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Common Problems Associated with the Foot &
Ankle
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| Over pronated "flat feet" |
There are a multitude of painful problems associated with
the foot and/or ankle which can lead to a reduction in activity levels. These include: Over Pronation (Flat Feet) During
walking or running the foot and ankle complex has 2 main jobs to do whilst the foot is in contact with the
ground. - To act as a shock absorber through
early stance sometimes called shock absorption phase (when your foot initially makes contact with the ground)
- To act as a rigid
lever in late stance sometimes called toe off (as you go on to your toe to "push off" to the next step)
Shock Absorption Phase (Early Stance) As the foot makes contact with the floor it is supposed to help help absorb the forces of your body weight making
contact with the ground. It does this by pronating or rolling inward slightly to help cushion the impact of
walking or running. If the foot over pronates it has the appearance of being flat hence the term flat feet. There are a number of reasons for over pronation: Hypermobility Tight achiles tendon Hind/forefoot deformities Dysfunction
(muscles not working properly) Tonal problems
It is extremely important that a
full biomechanical assessment is done in order to establish the reason for over pronating. The reason for this is that the treatment
required will differ depending on the primary cause of the over pronation. Left
untreated over pronation can lead to a number of secondary conditions - Shin Splints
- Hallux valgus
(bunions)
- Plantar fasciitis
- Metatarsalgia
- Hallux limitus
- Anterior knee pain (due to tibial rotation associated with pronation)
- Fixed flat feet deformities
Toe Off Phase
(Late Stance) In late stance the foot is tasked
with propelling the body forward effectively and has to act as a rigid lever. To do this it must supinate or roll outward
slightly. In this position the small joints in the foot are very secure and provide a rigid platform to push
on to the next step. The problem with the overpronated foot however is that the
body has to work especially hard in order to pull the foot from the over pronated position. Shin splints are
as a result of the muscles involved in late stance having to work much harder than they would normally, resulting in pain
in the lower half of the leg. Treatment of Over Pronation (Flat
Feet) Foot orthotics are designed to prevent the foot from over
pronating during walking or running. This allows the foot to continue to act as both an effective shock absorber
in early stance and a rigid lever in late stance. Your orthotist can advise on the design
of your foot orthotics as they must be designed to specifically address the reason for your over pronation.
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| Over pronated "flat feet" |
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| corrected feet with foot orthotics |
Plantar
Fasciitis Plantar fasciitis (fashee-EYE-tiss) means inflammation of the plantar fascia. The plantar fascia is a strong
band of tissue (similar to a ligament) that stretches from the heel to the middle bones of the foot. It supports the arch
of the foot. Small injuries to the plantar fascia can cause inflammation and symptoms. The injury is usually near to where
it attaches to the heel bone. This condition is quite common. It mainly affects women and is also common in athletes.
Situations where it is more likely to occur include the following; If you do lots of walking, running, standing,
etc Sudden gains in weight or being overweight
will put extra strain on the heel Overuse
or sudden stretching of the sole. For example: athletes who increase their running intensity or distance; poor technique starting
'off the blocks' Tightness of the
Achilles tendon
Symptoms of Plantar Fasciitis Pain is the main symptom. This can be anywhere on the underside of the heel. Commonly one spot is
found as the main source of pain. This is often about 4 cms forward from the heel, and may be tender to touch. The pain usually
eases on resting the foot, but is often worst when first used in the morning. Gentle exercise may then ease things a little
as the day goes by, but a long walk often makes the pain worse. Sudden stretching of the sole of the foot may make the pain
worse, for example, walking up stairs or on tip-toes. Treatment of Plantar
Fasciitis Rest Painkillers Footwear Exercise & Splinting. Regular gentle stretching of the Achilles tendon and the plantar fascia will ease the symptoms. when
you are asleep at night, the plantar fascia tends to tighten which is why it is usually most painful first thing in the morning.
This can be overcome by the use of a night splint which is designed to maintain a stretch during periods of inactivity.
 Plantar fasciitis night splint (click here to buy online)
 Silicon heel cup (click here to buy online)
Metatarsalgia
Metatarsalgia
is pain in the ball of the foot. It is usually felt in the sole of the foot and sometimes feel like "walking on pebbles".
Other people feel a more diffuse vague pain, ache or burning. Some people have trouble around only one or two toes, others
have it throughout one or both feet. Anything which puts extra stress on the front of the foot can cause metatarsalgia. Common examples
are: - Overweight
- Inappropriate footwear
- High-arched "cavus" foot in which the bones in the front
of the foot (metatarsals) point down into the sole to an excessive extent, or a long metatarsal bone which takes extra pressure
- Claw
or hammer toes which press the metatarsals down towards the ground
- Stiff ankle which cannot be drawn up to right angles with the leg
but points the foot down to the ground
- A bunion or arthritis in the big toe can weaken the big toe and throw extra stress onto
the ball of the foot.
- A stretched or irritated nerve in the ball of the foot (neuroma) or behind the ankle (tarsal
tunnel syndrome) can produce pain in the ball of the foot. Diabetes can also produce irritation of the small nerves in the
foot leading to a burning pain.
- Athletes or walkers occasionally get stress fractures of the metatarsal bones.
- Arthritis, gout or inflammation of the joints in the ball of the foot can produce local pain
Treatment
of Metatarsalgia - Rest
- Ice the affected area
- Painkillers
- Appropriate
footwear
- Silicon Shock-absorbing insoles
- Metatarsal pads encorporated
into appropriate insoles
- Foot orthotics. Rigid or flexible
as designed by your Orthotist
Ankle
Problems Ankle pain can be
due to a number of reasons; a simple strain, footballers ankle, tibialis posterior syndrome, ligament stretches, fractures
and many more. These conditions may benefit from the use of an ankle brace designed to support and protect the joint allowing
the patient to continue life as normally as possible. Ankle braces come in many different form and a full assessment is necessary
to determine the most suitable one.
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| Bauerfeind Malleoloc Ankle Brace |
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