FOOT CARE

Achilles Tendonitis

What is it?

The Achilles tendon attaches the calf muscle to the heel bone. A patient will experience pain, inflammation, tightness, or swelling of the Achilles tendon (back of the ankle). This is one of the most common sport injuries that can affect both the feet and ankles.

What is the Cause?

Achilles Tendonitis is typically caused from overuse of the calf muscle, over-pronation or changes in daily activities. This can be caused from any repeated activity or exercise that strains the Achilles tendon. If Achilles tendonitis is not caught early and properly treated, it can lead to Achilles rupture, which will cause a sharp pain in the heal area and may require surgical intervention.

Recommended Treatment

Unfortunately, Achilles Tendonitis can take a long time to heal. Proper treatment includes: icing the affected area to reduce inflammation, anti-inflammatories, calf stretching, night splints and custom orthotics. A Chiropodist or Podiatrist can assess the symptoms and put together a treatment plan based on the patient’s individual needs.

Bunions (Hallux Abducto Valgus)

What is it?

A Bunion is a painful enlargement at the base of the big toe. Bunions can cause swelling, tenderness, redness and a reduced range of motion. Bunions tend to occur more frequently in women than men.

What is the Cause?

Some of the causes of bunion formation include: genetics, trauma, foot structure, improperly fitting shoes and improper foot function.

Recommended Treatment

A Chiropodist or Podiatrist will thoroughly examine the bunions and recommend an appropriate treatment plan. Shoes must fit properly, should be roomy and supportive and not be pointy or have high heels. This will help to ease discomfort and prevent further injury.

A Chiropodist or Podiatrist can also prescribe custom orthotics, that will assist in changing the distribution of pressure on the foot. Different cutouts, pads and changes to the shell of the orthotics can help to restore optimal biomechanical function to the feet.

Some patients may benefit from surgery. A Chiropodist or Podiatrist can assist in discussing these treatment options with the patient.

Calluses

What is it?

Calluses are patches of hard, thickened skin. They are most often found on the soles, heels or balls of the feet.

What is the Cause?

Calluses are the body’s natural defense against pressure. They are caused by friction from repetitive movement or repetitive irritation. Calluses frequently develop from wearing shoes without socks, walking barefoot, pressure points on the foot or having improper support or mechanics of the foot.

Recommended Treatment

Calluses are generally not very painful, however when they become very thick they can cause pain. If they are not properly treated, there is a risk of wound creation, and if untreated, infection can develop. In order to get rid of calluses, it is important to off-load pressure from that specific area, which can be achieved by custom orthotics prescribed by a Chiropodist or Podiatrist. Do not use any sharp objects to remove calluses. Rather, use a pumice stone or foot file to remove the skin build up. This is best done after a shower or bath, or after soaking feet in warm water for no more than 5 minutes. A Chiropodist or Podiatrist can use instruments to decrease the thickness of the skin, thus relieving the pressure and eliminating the potential for break down of the skin.

Claw/Hammer/Mallet Toes

What is it?

Toes bending into an unnatural position, causing pain.

Claw toes: Toes bend up at the joint, where the toes meet the foot and down at the other joints.

Hammer toes: Toes bend downwards

Mallet toes: Toes bends down at the joint closest to the end of the toe

What is the Cause?

Claw, hammer or mallet toes are generally caused by wearing improperly fitting shoes, which leads to instability of the foot. This can lead to the toes staying in an unnatural position for lengthy periods of time.

Recommended Treatment

Anti-inflammatory medications can help reduce any pain these conditions may cause. Taping the affected toe(s) to other toes as well as ensuring that shoes fit properly can also help to correct the problem. A Chiropodist or Podiatrist can prescribe custom orthotics, which contain pads that can be used to keep the affected toes in the proper position. If severe, surgery may also be a consideration.

Corns

What is it?

Corns are small, patches of thick, rough skin causing pain and redness. They are called corns because they are cone-shaped like a kernel of corn pointing and pressing into the foot, sometimes on a nerve. Corns are typically found on the metatarsal area (the ball of the foot), the tops or sides of the toes, as well as any area of increased pressure. Corns can be painful because they press deep into the layers of the skin and the patient often complain of feeling like they are walking with a stone or pebble in their shoe.

What is the Cause?

Similar to calluses, corns are the body’s natural defense against excess pressure in a very localized area.

