FOOT AND ANKLE CONDITIONS

Common Conditions

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CONDITION | Sports Podiatrists

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Tinea Pedis (Fungal Infection)

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Fungal Infection of the Nail Onychomycosis

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Achilles Tendinopathy

Achilles Tendinopathy is a condition that is generally caused through a series of tiny injuries to the Achilles tendon which usually occurs for a wide range of factors, such as overuse of the tendon in the case of runners. Achilles Tendinopathy is linked to pain, swelling, and stiffness of the Achilles tendon joining one’s heel bone to one’s calf muscles.

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Injury and Sprains

Ankle injuries are quite common nowadays. At the time of an injury, one may hear a popping or cracking sound and notice swelling, bruising, and ankle pain. Lateral or medical ligament sprains are normally highly tender over the injured ligament. One may experience trouble walking or standing on one’s feet, depending on the severity of one’s ankle sprain.

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Athlete’s Foot

Also known as Tinea Pedis, Athlete’s foot is a contagious fungal infection affecting feet skin, and can easily be spread to the toenails and the hands. As this condition is commonly seen in athletes, it is thereby called Athlete’s Foot. Although the condition is not that serious, sometimes it becomes hard to be cured. If one has diabetes or a weakened immune system and suspects to be suffering from Athlete’s foot, one is highly encouraged to immediately talk with one’s doctor.

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Bunions

As per the findings of Mayo Clinic, Foot bunions are generally caused due to repeated uneven pressure being applied to the joints and tendons in the feet. Indeed, the integrity of the joint in one’s big toe is usually weakened because of an imbalance of pressure or heavy or shifting weight. As a result, parts of the joints are molded into a hard knob that protrudes from the foot. According to Mayo Clinic, as of 2015, it has yet to be demonstrated whether narrow, tight or high-heeled shoes contribute to the formation of Foot bunions. This condition can either be caused by an injury to the foot or, better yet, due to deformities that were present at the time of birth. Interestingly, some people generally inherit a foot type that is more inclined to causing bunions. Along these lines, it is worth mentioning that bunions are also caused if one frequently performs activities that put excessive stress on the feet, especially on the big toes. Finally, foot bunions can also be caused by certain types arthritis, such as rheumatoid arthritis or arthritis producing inflammation.

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Blisters

A blister can be defined as a small pocket of body fluid (e.g., lymph, serum, plasma, blood, or pus) that is usually formed within the upper layers of the skin due to a wide range of factors, including friction (or forceful rubbing), burning, freezing, chemical exposure, or infection.

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Corns

Corns and calluses are some additional foot problems that are treatable with the help of medicated products to chemically trim down the thickened, dead skin.

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Tinea Pedis (Fungal Infection)

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Flat Feet – Pes Planus and Over-Pronation

Flatfoot is a condition which occurs when the longitudinal arche in one’s foot, which runs lengthwise along the sole of the foot, is abnormally developed, such that it is lowered or flattened out. This condition may affect one foot or both feet.

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Ganglion Cysts)

A Ganglion Cyst is a tumor or swelling which is usually developed on top of a joint or through tendon (a tissue connecting muscles to bones) sheath. The physical look of the cyst is like a sac of liquid inside of which is a clear, yet thick and sticky, jellylike material. Such a cyst may feel either firm or spongy, depending on the size of it.

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Forefoot Pain – Metatarsalgia

A common type of overuse injury of the foot is called Metatarsalgia. More specifically, the term ‘Metatarsalgia’ refers to pain and inflammation in the ball of one’s foot. Interestingly, it is usually viewed as a symptom of other feet conditions, rather than being categorized as a specific disease.

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Gout

A painful inflammation of a given joint is known as Gout. Although the joins in the hands, wrists, knees, ankles, and elbows can be affected by this condition, it is usually the joint in the big toe that is commonly affected. Gout occurs when there is a build of waste material, such as uric acid, thus forming tiny crystals in some joints of the body.

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Hammertoe

Foot deformities, such as Hammertoe and Mallet Toe, occur because of an imbalance either in the muscles, tendons or ligaments that usually hold the toes straight. The cause of development of such deformities is often associated to the type of shoes one wears, to one’s foot structure, as well to trauma and certain disease processes. An abnormal bend in the middle joint of any given toe is labelled as Hammertoe. As for Mallet Toe, it often affects the joint located near the toenail. Both Hammertoe and Mallet Toe normally occur in one’s second, third, or fourth toe. To help relieve the pain and pressure caused by Hammertoe and Mallet Toe, one ought to change one’s footwear, or alternatively wear shoe inserts. Some patients with severe cases of Hammertoe or Mallet Toe may require a surgery to get relief.

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Heel Pain and Heel Spurs

A Heel Spur occurs whenever there is a calcium deposit in the body that causes a bony protrusion on the underside of either heel bone. On X-rays, a Heel Spur can extend up to a half-inch; however, when there is no visible X-ray evidence, the same condition is often labelled as a Heel Spur Syndrome. While Heel Spurs are normally painless, they can nevertheless cause an inflammation of plantar fasciitis and, as such, heel pain.

