Foot Conditions

The information provided on this page is of a general nature only, and should not be used as a guide to treatment, or replace the advice of a qualified health professional

Posterior (Back of) Heel Pain

The Achilles Tendon attaches to the back of the heel bone.  It is the largest tendon in the body & attaches the 2 muscles of your calf (the Gastrocnemius & Soleus) to your heel bone.  Pain at the back of the heel usually involves this tendon to some degree.  The pain may be from inflammation of the tendon, some wearing of the tendon, a strain or tear of the tendon or inflammation of the structures around the tendon such as the tendon sheath or the fluid filled sac that sits between the tendon and the bone, known as a bursa.

There are many causes of posterior heel pain including weight gain, tight muscles, increasing activity levels, poor footwear, increased age & poor foot mechanics.  It is important to have your heel pain thoroughly assessed to determine the correct diagnosis.  This may require an x-ray &/or an ultrasound to be taken to get a better understanding of the structures involved.

Treatment of posterior heel pain may include rest, anti-inflammatory techniques, dry needling techniques, therapeutic laser & ultrasound, strapping techniques, stretching & strengthening techniques, improved footwear, heel lift use & functional orthotics.

Plantar (Bottom of) Heel Pain - Often diagnosed as Plantar Fasciitis

Pain at the bottom of the heel is a common problem seen by the podiatrists at Step Ahead Podiatry.  Plantar heel pain could be one of many conditions but is often referred to as plantar fasciitis.

Plantar fasciitis is an inflammation of the thick ligament type structure that runs along the bottom of your foot from the heel to the ball of the foot.  Symptoms will often include pain on first rising in the morning which subsides after a few steps.  The pain will then settle for a period of time but will return if you are on your feet for prolonged periods.  Often the pain will subside whilst sitting or resting but as soon as you put weight on the foot again it will be incredibly painful straightaway.  If not treated promptly plantar fasciitis can become a chronic condition where the plantar fascia actually begins to breakdown & may completely rupture.

Other causes of plantar heel pain may include strain & inflammation in the muscles of the foot that attach to the heel, irritation or damage to the fat pad underneath the heel, irritation or inflammation of the nerve that runs to the heel, bone conditions such as bruising, fracture or in rare cases osteoma.

There are many causes of plantar heel pain including weight gain, traumatic injury, increasing activity levels, poor footwear, increased age & poor foot mechanics.  It is important to have your heel pain thoroughly assessed to determine the correct diagnosis.  This may require an x-ray &/or an ultrasound to be taken to get a better understanding of the structures involved.

Treatment of posterior heel pain may include rest, anti-inflammatory techniques, dry needling techniques, therapeutic laser & ultrasound, strapping techniques, stretching & strengthening techniques, improved footwear  & functional orthotics.

 
Dorsal (Top of) Foot pain

Pain at the top of the foot is often known as dorsal impingement syndrome. This is when the joints of the foot become irritated due to poor foot mechanics.  If not treated dorsal impingement can become chronic & lead to arthritic changes in the joints. Pain may also come from stress fracture, ligament injury, irritation or injury of the tendons that run on the top of the foot or from irritation of the nerves of the foot.

There are many causes of dorsal foot pain including traumatic injury, weight gain, increasing activity levels, poor footwear, increased age & poor foot mechanics.  It is important to have your foot pain thoroughly assessed to determine the correct diagnosis.  This may require an x-ray &/or an ultrasound to be taken to get a better understanding of the structures involved.

Treatment of dorsal foot pain may include rest, anti-inflammatory techniques, foot joint mobilisation techniques, range of motion exercises, therapeutic laser & ultrasound, strapping techniques, improved footwear & functional orthotics.

 
Forefoot (Ball of the foot) Pain

There are many structures in the ball of the foot including bones, ligaments, tendons, nerves & bursae (fluid filled sacks).  Any of these structures can be injured or irritated & cause ball of the foot pain.

