Common Foot Problems

Common Foot Problems
A Project by

Your Foot
• The feet are flexible structures of bones, joints,
muscles, and soft tissues that let us stand
upright and perform activities like walking,
running, and jumping.
 The foot contains
 26 bones
 33 joints
 19 muscles
 107 ligaments.

• The feet are divided into three sections
1. Forefoot
2. Midfoot
3. Hindfoot

 Forefoot
 Contains the five toes (phalanges) and the five longer
bones (metatarsals).
 Midfoot
 Pyramid-like collection of bones that form the arches of
the feet.
 Include the three cuneiform bones, the cuboid bone, and
the navicular bone.
 Hindfoot
 Forms the heel and ankle.
 The talus bone supports the leg bones (tibia and fibula),
forming the ankle.
 The calcaneus (heel bone) is the largest bone in the foot.

Foot arches
 Foot has three distinct arches.
 Two "longitudinal" arches (one on each side)
run from front to back
 One "transverse arch"
runs across the midfoot from inside to outside.

Functions of foot arches
 The structure of an arch is the spread the load
out so it can be supported with the least amount
of effort and material.
 Some shock absorbency,
 Prevents blood vessels and nerves from being
crushed.

Functions of the foot
 Proper functioning of the foot is required for
normal gait

 Weight Distribution
Weight of the body is supported by the foot, and is
transmitted and distributed over 6 areas
Functions of the foot

Common foot complaints
 Hammertoes
 Heel pain
 Bunions
 Athlete’s foot
 Warts
 Ingrowing nails

Bunions
• Common bunion is a localized area of
enlargement of the inner portion of the joint at
the base of the big toe.(abnormal bony bump)
• Big toe pushes up against other toes, forcing big
toe joint in the opposite direction
• Causes the big toe to move outward ( hallux
valgus deformity)

• Most commonly affect women.
• Bunions may or may not cause symptoms.
• A less common bunion is located at the joint at
the base of the smallest (fifth) toe.
Bunions

Bunions… Symptoms and Signs
• Foot pain in the involved area when walking or
wearing shoes. That is relieved by resting.
• Bulging bump on the outside of the base of big
toe
• Swelling, redness or soreness around big toe
joint
• Thickening of the skin at the base of big toe
• Restricted movement of big toe
• Positioning of the big toe toward the smaller
toes.

Bunions… Causes
• High-heeled or ill-fitting shoes
• Inherited foot type
• Foot injuries
• Deformities present at birth (congenital)
• May be associated with various forms of arthritis
and an activities that puts extra stress on the
feet (eg. Bunions are common in ballet
dancers.)

Bunions….Complications
• Bunions are permanent unless surgically
corrected, they are a structural deformity.
• If the cushioning sac of fluid (bursa) over the
affected joint becomes inflamed (bursitis), a
bunion can be very painful and interfere with the
normal activities.
• May get larger and more painful, making
nonsurgical treatment less effective.

Bunions…Treatments
Conservative treatment
Nonsurgical treatments that may relieve the pain
and pressure of a bunion include:
• Changing shoes. Wear roomy, comfortable shoes
that provide plenty of space for toes.
• Padding and taping. tape and pad your foot in a
normal position to reduce stress on the bunion and
alleviate the pain.
• Medications. Anti-inflammation medications/ local
injection of steroids to ease inflammation as well as
pain

Bunions… Conservative treatment

• Orthotic Inserts
Goal of orthotics:
 To reestablish the weight bearing parabola across all the
metatarsals
 Orthotics re-align the foot with the leg for more efficient
function. In essence, the foot does not have to work as
hard to accomplish the same movements.
 For mild to moderate bunions that do not hurt on a daily
basis, orthotic therapy can be very effective.
• Others….
 Simply resting the foot by avoiding excessive walking
 Stretching exercises to reduce tension on the inner part of
the joint

Severe Cases with persisting pain a surgical
operation is considered for removal of the
bunion.

 Bunion surgery is the ultimate correction of the
structural deformity. (That does not necessarily
mean that it is the best solution for every bunion)
 Surgical operation to remove a bunion is referred to
as a “Bunionectomy”.
 Surgery involves breaking the metatarsal bone and
moving it towards the second toe while relocating
the big toe straight on the bone.
 Some form of fixation is used to hold the metatarsal
in place (pin, screw, etc)

Shoes
Wearing comfortable shoes that fit well can
prevent many foot problems.

