Tag: Foot

  • 21
  • Jan
Stress Fracture of the Foot
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There are several locations of stress fracture in the foot, but there is only one type that atheletes can identify themselves. Metatarsal stress fractures are common and can often be self diagnosed. The pain is located on the shaft of the metatarsal behind the joint. It is usually felt on top, but may be deep inside.

The pain is usually reproduced by pressing on the metatarsal bone from the top. Bend the toe downward and note how the knuckle responds. The pain can be 1/2 inch to about 2 inches behind this joint. If the pain is anywhere else it is not a classic stress fracture.

After about 2 weeks a bump can usually be felt on the metatarsal in the location of pain.

Description of Pain in the Foot

Stress fracture can occur without knowing it. The pain can begin after a workout, during the first part of the next workout, or after sitting and sleeping.

The pain can also begin during a workout, sometimes in a very short period of time. The pain can become strong. This type of stress fracture is easier to identify because it is obvious, but it also usually means the damage is greater.

Many times there can be a low grade ache that does not really hurt much for as long as a week or two, only to become quickly more sore and obvious. This is usually the time that a stress syndrome becomes a true stress fracture.

The pain is described as an ache, sometimes piercing.

The pain can vary from the mildest form that only hurts with exercise, to intense pain that forces one to use crutches for walking.

Cause of Stress Fracture of the Foot

  • Excessive intensity of workouts prior to the body adapting.
  • A singular event that exceeds the current level of the skeletal and muscular fitness of the athlete.
  • Poor bone density – Osteoporosis.

Treatment for Stress Fracture of the Foot

If the foot hurts too much to walk with a normal gait, an X-ray is strongly advised to rule out a complete fracture.

A cast is not usually needed for mild to moderate stress fractures unless the pain prevents normal activity. Fortunately this pain is also an indicator of the extent of the fracture. More pain means a more severe fracture. A doctor will know how to make the foot more comfortable.

Consequences of Running / Walking Through the Pain

Progression of the injury is probable. A mild stress fracture can become a complete fracture.

Many athletes who are training for a significant goal decide to take the risk and run with a mild stress fracture (moderate or severe fractures are too painful). Some make it through, but many aggravate the injury, requiring a lot more rest. Unfortunately, a mild stress fracture can become a serious true fracture within 2 – 3 strides.
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  • 20
  • Jan
Big Toe Pain Cause by Running
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Pain that Is Deep Inside the Big Toe Joint.

Location of the Big Toe Pain

The most common injury of the big toe is in the joint where the big toe meets the foot. Most commonly the pain is felt deep inside the joint, but there may be some tenderness on top of the joint and toe.

  • If the big toe hurts almost entirely on top, the injury is called Hallux Limitus.
  • If the big toe hurts almost entirely on top and the joint id enlarged on top with limited ability to bend the toe upward, the injury is Hallux Rigidus.
  • If the big toe joint hurts only on the bottom, is is Seasamoiditis injury.
  • If the big toe hurts on the inner side of the joint toward the other foot and there is an enlarged joint, is it a bunion.
  • If the big toe hurts at the joint near the back of the toenail, it is injured interphalangeal joint.

Description of the Big Toe Pain

The big toe pain is usually achy and starts as a dull feeling that grows.

Running and walking usually causes the pain to increase during the workouts as an achy feeling. In most cases, the pain decreases over several days of rest. The pain may be on the surface or on the joint, but it may also be surface pain or located near or on the bunion bump (if present).

Big Toe Pain that hurts with everyday activity and does not go away after resting from running / walking is more serious and should be evaluated by a doctor.

Gout

Less common is an intense throbbing pain that is especially noticed at night and is not directly related to workout, called Gout. This is the result of a process where production of a chemical that is normally present in the body, increases significantly. The big toe joint is a common target for this substance. The body then attacks the “crystals” of this chemical as if they were irritating foreign objects. This damages the normal tissue and causes pain, redness, and swelling. Any sore big toe can hurt at nigh and feel stiff upon awakening, but Gout pain is intense and increases at night.

Seasamoiditis

Sesamoiditis is noted by pain on the bottom of the foot at the base of the big toe, beneath the joint, that may feel like bruising – sometimes with sharper pain qualities. Sometimes the area can swell and feel thicker. If this occurs, it is a worse injury, sometimes a fracture. See a doctor.

Causes of Big Toe Pain

Excessive pronation is the primary cause for runners. This is especially true when it occurs after the heel starts to lift – a condition called “propulsion pronation” or “late mid-stance pronation.” This often occurs inside the shoe and has no visible signs. The repetitive motion of running and walking, as the distance increases, results in irritation.

High-arched feet are more likely to put extra pressure on the ball of the foot under the big toe base. This triggers impact-caused sesamoid pain, and is not related to pronation.

Those with bunions are likely to have pain because the joint no longer works correctly. The size of the bunion is not related to the quantity of pain, however.

