Feet Archives - New Mexico Orthopaedic Associates

What is Hammer Toe or Mallet Toe?

Article featured on Mercy Health

What is hammer toe or mallet toe?

Hammer toe is a foot abnormality that occurs because of imbalanced muscles, tendons, or ligaments around the toe. It typically impacts the second, third, or fourth toes. The toe appears like a hammer because it is bent in the middle joint of the toe.

Hammer toe can be healed with relatively simple treatments, but if left untreated may require surgery. Many people with hammer toe develop corns or calluses on the top of the middle joint of the toe or on the tip of the toe.

A mallet toe is like hammer toe but impacts the joint closest to the tip of the toe.

Causes of hammer toe or mallet toe

There are many causes of hammer or mallet toe including:

Shoes that do not fit properly such as high-heeled shoes that do not have a proper toe box.
An impact such as jamming and breaking the toe can cause hammer toe or mallet toe.
Imbalanced toe muscles can cause toes to contract.

Risk factors for hammer toe or mallet toe

Age — hammer toe or mallet toe affect older people more than younger people but all ages can develop the conditions.
Gender — women are more likely to develop hammer or mallet toe.
Heredity — hammer toe or mallet toe can be passed down from parents.
Second toe length — a person who has a long second toe (longer than the big toe) is more likely to develop hammer or mallet toe.

Symptoms of hammer toe or mallet toe

Symptoms of hammer toe or mallet toe include:

Bend in the joint of the toe that is not typical
Pain when bending the toe
Corns or calluses that form from rubbing in shoes
Pain in the ball of the foot under the bent toe
Swelling and redness in the toe joint

Diagnosis of hammer toe or mallet toe

A primary care physician or an orthopedic specialist will diagnose hammer toe or mallet toe in a physical exam.

In order to get a better view of what is happening in the bones, joints, and muscles the physician may also order an x-ray.

Treatments for hammer toe or mallet toe

Treatments for hammer toe or mallet toe can be as simple as changing your shoes to surgery for the most severe cases. More advanced treatment options include:

Orthotics
Splint or brace
Rehabilitation or physical therapy

Recovery from hammer toe or mallet toe

Recovery after surgery to correct hammer toe can take as few as 2 weeks to as many as 3 months depending on the severity of the injury.

It is important to follow your physician’s instructions on resting your foot and choice of footwear during the healing process.

Patients who have surgery on the right foot will need to avoid driving for a few weeks to allow the injured toe to heal.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

2 Simple Exercises to Keep Your Feet Healthy

in Exercise, Feet

Article featured on Cone Health

According to Marcus Duda, MD, a Greensboro orthopedist and member of the Cone Health Medical and Dental Staff, proper foot care is important to your health.

“During the pandemic, people became less active as gyms closed and activities stopped,” says Dr. Duda, a foot and ankle surgeon who has patented a graduated compression sock. “I started seeing a lot more foot and ankle issues.”

Many patients complained of a stone bruise or burning pain on the bottom of the foot and ankle stiffness. Achilles contracture or tendon stiffness was the culprit.

“After prolonged sitting, the Achilles tendon tightens and puts more pressure on the plantar fascia on the bottom of the foot,” shares Dr. Duda. “Stretching out this tendon takes pressure off and relieves the pain.”

Dr. Duda suggests simple exercises. While leaning against the kitchen counter with your hands, place one foot back with the heel flat on the floor and lean forward with knees straight. As you stretch the back of your calf, you should feel the stretch from your heel up through the back of the knee. Stretch for 60 seconds five times a day.

“As you age, connective tissue called fascia weakens,” he adds. “This can lead to pain and weakness in your joints and muscles along with balance problems.”

To build fascial strength, Dr. Duda recommends doing short 30-second exercises several times a day. Hold onto the counter, and face forward. With bare feet, raise up on your toes like you are trying to grab a marble while lifting your heels. Once you have enough strength, try hopping on the ball of your foot.

If your foot or ankle pain is severe or does not go away, consult with your doctor or orthopedist.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Best Foot Exercises for Healthy Feet

in Exercise, Feet, Foot Pain

Article featured on Medical News Today

What are the best foot exercises for healthy feet?

Many people experience foot or ankle pain at some point. Keeping the feet strong can help alleviate this soreness and improve overall health and flexibility.

Most foot exercises are simple and require no complicated equipment to perform. People can do them at home or in the gym as part of a regular exercise routine. The following exercises can improve flexibility and mobility in the feet.

1. Toe raise, point, and curl

This exercise has three stages and will help strengthen all parts of the feet and toes.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Keeping the toes on the floor, raise the heels. Stop when only the balls of the feet remain on the ground.
Hold this position for 5 seconds before lowering the heels.
For the second stage, raise the heels and point the toes so that only the tips of the big and second toes are touching the floor.
Hold for 5 seconds before lowering.
For the third stage, raise the heels and curl the toes inward so that only the tips of the toes are touching the floor. Hold this position for 5 seconds.
Build flexibility and mobility by repeating each stage 10 times.

2. Big toe stretch

Keeping a wide range of motion in the big toe is important. The following exercise also has three stages and is designed to stretch and relieve pain in the toes from wearing tight shoes.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Bring the left foot to rest on the right thigh.
Using the fingers, gently stretch the big toe up, down, and to the side.
Keep the big toe in each position for 5 seconds.
Repeat this 10 times before switching to the other foot.

Exercises for strength

The following exercises can help enhance the strength of the feet.

3. Toe splay

Doing the toe splay exercise can improve control over the toe muscles. People can do it on both feet at once or on alternate feet, depending on which they find more comfortable.

To do this exercise:

Sit in a straight backed chair, with the feet gently resting on the floor.
Spread the toes apart as far as possible without straining. Hold this position for 5 seconds.
Repeat this motion 10 times.
Once a person has built up their strength, they can try looping a rubber band around the toes. This will provide resistance and make the exercise more challenging.

