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Foot Care Glossary of Terms

Achilles Tendonitis

Definition

In the back of the leg down by the ankle is the Achilles tendon, where different tendons of the back of the leg meet. This large tendon inserts onto the heel in an area that does not have much blood flow. Achilles tendonitis is the inflammation of this tendon.

When this tendon is inflamed, it becomes very difficult to walk, especially in the morning when getting out of bed. Standing, running, and jumping aggravates the condition. The pain may burn, pierce or shoot off to other parts of the foot or leg. Achilles tendonitis may precede a rupture of the tendon which requires surgery.

Cause

The following are known causes of Achilles tendonitis:
• overpronation in the foot/feet
• activities that stress the foot: ballet or dancing barefoot, jumping without adequate shoes to support the foot, or forcing oneself to repeatedly run beyond one’s capacity, running on unstable ground, running without warm-up of the foot muscles
• collapse of the arch of the foot
• shoes without proper arch support
• shoes that result in overpronation of the foot
• injury to the Achilles tendon
• anomaly of the heel bone, or faulty heel bone development

Treatment & Prevention

Treatment involves orthotic arch supports, heel cups or cradles, and sometimes a heel lift in certain types of feet. This is especially important for athletes who stress the feet more than the average person.

Prevention revolves around the avoidance of activities that can cause overpronation or tiredness of the plantar foot muscles. This then will lead to overpronation is important in runners, gymnasts and other athletes.

The avoidance of shoes that have no arch support, shoes that don’t elevate the heel at least slightly, and walking or running barefoot is recommended.

Ankle Instability

Definition

Ankle instability is when the ankle turns in during standing, walking or running. These episodes where the ankle “gives way” is associated with a feeling of wobbliness or as if the ankle can’t be trusted, especially while participating in athletic activities or running on uneven surfaces.

Cause

The cause of ankle instability is previous ligament injuries that have not healed completely. Rehabilitation focuses on strengthening the ligaments and muscles of the foot after an injury. When these exercises are performed, they always include proprioceptive exercises that re-train the ankle how to move in all different positions. Without this training, ankle instability will result.

Chronic ankle instability may occur when repeated ankle sprains occur and each of them are not sufficiently healed.

Treatment and Prevention

Medical attention is required for ankle instability because other reasons besides previous ankle sprains. The cause may be tumors or bone infections; however, these are usually accompanied by other signs and symptoms, such as pain, fatigue, and odd sensations in the ankle. X-rays rule out other causes of ankle sprain.

Ankle instability treatment includes retraining the ankle how to move with physical rehabilitation. It also includes strengthening all the muscles and ligaments of the foot. An ankle brace may provide temporary support.

Painkillers and anti-inflammatory medications may also be prescribed.

Ankle instability may require surgery to repair the ligaments, tendons and muscles in extreme cases.

Ankle Sprain

Definition

The ankle has many ligaments holding it in a position suitable for walking, running and lying down. When one or more of these ligaments is torn or overly stretched, this is called an ankle sprain. The injury to the muscle causes pain, swelling, sometimes bruising, and alters the way someone walks. The symptoms vary depending on how many ligaments are torn and how severe the tears are.

Cause

Ankle sprains are caused by a sudden turn of direction while walking or running, or from an outside force that knocks the ankle out of its normal position. For example, a runner who steps into a hole that was thought to be a shallow puddle will be enough to cause an ankle sprain. Another example is a football player running with the football to the goal line who is tackled and receives a blow to his ankle.

Each successive ankle sprain makes the ankle more and more unstable and prone to developing more ankle sprains.

Treatment and Prevention

All ankle sprains should be treated medically to determine if there has been a fracture of any of the bones of the feet. Some fractures may cause internal bleeding and other complications, and may need further medical intervention.

Inflammation is the enemy of a healing ankle sprain, so ice is usually the first phase of treatment. In ice treatment, an ice pack is placed on top of 4 to 6 towel layers laid on top of the ankle. The ice is left on the ankle for 10 -15 minutes. This can then be followed by a hot pack on top of 4 to 6 towel layers for another 10-15 minutes.

Since walking on an injured ankle with an ankle sprain worsens it, rest from weight bearing is recommended for up to 6 weeks. Sprained ankles should be elevated to keep excess blood from collecting at the injured ligament area. However, restoring ankle movement must happen as soon as possible, and this may be accomplished with physical therapy. Consider a soft cushioned heel and arch support or cushioned insoles while your ankle is healing.

An ACE bandage is used to wrap an ankle that has been sprained. This will serve two functions – to control swelling and remind you that you have an injury that needs time to properly heal.

In cases where there are multiple ligaments torn along with fractured bones, surgery is necessary to start the repair. Painkillers and anti-inflammatory drugs are often prescribed to reduce inflammation.

Arch Pain/Strain

Definition

Arch strain occurs in the foot whenever the muscles of the feet are overstressed or unable to handle the workload put upon them. Arch pain is pain in the area of any of the arches of the foot:

• Medial longitudinal arch: on the inner part of the underside of the foot, closest to the midline of the body between the bottom of the toes to the heel
• Lateral longitudinal arch: on the outer part of the underside of the foot, towards the outside of the foot, between the bottom of the toes to the heel
• Metatarsal arch: on the bottom of the ball of the foot between the big toe and the smallest toe

The pain associated with arch strain may be dull, aching pain or sharp pain, depending on the condition. Burning sensations may also accompany the arch pain.

Cause

Arch pain may occur from many different causes:
• Biomechanical problems of the foot
• Foot injuries
• Plantar fascitis, an inflammation of a band of tissue from the toes to the heel on the underside of the foot
• Overpronation of the foot
• Flat feet
• Abnormally high arch in feet
• Wearing high heels for too long

What most of these causes of arch pain have in common is that there is an underlying biomechanical problem of the foot. This can easily be addressed by what is worn on the feet via shoes and inserts.

Treatment & Prevention

Arch pain due to any of these conditions needs to be examined by a medical doctor or a podiatrist so that the condition is remedied as soon as possible.

The problem with untreated foot problems is that the longer they continue, the more damage that can happen to the body. For example, pain that starts out in the foot could end up in causing abnormal walking patterns that then lead to problems in the knee, then the hip, then the back, and neck. Wearing high heels creates faulty biomechanics of the foot, leg, knee, hip and lower back. Your feet are very important to take care of!

Overpronation and flat feet can be remedied with foot inserts and orthotic arch supports. Foot injuries can be taken care of medically so that they will fully heal and the tissues of the foot will recover.

Arthritis

Definition

When there is swelling of a joint(s), there is arthritis. There are dozens of types of arthritis, each with slightly different symptoms. For example, osteoarthritis symptoms include a red, hot, painful, swollen joint in the feet in the morning but as the day goes on and the joint warms up, the pain subsides, only to return the next morning after a night of immobility in the joint. In osteoarthritis the cartilage and joint capsule wears away.

Rheumatoid arthritis symptoms include red, hot, swollen joints that are painful round the clock although there may be periods where the pain subsides. The symptoms may include the deformation of the joints as the disease essentially “eats through” the joints, causing their misalignment.

The older you get, the more prone you become to developing arthritis. Arthritis in the foot is quite common because there are dozens of joints in the foot that may become affected.

Cause

Arthritis may be caused by:
• Abnormal wear and tear on a joint
• An injury to a joint that does not heal
• An infection in the joint
• A metabolic disorder
• An autoimmune disorder
• Colon disorders such as irritable bowel syndrome may be related to arthritis symptoms

For example, osteoarthritis is thought to be a “wear and tear” disease of the joints, initiated by an injury or faulty biomechanics of the body that result in excess stress on the joints. Rheumatoid arthritis, on the other hand, is a disease that affects several joints in the body, including the neck, spine, hands, feet, knees and hips or sacroiliac joints.

Rheumatoid arthritis is often considered an autoimmune disease although it may have an infectious origin. Gout is also considered a type of arthritis because the body’s metabolic pathways produce crystals that are deposited in the joints throughout the body.

Treatment & Prevention

Treatment of arthritis may include a ¾ orthotic insoles or an arthritic insert, shoes that allow the toes to wiggle upward and sideways (wide shoes and high toe boxes)

It is common for those with rheumatoid arthritis affecting the foot to need special orthotics or special shoes to accommodate the deformities.

The way that arthritis affects the individual person determines the treatment, the type of shoe or orthotic aid required, and the follow-up treatment.

Prevention of arthritis involves:
1. A good anti-inflammatory diet with plenty of antioxidants, vitamins and minerals that can help rebuild the cartilage
2. Wearing proper supportive shoes
3. Healing of injuries to joints quickly after they occur

Athlete's Foot

Definition

Athlete’s foot is a common fungal infection that strikes the skin of the foot, especially the skin surrounding the toes and the heel. The fungus likes the skin of the feet because it is often moist and sweaty; an area where fungi can grow rampant.

The infection may cause burning, itching, redness, cracks and fissures, oozing, and pain. There are two types of athlete’s foot: the dry type and the wet type. The dry type has cracks and fissures; the wet type has oozing of open areas.

Cause

The cause of Athlete’s foot is Athlete’s foot fungi grow in warm, wet areas commonly shared by people who walk barefoot; such as the shower stalls at health clubs, dressing rooms, swimming pool lockers and other similar types of locations.

Treatment & Prevention

Once you get Athlete’s foot, it must be treated medically with anti-fungal medication. The fungus is very stubborn and needs attention for at least 90 days to eliminate it, as the skin on the feet grows quite slowly. It’s easy to spread the infection from one place to another, especially if there are open cracks on the skin. If the Athlete’s foot fungus has infected the nail, then treatment may extend to six months.

Prevention involves keeping the feet clean and dry, and not touching the area that is infected and then another uninfected area of the skin, even on other parts of the body. It’s important to wash your hands after cleaning the area or even after spreading the antifungal medication on the foot. Other preventive measures include:
• wearing socks when wearing shoes
• wearing shoes that allow circulation around the toes
• using medicated foot powder
• taking care of other infections in the body, including dental infections, yeast infections, and colds and flu

There is another area of prevention that’s important to address: that of immune system function. When immune function is low, it’s easier for Athlete’s foot – and other fungi – to attack the body. Thus, diabetics are most prone to develop Athlete’s foot, even though they may not be athletes.

