Common foot problems

Common Foot Problems

Metatarsalgia (Pain in the ball of the foot)

Definition

Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the area just before the toes, more commonly referred to as the ball-of-the-foot). This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot. Metatarsalgia (ball-of-foot-pain) is often located under the 2nd, 3rd, and 4th metatarsal heads, or more isolated at the first metatarsal head (near the big toe).

Cause

With this common foot condition, one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. It is common to experience acute, recurrent, or chronic pain with metatarsalgia. Ball-of-foot pain is often caused from improper fitting footwear, most frequently by women's dress shoes and other restrictive footwear. Footwear with a narrow toe box (toe area) forces the ball-of-foot area to be forced into a minimal amount of space. This can inhibit the walking process and lead to extreme discomfort in the forefoot.

Other factors can cause excessive pressure in the ball-of-foot area that can result in metatarsalgia. These include shoes with heels that are too high or participating in high impact activities without proper footwear and/or orthotics. Also as we get older, the fat pad in our foot tends to thin out, making us much more susceptible to pain in the ball-of-the-foot.

Treatment and Prevention

The first step in treating metatarsalgia is to determine the cause of the pain. If improper fitting footwear is the cause of the pain, the footwear must be changed. Footwear designed with a high, wide toe box (toe area) and a rocker sole is ideal for treating metatarsalgia. The high, wide toe box allows the foot to spread out while the rocker sole reduces stress on the ball-of-the-foot.

Unloading pressure to the ball-of-the-foot can be accomplished with a variety of footcare products. Orthotics designed to relieve ball-of-foot pain usually feature a metatarsal pad. The orthotic is constructed with the pad placed behind the ball-of-the-foot to relieve pressure and redistribute weight from the painful area to more tolerant areas. Other products often recommended include gel metatarsal cushions and metatarsal bandages. When these products are used with proper footwear, you should experience significant relief.

If problem persists, consult your foot doctor.

Achilles Tendonitis

Definition

Achilles tendonitis causes inflammation and degeneration of the achilles tendon. The achilles tendon is the large tendon located in the back of the leg that inserts into the heel. The pain caused by achilles tendonitis can develop gradually without a history of trauma. The pain can be a shooting pain, burning pain, or even an extremely piercing pain. Achilles tendonitis should not be left untreated due to the danger that the tendon can become weak and ruptured.

Achilles Tendonitis is aggravated by activities that repeatedly stress the tendon, causing inflammation. In some cases even prolonged periods of standing can cause symptoms. It is a common problem often experienced by athletes, particularly distance runners. Achilles Tendonitis is a difficult injury to treat in athletes due to their high level of activity and reluctance to stop or slow down their training.

Individuals who suffer from achilles tendonitis often complain that their first steps out of bed in the morning are extremely painful. Another common complaint is pain after steps are taken after long periods of sitting. This pain often lessens with activity.

Cause

There are several factors that can cause achilles tendonitis. The most common cause is over-pronation. Over-pronation occurs in the walking process, when the arch collapses upon weight bearing, adding stress on the achilles tendon.

Other factors that lead to achilles tendonitis are improper shoe selection, inadequate stretching prior to engaging in athletics, a short achilles tendon, direct trauma (injury) to the tendon, and heel bone deformity.

Treatment and Prevention

Athletes, particularly runners, should incorporate a thorough stretching program to properly warm-up the muscles. They should decrease the distance of their walk or run, apply ice after the activity and avoid any uphill climbs. Athletes should use an orthotic device like The Ultimate Heel and Arch Support for extra support.

The Ultimate elevates the heel to reduce stress and pressure on the achilles tendon. The device is made with light-weight, shock absorbing materials. The Ultimate Heel and arch Support can be used to control over-pronation, support the longitudinal arch, and reduce stress on the knees. ankles and achilles tendons.

If the problem persists, consult your foot doctor.

Runner's Knee
Patellofemoral Pain Syndrome

SYMPTOMS

Pain

Along the medial (inner) aspect of the kneecap or just below the kneecap When using stairs or going up/down hills Worse after prolonged sitting with the knees bent More of a dull ache Cracking or grating in the knee
Eventually, knee may want to "catch" and may feel like it wants to give out

DEFINITION

Softening of the cartilage on the patella (kneecap)
Roughening of the cartilage under the patella caused by the kneecap not tracking properly (patella does not glide smoothly over the femur/thigh bone)
May also be referred to as Chondromalacia Patella
One of the most common knee problems in running and other sports (may occur at any age)

PRIMARY CAUSES

Excessive Pronation

Pronation is a normal movement of the foot, that allows the arch to flatten to a degree, which helps the body to absorb shock and adapt to different ground surfaces.
In analyzing ones gait, first contact is on the heel and outside of the foot, followed by a shift of body weight forward, toward the arch and toes.
If the foot is weak or tired and/or the footwear is not supportive, then the arch can flatten more than normal, which is excessive pronation.
Flattening of the arch (excessive pronation) increases stresses on the foot, which can further contribute to ankle, knee, hip and low back problems (a chain reaction).
This repetitive, excessive pronation, is the main contributor to many lower extremity, overuse injuries

CONTRIBUTING FACTORS

Mechanical conditions including wide hips (females) knock knees, patella alta (high patella) and subluxating patella.
Over pronation of the foot .
Weakness of the quad, especially the VMO (Vastus Medialis Oblique Muscle) which runs along the inner aspect of the thigh and connects at the knee
Overuse, or an increase in hill running or stair use
Too large of a Q-angle at the knee (this is the angle of quad muscle's effective pull on the kneecap) Less than 12 degrees is normal and greater than 15 degrees is abnormal

TREATMENT – ADVICE GIVEN MOST OFTEN IN CURRENT LITERATURE

The 3 S's – Stretching, Strengthening and Supporting, along with ICE and REST, have been found to be the simplest and most effective for these injuries.

Stretching of the hamstring, quad, calf and IT Band with help to decrease pressure at the kneecap.
Strengthening of the quad, especially the VMO (vastus medialis oblique muscle) will help the kneecap to glide more correctly through the groove at the knee joint.
Supporting the foot with proper shoes and insoles, can prevent or help to eliminate the vast majority of lower extremity problems due to faulty biomechanics. This may be a Birkenstock sandal, with a broad base and contoured footbed, that is low to the ground and conforming to the foot. It may be a shoe with an upper that wraps the foot and supports the arch and heel thus limiting excessive pronation. The vast majority of footwear have more than enough cushion but very little support for the arch and heel. One of the easiest and most effective solutions is to add a simple over the counter insole that provides a forgiving support for both the arch and heel.
Avoid downhill running or going up/down stairs.
Avoid exercises done with the knee bent unless being done as an isometric
Physical Therapy including exercise, ultrasound, iontophoresis and patellar mobilization.