Foot and Ankle Conditions

The Achilles tendon connects two calf muscles to the heel and is the largest tendon in the body. Achilles tendinitis is a condition where this tendon gets overused, resulting in inflammation and pain. This is a common condition seen in athletes of varying abilities and ages as well as ordinary people who exercise regularly. In general, Achilles tendinitis is more common in older athletes and middle-aged people.

Causes:

• Overuse of the tendon while running, jumping, climbing or walking for exercise or athletic training for various sports. Especially those sports that involve intense activity on hard surfaces like basketball, soccer, volleyball, running etc.
• Inadequate warm up or rapid loading of the workout (increasing the intensity too quickly)
• Bone spur or bony growth
• Flat feet may aggravate the condition.

Symptoms:

• Heel pain and inflammation
• Tenderness and swelling above the heel in the morning
• Inability to put down the foot or heel in the morning
• Pain that increases with activity and use.

Treatment:

• Resting the tendon or modifying activities that aggravate the condition
• Icing the painful area, several times a day
• Use of a strapping bandage to support the tendon
• Use of an analgesic gel or nonsteroidal anti-inflammatory drug to relieve pain
• Changing to an activity that does not stress the affected area e.g. Swimming instead of running, climbing or jumping
• Inserts in the shoes under the heel and footwear with good support
• Stretching exercises and massage recommended by a professional therapist
• Ultrasound and shock wave therapy
• Surgery is an option for extreme cases where patients have not responded adequately to the other treatments.

When ligaments supporting the bones and joints of the ankle are subjected to sudden and uneven load bearing they get pushed, stretched and/or torn resulting in a sprain. Most sprains are mild injuries and can easily be treated with rest and an ice pack.

Causes:

Ankle sprains are some of the most common foot injuries that can happen to anyone, almost anywhere, at any time from simply stepping off the curb to participating in elite sports.  However, some people are more prone to ankle sprains than others.

Symptoms:

• Swelling and heaviness in the ankle
• Painful movement of the ankle
• Difficulty in weight-bearing or walking may be painful
• Feeling of weakness or ankle gives away easily.

Treatment:

• Use an ice pack on the injury at regular intervals
• Raise and rest the ankle
• Use an analgesic gel or an oral nonsteroid anti-inflammatory drug as prescribed by health care professionals
• Strapping and compression bandages may also be used for supporting the injured ligament.
• Some sprains may require a cast or splint and crutches
• Very severe sprains may require surgical correction and tightening of the ligament.

Arthritis is a very common affliction in the over 50s population.  In arthritis, the cartilage in the joints is affected and it no longer cushions the bones causing them to rub against each other. This results in swelling, pain and fluid accumulation in joints such as the hips, knees, elbows, knuckles, ankles and feet. The affected joints hinder normal movement, mobility and confidence in conducting daily activities. The pain, swelling and immobility increases with the progression of the disease, making it a debilitating and crippling condition. There are several types of arthritis; juvenile, infectious, rheumatoid (autoimmune disorder) and osteoarthritis are some of them. Osteoarthritis is most common in a normal aging population.

Causes:

• Hereditary
• Wear and tear of joints due to aging
• Overweight individuals are more prone to osteoarthritis as the extra weight puts increased pressure on the joints and the cartilage.

Symptoms:

• Stiffness in the joints in the morning that dissipates as the day goes on
• Swelling or pain in the joints
• Fluid accumulation in the joints
• Throbbing joint pain and muscle weakness
• Deteriorating joint mobility and movement.

Treatment:

• Early diagnosis of osteoarthritis can help in effective management of the disease
• Exercise
• Physiotherapy
• Medication
• Orthotic inserts in shoes for better support.

Athlete’s foot is a fungal infection on the feet usually seen between the toes but may also spread to the sides of the foot. The fungus that causes Athlete’s foot thrives in wet and damp conditions and spreads easily but can be prevented by simple precautions like keeping feet and shoes clean and dry; wearing sandals or flip-flops at pools and public showers.

