Congenital Foot Problems

A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.

The following are specifics about a few of these conditions:

-    Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.

-    Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.

-    Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.

-    Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.

-    Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.

-    Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.


 

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Sever's Disease

Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.

Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.

Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.

Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.

If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.

Gout

Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men. 

Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.

People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.

Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.

Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.

To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks. 

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.

There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.

People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.

Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.

If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Every Day Foot Care

Our feet are important in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if feet are cared for and looked after regularly, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly daily. Remember to get between the toes and keep the toenails trimmed and short. If the feet feel dry or there are signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If cream or lotion sits too long, they can cause fungal and bacterial growth. When moisturizer is used between the toes, it can also cause the skin to soften too much.

Shoes are also an important aspect of foot care. When one is picking out shoes, make sure they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet. Good shoes pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture off the feet. Without socks, the build-up of sweat in a closed-toe shoe can cause fungal problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend a lot of time on your feet, make sure that your shoes show no signs of wear. Shoes should offer ample support for the arches and the overall foot. Additionally, try to make foot cleaning and maintenance a daily habit. If you keep these things in mind, your feet will stay healthy and safe.

How to Handle a Long Work Day on Your Feet

In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.

If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.

Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.

You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.

Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.

Flatfoot

Flatfoot is a foot disorder that is not as straightforward as many people believe.  Various types of flatfoot exist, each with their own varying deformities and symptoms.  The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot.  Other signs of flatfoot include:

  • “Toe drift,” or the pointing outward of the toes and the front part of the foot
  • The tilting outward of the heel and the tilting inward of the ankle
  • The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
  • Hammertoes
  • Bunions

One of the most common types of flatfoot is flexible flatfoot.  This variation usually starts in childhood and progresses as one ages into adulthood.  Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing.  When not standing, the arch returns.  Symptoms of flexible flatfoot include:

  • Pain located in the heel, arch, ankle, or along the outside of the foot
  • Overpronation, or an ankle that rolls in
  • Shin splint, or pain along the shin bone
  • General foot aches or fatigue
  • Pain located in the lower back, hip, or knee

Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit.  X-rays may be taken to define the severity and help determine the treatment option best for your condition.  Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices.  If nonsurgical methods prove ineffective, surgery may be considered.  Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.

Toe Pain

Toe pain can originate from corns, calluses, hammertoes, and bunions, as well as ingrown toenails, sprains, fractures, and dislocations. Corns develop as the toe rubs against the inside of a shoe which causes the skin to thicken as a form of protection. A corn is typically cone-shaped and has a small, hardened spot that points inward. When a corn is pressed into the skin, the toe becomes painful. Corns usually form on the top or side of the toe. A callus is also a thickened patch of skin that generally forms on the bottom of the foot. Calluses are the result of friction from the toe rubbing against the inside of a shoe. They may also occur by walking barefoot or having flat feet. A hammertoe is a bump on the knuckle of the second toe that is produced by wearing shoes that are too short for your feet. The bony protrusion rubs against the top of the shoe causing pain and irritation. A bunion is a malformation of the big toe. The base of the big toe pushes away from the smaller toes, forcing the top of the big toe to press toward the other toes. Bunions can be hereditary, or they can result from injury to the toe joint or from wearing high heels with a narrow toe box. The toe becomes inflamed, and a bump may develop at the end of the misplaced bone. Ingrown toenails typically affect the big toe and its surrounding skin. The nail will dig into the skin and become painful. Wearing tight or narrow shoes that compress the big toe causes the nail to grow into the fleshy part of the toe. Cutting toenails incorrectly can also add to the development of an ingrown toenail. A toe sprain originates from a torn or stretched ligament. Strapping the injured toe to the toe next to it for stabilization is common. A broken or fractured toe usually occurs from trauma like dropping a heavy object on it or bumping into something extremely hard and rigid. Osteoporosis, a thinning of the bones, can also bring about toe fractures. 

Any of the conditions mentioned can lead to pain and irritation. While some are more serious than others, seeking an examination and diagnosis from a podiatrist is a good idea. A podiatrist can treat each ailment and get you back on your feet again without pain.


 

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