We believe in a holistic and evidenced-based approach to treating all foot and ankle pathologies.
Arthritis in Big Toe Joint (Hallux Rigidus or Hallux Limitus)
Osteoarthritis (OA) is the most common type of arthritis, and it can affect joints anywhere in the body. The base of the big toe (first metatarsophalangeal joint) is a very common site for arthritis. This can cause pain as the big toe needs to bend with every step! When cartilage in the joint wears down, bones become exposed and rub against each other. This causes swelling and pain in the joint and can limit your range of motion. Osteoarthritis generally starts slowly but worsens over time.
When the big toe joint does not work properly it can affect the normal walking step. We need our big toe to bend when we push-off (propulsion). When there is jamming in the big toe joint it can also cause callus on the side of the toe and bone spurs on the toe of the joint. Hallux’ is the medial term for the big toe. When arthritis affects the big toe it can stiffen the joint. When there is slight stiffness in the toe it is called ‘Hallux Limitus’. When there is no movement in the big toe joint it is called ‘Hallux Rigidus’.
Bunions and Hammer Toes (Hallux Valgus)
Hallux Valgus is the medical term for Bunions. It is seen as a ‘bump’ on the outside of your big toe joint and the big toe turning in towards your smaller toes. This bump is a deviation of the first metatarsal bone and often an overgrowth of the bone on the metatarsal head. The big toe, known as the Hallux, starts to move towards the lesser toes. This can cause deformity in the smaller toes. One of these deformities is known as a Hammer Toe. A hammer toe is when the toe starts to bend or curl downward instead of pointing forward. It normally affects the 2nd toe but can also affect the 3rd and 4th toes.
Ball of the foot pain (Metatarsalgia)
‘Metatarsalgia’ is a general term to describe a pain in the ball of the foot. It is common to get a pain in the ball of your foot as there are joints across this part of your foot called the metatarsophalangeal joints. There is also a large amount pressure going through this part of the foot with each step you take. When you get pain in these joints it is either caused by injury to the joint itself or changes in the joint or an injury to the surrounding structures. There are many different diagnoses that come under this term Metatarsalgia. Differential Diagnosis include: Capsulitis/ Synovitis, Stress Fracture, Arthritis, Plantar Plate Injury, Intermetararsal Bursititis or a Neuroma.
Arch Pain
Pain in the arch region or instep of your foot is common injury we would see in our clinic. There are many structures that can get injured in this area. Sometimes it is due to the shape of your foot (flat foot or high arch), increasing your level of activity, overuse or trauma. One of the main structures that can get injured is your Posterior Tibialis Tendon. This tendon helps lift our arch during the gait cycle. Most flat feet are not painful, particularly those flat feet seen in children. However, sometimes adults can develop painful flat feet. The adult acquired flatfoot is a progressive, symptomatic (painful) deformity resulting from gradual stretch of the posterior tibialis tendon as well as the ligaments that support the arch of the foot. Pain in this deformity occurs because soft tissues have been torn. The deformity progresses because once the vital ligaments and posterior tibial tendon are lost.
Heel Pain and Heel Spurs
Heel pain most commonly occurs at the inside bottom part of the heel. It is normally characterised by pain first place in the morning as you get out of bed! Heel pain is normally caused by injury to the plantar fascia. The plantar fascia is the flat ligament that connects your heel bone to your toes. It supports the arch of your foot, but it can become strained, irritated or swollen when injured.
Plantar heel pain includes a range of conditions which can occur separately or in a combination:
– Thickening of the fascia (Plantar Fasciitis)
– Soft tissue oedema (swelling/inflammation) above or below the fascia
– Bow marrow oedema (inflammation of the bone)
– Plantar fascia tear
– Nerve entrapment
Heel spurs are a bony growth in the calcaneal bone. They can make an area tender but are not always the cause of heel pain.
Pain in the back of the heel (Achilles Tendinopathy)
Pain at the back of the heel in adults is normally caused by pain in the Achilles Tendon. When this tendon has been overused from an increase in level or intensity of activity, overuse, or trauma. The Achilles tendon can get inflamed, degenerate and cause pain. In the worst case scenario it can rupture.
Leg Length Discrepancy
Leg Length Discrepancy is when your lower extremity limbs are of unequal length. This leg length difference can be structural, caused by different lengths of the bones, or functional, muscle tightness or pain higher up causing leg to seem shorter. While a slight leg length difference is found in 70% of the population, if it is causing pain or problems when you are walking it must be treated. It is commonly found after a hip or leg surgery.
