Common Foot and Ankle Conditions page 1
Alaska Foot & Ankle Specialists (AFAS) is an entire clinic dedicated exclusively to diseases and conditions of the foot and ankle. Whatever your condition, the providers at AFAS have the training and experience to provide a solution.
Below is an interactive list of 15 common foot and ankle conditions. Click each title to learn more:
The Achilles tendon is a band of tissue that connects a muscle to a bone. It runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the “heel cord,” the Achilles tendon facilitates walking by helping to raise the heel off the ground.
Two common disorders that occur in the heel cord are Achilles tendonitis and Achilles tendonosis.
Achilles tendonitis is an inflammation of the Achilles tendon. This inflammation is typically short-lived. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which case the tendon loses its organized structure and is likely to develop microscopic tears. Sometimes, the degeneration involves the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.
A fracture is a partial or complete break of a bone. Fractures in the ankle can range from the less-serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both.
Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and, therefore, require an accurate and early diagnosis. They sometimes occur simultaneously.
Ankle pain is often due to an ankle sprain, but can also be caused by ankle instability, arthritis, gout, tendonitis, fracture, nerve compression (tarsal tunnel syndrome), infection or poor structural alignment of the leg or foot. Ankle pain can be associated with swelling, stiffness, redness and warmth in the area. The pain is often described as an intense, dull ache that occurs during weight-bearing activities and ankle motion.
Initial treatment may consist of rest, ice, elevation and immobilization, but may also include nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, and physical therapy and cortisone injection.
For more information on ankle pain, see these foot and ankle conditions:
• Achilles tendonitis
• Ankle fracture
• Ankle sprain
• Tarsal tunnel syndrome (nerve compression)
An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue—like rubber bands—that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.
Some ankle sprains are much worse than others. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.
A sprained ankle is often caused by rolling the ankle during sports, hiking or other physical activity.
Pain across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as “arch pain.” Although this description is nonspecific, most arch pain is due to strain or inflammation of the plantar fascia (a long ligament on the bottom of the foot). This condition is known as “plantar fasciitis” and is sometimes associated with a heel spur.
In most cases, arch pain develops from overuse, unsupportive shoes, weight gain or acute injury. If arch pain persists beyond a few days, call AFAS for an appointment. A foot-and-ankle surgeon can diagnose the cause of your pain and provide treatment to prevent this condition from becoming worse.
If it is plantar fasciitis, you are probably a good candidate for shockwave therapy. We are the only provider in Alaska offering this high-tech, non-surgical treatment that has proven to be very effective. It’s also fast and surprisingly affordable.
Athlete’s foot is a skin infection caused by fungus. A fungal infection may occur on any part of the body; on the foot, it is called “athlete’s foot.” The medical term for it is “tinea pedis.” Fungus commonly attacks the foot because it thrives in a dark, moist, warm environment, such as a shoe.
Fungal infections are more common in warm weather, when feet tend to sweat more. Fungus thrives in damp areas, such as swimming pools, showers and locker rooms. Athletes often have sweaty feet and use the facilities where fungus is commonly found, thus the term “athlete’s foot.”
Athlete’s foot usually produces itchy, dry, scaling skin. It is commonly seen on the soles of the feet and between the toes. In advanced cases, inflammation, cracks and blisters may form; an infection caused by bacteria can also result. The fungus can spread to other areas of the body, including toenails and groin.
You can limit your chances of getting athlete’s foot by avoiding walking barefoot combined with good foot hygiene. Feet should be washed every day with soap and water and thoroughly dried, including between the toes. Feet should be kept as dry as possible. If your feet sweat a lot, you may need to change your socks during the day.
Osteomyelitis (an infection of the bone) can be caused by a variety of microbial agents (bacteria, fungus), the most common of which is staphylococcus aureus.
This serious infection can occur from a number of sources:
• It may enter bone through an injury, such as an open fracture with the bone ends piercing the skin.
• It can spread from elsewhere in the body or through the bloodstream.
• It can result from a chronic foot wound or infection, such as a diabetic ulcer.
To diagnose the condition, your AFAS doctor will examine the area and may order blood tests and X-rays or other imaging studies. Treatment options include surgery, antibiotic therapy and hyperbaric oxygen therapy.