4. Toe curls

Doing toe curls builds up the flexor muscles of the toes and feet, improving overall strength.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Lay a small towel on the floor in front of the body, with the short side facing the feet.
Place the toes of one foot on the short side of the towel. Try to grasp the towel between the toes and pull it toward oneself. Repeat this exercise five times before switching to the other foot.
To make this exercise more challenging, try weighing down the opposite end of the towel with an object.

5. Marble pickup

Doing the marble pickup can increase strength in the muscles on the undersides of the feet and toes.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place an empty bowl and a bowl of 20 marbles on the floor in front of the feet.
Using only the toes of one foot, pick up each marble and place it in the empty bowl.
Repeat this exercise using the other foot.

6. Sand walking

Walking barefoot on sand is a great way to stretch and strengthen the feet and calves. This is a good exercise in general because sand’s soft texture makes walking more physically demanding.

To do this exercise:

Head to a beach, a desert, a volleyball court, or any other location with sand.
Remove the shoes and socks.
Walk for as long as possible. Try increasing the distance slowly over time to avoid overexerting the muscles in the feet and calves.
The following exercises can be helpful for pain relief.

7. Toe extension

The toe extension is useful in preventing or treating plantar fasciitis, which is a condition that causes pain in the heel when walking and difficulty raising the toes.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place the left foot on the right thigh.
Pull the toes up toward the ankle. There should be a stretching feeling along the bottom of the foot and heel cord.
Hold for 10 seconds. Massaging the arch of the foot while stretching will help ease tension and pain.
Repeat this exercise 10 times on each foot.

8. Golf ball roll

Rolling a golf ball under the foot can help relieve discomfort in the arch and ease pain associated with plantar fasciitis.

To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place a golf ball — or another small, hard ball — on the floor next to the feet.
Lay one foot on the ball and move it around, pressing down as hard as is comfortable. The ball should be massaging the bottom of the foot.
Continue for 2 minutes, then repeat using the other foot.
A frozen bottle of water can be a soothing alternative if no suitable balls are available.

9. Achilles stretch

The Achilles tendon is a cord connecting the heel to the calf muscles. It can strain easily, but keeping it strong may help with foot, ankle, or leg pain.

To do this exercise:

Face a wall and raise the arms so that the palms of the hands are resting flat against the wall.
Move one foot back, keeping the knee straight. Then, bend the knee of the opposite leg.
Keep both the heels flat on the floor.
Push the hips forward until there is a stretching feeling in the Achilles tendon and calf muscles.
Hold for 30 seconds before switching sides. Repeat three times on each side.
For a slightly different stretch, bend the back knee and push the hips forward.

Foot health and safety tips

To help keep the feet strong and healthy:

Complete a thorough warmup routine before exercising.
Wear supportive footwear for day-to-day activities and sports.
Replace worn-down shoes as often as possible.
Build up strength and flexibility slowly to condition the feet and ankles.
Avoid uneven surfaces, especially when running. Try not to run uphill too often.
Listen to the body. Do not overdo activities.
Prevent any recurrence of injury by resting and seeking appropriate treatment.

Summary

Keeping the feet and ankles healthy is a good idea. Performing the exercises above can help ease existing pain, prevent discomfort, and reduce the risk of injury.

People with a diagnosed foot condition such as plantar fasciitis or strain to the Achilles tendon may wish to try exercises to help.

Always check with a healthcare professional, if possible, before starting a new exercise and stretching routine.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What are the best foot exercises for healthy feet?

in Exercise, Feet, Foot Pain

Article from MedicalNewsToday, medically reviewed by Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS — Written by Bethany Cadman

Many people experience foot or ankle pain at some point. Keeping the feet strong can help alleviate this soreness and improve overall health and flexibility.

Regularly exercising and stretching the feet and ankles can help ensure that the muscles are providing the best support. These exercises may also increase range of motion in the feet, helping keep a person active for as long as possible.
Most foot exercises are simple and require no complicated equipment to perform. People can do them at home or in the gym as part of a regular exercise routine.

Exercises for flexibility and mobility

The following exercises can improve flexibility and mobility in the feet.

1. Toe raise, point, and curl

This exercise has three stages and will help strengthen all parts of the feet and toes.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Keeping the toes on the floor, raise the heels. Stop when only the balls of the feet remain on the ground.
Hold this position for 5 seconds before lowering the heels.
For the second stage, raise the heels and point the toes so that only the tips of the big and second toes are touching the floor.
Hold for 5 seconds before lowering.
For the third stage, raise the heels and curl the toes inward so that only the tips of the toes are touching the floor. Hold this position for 5 seconds.
Build flexibility and mobility by repeating each stage 10 times.

2. Big toe stretch

Keeping a wide range of motion in the big toe is important. The following exercise also has three stages and is designed to stretch and relieve pain in the toes from wearing tight shoes.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Bring the left foot to rest on the right thigh.
Using the fingers, gently stretch the big toe up, down, and to the side.
Keep the big toe in each position for 5 seconds.
Repeat this 10 times before switching to the other foot.

Exercises for strength

The following exercises can help enhance the strength of the feet.

3. Toe splay

Doing the toe splay exercise can improve control over the toe muscles. People can do it on both feet at once or on alternate feet, depending on which they find more comfortable.
To do this exercise:

Sit in a straight backed chair, with the feet gently resting on the floor.
Spread the toes apart as far as possible without straining. Hold this position for 5 seconds.
Repeat this motion 10 times.
Once a person has built up their strength, they can try looping a rubber band around the toes. This will provide resistance and make the exercise more challenging.

4. Toe curls

a person curling their toes using a towel

Doing toe curls builds up the flexor muscles of the toes and feet, improving overall strength.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Lay a small towel on the floor in front of the body, with the short side facing the feet.
Place the toes of one foot on the short side of the towel. Try to grasp the towel between the toes and pull it toward oneself. Repeat this exercise five times before switching to the other foot.
To make this exercise more challenging, try weighing down the opposite end of the towel with an object.