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High Arched Feet – Pes Cavus and Over-Supination

The expression Cavus Foot refers to a condition of the foot having a very high arch due to the ball and heel of one’s foot experiencing an excessive amount of weight, especially when walking or standing. Such a condition can occur either in one foot or in both feet and often leads to various symptoms, including pain and instability.

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Knock Knee – Genu Valgum

Commonly known by the Latin expression Genu Valgum, Knock Knee occurs when the knees angle in and touch one another when the legs are straightened. Patients with severe cases of such a deformity are unable to touch their feet together while straightening them.

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Morton’s Neuroma

This condition emerges with the thickening of the tissue around one of the nerves leading to one’s toes and, as such, it causes a sharp, burning sensation in the ball of one’s foot. As a result, one’s toes may also sting, burn, or feel numb. The cause of this condition is often linked to high-heeled shoes.

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Sesamoiditis

A common ailment of the plantar forefoot is Sesamoiditis that causes pain in the ball of one’s foot, mainly under the big toe joint where the small sesamoid bones are located.

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Plantar Fasciitis

Plantar Fascia is a thick fibrous band of connective tissues that originate in the heel bone and extend to the toes. When one’s plantar fascia develops micro tears or, better yet becomes inflamed, that condition is known as plantar fasciitis.

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Plantar Plate Tear

Pain under metatarsophalangeal joints, especially under the second one, is often due to a tear (or pre-dislocation) of the plantar plate. Plantar Plate Tear can also be defined as toe deformity or floating toe syndrome.

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Hallux rigidus

First metatarsophalangeal-joint osteoarthritis (First MTPJ OA) also known as hallux rigidus is big toe joint disease primarily describes a painful complaint of the first metatarsophalangeal joint identified predominantly by reduction of the first metatarsophalangeal joint dorsiflexion at it is maximal range of motion. The condition is especially prevalent among the elderly, as well as women who frequently wear high-heeled shoes. Many professionals predicted that osteoarthritis was initiated by wear and tear of the cartilage. But, recent studies indicate that osteoarthritis is an illness of the entire joint. Collectively, many studies have demonstrated the risk factors for first MTPJ OA as being foot structure, trauma, joint disease, and gait abnormalities (Zammit et al., 2010; Welsh et al, 2012). The condition is also more common among the musician, and athletes and Agoropoulos et al., (2013), have concluded that there is a connection between 1st MTPJ osteoarthritis, and an individual’s genes.

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Hallux limitus)

Hallux limitus is the term used to describe loss of motion in your big toe joint.

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Osteoarthritis Foot and Ankle

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Achilles Tendinopathy

Achilles Tendinopathy is a condition that is generally caused through a series of tiny injuries to the Achilles tendon which usually occurs for a wide range of factors, such as overuse of the tendon in the case of runners. Achilles Tendinopathy is linked to pain, swelling, and stiffness of the Achilles tendon joining one’s heel bone to one’s calf muscles.

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Ankle Injuries and Sprains

Ankle injuries are quite common nowadays. At the time of an injury, one may hear a popping or cracking sound and notice swelling, bruising, and ankle pain. Lateral or medical ligament sprains are normally highly tender over the injured ligament. One may experience trouble walking or standing on one’s feet, depending on the severity of one’s ankle sprain.

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Sesamoiditis

A common ailment of the plantar forefoot is Sesamoiditis that causes pain in the ball of one’s foot, mainly under the big toe joint where the small sesamoid bones are located.

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Stress Fractures of the Feet

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Shin Splints

The expression ‘Shin Splints’ refers to shin pain, either along the inside or front edge of the shin. Shin Splints primarily affects participants of running sports. There are two main types of Shin Splints, namely Anterior Shin Splints and Posterior Shin Splints. Found on the front part of the shin bone, Anterior Shin Splints involves the tibialis anterior muscle that lifts and lowers one’s foot. Indeed, it lifts one’s foot during the swing phase of a stride and then it gradually lowers it to prepare one’s foot for the phase of support. One suffers from Anterior Shin Splints if one’s anterior shin pain increases when one lifts one’s toes up while keeping one’s heels on the ground. In the Medical field, Anterior Shin Splints are sometimes also referred to as Anterior Tibial Stress Syndrome (ATSS). Contrary to Anterior Shin Splints, Posterior Shin Splints are found on the inside rear part of the shin bone and involves the tibialis posterior muscle that lifts and controls the medial region of one’s foot arch during the phase of weight bearing. When one’s tibialis posterior is weakened or lacks endurance, one’s foot arch overpronates, thus causing torsional shin bone stress. If one feels pain along the inside rear region of one’s shin bone, one is likely to be suffering from Posterior Shin Splints or tibia stress fractures. In the Medical field, these two conditions are often referred to as Medial

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Bowlegs – Genu Varum

Genu Varum is a Latin expression that is commonly used to refer to Bowlegs. This condition is caused due to different factors and may be present from infancy through adulthood. As the condition worsens, the patient suffering from Bowlegs usually ends up exhibiting lateral knee thrust and a waddling gait. Interestingly, in-toeing and secondary effects on the hip and ankle are also associated with Bowlegs. It also worth stating that Bowlegs is either a unilateral problem associated with a functional limb-length discrepancy, or yet a bilateral condition. One’s family and medical history can reveal clues with respect to the likelihood of persistence or progression of this condition.

