Foot Info (Bunions, Hallux Rigidus, Flat Feet, Metatarsalgia, Plantar Fasciitis), Midlands
FootBunionsHallux RigidusClaw ToesFlat FeetHigh Arch FootMorton's NeuromaMetatarsalgiaPlantar Fasciitis
Bunions (Hallux Valgus)
Bunion is an enlargement of the firstmetatarsal bone at the base of the bigtoe. The big toe deviates towards thesecond toe. The symptoms bunions includeredness, swelling, and pain at the siteof the enlargement. These symptoms occurwhen wearing shoes that rub against theenlargement, irritating the soft tissuesunderneath the skin and producinginflammation. Overtime they can developcallosities, deformities of lesser toesand arthritis in the big toe joint.Bunions need not be treated surgicallyunless they are painful and interferingwith daily activities. Recent advancesin surgical techniques have led to avery high success rate in treatingbunions.
Hallux Rigidus(Stiff Big Toe)
Hallux rigidus is acondition caused by arthritis at thebase of the big toe. It commonly affectsactive people as a result of repeatedminor trauma. The stiffness of the toeis especially noticeable on the upwardbending caused by walking
or running.This stiffness causes pain. A bump onthe top of the big toe can be noticed.Surgery should only be undertaken ifyour symptoms are significant.
Surgery involves removing excess bonyprominence, fusion of the big toe jointor a total toe joint replacement.
Tailor's Bunion (Bunionette)
Tailor'sbunion is an enlargement of the fifthmetatarsal bone at the base of thelittle toe. The symptoms of tailor'sbunions include redness, swelling, andpain at the site of the enlargement.These symptoms occur when wearing shoesthat rub against the enlargement,irritating the soft tissues underneaththe skin and producing inflammation.Surgery is often considered when paincontinues despite wearing comfortableshoes. Surgery is highly successful inthe treatment of tailor's bunions.
Hammer toe is bending of one or both joints of thesecond, third, fourth, or fifth (little)toes. This abnormal bending can putpressure on the toe when wearing shoes,causing callosities to develop.Hammertoes usually start out as milddeformities and get progressively worseover time. In the earlier stages,hammertoes are flexible and the symptomscan often be managed with noninvasivemeasures. But if left untreated,hammertoes can become more rigid andsurgery is needed to correct thedeformity.
AMorton's neuroma is a thickening ofnerve tissue that may develop at thebase of the second, third or fourthtoes. A neuroma is the result ofcompression and irritation of the nerve.You will probably have Pain, Tingling,burning, or numbness in the foot.Surgery may be considered in patientswho have not received adequate relieffrom other treatments.
Cavus Foot(High-Arched Foot)
Cavus foot is acondition in which the foot has a veryhigh arch. Because of this high arch, anexcessive amount of weight is placed onthe ball and heel of the foot whenstanding. Cavus foot can lead to avariety of signs and symptoms, such aspain and instability. It can develop atany age, and can occur in one or bothfeet. Cavus foot is often caused by aneurologic disorder or other medicalcondition--for example, cerebral palsy,Charcot-Marie-Tooth disease, spinabifida, polio, muscular dystrophy, orstroke.
If non-surgical treatmentfails to adequately relieve pain andimprove stability, surgery may be neededto decrease pain, increase stability,and compensate for weakness in the foot.Surgery is also considered for casesthat are likely to get worse--even ifthere is currently no pain orinstability. In these instances, thegoal of surgery is to help reduce theseverity of future problems.
Thesurgeon will choose the best surgicalprocedure or combination of proceduresbased on the patient's individual case.In some cases where an underlyingneurologic problem exists, surgery maybe needed again in the future due to theprogression of the disorder.
Flexible flatfoot is one ofthe most common types of flatfoot. Ittypically begins in childhood oradolescence and continues intoadulthood. It usually occurs in bothfeet and generally progresses inseverity throughout the adult years. Asthe deformity worsens, the soft tissues(tendons and ligaments) of the arch maystretch or tear and can become inflamed.
If you experience symptoms with flexibleflatfoot, the foot and ankle surgeon mayrecommend various treatment options,including Activity modifications,Weight loss, Physical therapy, Orthoticdevices, Shoe modifications and Surgery.
Flat Foot (Adult type)"Adult-acquired flatfoot"
Posterior Tibial Tendon Dysfunction (PTTD)
Posterior tibial tendon dysfunction(PTTD) is an inflammation and/oroverstretching of the posterior tibialtendon in the foot. An importantfunction of the posterior tibial tendonis to help support the arch. But inPTTD, the tendon's ability to performthat job is impaired, often resulting ina flattening of the foot. Overuse of theposterior tibial tendon is frequentlythe cause of PTTD. In fact, the symptomsusually occur after activities thatinvolve the tendon, such as running,walking, hiking, or climbing stairs. Thesymptoms of PTTD may include pain,swelling, a flattening of the arch, andan inward rolling of the ankle.
Inmany cases of PTTD, treatment can beginwith non-surgical approaches that mayinclude Orthotic devices orImmobilization. Sometimes a short-legcast or boot is worn to immobilize thefoot and allow the tendon to heal
Incases of PTTD that have progressedsubstantially or have failed to improvewith non-surgical treatment, surgery maybe required. For some advanced cases,surgery may be the only option. Surgicaltreatment may include repairing thetendon, realigning the bones of thefoot, or both. Your foot and anklesurgeon will determine the best approachfor your specific case.
Heel Pain(Plantar Faciitis)
Plantar fasciitisis an inflammation of the band of tissue(the plantar fascia) that extends fromthe heel to the toes. People withplantar fasciitis often describe thepain as worse when they get up in themorning or after they've been sittingfor long periods of time.