5. Marble pickup

A person picking up marbles with their toes

Doing the marble pickup can increase strength in the muscles on the undersides of the feet and toes.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place an empty bowl and a bowl of 20 marbles on the floor in front of the feet.
Using only the toes of one foot, pick up each marble and place it in the empty bowl.
Repeat this exercise using the other foot.

6. Sand walking

A person walking on the beach with sand on the bottom of their foot

Walking barefoot on sand is a great way to stretch and strengthen the feet and calves. This is a good exercise in general because sand’s soft texture makes walking more physically demanding.
To do this exercise:

Head to a beach, a desert, a volleyball court, or any other location with sand.
Remove the shoes and socks.
Walk for as long as possible. Try increasing the distance slowly over time to avoid overexerting the muscles in the feet and calves.

Exercises for pain

The following exercises can be helpful for pain relief.

7. Toe extension

The toe extension is useful in preventing or treating plantar fasciitis, which is a condition that causes pain in the heel when walking and difficulty raising the toes.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place the left foot on the right thigh.
Pull the toes up toward the ankle. There should be a stretching feeling along the bottom of the foot and heel cord.
Hold for 10 seconds. Massaging the arch of the foot while stretching will help ease tension and pain.
Repeat this exercise 10 times on each foot.

8. Golf ball roll

a person rolling their foot on a tennis ball

Rolling a golf ball under the foot can help relieve discomfort in the arch and ease pain associated with plantar fasciitis.
To do this exercise:

Sit up straight in a chair, with the feet flat on the floor.
Place a golf ball — or another small, hard ball — on the floor next to the feet.
Lay one foot on the ball and move it around, pressing down as hard as is comfortable. The ball should be massaging the bottom of the foot.
Continue for 2 minutes, then repeat using the other foot.
A frozen bottle of water can be a soothing alternative if no suitable balls are available.

9. Achilles stretch

The Achilles tendon is a cord connecting the heel to the calf muscles. It can strain easily, but keeping it strong may help with foot, ankle, or leg pain.
To do this exercise:

Face a wall and raise the arms so that the palms of the hands are resting flat against the wall.
Move one foot back, keeping the knee straight. Then, bend the knee of the opposite leg.
Keep both the heels flat on the floor.
Push the hips forward until there is a stretching feeling in the Achilles tendon and calf muscles.
Hold for 30 seconds before switching sides. Repeat three times on each side.
For a slightly different stretch, bend the back knee and push the hips forward.

Foot health and safety tips

To help keep the feet strong and healthy:

Complete a thorough warmup routine before exercising.
Wear supportive footwear for day-to-day activities and sports.
Replace worn-down shoes as often as possible.
Build up strength and flexibility slowly to condition the feet and ankles.
Avoid uneven surfaces, especially when running. Try not to run uphill too often.
Listen to the body. Do not overdo activities.
Prevent any recurrence of injury by resting and seeking appropriate treatment.

Summary

Keeping the feet and ankles healthy is a good idea. Performing the exercises above can help ease existing pain, prevent discomfort, and reduce the risk of injury.
People with a diagnosed foot condition such as plantar fasciitis or strain to the Achilles tendon may wish to try exercises to help.
Always check with a healthcare professional, if possible, before starting a new exercise and stretching routine.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

All About Foot Pain- Causes and Treatments

in Feet, Foot Pain, Uncategorized

Foot Pain

Feet. They carry you from here to there every day. But you may not think much about them until they hurt. And when they do, you want relief. To get the right treatment, you need to know the problem. The first thing to consider is where your pain is located.

Heel Pain

If your pain is in your heel, you may have plantar fasciitis. That’s an irritation or inflammation of the band of tough tissue connecting the heel bone to the toes. Usually, it hurts the worst in the morning when you’re getting out of bed. You can feel it in your heel or in your arch.

To treat it:

Rest your foot.
Do heel and foot muscle stretches.
Take over-the-counter pain relievers.
Wear shoes with good arch support and a cushioned sole.

Heel spurs are another source of foot pain. These are abnormal growths of bone on the bottom of your heel. You can get them from wearing the wrong shoes or from an abnormal walk or posture, or even from activities like running. The spurs may hurt while you’re walking or standing. Lots of people have them, but most don’t have pain. People with flat feet or high arches are more likely to have painful heel spurs.

To treat them:

Wear a cutout heel pad.
Use a custom-made insert (called an orthotic) worn in the shoe.
Wear shoes that fit well and have shock-absorbing soles.
Take over-the-counter pain relievers.
Rest your foot.
Try physical therapy.
If you still have pain, ask your doctor about medical procedures.

A stone bruise is a deep bruise of the fat pad of the heel or ball of the foot. It’s often from an impact injury, but it can also happen after stepping on a hard object. The pain feels like you’re walking on a pebble. It will gradually go away on its own.

In the meantime:

Rest your foot.
Ice the area.
Take over-the-counter pain relievers.

A heel fracture is usually a high-impact injury such as from a fall or car accident. Your heel bone may not just break, it could also shatter. Heel pain, bruising, swelling, or trouble walking are the main symptoms.

To treat it:

Don’t put pressure on the heel. You can use crutches.
Protect the heel with pads.
Wear a splint or cast to protect the heel bone.
Ask your doctor about over-the-counter or prescription pain relievers.
Try physical therapy.
If you’re still in pain, ask your doctor about surgery.

Ball of Foot Pain

Metatarsalgia. You feel this pain and inflammation in the ball of your foot. Ill-fitting shoes are the usual cause. But you might get it from strenuous activity, such as running or jumping. It’s sometimes called a stone bruise as well.

To treat it:

Take pain relievers.
Ice and rest your foot.
Wear comfortable footwear.
Try shoe inserts to relieve pressure on the ball of your foot.

Morton’s neuroma causes a thickening of the tissue around the nerves between the bases of the toes (usually between the third and fourth toes). You typically feel pain, odd sensations or numbness over the ball of your foot. Women have it more often. It can be a result of wearing high heels or tight shoes.