Causes:

• Bare feet in public showers and around swimming pools
• Feet in closed shoes that do not get adequate ventilation
• Damp socks and shoes not dried properly
• Excessively sweaty feet not cleaned and dried

Symptoms:

• Itching, scaly skin between the toes
• Peeling and flaking skin on the sides of the foot
• Inflammation
• Blisters

Treatment:

• Over-the-counter medications like clotrimazole.
• Adequate cleaning and drying of feet
• Products that control excessive sweating
• Use of clean and dry cotton socks
• Footwear that allows ventilation
• Consult our office for stronger medication and professional treatment.

A bunion is formed when there is prolonged pressure on the big toe and its base pushes outwards. The big toe may start pointing towards the second toe or even go over it. As the big toe is essential for foot flexion and balance, walking becomes increasingly uncomfortable and painful as the bunion gets larger.

Causes:

• Hereditary
• Gender related, seen more in women than men.
• Narrow, tight-fitting shoes.

Symptoms:

• The base of the big toe has thickened skin
• The base of the big toe appears red, painful and scaly
• The base of the big toe pushes outwards forming a bony bump
• The big toe points to or goes over the second toe
• Very painful to walk.

Treatment:

• Timely treatment of bunions is essential to prevent worsening of the condition, chronic pain, deformity and arthritis
• Change to wide-toed shoes or a more comfortable style of shoes
• Use over-the-counter foam or gel pads to cushion the bunion
• Wedges of foam called separators or spacers are also available and can be inserted between the toes
• Bunion surgery or bunionectomy can realign the toe and remove the bony bump. This is a day surgery and no overnight hospital stay is necessary. Recovery may take several weeks.

Corns and calluses are areas of thickened skin on the feet and palms. They are dull in appearance and may be rough, raised and/or round. When they occur on the soles of the feet, they are called calluses and their appearance on the toes or feet are called corns.

Causes:

• Constant rubbing or friction of the foot inside a shoe
• Hammer toes
• Deformed toes due to conditions like arthritis or injury
• Inadequate circulation
• Poor foot care in diabetes.

Symptoms:

• Dull, thickened skin on a part of the foot that rubs against the shoe
• Red, scaly skin on a bony part of the foot
• Painful areas of the feet that scrape on the inside of a shoe.

Treatments:

• Wearing more comfortable shoes
• Use of padding or gel pads inside shoes
• Please consult a podiatrist before use of over-the-counter corn and callus removal products
• Corns and calluses may be treated in our office

In the first few years of life, feet show dramatic growth and development from tiny baby feet to an integral part of mobility. It is important to keep a watchful eye on your children’s feet as they learn to stand, walk and run. The bones of the foot are well-formed by the time a child is 8 years old.

Always ensure that children wear comfortable shoes that leave space between the toes and the end of the shoe. Measure children’s feet regularly before buying new shoes.

Causes:

• Children may develop a particular way of sitting, standing, walking, running etc. which may not be the best method in the long run and should be corrected earlier rather than later.
• Flat feet
• Hammertoes

Things to look out for:

• Do not make your child walk unless they are ready for it
• Toes turning in or out as they start walking
• As they take a step, toes touching down first instead of the heel
• Flat feet.

Treatment:

Most of the problems mentioned above can be easily corrected by a professional and include very simple solutions like:

• Changing the sitting position of a child
• Different style of shoes (closed rather than open)
• Avoiding hand-me-down footwear
• Padded shoes
• Orthotic support shoes
• Customized orthotic inserts we can have made in our office

If you have diabetes, taking care of your feet becomes very important because there can be damage to blood vessels and nerves over time, resulting in poor circulation and numbness.

Causes:
• In diabetes even small injuries on the feet like a tiny cut, an insect bite or a blister which would normally heal itself can linger and need treatment. They get infected very easily.

• Tight fitting, poorly ventilated shoes can easily aggravate poor circulation, numbness and infection. Nerve damage can cause numbness in the feet and the initial pain or discomfort, may often not even be felt by a diabetic.

