Syndromes of pain in the plantar fascia have been called plantar fasciitis; however, because there is usually no inflammation, plantar fasciosis is more correct. The plantar fascia is the thick connective tissue which supports the arch of the foot. Normally this syndrome presents with an insidious pain . As tearing in the fibres of the fascia continue the pain becomes more aggressive and can render the patient unable to weight bear.
Consistent with pain first thing in the morning that becomes better with activity, this syndrome if often misdiagnosed. The Podiatrist will use their extensive knowledge of foot anatomy to diagnose and treat it. There are many conservative and surgical management options. The podiatrist will need to assess your condition as acute or chronic before providing best management for you.
Flat feet is a generic term used by the public to describe the overpronation at the arch in gait. Loading to the inside border of your feet predisposes your feet to overuse injuries as the muscles between the foot and ankle cannot pivot around the correct axis point. Flat feet generally become problematic in active people or those who spend great lengths of time on their feet. Not everyone with Flat feet will have associate foot pain. If you are concerned whether your flat feet are responsible for foot, ankle, knee or back pain the podiatrist can do a full biomechanical assessment on you to determine their involvement.
Posterior Tibial Dysfunction occurs when the tendon of the Posterior Tibial muscle becomes inflamed and in some cases torn. It radiates pain and swelling down the inside border of the foot and ankle. People with Posterior Tibial dysfunction will notice their foot has become characteristically “flat” as the tendon can no longer support the arch of the foot.
Generally due to overuse of heavy loading sports such as running, tennis, basketball, netball etc. the Posterior Tibial muscle becomes inflamed with increased activity.
Your podiatrist will characterize the condition as acute or chronic and follow appropriate imaging and treatment recommendations upon diagnosis.
Retrocalcaneal spurring involves a bony spur developing on the back of the calcaneus ( heel bone). Often it presents secondary to achilles tendinopathy and involves the insertion of the achilles tendon at the heel bone. This is different to a haglund deformity which is a bony spur at the back of the heel bone that does not involve the achilles tendon. The podiatrist will use imaging to diagnose the condition and recommend either conservative or surgical management based upon findings.
Retrocalcaneal Bursitis occurs when the bursa sac located between the achilles tendon and the calcaneus (heel bone) becomes inflamed. Often the patient will notice an inflamed red lump at the back of their heel and associate tightness through the achilles tendon and calf muscles. Depending upon position, inflammation and cause of the bursitis conservative and surgical managements exist.
Your podiatrist may use imaging in diagnosis of this condition.
The ligaments of the ankle are grouped into two categories:
|Medial Collateral / Deltoid Ligament||Lateral Collateral Ligament|
|Anterior Talotibial ligament||Talofibular ligament|
|Posterior Talotibial ligament||Calcaneofibular ligament|
|Calcaneotibial ligament||Talocalcaneal ligament|
|Tibionavicular ligament||Posterior Talocalcaneal ligament|
|Posterior Talofibular ligament|
Ligament tears of the ankle are generally as a result of a ankle sprain or trauma to the ankle. Inversion sprains are most common and affect the lateral collateral ligaments. The podiatrist will assess your ankle and may require imaging to diagnose a partial or full tear in ligament. Often swelling and point tenderness will be evident on ligament tear, and some instability on weight bearing is common. Often the podiatrist can implement orthotics to prevent re-occurrence of ankle sprains once the tear has healed.
Tarsal tunnel syndrome is a condition that is caused by compression of the posterior tibial nerve as it passes underneath the flexor retinaculum at the level of the ankle. Often patients complain of a burning sensation and pain in the heel. The pain radiates sharply and can cause tingling to the toes. Tarsal Tunnel can be very difficult to diagnose and may require MRI or ultrasound to differentiate diagnosis. The podiatrist will assess you for ‘Tinels sign’ and look at other possible causes. The degree of pain will direct the podiatrist to conservative or surgical management.
Sinus Tarsi Syndrome is a lateral foot pain which normally present after an inversion ankle sprain. It can also be caused through overpronation of the foot impinging upon the soft tissues within the sinus. The patient will feel instability and pain upon weight bearing specific to the sinus tarsi area. The podiatrist may require imaging of MRI to diagnose the condition. Both conservative and surgical management may be indicated for the treatment of sinus tarsi. The podiatrist will assess the level of injury and provide appropriate management solutions.
Fractures are broken bones. They are extremely common in the foot and ankle due to sport related injuries and trauma. There are 33 bones in the foot and they can occur within any of them in the form of a stress fracture within the bone or a bone break.
- The fibula is the smaller leg bone located to the outside border of your leg and often more susceptible to fracture than it bigger brother the tibia. Treatment of a fracture here would depend upon the how and where the injury occurs along the bone. Often patient will be plaster cast or be asked to wear a Cam walker boot for a period of time.
- Heel Bone fractures occur in the calcaneus. They are extremely painful and will render the patient unable to bear weight. Often due to jumping or falling from great height onto your foot. It is extremely important they are treated corrected and may require surgery.
- Fractures of talus often require surgery. This is an extremely important bone that form the ankle joint pivot point. Often an injury to the talus will result in secondary arthritis throughout the ankle joint later in life.
- Navicular stress fracture occurs within the middle of the foot’s inside border. Generally associated with athletics and overuse. The stress fracture pain will begin as a mild vague pain that gets worse with time and activity. A bone scan or MRI is usually required to diagnose a stress fracture. A period of non weight-bearing in cast or a cam walker is necessary to treat this injury
- Fracture within the Lisfranc complex includes multiple bones of the midfoot and dislocation of the joints. It is a fracture common to skier and car accident bracing impact injury. This fracture may require surgery, but again depends on the degree of injury which your podiatrist will assess with imaging.
- A Jones Fracture is a common fracture of the bases of the 5th metatarsal. It occurs when a person rolls their ankle to the outside. Patient who sustain this injury will have intense swelling and find it difficult to bear weight on their foot. They will require casting or a cam walker for a non weight bearing period of time.
- Metatarsal stress fractures along the shaft of the foot bones generally occur in patients who increase their activity rapidly. The podiatrist will require a bone scan or MRI to diagnose the stress fracture. You will be required to be non weight bearing.