The midfoot is primarily made up of your foot’s arch, which consists of a series of many small complex joints. The arch is considered the bridge which connects the ball of your foot and your heel, the two areas which bear most of your body’s weight when standing and walking.
Healthy function of the midfoot is very important as its flexibility allows for the foot to adapt to uneven ground, and therefore helping you to maintain balance. Because the midfoot is the high-point of the foot, the joints in this area are subject to problems if the arch falls, flattens or collapses. A foot with a collapsed arch is considered an unstable foot and this can result in excessive stress on the joints and soft tissue (i.e. plantar fascia) of the midfoot, with subsequent pain.
Flatfeet is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch.
Other characteristics shared by most types of flatfoot include:
“Toe drift,” in which the toes and front part of the foot point outwardThe heel tilts toward the outside and the ankle appears to turn inA tight Achilles tendon, which causes the heel to lift off the ground earlier when walking and may make the problem worseBunions and hammertoes may develop as a result of a flatfoot.
The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. PTTD is often called “adult acquired flatfoot” because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn’t treated early.
A Cavus foot is a condition in which the foot has a very high arch. Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing. Cavus foot can lead to a variety of signs and symptoms, such as pain and instability. It can develop at any age, and can occur in one or both feet.
Like flat feet this condition can be symptomless, but if pain occurs such as calluses on the soles of feet, ankle instability or hammer/clawed toes the orthotics will help.
Stress fractures of the lower extremities account for 95% of all stress fractures in athletes. In the foot the most common sites are the metatarsals (forefoot) whilst in the lower leg it is in the lower third of the tibia.
They are also common in the metatarsals of older patients who may have a degree of osteoporosis
Stress fractures are overuse injuries and result from fatigue failure within the bone, although surrounding muscles actually fatigue first. The muscles are unable to absorb added shock and this is then transferred to the bone leading to a tiny crack.
Symptoms are usually gradual in onset but progress to more intense localised pain with swelling. Pain is usually most severe during exercise but may also be present at rest.
Poor lower leg mechanics (flat feet), poor footwear, poor training and diet insufficiencies can all be factors which cause stress fractures.
Numerous conditions can cause pain and discomfort in the rearfoot, but by far the most common rearfoot pain is heel pain. There are a number of conditions that may result in pain in the region of your heel, with plantar fasciitis being the most common. Due to the large range of conditions that may cause rearfoot and heel pain, it is vital an accurate diagnosis is made in order to achieve the best outcomes from treatment.
At Podiatry Illawarra, Anthony has undertaken extensive training and education in order to perform comprehensive assessments of the rear foot, allowing us to establish a clear and accurate diagnosis. A clear diagnosis allows us to develop effective treatment plans tailored specifically to you, an approach proven to be highly successful.
Many conditions can cause serious discomfort or pain in the rearfoot. By far the most common complaint is heel pain which can be attributed to a number of conditions.
Plantar Fasciitis is the most common cause of heel pain seen by Podiatrists. Most people who suffer from this condition experience severe pain in the heel of the foot when taking their first few steps out of bed in the morning or after prolonged sitting. The pain classically occurs again after lunch, and after exercise. Some people feel a sharp/stabbing pain, whilst others feel a dull ache.
If plantar fasciitis is not treated appropriately it may become a chronic condition and will prevent you from walking. It may also contribute to developing symptoms in your feet, knees, hip and back due to the changes in the way in which you walk to accommodate the condition.
The good news is that Plantar Fasciitis can be treated relatively easily and results of treatment can be felt quickly. A thorough medical history, assessment of the symptoms, analysis of foot function and footwear will confirm diagnosis.
The treatment regime normally consists of a combination of stretches, ice, rest, footwear and insoles.
Achilles tendonitis pain is often felt in the lower third of the Achilles tendon, approximately 5cm from its insertion into the heel. Pain can also occur at the tendon’s attachment site to the heel. Achilles tendonitis can be either acute or chronic. Symptoms are aggravated by activity and relieved by rest.
It is caused by overuse or excessive strain on the achilles tendon and accounts for an estimated 11% of all running injuries. Poor foot mechanics and excess pronation is often a factor that goes unnoticed. Achilles tendonitis is often now referred to as achilles tendinopathy. This is because it is thought to be due to tendon fibre degeneration rather than inflammation.
Treatment outcomes are best if treated early. The tendon has a poor blood supply meaning that healing is often slow so don’t let this problem progress into the chronic form.
Sever’s disease is a common cause of heel pain, particularly in the young and physically active. During puberty the calcaneus (heel bone) consists of two areas of bone known as ossification centres. These two areas are divided by an area of cartilage known as the calcaneal apophysitis.
The Achilles tendon attaches the triceps surae (calf muscles) to the calcaneus. As a child grows the calcaneus grow faster than the surrounding soft tissue, which means the Achilles tendon is pulled uncomfortably tight. This increase in tensile load can cause inflammation and irritation of the calcaneal apophysis (growth plate) which is known as Sever’s Disease. The pain is exacerbated by physical activities, especially ones involving running or jumping. Sever’s disease most commonly affects boys aged 12 to 14 years and girls aged 10 to 12 years, which corresponds with the early growth spurts of puberty.
Treatment can include rest, ice, insoles, stretches.
Haglund’s deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).
Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Non-surgical treatment can include one or more of the following: Anti-inflammatory drugs, ice, stretches, heel lifts, shoe modification, rest, orthotics.
Comprehensive podiatry for the Illawarra