Don’t give up on your Athlete’s foot infection until it’s cleared up. There are remedies and medical solutions for it that work.

Blue Toe Syndrome

Definition

Blue toe syndrome is a condition where the toes turn blue because of a blood clot that is occurring somewhere in the body, usually in the toe, foot, leg, or even the heart.

Cause

When the toes turn blue, this can be caused by a number of things. However, the Blue Toe Syndrome is most commonly caused by an embolism. Here are some other causes of blue toe syndrome:
• high levels of white blood cells, platelets and immunoglobulins
• inflammation of the blood vessels
• spasm of the blood vessels such as in Raynaud’s phenomenon and Pernio
• systemic lupus erythematosus
• essential thrombocytopenia
• frostbite of the toes
• medication side effects (Warfarin, steroids)
• illegal drugs such as amphetamine and cocaine

The most common reason for the Blue Toe Syndrome is a blood clot.

Treatment and Prevention

Medical treatment is important and varies depending on the cause. Warfarin, an anticoagulant, is prescribed which clears the blood of clots, if the cause is an embolism. However, it won’t work if the blue toes are caused by Warfarin.

If the blue toe syndrome has occurred because of illegal drug use, the drugs need to be stopped. If it’s a result of SLE or thrombocytopenia, or other medical condition, the blue toes should resolve when the medical conditions are addressed.

Bunionettes

Definition

A bunionette is a smaller bunion that is located on the opposite side of the foot from a bunion. The bunion appears on the joint between the big toe and the first metatarsal bone; a bunionette appears on the joint between the 5th toe and the 5th metatarsal bone.

In the case of a bunionette, the 5th toe is what moves inward towards the 4th toe. When the toe moves, the bones of the foot becomes maligned and the joint becomes more pronounced and more angular. It then becomes red, inflamed, and painful.

Cause

A bunionette is called a Tailor’s Bunion because of the body position that a tailor sits in during his or her work, making it possible for the bunionette to develop.

Some of the other causes of a bunionette include:
• shoes that do not fit properly, crowding the little toe
• wearing high heels
• wearing tight, narrow dress shoes
• wearing shoes too small for one’s feet
• wearing pointed shoes

Treatment & Prevention

Treating the pain of a bunionette in the beginning stages of its formation involves soaking the foot in a foot bath that is soothing and relaxing.

However, the root cause of the bunionette should be uncovered and addressed. If the cause is improper fitting shoes, the purchase of new shoes is in order. Generally, this involves wide shoes with a high toe box that allows the toes to fit comfortably in the shoe without being crowded in any way.

Orthotic inserts such as arch supports or ones with heel pads may provide the alignment that the foot needs to prevent further progression of the bunionette. Night splints and bunion shields for the bunionette may be helpful as well.

Bunions

Definition

A bunion is a deformity of the foot, at the area where the big toe meets the long bones of the foot. This joint protrudes out towards the inside of the foot and results in the big toe migrating toward the other toes. In some cases, the big toe overlaps the second toe, which then causes other problems.

Symptoms of the bunion include:
• inflammation of the big toe/first metatarsal joint
• redness and swelling of the joint and surrounding area
• bulging and “wrinkle” in the person’s shoe
• pain in the joint
• inability to find shoes wide enough to fit the increasingly larger joint

A bunion is called hallux valgus because the big toe moves laterally, which refers to the term valgus. The word hallux refers to the big toe.

Cause

A bunion is thought to result from wearing tight shoes, narrow shoes, shoes that crowd the foot, and high heels. Shoes that don’t fit well are also a cause. However, some hereditary disorders carry a genetic predisposition to bunions. Also, flat feet may be related to the development of bunions.

Although bunions are commonly found in women, they are also found in men.

Treatment & Prevention

Depending on the development of the bunion and the progression of the big toe, surgery may be necessary. If the bunion is left to progress, it can result in crippling and the inability to walk.

Usually, both feet are afflicted with bunions, and surgeons prefer to surgically correct both feet at once. This makes it difficult for the patient to walk for six weeks, but not having bunions may be well worth the initial pain.

In milder cases, orthotic arch supports, high heel inserts, as well as bunion shields or splints may be used to alleviate the pain. The pain may be relieved by warm foot soaks temporarily. Biomechanical correction of the foot is essential to the prevention of the progression of the bunion. Also, discarding any shoes that contribute to the development of bunions is essential, and their replacement with wide shoes that sufficiently support the foot is critical.

Burning Feet

Definition

Burning feet is a condition where the feet feel as if they are on fire or exceptionally warm. The sensation of burning feet only occurs when the nerves of the body are affected by something that irritates them. Burning sensations, hot sensations, cold sensations and the feeling of ants crawling are symptoms that occur when the nerves are disrupted.

Cause

There are several causes of burning feet:
• Athlete’s foot, where the fungus causes the burning sensation
• Chemotherapy, which alters the peripheral nerves and causes the burning feeling
• Vitamin B12 deficiency
• Alcoholism
• Diabetic neuropathy
• AIDS/HIV

Treatment and Prevention

The longer you wait for the cause of the burning feet to be diagnosed, the more you risk developing potential problems with the disorder.

For example, if the cause is a vitamin B12 deficiency, the burning feet is a symptom that indicates nerve damage is occurring. If vitamin B12 deficiency continues, there can be irreversible changes in the nerves.

The burning feet that occurs with alcoholism is the result of a vitamin B1 deficiency.

Athlete’s foot is best treated with topical ointments and sometimes the addition of systemic antibiotics that are antifungals. While your Athlete’s foot is clearing up – which takes time – it may help to place orthotic inserts inside your shoes. These can act to cool down the foot, if they are made in a certain way with specific types of material for this purpose.

Burning Feet Syndrome

Definition

Burning feet syndrome is a medical condition that often affects women between the ages of 20 and 40 years old. The syndrome causes several different symptoms that occur at nighttime:
• burning feet without redness and tenderness
• excess sweating
• scotoma, or blind spot in the eye
• hyperesthesia, an increase in sensitivity of what is felt by the senses
• aching of the feet
• amblyopia, or lazy eye

The burning of the feet may extend up to the lower legs or may also include the feeling of ants crawling on the skin on the feet and skin up to the lower legs.

The syndrome is also called Grierson-Gopalan syndrome, named after the discoverers.

Cause

No one knows what causes the burning feet syndrome but it appears to have a hormonal or nervous system origin. It may also be associated with rheumatoid arthritis, kidney failure, and vitamin B deficiencies. Specifically vitamin B1 and vitamin B12 deficiencies cause burning feet.

Treatment and Prevention

It’s difficult to treat burning feet syndrome because there are no medications that will help. Tired feet also may be accompanied by burning so orthotic arch supports or inserts may relieve the stresses felt on the feet.

There are also cool Insoles that are cooling to the feet. Burning is relieved by soaking the feet in a cold water footbath.

Calcaneal Spur

Definition

A calcaneal spur is a heel spur, a bony formation found on the back of the heel. It is diagnosed on an x-ray. There is often pain from the condition and it interferes with the ability to walk.

Cause

The location of the calcaneal spur tells you where the irritation to the bone is occurring. A spur is the body’s way of protecting itself from irritation. The spur may be found at the bottom of the back of the heel, or higher up on the heel.

A calcaneal spur may also be the result of a foot condition called plantar fascitis, Achilles tendonitis, or ankylosing spondylitis.

Treatment and Prevention

In severe cases, a calcaneal spur may be surgically removed. Otherwise, methods to relieve the pain and irritation are recommended, which include orthotic inserts and/ or cushioned arch supports.

The reason why these are helpful is that they cushion the heel and provide the support of the foot so that the bones of the foot line up.

If a calcaneal spur is caused by plantar fascitis, then specific plantar fascitis heel supports, lifts or cups as well as inserts or arch supports will help.

Calluses

Definition

The foot is perfectly designed to withstand the stress of normal walking and running. When the biomechanical forces on the foot are out of balance or excessive, certain parts of the foot begin developing a blister and then a callus in order to protect the internal tissues of the foot from those forces. The area becomes hardened and thickened, and is usually on the ball of the foot but may be anywhere on the foot – side of the big toe, on any of the toes, on the sides of the small toe, or on the heel.

Cause

There are several causes of calluses:
• The foot anatomy is biomechanically incorrect, allowing stresses to accumulate in the foot.
• The type of shoes worn is altering the distribution of the forces and compression of the foot during walking, standing, running and jumping.

Treatment & Prevention

The key to eliminating calluses is identifying where the excessive pressure is coming from on the foot. Is it from wearing high heels that place most of the body weight on the ball of the foot? If so, the treatment starts with wearing shoes that don’t alter the normal biomechanics of the foot.

Is the callus resulting from the excessive compressive forces on the foot from obesity? In this case, the weight must come off – and the person will feel much better in many ways as a result.

Is it because the foot is biomechanically altered due to flat feet, high arches, or overpronation? If so, then the addition of orthotic inserts, heel pads, cushioned arch supports, high heels inserts, or orthopedic shoes will be the answer. There are also orthotic inserts that act as shock absorbers and donut-shaped pads that may alleviate the pressure on the foot over the callus.

All these changes that are addressed by attacking the root cause will prevent the callus from worsening. However, softening the callus with foot lotions and essential oils may help drastically to lessen them. Cutting the callus with a razor blade or filing it down with a nail file or foot file is not recommended because it can cause infection or even remove some important tissues

Surgery is a last resort for calluses.

Capsulitis of the Second Toe

Definition

Capsulitis of the second toe is an inflammation of the ligaments that are located at the base of the toe in the ball of the foot. Because of the anatomical structure and shape of these ligaments, the area is called a capsule. Capsulitis may also occur at the capsule of other toes.

Capsulitis causes pain in the ball of the foot and swelling. If the inflammation continues, it may cause the toe to start migrating towards the big toe, called crossover toe.

Cause

Capsulitis is more likely to occur when the weight of the foot is distributed unevenly, increasing the compressive forces onto the ball of the foot. A high arched foot, Achilles tendon problems, and a 2nd toe that is longer than the big toe are conditions that predispose a person to develop capsulitis. Tight calf muscles may also contribute to the development of capsulitis.

Injury to the capsule is another cause of capsulitis.