• The high blood sugar levels in diabetes make it hard for antibiotics and other medications to heal the wound quickly.

Symptoms:
• Numbness of feet
• Blisters caused by ill-fitting shoes
• Tiny cuts, wounds or insect bites
• Discomfort caused by calluses and corns on the feet.

Treatment:

Rather than treatment, make regular appointments with our office for inspection of your feet and early assessment of corns, calluses, cuts and blisters.

Dry, Cracked Heels

Dry, cracked heels are a very common problem that can easily worsen from lack of treatment. In some cases, dry cracked heels are an indication of other underlying problems like poor blood circulation or nerve damage.

Causes:

• Open-back shoes
• Going barefoot when you have a tendency for cracked heels
• Poorly moisturized feet
• Being overweight

Symptoms:

• Heels that feel very dry and itchy
• Skin on heels starts peeling in vertical ‘flakes’
• Heels that have cracks or fissures
• Cracks or fissures that are painful to walk on
• Bleeding from the cracks on a heel

Treatment:

• Regularly moisturize the heels with foot cream
• Use special creams formulated to prevent cracks on heels
• Call our office if the problem persists

The soles of the feet have an arch that prevents most of the sole from touching the ground as you stand, walk etc. The arch helps in better balance and posture; and causes less strain on the knees, hips, ankles and the feet. When the arch of the foot is lower than normal, it is called flat feet or pes planus. Some people are born with flat feet while others may gradually develop them over the course of life.

Causes:

• Born with flat feet
• Arches do not develop during childhood
• Arches fall due to injury
• Aging
• Conditions like arthritis
• Footwear with poor arch support.

Symptoms

• Most flat feet do not cause any pain or discomfort
• Arch of the foot is very close to the ground or touches the ground
• Shoes when kept next to each other turn inwards
• Tired feet
• Foot pain
• Knee pain
• Hip pain
• Ankle pain.

Treatment

• Icing
• Simple foot stretching and strengthening exercises
• Physiotherapy
• Taping the foot
• Wedge or heel support in footwear
• Customized orthotic inserts for footwear
• Nonsteroidal anti-inflammatory drugs in prescribed amounts
• In very severe cases, surgery is recommended for correction or repair of the tendons that support the arch.

Foot Ulcers

A foot ulcer is a lesion on the sole of the foot where the skin has broken and the tissue underneath is easily visible.

Causes:

• Poor foot care
• Poor circulation
• Diabetes
• Vascular diseases.

Symptoms:

• An open wound on the foot
• A lesion that makes walking painful and difficult
• The lesion does not heal easily.

Treatment:

• Limiting mobility to avoid repeated pressure on the wound while walking
• Use of a wheel chair, total contact cast, or offloading insert/ shoe
• Cleaning and dressing the wound
• Treating the wound with medication and/or enzymes to expedite the healing process.

A break in a bone is a fracture. Simple fractures are single, clean breaks in a bone while compound fractures are complicated breaks. Fractures caused by accident or injury are called traumatic fractures. Stress fractures are minute cracks in the bone caused by repeated mild trauma to the bone e.g. Repeated intense action by a high jump athlete or a gymnast that stresses the same places in the bones over and over again.

Causes:

• Accidents
• Sports injuries
• Low bone density
• Osteoporosis

Symptoms:

• Pain
• Swelling and tenderness
• Numbness
• Inability to use the part of the body due to extreme discomfort.

Treatments:

Most fractures need to be assessed and treated by a medical doctor. A splint or a cast is common. Some fractures may also need surgery to insert a screw or a plate to hold the bone together as it heals and joins together. Recovery may take several weeks to months depending on the complexity and location of the fracture.

Fungal infections can occur underneath the surface of the nail. The fungus attacks the nail, makes it discoloured, thickened and brittle. Nail infections can occur as a single condition or in conjunction with other conditions like Athlete’s foot or other bacterial and yeast infections. Fungal infections can spread to the other toe nails, skin and finger nails.