Recommended Treatment

Properly fitting shoes and/or custom orthotics are very important in the treatment of corns. It is important to find a pair of shoes that will reduce the amount of pressure in the feet and do not rub against the top or sides of the feet. A Chiropodist or Podiatrist can remove the hard, rough skin, and custom made orthotics can decrease the excess pressure.

Diabetic Foot Problems

What is it?

Having diabetes can create potential complications, such as Diabetic Neuropathy (loss of sensation), foot pain, ulcers and infection.

What is the Cause?

Diabetes affects the vascular (blood system) and nerve system which in turn affects various parts of the body, including the feet.

Recommended Treatment

The most important aspect of diabetic foot care is prevention of further complications, such as wounds and infections, which can in turn lead to more serious complications such as amputations. A Chiropodist or Podiatrist can help educate the patient about proper foot care, and help to monitor the condition of the feet, in order to prevent potential complications .

A diabetic patient must ensure that feet are cleaned and dried thoroughly every day. A daily inspection of the feet and toes is essential, in order to identify any changes or concerns. It is also important to examine footwear for anything that might cut the feet or cause excessive pressure. A Chiropodist or Podiatrist will recommend an annual assessment of the feet, and can determine if more frequent care is needed.

The patient is advised to work closely with their healthcare team to monitor their diabetes and related conditions and see a Chiropodist or Podiatrist in regular intervals to monitor the vascular (blood) and neurological (nerve) health of their feet.

Diabetic Neuropathy

What is it?

Having diabetes can create a variety of long term health problems. If blood sugar levels are not properly managed for an extended period of time, serious complications may occur. Diabetic Neuropathy is a complication that causes damage to nerves in the feet and legs. As a result of this damage, there may be reduced feeling in the hands and feet, possible tingling sensations, foot pain, and the inability to feel hot or cold.

What is the Cause?

Diabetic Neuropathy is caused by a variety of reasons. Some of these reasons include: high blood glucose levels, having diabetes for an extended period of time, kidney disease, being overweight and having low levels of insulin. Other factors include smoking and alcohol abuse that can cause damage to blood vessels, whose primary role is to carry oxygen and nutrients to nerves. Additionally, there are some genetic components that simply make some diabetic patients more susceptible to Diabetic Neuropathy.

Recommended Treatment

Once nerves are damaged, they cannot be replaced. Nevertheless, there are several treatment options that can help to reduce foot pain and prevent further nerve damage.

Daily inspection of the feet and toes for any changes or concerns is very important. Managing the disease, by exercise and maintaining a healthy diet can also help to lower blood sugar levels.

To help manage nerve pain, over the counter pain relievers can treat mild to moderate pain, and prescription medications can alleviate more severe pain. It is crucial to work closely with the healthcare team to monitor diabetes and related conditions. Daily inspection of the feet and toes is essential, in order to identify any changes or concerns. A Chiropodist or Podiatrist will educate the patient on how to conduct daily inspections of the feet will recommend a treatment plan based on the specific condition.

Gout

What is it?

Gout is a type of arthritis. It is most commonly seen in the base of the big toe. Gout is characterized by sudden severe episodes of joint pain. The joint affected may be extremely hot and inflamed. There may be swelling and redness of the joint, and tenderness in and around joint.

What is the Cause?

Gout is caused by a buildup of high levels of uric acid in the blood. This buildup forms crystals which accumulate in the joints (most commonly the big toe or ankle). Men are more likely to have gout; however women are more and more likely to develop gout after menopause.

Recommended Treatment

A family doctor can prescribe medications to address Gout. These medications can lower the amount of uric acid in the body. Dietary changes are also crucial for treatment and a diet low in purine is often recommended. It is important to treat Gout early, because if left untreated, Gout can lead to irreversible joint damage and kidney problems. A Chiropodist or Podiatrist can help to reduce pressure and pain on the affected joint(s) by prescribing a custom orthotic.

Heel Spur

What is it?

A heel spur is a bony growth on the heel bone that can cause a sharp pain in the bottom or inside of the heel. Sometimes heel spurs can be asymptomatic.

What is the Cause?

Heel spurs are caused by the plantar fascia pulling on the heel where it attaches to the bone, with a bony growth forming at that attachment point. The plantar fascia is the tendon that attaches the heel to the metatarsal bones of the foot. Heel spurs can be caused by a number of factors, including over-pronation, high arches and tight calf muscles.

