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Conditions you may be experiencing:
The plantar fascia is a thin, web-like, ligament that connects the heel to the front of the foot. It acts as a kind of shock absorber, supporting the arch of the foot and aiding in walking and running. When the plantar fascia experiences too much stress or strain it can become irritated or damaged. The resulting inflammation of the plantar fascia is known as plantar fasciitis, and it is one of the most common causes of foot pain in active patients. If left untreated plantar fasciitis has the potential to become a chronic condition, ultimately impacting the patient’s normal level of activity.
Causes of Plantar Fasciitis
It is estimated that the plantar fascia carries as much as 14% of the total load of the foot. That stress can often lead to irritation or damage of the ligament. Active adults between the ages of 40 and 70 are at greatest risk for developing plantar fasciitis, and the condition is somewhat more common in women than in men.
While plantar fasciitis often presents with no specific primary cause, there are several factors that can put patients at greater risk for developing the condition.
- Obesity: carrying excess weight places increased pressure on the plantar fascia ligament, making it more prone to irritation or damage.
- Repetitive impact activities: long distance runners, and even casual joggers, are at a greater risk of developing plantar fasciitis. Workers whose jobs require long periods of standing or walking (restaurant workers, factory employees, etc.) are also at a greater risk.
- Pre-existing foot problems: patients with high arches or flat feet may be more prone to suffer from plantar fasciitis.
- Improper footwear: wearing shoes with overly soft soles or poor arch support can lead to plantar fasciitis.
Symptoms of Plantar Fasciitis
- Pain at the bottom of the heel sometimes extending into the arch
- Pain while taking the first steps of the morning, or after sitting
- Pain diminishes after warming up
- May feel like a nail driving up from the bottom of the heel
Stress Fractures of the Foot (Small Crack in the Foot Bone)
A stress fracture is a small crack in a bone. Stress fractures most commonly occur in the weight-bearing bones of the lower legs and feet. They are most often the result of overuse, or a sudden change or increase in physical activity. Stress fractures of the foot are a common injury among athletes who participate in running and jumping intensive sports such as track and field, basketball, tennis and gymnastics. However, stress fractures can also occur in the bones of non-athletes, particularly as the result of a sudden change in exercise routines or other physical activities. People suffering from osteoporosis, or other bone weakening diseases, are at a significantly greater risk and may suffer a stress fracture as the result of ordinary every day activities.
Stress fractures most often occur in the second and third metatarsals of the foot. This is the greatest area of impact when walking, running or jumping. Stress fractures of the foot can also occur in the calcaneus (heel), the navicular (a small bone at the top of the middle of the foot), and the talus (the large bone in the ankle that connects with the tibia, calcaneus, and navicular bones of the foot).
Causes of Stress Fractures of the Foot
Stress fractures are classified as overuse injuries. In most cases they are the result of a change in the manner, frequency, or duration of physical activities. While stress fractures of the foot are mostly associated with athletes, they are not uncommon in non-athletes and can happen to anyone with an active lifestyle.
The following contributing factors can place patients at a greater risk for stress fractures of the foot:
- Improper equipment: the wearing of worn or improper footwear while exercising can increase the likelihood of stress fractures to the foot and ankle.
- Poor conditioning: failing to warm up properly before an exercise routine can place undue stress on the weight-bearing bones of the lower leg and foot, increasing the risk of stress fractures. Starting a rigorous exercise regime before the body has become accustomed to the stress and strain can increase the likelihood of stress fractures.
- Bone insufficiency: chronic conditions that decrease bone strength and density, such as osteoporosis, greatly increase the risk of stress fractures. Patients suffering from decreased bone density may experience stress fractures as the result of common daily activities.
Symptoms of Stress Fractures of the Foot
The most common symptoms associated with a stress fracture of the foot include the following:
- Pain develops gradually, increases with weight-bearing activity, diminishes with rest
- Pain becomes more severe and occurs during normal daily activities
- Swelling on top of foot
- Tenderness to touch at site of fracture
- Possible bruising
Arthritis of the Foot (Joint Pain and Inflammation)
The foot and ankle are made up of 26 bones and 33 joints. The ends of the joints are covered with a thin layer of articular cartilage, a slick substance which allows the bones in the joints to glide smoothly over one another during the natural movement of the foot and ankle. Articular cartilage also acts as a kind of shock absorber for the joints, protecting the bones in the foot and ankle during normal activities like walking, running and jumping.
