Foot Problems

 Our feet take a tremendous amount of abuse throughout our life and are, for the most part, ignored until we experience a painful foot condition. Some of the more common foot problems are outlined on this page. If you think you may have one of these conditions, we would strongly recommend that you seek medical advice.
 

It's no wonder that so many of us experience foot problems during our lifetime. The average adult takes 8,000 steps a day. Because you have momentum when you walk the actual force of your foot striking the ground is about 1.5 times your body weight. By way of example, the feet of a 200 pound man will experience the equivalent force of over TWO MILLION pounds each and every day.

Even more astounding is the statistic that the average person will walk over 75,000 miles, which is equivalent to three times around the world! 

These facts, coupled with the desire of people to remain active as they age explains why pedorthic services are increasingly in demand. 

Heel Pain Syndrome is caused by repetitive pressure placed on the heel of the foot when walking, which causes soreness of the heel. "Itis" usually refers to the inflammation of a certain part of the body, therefore Bursitis refers to the constant irritation of the natural cushion that supports the heel of the foot (the bursa). Bursitis is often associated with Plantar Fasciitis, which affects the arch and heel of the foot. Plantar Fasciitis is caused by inflammation of the tissues connected to the heel bone, due to excessive pulling and stretching of the fibrous bands that support the arch of the foot. Continuation of this irritation can lead to heel pain, arch pain or a bony growth on the bottom of the heel bone called a "heel spur". Another condition related to Plantar Fasciitis is swelling on both sides of the Achilles tendon.
 

Arch supports and orthotics (special insoles) are the best treatment for this type of condition as they gently support the longitudinal arch of the foot allowing it to settle into a more natural position. Arch supports or adhesive pads can also help to strengthen the arch but orthotics may be a more permanent solution. An orthotic device (special insole) such as a heel cup or heel cradle will help to absorb shock to the heel by raising the heel, which will redistribute pressure and provide a cushion for the plantar fascia. If the heel pain is caused by over pronation then an orthotic with medial posting that supports the arch will correct over pronation preventing further heel pain. Appropriate footwear is a key consideration in preventing heel pain; therefore shoes must be spacious and supportive.

 Hammer toes are caused by a biomechanical imbalance where the muscle structures of the toes are partially or completely dislocated. This causes the toes to become bent and crooked, and the joints of the toes to protrude. 

This condition can be hereditary or caused by inappropriate, ill-fitting shoes. Caution must be taken with hammertoes as they can lead to the development of ulcers and infections, which can be very serious for people with diabetics especially.
 

Hammertoes can be very painful, especially if irritated by a tight fitting shoe and can often lead to corns, calluses and sufferers can sometimes experience cramps in the toes and feet.

 A bunion is a bony lump on the inside of the foot next to the big toe. When aggravated this can cause a bursa, which is a sac of fluid that becomes inflamed, red and sore.
 

Bunions occur when the big toe is forced into a position contrary to its normal alignment. This can occur through continuous standing and walking which weakens the anterior metatarsal arch, causing the foot to become flattened and the big toe joint to project inwards. Pressure is then placed upon the projecting joint by the shoe, which creates a bursa (hollow pocket lined with fluid) that becomes inflamed when aggravated. This lump on the inner foot can become red, swollen and painful if left untreated. Bunions are common in professions that involve continuous standing and walking, e.g. Police, Postal Workers, Hairdressers, Waiters. Women tend to be more prone to bunions due to their choice of shoes which are often high heeled, narrow and unsupportive.
 

Wearing non-constrictive footwear can prevent bunions. Avoid shoes that are ill fitted, have high heels or pinch. Invest in shoes that are supportive, have a wide fitting toe, low heel and good quality insoles. In addition to following the advice above regarding sensible footwear, bunions can be treated with anti-inflammatory medications. Cold compresses, massage and foot soaking are all methods in which you can relieve painful bunions. Good palliative measures consist of reusable gel pads, adhesive padding and orthotics that reduce pressure to the problem area. Depending on the severity of the problem, surgery may be necessary, although cortisone injections and orthotics are a useful starting point.

 Corns and calluses develop when normal skin activity is over-stimulated resulting in a thickening layer of skin. This over-stimulation can result from congenital, hormonal, occupational & infective factors. A callous is a diffuse area of thickened skin, were as a corn is an area of a callous that have become moulded into a nucleus.

Neuropathy refers to loss of feeling in the feet and can occur as a result of complications in people with diabetes. The most common form of neuropathy is peripheral neuropathy, which occurs when the nerves that run from the brain to the organs, muscles, skin and glands are impaired.  This condition can cause inability to feel heat, cold or even pain, therefore diabetics may not be able to feel any cuts or sores on the soles of their feet. If left untreated these minor cuts and sores could get infected and result in ulceration which could lead to amputation. Therefore people with diabetes should perform a daily check of their feet to prevent any problems occurring. Neuropathy associated with other medical conditions or disorders require similar advice regarding foot care.

The big toe joint is the site most commonly affected by osteoarthritis, but any of the joints in your feet can be affected. Many people notice changes in the arch structure of their feet as they get older, and mild arthritis in the arch area is common. Osteoarthritis is less common in the ankle, but can occur if there has been an earlier injury or as a result of long-standing inflammatory arthritis.
 

The term 'inflammatory arthritis' encompasses rheumatoid arthritis (RA), reactive arthritis (Reiter's syndrome), psoriatic arthritis and ankylosing spondylitis. The effect on the feet depends on exactly which type of arthritis you have. Rheumatoid arthritis, for instance, tends to affect many of the foot joints, while reactive arthritis usually affects only the ankle. People with inflammatory arthritis can also have inflammation and discomfort in the tendons and the other 'soft tissue' structures in the feet. The part under the heel where the tendons attach to the heel bone is quite often affected in this way.

An ingrown toenail is a condition where one or both sides of the nail cut into the flesh of the toe. An ingrown toenail can cause swelling, redness or infection and can be very painful.  If you are suffering from an ingrown toenail we recommend that you visit a Podiatrist who can treat the nail and prevent further complications. If you are diabetic or have any vascular problems it is vital that you get treatment for the toenail, as it is prone to infection and if left untreated could eventually lead to loss of limb.

If the toenail becomes thick and discolored turning yellow or brown, you may have acquired a fungal infection, therefore it is advised that you contact a Podiatrist for advice..

Pes planus otherwise termed as flat feet is a biomechanical problem experienced by a surprisingly high percentage of the population. Flat feet are a condition where the arch of the foot appears flattened. This causes the foot to roll inwards in order to gain contact with the floor and support the weight of the body, and is the main clinical feature of excessive pronation.
 

Pes Planus or Flat Feet can occur in people of all ages and is very common. However, older generations can be more susceptible to over pronation and flat feet because they tend to partake in lower levels of physical activity and gain weight with age, which can disturb the biomechanical balance of the foot.

Pes Planus or Flat Feet are most commonly a congenital condition but can also be acquired as a result of the foot being repetitively subjected to hard surfaces eventually weakening the arch of the foot. In today's world of concrete and tarmac it is therefore not surprising that this condition is becoming more and more frequent in people of all age groups. Other causes of flat feet can include: obesity and pregnancy.
 

Pes Planus can be effectively treated with orthotics (special insoles) that provide biomechanical support and help feet to function more efficiently. The most effective orthotics are those which are custom made to fit your foot, but in many cases a non-prescription orthotics or insoles can be used. The orthotic should provide both support for the longitudinal arch and medial rear foot posting to combat over pronation. Orthotics should be combined with supportive footwear that fits the foot correctly and contains a firm, low heel.