Treatment and Prevention

As long as the second toe hasn’t crossed over to the big toe, the capsule is still able to be saved. Ice should be used to decrease the inflammation by placing an ice pack on top of 4 to 6 towel layers for 20 minutes. The towel layers allow the ice to deliver the numbing effect slowly and not shock the body.

Wearing shoes that support the foot in its proper position is key to success. The shoes often will need replacement custom orthotic inserts and/or arches, metatarsal pads and heel cups.

If tight calf muscles are the cause, a massage therapist is needed to massage the muscles to eliminate any and all trigger points. The foot should also be massaged. Stretching exercises may then prevent the calf muscles from tightening in the future.

To prevent migration of the toe, taping and splinting may be used. It is best that the podiatrist instruct a patient in this procedure.

In cases where the toe has migrated, surgery may be needed to correct the condition.

Cavus Foot

Definition

Pes cavus foot is a foot with a high arch, one higher than normal. At first glance, a pes cavus foot may appear ‘prettier’ than a normal foot; but the distribution of the compressive forces of the foot on a high-arched foot is abnormal. This results in greater forces placed on the ball of the foot and on the heel.

Pain may occur in any part of the foot as a result of this condition.

Cause

A pes cavus foot may develop as a result of neurological disorders and infectious disease such as polio, stroke, cerebral palsy, and spina bifida. Charcot-Marie-Tooth Disorder may also be related to the development of a pes cavus foot.

Pes cavus may also be congenital. Babies are born with flat feet and the arches develop over time. During the development phase, pes cavus could result.

A high arched food can lead to additional foot disorders such as Achilles tendonitis or plantar fascitis as well as hammer toes, corns and calluses.

Treatment and Prevention

Supportive shoes with custom orthotics is essential to the relief of pain associated with a pes cavus foot. Orthotic inserts that cushion the foot along with heel supports usually benefit the foot a lot. For over-the-counter insoles, consider a high arched orthotic or sensitive foot insole.

Prevention of other foot disorders by the proper choice of shoes with a wide toe box and high toe box are essential.

Charcot Foot

Definition

Charcot Foot is the name of a condition that starts out with nerve damage called neuropathy. In neuropathy, such as what occurs in diabetics, the patient is unable to feel any sensations on the foot such as temperature changes, pressure, or where the foot is in space. By not feeling the sensations, the patient is unaware of the damage to the foot that is occurring.

After the neuropathy, the arches of the foot begin to collapse. This allows the bones of the lower leg – the tibia and fibula to push through the collapsed bones of the feet so that the weight of the body has pushed these bones through to the level of the bottom of the foot. It’s as if the patient is now walking on the tibia and the fibula – bones never meant to be walked on. There is a noticeable deformity of the foot at this point.

The symptoms of Charcot Foot may include pain and swelling, redness and heat from the afflicted foot.

Cause

The cause of Charcot’s foot is the neuropathy. In some cases, an association to neuropathy with a tight Achilles tendon has been found.

Treatment and Prevention

The Charcot foot condition progresses to total disability so it must be treated medically early. The ultimate solution is removing the neuropathy, which is caused by sugar deposits on the nerves (high blood sugar levels).

If surgery is not recommended, adequate foot support is imperative. Complete bedrest or non-weightbearing is essential for healing to occur in the early stages. A cast may be required, or a brace along with crutches or a wheelchair.

Custom orthotic inserts help prevent the reoccurrence of the condition once early medical intervention is initiated. Consider a sensitive foot insole.

Chilblains

Definition

Chilblains is an uncommon medical condition where the foot develops ulcer-like looking sores and the toes may turn blue or have a blue mark underneath them. It usually shows up in the winter when the weather is cold and moist.

Chilblains is a painful condition and may affect the fingers, ears, nose, buttocks, or thighs. It shows up after being exposed to the cold for several hours.

Cause

No one knows why some people develop chilblains after exposure to the cold while others don’t. The condition is most often seen in thin or underweight women.

Treatment and Prevention

The sores usually resolve themselves, taking anywhere from a few days to a few months. For cushion support consider sensitive feet insoles.

Claw Toes

Definition

A normal toe has all its joints – the proximal (PIP) and distal (DIP) interphalangeal joints – lined up in a straight line. In the foot condition known as claw toes, the PIP and/or DIP joints are not lined up perfectly in a 180-degree line; they may be at 30 or 45 degrees or more. This makes the toe appear as if it were a claw or hammer. Hence the name claw toes refers to this condition.

Once the muscles of the toes contract – and don’t relax – the DIP and PIP joints take on this shape. If the muscles are contracted for the entire day and don’t relax at night, the tendons and ligaments begin to adapt to the contraction and after time, these tissues ‘forget’ where they are supposed to be. The toe then permanently forms a clawlike appearance, curling downward.

Claw toes are considered rigid if the joint is locked and no movement can occur. Claw toes are considered flexible if it can be straightened with your hand.

Claw toes cause pain in the toes which can start to alter one’s gait while walking or running. Claw toes could lead to the development of other foot problems such as corns and calluses.

Cause

Claw toes may be caused by the following:
• improper-fitting shoes
• muscle imbalance, possibly due to incorrect athletic techniques used in jumping, running or walking
• arthritis

Treatment & Prevention

Many foot problems, including claw toes, can be avoided by examining one’s shoes and discarding the pairs that do not support the foot or do not have a high toe box or wide toe box. Any pair of shoes that crams the toes together is a recipe for causing claw toes, calluses, corns, and bunions.

Specific types of splints and crests may be used in the treatment of claw toes. Massaging one’s foot and improving the range of motion of the joints affected is also helpful and can alleviate some of the pain of claw toes. When wearing shoe insoles, consider a ¾ length insole.

Surgery is a last resort for this foot issue.

Corns

Definition

A callus that forms on the tips, tops, or sides of the toes is called a corn. It is usually rounded in shape, reddened, and becomes redder after walking, running or jumping.

Corns may be found on ant toe but are commonly found on the top and side of the 5th toe.

Corns may also form between the toes and these are sometimes called soft corns. These soft corns may not harden because of the moisture of the environment between the toes.

All corns have one specific point of contact with a shoe that caused the formation initially. This point may take on the shape of a cone inside the actual corn that then presses on the nerve that innervates the toe that is affected. This is one source of the pain of a corn. Another source of pain from the corn is from the continual friction that occurs on the hardened callus.

Cause

There are several major causes of corns:
1. Improperly-fitting shoes that cause a callus on the toe, especially high heels and shoes too big for the foot
2. Morton’s toe (short 1st metatarsal with hypermobility caused by overpronation, named after Dr. Dudley Morton), which causes a callus on the toe
3. Tight-fitting stockings or socks which cause contraction of the toe(s)
4. Arthritis which deforms a toe

Treatment & Prevention

Corns may lead to the development of bursitis in the joints of the toe that are affected. In other cases, an ulcer may form.

Changing the type of shoes that one wears is one of the best things you can do to start treatment of corns. By choosing wide and tall toe box shoes, you make room for the toes that are affected by corns and the friction on them may stop.

¾ Orthotic inserts, arch supports to prevent overpronation, and the avoidance of tight socks or stockings are also helpful in alleviating pain from corns.

Diabetic Foot

Definition

Diabetes causes vascular and nervous system changes throughout the entire body, and one of those types of changes relates to the feet. The most common changes experienced by many diabetics is decreased circulation and decreased ability to feel where the foot is in space, heat sensations, cold sensations or pain. The loss of sensation in the foot is called neuropathy.

Thus the term “diabetic foot” usually refers to the neuropathy found in a diabetic.

Diabetics are also prone to develop infections due to decreased immunity. Their ability to recover from infections is also depressed. This means that a diabetic with an infection can potentially develop a raging infection that turns into blood poisoning and needs the amputation of the foot – or toe. Thus, another definition for “diabetic foot” is the foot of a diabetic that has impaired circulation and is susceptible to infection, and is subsequently at risk for amputation.

Cause

Neuropathy occurs in about 1 out of every 4 diabetics and is due to the high levels of blood sugar in the bloodstream. The sugar deposits on the nerves, deadening them to feelings. Because the feelings are deadened, infections and foot deformities are more likely to result and progress because the diabetic does not feel them occurring.

Poor circulation results from narrowing of arteries and disappearance of the small arterioles that bring circulation to the foot. Poor circulation can result in a foot that doesn’t sweat, or to swelling, which causes friction on the toes, leading to corns, ulcers, infections, calluses and hammer toes. The root cause of the impaired circulation is diabetes itself.

Treatment & Prevention

The first line of defense against developing a diabetic foot and all its associated ailments is the elimination of diabetes or at least the excessively high blood sugar levels which cause further progression of the neuropathy, impaired circulation and disease itself.

The second line of defense against developing a diabetic foot is proper footwear along with diabetic insoles and the normalization of the biomechanics of the feet. Diabetic shoes must be:
• wide enough
• tall enough in the toe area
• correct any arch anomalies
• reduce pressure on any areas of the foot that is bothered by friction
• correct any present deformities such as corns, bunions, calluses, and hammer toes
• provide firm support of the heel for foot stability

The third line of defense involves proper hygiene of the foot with daily checking for infection, cuts, scrapes, sores, swelling or any other issues as well as daily washing and drying of the feet. Fresh socks should be worn daily; seamless socks and padded socks are best. The skin should be kept soft with lotion or essential oils. Barefoot walking is not recommended.

The fourth line of defense involves the restoration of the microcirculation of the foot. The only known way to do this is with hyperbaric oxygen treatment, which is usually accepted by insurance companies for diabetics, especially if they are facing amputation. Breathing levels of 100% oxygen under pressure forces the new formation of these small blood vessels.

Discolored Nails

Definition

The term “discolored nails” refers to toenails that have changed from the normal pink color to white, yellow or brown. Discolored nails can occur on just one nail on the foot or several.

Cause

Discolored nails is generally due to a fungal nail infection.

The body usually prevents nail infections from occurring but if someone is deficient in certain nutrients that boost immunity, it’s easy to develop the infections.

Treatment

Medical treatment can be either a topical treatment or an oral antibiotic type of treatment. Oral medications can have harsh effects on the liver, so it’s best to look for other solutions. Addressing the body from the perspective of building the immune system is a good strategy and for this, nutritional supplements are used. This method can be used in combination with topical ointments for best results.

