Foot Pain Archives - New Mexico Orthopaedic Associates

Best Foot Exercises for Healthy Feet

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.

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.

Rheumatoid Arthritis within Foot and Ankle

in Ankle Pain, Arthritis, Foot Pain

Article featured on OrthoInfo

Rheumatoid arthritis is a chronic disease that attacks multiple joints throughout the body. It most often starts in the small joints of the hands and feet, and usually affects the same joints on both sides of the body. More than 90% of people with rheumatoid arthritis (RA) develop symptoms in the foot and ankle over the course of the disease.

Description

Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In RA, the defenses that protect the body from infection instead damage normal tissue (such as cartilage and ligaments) and soften bone.

How It Happens

The joints of your body are covered with a lining — called synovium — that lubricates the joint and makes it easier to move. Rheumatoid arthritis causes an overactivity of this lining. It swells and becomes inflamed, destroying the joint, as well as the ligaments and other tissues that support it. Weakened ligaments can cause joint deformities — such as claw toe or hammer toe. Softening of the bone (osteopenia) can result in stress fractures and collapse of bone.

In RA, the lining of the joint swells and becomes inflamed. This slowly destroys the joint.

Rheumatoid arthritis is not an isolated disease of the bones and joints. It affects tissues throughout the body, causing damage to the blood vessels, nerves, and tendons. Deformities of the hands and feet are the more obvious signs of RA. In about 20% of patients, foot and ankle symptoms are the first signs of the disease.

Statistics

Rheumatoid arthritis affects approximately 1% of the population. Women are affected more often than men, with a ratio of up to 3 to 1. Symptoms most commonly develop between the ages of 40 and 60.

Cause

The exact cause of RA is not known. There may be a genetic reason — some people may be more likely to develop the disease because of family heredity. However, doctors suspect that it takes a chemical or environmental “trigger” to activate the disease in people who inherit RA.

Symptoms

The most common symptoms are pain, swelling, and stiffness. Unlike osteoarthritis, which typically affects one specific joint, symptoms of RA usually appear in both feet, affecting the same joints on each foot.

Anatomy of the foot and ankle.

Ankle

Difficulty with inclines (ramps) and stairs are the early signs of ankle involvement. As the disease progresses, simple walking and standing can become painful.

Hindfoot (Heel Region of the Foot)

The main function of the hindfoot is to perform the side-to-side motion of the foot. Difficulty walking on uneven ground, grass, or gravel are the initial signs. Pain is common just beneath the fibula (the smaller lower leg bone) on the outside of the foot.
As the disease progresses, the alignment of the foot may shift as the bones move out of their normal positions. This can result in a flatfoot deformity. Pain and discomfort may be felt along the posterior tibial tendon (main tendon that supports the arch) on the inside of the ankle, or on the outside of the ankle beneath the fibula.

Midfoot (Top of the Foot)

With RA, the ligaments that support the midfoot become weakened and the arch collapses. With loss of the arch, the foot commonly collapses and the front of the foot points outward. RA also damages the cartilage, causing arthritic pain that is present with or without shoes. Over time, the shape of the foot can change because the structures that support it degenerate. This can create a large bony prominence (bump) on the arch. All of these changes in the shape of the foot can make it very difficult to wear shoes.

This x-ray shows signs of RA of the midfoot. Note that the front of the foot points outward and there is a large bump on the inside and bottom of the foot.

Forefoot (Toes and Ball of the Foot)

The changes that occur to the front of the foot are unique to patients with RA. These problems include bunions, claw toes, and pain under the ball of the foot (metatarsalgia). Although, each individual deformity is common, it is the combination of deformities that compounds the problem.
The bunion is typically severe and the big toe commonly crosses over the second toe.

People with RA can experience a combination of common foot problems, such as bunions and clawtoe.

There can also be very painful bumps on the ball of the foot, creating calluses. The bumps develop when bones in the middle of the foot (midfoot) are pushed down from joint dislocations in the toes. The dislocations of the lesser toes (toes two through five) cause them to become very prominent on the top of the foot. This creates clawtoes and makes it very difficult to wear shoes. In severe situations, ulcers can form from the abnormal pressure.

Severe claw toes can become fixed and rigid. They do not move when in a shoe. The extra pressure from the top of the shoe can cause severe pain and can damage the skin.

