Tag: Foot

  • 18
  • Mar
Peroneal Tendon Subluxation
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Brief Outline of Peroneal Tendon Subluxation

Peroneal tendon subluxation (dislocation) is most commonly a chronic condition that develops after a sprain or fracture. The tendon moves out of the groove in which it is supposed to sit due to damage to the structures designed to hold it in place. Pain on the lateral side (outside) of the ankle and a popping sensation may be signs of this condition. Running and jumping can cause repetitive stress to the tendon, especially when it is dislocating repetitively.

Anatomy and Physiology of Peroneal Tendon Subluxation

The tendons of peroneus longus and peroneus brevis run from the peroneal muscles to the foot. They pass around the lateral malleolus through a groove in the bone. They are held in this groove sheath that is reinforced by a band of ligament. When this ligament or sheath is damaged, it reduces the stability of the tendons, allowing movement out of the groove. Some people are predisposed to this injury due to a shallow, or non-existent groove where the tendons lie. Peroneal tendon subluxation may occur also if the tip of the lateral malleolus is fractured with forces dorsiflexion, or a direct blow.

Ankle Peroneal Subluxation

 

Cause of Peroneal Tendon Subluxation

Tearing or stretching of the ligaments that support the tendons, usually due to an ankle sprain or fracture. Repetitive stress to the tendons, causing inflammation and swelling, allowing the tendons to slide out of the groove.

Signs and Symptoms of Peroneal Tendon Subluxation

Pain and tenderness along the tendons. Popping or snapping sensation on the lateral side of the ankle. Swelling may be noted along the bottom of the fibula.

Complications If Left Peroneal Tendon Subluxation Unattended

The peroneal tendons become irritated when they dislocate, which causes inflammation. This inflammation an lead to tearing or complete rupture of the tendons if left untreated.

Immediate Treatment for Peroneal Tendon Subluxation

R.I.C.E. Anti-inflammatory medication. Possible immobilisation, especially with acute dislocation. Seek medical attention.

Rehabilitation and Prevention of Peroneal Tendon Subluxation

Strengthening of the muscles in the lower leg after pain subsides and normal function returns will help support the tendons. Treating ankle sprains properly will help prevent subluxation. Strong calf and shin muscles will help support the whole foot and ankle structure, preventing this condition as well.

Long-term Prognosis for Peroneal Tendon Subluxation

When treated promptly, subluxation of the peroneal tendons usually responds well to non-surgical techniques. In some cases, surgery may be required to repair the sheath and ligaments that cover the tendon to restore stability.
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  • 27
  • Feb
Fracture of the Foot
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Brief Outline of Fracture of the Foot

A foot fracture may involve any of the twenty-six bones of the foot but most commonly occurs in the metatarsals. Contact sports and those that could result in high impact landing or collisions can lead to foot fractures. Those athletes with lower bone density due to poor nutrition, osteoporosis, (or inadequate or absent menstrual cycles in females) are more susceptible to fractures.

Anatomy and Physiology of Fracture of the Foot

Foot Anatomy

The foot consists of twenty-six small bones. The seven tarsals form the ankle. The two largest tarsals carry the body weight: the calcaneus, or the heel bone, and the talus, which lies between the tibia and the calcaneus. The tibia and fibula rest on top of the talus. The five metatarsals are long, narrow bones that form the instep or sole of the foot and the fourteen phalanges consist of short, narrow bones that form the toes, with two joints in the big toe and three in the others. These bones, due to their location and shape, are more susceptible to fracture. When a force is applied to the shaft of the metatarsals, they may fracture.

Cause of Fracture of the Foot

Trauma to bones of the foot, e.g. fall, blow, collision, or violent twisting.

Signs and Symptoms of a Fracture Foot

Pain, which can be severe. Swelling and discolouration, and possible deformity at the fracture site. Pain when weight-bearing, and possible inability to walk. Numbness of the foot or toes.

Complications if Left the Fracture Foot Unattended

A fracture that is left untreated can lead to damage to the blood vessels and nerves in and around the fracture site. The bones may heal incorrectly or not heal at all. Weakness and instability in the foot may result as well.

Immediate Treatment for Fracture Foot

Ice, elevation, and possible immobilisation. Consult an orthopaedic surgeon.

Long-term Prognosis for Fracture Foot

If allowed to heal completely, a fracture will usually heal to become stronger than before the injury. In fractures that are compound or misaligned, surgical pinning may be required to stabilise the bone until it heals. If the ligaments are stretched or torn, the chance of re-injury increases.
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  • 25
  • Feb
Retrocalcaneal Bursitis
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Brief Outline of Retrocalcaneal Bursitis

The retrocalcaneal bursa helps to lubricate and cushion the tendon as it runs over the heel. This bursa takes a lot of stress during repetitive flexing and extending of the foot, such as during running, walking or jumping. Worn or incorrectly sized footwear or excessive pronation of the foot can also lead to problems with this bursa, as well as the Achilles tendon. Shoes that fit too tightly, especially in the back, may put additional stress on the tendon and bursa.