To treat it:

Wear shoe inserts to reduce pressure on the nerve.
Get a steroid or other injection into the foot.
Take pain relievers.
Don’t wear high-heeled shoes or ones with a narrow toe box.
Avoid activities that put pressure on the neuroma.
Ask your doctor about surgery.

Sesamoiditis. Near your big toe are 2 bones that are connected only by tendons. They’re called sesamoids. You get sesamoiditis when the tendons surrounding them become injured and inflamed. It’s a form of tendinitis, common with runners and ballet dancers.

To treat it:

Rest your feet.
Ice where it hurts.
Wear a foot pad under the toe in a comfortable shoe.
Tape the big toe to immobilize the joint and allow for healing.
Wear low-heeled shoes.
Ask your doctor about steroid injections.

Arch Pain

Plantar fasciitis. This is the most common cause of arch pain. Plantar fasciitis can affect the heel, arch, or both. Treatment is the same regardless of the location. For persistent plantar fasciitis, an injection with a mixture of a steroid and local anesthetic can be helpful.

Fallen arches , or flat feet, happen when the arches of the feet flatten out (often when standing or walking), causing foot pain and other problems. Flat feet can be treated with shoe inserts, shoe adjustments, rest, ice, using a walking cane or brace, or physical therapy. Sometimes surgery is necessary.

Toe Pain

Gout , which is a form of arthritis, can causes pain in the toes. Crystals collect in toe joints, causing severe pain and swelling. The big toe is often affected.

To treat it:

Rest the foot.
Ice the area.
Take medication such as colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs), or prednisone
Avoid foods that can make gout worse.

A bunion is a bony bulge along the edge of the foot, next to the base of the big toe. It’s associated with misalignment of the first toe joint. Anyone can get them, especially if they wear ill-fitting or uncomfortable shoes. It often shows up as people age. People with bunions often also have hammertoes as well. Try changing to more comfortable shoes or wearing shoe inserts. If you’re still in pain, your doctor may suggest surgery.

A hammertoe is when your second, third, or fourth toe bends at the middle joint, creating a hammer-like appearance. It can come from a muscle imbalance, but it can also be brought on by wearing ill-fitting shoes.

Your doctor will likely recommend you wear shoes with a wide, deep toe bed. She may also give you exercises to stretch your toe muscles. If you still have problems, you can talk to your doctor about surgery.

Claw toe is when your toe points down or up and is unable to straighten. It’s often the result of nerve damage from diseases like diabetes or alcoholism, which weakens the muscles in your foot. Without special footwear to accommodate the claw toe, you may develop irritation and calluses.

To treat it:

Change to better-fitting footwear. Avoid high heels and tight shoes.
Do stretches for your toes and toe joints.
Try shoe inserts.
Ask your doctor about surgery.

An ingrown toenailis when skin on one or both sides of a toenail grow over the nail. It can be painful and may lead to infections.

To treat it:

Soak the foot in warm water four times a day.
Once daily, wedge a piece of gauze between the nail and wet skin.
If these treatments don’t work, see a doctor.

Turf toe is when you feel pain at the base of the big toe. It’s an overuse injury usually caused by strain. Turf toe may also be a form of sesamoiditis or a sesamoid fracture.A toe sprain may happen when you jam or stub your toe, damaging the tendon or soft tissues of the toe. If you don’t have a fracture, the pain and swelling should go away within days.A toe fracture, or broken bone, can happen in any of the bones of the toes. Minor fractures may only require rest, ice, and pain relievers. Serious fractures may need surgery. Go to a doctor to be sure.

Hallux rigidus (stiff big toe) is a type of arthritis at the base of the big toe. Symptoms are pain and stiffness of the joint that worsens over time. Treatment can include pain relievers and stretching exercises. Surgery may be needed in some cases.

Corns and calluses. Corns are thick buildups of tough skin on a point of irritation or pressure on the foot or toe. They sometimes look like horns. Calluses are wider areas of tough skin buildup on the toes or feet. They happen as a result of irritation or pressure. Calluses and corns are generally caused by poor-fitting footwear.

To treat them:

Wear better-fitting shoes.
Soak the foot and use a pumice stone to wear down the extra skin.

A sesamoid fracture is a break in the small bones (sesamoids) that are embedded in tendons attached to the big toe. Pain in and around the big toe is the main symptom.

To treat it:

Rest, ice, and elevate your foot.
Wear stiff-soled shoes or foot pads to relieve pressure.
Take pain relievers.
If you’re still in pain, talk to your doctor.

Pain on the Foot’s Outer Edge

The outer edge of your foot, the fifth metatarsal bone, is a commonly broken bone in the foot. Pain, swelling, and bruising along the outer foot edge after an injury are symptoms. If you think you may have broken a bone, see a doctor and have an X-ray.

To treat it:

Take pain relievers.
Rest, ice, and elevate your foot.
Don’t walk on it.
Ask your doctor if surgery is necessary.
A cast may be necessary in some circumstances.

Foot Pain That’s Anywhere or Everywhere

Neuropathy, or nerve damage in the feet, is most often caused by diabetes. The pain can be burning, stinging, or feel like electricity. It can happen anywhere in the feet. Ask your doctor about pain relief options and ways to prevent further worsening.

Tendinitis is inflammation and irritation of tendons, the bands attaching muscles to bones. Tendons run along all the surfaces of the foot and can cause foot pain in many different locations.

To treat it:

Rest your foot.
Take pain relievers.
Steroid injections can help.
Surgery is rarely needed.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Tips for Preventing Foot and Ankle Injuries

in Ankle Pain, Feet

Article Featured on UCFS Health

Foot and ankle injuries are common in sports, especially running, tennis and soccer. But sports enthusiasts can decrease the risk of injury by taking some precautions.

Warm up prior to any sports activity

Lightly stretch or better yet, do a slow jog for two to three minutes to warm up the muscles. Don’t force the stretch with a “bouncing motion.”

Condition your muscles for the sport

The amount of time spent on the activity should be increased gradually over a period of weeks to build both muscle strength and mobility. Cross training by participating in different activities can help build the muscles.