Doctor Examination

Medical History and Physical Examination

After listening to your symptoms and discussing your general health and medical history, your doctor will examine your foot and ankle.
Skin. The location of callouses indicate areas of abnormal pressure on the foot. The most common location is on the ball of the foot (the underside of the forefoot). If the middle of the foot is involved, there may be a large prominence on the inside and bottom of the foot. This can cause callouses.
Foot shape. Your doctor will look for specific deformities, such as bunions, claw toes, and flat feet.
Flexibility. In the early stages of RA, the joints will typically still have movement. As arthritis progresses and there is a total loss of cartilage, the joints become very stiff. Whether there is motion within the joints will influence treatment options.
Tenderness to pressure. Although applying pressure to an already sensitive foot can be very uncomfortable, it is critical that your doctor identify the areas of the foot and ankle that are causing the pain. By applying gentle pressure at specific joints your doctor can determine which joints have symptoms and need treatment. The areas on the x-ray that look abnormal are not always the same ones that are causing the pain.

Imaging Tests

Other tests that your doctor may order to help confirm your diagnosis include:
X-rays. This test creates images of dense structures, like bone. It will show your doctor the position of the bones. The x-rays can be used by your doctor to make measurements of the alignment of the bones and joint spaces, which will help your doctor determine what surgery would best.
Computerized tomography (CT) scan. When the deformity is severe, the shape of the foot can be abnormal enough to make it difficult to determine which joints have been affected and the extent of the disease. CT scans allow your doctor to more closely examine each joint for the presence of arthritis.
Magnetic resonance imaging (MRI) scan. An MRI scan will show the soft tissues, including the ligaments and tendons. Your doctor can assess whether the tendon is inflamed (tendonitis) or torn (ruptured).

Rheumatology Referral

Your doctor may refer you to a rheumatologist if he or she suspects RA. Although your symptoms and the results from a physical examination and tests may be consistent with RA, a rheumatologist will be able to determine the specific diagnosis. There are other less common types of inflammatory arthritis that will be considered.

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Nonsurgical Treatment

Although there is no cure for RA, there are many treatment options available to help people manage pain, stay active, and live fulfilling lives.
Rheumatoid arthritis is often treated by a team of healthcare professionals. These professionals may include rheumatologists, physical and occupational therapists, social workers, rehabilitation specialists, and orthopaedic surgeons.
Although orthopaedic treatment may relieve symptoms, it will not stop the progression of the disease. Specific medicines called disease-modifying anti-rheumatic drugs are designed to stop the immune system from destroying the joints. The appropriate use of these medications is directed by a rheumatologist.
Orthopaedic treatment of RA depends on the location of the pain and the extent of cartilage damage. Many patients will have some symptom relief with appropriate nonsurgical treatment.

Rest

Limiting or stopping activities that make the pain worse is the first step in minimizing the pain. Biking, elliptical training machines, or swimming are exercise activities that allow patients to maintain their health without placing a large impact load on the foot.

Ice

Placing ice on the most painful area of the foot for 20 minutes is effective. This can be done 3 or 4 times a day. Ice application is best done right after you are done with a physical activity. Do not apply ice directly to your skin.

Nonsteroidal Anti-inflammatory Medication

Drugs, such as ibuprofen or naproxen, reduce pain and inflammation. In patients with RA, the use of these types of medications should be reviewed with your rheumatologist or medical doctor.

Orthotics

An orthotic (shoe insert) is a very effective tool to minimize the pressure from prominent bones in the foot. The orthotic will not be able to correct the shape of your foot. The primary goal is to minimize the pressure and decrease the pain and callous formation. This is more effective for deformity in the front and middle of the foot/
For people with RA, hard or rigid orthotics generally cause too much pressure on the bone prominences, creating more pain. A custom orthotic is generally made of softer material and relieves pressure on the foot.

Braces

A lace-up ankle brace can be an effective treatment for mild to moderate pain in the back of the foot and the ankle. The brace supports the joints of the back of the foot and ankle. In patients with a severe flatfoot or a very stiff arthritic ankle, a custom-molded plastic or leather brace is needed. The brace can be a very effective device for some patients, allowing them to avoid surgery.

A custom-molded leather brace can be effective in minimizing the pain and discomfort from ankle and hindfoot arthritis.

Steroid Injection

An injection of cortisone into the affected joint can help in the early stages of the disease. In many cases, a rheumatologist or medical doctor may also perform these injections. The steroid helps to reduce inflammation within the joint. The steroid injection is normally a temporary measure and will not stop the progression of the disease.

