Category Archives: Uncategorized

LISFRANC INJURY

Summary

  • Lisfranc injuries occur at the midfoot where a cluster of small bones forms an arch on top of the foot between the ankle and the toes.Lisfranc fracture-dislocations are swollen and painful with some bruising and inability to put any weight on the foot.

How did I get this?

  • Lisfranc injuries occur as a result of direct or indirect forces to the foot. A direct force often involves something heavy falling on the foot. Indirect force commonly involves twisting the foot.Commonly occur in automobile accident victims, military personnel, runners, horseback riders, football players and participants of other contact sports, or something as simple as missing a step on a staircase.

What can I do about it?

  • Refrain from putting weight on the foot.
  • Oral anti-inflammatory medications (ibuprofen) help reduce pain and inflammation.
  • Swelling is reduced by icing the affected area and keeping the foot elevated.

What help can I get for this?

  • Podiatrist will place the affected foot in a cam walker to keep it immobile, and crutches are used to avoid putting weight on the injured foot.
  • Orthopaedic foot surgeon for possible surgical treatment to realign the joints and return the broken (fractured) bone fragments to a normal position.

When will it get better?

  • The majority of the recovery occurs in the first 6 months, but it is often a year or more before patients reach their point of maximal improvement. If the surgical treatment fails or the joint damage from the injury leads to severe arthritis, then a fusion (arthrodesis) of the Lisfranc joints may be necessary. Despite the stiffness of a fused joint most patients with successful fusion of the midfoot joints have good function of the foot.

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Intermetatarsal Bursitis

Summary

  • A bursa is a fluid-filled cushioning sac. They are located near tendons, ligaments, skin, and muscles that would otherwise rub directly across the surface of a bone. They are very important to prevent friction, absorb shock, and decrease the wear and tear between moving structures. The intermetatarsal bursae are located on the bottom of the foot near the base of the toes. They can be irritated when one metatarsal bone takes more load than the others. When this happens, the soft tissue between the bone and the skin becomes compressed and inflammation in the bursa can begin. Walking barefoot on a hardwood or tiled floor without cushioning will increase pain noticeably due to the direct pressure on the metatarsal bursa.

How did I get this?

  • It is commonly due to strain or irritation of the bursa. Wearing narrow or excessively worn footwear throughout the day or while playing sports also increase your chance of bursitis developing in your feet and toes.

What can I do about it?

  • Anti-inflammatory tablets (e.g. Ibuprofen) can help although should not be taken for long periods without professional advice.
  • Hot or cold ice packs can help symptoms to improve
  • Rest the foot.
  • Perform stretching exercises to improve joint motion.
  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a protective pad.
  • See a podiatrist.

What help can I get for this?

  • Podiatrists may advise appropriate shoes or add padding to your existing shoes, consider prescribing orthotics, advise taping / strapping.
  • Your Doctor may administer a cortisone injection to reduce inflammation if indicated, and possibly suggest surgical management.

When will it get better?

  • Conservative treatments may be sufficient to resolve symptoms and prevent recurrence. However, if the bursitis becomes chronic surgery may be necessary.

High ankle sprain

Summary

  • A high ankle sprain occurs when there is an injury to the large ligament above the ankle that joins together the two bones of the lower leg. Symptoms include pain when the ankle is externally rotated (turned to the outside) or when the calf is squeezed.

How did I get this?

  • A high ankle sprain occurs from a twisting or rotational injury. The high ankle sprain also can occur in the setting of an ankle fracture, which means the bones of the ankle are broken.

What can I do about it?

  • Rest the leg.
  • Ice application for 20 minutes every two to three hours for minimizing inflammation.
  • Gently compress the leg, and elevate the leg with the toes higher than the nose to decrease inflammation.
  • Seek podiatry consultation.

What help can I get for this?

  • Podiatrist for possible immobilization and taping of the ankle for healing.
  • Feet and ankle surgeon for possible surgery if there is a broken bone or widening of bones involved.

When will it get better?

