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Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking.
Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.
Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.
The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.
Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.
An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.
In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.
The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.
While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.
Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.
A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas. Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.
Orthotics are shoe inserts that are meant to correct an irregular walking gait or provide cushioning to the feet. Orthotics come in a variety of different models and sizes, including over-the-counter and customizable variants. Customizable orthotics can be shaped and contoured to fit inside a specific shoe and are typically prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.
Orthotics are beneficial because they can help prevent injuries from occurring and provide cushioning to keep pain levels down to a minimum. They also allow for the correct positioning of the feet. Orthotics can act as shock absorbers to help remove pressure from the foot and ankle. Therefore, orthotics can make bodily movements, such as walking and running, become more comfortable as well as help prevent the development of certain foot conditions.
Orthotics alleviate pain and make the foot more comfortable by slightly altering the angle at which the foot strikes the ground surface, therefore controlling the movement of the foot and ankle. Orthotics come in different variants and can be made of various materials. To determine what type of orthotic is most suited to your feet and your needs, it is best to consult your podiatrist. He or she will be able to recommend a type of orthotic that can help improve your foot function or prescribe a custom orthotic to best fit your feet.
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men.
Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.
People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.
Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.
Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.
To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks.
Heel spurs are the result of calcium deposits that cause bony protrusions on the underside of the heel. Heel spurs are usually painless, but they have the potential to cause heel pain. Heel spurs tend to be associated with plantar fasciitis, which is a condition that causes inflammation of the band of connective tissue that runs along the bottom of the foot. They most often occur to athletes whose sports involve a lot of running and jumping.
Some risk factors for developing heel spurs include running and jogging on hard surfaces, being obese, wearing poorly fitting shoes, or having walking gait abnormalities.
It is possible to have a heel spur without showing signs of any symptoms. However, if inflammation develops at the point of the spur’s formation, you may have pain while walking or running. In terms of diagnosis, sometimes all a doctor needs to know is that the patient is experiencing a sharp pain localized to the heel to diagnose a heel spur. Other times, an x-ray may be needed to confirm the presence of a heel spur.
Heel spurs can be prevented by wearing well-fitting shoes that have shock-absorbent soles. You should also be sure that you are choosing the right shoe for the activity you want to partake in; for example, do not wear walking shoes when you want to go on a run. Additionally, maintaining a healthy weight can be beneficial toward preventing heel spurs, as it will prevent an excess amount of pressure being placed on the ligaments.
There are a variety of treatment options for people with heel spurs. Some of these include stretching exercises, physical therapy, shoe inserts, or taping and strapping to rest stressed muscles and tendons. If you have heel pain that lasts longer than a month, don’t hesitate to seek help from a podiatrist. Your doctor can help you determine which treatment option is best for you.
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.
Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.
Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.
Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.
It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.
Custom orthotics offer a tailored approach to foot health, providing a host of benefits that extend far beyond conventional shoe inserts. One of the primary advantages lies in their ability to address specific biomechanical issues. Unlike off-the-shelf inserts, custom orthotics are crafted based on an individual's unique foot structure, gait, and any existing foot conditions.
The personalized design of custom orthotics ensures optimal support for the arches, promoting proper alignment and distributing pressure evenly across the feet. This can be particularly beneficial for individuals dealing with issues such as overpronation or underpronation, as custom orthotics help correct imbalances that may lead to discomfort or injury.
Beyond biomechanics, custom orthotics can alleviate a range of foot problems, including plantar fasciitis, bunions, and metatarsalgia. They provide targeted relief to areas under stress, reducing pain and inflammation. Additionally, for those with specific medical conditions like diabetes, custom orthotics can play a crucial role in preventing complications associated with poor foot health.
Comfort is another key aspect of custom orthotics. By accommodating the unique contours of an individual's feet, these inserts enhance overall comfort, making daily activities more enjoyable. Whether for athletes looking to optimize performance or individuals seeking relief from chronic foot pain, custom orthotics offer a versatile solution.
Investing in custom orthotics is an investment in long-term foot health. They not only provide immediate relief but also contribute to the prevention of future issues. With the ability to seamlessly integrate into various types of footwear, custom orthotics empower individuals to prioritize foot comfort without compromising on style. In essence, custom orthotics are a personalized prescription for happy, healthy, and pain-free feet.
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Broken ankles or “ankle fractures” are injuries that occur when the bones that make up the ankle joint are broken. Ankle injuries are some of the most common bone and joint injuries. The ankle joint is made up of three bones that join. The tibia is the main bone, and it makes up the inside of the anklebone. The fibula is a smaller bone, and it makes up the outside of the anklebone. A membrane called the joint capsule is lined with a layer called the synovium, which covers the entire joint. The synovium produces synovial fluid which allows for the joint surfaces to move.
An ankle becomes broken when the joint is stressed beyond the strength of its limits. When an ankle is fractured, ligaments may also tear at the same time. Fractures often occur to the ankle rolling or twisting in an unusual way. At times, a fracture may even be caused by an extreme force applied to the joint.
Symptoms of a broken ankle include pain, swelling, bruising, discoloration, numbness, and an inability to move the toes. If you have a broken ankle, you may also hear something tear or snap when you initially suffered the injury. If you have pain from a broken ankle, beware that the pain will not always come from the exact area of the fracture; you may also experience pain from associated foot fractures. The swelling you may experience can suggest that soft tissue damage may have occurred due to the injury.
There are differences between an ankle fracture and an ankle sprain. The difference is that a fracture or break in the bone is required to classify an injury as a broken ankle. An ankle sprain occurs when there is a tear or disruption of ligaments in the ankle. In some cases, the prognosis of an ankle sprain may be worse than that of a fracture.
X-rays are the most common way to diagnose a broken ankle. X-rays show if the ankle is broken and where exactly the fracture is located. It will also show how many pieces of broken bone there are. A second method of testing to see if an ankle is broken is a stress test. To do this, the doctor will put pressure on the ankle and perform a stress test to determine if the fracture requires surgery. Other methods for diagnosis include CT scans and MRI scans.
If you are suffering from a broken ankle, consult with your podiatrist immediately to receive a proper diagnosis and treatment.
A neuroma is a thickening of nerve tissue and can develop throughout the body. In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes. The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.
Neuromas can be caused by anything that causes compression or irritation of the nerve. A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes. Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas. Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.
Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up. Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot. An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.
Treatment for Morton’s neuroma can vary between patients and the severity of the condition. For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed. Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition. The severity of your condition will determine the procedure performed and the length of recovery afterwards.
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If the bone is removed, it is then replaced with prostheses, synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
