Foot and Ankle

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Forefoot Conditions

Metatarsalgia

Metatarsalgia is the general name given to pain in or across the ball of the foot. Some of the bones in this area of the foot can become inflamed and painful following high pressure over a long period of time. One cause could be ill-fitting footwear. As we become older, the fat pad beneath the bone heads tend to thin and this makes us more susceptible to this condition. Symptoms include pain in the ball of the foot.

Corns and Callouses

A corn or callous refers to a patch of hard or thickened skin on the foot. They will generally form in an area that’s exposed to high pressure. A corn forms in a similar way and has a cone-shaped core with a point that can press on a nerve and cause pain. After an extended period of time these may become painful.

Morton’s Neuroma

Morton’s Neuroma is a common foot problem associated with pain, swelling and inflammation of a nerve in the front of the foot. The most commonly affected nerve is between the 3rd and 4th toes. Symptoms include feeling a burning or sharp pain in the affected area. You may experience numbness, tingling or cramping of the forefoot and pain when weight bearing.

Problematic Toes

Claw Toes

A Claw Toe is curled down in the middle and end of the toe to a claw-like position. It can have many causes such as by ankle injuries, surgery or inflammation. Symptoms include pain, corns or calluses.

Mallet Toes

A Mallet Toe occurs when the joint at the end of the toe can’t straighten and tends to be caused by tendon or ligament tightening. The tip of the toe may be turned down against the shoe which causes pressure and discomfort. Symptoms include pain or discomfort in the toes.

Big Toe Problems

Bunion

A bunion is a bump on inside of the big toe which forms as the big toe moves towards the smaller toes. A bunion might develop due to an abnormality in your big toe. Symptoms include pain in the big toe joint. 

Hallux Limitus/Rigidus

Hallux limitus is when the big toe (hallux) doesn’t bend as much as it should. 

Hallux rigidus is when there is no movement in the big toe joint. Ligaments can become tightened following an abnormal walking pattern which may cause either of these conditions. Another cause can be arthritic changes within the big toe joint. Symptoms include pain in the big toe join across the ball of the foot when walking.

Sesamoiditis

Sesamoiditis mainly affects younger people involved in physical activity. It refers to irritation of the bones which lie within the tendon that runs to the big toe. When you push off against your big toe the bones involved can become irritated or even fractured. Symptoms include pain under the big toe during activities such as walking and running.

Hindfoot Conditions

Plantar Fasciitis

Plantar fasciitis or Plantar heel pain is a very common Orthopaedic condition. It refers to the thin, web-like ligament which connects your heel to the front of your foot. This area acts as a shock absorber to support the arch of your foot and helps you to walk every day. General wear and tear over time or too much pressure on the foot can cause this condition. Plantar fasciitis can cause pain or stiffness felt in your heel.

Achilles Tendonitis/Rupture

The Achilles tendon connects the heel to the muscles of the lower leg. The Achilles tendon is the thickest and strongest tendon in the body.

When the Achilles tendon becomes inflamed, we call this Achilles Tendonitis. Overuse, misalignment, improper footwear, medication side effects, and accidents can all result in Achilles tendonitis. Symptoms include tenderness at the back of the heel and being unable to flatten the foot to the floor. This can be more difficult first thing in the morning.

If a force is applied suddenly to the Achilles tendon this can cause the tendon to rupture. The tear may be partial or complete and comes on suddenly with a popping sound. Common symptoms include hearing or feeling a sudden snap when the tendon tears. You might struggle to push off correctly onto the ball of your foot which makes walking more difficult.

Peroneal Tendonitis

Peroneal tendons are on the outside of the ankle. Tendonitis can occur when microtears cause damage or inflammation to the tendons. Symptoms include pain at the back area or outside of the foot. 

Sever's Disease

Sever’s disease (calcaneal apophysitis) is a common condition affecting active children between 8 and 14 but occasionally as young as 6. The condition presents as pain at the back and side of the heel (calcaneus), where the calf muscles attach to the heel at the growth plate (apophysis). It is said to account for 2-16% of musculoskeletal attendance of children at sports clinics.
When the muscles and tendons pull at the growth plate, the repeated motion can cause inflammation and swelling in this region, resulting in pain at the back of the heel. With management, symptoms often resolve within a few months and rarely causes lasting problems. 

Ankle Condition

Acquired flat foot

The Posterior tibial tendon runs along the inside of the ankle to the foot and helps support the arch during walking. When the tendon becomes damaged or inflamed the arch will drop or flatten leading to a flattened arch. The cause of PTTD is generally overuse of the tendon. Symptoms include pain along the tendon from the inside of the ankle to the foot, particularly after being active. The ankle may begin to roll inwards (pronation) with the toes beginning to point outwards. As the conditions gets worse you may also experience pain on the outside of the foot below the ankle.

• What is Over pronation?

Foot Drop

Foot drop is a muscular weakness or paralysis which makes it difficult to lift the front part of your foot and toes. This can cause you to drag your foot on the ground making it difficult to walk. Foot drop is a sign of an underlying problem rather than a condition itself. It can be muscular, caused by nerve damage in the leg, or the result of a brain or spinal injury or a neurological condition such as Multiple Sclerosis / Parkinson’s. (NationalFoot Drop Society)

We have a number of articles on the orthotic treatment for footdrop

• Foot Drop Clinic 
• using orthoses to improve walking difficulties in MS
  
• AFO Overview
• Carbon Fibre AFO
• Silicone Ankle Foot Orthosis (SAFO)
• TurboMed Xtern