Choose athletic shoes specifically for your foot type

People whose feet pronate or who have low arches should choose shoes that provide support in both the front of the shoe and under the arch. The heel and heel counter (back of the shoe) should be very stable. Those with a stiffer foot or high arches should choose shoes with more cushion and a softer platform. Use sport-specific shoes. Cross training shoes are an overall good choice; however, it is best to use shoes designed for the sport.

Replace athletic shoes when the tread wears out or the heels wear down

People who run regularly should replace shoes every six months, more frequently if an avid runner.

Avoid running or stepping on uneven surfaces

Try to be careful on rocky terrain or hills with loose gravel. Holes, tree stumps and roots are problems if you are trail running. If you have problems with the lower legs, a dirt road is softer than asphalt, which is softer than concrete. Try to pick a good surface if possible. However, if you’re racing, be sure to train on the surface you’ll eventually run on.

Be careful running too many hills

Running uphill is a great workout, but make sure you gradually build this up to avoid injuries. Be careful when running downhill too fast, which can often lead to more injuries than running uphills!

Prevent recurrent injuries

Athletes who have experienced ankle injuries previously may benefit from using a brace or tape to prevent recurrent ankle injuries.

Listen to your body

If you experience foot and ankle pain during a sport, stop the activity or modify the activity until the pain subsides. Also, if you have been injured, you should go through a period of rehabilitation and training before returning to the sport to prevent recurrent injuries.

Running and Tennis Injuries

Running and tennis injuries include ankle sprains, Achilles tendonitis and plantar fasciitis. Ankle sprains, a partial or complete tear of any of the ligaments responsible for supporting and stabilizing the ankle joint, usually result from landing on an uneven surface and having the foot turn awkwardly.

Injury to the Achilles tendon, the strongest and largest tendon that connects the back of the calf muscle to the heel bone, occurs from overuse and is usually an acute inflammation or a partial tear. If the tendon is weak, it can rupture with the right force.

It is also common for the plantar fascia, the tough tissue that maintains the arch of the foot and runs from the heel to the toes, to become inflamed, resulting in heel or arch pain.

Runners also may experience injury to the tendons or ligaments located on the outside and inside of the ankle and stress fractures of the foot bones. In running, any one incident may not be enough to fracture the foot; however, over time, repetition of abnormal forces or stress can cause the bone to weaken or break. Five to 15 percent of all running injuries are stress fractures. Of those injuries, 49 percent occurred in those who ran between 25 miles to 44 miles per week.

Soccer Injuries

Unlike foot and ankle injuries in tennis and running, which are usually overuse injuries, soccer injuries often result from trauma such as a direct blow to the lower leg. Because soccer is a contact sport, collision injuries from striking another player are common, accounting for 30 percent of all soccer injuries.

Ankle injuries in soccer account for 20 to 30 percent of all soccer injuries—the most common being ankle sprains. Soccer players also may experience turf toe, a sprain that results from stubbing the toe while running or improperly planting one’s cleats.

Treatment

Treatment for these injuries varies depending on the severity of the injury. Most strains and sprains can be treated with rest, ice, compression and elevation (RICE). Moderate to severe cases, however, may require some form of immobilization such as a brace or a cast. Certain injuries that don’t heal within the expected time frame may require surgery.

It is important to seek medical attention as soon as possible for foot and ankle injuries, especially if it is causing you to limp or there is swelling. Prompt and appropriate treatment and rehabilitation ensures the best possible recovery.

How to Tell if Your Foot is Broken: Symptoms & Treatment Options

in Feet, Fractures

Article Featured on Mayo Clinic

Overview

Foot and ankle bones

A broken foot is an injury to the bone. You may experience a broken foot during a car crash or from a simple misstep or fall. The seriousness of a broken foot varies. Fractures can range from tiny cracks in your bones to breaks that pierce your skin.

Treatment for a broken foot depends on the exact site and severity of the fracture. A severely broken foot may require surgery to implant plates, rods or screws into the broken bone to maintain proper position during healing.

Symptoms of a Broken Foot

If you have a broken foot, you may experience some of the following signs and symptoms:

Immediate, throbbing pain
Pain that increases with activity and decreases with rest
Swelling
Bruising
Tenderness
Deformity
Difficulty in walking or bearing weight

When to see a doctor if you think your foot is broken

See a doctor if there is obvious deformity, if the pain and swelling don’t get better with self-care, or if the pain and swelling gets worse over time. Also, see a doctor if the injury interferes with walking.

Common Causes of a Broken Foot

The most common causes of a broken foot include:

Car accidents. The crushing injuries common in car accidents may cause breaks that require surgical repair.
Falls. Tripping and falling can break bones in your feet, as can landing on your feet after jumping down from just a slight height.
Impact from a heavy weight. Dropping something heavy on your foot is a common cause of fractures.
Missteps. Sometimes just putting your foot down wrong can result in a broken bone. A toe can get broken from stubbing your toes on furniture.
Overuse. Stress fractures are common in the weight-bearing bones of your feet. These tiny cracks are usually caused over time by repetitive force or overuse, such as running long distances. But they can also occur with normal use of a bone that’s been weakened by a condition such as osteoporosis.

Risk factors

You may be at higher risk of a broken foot or ankle if you:

Participate in high-impact sports. The stresses, direct blows and twisting injuries that occur in sports such as basketball, football, gymnastics, tennis and soccer can causes foot fractures.
Use improper technique or sports equipment. Faulty equipment, such as shoes that are too worn or not properly fitted, can contribute to stress fractures and falls. Improper training techniques, such as not warming up and stretching, also can cause foot injuries.
Suddenly increase your activity level. Whether you’re a trained athlete or someone who’s just started exercising, suddenly boosting the frequency or duration of your exercise sessions can increase your risk of a stress fracture.
Work in certain occupations. Certain work environments, such as a construction site, put you at risk of falling from a height or dropping something heavy on your foot.
Keep your home cluttered or poorly lit. Walking around in a house with too much clutter or too little light may lead to falls and foot injuries.
Have certain conditions. Having decreased bone density (osteoporosis) can put you at risk of injuries to your foot bones.