Recommended Treatment

To treat a Heel Spur, a thorough stretching regime is recommended. As well, off-loading pressure from the heel and controlling over pronation with custom orthotics prescribed by a Chiropodist or Podiatrist can help.

Ingrown Toenails

What is it?

An ingrown toenail is when the toenail grows into the skin at the side of the toe. This can lead to pain, redness, inflammation and potential infection. Often the big toe is affected, but any of the toes can have an ingrown nail.

What is the Cause?

An ingrown toenail can occur for several reasons. The most common reasons for ingrown toenails include trauma to the toenail (E.g. stubbing the toes), cutting toenails too short and wearing poorly fitting footwear.

Recommended Treatment

If an ingrown toenail is not adequately treated, there is a high chance it will recur. Treatment options include: wearing well- fitting shoes and soaking the feet in warm salt-water solutions (to help draw out the infection) for no more than 5 minutes, and covering the affected area with a bandag. A Chiropodist or Podiatrist can remove part of the toenail and through follow up care, can ensure that the nail grows back properly.

Metatarsalgia

What is it?

Metatarsalgia is pain and inflammation in the ball of the foot. The pain gets worse when walking or running and gradually gets worse over the course of several months.

What is the Cause?

There are several causes of metatarsalgia. These include but are not limited to: repetitive stress/impact on the ball of the foot, foot injuries, over-pronation (foot falling inward), over-supination (foot rolling outward) and wearing high heeled shoes. Additionally, as we age, the ‘fat pad’ under the ball of the foot shifts and as a result, there is less cushioning of the feet.

Recommended Treatment

There are several recommended remedies to treat metatarsalgia. A Chiropodist or Podiatrist will examine the foot in order to determine the best treatment options. These include: anti-inflammatory medications, ice, massage and adding cushioning pads to shoes. A Chiropodist or Podiatrist can prescribe custom orthotics to help redistribute pressure on the foot.

Morton’s Neuroma

What is it?

Morton’s Neuroma is a sharp pain that usually occurs between the 3rd and 4th toes, where they meet the foot. Usually there is no external indication such as a bump, instead there may be pain, swelling, tingling or numbness in the toes. There may also be a burning sensation in the ball of the foot that extends to the toes. It is very common for people with this condition to experience extreme pain while walking. Morton’s Neuroma usually starts suddenly and the symptoms will often worsen with time.

What is the Cause?

Morton’s Neuroma develops from pressure or irritation to nerves that lead to toes. In response to this, the nerve tissue grows and thickens. Wearing high heels or shoes that squeeze the forefoot, causing extra pressure on nerves between those toes, can cause this condition.

Recommended Treatment

There are numerous treatment options for this condition. It is best to have a Chiropodist or Podiatrist examine the foot in order to determine the best treatment plan. Some treatment options include: topical and/or oral anti-inflammatory medications, icing the foot, wearing proper fitting footwear and massaging the foot and toes. Also recommended are pads to support the heads of the metatarsal bones (the five long bones located midfoot), creating more space for the nerves. Custom orthotics are often prescribed to treat the biomechanical factors that may have caused this condition.

Morton’s Toe

What is it?

Morton’s Toe is when the second toe is longer than the big toe, causing pain behind the second toe where it meets the foot.

What is the Cause?

This is a genetic condition.

Recommended Treatment

It is important to ensure that shoes are the correct size. As well, pads are recommended to support the heads of the metatarsal bones, to alleviate pressure on the second toe. These pads can be incorporated into a custom orthotic.

Osteoarthritis

What is it?

Osteoarthritis is the most common type of arthritis. This occurs when the cartilage between the joints wears down. Symptoms include: pain in the joints, joint stiffness, tenderness, swelling and pain that becomes worse after being active.

What is the Cause?

Osteoarthritis is caused by the degradation of the cartilage at the ends of bones. It can be exacerbated by improper biomechanics/alignment. Risk factors of osteoarthritis include: age (risk increases with age), sex (females), carrying excess weight and genetics.

Recommended Treatment

It is essential to ensure the feet have proper support, with custom orthotics and proper shoes. A patient must also ensure that shoes provide sufficient shock absorption.