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Surgical Treatment

Your doctor may recommend surgery depending upon the extent of cartilage damage and your response to nonsurgical options.
Fusion. Fusion of the affected joints is the most common type of surgery performed for RA. Fusion takes the two bones that form a joint and fuses them together to make one bone.
During the surgery, the joints are exposed and the remaining cartilage is removed. The two bones are then held together with screws or a combination of screws and plates. This prevents the bones from moving.
Because the joint is no longer intact, this surgery does limit joint motion. Limited joint motion may not be felt by the patient, depending on the joints fused. The midfoot joints often do not have much motion to begin with, and fusing them does not create increased stiffness. The ankle joint normally does have a lot of motion, and fusing it will be noticeable to the patient. By limiting motion, fusion reduces the pain.
Fusion can be a successful technique. However, because patients with RA also show damaged cartilage and loose ligaments, the success rate of this type of surgery is lower in patients with RA than in patients without RA. The use of newer generation medication can slow the progression of the disease and impact the type of surgeries that can be performed successfully.
Other surgeries. The front of the foot is where there are more surgical options for some patients. Surgeons can now perform joint sparing operations to correct the bunion and hammertoes in some patients. Your surgeon will review the most appropriate options for your case.

Ankle

Ankle fusion and total ankle replacement are the two primary surgical options for treating RA of the ankle. Both treatment options can be successful in minimizing the pain and discomfort in the ankle. The appropriate surgery is based upon multiple factors and is individualized for every patient.

This patient had arthritis of the hindfoot. It was treated by fusing all three joints of the hindfoot (triple fusion). An ankle replacement was also done in order to improve mobility and avoid the severe stiffness that would result from another ankle fusion. The ankle replacement implants can be seen here from the front and the side.

Patients with severe involvement of other joints around the heel or patients who have previously undergone a fusion on the other leg, may be more suited for ankle replacement. In addition, patients who have fusions within the same foot may be more suited for an ankle replacement.
Newer generation ankle replacement implants have shown promising early results. Ankle replacement implants have not yet been shown to be as long-lasting as those for the hip or knee, due to the fact that the newer generation of implants have not been available long enough to determine how long they will last.

These x-rays show an ankle fusion from the front and the side. The number and placement of screws and the use of a plate are dependent upon the surgeon’s technique.

Following ankle fusion, there is a loss of the up and down motion of the ankle. The up and down motion is transferred to the joints near the ankle. This creates a potential for pain in those joints, and possibly arthritis.
Patients are able to walk in shoes on flat, level ground without much difficulty after an ankle fusion, despite the loss of ankle motion. The joints in the foot next to the ankle joint allow for motion similar to the ankle joint, and help patients with fused ankle joints walk more normally.

Over time, the increased stress that is placed on the rest of the foot after an ankle fusion can lead to arthritis of the joints surrounding the ankle. This patient had pain in the subtalar joint (arrow) and required an additional fusion of that joint to minimize the pain. Increased stress on other joints is the most concerning problem following ankle fusion.

Hindfoot (Heel Region of the Foot)

A fusion of the affected joints of the hindfoot is the most common surgery used to treat patients with flatfoot or arthritis of the hindfoot. A triple arthrodesis is a fusion that involves all three joints in the back of the foot. Occasionally, the joint on the outside of the foot is not fused if there is minimal to no involvement of that joint (this is at the surgeon’s discretion). This type of fusion eliminates the side-to-side motion of the foot, while preserving most of the up and down movement.
If RA is only in one joint, then a fusion of just that affected joint may be all that is needed.

(Left) In this x-ray, two of the three joints in the hindfoot have been fused. (Right) Just the subtalar joint is fused in this x-ray.

Any fusion of the hindfoot will limit side-to-side motion of the foot. This will affect walking on uneven ground, grass, or gravel. There is no method to replace the joints of the hindfoot.

Midfoot (Middle of the Foot)

Fusion is the most reliable surgical method to treat RA of the midfoot joints. If the shape of the foot is not normal, surgery is designed to help restore the arch and minimize the prominences on the foot.
There are joint replacement implants available for joints on the outside of the midfoot. This may preserve some midfoot motion. However, the use of these implants is at the surgeon’s discretion. These implants are not available for the joints on the inside of the midfoot.
Although the foot cannot be returned to a normal shape, the goals are to reduce pain in the foot and improve the potential for the patient to wear more normal shoes.

(Top) This x-ray shows RA of the midfoot that has collapsed the arch. (Bottom) The surgical reconstruction involved a fusion of the middle of the foot with plates and screws.