Causes:

• Wet damp conditions for feet e.g. Around swimming pools and public showers
• Excessive perspiration
• Poorly ventilated shoes
• Damp shoes or socks
• Sharing nail clippers, socks and shoes
• Injury to the nail
• Conditions like diabetes, circulatory problems, immune-deficiency disorders
• People with a tendency for Athlete’s foot are more prone to fungal nail infections.

Symptoms:

• Walking is painful when wearing shoes
• Nails appear discoloured and thickened
• Nails become brittle and difficult to trim.

Treatments:

• Over-the-counter ointments, cream and medicated liquid treatments that can be applied on to the affected nail.
• Oral medication
• Use of foot powders to keep feet dry
• Change into clean, dry cotton socks often
• Ensure shoes are dry and ventilated
• Wash, clean and dry feet
• In extreme cases, partial or complete removal of the nail may be recommended.

A ganglion cyst is an accumulation of fluid under the skin. It is seen in the sheath covering the joints and tendons and commonly occurs in wrists, ankles and feet. Sometimes cysts can grow near or under a toenail and affect its growth. Cysts also cause pain if they push against a nerve.

Causes:

There is no definite cause for the formation of ganglion cysts but individuals may have a tendency for the formation of these cysts. Repeated injury to the foot could also contribute towards a cyst.

Symptoms:

• The skin over the cyst may have a lumpy appearance
• A sensation of pain or discomfort when the shoe presses down on a particular part of the foot or nail.

Treatments:

• Comfortable shoes
• Drainage of the cyst after numbing the affected area
• A steroid may be injected into the cyst so that fluid cannot accumulate again
• Surgical removal of the cyst is recommended in extreme cases.

• Gout is an arthritic condition which is the result of a build up of uric acid. It usually affects only one of the big toes, causing severe pain and swelling. Gout is more common in men than women.

Causes:

• Hereditary
• Excess production or poor disposal of uric acid in the body
• High intake of alcohol or diet of certain foods such as red meats, shellfish

Symptoms:

• Only one big toe is swollen and painful
• Severe pain in the toe at night
• Severe pain in the big toe at night that recurs every few months.

Treatments:

• Application of an icepack or cooling gels
• Anti-inflammatory medication
• Prescribed medication for gout by our office

Haglund’s deformity is the formation of a bump on the back of the heel where the Achilles tendon connects to the heel. It is also called a ‘pump bump’ (caused by tight pump shoes) or retrocalcaneal bursitis. This condition is more common in women and usually caused by wearing shoes that are rigid against the heel.

Causes:

• Constant friction of the heel against shoes with a firm rigid back
• Shape of your foot and high arches
• Tendency to walk on the outside of your feet.

Symptoms:

• Appearance of a bony bump on the back of the heel
• Pain while walking or running
• Pain when on tip toes
• Red, warm skin on the back of the heel.

Treatment:

• More comfortable shoes
• Use of an ice pack or cooling gel
• Avoid activities that aggravate the pain
• Use of nonsteroidal anti-inflammatory drugs
• Customized heel wedges
• Ultrasound treatment to decrease the inflammation

When the big toe cannot bend appropriately at the joint as you stand, walk and run it is called Hallux Limitus/Rigidus. ‘Hallux’ refers to the big toe and ‘Limitus’ means limited movement. As the condition progresses, the limited bending decreases further to become Hallux Rigidus (rigid).

Causes:

• Abnormal foot structure
• Bone injuries like stubbing your big toe
• Bone spurs
• Wear and tear of cartilage
• Arthritis

Symptoms:

• Pain and stiffness in the joint
• Swelling in the joint
• Discomfort and stiffness in cold weather

Treatment:

• Ice pack as relief for pain and swelling
• Shoes with orthotic support
• Shoes with stiff or rocker-bottom soles
• Nonsteroid anti-inflammatory drugs
• Physical therapy
• Injection of corticosteroids
• Surgery

Hammertoe is a condition where the second, third and/or fourth toes are bent at the first joint. As the condition progresses the joints get rigid and walking becomes difficult.