Arthritis is an inflammatory condition that affects the joints, causing damage to the protective layers of cartilage. Over time, the articular cartilage in the affected joint begins to break down, exposing the ends of the joint and allowing the unprotected bones to rub together. This results in pain and stiffness in the affected joint, and can eventually lead to irreparable damage to the joint itself. Arthritis can affect any joint in the body, especially the small joints in the ankle, mid-foot and big toe.
Causes of Arthritis of the Foot
There are more than 100 different types of arthritis. The three that most commonly affect the joints in the ankle and foot are osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. Although the symptoms associated with these different types of arthritis tend to overlap, the causes vary according to type.
Osteoarthritis – Osteoarthritis is the result of wear and tear to the cartilage of the joint. Over time the protective layers of cartilage in the joint degenerate, exposing the joint ends and allowing the bones to rub together. This results in the pain and stiffness so commonly associated with the condition. Osteoarthritis primarily affects middle-aged adults, though it has been known to present in younger patients as well. Individuals with a family history of osteoarthritis appear to have a greater risk of developing the condition later in life.
Rheumatoid Arthritis – Rheumatoid arthritis is an autoimmune disease which affects multiple joints throughout the body. In patients with RA the immune system begins to attack the body’s own tissues, damaging cartilage and ligaments. In most cases, rheumatoid arthritis first presents in the smaller joints, including those in the ankle and foot. The underlying cause of rheumatoid arthritis is still unknown, but current research suggests that some people by have a genetic predisposition for the disease.
Post-Traumatic Arthritis – Injuries to the foot or ankle, such as a dislocation or a fracture, can lead to post-traumatic arthritis. Even when properly treated, an injured joint is much more likely to become arthritic than a non-injured joint.
Symptoms of Arthritis of the Foot
The most common symptoms associated with arthritis of the foot or ankle include:
- Pain on bottom of foot near the heel
- Pain with the first few steps
- Pain subsides after a few minutes of walking
- Greater pain after (not during) exercise or activity
Hammer Toe (Toe Deformity)
Hammer toe is a foot deformity caused by an imbalance in the muscles, tendons, and ligaments that normally hold a toe straight. This results in an abnormal bending of the middle joint of the toe, causing the toe to resemble a ‘hammer’ or to take the shape of an inverted ‘V’. Typically, in the early stages of the condition the affected toe will remain flexible and will respond to basic treatment. However, if left unchecked, a hammer toe can become fixed and may require surgery to restore it to its natural position. Hammer toe most commonly affects the second, third, or fourth toes of the foot.
Causes of Hammer Toe
The muscles of each toe work in pairs, in order to maintain basic flexibility and dexterity. When the muscles of a toe go out of balance, increased pressure is placed on that toe’s tendons and ligaments. This pressure forces the affected toe into a ‘hammerhead’ or inverted ‘V’ shape. There are three main reasons the muscles in a toe may be forced out of balance, leading to hammer toe:
- Genetics – Some patients may have a genetic predisposition for developing hammer toe. An inherited instability in the foot, such as flat feet or exceptionally high arches, can put some patients at a higher risk for developing hammer toe in one or more of their toes.
- Injury – Injuries to the toes, particularly from ill-fitting shoes, can lead to hammer toe. Wearing shoes that are too tight, too short, or too pointy can force the muscles in the toes out of balance. Women who wear high heels are especially prone to developing hammer toe.
- Arthritis – Arthritis can often cause the balance in a toe to be disrupted, placing unusual pressure on the tendons and ligaments of the affected toe. Patients with arthritis of the foot typically have a higher risk for developing both flexible and rigid hammer toe.
Symptoms of Hammer Toe
The symptoms of hammer toe include:
The second, third, or fourth toe of the foot is bent at the middle joint
Corns or calluses on the top of the middle joint of the toe, or on the tip of the toe
Pain in toes or feet and difficulty finding comfortable shoes