Forefoot (Toes and Ball of the Foot)

The choice of treatment for patients with a bunion or lesser toe deformities (hammer or claw toes) depends on a number of factors.
If the disease is very mild, joint-sparing procedures that preserve motion can be considered. The decision is dependent on the medication that the patient is taking and the amount of damaged cartilage that is present. A fusion of the great toe may be recommended despite that fact the bunion is very mild. If there is damage to the cartilage of the great toe joint, correcting the bunion will not minimize the arthritic pain.
If the RA has progressed and the lesser toes (two through five) have dislocated, a complex operation to minimize the pain and restore the shape of the foot may be recommended. The operation involves fusion of the big toe and removing a portion of bone of each of the metatarsals. This surgery removes the prominent bone on the bottom of the foot that is a source of the pain and allows the toes to re-align into a better position.
Occasionally, the lesser toe metatarsals can be preserved by shortening them to allow the toes to resume their position within the joints. This is not always possible, however, and the joint may have to be removed.

RA of the forefoot before and after fusion

(Left) RA of the forefoot. The big toe is deviated and crosses over the second toe, a typical appearance of a bunion. The lesser toes (two through five) are dislocated, resulting in painful and severe claw toes. (Right) This x-ray taken immediately after fusion of the big toe shows that the prominent bones on the ball of the foot were removed and the claw toes were corrected. The pins hold the toes in place while the soft tissues heal. The pins are removed in the office after 4 to 6 weeks with minimal discomfort.

To fix the bend in the toes themselves, the surgeon may suggest cutting a tendon or removing a small portion of bone of the toes to allow them to straighten. Pins that stick out of the foot are temporarily required and will be removed in the office after healing takes place.
There are some newer implants available that can be buried within the toes, which avoid the need for pins sticking out of the foot. These implants may not work if the bone is soft, or if significant destruction of the joints has occurred.
This operation puts a lot of stress on the blood vessels and skin of the foot. In severe cases, the toes may not survive the operation and may require amputation of a portion or the entire toe. This operation can provide the patient with a high level of function and the ability to enjoy a wider variety of shoewear.

Reconstruction of the foot does not mean that a patient will be required to wear bulky and unappealing shoes every day. The patient shown here had both feet reconstructed. She is able to wear sandals and mild heels without difficulty. Although these types of shoes are not recommended all the time, they can be worn from time to time. Not all patients will achieve such an excellent result.

Preparing for Surgery

Many of the medications that help with RA also affect the ability of the body to heal wounds and fight infection. Your surgeon will work with your rheumatologist or medical doctor to review which of your medications will need to be stopped prior to surgery. Once the wounds are healed, the medication is typically resumed.
This period of time can be very difficult for patients with other areas of the body that are affected by RA. Many fusions require at least 6 weeks of time where no pressure can be placed on the foot. Making appropriate preparations to ensure you have help at home is crucial for success after surgery.

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.

8 Common Foot Injuries

in Foot Pain

Article featured on Healthgrades

What to Know About Foot (and Ankle) Injuries

Inside your foot lies machinery that would impress any engineer. A total of 26 bones, 33 joints, and more than 100 tendons, muscles and ligaments work in tandem to support your weight and propel you through your daily routine. Just as the highest-tech machine can malfunction, flaws in the inner workings of your feet—or overwhelming demands from the outside—can cause injuries. Here are eight problems that can strike your feet, along with solutions.

1. Neuromas

Too-tight or high-heeled shoes, among other causes, can compress the nerves between your toes. Most often, this occurs between your third and fourth toes, a condition called Morton’s neuroma. The pain, tingling, and numbness of a neuroma can often be relieved with padding, icing, orthotics, and wearing shoes with a wide toe box and low heels.

2. Stress Fracture

Among the more severe sports injuries, stress fractures often occur when you overdo a high-impact activity like running, dance or basketball. Fatigued muscles transfer stress to the bone. A small, hairline crack forms, causing potentially severe pain. Though stress fractures can occur in any part of your foot, they most often form in the second and third metatarsals, or long toe bones. Rest allows your bones to heal, usually in 6 to 8 weeks.

3. Plantar Fasciitis

Does the first step out of bed in the morning have you howling in pain? You likely have plantar fasciitis, an inflammation of the band of tissue—facscia—connecting your toes to your heel on the bottom of your foot. High-impact sports, extra weight, and jobs that require walking or standing on hard surfaces increase your risk. Stretch your foot and calf frequently, and consider wearing a night splint that lengthens your plantar fascia while you sleep.

4. Heel Spurs

Heel spurs occur when calcium deposits build up on the bottom of your heel bone. Often, they don’t cause pain themselves—but they can irritate the plantar fascia, triggering pain along the arch and heel. Calf and foot stretches work well to relieve it; rarely is surgery to remove the spur necessary.