One of the natural treatments that may be used is called Here2Clear™ Nail Renewal Therapy with 2nd Skin® Technology. This is a kit that contains a silver-containing gel which contains silver that is applied to the top of the nail, followed by the 2nd Skin ® Moist Pad that softens the nail plate and transports the Solver Sol® Technology to the source of the discoloration.

In laboratory studies, Here2Clear Nail Renewal Therapy quickly (<24 hours) and effectively (>99%) kills a broad range of organisms, including T. rubrum & T. mentagrophytes (the two organisms commonly associated with nail fungus), as well as C. albicans, Ps. aeruginosa, and S. aureus.

Independent clinical trials on more than 30 persons with yellow, thick and discolored nails found a significant improvement in their nails over the course of the trial ranging from 50% to 75%.

Disfigured Toes

Definition

The definition of disfigured toes is a misshapen toe. There are many different forms of disfigured toes:
• hammertoes
• claw toes
• mallet toes
• polydactyly or more toes than the five found on humans
• bunions

Each of these conditions is different and may have different symptoms as well. In many cases, there is pain as well as swelling.

Cause

The cause of each of the different types of disfigured toes varies, but many of them are due to faulty biomechanics of the foot such as flat foot, high-arched feet, or the result of other conditions such as rheumatoid arthritis, injuries, infections, or even genetic disorders. Wearing improper shoes such as high heels is another cause.

If a toe starts out normal and becomes disfigured, then there are changes in the toe leading up to the eventual deformity. When the ligaments and muscles of the toe are overly stretched or contracted for long periods of time, the toe becomes disfigured.

Treatment and Prevention

Early diagnosis of faulty biomechanics of the foot is important. Orthotic inserts and arch supports that create alignment of the bones of the foot are necessary. These can also prevent the formation of the disfigured toes.

In some conditions the solution is surgery.

Dry Skin of the Foot

Definition

Dry skin can occur on the feet just as it can occur on other parts of the body. The skin loses its moisture, cracks, fissures form and there may be thickened areas around the heels as well. Peeling is common and the feet may change color, taking on a yellow or brown color.

As the condition continues, pain may set in. If there are fissures, then bacteria and fungi may enter and cause infections in the feet. Bleeding may also occur if the fissures are deep enough and affect capillaries.

Cause

Dry skin is caused by many different conditions:
• Diet with omega 3 fat deficiency
• Faulty sweat glands
• Obesity which destroys the sweat glands of the feet
• Chronic conditions such as eczema and psoriasis

Treatment and Prevention

Treatment of dry skin of the feet may start with the application of lotion to the feet. This will add a little lubrication to the area that is affected and can relieve some of the dryness. However, the lotion must be repeatedly applied.

If the condition is due to obesity, a weight loss diet is needed. If the cause is due to faulty sweat glands, then a medical consultation is necessary to determine the next steps.

If the condition is accompanied by fissures, then it is important to monitor the feet for any infections and treat them accordingly.

Any faulty biomechanics of the foot that puts abnormal pressure on the foot should be corrected with orthotic inserts or consider a sensitive foot insole.

Ectrodactyly (Split Hand Foot Malformation)

Definition

Split hand foot malformation, also called ectordactyly, is a condition where the hand and/or foot is missing one or more fingers or toes. When a finger or toe is missing, the hand or foot takes on the appearance of a lobster claw.

There have been cases reported where a hand is only made of a thumb and one finger. However, those who have this condition can still write in cursive, sew by hand with needle and thread, and do other normal daily tasks, including tying one’s own shoes.

Some famous people who have had ectrodactyly include a chess world champion named Mikhail Tai and the actress Bree Walker from the television show, Nip/Tuck.

Cause

Split hand foot malformation is a genetic disease, passed down from parents with the trait, or the condition can occur if there’s a mutation in the DLX5 gene. The problem may occur on chromosome 7 and when it does, the person may also have hearing loss.

The expression of genetic disorders may occur because of nutrient deficiencies. However, experts still have much to learn about this disorder.

Treatment and Prevention

Those with ectrodactyly may require special orthopedic shoes or at the least, orthotic insoles and arch supports to provide some structure for the feet.

Eczema of the Foot

Definition

Eczema of the foot is a condition where the foot has dry, irritated scaly areas on the skin of the foot. The areas may crack and bleed, leaving the individual susceptible to infection. In some cases, there may be blister-like sores. The affected areas itch and may scar.

Eczema is an inflammatory condition that is twice as common in women as men.

Cause

Excessive sweating may be one of the causes of eczema in some cases. Allergies may also be related to the development of eczema.

Excessive foot washing may also strip away the natural oils of the foot that are protective against the development of eczema.

Some experts report that the body’s toxicity level and ability to absorb amino acids necessary for the synthesis of skin may affect the production of eczema.

Treatment and Prevention

Here are some helpful tips that can reduce the eczema:
1. Avoid harsh soaps that can strip the skin further of its own healing oils.
2. Avoid any substances that you are allergic to, including substances found in soaps.
3. Replace shoes that induce foot sweating.
4. Try footbaths with a few drops of essential oils added to the water.
5. Use lotions after bathing. Medicated lotions may be necessary if there is infection.
6. Analyze your diet for any deficiency of omega 3 fats. If deficient, add the oils to your diet.
7. Use custom orthotics that can keep the foot in an ideal climate – not too hot and not too cold or dry. Consider an over the counter sensitive foot insoles.

Equinus

Definition

One of the motions that the ankle does is allow you to point your toes and foot downward towards the floor or upward towards the front of the leg. When the ankle won’t perform the upward motion, the condition is called equinus.

Since this motion is necessary for proper gait, equinus leads to gait problems such as putting the weight of the body on the ball of the foot, walking on the toes, bending at the knee or hip, or even contracting the muscles of the foot until the arch is lost. Thus, the original calf cramping, pain in the ankle, arch, ball of the foot or heel, and blisters on the ball of the foot or the arch can lead to the development of bunions, hammertoes, flat feet, tendonitis, plantar fascitis, or even shin splints.

Cause

Tight calf muscles or Achilles tendon is often at the root of this problem. This may occur from wearing high heels, walking on crutches, wearing a cast, diabetes, or other reasons such as a congenital condition or short leg syndrome.

If a bone in the ankle has fractured and has been displaced to block the ankle’s range of motion, this may be another cause.

Treatment and Prevention

A medical evaluation is necessary to determine why the range of motion in the ankle is limited. This will include orthopedic tests and an x-ray. In some cases, surgery may be necessary.

In equinus, it’s critical to do the following:
• Relieve the muscle tightness with massage therapy and stretching exercises
• Wear orthotic arch supports to correct the faulty biomechanics of the foot. This may include arch supports, heel cup for stability and metatarsal pads to cushion the ball of the foot.
• Restore the proper gait.

Fibrodysplasia ossificans progressiva (FOP)

Definition

Fibrodysplasia ossificans progressive (FOP) is a connective tissue disorder that is genetic in nature. It’s a rare condition. In this condition, ligaments, tendons and muscles become tough fibrous tissues that may even then become calcified as bone. It happens when there’s an injury to the tissue.

The only symptom of the disease is a big toe that is malformed when a baby is born.

Cause

The cause is thought to be genetic.

Treatment and Prevention

At this time there is no known treatment for this disease. Surgery is essentially another “injury” to the foot and causes more fibrous tissue to be produced, and more bone formation.

However, palliative measures may be used to reduce the suffering and pain from the condition. For example, orthotic inserts or sensitive feet insoles can at least reduce the pressure on the foot at different locations.

Flat Feet

Definition

After you’ve stepped barefoot into a puddle and then on dry cement, you’ll see a footprint. If your footprint is wide throughout the whole footprint, you have a flat foot. A flat foot is when the bones of the feet collapse downward with a step of the foot. The naturally-occurring arches in the feet are not supporting the foot adequately.

This results in stressed foot muscles which can make your feet tire quickly from minimal amounts of walking. However, over time, flat feet can lead to other more serious problems that can result in a lot more discomfort and pain, such as heel spurs, plantar fascitis, bunions, calluses, corns, and metatarsalgia.

Cause

There are several causes of flat feet:
• Obesity, which puts more compressive forces on the foot from the added weight
• Pregnancy
• Repetitive movements that pound the foot into the ground such as running, jumping, and sprinting. Flat feet are worsened by running on hard surfaces such as concrete.
• Birth. We are all born with flat feet. The arch develops over time.
• Biomechanical flaws of the foot.
• Improperly fitting shoes with no support
• Running barefoot

Treatment and Prevention

Flat feet rarely need surgery. By simply adding orthotic arch supports to the shoes, flat feet can be remedied. A heel cup or heel lift may also assist in correcting the over-pronation that occurs in the foot from flat feet.

Foot Acupuncture

Definition

Foot acupuncture is often used as a treatment for different foot conditions, and other conditions that affect the rest of the body. It involves the insertion of very thin needles into the foot at specific locations. The needles activate points which redirect the flow of blood circulation to the areas of the foot that need it. The needles are left in for about 10 to 20 minutes, then removed. There is no blood when the needles are removed and very little if any pain during the procedure. A qualified acupuncturist must perform the foot acupuncture.

Cause

The causes treated by acupuncture include Morton’s neuroma, plantar fascitis, Achilles tendonitis, neuropathy, ankle pain, foot pain, ankle sprains and strains.

Treatment and Prevention

To be treated with acupuncture, a series of treatments is needed. Each treatment brings more and more restoration to the body and as a result, many foot conditions may be resolved. However, one needs to be sensible about the type of results that will be obtained. If there’s a foot deformity, acupuncture treatments won’t restore the foot to its original shape.

Soft tissue injuries or foot problems with the muscles, tendons and ligaments are most likely to be healed with acupuncture. Consider sensitive feet insoles.

Foot Bath

Definition

A foot bath is a type of treatment that those with foot disorders often use to relieve foot pain and swelling.

In this treatment, the foot or feet are immersed into a small plastic tub or a bathtub with the water at least up to the level of the ankle. Different substances may be added to the water for therapeutic purposes. The average length of time the feet soak is between 10 and 20 minutes.