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Paediatric Foot Care

Paediatric pain, growing pain, developmental lower limb pain, Limb length discrepancy etc.

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Duck Feet – Out-Toeing

Out-toeing is a condition that exhibits an externally rotated (or “turned out”) appearance of a child’s feet when they walk. This could be possibly due to an underlying neurological condition, growth or a a persistent fetal position.

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Flat feet – pes planus and over-pronation

Children with flat feet do not have an arch while standing. In infants, the fat pad in the foot covers the developing arch and in young children with flat feet are due to the loose joints. Flat feet are commonly flexible resulting in an arch that can been seen when the child is standing on the balls of their feet. Most children will develop an arch when standing by around six 6 years however, in about 1 in 5 children don’t develop an arch (Cornwall et al, 2008).

Children with flat feet have been observed to have a lowered medial longitudinal arch and with an everted calcaneus. These Children normally develop flat feet which tend to be flexible however it is more of a concern when children present with rigid flat feet and can cause pain (Evans, 2010).

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Freiberg Disease – Freiberg infraction

Commonly known as Freiberg infraction, Freiberg Disease is a type of avascular necrosis that is usually developed in the metatarsal bone of the foot, especially the second one. The cause of this condition is often attributed to physical stress that causes multiple tiny fractures where the middle of a metatarsal bone meets the growth plate.

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Growing pain

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Knock knee – genu valgum

Commonly known by the Latin expression Genu Valgum, Knock Knee occurs when the knees angle in and touch one another when the legs are straightened. Patients with severe cases of such a deformity are unable to touch their feet together while straightening them.

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Kohler’s disease

Kohler’s Disease primarily affects children, especially boys, between the ages of six and nine. It is a rare bone disorder of the foot and is caused when one’s navicular bone temporarily loses its blood supply. Young girls can also be affected by this condition.

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Osgood-schlatter disease

This condition is developed where there is an inflammation of the area below the knee; it usually occurs during growth spurts as it is precisely at that time when bones, muscles, tendon, and other bone structures are rapidly changing.

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Pigeon toes – in-toeing

Intoeing (also known as pigeon toes) is when the feet turn inwards (adducted angle of gait) when walking. It is a common concern in childhood. Intoeing may be due to a single cause or multiple factors. The main causes of intoeing gait is associated with different developmental patterns at different ages (Jacobs, 2010).

1-2 year old: metatarsus adductus
2-3 year old: internal tibial torsion
Over 3 years: femoral torsion
If intoeing gait is not developmental it is important to consider familial, neurological and orthopaedic involvement. A very common differential diagnosis is cerebral palsy as intoeing gait is a frequent problem in children with cerebral palsy (Evans, 2010).

Signs and symptoms

Most children grow out of it by the ages of 8-10. The child typically presents with:

The foot adducted with a narrow base of gait.
Feet turn inwards
Feet shaped like crescent moon (usually in infants)
Shin or thighbone that turn inward
Limping, tripping
Pain (some patients)

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Sever’s Disease – calcaneal Apophysitis

Calcaneal apophysitis emerges through the rapid developmental period when skeletal development outgrows the length of the muscles/tendon. The insertion of the Achilles tendons at that point pulls on the calcaneal growth plate where the apophysis of the heel may be still open, thus causing increased pain and inflammation in that region. This consolidated with high amounts of activity and mechanical overuse can bring on additional aggravation.

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Charcot’s Arthropathy – Neuropathic Foot

Charcot Arthropathy, commonly known as Charcot foot and ankle, is a syndrome in patients who suffer from neuropathy or loss of sensation. It involves fractures and dislocation of bones and joints that often occur with minimal or without any trauma.

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Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth Disease (CMT) refers to a range of inherited genetic disorders affecting one’s peripheral nervous system that controls one’s ability to move and feel parts of one’s body, be it hands or feet. ‘Neuropathies’ is a term that designates disorders of one’s peripheral nerve stretching from the spinal cord to the muscles.

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Freiberg Disease – Freiberg infraction

Commonly known as Freiberg infraction, Freiberg Disease is a type of avascular necrosis that is usually developed in the metatarsal bone of the foot, especially the second one. The cause of this condition is often attributed to physical stress that causes multiple tiny fractures where the middle of a metatarsal bone meets the growth plate.

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Haglund’s Deformity

A bony enlargement that occurs on the back of the heel is known as Haglund’s Deformity. As this bony enlargement rubs against shoes, irritation of the soft tissue located near the Achilles tendon becomes inevitable. This then leads to an inflammation of the bursa, also known as a fluid-filled sac found in between the tendon and the bone.

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Kohler’s Disease

Kohler’s Disease primarily affects children, especially boys, between the ages of six and nine. It is a rare bone disorder of the foot and is caused when one’s navicular bone temporarily loses its blood supply. Young girls can also be affected by this condition.

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