5. Bunions

This bump of bone and tissue at the base of your big toe forms when the joint connecting it to your foot shifts out of place. Narrow-toed and high-heeled shoes cause most cases, though heredity plays a small role. Left untreated, bunions can cause pain so severe it limits your ability to walk. Fortunately, treatments like ice, over-the-counter foot pads, and wearing shoes with wider toe boxes often bring relief.

6. Sesamoiditis

Your sesamoids—two pea-shaped bones lodged in the tendon beneath the ball of your foot—help the big toe move normally. Activities that place strain on the ball of the foot, including running and golf, can injure the bones, tendons, or surrounding tissue. Padding, strapping, or taping the foot can relieve pressure on the sesamoids, while anti-inflammatory drugs reduce pain and swelling.

7. Achilles Tendinitis

The lengthy Achilles tendon can grow thick, inflamed, swollen or painful when asked to do too much, too soon (for example, after beginning an ambitious exercise program). Tight calf muscles may also play a role. Often, pain decreases after switching from a high-impact exercise to a cross-training program, such as biking, elliptical or swimming, paired with moves to stretch and strengthen the calves.

8. Ankle Sprains

About 25,000 people fall, step or twist their way into an ankle sprain each day. This common injury occurs when the ligaments on the outer side of your ankle stretch or tear, causing pain, swelling, and sometimes an inability to bear weight. Talk with a doctor if that’s the case, or if you have severe swelling or deformity. For mild sprains, rest, ice, compression and elevation—the RICE protocol—usually does the trick.

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.

Common Heel Pain

in Foot Pain

This article is featured on Humpal Physical Therapy & Sports Medicine Centers
Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of heel pain and is sometimes called a heel spur. Plantar fasciitis is the correct term to use when there is active inflammation. Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead. Acute plantar fasciitis is defined as inflammation of the origin of the plantar fascia and fascial structures around the area. Plantar fasciitis or fasciosis is usually just on one side. In about 30 per cent of all cases, both feet are affected.

ANATOMY

Where is the plantar fascia, and what does it do?

The plantar fascia (also known as the plantar aponeurosis) is a thick band of connective tissue. It runs from the front of the heel bone (calcaneus) to the ball of the foot. This dense strip of tissue helps support the arch of the foot by acting something like the string on an archer’s bow. It is the source of the painful condition plantar fasciitis.
The plantar fascia is made up of collagen fibers oriented in a lengthwise direction from toes to heel (or heel to toes). There are three separate parts: the medial component (closest to the big toe), the central component, and the lateral component (on the little toe side). The central portion is the largest and most prominent.
Both the plantar fascia and the Achilles’ tendon attach to the calcaneus. The connections are separate in the adult foot. Although they function separately, there is an indirect relationship. If the toes are pulled back toward the face, the plantar fascia tightens up. This position is very painful for someone with plantar fasciitis. Force generated in the Achilles’ tendon increases the strain on the plantar fascia. This is called the windlass mechanism. Later, we’ll discuss how this mechanism is used to treat plantar fasciitis with stretching and night splints.

CAUSES

How does plantar fasciitis develop?

Plantar fasciitis can come from a number of underlying causes. Finding the precise reason for the heel pain is sometimes difficult.
As you can imagine, when the foot is on the ground a tremendous amount of force (the full weight of the body) is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body. This is just how the string on a bow is stretched by the force of the bow trying to straighten. This leads to stress on the plantar fascia where it attaches to the heel bone. Small tears of the fascia can result. These tears are normally repaired by the body.
As this process of injury and repair repeats itself over and over again, bone spur (a pointed outgrowth of the bone) sometimes forms as the body’s response to try to firmly attach the fascia to the heel bone. This appears on an X-ray of the foot as a heel spur. Bone spurs occur along with plantar fasciitis but they are not the cause of the problem.
As we age, the very important fat pad that makes up the fleshy portion of the heel becomes thinner and degenerates (starts to break down). This can lead to inadequate padding on the heel. With less of a protective pad on the heel, there is a reduced amount of shock absorption. These are additional factors that might lead to plantar fasciitis.

Fat Pad

Some physicians feel that the small nerves that travel under the plantar fascia on their way to the forefoot become irritated and may contribute to the pain. But some studies have been able to show that pain from compression of the nerve is different from plantar fasciitis pain. In many cases, the actual source of the painful heel may not be defined clearly.

SYMPTOMS

What does plantar fasciitis feel like?

The symptoms of plantar fasciitis include pain along the inside edge of the heel near the arch of the foot. The pain is worse when weight is placed on the foot. This is usually most pronounced in the morning when the foot is first placed on the floor.
Prolonged standing can also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the toes back toward the face can be very painful.