Complications from a Broken Foot

Complications of a broken foot are uncommon but may include:

Arthritis. Fractures that extend into a joint can cause arthritis years later. If your foot starts to hurt long after a break, see your doctor for an evaluation.
Bone infection (osteomyelitis). If you have an open fracture, meaning one end of the bone protrudes through the skin, your bone may be exposed to bacteria that cause infection.
Nerve or blood vessel damage. Trauma to the foot can injure adjacent nerves and blood vessels, sometimes actually tearing them. Seek immediate attention if you notice any numbness or circulation problems. Lack of blood flow can cause a bone to die and collapse.

Prevention

These basic sports and safety tips may help prevent a broken foot:

Wear proper shoes. Use hiking shoes on rough terrain. Wear steel-toed boots in your work environment if necessary. Choose appropriate athletic shoes for your sport.
Replace athletic shoes regularly. Discard sneakers as soon as the tread or heel wears out or if the shoes are wearing unevenly. If you’re a runner, replace your sneakers every 300 to 400 miles.
Start slowly. That applies to a new fitness program and each individual workout.
Cross-train. Alternating activities can prevent stress fractures. Rotate running with swimming or biking.
Build bone strength. Calcium-rich foods, such as milk, yogurt and cheese, really can do your body good. Taking vitamin D supplements also can help.
Use night lights. Many broken toes are the result of walking in the dark.
Declutter your house. Keeping clutter off the floor can help you to avoid trips and falls.

Diagnosing a Broken Foot

During the physical exam, your doctor will check for points of tenderness in your foot. The precise location of your pain can help determine its cause. They may move your foot into different positions, to check your range of motion. You may be asked to walk for a short distance so that your doctor can examine your gait.

Imaging tests

If your signs and symptoms suggest a break or fracture, your doctor may suggest one or more of the following imaging tests.

X-rays. Most foot fractures can be visualized on X-rays. The technician may need to take X-rays from several different angles so that the bone images won’t overlap too much. Stress fractures often don’t show up on X-rays until the break actually starts healing.
Bone scan. For a bone scan, a technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to your bones, especially the parts of your bones that have been damaged. Damaged areas, including stress fractures, show up as bright spots on the resulting image.
Computerized tomography (CT). CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body. CT scans can reveal more detail about the bone and the soft tissues that surround it, which may help your doctor determine the best treatment.
Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your foot and ankle together. This imaging helps to show ligaments and bones and can identify fractures not seen on X-rays.

Treating a Broken Foot

Treatments for a broken foot will vary, depending on which bone has been broken and the severity of the injury.

Medications

Your doctor may recommend an over-the-counter pain reliever, such as acetaminophen (Tylenol, others).

Therapy

After your bone has healed, you’ll probably need to loosen up stiff muscles and ligaments in your feet. A physical therapist can teach you exercises to improve your flexibility and strength.

Surgical and other procedures

Reduction. If you have a displaced fracture, meaning the two ends of the fracture are not aligned, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
Immobilization. To heal, a broken bone must be immobilized so that its ends can knit back together. In most cases, this requires a cast.
Minor foot fractures may only need a removable brace, boot or shoe with a stiff sole. A fractured toe is usually taped to a neighboring toe, with a piece of gauze between them.
Surgery. In some cases, an orthopedic surgeon may need to use pins, plates or screws to maintain proper position of your bones during healing. These materials may be removed after the fracture has healed if they are prominent or painful.

Preparing for your appointment for a Broken Foot

You will likely initially seek treatment for a broken foot in an emergency room or urgent care clinic. If the pieces of broken bone aren’t lined up properly for healing, you may be referred to a doctor specializing in orthopedic surgery.

What you can do

You may want to write a list that includes:

Detailed descriptions of your symptoms
Information about medical problems you’ve had
Information about the medical problems of your parents or siblings
All the medications and dietary supplements you take
Questions you want to ask the doctor

For a broken ankle or foot, basic questions to ask your doctor include:

What tests are needed?
What treatments are available, and which do you recommend?
If I need a cast, how long will I need to wear it?
Will I need surgery?
What activity restrictions will need to be followed?
Should I see a specialist?
What pain medications do you recommend?

Don’t hesitate to ask any other questions you have.

What to expect from your doctor

Your doctor may ask some of the following questions:

Was there a specific injury that triggered your symptoms?
Did your symptoms come on suddenly?
Have you injured your feet in the past?
Have you recently begun or intensified an exercise program?

What to do in the meantime

If your injury isn’t severe enough to warrant a trip to the emergency room, here are some things you can do at home to care for your injury until you can see your doctor:

Apply ice for 15 to 20 minutes at a time, every three to four hours to bring down the swelling.
Keep your foot elevated.
Don’t put any weight on your injured foot.
Lightly wrap the injury in a soft bandage that provides slight compression.

Adult Acquired Flatfoot

in Feet

Article Featured on AAOS

A variety of foot problems can lead to adult acquired flatfoot deformity (AAFD), a condition that results in a fallen arch with the foot pointed outward.

Most people — no matter what the cause of their flatfoot — can be helped with orthotics, braces and physical therapy. In patients who have tried these treatments without any relief, surgery can be a very effective way to help with the pain and deformity.

This article provides a brief overview of the problems that can result in AAFD.

One of the more common signs of flatfoot is the “too many toes” sign. Even the big toe can be seen from the back of this patient’s foot. In a normal foot, only the fourth and fifth toes should be visible.

Symptoms

Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below:

Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle.
Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time.
When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain.
Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which can result in numbness and tingling on the top of the foot and into the toes.
Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.

Cause

As discussed above, many health conditions can create a painful flatfoot.

Posterior Tibial Tendon Dysfunction (PTTD)

Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot.

The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse.

The posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot.

Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use.

Arthritis

Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat.

