Common podiatric conditions and injuries include:
- Ingrown Toenails
- Verrucae Pedis
- Plantar Fasciitis
- Severs Disease
- Cuboid Syndrome
- Achilles Tendonitis
Ingrown Toenails: This is a common condition usually found in male adolescents and people who wear tight fitting shoes. An ingrown nail is where the nail edge pierces the skin fold and causes an inflammatory reaction. When swelling and infection sets in the skin enlarges and causes more pressure on the nail edge making further laceration more likely. Poor nail cutting and sweaty foot types tend to induce this condition which is commonly found on the big toe (hallux). Sometimes it is the sharply curved shape of the nail itself that causes the problem. Often a small portion of the offending nail can be removed painlessly and the problem solved quickly. However a minor surgical procedure is also available for this issue.
Verrucae Pedis: Plantar warts, also known as verrucas, appear most commonly on the sole of the foot. They can occur as a single verruca, or surface as clusters (mosaic). They are normally raised and circular, and the skin is harder and flatter than the healthy area surrounding them. Their centers are dotted with black pinpoints (peppered appearance). Verrucae are caused by the human papilloma virus. This virus is commonly found on skin, but cannot do damage unless it penetrates the skin through cuts and cracks. It can be contracted by walking barefoot where the virus is present. There is no set time a verruca will occur for. They can spontaneously disappear then reappear in the same spot and they can be confused with callus and corns as they look similar. If you are not sure, see one of our podiatrists. We offer a range of treatments including salicylic acid, silver nitrate and freezing (cryotherapy). These treatments may need multiple follow ups, usually taking around 15 minutes.
Plantar Fasciitis: The plantar fascia is a band of fibrous tissue that covers the sole of the foot and aids in propulsion. The cause of this condition varies and includes poor footwear while exercising, an excessively pronated foot type, and overuse. Gold standard treatment for this condition is to tape the foot to shorten the fascial band which allows healing. A soft Cushion Footbionic Orthotic is also beneficial, as is wearing shoes with a slight heel on them; all these treatment modalities take pressure away from the injury site and are important to the long term management of this condition.
Callus: A callus is an irritated area of skin which has become thick and hard in response to repeated friction and pressure. It is actually an accumulated of dead skin cells and is the body’s natural response to a combination of friction and pressure. Calluses are most often found on feet because of frequent pressures. Generally calluses are not harmful however can progress and create other problems, such as corns, ulcerations or infections. Simple debridement can eliminate a callus usually completely painlessly. A biomechanical approach of reducing or eliminating pressure is used to prevent recurrence of callus formation. This may vary from shoe advice or modification to simple cushioning or weight redistribution.
Sever’s Disease: This is a very common condition affecting children aged between 9-13 years. It is seen more commonly in boys – particularly active ones! Sever’s Disease is a growth plate irritation that occurs in the heel bone (calcaneus). The heel bone is not yet fused together at this age and thus the growth plate can easily become inflamed. Stresses such as increased activity, hard grounds and low profile footwear can exacerbate this very easily. Discomfort is usually related to activity in that the more activity the child participates in the more pain is created. Often these children can limp while they are playing sport however they recover quickly. Thus the day following significant pain and limping there can often be no sign of discomfort. Severs also seems to coincide with a reasonable growth spurt. Treatment focuses upon reducing loading on the heel and Achilles via elevating and supporting the heel with the use of cushioning, taping, calf stretching and activity modification.
Sesamoiditis: The two main sesamoids (bones embedded in a tendon and assist in tendon glide and movement such as the patella in the knee) of the foot are located under the base of the big toe (hallux). The bones serve to enhance the lever action of the foot in walking and are subjected to significant load. Injury to these bones through trauma, poor footwear and systemic conditions also affects the surrounding tendons and ligaments. Treatment includes in-shoe cushioning, taping the area to temporarily limit movement, and healing the inflammation through rest and ice.
Neuroma: A neuroma is an enlargement of a nerve that runs into the forefoot. This usually occurs in between your 3rd and 4th toes (Morton’s Neuroma). The nerve becomes thickened or enlarged as a result of compression and irritation. Thickening is due to fibrofatty tissue being laid down in the inflamed area. Both the thickening and irritation can cause nerve damage with symptoms such as burning, radiating pain or numbness / pins and needles into the affected toes. Pain is often worse in the morning and patients frequently want to remove their footwear and massage their foot. Footwear is often a contributing factor with tight or high heeled shoes exacerbating the problem. Treatment involves reducing compressive forces by redistributive padding, footwear modification or cortisone injection. Sometimes surgery is required.
Cuboid Syndrome: This condition causes pain and weakness on the outside of the foot at the joint between the heel bone (calcaneus) and the cuboid. The pain and subsequent inflammation can affect the tendons on the outside of the ankle and limit the patient’s ability to move smoothly through the gait cycle. Treatment can involve joint manipulation, taping and short term exercise modification.
Achilles Tendonitis: The Achilles tendon originates from the calf muscles (gastrocnemius, soleus and plantaris) and inserts into the back of the heel bone (calcaneus). This tendon can take up to seven times your body weight when running and is vital in your everyday gait cycle. Due to the constant pressure on the Achilles structure, pain associated with inflammation, degeneration and rupture is common and requires specific care. Treatment focuses on reducing load on the Achilles with the use of taping, in-shoe devices and a programme of rest, stretching and strength work.
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