms may be of gradual onset over 6 months.
  • Morton neuroma (inter-digital neuroma) produces symptoms of Metatarsalgia due to irritation and inflammation of the digital nerve located in the web space between the metatarsal heads. Patients with Morton neuroma may complain of toe numbness, in addition to pain in the forefoot. The term Morton neuroma is a misnomer because no neuroma truly exists. Rather, the lesion results from a mechanical entrapment neuropathy.
  • Pain and tenderness are experienced on the plantar surface of the metatarsal head, which often is accompanied by the development of a callus formation (plantar keratosis).

PAIN:

  • The foot frequently is injured during sports activities.
  • As in many other overuse syndromes, the condition may be the result of an alteration in normal biomechanics that has caused an abnormal weight distribution among the metatarsal heads.
  • Persistent stress can lead to chronic irritation and inflammation of the periosteum and adjacent tissues.
  • The following factors can contribute to excessive localized pressure over the forefoot.

Neuroma

DESCRIPTION:

A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs at the base of the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. “Intermetatarsal” describes its location – in the ball of the foot between the metatarsal bones (the bones extending from the toes to the midfoot). Neuromas may also occur in other locations in the foot. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.

Neuroma

SYMPTOMS:

  • Pain in the ball of the foot
  • Numbness or tingling
  • Burning

SOLUTIONS:

Orthotics are prescribed to lift and separate the metatarsals to prevent the nerve impingement.

Plantar Fasciitis

Plantar Fasciitis

DESCRIPTION:

When your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis (fashee-EYE-tiss). It’s an overuse injury affecting the sole or flexor surface (plantar) of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.

You’re more likely to get the condition if you’re a woman, if you’re overweight, or if you have a job that requires a lot of walking or standing on hard surfaces. You’re also at risk if you walk or run for exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches are also more prone to plantar fasciitis.

The condition starts gradually with mild pain at the heel bone often referred to as a stone bruise. You’re more likely to feel it after (not during) exercise. The pain classically occurs again after arising from a midday lunch break.

If you don’t treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis changes the way you walk.

HELP:

Rest is the first treatment for plantar fasciitis. Try to keep weight off your foot until the inflammation goes away. You can also apply ice to the sore area for 20 minutes three or four times a day to relieve your symptoms. Often a doctor will prescribe nonsteroidal anti-inflammatory medication such as ibuprofen. A program of home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treating the condition and lessening the chance of recurrence.

People with Plantar Fasciitis should never go bare foot even around the house. When a person with this condition gets out of the bed in the morning the first few steps are very painful. This is because the Plantar Fascia is stretched with out proper support while stepping barefoot out of bed. This aggravation each morning will reduce or eliminate any chance of healing.

It is highly recommended that a person steps out of bed straight into shoes, sandals, or slippers with adequate support so the fascia tissue is not strained. If a person experiences pain out of bed in the morning then there is not enough support in the arch. Once a person is ready for their every day shoes or work shoes it is important they have equal or more support in the arch.

Pronation

DESCRIPTION:

In simple term, pronation is the flattening out of the arch when the foot strikes the ground. Normally, the foot will pronate to absorb shock when the heel hits the ground, and to assist in balance during mid-stance. The ankle will ‘tip’ towards the inside.

Pronation

PROBLEMS:

With excessive pronation/ over pronation, the arch flattens, collapses, and soft tissues stretch. This causes the joint surfaces to function at unnatural angles to each other. When this happens, joints that should be stable now become very loose and flexible.

At first, excess pronation may cause fatigue. As the problem gets worse, strain on the muscles, tendons, and ligaments of the foot and lower leg can cause permanent problems and deformities. The more a person pronates the more pressure they apply on the medial side of the foot. This leads to more foot deformities and callous formation.

PAIN:

DON’T WALK BARE FOOT. A shoe or a supportive sandal must be worn at all times. By supporting the arch it will decrease the amount of pressure the heel will have to absorb.

Sesamoiditis

DESCRIPTION:

Sesamoiditis is a general description for any irritation of the sesamoid bones. Sesamoid bones are tiny bones within the tendons in the foot that run to the big toe. The sesamoid bones function as a pulley, increasing the leverage of the tendons controlling the toe.

Sesamoiditis

PROBLEMS:

The most common symptom of sesamoiditis is pain in the ball-of-the-foot and swelling. The pain often occurs on the medial or inner side.

The pain may be constant, or it may occur with, or be aggravated by, movement of the big toe joint. The pain is often accompanied by swelling throughout the bottom of the forefoot.

PAIN:

Sesamoiditis is usually caused by repetitive, excessive pressure on the forefoot. Other causes include increased activity, stress fractures, having a high arched foot, and having a bony foot. If you have a bony foot, you may not have enough fat on your foot to protect your sesamoid bones and tendons.

Tibialis Posterior Tendonitis

DESCRIPTION:

Posterior Tibialis Tendonitis is a strain placed on the posterior Tibialis tendon. The posterior Tibialis tendon runs along the inside of the ankle and the foot.

Tibialis Posterior Tendonitis

PROBLEMS:

When there is post-Tibialis tendon disjunction, the tendon does not function to hold up the arch, resulting in flat feet. This can lead to heel pain, arch pain, plantar fasciitis and/or heel spurs. With post-tibial Tendonitis, pain will be more severe upon weight bearing, especially while walking or running.

SYMPTOMS:

  • Pain and swelling on the inside of the ankle
  • Loss of the arch and the development of a flatfoot
  • Gradually developing pain on the outer side of the ankle or foot
  • Weakness and an inability to stand on the toes
  • Tenderness over the mid foot, especially when under stress during activity

PAIN IS CAUSED BY:

Injury is the main cause.

  • Most injury is caused from strain on the Posterior Tibialis Tendon from over use from sport activity.
  • Injury from impact or fall.
  • Walking incorrectly on the inside of the foot.
  • Diseases such as arthritis.
  • Weight gain.

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