Overlapping Toes

What is it?

Overlapping toes is when one toe rests on another toe beside it. It can occur with any of the toes. Symptoms of overlapping toes can include: pain, inflammation, toe calluses and corns and the symptoms can worsen if left untreated.

What is the Cause?

Some causes include: improperly fitting footwear, genetics, bunions and Rheumatoid Arthritis.

Recommended Treatment

There are numerous ways to treat overlapping toes. Properly fitting shoes, bunion treatments, toe separators, splints or even surgery are possible options. The best course of treatment can be determined after consulting with a Chiropodist or Podiatrist.

Over-pronation

What is it?

Over-pronation of the foot is excessive rolling inward. Over–pronation can cause: arch pain, heel pain, bunions, Achilles Tendonitis and hammer toe. Over-pronation can also cause a patient to be more susceptible to injuries.

What is the Cause?

There are several causes of over-pronation. These causes include: excessively flexible feet, genetics, being overweight and pregnancy.

Recommended Treatment

An over-pronator should wear custom orthotics and supportive shoes in order to keep their feet in a more stable position.

Plantar Fasciitis

What is it?

Plantar Fasciitis is pain and inflammation on the bottom of the foot, specifically under the heel, arch and sometimes forefoot. The pain may worsen throughout the day, with patients often experiencing a sharp pain in the morning, with a decrease in pain after a few minutes of walking and a gradual escalation of the pain during the course of the day.

What is the Cause?

Plantar Fasciitis is caused by pulling the tendons that support the arch. Constant straining of these tendons can cause micro tears. Plantar Fasciitis can also be caused by over-pronation, high arches, unsupportive footwear, walking or running on hard surfaces for long durations and being overweight.

Recommended Treatment

In order to reduce pain, stretching, icing, and resting the foot are recommended.

Orthotics are also highly recommended in order to treat the biomechanical issues. Additionally, patients are advised to avoid walking barefoot, and to rather wear supportive shock absorbing shoes at home.

Post-Tib Tendonitis

What is it?

Post –Tib Tendonitis is a common foot problem. This condition occurs when the tibial tendon is torn, which results in pain and swelling on the inside of the ankle or pain in the arch or heel. This pain typically intensifies with physical activity.

What is the Cause?

The condition is caused by overuse of the Tibialis Posterior Muscle (inner calf muscle).

Recommended Treatment

In order to effectively treat this condition, sufficiently supportive and cushioned shoes are highly recommended. Custom orthotics can also help to ensure adequate support of the feet.

Rheumatoid Arthritis

What is it?

Rheumatoid Arthritis is a painful swelling in the joints leading to erosion of the affected bones and joints. This is a systemic autoimmune disease often affecting the hands and feet. Symptoms of this condition include: swollen and tender joints, joint redness, weight loss and fatigue. Many patients with Rheumatoid Arthritis also experience symptoms that involve other parts of the body, besides just the joints (i.e. skin, eyes, heart, etc.).

What is the Cause?

This condition occurs when the immune system attacks the lining of the joints which breaks them down. Genetics also play a role in Rheumatoid Arthritis.

Recommended Treatment

Treatment of Rheumatoid Arthritis includes: reducing the amount of pressure on the affected joints, ensuring sufficient cushioning and shock absorption, wearing custom orthotics, routine foot care appointments. Prescription medications can help to alleviate the pain.

Turf Toe

What is it?

Turf Toe is pain and swelling at the joint of the big toe. This causes a reduced range of motion in the big toe joint.

What is the Cause?

Turf Toe is caused by sprained ligaments in the big toe joint, usually by jamming/stubbing the big toe.

Recommended Treatment

To properly treat Turf Toe, rest, icing and anti-inflammatory medications are all recommended.

Warts

What is it?

Warts are small, rough bumps on the top layer of the skin. They are similar in colour to the rest of the skin and are generally painless unless they are located in high-pressure areas. Warts are very contagious.

What is the Cause?

Plantar warts are usually caused by Human Papillomavirus (HPV). They are typically transmitted through a cut on the skin.

Recommended Treatment

There are a variety of treatment options for warts. Treatment options to remove warts include: salicylic acid, topical medications, freezing the wart using liquid nitrogen and surgically removing the wart. It is best to consult with a Chiropodist or Podiatrist to determine the proper course of treatment.