Causes:

• Possibly from birth
• An imbalance of the muscle structure of the toes
• Very narrow shoes that squeeze the toes together
• Arthritis

Symptoms:

• Hammer or claw-like appearance of the toes (bent at the first joint)
• Pain on the top of the toes
• Toes have corns on the joint where they rub against the shoes
• Swollen first joint of the toe
• Difficulty in finding comfortable shoes

Treatment:

• Use an ice pack on the hammertoe to decrease swelling
• Use of non-steroid anti-inflammatory drugs to alleviate pain and swelling
• Exercises to strengthen the muscles
• Hammertoe pads to cushion the feet
• Orthotics
• Foot manipulation
• Splinting or use of wedges to separate and straighten toes
• Cortisone injections
• Surgery

High Arches/Cavus Foot

The arch of the foot runs from the toes to the heel. High arches (Pes cavus) or a high instep causes pain because of intense pressure on the toes and heel while doing normal, daily activities. This condition is less common than flat feet.

Causes:

• Hereditary
• Bone condition
• Neurological condition

Symptoms:

• Difficulty finding well-fitting shoes
• Shortened foot length compared to height
• Foot pain
• Tired feet

Treatments:

• Comfortable shoes
• Shoes with orthotic arch support
• Very high arches can be corrected by surgery

Ingrown Nails

Ingrown toe nails are those that press and push into the skin of the nail grooves causing pain, swelling and discomfort. Although any toe nails can be affected, big toes are most vulnerable to this condition.

Causes:

• Heredity
• Very tight shoes that press hard into the nails
• Improperly trimmed nails
• Pulling or tearing at the corner of the nails while trimming
• Injury (e.g. Stubbing the toe)
• Nail infection
• Deformities in the foot or toes
• Conditions like arthritis and diabetes may aggravate ingrown nails due to poor circulation, nerve damage and mobility issues.

Symptoms:

• Painful toes where the nail digs into the flesh
• Nails appear sore and red
• Very hard swollen toes
• Infected nail
• Skin begins to grow over the nail

Treatments:

• Soaking the foot in a warm salt bath
• Antibiotics may be used topically or orally to treat the infection
• Partial or complete removal of the infected nail
• Partial or complete removal of the ingrown nail

Metatarsalgia/ Metatarsal Pain

The metatarsal region of the foot is also called the middle of the foot or the ball of the foot. Metatarsalgia or metatarsal pain is generally not a serious condition.

Causes:

• High impact activities or intense training activities
• Ill-fitting shoes
• High arches
• Excessive weight
• Rheumatoid arthritis
• Gout

Symptoms:

• Sharp pain in the ball or middle of the foot
• Aching or burning pain on the ball of the foot
• Pain that increases with running, jumping or flexing feet on a hard surface
• An uncomfortable feeling like a pebble in a shoe
• Development of a callus on the affected area

Treatments:

• Use an ice pack
• Rest the foot
• Change to more comfortable and supportive footwear
• Use of gel padded, shock absorbing insoles
• Customized orthotic support for high impact activities
• Physical therapy

Nail Fungus
Many people don’t realize they have a fungal nail problem. Moreover, many do don’t seek treatment. Still, fungal toenail infections are a common foot health problem.

Such infections can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish, but it can present serious problems if left untreated.

Also referred to as Onychomycosis, fungal nail infections are an infection underneath the surface of the nail, which can also penetrate the nail. In addition to causing difficulty and pain when walking or running, fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate.

A group of fungi called dermophytes easily attack the nail, thriving off keratin, the nail`s protein substance. When the tiny organisms take hold, the nail may become thicker, yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.

Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete`s foot and excessive perspiration.

You can prevent fungal nail infections by taking these simple precautions:

• Exercise proper hygiene and regularly inspect your feet and toes.
• Keep your feet clean and dry.
• Wear shower shoes in public facilities whenever possible.
• Clip your nails straight across so that the nail does not extend beyond the tip of the toe.
• Use a quality foot powder – talcum, not cornstarch – in conjunction with shoes that fit well and are made of materials that breathe.
• Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active life styles.
• Disinfect home pedicure tools and don`t apply polish to nails suspected of infection.

