Other Foot and Ankle Conditions

Other foot and ankle conditions include:

Plantar fasciitis

What is plantar fasciitis?

Plantar fasciitis is common cause of heel pain. It’s due to degeneration of the plantar fascia, which is a band of thick tough tissue that runs from heel, along the sole of the foot, to the base of the toes. It forms the arch of the foot and helps you walk and run by stabilising the foot joints and acting as a shock absorber.

The plantar fascia takes a lot of stress – every time you take a step, a force equal to three times your body weight passes through it. This makes it prone to injury and damage. The damage is usually in the form of very small tears where the fascia joins onto the heel bone.The plantar fascia has a very poor blood supply and so these tears heal very slowly.

Plantar fasciitis is common in runners and people engaged in running/jumpingactivities (eg football, basketball, tennis, ballet). If you spend a lot of time on your feet, especially if you’re carrying extra weight, increases your chance of developing plantar fasciitis. Having a very high arch or flat feet also increase your risk.

If you have plantar fasciitis you may also have heel spurs (also called calcaneal spurs). These are calcium deposits that occur where the fascia is most degenerative (on your heel). They don’t cause your heel pain, but are due to the ageing process going on in your  plantar fascia. Many people have heel spurs without feeling any pain.

Plantar fasciitis occurs equally in women and men. It is most common in people aged 40–60 years of age.

What are the symptoms of plantar fasciitis?

The symptoms of plantar fasciitis are:

  • a sharp stabbing pain in your heels
  • pain that is usually worse when taking your first steps after getting out of bed, but may also occur after standing for a long time, after exercising or after sitting for a while

The pain may come and go.

What does your doctor look for?

Your doctor will ask about your symptoms, including when the pain started, what brings it on, what makes better/worse. You will probably be asked about your activities, your footwear and whether you’ve had any previous foot injuries.

Your doctor will examine your feet looking for deformities, pain and restricted movement. You may be asked to stand and walk on your toes or stand on one leg and raise the heel off the floor.

What investigations are needed?

Usuallyno investigations are required unless another diagnosis (eg stress fracture) is suspected. In this case, your doctor may request an X-ray.

How is plantar fasciitis treated?

Plantar fasciitis may be treated with self-care such as losing weight (if needed), wearing supportive shoes and choosing low-impact activities (eg swimming) or avoiding hard surfaces. Your doctor may suggest additional treatment options for plantar fasciitis such as:

  • therapy (eg physiotherapy and stretching exercises, massage, shoe implants, splints)
  • medication (eg anti-inflammatories, steroid injection into the heel, botulinum toxin injections)
  • surgery – is incredibly rare as this condition settles in the majority of patients after 12-18 months.

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.

Plantar fasciitis surgery

Surgery is generally reserved for patient with symptoms that don’t improve with other treatments. Surgery involves releasing the plantar fascia from the heel bone. It may also involve removing heel spurs.

Possible complications

Plantar fasciitis surgery is associated with complications such as increased pain, infection, fascia rupture and nerve damage.

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Tarsal tunnel syndrome

What is tarsal tunnel syndrome?

Tarsal tunnel syndrome is a condition where a nerve to the foot is compressed as it passes through the tarsal tunnel in the ankle. The nerve involved is the tibial nerve, which is a branch of the sciatic nerve that runs all the way down the leg from the lower back. The tibial nerve controls sensation and muscle movement along the bottom and inner part of your foot.

The tarsal tunnel is formed by the Achilles tendon, the bony bumps on the inside of the ankle and a strong piece of connective tissue called a retinaculum. The tunnel can become narrowed and compress the tibial nerve due to:

  • arthritis
  • injury from overuse (eg long distance running)
  • injury from trauma (eg ankle sprain or other injury causing swelling/scarring around the ankle)
  • complications of lower limb surgery (causing swelling/scarring around the ankle)
  • a cyst, ganglion or other growth

People with flat feet and diabetes are more prone to tarsal tunnel syndrome.

What are the symptoms of tarsal tunnel syndrome?

The symptoms of tarsal tunnel syndrome include:

  • a burning pain along the sole of your foot and that may radiate up into your calf
  • numbness and tingling along the sole of your foot
  • pain that is worsened by being on your feet for a long time and relieved by rest and putting your feet up
  • pain that may be worse at night
  • symptoms can be exactly the same as or occur in conjunction with plantar fasciitis.

What does your doctor look for?

Your doctor will ask about your medical history and about your symptoms. Your doctor will also perform a physical examination including assessing your feet for areas of pain or deformity, muscle wasting and the Tinel’s sign, which is radiating pain after tapping or pressing the bony bump on the inside of your ankle.

What investigations are needed?

A diagnosis can usually be made based on history and physical examination. Further testing may include nerve conduction studies or an MRI to look for specific causes of the compression.

How is tarsal tunnel syndrome treated?

Treatment options for ganglion cysts include:

  • therapy (eg shoe inserts, physiotherapy and massage)
  • medication (eg anti-inflammatories, steroid injections into the area)
  • surgery

Our specialists at Orthopaedic Clinics Gold Coast will work with you to create the best treatment plan for your particular situation.

Tarsal tunnel syndrome surgery

Surgical treatment involves relieving pressure on the nerve by cutting the retinaculum. This improves or resolves symptoms in up to 90% of cases.

Other – Adult acquired Flat foot

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