What qualities make up a well-constructed
shoe?
• Lightweight walking shoe
• With breathable upper materials, such as leather
or nylon mesh.
• Very firm heel counter, the heel should have
reduced cushioning to position the heel closer to
the ground for walking stability.
• The front or forefoot area of the shoe should
have adequate support and flexibility.

Shoes…. Tips for choosing right shoes
for you
• The size of your feet changes as you grow older so
always have your feet measured before buying
shoes.
• Most of us have one foot that is larger than the
other, so fit your shoe to your larger foot.
• Don't select shoes by the size marked inside the
shoe but by how the shoe fits your foot.
• Select a shoe that is shaped like your foot.

• Make sure there is enough space (3/8" to 1/2") for
your longest toe at the end of each shoe when you
are standing up.
• Make sure the ball of your foot fits comfortably into
the widest part of the shoe.
• Don't buy shoes that feel too tight and expect them
to stretch to fit.
• Your heel should fit comfortably in the shoe with a
minimum amount of slipping
• Walk in the shoes to make sure they fit and feel
right.
Shoes…. Tips for choosing right shoes

Hammertoes
 A hammer toe or contracted toe is a deformity
of the proximal interphalangeal joint of the
second, third, or fourth toe causing it to be
permanently bent, resembling a hammer.

Hammertoes.... Causes
 Wearing poorly fitting shoes that can force the
toe into a bent position (eg. High heels)
 Muscle, nerve, or joint damage resulting from
conditions such as osteoarthritis, rheumatoid
arthritis, stroke or diabetes
 Often found in conjunction with bunions or other
foot problems

Hammertoes....Symptomes/Signs
 Pain with walking
 Difficulty moving the toe
 Corns and calluses resulting from the toe
rubbing against the inside of footwear

Hammertoes....Treatment
 Conservative treatment
 Physical therapy
 New shoes with soft, spacious toe box
 Wear shoe inserts (orthotics) or pads to reposition
the toe and relieve pressure and pain.
 Surgical treatment
If the toe has become tight and inflexible

Hammertoes… Conservative Treatment

Hammertoes… Surgical Treatment

Heel pain
“pain usually occurs underneath your heel
(plantar fasciitis) or just behind it”

Heel pain….Causes
 Achilles tendinitis
 Achilles tendon rupture
 Bone bruise
 Bone cyst
 Bone spurs
 Bursitis
 Fracture
 Gout
 Heel pad wear and tear
 Neuroma
• Osteomyelitis
• Peripheral neuropathy
• Pinched nerve
• Plantar fasciitis
• Problems with your gait
• Rheumatoid arthritis
• Stress fractures
• Tarsal tunnel syndrome
• Tendinitis

Heel pain... Treatment
 Treatment of heel pain depends entirely on the
cause of the problem.
 Therefore, it is of utmost importance that you
understand the cause of your symptoms before
embarking on a treatment program.
 Some general measures
 Rest
 Apply Ice Packs
 Exercises and Stretches
 Anti-Inflammatory Medications
 Shoe Inserts-Orthotics

Heel pain... Treatment
Orthotic Inserts

Neuroma
“Neuroma is a growth or tumour of nerve
tissue”.

Morton's Neuroma
• Morton's neuroma is a painful condition that
affects the ball of your foot, most commonly the
area between your third and fourth toes.
• Involves a thickening of the tissue around one
of the nerves leading to your toes.
• May occur in response to irritation, injury or
pressure.

• A feeling as if you're standing on a pebble in your
shoe
• A burning pain in the ball of your foot that may
radiate into your toes
• Tingling or numbness in your toes
Morton's Neuroma…. Symptoms

• Non Surgical Treatment
 Arch supports and foot pads fit inside your shoe and
help reduce pressure on the nerve
 An “Arch Cookie” pad can help to spread the
metatarsals and give the nerve more space
 Injection of steroids into the painful area
 Injections of medications to desensitize the nerve
Morton's Neuroma…. Treatments

• Surgical Treatment
 Cryogenic neuroablation
• This minimally invasive procedure
• Exposes the nerve to very cold temperatures
• It interferes the transmission of pain signals
• Results are not permanent.
 Decompression surgery.
• In some cases, surgeons can relieve the pressure on the
nerve by cutting nearby structures

 Removal of the nerve
• Surgical removal of the growth may be necessary if
other treatments fail to provide pain relief.
• As a last resort, because the procedure removes both
the neuroma and the nerve, which can leave
permanent numbness in the affected toes.