Cause

Foot baths may be used for many different foot conditions, including:
• tiredness of the foot muscles
• plantar fascitis
• Achilles tendonitis
• heel spurs
• bunions
• hammer toes
• claw toes
• Morton’s Neuroma
• sesamoiditis

Any inflammatory condition of the foot may be benefited by a cold foot bath since coldness can reduce inflammation. Warm foot baths stimulate circulation of the foot.

Treatment and Prevention

1. To create a home foot bath, get a plastic bucket or foot bath device that your feet will fit in comfortably. Collect any substances you will add to the water for therapeutic purposes, such as herbs, essential oils, or Epsom salt.
2. Fill the bath with warm water so that the whole foot will be emerged in water up to the level of the ankle. Add the therapeutic substances.
3. Immerse your bare feet into the warm foot bath. If you need a cold foot bath, add cold water gradually to the warm foot bath, so as not to shock your feet.
4. Keep the feet immersed for about 10 to 20 minutes.
5. Remove your feet and dry thoroughly.

Foot Blisters

Definition

A foot blister is a swelling of the skin that contains fluid and is painful. Blisters can appear on any part of the foot.

Cause

A blister can form on the feet from several different conditions:
• Wearing shoes too tight
• Wearing shoes while feet are wet
• An infection of the foot
• An allergy

Any time there is continuous friction between any part of the foot and a shoe along with moisture, a blister can form.

Treatment and Prevention

Foot blisters should be done in the following manner:
1. Clean the area with soap and water.
2. Put a gauze bandage on top of the blister.
3. Don’t try to burst the blister.
4. Wrap the area so the bandage stays in place.
5. Allow the healing to occur.

Prevention can be accomplished by using first aid tape over the skin that is susceptible to develop a blister. Check out our Spenco 2nd Skin Blister & Dressing Kits.

For example if you have purchased new shoes and expect a blister to develop, use the first aid tape to cover the area. Don’t use the tape if you already have a blister.

Another method of prevention is wearing two pairs of socks instead of one.

Foot Reflexology

Definition

Foot reflexology is a type of treatment to the foot that is considered alternative healing and wellness. A reflexologist, someone trained in the art, applies pressure to different parts of the foot for short periods of time. The points used correspond to the acupuncture meridians and points that are activated for different conditions.

Although medical studies have not proven that reflexology is effective for any medical condition, many who have this treatment performed on their foot do notice benefits.

Foot reflexologists report that reflexes occur in the body’s organs when certain points are stimulated. When the meridians are “cleared” of obstructions, then the restoration of the “chi” to the organ can occur. This is the same philosophy that acupuncturists use to explain the efficacy of their treatment, and acupuncture is accepted as a valid effective treatment for many conditions by the World Health Organization.

The difference between foot reflexology and foot acupuncture is that foot reflexology uses the hands to activate the points, not needles.

Cause

Any conditions that are treated by foot acupuncture may be potentially treated by foot reflexology. This list includes the following conditions:
• Morton’s neuroma
• Achilles tendonitis
• plantar fascitis
• neuropathy
• ankle or foot pain
• ankle sprains and strains

Treatment and Prevention

A trained reflexologist should be sought out for this type of treatment. Reflexology points on the foot are held for a short period of time, sometimes up to one minute.

Reflexology should not be used as a substitute for medical treatment but may hasten recovery when used with medical treatment.

Ganglion Cyst in the Foot

Definition

A ganglion cyst that occurs in the foot is a mass that feels soft and is located on the foot, usually on the top of the foot. The cyst varies in size, sometimes getting larger and other times appearing smaller. The cyst arises from the joint capsule or the sheath around the tendons. The inside of the cyst may be filled with waste matter or synovial fluid or both.

Symptoms occur whenever pressure is placed on the cyst. If the ganglion cyst is located on the bottom of the foot and begins to grow larger, there will be pain. If the ganglion cyst is located on the top of the foot, shoes may rub against the ganglion cyst and cause additional problems such as blisters with the potential for infection.

Cause

No one knows the cause of ganglion cysts. However, trauma may precipitate the formation of a ganglion cyst.

Treatment and Prevention

The size, location and symptoms caused by the ganglion cyst determine its treatment. Often the cyst will be “watched” and the patient is left to deal with it on his own. In this case, it’s best to accommodate the cyst with customized orthotics so that it is not bothered. These will vary from person to person because the location of the cyst will vary.

Medical treatment may involve draining the cyst if it enlarges but this often will not prevent the reoccurrence. Surgical removal does not prevent the reoccurrence of a cyst.

Gouty Toe

Definition

A gouty toe is the name for a condition where the big toe accumulates large concentrations of uric acid which forms crystals inside the joint. The big toe swells up, is red and hot, and very painful. Even putting on a sock may increase the pain.

Cause

A gouty toe only occurs in those who have gout or high levels of uric acid. Gout is a form of arthritis that is associated with the increase in uric acid from the breakdown of purines from food and in the body. In normal physiology, the body is able to remove uric acid so that it won’t accumulate in the joints. However, normal physiology becomes abnormal in conditions such as diabetes, high blood pressure, obesity, and while taking certain medications such as aspirin and diuretics.

Treatment and Prevention

Diet changes should be made immediately, avoiding red wine, beer, other alcoholic drinks, red meat, shellfish and organ meats while increasing the consumption of pure water. By increasing water, the crystals can be prevented from forming in the body in the first place.

Without treatment the symptoms will subside, however, it helps to stay off the feet and to elevate the foot to help reduce swelling. Painkillers may also be recommended.

The avoidance of tight shoes during episodes of gouty toe is a no-brainer, since the pressure from just wearing a shoe increases pain. Consider ¾ cushioned insoles that would not be near the gouty toe.

Haglund’s Deformity

Definition

A Haglund’s deformity of the foot occurs when the heel bone becomes enlarged. This enlargement irritates the Achilles tendon when shoes are worn and causes pain and inflammation. The pain is from joint inflammation and swelling at the back of the heel.

Cause

Shoes that have a rigid back may create a callus that forms at the back of the heel. Wearing the shoes then forces the body to try to protect itself and it starts forming the bony enlargement.

The condition is more prevalent in those who have Achilles tendon problems or a high-arched foot. Overly supinating the foot – walking on the outside of the heel – can also cause a Haglund’s deformity.

Treatment and Prevention

Custom orthotic arch supports, inserts and proper heel support are important for those who have a Haglund’s deformity. Heel pads reduce the stress felt on the heel and elevate the area above the point of irritation. Softer backed shoes can stop irritation on the area.

Stretching exercises relieve the tension from the Achilles tendon. Ice reduces pain and inflammation, as does ultrasound and cold laser. Pain medication may be prescribed.

None of these will remove the actual deformity; they will only lessen the pain of it. The same measures – orthotic supports, softer shoes, and stretching – are used in prevention.

Hallux Limitus

Definition

Hallux limitus, also called Hallux rigidus, refers to a stiffened big toe which is unable to move in the up or down direction. Since movement of the big toe in these planes is important for walking, pain results in the big toe. Whenever there is restricted movement in the body anywhere, pain results.

When the big toe becomes stiff, a callus may form on top of the big toe and other toes. Because of the pain, the person with this condition starts walking in a manner to avoid the pain and calluses form.

The joint most commonly affected is not the joints of the big toe, but rather the joint where the big toe meets the first metatarsal.

Hallux limitus is often seen in people over the age of 30.

Cause

Previous damage to the toe where the cartilage is damaged could cause Hallux limitus. Wearing shoes that don’t allow the toes to move around or wriggle is another cause. The longer the big toe sits in a shoe where no movement is allowed, the sooner it will become stiff from lack of circulation.

Treatment and Prevention

Using ice to reduce any inflammation in the joint of the big toe is helpful in Hallux limitus. To do this, lay a few towels over the toe so that you have 3-4 layers of cloth over the toe) and then add an ice pack on top of it. Cover the ice pack with another towel layer, set your clock for 10 minutes. Remove the ice and towels after 10 minutes.

Since the big toe must be properly aligned in the foot, it’s important to have a health professional evaluate the alignment of the big toe and the other bones in the foot. Custom orthotics are easily added to shoes to make up for any defects in normal anatomy seen in a foot.

Arch supports or sensitive foot insoles are often very useful in cases of Hallux limitus, as well.

Hallux Rigidus (Rigid Toe)

Definition

Hallux rigidus is a condition where the big toe becomes stiff and unable to move up or down. As a result, walking becomes harder and harder – and painful. There may be swelling and a callus or bunion may form.

The callus may form on top of the big toe because the inflamed toe is rubbing against the top of the shoe. Also, a callus may form on other toes as the person starts to shift their weight to the outside of the foot just to make it easier to walk with an inflamed big toe.

The joint most affected is the joint between the part of the big toe closest to the foot and the long bone of the big toe found in the mid foot. This joint is called the metatarsophalangeal joint.

This condition most commonly afflicts people after the age of 30.

Cause

Experts still don’t understand what causes hallux rigidis. It may be due to a previous big toe injury that damages the cartilage or faulty biomechanics of the foot.

Bunion sufferers report that wearing certain pairs of shoes result in greater stiffness of this same joint, so it is possible that footwear may contribute to the development of hallux rigidus.

Treatment and Prevention

Since the big toe joint is inflamed in this disorder, self-treatment with ice is a good way to decrease inflammation and pain.

Wearing orthotic insoles, cushioned arch supports, sensitive foot insoles, and other orthotic devices can only help the condition and lessen the pain.

Hallux Varus

Definition

Hallux varus is a condition of the foot affecting the big toe when the toe starts to move away from the other toes. As the condition progresses, it may appear that the big toe wants nothing to do with the little toes.

As the condition worsens, the big toe loses flexibility and may become stiffened. The condition causes pain in the big toe. Hallux varus may lead to the development of ingrown toenails.

Cause

Hallux varus may result from bunion surgery. Here are some additional causes of the condition:
• congenital deformity
• trauma or injury
• absence of the sesamoid bone associated with the big toe
• tight tendons in the big toe

Treatment and Prevention

Depending on severity, surgery may be required, even if the condition was a result of bunion surgery. The additional surgery will realign the big toe with the 1st metatarsal bone.

Corrective shoes or custom orthotic devices such as splinting of the toe may be helpful in hallux varus.