  • The recovery for high ankle sprains can take considerably longer than typical ankle sprains. It usually takes six weeks or more to return to play, but can sometimes take even longer. One good indication that you are ready to go back to sports is if you can hop on the foot 15 times. Surgery will make even more time for recovery and rehabilitation.

HAMMER TOE

Summary

  • Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes when the long muscles originating from the lower leg overpower the smaller muscles in the foot. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop such as pain or irritation of the affected toe when wearing shoes, a buildup of skin (on toe, between two toes, or on the ball of the foot), inflammation, redness, or a burning sensation.

How did I get this?

  • Family history, arthritis, trauma, bunions, tight footwear, and neurological conditions such as stroke or peripheral neuropathy.

What can I do about it?

  • New shoes that have soft, roomy toe boxes (should be 1cm longer than your longest toe).
  • Avoid wearing tight, narrow, high-heeled shoes.
  • Find a shoe with a deep toe box that accommodates the hammer toe.
  • Sandals may help, as long as they do not pinch or rub other areas of the foot.

What help can I get for this?

  • Podiatrist may prescribe pads designed to shield corns and calluses from irritation.
  • Podiatrist may prescribe orthotic devices placed in your shoe to help control the muscle/tendon imbalance.
  • Podiatrist may advise splints or small straps to realign the bent toe.
  • Possible surgery when the hammertoe has become more rigid and painful, or when an open sore has developed.

When will it get better?

  • This is a progressive deformity which can only be corrected with surgery. Treatment for the symptoms and appropriate footwear will help to keep you comfortable.
  • After surgery the length of the recovery period will vary, depending on the procedure or procedures performed.

Hallux Valgus

Summary

  • It is a deformity of the big toe joint, which pushes it towards smaller toes causing pain, inflammation, swelling, and stiffness around the joint, especially with pressure from tight shoes.

How did I get this?

  • Arthritis can be a risk factor.
  • Family history of Hallux Valgus.
  • Wearing tight shoes can contribute to the problem.

What can I do about it?

  • Wear good fitting shoes.
  • Avoid high heels.
  • Wear a pad over the bunion.
  • See a podiatrist.

What help can I get for this?

  • Podiatrist may advise on appropriate footwear, padding, night splints.
  • Podiatrist may consider prescribing orthotics.
  • Foot and ankle surgeon may advise on surgery if the joint is too painful.

When will it get better?

  • The symptoms may well settle, especially if you are careful with shoes, but the deformity is likely to progress.Surgery is the only effective way of correcting the deformity (but it may still reoccur in the future).

Hallux Limitus / Rigidus

Summary

  • Hallux rigidus/limitusis a disorder of the joint (form of degenerative arthritis)located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe.

How did I get this?

  • History of trauma in the feet.
  • Faulty foot function.
  • History of arthritis.
  • Family history is a risk factor.

What can I do about it?

  • Rest from activities affecting the joint.
  • Stop wearing high heeled shoes.
  • Applying ice packs reduce inflammation for short period of time.
  • Contrast bath using alternating cold and hot water (30 seconds each for five minutes) to reduce inflammation.
  • Short term use of anti-inflammatory drugs such as ibuprofen to reduce pain and inflammation.

What help can I get for this?

  • A podiatrist may provide shoe modifications, padding, or orthoics.
  • An orthopaedic foot surgeon may assist with removing bony lumps or fusing the joint.

When will it get better?

  • It depends on severity, patient activity and expectation as well as the particular treatment used. Podiatry and activity modification can provide fast relief, along with appropriate footwear.

Freibergs Disease

Summary

  • Freiberg’s disease is a relatively uncommon disorder that affects the joints of metatarsals (the bones that extend from the arch of your foot to your toes).
  • The disease is associated with the gradual collapse or disintegration of the joint surfaces between the metatarsals as well as the formation of abnormal joint tissue. Symptoms include chronic history of forefoot pain, foot stiffness, and walking with a limp.

How did I get this?

  • The specific events or factors that cause Freiberg’s disease are not completely understood.
  • However, there are several risk factors for the disease, which include age and gender (Freiberg’s disease occurs most often in female adolescents and young women, although the disease can occur in any person at any age), excessively long metatarsals, and foot trauma.