Anatomy and Physiology of Retrocalcaneal Bursitis

The retrocalcaneal bursa lied between the anterior Achilles tendon insertion and the calcaneus (heel bone). The repetitive friction of the tendon running over this bursa during active plantar flexion during push-off compresses the bursa between the tendon and bone, and can cause inflammation.

Cause of Retrocalcaneal Bursitis

Repetitive stress to the bursa by the friction of the Achilles tendon during walking, running, or jumping. Increasing duration or distance too quickly. Improper footwear or waling/running gait. Injury to the Achilles tendon.

Signs and Symptoms of Retrocalcaneal Bursitis

Pain especially with walking, running, or jumping. Tenderness over the heel area. Redness and slight swelling may be noted over the heel.

Complications of Retrocalcaneal Bursitis

The bursa can rupture completely if the injury is left unattended. This complete rupture could lead to other problems with the Achilles tendon due to increased friction. The pain may make it difficult to get up on the toes during walking, running, or jumping.

Immediate Treatment for Retrocalcaneal Bursitis

Rest, Ice. Anti-inflammatory medication and injection. Shockwave therapy.

Long-term Prognosis for Retrocalcaneal Bursitis

Proper treatment and rest should lead to a complete recovery. In rare cases the fluid that builds up due to the inflammation may need to be drained to facilitate healing. Surgery is only necessary in extreme cases that do not respond to rest and rehabilitation.
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  • 24
  • Feb
Sesamoiditis
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Brief Outline of Sesamoiditis

The tendons surrounding the sesamoid bones can become irritated and inflamed, causing a condition similar to tendinitis. Runners, dancers, and catchers in baseball are all susceptible to this injury. Increasing activity too quickly causes additional trauma to the small sesamoid bones.

Foot Sesamoiditis

Anatomy and Physiology of Sesamoiditis

A sesamoid is a small nodular bone that is not attached to another bone, but instead is embedded in a tendon or joint. The knee cap is the largest sesamoid bone in the body but there are also two small ones in the forefoot. The sesamoid bones in the foot are located along the plantar fascia surface of the first metatarsal head, with one on the lateral aspect, and the other more medial. The sesamoid bones are spherical and embedded in the tendon of the flexor hallucis brevis. They provide a smooth surface for the tendon to travel over and help the tendon to transmit the force generated by the muscles. The sesamoid bones in the foot also help elevate the bones of the big toe and assist in weight bearing.

Cause of Sesamoiditis

Increased acitivity without proper conditioning. Little natural padding in the forefoot, leaving the sesamoid bones unprotected. High arches leading to running on the balls of the feet.

Signs and Symptoms of Sesamoiditis

Gradual onset of pain. Pain over the bone and surrounding tendon. Pain increases with activity.

Complications If Left Sesamoiditis Unattended

If left sesamoiditis unattended, this condition can worsen to the point that the pain becomes debilitating. The inflammation in the tendon can cause irritation to surrounding tissue. As with tendinitis, a complete rupture may occur if the condition is allowed to go untreated.

Immediate Treatment for Sesamoiditis

Anti-inflammatory medication or anti-inflammatory injection.

Long-term Prognosis for Sesamoiditis

Sesamoiditis responds well to anti-inflammatory treatments. Complete recovery can be expected, with no lingering effects. In rare cases where the condition does not respond to preliminary treatments, surgical intervention may be required.
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  • 05
  • Feb
Pain Under The Heel
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Pain in the sole of the foot, directly under the heel, is often caused by plantar fasciitis. This troublesome condition causes pain which is particularly severe when you first get out of bed in the morning but then eases a little as you continue to walk. The plantar fascia is a tough fibrous band, shaped like a triangle, which joins the ball of the foot with the heel bone. The strain and inflammation occur at the joint where the fascia joins the heel bone. Sometimes, an extra bit of bone, known as spur, may grow at this point.

Plantar Fasciitis

Plantar fasciitis often affects people who are on their feet a lot in their work and those who are overweight, so good footwear and losing weight can help. It an also be a feature of some types of inflammatory arthritis, but this is unusual.

In older people, pain under the heel can also be the result of thinning of the fat pad. There is normally a dense cushion of tissue, mostly fat, under the heel, which acts as a shock absorber when walking. This cushion may become thin as you get older and the heel bone is no longer so well protected. Well-fitting shoes with soft, sponge rubber soles and heels, perhaps with a soft insole as well, will protect the heel.

Heel Pad
Heel Cups

Treatment for Heel Pain

Anti-inflammatory injection often helps plantar fasciitis. Anti-inflammatory drug, wearing heel cups do help with the symptoms.
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