Foot and Ankle

Morton’s Syndrome
Morton’s Syndrome, also called Morton’s Neuroma, is when nerves in the foot, specifically between the toes, are pinched by the metatarsal bones and become enflamed. This generally happens if the arch in your foot is weak and results in pain or a numb sensation on the inside of the two toes the nerve comes from. At times, Morton’s Syndrome may develop from a benign tumor in the webbing between your toes or ill-fitting shoes. Athletes who spin on the ball of their foot like tennis or golf athletes carry a heightened risk factor.

If you experience pain when you press between the bones of your foot, when you squeeze the foot, or on one toe and the adjacent side of the next toe, you may want to have a physician check for Morton’s Syndrome. To prevent Morton’s Syndrome, rest is generally recommended, though sometimes wearing a metatarsal raise to raise and spread the bones of the forefoot are also recommended. Rehabilitation, strengthening, and stretching will probably follow a positive diagnosis.

Plantar Facia Injury/Strain
The plantar fascia, or arch ligament, runs from under the heel to the front of the foot. Should this ligament get injured or strained from overuse or being stretched past its limits, you may feel localized pain and tenderness over the plantar fascia or you may notice a nodule or lump around the area a strain or rupture may have occurred.

May become chronic if not treated. Symptoms to look out for include a mild pain at the heel bone often called a “stone bruise”. It is more likely to be felt after exercise or after arising from a midday lunch break.

Preventing a plantar fascia strain is a relatively simple matter; simply rest or use a crutch once pain is felt and some physicians may recommend rehabilitation. The injury heals in at most 3 weeks.

Treating Plantar Fasciitis is simple: rest is the most important. Keep weight off of the afflicted foot and apply ice for twenty minutes a few times each day as needed. There are also some home exercises that can be done to treat the injury.

Stress Fracture
A stress fracture is sometimes referred to as a hairline style of break in a bone caused by overuse.

Metatarsal Fracture
The metatarsals are the long bones in the forefoot attaching to the phalanges (toe bones). These bones can get fractured from either a sudden impact through a sport like football or gradually fractured through continued stress. Athletes with a second toe longer than their first are more prone to stress fractures on their second toe’s metatarsal.

Overuse and too much training in a short period of time are typical causes of metatarsal fractures. Other symptoms indicating a stress fracture include a gradual onset of pain and swelling. In acute fractures brought on by a sudden impact, symptoms include acute pain and immediate, often severe swelling.

With stress fractures, your physician will usually recommend rest and activity can be resumed in about six weeks. Acute fractures demand a cast in most situations and also require about six weeks of rest.

Heel Spurs
A heel spur is the result of chronic inflammation of the plantar fascia, called plantar fasciitis. Essentially, a heel spur is a growth of bone on the bottom of the heel due to neglecting treatment for plantar fasciitis.

Treatment is generally started by taping the foot, anti-inflammatory medication to control pain and swelling, and possibly cortisone injections. Physical therapy may also be used and in rare instances, surgery.

Achilles Tendon Injuries/Pain
Joining the muscles of the lower leg to the heel of the foot, the Achilles tendon is both very important and very vulnerable to damage. Sometimes, this tendon can be stretched beyond its limit and become inflamed, tear, or rupture.

Damage to the Achilles tendon is generally due to overuse, with pain appearing gradually at first then growing more constant until exercise/activity is too painful to continue with. Weak calf muscles are also to blame; should the calf muscle become tired, it tightens and shortens, heightening the risk for damage to the Achilles tendon. A sudden increase in training, speedwork, or hill runs lead to Achilles tendon damage.

The obvious treatment for Achilles tendonitis is to scale back your level of training. Stretch your calves after exercise while they are still flexible. The best thing to do is keep an eye on your muscle’s soreness and balance your training with that in mind.

Ankle Sprains
This very common ankle injury results from the stretching/tearing of ligaments around the ankle joint. Ankle sprains may result from weight being applied to the foot while in an inverted or everted position, like when running or jumping on an uneven surface. The foot may roll in or out, stretching the ligaments. Sometimes a loud snap or pop is heard at the time of the sprain.

Treating ankle sprains is usually a matter of the RICE plan (rest, ice, compress, elevate). Anti-inflammatory medicine may be used to control swelling for the first 7-10 days.

Bunions are painful swelling of the soft tissue and bone enlargement over the inside of the ball of the big toe. This may give an appearance of the big toe turning in towards the other toes; in extreme cases it may appear to lie across them.

Pronation is a key factor in being prone to bunions. If you have pain around the ball of the big toe, you may not only have a bunion, but you may have difficulty or even be unable to wear certain types of shoes.

Using foam, keep the big toe and its partner separate. 1cm of foam should be sufficient. If that does not help, a podiatrist can offer an orthotic device for your feet or suggest surgery in serious cases.

Bursitis in the Foot/Ankle
This is the term used for the inflammation of the bursa, a sac that decreases friction between joints moving in different directions. When the bursa becomes enflamed, any further use of it causes increased irritation. This condition arises from overuse of a repetitive movement or continuous and excessive pressure, like resting your elbows on a desktop for long periods of time.

There are many types of bursitis (elbow, knee, shoulder, hip, etc), but most diagnoses are consistent in that each show tenderness and swelling over the bursa along with pain during movement. Inflamed bursas carry a small chance of getting infected. If you experience open wounds around the area of bursitis, redness, or a fever/chills, contact a doctor immediately.

Treating bursitis is a matter of resting and protecting the affected area. Ice it down, take anti-inflammatory medicines to control swelling, with physical therapy & cortisone injections available for persistent cases. Physical rehab may be recommended for serious cases.

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