Sesamoiditis

SESAMOIDITIS

COMMON PROBLEMS

SESAMOIDITIS

Sesamoiditis is a forefoot condition often found in active people who practice dancing or running. The most common symptom is pain under the big toe or ball of the foot, specifically at the sesamoid bones. These two pea-shaped bones are actually embedded in a tendon located in the ball of the foot. Simply stated, the role of the sesamoid bones is to absorb the weight placed on the ball of the foot when you walk, run and jump. Problems arise when these bones become irritated or even fracture. Since they are inside a tendon, you subsequently develop a tendonitis. Sesamoiditis pain appears gradually at first, increasing with aggravating factors such as physical activity. People typically experience a dull or sharp pain under the big toe or ball of the foot, generally with little swelling or reddening. Running and other aerobic activities are the primary instigators. Individuals with thin or boney bone feet are more at risk, as they lack sufficient fat tissue to “cushion the impact” for the sesamoid bones. Sometimes, a trauma can initiate the symptoms. The size of the sesamoid bones, patient weight, foot structure, activity level and type of shoe are all potential factors contributing to sesamoiditis.

THE SOLUTIONS

WHAT CAN I
DO ABOUT IT?

Treatment of sesamoiditis is almost always non-invasive. In minor cases, rest, shoe modification and metatarsal pads can effectively reduce pressure on the forefoot. The use of athletic bandages can help control movement of the big toe to immobilize the joint and thus promote healing. Custom orthotics are also recommended to promote better foot function, compensate for biomechanical defects and prevent further injury.

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Ingrown toenail

INGROWN TOENAIL

COMMON PROBLEMS

INGROWN TOENAIL

An ingrown toenail occurs when the nail grows into the skin or when the skin on one or both sides of the nail grows over that same nail. This can be quite painful and possibly lead to infection of the toe and even the underlying bone in certain cases. Ingrown toenails can be a chronic and recurring issue, with repeated episodes of pain and infection. Irritation, discomfort, redness, edema (swelling) and the presence of pus are often the symptoms. Ingrown toenails can occur for several reasons. Excessive curvature of the nail, whether congenital or not, is a common cause. Minor repeated trauma or major trauma can also play a role. This would include pressure on the toes such as when playing a sport or when an object impacts the toe. Another frequent culprit is poor nail-cutting technique, which allows skin to grow over a section of the nail. Of course, wearing shoes that are too tight will cramp the toes and aggravate the situation. Signs of infection include redness, pain, edema and pus on the side of the nail. There is usually presence of swelling of the adjacent skin as well. Infection develops when the ingrown toenail is kept in a moist, warm and bacteria-friendly environment (when we wear socks and shoes). As the nail penetrates the skin, it creates a gateway for pathogens from the surrounding tissues. If the ingrown toenail is left untreated, the nail can dig deeper under the skin. This leads to a much more severe infection, possibly at the bone level.

THE SOLUTIONS

WHAT CAN I
DO ABOUT IT?

An ingrown toenail should be treated immediately. If there is no infection, discomfort can be temporarily relieved by doing the following: 1. Soak the foot in warm water with Epsom salt water (1 tablespoon salt in 4 litres of water) 2. Wipe the foot with a clean towel and massage the skin surrounding the nail in a downward motion 3. Apply an antiseptic solution (e.g. Polysporin) to the painful area 4. Apply a sterile bandage around the toe 5. Consult a podiatrist. A podiatrist can safely and easily remove the wedge or spike of nail penetrating the skin. If the ingrown nail is too painful, local anaesthetic may be used during the procedure. However, even though the portion of nail has been removed, the infection itself (if present) is not cured by this method. Ingrown nails tend to reoccur, often in the same place. This is due to the width and curvature of the nail. When an ingrown toenail is severe or has not responded to previous treatments, minor surgery may be necessary. This simple procedure involves burning the root at the corner of the nail, thus preventing regrowth. Rest is recommended after surgery, but most people are able to return to work or school right away. Avoiding sports activities for a week or so is also recommended. The procedure has a 98% success rate and offers a permanent solution to a very painful problem.

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Metatarsalgia

METATARSALGIA

COMMON PROBLEMS

METATARSALGIA

Metatarsalgia is a pain in the forefoot at the metatarsal level, located on the ball of the foot. The bones located in this region of the foot move in unison with the toes. The pain or inflammation occurs under their distal ends (near the toes) and can take various forms. A burning sensation, shocks, bruising (blue colour) or excessive pressure are often associated with metatarsalgia. The pain tends to worsen during certain activities and when loading the forefoot, such as while crouching. Many people are at risk of developing this condition.

THE SOLUTIONS

WHAT CAN I
DO ABOUT IT?

Depending on the exact cause of metatarsalgia, several treatment options are available. Particularly effective, are insole cushions which are inserted into the shoes. Removable padded cushions can also be made, while orthotics may be prescribed if the cause is biomechanical in nature. Specific shoes may also be recommended.

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Heel pain

HEEL PAIN

COMMON PROBLEMS

HEEL PAIN

Heel pain, or talalgia, has multiple origins and can show itself in many ways. Burning, tingling, shooting pains, difficulty walking after a period of rest, pain under or behind the heels during physical activity or at the end of the day and many other symptoms are often reported. Heel discomfort can come from various sources, such as biomechanical, nerve, traumatic, circulatory and numerous medical conditions. That said, it’s imperative to make a proper diagnosis. The podiatrist is the best-trained professional to precisely determine the root cause of your pain. Plantar fasciitis, nerve irritation, bursitis, stress fractures, lack of adipose tissue and heel cracks are all disorders that can lead to talalgia.

THE SOLUTIONS

WHAT CAN I
DO ABOUT IT?

The management of talalgia varies greatly depending on the root cause of the problem. Several conservative treatment options are available. These include: a change of shoes, rest, ice, immobilization, strap support, exercises, orthotics and corticosteroid injections. It is essential for the podiatrist to establish the origin of the disorder, so that you receive the most effective treatment plan.

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Strappings

Corticosteroid injections

Night splints

Physical therapy

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Ankle pain

ANKLE PAIN

COMMON PROBLEMS

ANKLE PAIN

Ankle pain is often the result of injury or uncorrected faulty biomechanics. Stiffness, instability and inflammation are the symptoms most people experience. The resulting pain is usually diffuse, but in the cases of sprains, may involve specific structures such as ligaments. Ligaments can be stretched, partially or completely torn and even cause ankle fractures depending on the force of the impact or type of injury. Inflammation of muscle tendons, bone abnormalities and nerve compression can also create ankle discomfort.

THE SOLUTIONS

WHAT CAN I
DO ABOUT IT?

In the case of a new sprain, bandages, ice and rest are recommended. Immobilization and compression may also be necessary depending on the severity of the injury. With repetitive strains, it’s likely an issue with the biomechanics of the foot. In this case, you’ll need to consider modifying things like your shoes and the way you practice sports. To avoid chronic sprains and further injury, custom orthotics and splints are the recommended treatment.

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