Depending on the type of infection you have, over-the-counter liquid antifungal agents, while sometimes effective, may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed by a process called debridement.

In some cases, surgical treatment is prescribed, during which the infected nail is removed. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured, and prevents the return of a deformed nail.

Black Toenails
Black toenails can result from a variety of things. Athletes will often encounter a problem with their toenails turning dark. Darkened nails often occur from the toe hitting the end or the top of the shoe toe area. The darkened nail is essentially a bruised nail. Sometimes, the bruise can lead to a fungal nail infection. If you are a diabetic, any change in the color of your toenail should be evaluated. Contact our office to set up an appointment. The pressure, which caused the bruising of the nail, can cause a small sore under the toenail, and the sore can become infected.

Treatment may include trimming the loose nail back and applying a topical anti-fungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied. Patients with diabetes should not treat this condition themselves and should contact our office.

Neuroma

 A ‘pinched nerve’ or a nerve tumor is called a neuroma and is a painful condition. Neuromas occur most commonly between the third and fourth toes. They are caused by tissue rubbing against the nerves and irritating them.

Causes:

There are no definite causes for the formation of a neuroma. But some factors may contribute to their growth:

• Flat feet
• Feet with high arches
• Biomechanical problems
• Injury
• Trauma
• Repeated stress
• Improper footwear

Symptoms:

• A burning sensation or pain between the toes
• Tingling or numbness between the toes

Treatment:

• Comfortable or padded shoes
• Shock absorbing insoles to decrease pressure on the feet
• Surgery is an option when the other treatments are ineffective

Heel Pain (Plantar fasciitis)

Inflammation of the connective tissue that runs along the arch of the foot and joins the toes to the heel bone is called plantar fasciitis.

Causes:

• Shoes with poor orthotic support
• Flat feet
• Excess weight

 Symptoms:

• Stabbing heel pain early in the morning or after standing or sitting for a long time
• Heel pain
• Foot pain

Treatment:

• Rest the foot
• Use an ice pack
• Tape or strap the foot
• Stretching exercises or physical therapy
• Steroid or anti-inflammatory medication
• Shoes with arch support
• Customized orthotic supports in shoes

Posterior Tibial Tendonitis

 The posterior tibial tendon attaches the calf muscles to the bones in the foot. Its function is to provide support for the arch and hold up the muscles in the foot. Inflammation or tearing of this tendon causes pain and poor foot support known as posterior tibial tendonitis. Over time it can result in a flat foot or arthritis.

Causes:

• Gradual wear and tear with overuse
• Injury
• Fall
• Excess weight
• Inadequate warm up and cool down routines when training for a sport
• Sudden increase in the intensity of workouts

Symptoms:

• Pain in the lower leg and ankle especially when walking or running uphill
• Pain that worsens with increased activity

Treatment:

• Rest
• Orthotic support in shoes
• Stretching and strengthening exercises
• Physical therapy
• Walking boots
• Consult our office

Sesamoiditis

 Sesamoiditis is an inflammation under the big toe in the ball of the foot. Sesamoids are two small bones in the joint beneath the big toe, these bones connect many ligaments in the foot which can get irritated or inflamed and cause pain.

Causes:

• Sesamoiditis is usually seen in young people with very intense activity involving the forefoot, e.g. ballet dancing, sprinting and baseball catchers.
• High arched feet and flat feet also contribute to the condition

Symptoms:

• Pain in the ball of the foot that begins as a mild ache and slowly develops into a throbbing pain.