The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch.

Injury

An injury to the ligaments in the foot can cause the joints to fall out of alignment. The ligaments support the bones and prevent them from moving. If the ligaments are torn, the foot will become flat and painful. This more commonly occurs in the middle of the foot (Lisfranc injury), but can also occur in the back of the foot.

In addition to ligament injuries, fractures and dislocations of the bones in the midfoot can also lead to a flatfoot deformity.

Diabetic Collapse (Charcot Foot)

People with diabetes or with a nerve problem that limits normal feeling in the feet, can have arch collapse.

This type of arch collapse is typically more severe than that seen in patients with normal feeling in their feet. This is because patients do not feel pain as the arch collapses. In addition to the ligaments not holding the bones in place, the bones themselves can sometimes fracture and disintegrate – without the patient feeling any pain. This may result in a severely deformed foot that is very challenging to correct with surgery. Special shoes or braces are the best method for dealing with this problem.

Summary

Adult acquired flatfoot is one of the most common problems affecting the foot and ankle. Treatment ranges from nonsurgical methods — such as orthotics and braces — to surgery. Your doctor will create a treatment plan for you based on what is causing your AAFD.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Causes and treatments for pain in the arch of the foot

in Feet, Pain Management

The arch of the foot is an area along the bottom of the foot between the ball and the heel. Pain in the arch of the foot is a common problem, especially among athletes. The arch is made up of three separate arches that form a triangle. Each arch is made up of bones, ligaments, and tendons.

There are many potential causes of pain in the arch of the foot. Keep reading for more information on these causes, as well as the possible treatments.

Causes

The two most common causes of pain in the arch of the foot involve injury and structural issues. Structural issues typically refer to high or low arches or other abnormalities in the foot and surrounding area.

In both cases, several factors can trigger or aggravate these issues, including:

aging
overuse
weight gain
physical stress
neurological conditions

Causes of pain in the arch of the foot include:

Overpronation

Overpronation refers to how a person’s foot moves while walking, running, or jogging. A person who overpronates strikes the ground with the outer portion of the heel first. As the person completes the step, the foot rolls too far onto the arch. The extra pressure causes the arch to flatten.

Long term, overpronation can damage the tendons, muscles, and ligaments. This damage can lead to pain in the arch, knee, hip, or back. It may also cause hammertoe and calluses. A person who overpronates often benefits from extra support when walking. Support can include stability shoes and prescription arch supports.

Plantar fasciitis

Plantar fasciitis is a degenerative condition of the plantar fascia and a common causes of heel pain. The plantar fascia is a ligament that connects the back of the foot to the front.

Common causes of plantar fasciitis include:

injury
overuse
inflammation

Anyone can get plantar fasciitis, but activities such as running can increase the risk. If a person has plantar fasciitis, they often feel pain when waking up. The pain typically gets worse throughout the day with walking and standing. In addition to arch pain, a person may feel stiffness in the heel or ball of their foot.

People with plantar fasciitis may need to stop doing activities such as running to let the foot heal. They can also consider wearing support shoes or using inserts to help take pressure off the arch.

Cavus foot

Cavus foot is a structural abnormality that causes a high arch. Causes of cavus foot include:

genetics
stroke
cerebral palsy
Charcot-Marie-Tooth disease

If a person has cavus foot, they may feel pain when walking or standing. They may also have reduced stability, which can lead to ankle sprains and injuries.

A person may have other issues related to cavus foot, including:

claw toe
hammertoe
calluses

People with cavus foot can consider support shoes or inserts to help stabilize their feet and avoid pain and possible injury.

Posterior tibial tendon dysfunction

The posterior tibial tendon connects one of the calf muscles to the inner part of the foot. Posterior tibial tendon dysfunction (PTTD) occurs when this tendon is injured or inflamed. If the posterior tibial tendon cannot support the arch, a person may feel pain there as a result.

PTTD pain typically occurs in the inner part of the ankle and back of the calf. The pain usually occurs while running or walking briskly and goes away once a person stops. An ankle brace or specially designed inserts can help correct PTTD.

Flat feet

Flat feet can occur in children or adults. In many cases, flat feet cause no issues, but they can also cause a person to experience pain in the arch, other areas of the foot, legs, ankles, and back.

A person may not realize they have flat feet until symptoms occur. A doctor may recommend using supportive shoes or inserts to help provide additional support for the arch.

Treatment

In some cases, home treatments and stretching are not enough to relieve pain. If this is the case, a doctor or podiatrist may recommend one or more of the following:

physical therapy
night splints
braces
casts
surgery
cortisone injections
prescription pain relievers (prescription non-steroidal anti-inflammatory medications)
prescription orthotics, support shoes, or inserts

Home remedies and stretches

While undergoing treatment, a person should still consider home remedies and stretches to help alleviate the pain. A person should not attempt these if a doctor advises them not to move the foot.

Some home remedies include:

Resting: Stop or significantly reduce doing any activity that aggravates the arch.
Applying ice: Apply an ice pack wrapped in a cloth to the arch and other tender areas to help reduce swelling.
Wearing socks: Avoid walking around in bare feet.
Using support: Consider using cushions, inserts, and support shoes.
Splinting: Ask a doctor about splinting the foot at night to help keep it supported while sleeping.
Using medication: Try over-the-counter pain relievers, such as ibuprofen.

