Common Foot Problems

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of foot pain. The plantar fascia is a band of fibrous tissue that connects your heel to your toes. It plays an import role in foot function as it provides support to the arch of the foot. Plantar fasciitis is the medical term to describe when this structure becomes painful and inflamed. It commonly occurs in just one foot but can present in both. Plantar fasciitis normally resolves itself within 2-6 weeks however for some it can be long lasting and can be very debilitating.

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Posterior Tibial Tendon Dysfunction

Posterior Tibial Tendon Dysfunction (PTTD) is a common cause of arch pain.
The tibialis posterior muscle is located in the calf and runs along the tibia and fibula. The muscle has a long tendon which connects into the arch of the foot. This is known as the tibialis posterior tendon.
The main function of the tibialis posterior muscle and its tendon is to control the speed at which the foot pronates during gait. It therefore experiences very high forces when walking and running.
PTTD is the medical term to describe when the tendon becomes inflamed and damaged. It is also known a tibialis posterior tendinopathy.
Early treatment of PTTD is the key to prevent significant damage to the tendon occurring. In the early stages of the condition PTTD responds well to conservative management such as physiotherapy and Orthotics.

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Metatarsalgia

Metatarsalgia is the medical term used to refer to pain at the ball of the foot. In order to treat Metatarsalgia it is important to first diagnose the specific problem causing the pain. Common reasons for pain around the ball of the foot include:

  • Mortons Neuroma
  • Sesamoiditis
  • Plantar Plate Tear
  • Freibergs Disease

Mortons Neuroma

A Neuroma is a thickening of a nerve. They may develop anywhere in the body. A Morton’s Neuroma as the name for a Neuroma that develops on the interdigital nerves in the fore foot between the metatarsals. This inflammation is thought to occur due to the nerve being over stretched.

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Sesamoiditis

A sesamoid bone is a bone located in a tendon. The largest sesamoid bone in the body is the Patella (knee cap). Sesamoiditis is the medical term for pain of the sesamoid bones. There a two small sesamoid bones located under the big toe joint. Sesamoiditis is a common cause of forefoot pain and is frequently seen in dancers, runners, people who frequently wear high heels or have a high arch. The sesamoid bones in the foot can also fracture or dislocate.
The plantar plate is a fibrocartilaginous structure which stabilises the metatarsophalangeal joints (MTPJ). It originates from the met heads and attaches into the bottom of the toes. It is also the attachment site for the plantar fascia.

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Freibergs Disease

Freibergs disease is avascular necrosis of the growth plate in the metatarsal bone. It most commonly occurs in the 2nd metatarsal. It is commonly diagnosed during adolescence however it can occur at any time. It is more prevalent in those who have a shortened 1st metatarsal as this puts more stress on the 2nd metatarsal bone.

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Overpronation

Pronation is a term often demonised by footwear and insole manufactures in the pursuit to encourage buyers to buy their newest trainer or insole.
Pronation is the medical term used to describe the motion of the foot when the arch flattens and the ankle roles in. It is a normal and necessary motion of the foot that involves movement in several small joints in the ankle and mid foot. It provides shock absorption to the rest of the leg and allows the foot to adapt to uneven terrain.
Research has shown there are a wide variety of normal foot postures within the population and the amount of pronation a person displays can vary. Furthermore a recent study involving a large sample size of 900 showed no link between pronation and foot pain/injury. Therefore a foot that pronates a lot does not necessarily require orthotics providing there is no pain present.

Treatments for Overpronation

However for those that do experience pain due to over pronation there are treatments proven to help such as:

  • Improving intrinsic muscle strength to increase strength and control of the arch
  • Increasing Glut strength to improve foot placement
  • Foot Orthotics to reduce stress on the soft tissue structures

Achilles Teninopathy

The Achilles tendon is one of the largest tendons in the body. It connects the calf muscles to the heel bone and is subjected to very high forces, especially when doing things like running and jumping. Achilles tendonitis is the medical term used when the tendon becomes sore and damaged. It is commonly seen in active individuals but can happen to anyone. Achillies tendonitis is more common in men and is more common as you age. Achillies tendonitis is thought to be caused by repetitive strain on the tendon. The Achilles tendon is subject to very high loads when you run or jump.

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Shin Splints

Medial tibial stress syndrome, also known as shin splints, is a common condition seen in runners and athletes. It can be a painful and debilitating condition that normally requires targeted rehabilitation to resolve. It is thought to be a bone stress reaction due to overloading of the soft tissues which attaches into the Tibia. This overloading can be caused by foot posture or running style which places the medial soft tissue structures under increased forces or by a sudden increase in activity.

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Hypermobility

Hypermobility is the medical term used to describe excess range of motion in the joints of the body. Hypermobility may present in just a few joints or can be widespread across many joints the body. It is common in childhood and usually lessens as children get older. Hypermobility is thought to affect approximately 10%-20% of the adult population.
Those with mild hypermobility may not experience any negative symptoms and therefore will not require treatment. For those with moderate to severe hypermobility they may experience pain and instability around the effected joints. This is due to the soft tissue structures being over stretched.

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Low Arches

Similar to the high arched foot posture a low arched foot posture is also a common foot shape seen in the general population. Having a low arch does not necessarily mean you have anything wrong with your feet that requires treatment. Many people have a low arched foot posture and do not experience foot pain. However for some with this foot posture it can result in pain as the muscles and tendons are over stretched.

Treatments for low arches

If you have this foot posture with pain then there are treatments to combat this indluding:

  • Strengthing the intrinsic mucles of the feet
  • Insoles to support the feet and reduce stress on the muscles and tendons
  • Improve foot and ankle mobility
  • Improve glut strength to improve foot placement

High Arches

A high arched foot posture is a normal foot posture seen in the general population. The medical term for high arches is Pes Cavus.
Having high arches alone does not mean there is anything wrong with your feet that require treatment. However some with this foot posture can experience excess callus build up and pain under their metatarsals (ball of the foot). This is a result of decreased plantar surface in contact with the ground.
Those with high arches are also more likely to have forefoot deformities such as a plantar flexed 1st ray or fore foot equines.

Treatments For High Arches

A moulded foot Orthotic can help resolve these symptoms by redistributing plantar pressures across the sole of the foot and offloading painful areas. It is also important to keep the foot as mobile as possible as those with high arches often have fairly stiff feet.

Bunions (Hallux Valgus)

A bunion as a prominence around the big toe joint which is the result of a change in alignment of the big toe joint. This joint is known as the first Metatarsalphalangeal joint, or the 1st MTPJ for short. The medical term for this change in joint alignment is Hallux Valgus.

Symptoms

Symptoms of a bunion may include pain around the joint, limited range of motion of the joint and difficulty in finding footwear to fit comfortably around the deformity. Secondary arthritis is, unfortunately, common in this condition.

Treatments

Treatments for a bunion include wearing shoes with a wide, soft toe box and insoles to decrease forces through the joint.
In cases of advanced hallux valgus where significant deformity is present Orthopaedic made to measure footwear may be prescribed to fit comfortably around the bunion.
If conservative measures are unsuccessful surgery to improve the alignment of the joint may be considered.

Whether you are, struggling with pain, having issues with mobility or training for a sporting event we will endeavour to find the best treatment to meet your individual needs and expectations.

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High St,
Tattenhall,
Chester,
CH3 9PX