The feet carry us through life and understandably there is a vast array of problems that can occur to the foot and ankle area. The foot and ankle is a very complex structure, for which your podiatrist is highly qualified to treat. The foot and ankle not only allows us to perform daily activities with ease, alas, tends to get overused and neglected, sometimes leading to debilitating conditions affecting our quality of life. Without regular assessments from a podiatrist, things can get overlooked and overused.
A few things a Podiatrist can expect to see in daily practice are:
Heel Pain/ Plantar Fasciits or “heel spurs” – A very common issue, with a focal point of pain at the origin of the plantar fascia on the inside of the heel or pain along the arch. Most people feel worse first thing in the morning or after periods of rest, usually feeling a sharp knife-like sensation. It can be an acute tear or chronic inflammation, with gradual small tears in the fascia. Early assessment by your podiatrist is essential to a speedy recovery.
Tarsal Tunnel Syndrome – A condition where compression is placed on the tibial nerve which supplies sensation and movement to the muscles along the bottom/ inner aspects of the feet. Often symptoms are sharp/ shooting pains, pins and needles, electric shock or burning symptoms radiating down the inside of your foot and ankle. It can occur from trauma, overuse, improper foot and ankle structure, complications post-surgery or and some chronic conditions such as diabetes and rheumatoid arthritis are at an increased risk of development. Your podiatrist can assess and diagnose this, with imaging used as a diagnostic tool often.
Bone Fractures of the Foot and Ankle – Usually resulting from trauma and/ or ankle instability. Usually a sudden snap or pop sensation, and inability to weight bear and can often lead to significant bruising and swelling. However, symptoms wont always arise the same, where a “dull ache” after a simple movement can be enough in some cases. Usually a complex issue, needing an assessment as soon as possible, if left, can delay healing or further damage the area. Often a period of rest and immobility is needed, followed by a period of rehabilitation and adjustment back to normal duties – directed by your podiatrist.
Sprained Ankle – A very common injury, defined by tearing of the ligaments connecting the lower leg to the foot. Causing instant pain and sometimes inability to weight- bear. Sprains are generally graded to 1 (mild), grade 2 (moderate) and grade 3 (severe) of the ligaments, with localised bruising and swelling. Often caused by a sudden twist or roll of the ankle. Early assessment and diagnostic imaging is often needed to get the extent of damage and a treatment plan put in place by your podiatrist.
Metatarsalgia – A general term for pain and inflammation in the forefoot. This can include capsulitis, synovitis/ bursitis, which can all have symptoms like a bruised sensation, tenderness, burning, throbbing all around the ball of your foot. It is important to get an assessment to determine the causation, as it is often mis-diagnosed and treated poorly. Generally overloading of the metatarsals and surrounding structures due to abnormal foot, ankle and lower limb function causes such symptoms.
Shin Splints or Medial Tibial Stress Syndrome – The main symptom of shin splints, is pain and stiffness of your shin. This is caused from overuse of the muscles surrounding and often mechanical inefficiency. This is something that needs adequate assessment of the problem by your podiatrist, as if left alone and push through the pain can lead to stress fracture of the tibia bone and a far longer recovery time than if treated in the early stages.
Mortons Neuroma – A compression of the nerves between the long bones of the forefoot, usually occurring between the 3rd to 4th or 2nd to 3rd toes. It is a compression of the forefoot, causing inflammation of the nerves/ bursa. Without treatment quickly becomes more regular. Symptoms such as sharp shooting pain, clicking sensation, pins & needles and numbness radiating to the toes are common. Sometimes it’s as simple as footwear modification with a metatarsal dome or pad placed in your shoe and/ or simply wearing wider shoes. However, sometimes it is a structural issue with the foot. Further thorough assessment by your podiatrist is important, without a proper assessment and treatment plan, it can lead to injections and/ or surgery.
Achilles tendonitis – A common injury categorised by a painful area at the back of the heel, where the Achilles inserts on the heel bone or mid-portion Achilles tendonitis approximately 5 cm from the insertion point. Often sharp pain and swelling, and sometimes a prominent lump can form over time can form at the heel bone. Commonly brought about by poor foot structure, biomechanics, tight posterior chain (hamstrings/ calves), physical activity or change to your normal load. This is something that has good results when treated properly by your podiatrist.
Osteoarthritis – As we now know, your feet and ankles withstand a lot of wear and tear over the years. The joints can become damaged, leading to degeneration or (osteoarthritis) causing swelling, pain, limited range of motion/ joint function and deformity. It cannot be reversed, so it’s very important to get onto it early and let the podiatrist assess your history and advise you further.
Ingrown Toe Nails – This can be moderate to severe pain affecting and of your toenails, commonly the big toes. The edge of the nail grows into the skin and can get inflamed and puss and blood can appear. Patients will treat it themselves, often leading to further issues. It can be addressed in clinic conservatively and relatively pain free with low risk of reoccurrence. However, when they do re-occur sometimes your podiatrist will need to operate and remove the problematic segment of nail permanently with a partial nail avulsion (PNA).
Corns and Callus – Callus and corns are caused by excess pressure or friction. Callus is an area of dead skin, usually underneath the feet, however can occur anywhere where pressure or friction points are.
A corn can be hard, soft, seeded or neurovascular in nature and are often a localised point of friction. Podiatry treatment often consists of footwear modification, pressure re-distribution within the shoe or regular “maintenance” to debride and remove all callus and corns.
Severs Disease – Similar to that of Achilles Tendoniitis, however occurring in children. Commonly affecting boys between 12 to 14 years and girls 10 to 12 years, corresponding with early or large periods of growth and development and change in activity levels. Often a sharp and uncomfortable pain, the bones are simply growing too fast for the muscles. Creating tension on the heel area, similar to that of Osgood Schaltters of the knee.
Pain is often felt at the Achilles insertion point behind the heel bone, it can be swollen and painful to touch. After assessment by your podiatrist, rest and stretching are usually the first point of call, with an array of other treatment options are implemented.
Warts – Small and harmless lumps caused by a virus known as papilloma virus (HPV). Often sore to squeeze, and rough in appearance. As it’s a virus, there is no “quick fix” unfortunately, however making sure you’re healthy from the inside out is imperative. Debridement and chemical treatment of the wart by your podiatrist is often the fastest way to resolve the issue.
Bunions and Bunionettes (Taylors Bunion) – Characterised by a bony lump or change of angle of the big toe or little toes. Often pain free, and more of an aesthetic issue than anything, however arthritic symptoms can occur to the joint. Commonly genetic, poor footwear, your foot mechanics and how you walk and run all put added pressure on the areas. They can be delayed and managed successfully by your podiatrist, the earlier you get your feet assessed the better.
Hammer Toes – Can occur both flexible and rigid, caused by foot mechanics, muscular imbalances and poor footwear, Treatment depends on the degree and cause and a thorough assessment is needed by your podiatrist to determine this.
Sesamoiditis – A pain under the big toe joint, the sesamoids are two small bones located within the tendons under the big toe. They allow adequate leverage for the big toe to perform its duties. It can start as a mild ache increasing gradually or often overuse and repetitive load sports such as dance, gymnastics and running. Treatment varies depending on the severity, however rest, offloading, immobilising and ice are commonly used, your podiatrist will advise you of the appropriate course of action after assessing the issue.
There is an extensive list of foot and ankle conditions, for which your podiatrist is highly qualified to address.
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