What can I do about it?

  • Freiberg’s disease may be asymptomatic or it may heal without treatment. But if symptoms are present, the following will be beneficial:
  • Rest the metatarsal joints allowing the joint Inflammation and irritation to go away.
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) are used commonly for pain.
  • Seek podiatry consultation.

What help can I get for this?

  • Podiatrist may advise comfort shoes with metatarsal pad to help offload the area and for protection, and a camwalker boot for protected weight bearing for a period of two to six weeks to allow the symptoms to settle.
  • Foot and ankle surgeon for surgical treatment if the nonoperative intervention fails to control the symptoms.

When will it get better?

  • Fortunately, the outcomes of both non-operative and operative management are good to excellent and most patients are able to return to previous activity.

Cuboid Dysfunction Fact Sheet

Summary

  • The Cuboid is a square shaped bone which lies between your heel and the 5th metatarsal.
  • Cuboid dysfunction can result if this bone and the surrounding joints are subject to repeated trauma and cause intermittent pain.

How did I get this?

  • The way that you walk, or if you have a high arched, or excessively flat foot can cause cuboid dysfunction. There is not usually a specific injury. The joints around the cuboid become inflamed and cause the pain.

What can I do about it?

  • Rest, ice packs, and soft cushioning footwear may be helpful.
  • Short term antiinflammatory drugs such as ibuprofen may relieve symptoms.

What help can I get for this?

  • A podiatrist will assist with footwear advice or modification, strapping, padding, orthotics, or joint mobilisation.

When will it get better?

  • With the correct support and reduction in activity you can expect an improvement over 6-8 weeks.

Compartment Syndrome

Summary

  • It is a condition where there is excessive pressure in the muscle compartment of the foot following fracture or injury. This can lead to tissue damage and requires immediate emergency attention. The pain is generally far in excess of what would be expected.

How did I get this?

  • If there is fracture or injury in the foot, there can be swelling which compresses the muscle compartment and may lead to severe pain, swelling and tissue damage.

What can I do about it?

  • Rest the area affected.
  • Elevate the feet above the heart to promote blood flow and aid in the inflammation.
  • Seek emergency medical attention.

What help can I get for this?

  • See your podiatrist or doctor without delay.
  • Will usually result in hospital admission and surgery.

When will it get better?

  • Conservative treatment options have not been shown to be effective for this condition.
  • Surgical intervention to relieve the pressure will be a better option for better and fast healing.

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Achilles Tendinopathy

Summary

  • Achilles Tendinopathy is a condition where there is pain, swelling, stiffness, and weakness in your Achilles tendon.
  • It is caused by repeated tiny injuries in this area.
  • Pain develops gradually especially in the morning upon waking up but is worse during rest after exercise.

How did I get this?

  • Achilles tendon is important part of your leg which is found behind and above your heel. It joins the heel bone to your calf muscles. This helps to bend your foot downwards at the ankle. Overuse of tendons, wearing inappropriate footwear during exercise, poor flexibility, and increased intensity of exercise can result to injury in your Achilles tendon. Other causes include arthritis and long-term use of some antibiotics (e.g. Ciprofloxacin).

What can I do about it?

  • Rest and avoid strenuous exercise (such as running). As you improve, you can restart exercise gradually.
  • Cold compress (ice pack) will help to decrease swelling and control the pain.
  • Compression using bandage can also minimize pain and aid in reducing the inflammation.
  • Elevate the injured area above the heart while sitting.
  • For prevention, make sure you stretch before and after exercise.
  • Short term use of anti-inflammatory drugs can be helpful to decrease the pain.

What help can I get for this?

  • A podiatrist for special heel pads to wear in the shoes for cushion and support, and a program of special exercises for the strengthening of the injured tendons.
  • Footwear advice or modification and possible orthoses to relieve strain on the Achilles tendon.
  • A surgeon, if symptoms do not improve after 3 to 6 months, might proceed with surgical repair of the tendons.

When will it get better?

  • Symptoms usually clear within 3 to 6 months of starting nonsurgical treatment (as described above). The earlier the diagnosis and treatment, the better the outcome.

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