The most common forefoot pain is often referred to as Morton’s Neuroma. This pain comes from irritation of a nerve in the foot where it sits between 2 of the heads of the long bones of the foot.  Pain from Morton’s Neuroma can be burning, sharp, dull, aching, knife like etc & is often referred to as feeling like having a hot pebble in the foot.

Other forefoot pain can be a result of strain of ligaments, strain/irritation of tendons, bone pain such as bruising, stress fractures, fracture or on rare occasions sarcoma, fat pad irritation, inflammation of bursae, joint irritation and arthritis.

There are many causes of forefoot pain including injury, weight gain, increasing activity levels, poor footwear, increased age & poor foot mechanics.  It is important to have your forefoot pain thoroughly assessed to determine the correct diagnosis.  This may require an x-ray &/or an ultrasound to be taken to get a better understanding of the structures involved.

Treatment of forefoot pain may include rest, anti-inflammatory techniques, foot joint mobilisation techniques, acupuncture & dry needling techniques, in shoe padding, range of motion exercises, therapeutic laser & ultrasound, strapping techniques, improved footwear & functional orthotics.

Bunions

A bunion is a condition that affects the big toe joint at the ball of the foot.  A change in alignment of the big toe leads to a progressive arthritic change in the joint with the development of a bony lump on the side of the joint.  Bunions may be painless but can be incredibly painful & can affect the way you walk.  Bunions also make it very hard to find shoes that fit.

It is thought that bunion development usually has an element of hereditary factors in its causes, meaning it runs in the family.  But other factors such as footwear choices & poor foot mechanics can have an influence of bunion formation.

Treatment of bunions may include improved footwear & footwear adjustment, foot strengthening exercises, dry needling techniques, use of custom made functional orthotics, joint mobilisation, night splinting & strapping techniques. However in some cases surgery is required to correct the bone alignment.

 
Toe Pain

The most common toe pain comes from ingrowing toenails or from corn development on the toes.  Once you have had one of these conditions you realise how important your toes can be.

Ingrowing toenails are often caused by poor toenail cutting techniques, picking toenails, poorly fitted footwear or through trauma.  A toenail becomes ingrown when a small spike of nail pierces the skin & cuts into the flesh of the toe like a knife. This makes wearing shoes very painful & may lead to altered walking patterns. If not treated correctly the area can become infected & require anti-biotics.  Treatment requires the correct removal of the offending spike of nail, use of appropriate antiseptic techniques such as salt water baths & use of antiseptic solutions & footwear adjustment. In some cases minor nail surgery procedures are required to permanently remove the side of the toenail.  If not treated properly & early enough then more dramatic surgical involvement can be required

Painful corns are areas of hard skin that develop at first to protect an area of the toe or foot from pressure & friction.  If the pressure &/or friction continue then the hard skin itself becomes painful.  Corns can be caused by toe deformities such as hammer or claw toes, poorly fitted footwear & poor foot mechanics. Corns can develop anywhere on the foot not just the toes.  Treatment of corns may include regular debridement (cutting away with a scalpel), inshoe padding, footwear adjustment, use of customised insoles, laser techniques, plugging using medical grade silicone or where appropriate use of gentle acids.  It is important to seek professional assistance with the treatment of corns as injury to the area (from self treatment) may in fact make them worse.

Leg, Knee & Hip Pain

Leg, knee & hip pain may all have an element of foot related causes.  Rolling in too much (excessive pronation) or not enough (excessive supination) can lead to changes in the forces that run up the leg.  This can lead to muscle strain in the leg or thigh, overloading of tendons leading to tendonitis & miss-position of the knee & hip which can lead to pain, swelling & if not treated correctly arthritic changes.

Thorough gait assessment (assessment of your walking pattern) can indicate where your foot might be contributing to pain anywhere along your leg.  Treatment can include use of customised functional orthotics, improved footwear, dry needling techniques, laser techniques, mobilisation & manipulation techniques, stretching & strengthening techniques.

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