Athlete’s foot
• Very common skin condition that affects the sole
of the foot and the skin between the toes.
• Usually a scaly, red, itchy eruption( occasionally
may be weepy and oozing.)
• Athlete's foot, also called tinea pedis, is the
most common type of fungal infection.

Athlete’s foot
 Athlete's foot is contagious and can be spread
by contact with an infected person or with
contact with contaminated surfaces, such as
towels, floors and shoes.

• a man ?
• Frequently wear damp socks or tight fitting
shoes
• Share mats, rugs, bed linens, clothes or shoes
with someone who has a fungal infection
• Walk barefoot in public areas where the
infection can spread, such as locker rooms,
saunas, swimming pools, communal baths and
showers
• Have a weakened immune system
Athlete’s foot... Risk factors

Athlete’s foot.... Causes
 Caused by a fungus (group of mold-like fungi
called dermatophytes ).
 Can be contracted in many locations, including
gyms, locker rooms, swimming pools, nail
salons, airport security lines, and from
contaminated socks and clothing
 Athlete's foot is closely related to other fungal
infections, including ringworm and jock itch-
change the towel when drying off!

Athlete’s foot... Symptoms
 Itching, stinging and burning
 Cracked and peeling skin
between your toes
on the soles of the feet
 Excessive dryness of the skin on the bottoms or
sides of the feet
 Toenails that are thick, crumbly, ragged,
discolored or pulling away from the nail bed

Athlete’s foot… Treatment
• Make the infected area less suitable for the
athlete's foot fungus to grow
 Keeping the area clean and dry.
 Absorbent socks like cotton that wick water away
• Antifungal creams and washes
 Tea tree oil
 Lamisil cream
 Ertazco

Plantar Warts
• Warts are local growths in the skin that are
caused by Human Papilloma Virus (HPV)
infection
• Plantar warts are noncancerous skin growths on
the soles of your feet
• Virus enters the body through tiny cuts or breaks

• Often develop beneath pressure points in the
feet, such as the heels or balls of the feet
• Pressure also may cause a plantar wart to grow
inward beneath a hard, thick layer of skin
(callus).
Plantar Warts

Plantar Warts…..Signs & Symptoms
• Small, fleshy, grainy lesions, or growths on feet
• Hard, thickened skin (callus) where a wart has
grown inwards
• Black pinpoints- "wart seeds" ( actually small,
clotted blood vessels)
• Lesions that interrupt the normal lines and
ridges in the skin of your feet
• Pain or tenderness when walking or standing

Plantar Warts….. Complications
• Plantar warts cause pain
• May alter your normal posture or gait — perhaps
without realizing the change
• Contagious

Plantar Warts…..Treatments
• Plantar warts may resolve on their own without
treatment within a couple of years.
• If they are causing pain or spreading, they
should be treated.
 Freezing (cryotherapy)
 Cantharidin.
 Minor surgery
 Laser treatment- can leave scarring

In Growing Toenails
(Onychocryptosis)
• Common condition in which the corner or side of
one of your toenails grows into the soft flesh of
that toe.
• Usually affects your big toe.
• Result is pain, redness, swelling and,
sometimes, an infection.

• Wearing shoes that crowd your toenails
• Cutting your toenails too short or not straight
across
• Injury to your toenail
• Unusually curved toenails
In Growing Toenails…Causes

• Pain and tenderness in your toe along one or
both sides of the nail
• Redness around your toenail
• Swelling of your toe around the nail
• Infection of the tissue around your toenail
In Growing Toenails… Symptomes /Signs

• Bacteria and fungi can easily infect the skin of the
feet and nails. (Staphylococcus,Pseudomonas,
Candida and Trichophyton)
• May cause deeper bacterial tissue infection
(Cellulitis), localized infection of the nail fold
(Paronychia), and scarringg of the nail fold and skin.
In Growing Toenails… Complications

Often mild cases be treated through lifestyle
 Applying an antibiotic cream
 Soaking the foot regularly in Epson Salt warm water
Medical interventions
 Lifting the nail
 Partially removing the nail/Removing nail and tissue
In Growing Toenails… Treatment

• Wear shoes that fit properly.
 Shoes that you wear every day should have
plenty of room around your toes.
 But not be too loose.
• When trimming your toenails:
 Considering briefly soaking your foot in warm
water to soften the nail
 Use a clean, sharp nail trimmer
In Growing Toenails… Prevention

• When trimming your toenails:
 Trim toenails straight across the top. Do not taper
or round the corners or trim too short
 Do not pick or tear at the nails
 Keep the feet clean and dry
In growing Toenails… Prevention

Thank You
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Common Foot Problems

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