DIAGNOSIS

How do health care providers diagnose the condition?

When you first visit medical care, the doctor will typically examine your foot and speak with you about the history of your problem. Diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished from these conditions.
Some patients may be referred to an additional doctor for further diagnosis. Once your diagnostic examination is complete, treatment options will be offered that will help speed your recovery, so that you can more quickly return to your active lifestyle.

TREATMENTS

Non-surgical Rehabilitation

Nonsurgical management of plantar fasciitis is successful in 90 per cent of all cases. When you begin physical therapy, Physical Therapists will design exercises to improve flexibility in the calf muscles, Achilles’ tendon, and the plantar fascia.
Treatments will be applied to the painful area to help control pain and swelling. Examples include ultrasound, ice packs, and soft-tissue massage. Physical Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine, prescribed by your doctor, into the sore area.
There may be customized arch support, or orthotic, designed to support the arch of your foot and to help cushion your heel. Supporting the arch with a well fitted orthotic may help reduce pressure on the plantar fascia. Alternatively, we may recommend placing a special type of insert into the shoe, called a heel cup. This device can also reduce the pressure on the sore area. Wearing a silicone heel pad adds cushion to a heel that has lost some of the fat pad through degeneration.
Your Physical Therapist will also provide ideas for therapies that you can perform at home, such as doing your stretches for the calf muscles and the plantar fascia. We may also have you fit with a night splint to wear while you sleep. The night splint keeps your foot from bending downward and places a mild stretch on the calf muscles and the plantar fascia. Some people seem to get better faster when using a night splint and report having less heel pain when placing the sore foot on the ground in the morning.
We find that many times it takes a combination of different approaches to get the best results for patients with plantar fasciitis. There isn’t a one-size-fits-all plan. Some patients do best with a combination of heel padding, medications, and stretching. If this doesn’t provide relief from symptoms within four to six weeks, then we may advise additional Physical Therapy and orthotics.
Finding the right combination for you may take some time. Don’t be discouraged if it takes a few weeks to a few months to find the right fit for you. Most of the time, the condition is self-limiting. This means it doesn’t last forever but does get better with a little time and attention. But in some cases, it can take up to a full year or more for the problem to be resolved.

Post-surgical Rehabilitation

Although recovery rates vary among patients, it generally takes several weeks before the tissues are well healed after surgery. The incision is protected with a bandage or dressing for about one week after surgery. You will probably use crutches briefly, and your Physical Therapist can help you learn to properly use your crutches to avoid placing weight of your foot while it heals.
The stitches are generally removed in 10 to 14 days. However, if your surgeon used sutures that dissolve, you won’t need to have the stitches taken out. You should be released to full activity in about six weeks.
Surgical release of the plantar fascia decreases stiffness in the arch. However, it can also lead to collapse of the longitudinal (lengthwise) arch of the foot. Releasing the fascia alters the biomechanics of the foot and may decrease stability of the foot arch. The result may be increased stress on the other plantar ligaments and bones. Fractures and instability have been reported in up to 40 per cent of patients who have a plantar fasciotomy.
Throughout your post-surgical recovery, your Physical Therapist will note your progress and be watchful for the development of fractures and instability.

PHYSICIAN REVIEW

Your doctor may order an X-ray to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation.
Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter’s syndrome, or ankylosing spondylitis. These are diseases that affect the entire body but may show up at first as pain in the heel.
A cortisone injection into the area of the fascia may be used but has not been proven effective. Studies show better results when ultrasound is used to improve the accuracy of needle placement. Cortisone should be used sparingly since it may cause rupture of the plantar fascia and fat pad degeneration and atrophy, making the problem worse.
Botulinum toxin A, otherwise known as BOTOX, has been used to treat plantar fasciitis. The chemical is injected into the area and causes paralysis of the muscles. BOTOX has direct analgesic (pain relieving) and anti inflammatory effects. In studies so far, there haven’t been any side effects of this treatment.
Shock wave therapy is a newer form of nonsurgical treatment. It uses a machine to generate shock wave pulses to the sore area. Patients generally receive the treatment once each week for up to three weeks. It is not known exactly why it works for plantar fasciitis. It’s possible that the shock waves disrupt the plantar fascial tissue enough to start a healing response. The resulting release of local growth factors and stem cells causes an increase in blood flow to the area. Recent studies indicate that this form of treatment can help ease pain, while improving range of motion and function.
Clinical trials are underway investigating the use of radio frequency to treat plantar fasciitis. It is a simple, noninvasive form of treatment. It allows for rapid recovery and pain relief within seven to 10 days. The radio waves promote angiogenesis (formation of new blood vessels) in the area. Once again, increasing blood flow to the damaged tissue encourages a healing response.

