Foot & Ankle Care

There are many forms of arthritis, but the broad definition is inflammation of a joint. As cartilage wears away or is damaged, the bones lose their protective cushion. This causes friction and rubbing, leading to inflammation, pain and stiffness in the joint. Because your feet and ankles bear weight and have many small bones and joints, arthritis is common in these areas.

Common Causes

• Wear and tear to cartilage over time
• Injury to the joint or cartilage
• Autoimmune disease, such as rheumatoid arthritis

Common Symptoms

• Joint pain that increases with motion, or after rest
• Joint swelling, warmth and redness
• Difficulty walking due to pain and stiffness

Your achilles tendon, which connects your calf muscles to your heel bone (calcaneus), is the largest tendon in the body. It’s used with every step you take, so even though it’s very tough, it’s also prone to inflammation. Achilles tendinitis is inflammation of the achilles tendon. There are several presentations of achilles tendinitis, but it’s typically an overuse condition, and the main symptoms are consistent.

Common Causes

• Sudden increase in intensity of exercise
• Tight or tense calf muscles
• Bone spur(s) on the heel

Common Symptoms

• Pain and stiffness along the back of the heel
• Severe pain after exercising
• Swelling or thickening of the tendon

Your achilles tendon, which connects your calf muscles to your heel bone (calcaneus), is the largest tendon in the body. Because it’s used with every step, jump, and foot movement you make, it’s prone to injury. A rupture occurs when the tendon fibers tear or separate, often in the center or at the heel bone. Achilles tendon injuries are most common in those ages 30-50, and are typically sports related.

Common Causes

• Sudden increase in intensity of exercise
• Sudden stress on the tendon, i.e. stepping in a hole
• Sudden starts and stops when running

Common Symptoms

• Severe pain and swelling near the heel
• Inability to stand on your toes or “push off” when walking
• Popping or snapping sound upon injury

Adult acquired flatfoot is both very common, and caused by a wide range of conditions. Broadly, this condition is the collapse of the arch in the foot. Certain injuries, tendon inflammation, arthritis, and other diseases can result in adult acquired flatfoot. There are many treatment options available, including a variety of non-surgical treatments.

Common Causes

• Damage to the posterior tibial tendon
• Inflammatory arthritis
• Diabetic collapse

Common Symptoms

• Pain and swelling along the arch of the foot
• Pain on the outside of the ankle
• Pain that worsens with activity

A sprained ankle is extremely common in people of all ages. While they often heal with home treatments, an untreated or severe sprain can permanently weaken the ankle ligaments. Sprains can range from minor overstretching to a complete tear of a ligament. Most of the time, a sprain involves the lateral ligaments on the outside of the ankle. Severe sprains often present similarly to fractures.

Common Causes

• Walking on an uneven surface
• Sudden rolling or twisting of the ankle
• Falling down

Common Symptoms

• Swelling, bruising and tenderness
• Ankle instability, inability to bear weight
• Popping sensation, if tearing occurs

A bunion, also called hallux valgus, is a painful bony bump that develops at the big toe joint, on the inside of the foot. They develop over time if the big toe is forced to lean toward the second toe, eventually causing misalignment of the joint. This enlarged joint often becomes inflamed and painful. Untreated, bunions may continue progressing over time, causing further damage to the bone structure. 

Common Causes

• Poorly fitting shoes, especially pointed toes
• Heredity
• Inflammatory conditions, such as rheumatoid arthritis

Common Symptoms

• Pain, tenderness and redness
• Callus or corn formed on the bump
• Stiffness in the big toe

A claw toe is a toe that has an abnormal bend, resulting in the toe digging down into the sole of your shoes or the ground. This often creates painful calluses. Without treatment, claw toes worsen over time, and can lead to permanent deformity. At first, claw toes remain flexible, but may harden as the condition progresses.

Learn more at orthoinfo.aaos.org

Common Causes

• Poorly fitting shoes
• Nerve damage from diabetes, alcoholism

Common Symptoms

• Upward extension from the ball of the foot
• Downward extension at the middle joint of the toe
• Corns or calluses on or around the toe

A hammer toe is a toe that is bent at the middle joint, causing it to resemble a hammer. Hammer toes may occur in the third, fourth or fifth toe. Because of the abnormal stress on the tip on the toe, painful calluses or corns may form on the toe. Early intervention of a hammer toe is critical to avoid surgery.

Common Causes

• Muscle imbalance
• Poorly fitting shoes, especially pointed toes & high heels

Common Symptoms

• Calluses or corns on or around the toe
• Pain in the toe
• Difficulty finding comfortable shoes

For individuals with diabetes, foot care is a significant concern due to nerve damage and poor circulation. Diabetic foot, or Charcot arthropathy, is a serious complication of diabetes. Poor circulation often disintegrates the bone, and nerve damage results in injuries or wounds going unnoticed. Small infections may become serious in a few days, and may permanently deform the foot.

Common Causes

• Diabetes
• Nerve damage
• Poor circulation

Common Symptoms

• Swelling of the foot
• Redness of the foot
• Bone deformity

Chronic ankle instability, or chronic lateral ankle pain, often develops after a serious ankle injury. Unfortunately, once an ligament or tendon has been injured, it’s likely to be reinjured. Chronic ankle instability causes recurring pain on the outside of the ankle, and serious cases may result in difficult walking or a feeling of stability while walking.

Common Causes

• Previous ankle sprain or tendon damage
• Arthritis of the ankle
• Scar tissue on the joint following an injury

Common Symptoms

• Pain on the outside of the ankle
• Feeling of instability of the ankle joint
• Repeated ankle sprains or injuries

Recurring pain at the bottom of the heel is likely caused by plantar fasciitis. The plantar fascia is a ligament that runs from your heel to the ball of your foot. When it becomes inflamed due to overstress or tearing, you experience pain and stiffness around the bottom of your foot. Plantar fasciitis is very common, particularly in athletes or active adults.

Common Causes

• Tight calf muscles
• Very high arch of the foot
• Repetitive impact activity i.e. running

Common Symptoms

• Pain on the bottom of the foot, near the heel
• Pain that is worse after rest
• Pain that is worse after (not during) exercise