Hammer Toes

Definition

A normal toe has all its joints – the proximal (PIP) and distal (DIP) interphalangeal joints – lined up in a straight line. In hammer toes, the PIP joint – the joint closest to where the toe joins the foot – is not lined up perfectly in a 180-degree line. The joint juts out at a 30 or 45 degree angle or sometimes more. This makes the toe appear as if it were a hammer. Hence the name “hammer toes” refers to this condition.

A hammer toe curls downward; however, one part of it extends upward above the level of the other toes. This part rubs against the shoe that a person wears and the friction begins to wear down the toe. The toe afflicted with hammer toe then can develop a callus.

Cause

Muscle imbalance, arthritis, and improperly-fitting shoes cause hammer toes.

The hammer toe curls downward because the tendons and ligaments of that toe pull it in a downward direction. This occurs because the muscles are contracting, but not relaxing.

The joints of the hammer toe may be flexible or rigid. When the condition started to develop, the joint is still moveable and the hammer toe is considered flexible. The longer the condition exists, the more the joint progresses towards immovability, and is called a rigid hammer toe.

Treatment & Prevention

Because of the part of the hammer toe that juts upward surpassing the level of the top of the other toes, it’s important to wear shoes that have a high toe box. Hammer toe crests and splints may also be used.

The best treatment for your hammer toes is to see a podiatrist who can determine the best treatment.

Prevention is based on evaluating each pair of shoes in the closet that are worn or those which may be purchased. If the shoes rub against the hammer toe in any way, they must be replaced by ones that won’t cause any friction.

Hand, Foot and Mouth Disease

Definition

Hand, foot and mouth disease is an infectious disease that usually affects children younger than 5 years old. The disease starts out with these symptoms:
• fever
• no appetite
• irritable
• sore throat

A few days later, sores develop in the mouth that blister and look like little ulcers. These may spread to the back of the throat, tongue, or cheeks. A few days later a rash shows up on the palms and soles of the feet but may also be seen on the knees, elbows, genitals, and buttocks.

The problem with hand, foot and mouth disease is that it may lead to the development of a headache and stiff neck and then meningitis or encephalitis although this is rare.

Hand, foot and mouth disease may also lead to loss of the nail.

Cause

Hand, foot and mouth disease is caused by the coxsackievirus A16 or enterovirus 71. It is contagious. It usually occurs in the summer or early fall and lasts 7 to 10 days.

Treatment and Prevention

Hand, foot and mouth disease can be prevented by:
• direct contact from an infected person
• cover your mouth when coughing
• don’t share eating utensils with someone with the disease
• avoid kissing an infected person
• clean toys with soap and water

Medical diagnosis of the condition may be helpful for peace of mind but antibiotics won’t help since the disease is caused by a virus. Aspirin is not recommended.

Hand Foot Uterus Syndrome

Definition

Hand, foot and genital (or uterus) syndrome is a condition where the development of the hands, feet, urinary tract and reproductive system is stunted. The thumbs are short, the big toe is short, the feet are short, and there are defects in the ureters. The development of the uterus is abnormal and can increase pregnancy complications later in life.

Cause

Hand, foot and genital syndrome is a genetic medical condition caused by mutations in the HOXA13 gene.

Treatment and Prevention

There is no known therapy or preventive measures that doctors know of at the present time.

It’s possible that specially designed orthopedic shoes or customized orthotics can help lessen the effects of the faulty anatomical development of the foot.

Heel Callus

Definition

A heel callus is a hardened or thickened part of the skin that occurs near or on the heel of the foot. It can eventually form a bone spur.

Heel calluses cause pain and inflammation. If they worsen they can make walking difficult.

Cause

Heel calluses can be caused by irritation from shoes or can be caused by plantar fascitis, an inflammation of the band of tissue that extends from the ball of the foot to the heel. The skin under the bone will form a reaction to protect the body from the inflammation and hardens and thickens.

Shoes with a narrow toe box can contribute to the development of toe calluses.

Treatment and Prevention

Some recommendations for heel calluses:
1. Change your shoes if you feel that they are contributing to the heel callus.
2. Purchase a pumice stone which can be used to rub on the area to smooth away the dead skin cells of the callus. A foot scrub or foot exfoliating lotion may also help.
3. Wear orthotic insoles, back of heel pads, and arch supports customized to your foot to prevent the irritation from continually occurring.
4. Don’t cut the callus off with a razor; you can easily develop an infection or go too deep and cut nerves, arteries and veins.
5. See a podiatrist for help if the callus continues to grow.

Heel Fissures

Definition

Heel fissures are cracks in the smoothness of the skin overlying the heel. They may be found anywhere on the heel. The cracks are usually accompanied by skin that is hardened or dry. Sometimes the skin may become flaky. The deeper the heel fissures, the more painful they are. Some heel fissures may bleed.

Cause

Skin normally secretes its own lubricating oils, but this does not happen in those with heel fissures. Inactive sweat glands may result because of peripheral neuropathy, as what is seen in those with diabetes.

Obesity may also be related to the development of heel fissures although no one knows why this correlation exists. It’s possible that the heels cracking may be related to a deficiency of omega 3 fats or other essential fats, which may occur more easily in obese individuals.

A hot, dry climate may contribute to the development of heel fissures; however, if this was the only cause, then everyone who lived in a hot, dry climate would have heel fissures, and this is not true. Thus there are most likely other factors contributing to the development of the fissures. Most likely, nutrition plays an important role and needs to be investigated further.

Walking barefoot for a majority of the time is also related to the development of heel fissures, as seen in cultures in underdeveloped nations where the people walk barefoot.

Treatment & Prevention

The danger of heel fissures is that the open areas of the skin are susceptible to the entrance of bacteria and fungi which cause infections. Keeping the area moisturized is a big key to the successful treatment of heel fissures. But what type of moisturizer would you use? Medicated moisturizers may be recommended by medical practitioners. Natural health enthusiasts rave about the healing power of essential oils for smoothing the skin of heel fissures.

Some recommend using a pumice stone to file down the scratchy skin, but this may also spread infection if an infection is starting.

Shoes should be fully supportive of the foot and the heel. Sandals are not recommended for those with heel fissures because they are generally unsupportive to the foot and also expose the fissures to bacterial contamination. For foot pain support, consider a sensitive foot insole or soft ¾ length comfort gel insoles.

Heel Pain

Definition

Heel pain is defined as soreness or pain which exists in the heel either at rest or when weight is supported by the foot and the heel.

Cause

Here’s a list of what may cause heel pain:
• shoes that have negative heels, the type where the heel sits lower than the ball of the foot
• repetitive stress to the heel, such as an increase in activities like marching, walking, running or jumping
• fat pad atrophy in the heel pad due to cortisone injections
• plantar fascitis
• overpronation, a biomechanical defect of the foot that causes the plantar fascia to overstretch and become inflamed, and then causes heel pain
• a vitamin B12 deficiency
• dehydration
• losing weight too fast, or putting on weight too fast

Treatment & Prevention

Heel pain is relieved when the compressive forces and shock of walking, running and jumping on the feet are absorbed by proper cushioning. An orthotic insert, such as an arch with additional customized designs like an elevated heel cup can make a big difference in the amount of heel pain a person feels.

An orthotic that addresses overpronation will alleviate the heel pain associated with overpronation problems of the foot, including plantar fascitis. This orthotic will most likely include arch supports.

As always, proper footwear is critical to the resolution of the problem.

Heel Spurs

Definition

A heel spur is a calcification that is generally shaped with jagged edges and is located on the heel. It is usually found close to the area where the Achilles tendon attaches to the heel.

Cause

Heel spurs are caused by traumatic injuries that may pull the tendon away from its insertion point, and then calcification occurs to patch up the area. Heel spurs may also occur from microtrauma that occur in the heel such as from jumping, running too much or too far, or other activities that impact the heel.

Overpronation in the foot, flat feet, or high arches can also predispose a person to form heel spurs. If the plantar fascia is overstretched, this may also lead to a heel spur over time.

Treatment & Prevention

To start healing, any activities that increase the compressive forces to the heel must be stopped. Healing will not occur unless further microtrauma stops.

If a heel spur has developed due to overpronation or arch problems, an orthotic insert with arch support can significantly help decrease pain felt with heel spurs. An additional heel lift will decrease the pain even more. Cushioned heel lifts take the pressure off the Achilles tendon which inserts into the heel.

Prevention of heel spurs includes the following:
• not wearing shoes with negative heels, where the heel is lower than the ball of the foot
• wearing heel supportive shoes with arch supports
• not increasing running or other athletic activities quickly
• not running uphill

High Arched Foot

Definition

A high arched foot is a foot with an arch higher than normal. Surprisingly to many, a high arched foot can cause pain just as much as a flat foot.

When a person has a high arched foot, the parts of the foot that normally absorb the pressures from the weight of the body are unable to do so. This results in more pressure on the heel and ball of the foot.

Cause

The following are common causes for the development of a high arched foot:
• infectious disease
• congenital deformity
• neurological disorder

For example, a high arched foot is associated with those who have developed Freidrich’s ataxia, polio, stroke, muscular dystrophy, cerebral palsy, clubfoot, spina bifida, Charcot-Marie-Tooth Disorder or stroke.

Depending on the cause, a high arched foot can lead to other problems such as claw toes, hammer toes, plantar fascitis, and Achilles tendonitis.

Treatment and Prevention

Medical treatment may include braces, high arched orthotic inserts and cushioned arch supports, and heel support for shoes. These devices may lessen the pain associated with the condition.

Hammer toes and claw toes may be prevented from developing by the purchase of shoes with a tall toe box.

Ingrown Toenails

Definition

An ingrown toenail is a toenail that begins to grow into the skin. The skin of the foot grows over one side or both sides of the toenail. When this happens, it is accompanied by a lot of pain, heat, irritation and redness in the area.

An ingrown toenail may lead to an infection and will have symptoms of inflammation, swelling, and discharge or pus. The nail will be quite painful.

Cause

Ingrown toenails are caused by:
• a traumatic injury to the toenail such as stubbing a toe or an incident where the toe is stepped on or crushed
• repetitive injuries to the nail, where the nail is pounded into the foot
• congenital conditions
• not cutting your toenails or cutting them incorrectly so they grow into the skin
• an infection of the nail
• arthritis predisposes someone to ingrown toenails
• shoes too narrow

Treatment & Prevention

An ingrown toenail that has become infected needs medical attention and antibiotics. The nail will most likely be removed, and a new one will grow back soon.