Again, this is a serious infection. Some of the possible symptoms are:
• tenderness, redness or swelling in the affected area
• loss of range of motion
Bone tumors are caused by an abnormal growth of cells. They may be benign (noncancerous) or malignant (cancerous). Although rare, bone tumors can occur in the foot and ankle. They can be primary (originating in the bone) or secondary (originating in another part of the body).
Symptoms of a bone tumor may include:
• Fracture from slight injury
• Bone pain, often at night
• Occasionally a mass or swelling in the area
A bone tumor is first diagnosed with X-rays. Advanced imaging modalities may be used to further evaluate the tumor. Surgical removal by a foot-and-ankle surgeon may be required for a definitive diagnosis.
A bunion is typically a progressive deformity of the great toe joint causing a large prominence of bone (bunion) on the side of the joint and deviation of the great toe towards the lesser toes – in other words, the bunion is pushing your big toe towards your smaller toes.
Bunion pain is associated with rubbing of the bump in shoes and/or motion of the joint. Soreness may be found under the ball of the foot in the presence or absence of a callus. Occasionally, redness or even a wound can form over the boney prominence. Drifting of the great toe into the lesser toes can contribute to hammertoes and poor alignment of the joint. With longstanding bunion, arthritis can develop and be seen on X-ray as wearing away of the joint. This arthritic process is what causes bunion pain with motion of the great toe.
Although certain poorly fitted shoes may contribute to symptoms and progression of bunion deformity, there is little evidence that shoes in and of themselves cause bunions. There are many examples of indigenous people who have never worn shoes yet experience very severe bunions. Bunions are typically an inherited, family trait that may progress.
Bursitis is an inflammation of a small, fluid-filled sac, called a “bursa,” located near a joint, bone or tendon. The bursa, which protects the area from friction, can become inflamed from repetitive motion or irritation from shoes. In the foot, the heel and toes are most often affected.
Symptoms of bursitis include:
• localized redness
Treatment may include resting the affected area, local ice therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, padding or corticosteroid injections to help reduce inflammation and relieve pain.
Calf pain can result from many different causes. Sometimes something as simple as over-activity causes strain in the calf muscle, or dietary imbalances may cause cramping in the calf.
However, calf pain may be a symptom of more serious problems, as well. Poor blood flow to the legs (peripheral vascular disease) may cause cramping in the calf when walking or sitting with the legs elevated. A blood clot in the calf (deep vein thrombosis) is a very serious problem and also produces pain in the calf.
Calf pain can also be the result of injuries, such as tearing of the calf muscle or tendonitis. In any case, it is not something that should be ignored. A foot-and-ankle surgeon should be seen for a thorough examination and diagnosis to determine whether the cause is due to a serious health problem, an injury or merely overuse.
A callus is a thickened area of skin on the foot caused by pressure and repeated rubbing, such as from a shoe or sock. The rubbing causes the skin to produce a layer of protective skin (a callus). Calluses vary in size and can become painful.
There are a number of treatments for painful calluses. People who have calluses are cautioned against performing “bathroom surgery,” as this can lead to cuts and infection. A foot-and-ankle surgeon can evaluate the cause of the calluses and recommend the treatment most appropriate for your condition. However, if the underlying cause of the callus is not treated or removed, the callus may return.
Ligaments surrounding the joint at the base of the second toe form a capsule, which helps the joint function properly. Capsulitis is a condition in which these ligaments have become inflamed. Although capsulitis can also occur in the joints of the third or fourth toes, it most commonly affects the second toe. This inflammation causes considerable discomfort and, if left untreated, can eventually lead to a weakening of surrounding ligaments that can cause dislocation of the toe. Capsulitis—also referred to as “predislocation syndrome”—is a common condition that can occur at any age.
It’s best to treat capsulitis before your toes are pushed out of alignment. But we can also treat advanced-stage capsulitis.
Cavus foot is a condition in which the foot has a very high arch. Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing.
Cavus foot can include a variety of signs and symptoms, such as pain and instability. It can develop at any age and can occur in one or both feet.
Charcot foot is a condition that causes weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture and, with continued walking, the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
Charcot foot is a serious condition that can lead to severe deformity, disability and even amputation. Because of its seriousness, it is important that patients living with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.