SURGERY

Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on several areas:

remove the bone spur (if one is present)
release the plantar fascia (plantar fasciotomy)
release pressure on the small nerves in the area

Usually the procedure is done through a small incision on the inside edge of the foot, although some surgeons now perform this type of surgery using an endoscope. An endoscope is a tiny TV camera that can be inserted into a joint or under the skin to allow the surgeon to see the structures involved in the surgery. By using the endoscope, a surgeon can complete the surgery with a smaller incision and presumably less damage to normal tissues. It is unclear whether an endoscopic procedure for this condition is better than the traditional small incision.
Surgery usually involves identifying the area where the plantar fascia attaches to the heel and releasing the fascia partially from the bone. If a small spur is present that is removed. The small nerves that travel under the plantar fascia are identified and released from anything that seems to be causing pressure on the nerves. This surgery can usually be done on an outpatient basis. This means you can leave the hospital the same day.

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.

Why are my legs and feet numb?

in Foot Pain, Neuropathy, Numbness in Legs & Feet

From Medical News Today; Medically reviewed by Seunggu Han, M.D. — Written by Jennifer Huizenon January 22, 2020

A person may feel numbness in their legs and feet due to sitting in a position that puts too much pressure on the nerves or reduces blood flow. However, long-lasting or unexplained numbness may be a sign of an underlying medical condition.

Long-term numbness or a tingling feeling in the legs and feet may be due to conditions such as multiple sclerosis (MS), diabetes, peripheral artery disease, or fibromyalgia. The sensation may be felt in the whole leg, below the knee, or in different areas of the foot.

In this article, we look at some of the reasons why a person might experience numbness in the legs and feet, along with symptoms and treatments.

Causes of numbness in legs and feet

Crossing the legs for a long time may cause numbness and tingling in the legs and feet.

Often, a person’s legs go numb temporarily because of their posture. However, chronic or long-lasting numbness in the feet and legs is almost always a sign of an underlying medical condition.

Conditions associated with feet and leg numbness include:

Posture

Postural habits that put pressure on nerves or reduce blood flow in the lower limbs are the most common cause of temporary numbness in the legs and feet. Many people say their leg has “fallen asleep,” and the medical term is transient (temporary) paresthesia.

Habits that can cause the feet and legs to fall asleep include:

crossing the legs for too long
sitting or kneeling for long periods
sitting on the feet
wearing pants, socks, or shoes that are too tight

Injury

Injuries to the torso, spine, hips, legs, ankles, and feet can put pressure on nerves and cause the feet and legs to go numb.

Diabetes

Some people with diabetes develop a type of nerve damage called diabetic neuropathy. Diabetic neuropathy can cause numbness, tingling, and pain in the feet, and if severe, the legs as well.

Lower back issues and sciatica

Problems in the lower back, such as a breakdown or herniation of spinal discs, can cause compression of the nerves going to the legs, leading to numbness or sensory disturbances.

Sciatica is the name for irritation of the sciatic nerve, which runs from the lower back to the legs. If this nerve becomes irritated or compressed, a person may experience numbness or tingling in their legs or feet.

Tarsal tunnel syndrome

Tarsal tunnel syndrome occurs when a nerve that runs down the back of the leg and along the inside of the ankle and into the foot is compressed, squeezed, or damaged.

The tarsal tunnel is a narrow space on the inside of the ankle. People with tarsal tunnel syndrome tend to feel numbness, burning, tingling, and shooting pain in their ankles, heels, and feet.

Peripheral artery disease

Peripheral artery disease (PAD) causes the peripheral blood arteries in the legs, arms, and stomach to narrow, reducing the amount of blood they can pump and reducing blood flow. The legs are one of the most common parts of the body impacted by PAD.

Most people with PAD experience pain and cramping in their legs and hips when they are walking or going upstairs. Some people with PAD also experience leg numbness and weakness.

Symptoms of PAD typically go away after a few minutes of rest.

Tumors or other abnormal growths

Tumors, cysts, abscesses, and benign (non-cancerous) growths can put pressure on the brain, spinal cord, or any part of the legs and feet. This pressure can restrict blood flow to the legs and feet, causing numbness.

Alcohol use

The toxins in alcohol can cause nerve damage that is associated with numbness, especially in the feet.