Soaking feet in a saline solution and drying them thoroughly, then covering the toe(s) is the best way to prevent ingrown toenails. Cutting the toenails straight across, making sure you can visibly see the corner of the nail prevents the nail from growing downward into the skin.

Avoiding shoes that are too narrow is a key to the prevention of ingrown toenails, as well.

Involuted Toenail

Definition

An involuted toenail is not the same thing as an ingrown toenail. An ingrown toenail grows into the toe and parts of it may disappear. An involuted toenail is a nail that is in clear view on the toe, but the sides start “pinching” into the toe, and an upward arch is formed with the nail. The sides of the nail are like the sides of the arch. The top of the arch sticks up above the level of the toe where the nail should be.

Pain can result from the toenail rubbing against the shoe. It’s possible that the arched toenail can get snagged on socks and other items if someone is walking barefoot as well.

Cause

Why people develop involuted toenails is unknown. Some experts say the cause is tight shoes while others say it’s inherited. It’s possible that cutting the sides of the nail too far down can contribute to this condition.

Treatment and Prevention

If poor-fitting shoes caused the involuted toenails or contributes to the irritation of them, then it’s important to replace the shoes. Shoes with a tall toe box are especially important.

In severe cases where the nail appears to be progressively buckling, the nail may need to be removed. This may prevent nail infections from occurring in the future.

IT Band Syndrome

Definition

If you are a runner, cyclist, or weight lifter, you may already know about IT Band Syndrome. This condition is an injury to the thigh and commonly found in those sports.

IT Band Syndrome causes pain on the outside of the knee during activity. The reason why it’s called the IT Band Syndrome is because it’s the IT Band that runs from the pelvis all the way down to just below the knee, which is involved. Whenever you run or move, this band of tissue stabilizes your knee. The IT Band is inflamed in this condition.

The symptoms may include swelling of the area on the outside of the knee or right above the knee joint. The stinging pain may be felt when the foot strikes the floor.

Many types of sports are associated with the IT Band Syndrome. Martial arts, mountain climbing, performing squats and deadlifts, running, cycling and even bowling can worsen the IT Band symptoms.

Cause

Not warming up properly before exercising is one of the main causes of this disorder, but there are many improper training habits that can contribute to it, including:
• Cycling with toes turned inward on the pedals
• Running up and down stairs or up and down hills
• Running on the shoulder of a road
• Hiking, walking or running long distances that you’re not used to

It’s not just bad training habits that are the culprit. The way your feet land on the ground during running or walking should be perfect; otherwise this IT Band will be overstressed in the body. Any foot anomaly such as high arches, low arches causing flat feet will stress the IT Band, as well. And like other foot and leg disorders, imbalances in the muscles especially the hip muscles could also be a cause.

Treatment and Prevention

If your foot has faulty biomechanics, orthotic arch supports are essential to restore some of the balance needed to alleviate this condition. So is muscle strengthening and re-balancing. Physical therapists often teach patients with IT Band Syndrome to loosen up the area with a foam roller.

Changing bad training habits is also important. Some trainers recommend compression wraps or athletic taping to strengthen the knee and decrease the pain during activity.

Surgery may be necessary if the condition doesn’t respond to conservative treatment.

Janeway Lesion

Definition

A Janeway lesion is a dark spot, usually circular, that occurs on the soles of the foot. It may also appear on the palms of the hands. Upon close examination, you will see an abscess in the area of the Janeway lesion.

A Janeway lesion is not painful.

Cause

A Janeway Lesion is caused the a blood clot that causes sepsis. It is usually associated with the toxin of Staphylococcus aureus, which causes inflammation of the inner lining of the heart.

Treatment and Prevention

Treatment involves medication for the Staphylococcus infection, which is especially important to prevent the damage to the heart and damage to the body wherever the emboli disrupt oxygen flow to the body. Not having enough oxygen to the body can cause dying tissue, which will cause additional problems and possibly even the loss of a limb.

Developing a Staphylococcus infection in the first place generally means that the individual is immune-compromised. Thus, it’s important to correct any deficiencies in the immune system, which are frequently due to faulty nutrition – not enough protein in the diet, zinc deficiency, selenium deficiency, vitamin A and vitamin C deficiency.

Lisfranc Injuries

Definition

Lisfranc injuries are generally fractures of the foot where the metatarsal bones are disjointed from the tarsus bone.

Cause

Lisfranc injuries are common during windsurfing, bicycling, or horseback riding. What these all have in common is that during these sports, the feet are strapped in place. Falling on the foot from an elevated height can also cause a Lisfranc injury.

This injury occurs when the person’s leg is twisted or pushed in a direction that doesn’t allow the foot to move in the same direction. Because the foot is strapped, it becomes trapped and susceptible to injury. The foot covers the area of the metatarsals. Depending on the amount of force applied to the foot, the metatarsal bones are dislocated and/or fractured.

Treatment and Prevention

Treatment may involve a cast and/or surgery where screws and wires are used to hold the metatarsals in place. Weight-bearing is not recommended for up to 3 months.

Madura Foot

Definition

Madura foot is a condition of the foot that results when a fungal infection causes nodules and a white, grainy discharge to appear on the foot. The nodules can spread over the entire foot, making the entire foot almost unrecognizable. The condition is more common in foreign countries such as Venezuela, Argentina, India, Columbia, Sudan, Somalia, Africa, Yemen and Central America.

Surprisingly, the condition is painless in the beginning.

The fungal infection can progress to cause destruction of the bones of the feet or even death. The infection may travel up the leg.

Cause

The cause of the condition is fungus, and the types of fungi that cause Madura foot are many. Fungal spores found in the soil are responsible for this condition. The fungi enters the skin from the soil via open wounds or tears in the skin. Mostly men working in the agricultural fields are those who are affected.

Treatment and Prevention

Madura foot is a condition that needs medical intervention. An x-ray is taken to view the extent of the internal damage caused by the fungi. Treatment involves isolating the fungi that causes it, then treatment with antifungals.

If treatment doesn’t work, then amputation may become a last resort, unfortunately.

Malignant Melanoma of the Foot and Ankle

Definition

Malignant melanoma of the foot and ankle is a cancer that is life-threatening that occurs on the foot and ankle. Malignant melanoma is often a deep lesion, and severity is based on how deep the lesion is. The range is about 0.75 mm all the way up to 4 mm for these lesions. The deeper the melanoma is, the more that melanoma extends into the dermis of the skin, and the greater the severity of the condition.

Melanoma affects the cells in the skin that causes melanin. In one study performed at the University of Michigan Medical Center in Ann Arbor, Michigan, researchers analyzed the records of 60 patients with this condition.

Lesions are usually asymmetrical with irregular borders, mixed colors, and grow over time.

They found that 57 were white and 3 were black; there were 2.3 times as many women as men, and that most of them were diagnosed around the age of 57. This research appeared in the Journal of Bone & Joint Surgery in America in September 1995.

Cause

Malignant melanoma, like other types of cancer, has many possible causes. Exposure to chemicals or toxins that cause cancer is a primary possible cause; so is deficiency of immune-system boosting nutrients such as zinc, vitamin A, vitamin C or selenium.

Another cause of melanoma is radiation from the sun’s harmful rays.

Treatment and Prevention

A biopsy is a confirmatory test for the presence of melanoma. After a biopsy is done, treatment can be started and varies depending on the patient’s overall health condition.

After five years, 63% were still alive. At the 10-year mark, 51% were still alive. If the melanoma is located on the plantar surface, the patient lived only 47 months, compared to melanoma located on the top of the foot or on the ankle – 6 years.

Mallet Toes

Definition

A mallet toe is a toe that is shaped like a mallet.

In normal anatomy, the distal interphalangeal joint (DIP) and proximal interphalangeal joint (PIP) are lined up properly and the toe joints are lined up in a 180 degree line. In a mallet toe, the toe joint farthest from the spot where the toe meets the foot (DIP joint) is out of alignment and points upward while the toenail points downward. The toe cannot straighten.

The affected toe then rubs against the top of the shoe, forming a blister, a hardened area and then a callus or a corn. There is also pain in the tip of the toe as it is crammed downward into the bottom of the shoe.

Cause

The cause of mallet toes can be arthritis or improperly fitting shoes such as narrow shoes.

Treatment & Prevention

The treatment of mallet toe begins with eliminating the friction and relieving pressure on the toe by wearing proper shoes. Shoes should be wide with a high toe box that allows extra room over the top of the toe. If your wearing orthotics, consider a ¾ orthotic arch support.

Metatarsal Stress Fracture

Definition

When too much stress occurs in the foot from walking or activity or even injury, a stress fracture may occur. It is followed by pain. The metatarsals are the long bones of the foot. The most common metatarsal that is fractured is the 2nd metatarsal.

Whenever there is a stress fracture in the foot, there will be pain and swelling in the foot near the fracture. Bruising is common. Any activity that involves the foot worsens the pain. When a tuning fork is placed on the fracture site, the pain worsens. An x-ray will show a stress fracture, but often it is a very slim line of fracture that may be easily missed.

Cause

Over-pronation of the foot makes it more possible for stress fractures to occur. There are other causes:
• too much athletic training with little recovery
• too much activity in walking, running, ballet, gymnastics, or other similar sports
• incorrect running shoes
• shoes without adequate cushioning
• faulty biomechanics of the foot
• trauma to the foot

Treatment and Prevention

To recover from a stress fracture, you must reduce weight bearing on the foot. A cast may be required. Activities involving the foot must also be curtailed. Depending on the extent of the stress fracture, surgery may be required. Like other fractures, healing time is a minimum of 4 to 6 weeks. Rehabilitation may be required after the cast is removed.

If the cause of the stress fractures is related to faulty biomechanics of the foot, such as with overpronation or alignment of the bones of the foot, orthotic inserts and/or orthotic arch supports will help considerably. Inserts may be cushioned; some of the newest inserts are made of gel that provides the foot with a feeling of walking on “clouds”.

Metatarsalgia (Forefoot/Ball of Foot Pain)

Definition

The metatarsal bones are the bones that make up the ball of the feet. In this same region is an arch of the foot called the metatarsal arch.

