Most Common

Foot and Ankle Complaints

 



Flat feet (Pes Planus):

Definition: The posterior tibial tendon is the tendon responsible for maintaining one's arch. The muscle originates in the calf and travels down the ankle to insert in the foot.

Symptoms: Patients will often complain of pain and discomfort behind the inside of the ankle (medial malleolus). This can be associated with swelling, heat, and pain along the entire tendon, particularly in the region of the inside of the ankle. The foot often represents the "too many toes" sign when viewed from behind. Shoes are often worn eccentrically with the inside of the shoe receiving the majority of the wear and the medial counter of the shoe being crushed by the weight of the individual. If the condition persist long enough, the foot will actually get stuck in this outward position and will not reconstitute itself, even when the person sits down and becomes non weight bearing.

Treatment: Treatment can be either conservative or operative. The conservative treatment refers to the use of medial heel wedges and in-shoe orthotics in order to help support arch, provided the foot is flexible. If the deformity is bad enough, a brace which extends from the shoe up the back of the calf may be necessary in order to hold the foot it proper orientation. Ultimately, surgical correction either by the use of tendon transfers or fusions of the bones can be curative.

Persons having complaints of flat feet or foot problems should seek medical attention by their family physician with possible referral to an orthopedic surgeon. Nonsteroidal anti-inflammatory medications (NSAIDs) can cause gastric, kidney, or liver problems. They should only be taken at the recommendation of your physician so that they can be properly monitored. Repeated cortical steroid injections also may lead to rupture of tendons or long term complications and should only be done under the supervision of your treating physician.

 

Bunions (Hallux Valgus):

Definition: A bunion occurs when the great toe is pushed in an outward position by the shoe. This results in the base of the toe, that is the inside aspect becoming more prominent and rubbing on the shoe itself. Often the problem is aggravated due to shoe wear, that being high heels with a narrow toe box. The condition does seem to occur more frequently in woman, as a result of shoe wear demands.

Symptoms: Patients often complain of an ache directly over the bump on the inside of the foot. They may have numbness or tingling of the great toe as a result of nerve irritation in this region. Often they give a history of preferring to wear sandals or to be barefoot as opposing to wear any shoes at all.

Treatment: The first treatment is often done by patients themselves, that is avoidance of shoes that hurt, mainly high heels with a narrow toe box. If this is unsuccessful, pads can be placed between the toes or over the bump, in order to reduce irritation in this location. Ultimately, the foot can be straightened by various techniques. Please consult your family practitioner or your orthopedic surgeon.

Persons having complaints of bunions or foot problems should seek medical attention by their family physician with possible referral to an orthopedic surgeon. Nonsteroidal anti-inflammatory medications (NSAIDs) can cause gastric, kidney, or liver problems. They should only be taken at the recommendation of your physician so that they can be properly monitored. Repeated cortical steroid injections also may lead to rupture of tendons or long term complications and should only be done under the supervision of your treating physician.

 

Heel Pain (Planar Fasciitis):

Definition: The planar fascia is a layer of tissue which connects the heel to the toes on the undersurface (sole) of the foot. When this area is stretched due to repeated stress, it often will develop inflammation directly where is attaches on the undersurface of the heel bone. This is the most common foot complaint seen in our practice. This condition occurs secondary to tightness in the calf region and this tightness is transmitted through the Achilles tendon and the calcaneus bone into the plantar fascia.

Treatment: The hallmark of treatment for this is stretching of the Achilles tendon for five minutes at a time, five times per day. This is done by having the patient keep their feet flat on the floor standing approximately two feet away from the wall and then with the knees and hips straight, keeping the heels on the floor, lean with the elbows against the wall causing the stretch on the Achilles tendon. Rarely, injections or surgery may be indicated.

Persons having complaints of heel pain or foot problems should seek medical attention by their family physician with possible referral to an orthopedic surgeon. Nonsteroidal anti-inflammatory medications (NSAIDs) can cause gastric, kidney, or liver problems. They should only be taken at the recommendation of your physician so that they can be properly monitored. Repeated cortical steroid injections also may lead to rupture of tendons or long term complications and should only be done under the supervision of your treating physician.

 

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