In addition, there are a few different techniques a person can do to help alleviate pain and make the arch less prone to injury. These include:

Foot Stretch

To perform this stretch:

sit down
place the foot on the opposite thigh
hold the toes with one hand while pushing in and down on the heel with the other
gently push the toes towards the heel and hold for 3–5 minutes

Calf stretch

When a person stretches their calves, they can relieve pain and pressure on the arch of the foot. To perform a calf stretch:

stand facing the wall and place both hands shoulder width apart on the wall
take a step back with one foot
bend the front knee forward while keeping the back knee straight and the heel on the floor
hold the stretch for 20–30 seconds, repeat three times and then switch legs

Roller or ball foot massage

A person can use a small tennis ball or foam roller to perform a massaging stretch on the foot. This technique is easiest to do while sitting. To use this technique, a person should:

take off their shoes and sit in a chair
place the ball or roller under the arch of the foot
roll it back and forth from the ball of the foot to the heel over the arch

About the arch of the foot

The arch is responsible for several functions in the foot. Some things the arch does include:

helps bear weight
helps stabilize movements
allows the foot to adapt to changes in the terrain as a person walks or runs
helps absorb shock
helps maintain balance

A person may feel an injury to the arch directly in the area. It is also possible to feel pain or discomfort in other areas, including the:

heel
ball of foot
top of foot
hips
legs
knees
back
ankles

In some cases, a person may feel the worst pain in the morning. However, most people will experience worse pain during activities, including standing, that directly involves the feet.

When to see a doctor

For occasional pain, resting, ice, and stretching are usually sufficient. However, if the pain does not go away after a few days, is severe, or frequently comes back, a person should talk to a doctor.

A doctor may refer a person to an orthopedic surgeon who specializes in the feet and ankles or a podiatrist, who is a foot specialist. They can examine the person’s foot, how they walk, and other factors to determine what the underlying issue is.

An examination may include:

looking for inflammation, tenderness, swelling, deformities,
checking balance, coordination, reflexes, sensation, and muscle tone
tests such as X-rays, CT scans, MRIs, or ultrasounds

Once a doctor determines the underlying cause of the pain, they will recommend treatments that specifically target the underlying cause and help alleviate pain.

Summary

Arch pain is a common problem, especially among athletes. In many cases, a person can stretch, rest, and ice the arch of their foot until the pain goes away.

Problems with the arch of the foot can also cause pain in different parts of the body, including the ankle, heel, legs, knee, and back. It is essential to treat the problem early to ensure that foot problems do not lead to back or knee injuries.

If the pain persists, gets worse, or is chronic, a person should talk to their doctor about additional treatment options.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Flexible Flatfoot in Children

in Feet

Article Featured on AAOS

When a child with flexible flatfoot stands, the arch of the foot disappears. Upon sitting or when the child is on tiptoes, the arch reappears. Although called “flexible flatfoot,” this condition always affects both feet.

Flexible flatfoot is common in children. While parents often worry that an abnormally low or absent arch in a child’s foot will lead to permanent deformity or disability, most children eventually outgrow flexible flatfoot without developing any problems in adulthood. The condition is usually painless and does not interfere with walking or participation in sports. If your child’s flexible flatfoot does not cause pain or discomfort, no treatment is needed.

Flexible flatfoot, showing the absence of an arch when standing. The arch reappears when the patient is sitting or on tiptoes.

Description

A flexible flatfoot is considered to be a variation of a normal foot. The muscles and joints of a flexible flatfoot function normally. Most children are born with very little arch in the feet. As they grow and walk, the soft tissues along the bottom of the feet tighten, which gradually shapes the arches of the feet.

Children with flexible flatfoot often do not begin to develop an arch until the age of 5 years or older. Some children never develop an arch. If flexible flatfoot continues into adolescence, a child may experience aching pain along the bottom of the foot. A doctor should be consulted if a child’s flatfeet cause persistent pain.

Doctor Examination

To make the diagnosis, your doctor will examine your child to rule out other types of flatfeet that may require treatment. These include flexible flatfoot with a tight heel cord (Achilles tendon), or rigid flatfoot, which may be a more serious condition.

Tell your doctor if anyone else in the family is flatfooted, as this may be an inherited condition. Your doctor will need to know about any known neurological or muscular disease in your child.

Your doctor will look for patterns of wear on your child’s everyday shoes. He or she may ask your child to sit, stand, raise the toes while standing, and stand on tiptoe. In addition, your doctor will probably examine your child’s heel cord (Achilles tendon) for tightness and may check the bottom of your child’s foot for calluses.

The arch disappears when standing (left) and reappears when the child is on tiptoes (right). Reproduced from Sullivan JA: Pedatric Flatfoot: Evaluation and Management. J Am Acad Orthop Surg 1999;7:44-53.

Treatment

Nonsurgical Treatment

Treatment for flexible flatfoot is required only if your child is experiencing discomfort from the condition.

Stretching exercises. If your child has activity-related pain or tiredness in the foot, ankle, or leg, your doctor may recommend stretching exercises for the heel cord.

Heel cord stretch.

Heel Cord Stretch
Lean forward against a wall with one leg in front of the other. Straighten your back leg and press your heel into the floor. Your front knee is bent. Hold for 15 to 30 seconds. Keep both heels flat on the floor. Point the toes of your back foot toward the heel of your front foot. This stretch should be performed three times on each leg.

Shoe inserts (orthotics). If discomfort continues, your doctor may recommend shoe inserts. Soft-, firm-, and hard-molded arch supports may help relieve your child’s foot pain and fatigue. They can also extend the life of your child’s shoes, which may otherwise wear unevenly.

In most cases, there is little benefit to using custom-molded arch supports. Over-the-counter arch supports, which are available at most sporting goods and running shoe stores, can be just as effective and are much less expensive to replace as your child grows. Online retailers often have inserts in difficult-to-find sizes.

Additional treatment. Your doctor may prescribe physical therapy or casting if your child has flexible flatfoot with tight heel cords.

A child at age 3 years (left) with flexible flatfoot. The same child at age 15 years (right) has a normal arch despite having received no treatment. Reproduced from Sullivan JA: Pedatric Flatfoot: Evaluation and Management. J Am Acad Orthop Surg 1999;7:44-53.

Surgical Treatment

Occasionally, surgical treatment may be recommended for an adolescent with persistent pain. Surgery is typically performed to create an arch in the foot and lengthen tendons that may be tight and causing pain. The surgery is usually performed in stages. One foot is corrected then, after several months of recovery, the second surgery takes place.

In a small number of children, flexible flatfeet become rigid instead of correcting with growth. These cases may need further medical evaluation.