Treatments:

• Rest
• Use of an ice pack
• Strapping the foot
• Nonsteroid anti-inflammatory drugs
• Use of customized orthotics
• Surgery

Shin Splints

Shin splint is pain felt on the shins or the sides of the shins while running or intense walking. The muscles and tendons near the shin pull on the bone causing pain and inflammation

Causes:

• Level of sport higher than fitness level
• Sports that involve a lot of running
• Feet that turn in or out excessively while stepping out
• Flat feet

Symptoms:

• Shooting pain on the shins or sides of shins
• Inflammation near the ankles and shins

Treatment:

• Rest
• Use an ice pack
• Nonsteroidal anti-inflammatory medication
• Stretching exercises or physical therapy
• Orthotic inserts in shoes for better support

Stress Fractures

 Stress fractures are tiny breaks in the bone caused by overuse, repeated pressure or weakness from conditions like osteoporosis or aging. Stress fractures are usually treated by rest or immobilization and may take weeks to heal. It is important to understand and assess the cause of the stress fractures so that the issues can be addressed to avoid further injury.

Causes:

• Sports like athletics, gymnastics, basketball where there is repetitive pressure on the bones at very high intensity.
• Sudden increase in activity and intensity, e.g. Someone who suddenly moves from a sedentary lifestyle to a very high impact exercise routine
• Existing foot problems like flat feet or very high arches
• Weakened bones due to conditions like osteoporosis or cancer
• Aging

Symptoms:

• Mild pain initially that worsens with time
• Pain that increases with use and decreases upon rest

Treatment:

• Ice the injury
• Rest
• Use proper footwear
• Engage in low weight-bearing activities like swimming
• Surgery may be required in some cases

Subungual Exostosis

 A subungual exostosis is a bony spur under the toenail which is the result of trauma to the toenail. Sometimes small tumors may also grow under the toenail or on other bones in the body.

Causes:

• Trauma to the toenail

Symptoms:

• Mostly asymptomatic but may progress to discomfort and pain
• Nail deformity

Treatment:

• Surgery may be required to remove the bony spur or tumor under the toenail.

Tarsal Tunnel Syndrome

 The posterior tibial nerve runs through the heel into the sole of the foot. Compression or pressure upon this nerve or inflammation of tissues around the nerve result in foot, ankle and toe pain, this is called tarsal tunnel syndrome.

Causes:

The exact cause is unclear but some of the contributing factors are:

• Inflammation
• Varicose veins
• Tumors in the foot

Symptoms:

• Burning or tingling sensation in the foot made worse by activity
• Numbness or weakness in the foot

Treatment:

• Nonsteroid anti-inflammatory drugs
• Use of orthotics
• Physical therapy
• Cortisone injections
• Surgery

Venous Stasis

Venous stasis or venostasis is a condition attributed to improper functioning of the veins in the leg. Blood that should be carried back to the heart is not adequately transported resulting in swollen feet, pooling of blood in the feet and blood clots. Venous stasis can also be a result of other conditions like chronic congestive heart failure and kidney disease.

Causes:

• Veins do not function adequately to carry the blood from the feet and ankles back to the heart
• Conditions like diabetes, kidney disorders and vascular disease.

Symptoms:

• Legs feel heavy and tired. These symptoms are relieved upon elevating the legs
• Swelling of ankles and feet
• Varicose veins that appear enlarged
• There may be blood clots in the superficial veins.

Treatment:

• Rest
• Elevation
• Compression stockings or dressings

Warts

A wart is a viral infection that affects the soft tissue through abrasions or microscopic cuts in the skin. Warts are harmless but can cause pain and discomfort. Warts on the soles of the feet are called plantar warts. They are grey, brown or appear as pinpoints of black and have a tendency to disappear and/or recur. If left untreated, warts may grow in size or create a cluster.

Causes:

• Walking barefoot on dirty surfaces
• Going barefoot around public swimming pools and showers
• Plantar warts are contagious and are easily spread by contact, skin shed from a wart or a bleeding wart.

Symptoms:

• Burning or stinging sensation on roughened, raised skin
• Dull raised circular patches of skin that are painful
• Discomfort while walking when pressure is applied on the wart.

Treatment:

• Regular examination of your feet as warts do tend to reappear in similar locations
• Medication: Use over-the-counter treatments with caution as they contain chemicals that may burn the wart along with healthy tissue around it.
• Freezing the warts
• Surgery
• Laser therapy