Gout can be triggered by the same motions that produce other types of big toe pain, but high Uric Acid levels must be present. Uric Acid is elevated by many factors. Certain foods, alcohol, medications, and an inherited inability to process Uric acid are causes.

Treatment for Big Toe Pain

When to Stop Running

The common sense guidelines apply to these injuries. Swelling, redness, inability to stride normally, increasing pain, and pain with daily activity – all are reasons to rest.

Consequences of Running or Walking Through Pain

Athletes often wait too long to seek help. The pain may be intermittent and not severe, often occurring only during longer workouts. The fear of surgery may also cause a delay in diagnosis. Unfortunately this denial allows a small progression of changes to the bones and possibly permanent damage to the joint surfaces –  when they night have been treated. At this point, the only alternative may be surgery.

There is a small but real risk of permanent damage by pushing through a singly episode of pain. Sometimes the pain begins a few days before an important race. Realistically it may be worth the risk to attempt the race but be prepare to drop out if the pain becomes too strong.
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  • 16
  • Dec
Bunions and Other Toe Deformities
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Before and After Bunion Corrective Surgery

This patient has bunion to her both feet. Correction of bunion is done to her left foot.

The hallux valgus (Bunion) is the most common foot deformity. Bunions are bony protrusions on the inside of the big toe and are a common source of pain and difficulty and wearing shoes. They are commonly associated with deformities of the other toes, such as Hammer toes and Claw toes. The main underlying problem is the protrusion of the “knuckle bone” (Metatarsal bone) of the foot.

Bunion with 2nd Hammer toe deformities

These forefoot deformities can also cause painful corns under the ball of feet, or along the sides of the feet at the Bunions, and occasionally at the 5th toe (also known as Bunionette Deformity). Another common association is that of flat feet, and tight calf muscles.

Many people live with these problems by wearing broader extra width shoes or open sandals but the more severe and problematic feet often need surgery.

However, foot surgery has traditionally always been associated with long down times and this has deterred many patients from surgery. Fortunately, new techniques and concepts in surgical management have shortened down times by as much as 90%.

Techniques been using Distal Osteotomies (e.g. Mitchell or Chevron Osteotomies ) for the milder bunions. An Osteotomy is a cut made in a bone to correct deformities. These are relatively simple procedures. However, they are not able to correct the more severe deformities.

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  • 01
  • Dec
Morton’s Neuroma
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What is Morton’s neuroma, and what causes it?

Morton’s neuroma is a swollen or thickened nerve in the ball of your foot. If you frequently squeeze your toes together for too long, the nerve that runs between your toes can swell and get thicker. The swell in the foot can make you pain when you walk. High-heels, tight or narrow shoes can make the pain worse.

Morton's Neuroma

What are the symptoms?

Morton’s neuroma can cause a very painful burning or sharp pain in your foot that feels worse when you walk. It may feel like a small lump inside the ball of your foot. It is usually between the third and fourth toes, but it can also be between other toes.

How is it diagnosed?

Physical examination by the doctor can identify Morton’s neuroma. He or she will squeeze or press on the bottom of your foot or your toes together to see if it’s painful. An X-ray of the foot can also ensure that no bony problem that causes the foot pain.

How is Morton’s Neuroma treated?

Simple treatments you can try at home:

  • Take anti-inflammatories to reduce the pain and swelling.
  • Rest your feet if possible.
  • Avoid wearing tight shoes.

Seek medical attention if the above steps do not relieve your pain. In some cases, a doctor may give you an anti-inflammatory injection to reduce the swelling and pain. If the injection does not help, you may need a surgery.

 

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  • 10
  • Oct
Broken Toe
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What is the cause of a broken toe?

You may break your toe if something drop on it or you accidentally bend it. A hairline crack (stress fracture) may happen to your toe if there is a sudden increase in sports activity such as walking or running.

What are the symptoms of a broken toe?

  • A snap or pop sound heard at the time of the injury.
  • Intense pain felt when the toe is moved or touched.
  • Swelling and bruising to the toe.
  • Deformity in the toe. E.g. toe pointing in the wrong direction or twisted out of the normal position. A dislocated toe can also look deformed.
  • Any movement to the toe can cause extreme pain.

How is a broken toe diagnosed?

An X-ray is usually recommended to detect whether the toe is broken or dislocated, and if it’s broken, the severity of the crack can be seen in the X-ray.

How is a broken toe treated?

Treatment to a broken toe depends on the severity of the break, the position of the break and which toe. Usually buddy splint is recommended, that is buddy-taped to your uninjured toe next to it. Your injured toe may need to buddy-taped for 2 to 4 weeks for the bone to heal.

In not so common cases, treatments include:

  • Using splints to stabilise the toe.
  • Surgery, if the break is severe.

If you leave the toe untreated, the fracture may cause chronic pain, limited movement and deformity.
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