Conditions & Descriptions
Sprained ankles are one of the most common injuries in sports. Because the inner ankle is more stable than the outer ankle, the foot is likely to turn inward (ankle inversion) from a fall, tackle, or jump. This stretches or tears ligaments, resulting in an ankle sprain.
Achilles Tendon Injury
The Achilles tendon connects muscles in the lower leg with the heel bone. Sports that tighten the calf muscles, such as basketball and running, can overstress the tendon and cause a strain or a rupture. A direct blow to the foot, ankle or calf can also cause it.
Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing. Many athletes, as well as others, suffer from chronic ankle instability.
With a bunion, the base of the big toe gets larger and sticks out. The skin over it may be red and tender, and wearing any type of shoe may be painful. In some cases, the big toe may angle toward the second toe, or even move all the way under it. The skin on the bottom of the foot may also become thicker and painful.
Ganglion cysts are among the most common benign soft-tissue masses. Although they most often occur on the wrist, they also frequently develop on the foot, usually on the top, but elsewhere as well. Ganglion cysts vary in size; may get smaller and larger over time and may even disappear, only to possibly return later.
This condition causes pain and stiffness leading to arthritis in the big toe joint, often making it difficult to move the big toe. The big toe joint is a very important part of how we walk, run, jump and function on a regular basis. The earlier stages of the condition are called “limitus” and often progress over time. It can be an inherited condition, or is more commonly caused by: increased stress to the joint from our biomechanics (the way we walk/run), workers who have to squat or kneel down, an old injury. It can also result from joint disease such as gout or rheumatoid arthritis. You may notice pain during rest or activity, “crackling” in the joint, swelling, difficulty wearing shoes, and even bone spurs (bumps) that appear. Many cases of this condition do not require surgery and can be simply treated with: physical therapy, injection therapy, anti-inflammatory medications (topical and oral), orthotics and good shoe gear. When the pain and function are unbearable, surgery can be a viable option which can include: shaving bone spurs (cheilectomy), joint decompression (osteotomy), stretching out the joint (arthrodiastasis), partial or total joint replacement, and lastly arthrodesis (fusion).
Hammer Toe/Claw Toe
A hammer toe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and require surgery. Claw toe is often the result of nerve damage caused by diseases such as diabetes, which can weaken the foot muscles. Having claw toe means the toes “claw,” digging down into the soles of the shoes and creating painful calluses. Claw toe gets worse without treatment and may become a permanent deformity over time.
This has many causes, some which include the following:
Plantar fasciitis: Acute or chronic inflammation of the thick band of tissue on the bottom of the foot. This can be caused by sudden increase in activity, shoe gear, or lifestyle. A common symptom is aching or burning that radiates from the heel to the arch with the first step in the morning; it can also be associated with an inferior heel spur. This is easily treated with physical therapy, stretching, splints, supportive shoe gear, injections, or medications. Surgery is only used as a final option.
Haglund’s deformity/Retrocalcaneal exostosis: Commonly called a “pump bump”, this is a bony enlargement on the back of the heel at the insertion of the Achilles tendon. A bursitis and/or calcification in the Achilles tendon can also be present. This can come from rubbing against shoe gear, a high-arched foot, walking on the outside of the heel, and a tight Achilles tendon. Physical therapy, padding and a myriad of therapies can treat this. Surgery to remove the bumps and repair the Achilles tendon may be warranted if the condition persists.
Tarsal Tunnel Syndrome: A common source of heel numbness, tingling, burning and pain, caused by mechanical impingement of the posterior tibial nerve as it travels through the tarsal tunnel into the foot. Flatfoot, an enlarged structure (i.e. cyst, varicose vein, bone spur, tendon inflammation), injury, or even diabetes or a systemic arthritis can cause this. A physical medicine evaluation is often warranted to perform electromyography and nerve conduction studies. Similar to carpal tunnel in the hand, a variety of conservative options are pursued, refractory cases may need a surgical release to reduce pressure on the nerve.
A stress fracture is a small crack in a bone which can develop from overuse, such as from high-impact sports like distance running or basketball. When muscles are overtired, they are no longer able to absorb the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones, creating a small crack or fracture. Most stress fractures occur in the weight-bearing bones of the foot and lower leg. The most common sites are the second and third metatarsals of the foot.