After afew minutes of walking the paindecreases, because walking stretches thefascia. For some people the painsubsides but returns after spending longperiods of time on their feet. Themain stay of treatment is exerciseprogram to stretch the fascia. A softinsole is used to help the pain. In somecases, corticosteroid injections areused to help reduce the inflammation andrelieve pain.
Aplantar fibroma is a fibrous knot(nodule) in the arch of the foot. It isembedded within the plantar fascia, aband of tissue that extends from theheel to the toes on the bottom of thefoot. A plantar fibroma can develop inone or both feet, is benign(non-malignant). The characteristic signof a plantar fibroma is a noticeablelump in the arch that feels firm to thetouch. This mass can remain the samesize or get larger over time, oradditional fibromas may develop. Peoplewho have a plantar fibroma may or maynot have pain. Non-surgical treatmentmay help relieve the pain of a plantarfibroma, although it will not make themass disappear.
Stress fractures are tiny,hairline breaks that are usually causedby repetitive stress. Stress fracturesoften caused by increase in dailyactivity. They may be caused by anabnormal foot structure, deformities, orosteoporosis. Stress fractures shouldnot be ignored, because they will comeback unless properly treated.
Achilles Tendon Rupture
An Achillestendon rupture is a complete or partialtear that occurs when the tendon isstretched beyond its capacity. Forcefuljumping, or sudden accelerations ofrunning, can overstretch the tendon andcause a tear. An injury to the tendoncan also result from falling ortripping. A person with a rupturedAchilles tendon may experience suddenpain (which feels like a kick or a stab)in the back of the ankle or calf,difficulty walking (especially upstairsor uphill) and difficulty rising up onthe toes
The diagnosis of anAchilles tendon rupture is typicallystraightforward and can be made throughthis type of examination. In some cases,however, the surgeon may order an US orMRI. Surgery offers important potentialbenefits. Besides decreasing thelikelihood of re-rupturing the Achillestendon, surgery often increases thepatient's push-off strength and improvesmuscle function and movement of theankle.
Haglund's Deformity ("pumpbump")
Haglund's deformity is a bonyenlargement on the back of the heel thatmost often leads to painful bursitis,which is an inflammation of the bursa (afluid-filled sac between the tendon andbone). In Haglund's deformity, the softtissue near the Achilles tendon becomesirritated when the bony enlargement rubsagainst shoes. Non-surgical treatment ofHaglund's deformity is aimed at reducingthe inflammation of the bursa. Ifnon-surgical treatment fails to provideadequate pain relief, surgery may beneeded. The foot and ankle surgeon willdetermine the procedure that is bestsuited to your case.
The Lisfranc joint is thepoint at which the metatarsal bones(long bones that lead up to the toes)and the tarsal bones (bones in the arch)connect. The Lisfranc ligament is atough band of tissue that joins two ofthese bones. It is important formaintaining proper alignment andstrength of this joint.
Injuries tothe Lisfranc joint most commonly occurin automobile accident victims, militarypersonnel, runners, horseback riders,football players, and participants ofother contact sports. Lisfranc injuriesoccur as a result of direct or indirectforces to the foot. A direct force ofteninvolves something heavy falling on thefoot. Indirect force commonly involvestwisting the foot. Anyone who hassymptoms of a Lisfranc injury should seea foot and ankle surgeon right away.
Arthritis and problems with footalignment may develop. In most cases,arthritis develops several months orlonger following a Lisfranc injury,requiring additional treatment.
Charcot foot is a suddensoftening of the bones in the foot thatcan occur in people who have significantnerve damage (neuropathy).The bones are weakened enough tofracture, and with continued walking thefoot eventually changes shape. As thedisorder progresses, the arch collapsesand the foot takes on a convex shape,giving it a rocker-bottom appearance,making it very difficult to walk.Charcot foot is a very serious conditionthat can lead to severe deformity,disability and even amputation. Becauseof its seriousness, it is important thatpatients with diabetes--a disease oftenassociated with neuropathy--takepreventive measures and seek immediatecare if signs or symptoms appear.Charcot foot symptoms include warmth tothe touch, redness in the foot, swellingin the area and pain.
Charcot footdevelops as a result of neuropathy,which decreases sensation and theability to feel temperature, pain ortrauma. When neuropathy is severe, thereis a total lack of feeling in the feet.Because of neuropathy, the pain of aninjury goes unnoticed and the patientcontinues to walk--making the injuryworse.
Early diagnosis ofCharcot foot is extremely important forsuccessful treatment. To arrive at adiagnosis, the surgeon will examine thefoot and ankle and ask about events thatmay have occurred prior to the symptoms.
X-rays are also essential fordiagnosis.
Following the surgeon'streatment plan for Charcot foot isextremely important. Failure to do socan lead to the loss of a toe, foot, legor life.
Thepatient can play a vital role inpreventing Charcot foot and itscomplications by following thesemeasures:
Diabetes patients shouldkeep blood sugar levels under control.This has been shown to reduce theprogression of nerve damage in the feet.Get regular check-ups from a footand ankle surgeon.Check both feet every day--andsee a surgeon immediately if there aresigns of Charcot foot.Be careful toavoid injury, such as bumping the footor overdoing an exercise program.Follow the surgeon's instructions forlong-term treatment to preventrecurrences, ulcers and amputation.
When a toenail isingrown, the nail is curved downward andgrows into the skin, usually at the nailborders (the sides of the nail). This"digging in" of the nail irritates theskin, often creating pain, redness,swelling, and warmth in the toe. If aningrown nail causes a break in the skin,bacteria may enter and cause aninfection in the area, which is oftenmarked by drainage and a foul odor. Themost common cause of ingrown toenails isimproper trimming. Cutting your nailstoo short encourages the skin next tothe nail to fold over the nail. Anothercause of ingrown toenails is wearingshoes that are tight or short.