General Foot Facts

Foot and ankle problems usually fall into the following categories:

• Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
• Arthritic foot problems, which typically involve one or more joint.
• Congenital foot problems, which occur at birth, are generally inherited.
• Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
• Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
• Traumatic foot problems, which are associated with foot and ankle injuries.

The top foot problems are:

• Bunions - misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem. New techniques have made surgery 90% or more successful and almost painless. Of course how YOU take care of the surgery site when you are home makes a big different in the result. Follow your podiatrist''s instructions. Ask questions if you are unsure about something. Dr. Young is always available to you.
• Hammertoe - a condition, usually stemming from muscle imbalance, in which the toe is bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Selecting shoes and socks that do not cramp the toes will alleviate aggravation.
• Heel spurs - Inflammation and thickening of the plantar fascia can be eliminated by many treatments available in our office. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced. When heel pain has lasted several months, shockwave treatment or minimal incision surgery to release the fascia are necessary. See the article on heel pain for more information. Actual spurs are no longer removed. When surgery is needed, the plantar fascia is released but the spur is left alone. You can''t treat xrays!
• Ingrown nails - toenails whose corners or sides dig painfully into the skin. Ingrown toenails are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity and poor foot structure. Ingrown nails can be prevented by trimming toenails straight across, selecting proper shoe style and size - not too tapered or shallow - and paying special attention to foot pain. Infections can occur without visual signs at first.
• Neuromas - enlarged nerves, most commonly between the third and fourth toes. They are caused by compression of the nerve against a ligament between the joints. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Treatments include metarsal pads, shoe inserts and/or cortisone injections. Diagnostic ultrasound can see the size of the neuroma. Dr. Young can decompress the nerve with a ten minute procedure that gives relief and allows the nerve to remain. Surgery to remove the neuroma is rarely necessary any longer.
• Plantar fasciitis (heel pain) - usually caused by an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain. there are many treatments that can help both new plantar heel pain and chronic long standing plantar fasciitis.
• Sesamoiditis - inflammation or fracture of the two small bones (sesamoids) under the first metatarsal joint. Proper shoe selection and orthotics help. Accomodation or taking the pressure off the joint to allow healing is usually sucessful.
• Shin splints - pain to either side of the leg bone, caused by muscle or tendon inflammation. It is commonly related to excessive foot pronation (collapsing arch), but may be related to a muscle imbalance between opposing muscle groups in the leg. Proper stretching and corrective orthoses (shoe inserts) for pronation can help prevent shin splints.
• Stress fractures -incomplete cracks in bone caused by overuse. With complete rest, stress fractures heal quickly. Extra padding in shoes helps prevent the condition. Stress fractures left untreated may become complete fractures, which require casting and sometimes surgery. It best if you can prevent the stress fracture from becoming complete and unstable. Sometimes a bone stimulator worn at home is prescribed to speed healing.