Chronic or excessive alcohol consumption can also lead to nerve damage that causes numbness. This type of nerve damage is linked to reduced levels of B vitamins, such as B-1 (thiamine), B-9 (folate), and B-12, which is caused by excessive alcohol intake.

Fibromyalgia

Fibromyalgia is a chronic or long-lasting condition that causes widespread body pain, aching, and tenderness. Some people with fibromyalgia also experience numbness and tingling in the hands and feet.

Most people with fibromyalgia experience a variety of symptoms including:

stiffness and soreness for no apparent reason, especially in the morning or after sleeping
chronic exhaustion
memory problems and difficulty thinking clearly, sometimes called fibro-fog
restless leg syndrome

Almost everyone with fibromyalgia experiences symptoms in more than one part of their body for at least 3 months at a time. If numbness in the legs and feet is not accompanied by any other symptoms or is not long-term, it is unlikely to be caused by fibromyalgia.

Multiple sclerosis

People with multiple sclerosis (MS) experience sensory nerve damage that can cause numbness in a small region of their body or whole limbs. Although numbness associated with MS often only lasts for a short period, it can last long enough to become disabling.

Stokes and mini-strokes

Strokes or mini-strokes can cause brain damage that may affect how the mind interprets and processes nerve signals. A stroke or mini-stroke can sometimes cause temporary or long-term numbness in parts of the body.

Symptoms

Numbness is just one of the many symptoms associated with temporary and chronic numbness.

Many people with numbness in their legs and feet experience additional symptoms at the same time or intermittingly, such as:

tingling
burning
tickling
itching
a crawling feeling under the skin

Treatment

The proper treatment for numb legs and feet depends entirely on the cause.

Medication

Medical options for long-term numbness in the legs and feet include:

Antidepressants. Some antidepressants, such as duloxetine and milnacipran, have been approved for the treatment of fibromyalgia.
Corticosteroids. Some corticosteroids can help reduce chronic inflammation and numbness associated with conditions such as MS.
Gabapentin and pregabalin. Medications that block or change nerve signaling may help reduce numbness associated with conditions such as fibromyalgia, MS, and diabetic neuropathy.

Home remedies

Home remedies that may help to relieve uncomfortable numbness in the legs and feet include:

Rest. Many of the conditions that cause leg and foot numbness, such as nerve pressure, improve with rest.
Ice. Ice can help reduce swelling that can put pressure on nerves. Apply cold compresses or wrapped icepacks to numb legs and feet for 15 minutes at a time several times daily.
Heat. Heat can sometimes help loosen stiff, sore, or tense muscles that can put pressure on nerves and cause numbness. However, avoid overheating numb legs and feet, as this may or worsen inflammation and cause pain and numbness.
Massage. Massaging numb legs and feet helps improve blood flow and may reduce symptoms.
Exercise. A lack of proper exercise can weaken the heart and blood vessels, reducing their ability to pump blood to the lower limbs. Activities such as yoga, Pilates, and tai chi can promote blood flow and reduce chronic inflammation or pain.
Supportive devices. Braces and specially designed footwear can help reduce nerve pressure caused by conditions such as injury, tarsal tunnel syndrome, or flat feet.
Epsom salt baths. Epsom salts contain magnesium, a compound known to increase blood flow and circulation. Epsom salts are available for purchase online.
Mental techniques and stress reduction. People with conditions that cause chronic numbness, such as MS and fibromyalgia, should try to focus on the fact that the periods of numbness are often short-lived and go away on their own. Stress also tends to make the symptoms of central nervous system disorders worse.
Sleep. Many of the chronic conditions associated with leg and feet numbness are known to worsen with a lack of proper sleep.
A healthful, balanced diet. Malnutrition, especially vitamin B deficiencies, can cause nerve damage leading to numbness. Getting enough vitamins and other nutrients can also reduce chronic inflammation and pain, which can cause numbness.
Alcohol reduction or avoidance. Alcohol contains toxins that can cause nerve damage and numbness. Alcohol also usually makes the symptoms of chronic pain and inflammatory conditions worse and can even cause flare-ups of symptoms.

When to see a doctor

Talk with a doctor about numbness in the legs and feet that:

is not related to postural habits or lifestyle factors, such as tight clothing and footwear
lasts for long periods
is accompanied by any other chronic symptoms
is accompanied by permanent or long-term changes in the color, shape, or temperature of the legs and feet

Numbness in the legs and feet is a common disorder, though when it becomes chronic, it may be a sign of an underlying medical condition.

Anyone who experiences numbness that is unexplained, persistent, frequent, painful, disabling, or accompanied by other chronic symptoms should see a doctor for a diagnosis and to discuss 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.

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.

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