Metatarsalgia refers to pain in the ball of the foot anywhere from the first through the 4th metatarsals. The pain is usually located right over the metatarsal that is inflamed.

Cause

Metatarsalgia occurs because there is excessive pressure occurring on the foot from external forces. These excessive forces are from:
• wearing very high heels
• athletic activities without proper shoe or orthotic support for arches and rest of foot
• too much athletic activity
• shoes that are too narrow
• shoes that don’t fit properly
• repeated cortisone injections that caused the depletion of the fat pads in the foot

Treatment & Prevention

Determining what is the root cause of the pain is the first step in treatment. Adding properly fitted orthotic insoles, cushioned insoles, or metatarsal pads may be the best solution.

Shoes that are wide enough for the foot allows the foot to relax a little from the stress it is feeling and start to recover.

Morton’s Neuroma

Definition

This common foot problem is the inflammation of a nerve between the different toes, usually the 3rd and 4th toe. This causes symptoms including burning sensation, sharp pain, tingling sensations, numbness in the foot, and cramping.

Cause

Nerves only become agitated when they are squeezed or compressed. The irritated nerve that causes Morton’s Neuroma is irritated because there’s extra pressure on it from walking, standing, running, or jumping. The extra pressure can also be from shoes with pointy toes or high heel walking that puts pressure on the ball of the foot.

It’s also possible that faulty biomechanics such as arch problems can contribute to Morton’s neuroma.

Treatment & Prevention

As for many other foot problems, the selection of proper shoes is paramount to treating the condition. Avoid high heels, shoes with pointy toes, and select wide shoes with a high toe box. Since the ball of the foot is stressed, an extra pad of support called a metatarsal pad may be added either to an existing orthotic insert or to a new arch support. Also, consider a forefoot cushioned insole. The function of this is to relieve the pain.

Morton’s Toe

Definition

Morton’s Toe is a condition named after Dr. Dudley Morton where the second toe is longer than the big toe. This causes pressure on the head of the metatarsal of the second toe, which results in pain and inflammation. A callus often forms on the ball of the foot under the metatarsal head as well.

Cause

The condition is usually congenital.

Treatment & Prevention

Replacing the insoles of the shoes with orthotic insoles or ¾ length orthotics that support the feet to take pressure off the second metatarsal head is the answer for Morton’s Toe. Shoes must be wide enough and tall enough in the toe area to accommodate the toes.

Arch supports may be included in orthotic insoles and will keep the foot bones aligned. If the foot bones become misaligned, other foot disorders will result.

Since the head of the metatarsal is felt on the bottom of the foot in the area of the ball of the foot, a metatarsal pad may alleviate the pain by reducing some of the stress on the foot.

Nerve Entrapment

Definition

Nerve entrapment is a condition where a nerve is compressed for long periods of time. When any nerve is compressed in the body, it reacts by causing symptoms such as pain, weakness, tingling, pins and needles sensations, and/or hot and cold sensations. The longer a nerve is compressed or entrapped by other tissues, the longer it takes to recover. However, there is a point of no return. A nerve that is entrapped for too long will eventually lose all function.

Nerve entrapment may occur in the foot. For example, the peroneal nerve of the leg may be entrapped at the head of the fibula in the area of the knee but because the nerve supplies sensation and strength to the muscles of the lower leg, and foot. This results in symptoms such as pain and hot sensations on the top part of the foot. It also makes it difficult to lift the foot.

Nerve entrapment may occur with any nerve of the foot, ankle, leg – or any other part of the body.

Cause

Nerve entrapment may be caused by several things:
• Traumatic crushing injury or wound
• Pressure from swelling in another part of the body near the affected nerve
• Arthritic calcifications on nearby bones
• Tumor or growth that presses on the nerve
• Compression by tight shoes

Treatment and Prevention

In severe cases, nerve entrapment should be relieved by surgery. This must be done before the nerve is thoroughly damaged so that it may have a chance to recover.

In less severe cases, pressure from swelling may be relieved by ice packs that decrease the local areas of swelling. If arthritis or tumor growth is causing the compression, a consultation with a medical doctor or podiatrist is essential to facilitate the best recovery strategy.

If nerve entrapment is caused by tight shoes, then the shoes causing the damage must be replaced by others that have lower heels, have a wider toe box and have a high toe box.

¾ orthotic inserts and arches may be helpful. Also special pads may be worn to decrease compression of the foot in shoes as well.

Neuropathy

Definition

Neuropathy is a nerve disorder that affects the nerves that supply the hands or feet. When the nerve is affected by neuropathy, symptoms such as numbness, strange hot or cold sensations, lack of sweating or increased sweating, and loss of feeling may be felt. Often peripheral neuropathy felt by diabetics is accompanied by loss of feeling in the legs and feet, making it difficult to walk.

Cause

Diabetic neuropathy in the feet is caused by the deposition of sugar on the nerves that lead to the feet. It’s a result of diabetes.

Treatment & Prevention

There are new emerging treatments for neuropathy that include hyperbaric oxygen treatments. However, many people don’t have the opportunity to receive these treatments. Hyperbaric oxygen therapy has been found to initiate nerve re-growth and regeneration.

The traditional treatments for neuropathy include the following, many which are still good preventative treatments:
• Don’t take a chance that you’ll develop foot infections from having neuropathy. Wear shoes with a wide toe box and a high toe box. Use orthotic inserts or sensitive feet insoles. Monitor your feet daily for any negative changes.
• Exercise daily.
• Schedule regular doctor and podiatrist office visits.
• Stop bad habits such as smoking or drinking alcohol.
• Work with a dietitian on lowering blood sugar levels.

Os Trigonum Syndrome

Definition

Os trigonum is a condition where an extra bone develops behind the ankle bone called the talus. The bone is embedded in a band of tissue and can prevent the talus from fusing with the rest of the bone during the developing years. It is associated with pain in the back of the ankle, especially when pointing the toes or during walking. However, in many cases, there is no pain at all.

It may be seen in either one or both feet.

Os trigonum syndrome occurs in those with os trigonum who are participating in activities that include a lot of toe pointing, such as ballet. This type of movement squeezes the bone between the ankle and heel, resulting in pain because the band of tissue it is attached to is torn or overly stretched. Inflammation results.

Cause

Os trigonum is a congenital problem. Os trigonum syndrome is caused by repetitive pointing of the toes or possibly an ankle injury. The area of the os trigonum will be tender and swollen.

Treatment and Prevention

Medical treatment may be necessary to rule out the diagnosis of other foot-related issues. Imaging tests will be ordered to make the proper diagnosis.

An orthotic insert may assist in eliminating some of the pain of this condition by relieving the stresses placed on the os trigonum. An ice pack on top of 4 to 6 towel layers for 10 to 15 minutes will help decrease inflammation. This may be repeated several times during the day. Rest, immobilization and giving it time to heal itself is also important.

Cortisone injections may be recommended; however, these have been found to decrease the fat pads in the foot, which is important to cushion the foot and avoid compressive force damage.

Osler Nodes

Definition

Osler Nodes are darkened sores on the pads of the fingers and toes that are painful. They may be felt during palpation of the area that’s affected.

Cause

Osler’s nodes are caused by an immune system reaction in the body. When the body is bombarded with an infectious agent, then the immune system cells combine with the toxins and form immune complexes. The immune complexes cause pain where they occur. They often are due to Staphylococcus aureus toxin which is associated with endocarditis, an inflammation of the heart.

Treatment and Prevention

Treatment involves the prescription of medication for the infection first. Once this is taken care of, the Osler nodes will fade away.

During the time that the pain is felt, tight shoes should be avoided. A shoe with a wide toe box and/or a high toe box will help alleviate the pain that may be aggravated by tight shoes.

Osteoarthritis of the Foot

Definition

Osteoarthritis of the foot is arthritis of the foot. Abnormal calcifications form on and around the joints and the cartilage may become eroded. The condition is more painful in the morning upon awakening when the blood flow to the foot has been minimized during the nighttime sleep.

The pain of osteoarthritis tends to lessen as the joints begin to move and blood flow increases.

Cause

Osteoarthritis is caused by:
• Old injuries to the foot that haven’t healed and result in joint dysfunction in the toes or other parts of the foot.
• Inadequate nutrition to the body that results in improper formation of the cartilage of the joints (deficiency of pantothenic acid, vitamin C, zinc, silica, vitamin A, manganese, calcium, magnesium, phosphorus, and vitamin D deficiencies).
• Overuse of the foot can weaken the joints and cause stress on them that eventually wears down the cartilage protecting the bones.

Treatment and Prevention

Osteoarthritis is diagnosed with the aide of an x-ray that visualizes the bone. This is important since there are many different types of arthritis or bone disorders, and an x-ray shows characteristic signs that lead to the diagnosis.

Hot packs applied to the afflicted joints improve circulation which alleviates the pain of arthritis. During times of acute pain and tenderness, cold packs may be used alternately with hot packs for best results.

Foot massages are also helpful to get the joints feeling increased circulation once again. It’s the lack of circulation that is associated with pain. For example, if a joint is covered with a calcium deposit, the area covered cannot get adequate circulation.

If osteoarthritis is caused by ill-fitting shoes, then it is important to replace the shoes with ones that are more suitable. Often, shoes that are wider and allow more room for the toes to wiggle are the most important for those with osteoarthritis. However, if the bones of the foot are misaligned and there is faulty biomechanics, orthotic insoles, arch supports and heel cups or lifts may be required. A professional should help someone with osteoarthritis determine what best they need.

Osteochondrosis

Definition

Osteochondrosis is a condition where a defect occurs just under then knee on the tibia or shin bone. This defect only occurs during a period of very rapid growth, such as in children who are going through a growth spurt.

Physiologically, there are changes occurring in the bone where the blood supply to the bone is stopped, followed by dying bone cells that are soon repaired by the body. During the process, the ossification of the bone – or hardening of the bone – is disturbed.

Symptoms include the slow onset of pain around the area where the problem is occurring. Osteochondrosis may also be found on the heel, where it’s called Sever’s disease, or on the 2nd, 3rd, or 4th metatarsal of the foot, which is also called Freiberg’s infraction. The problem may lie within the cartilage of the bone, or on the bone itself.

Cause

No one knows why osteochondrosis occurs, and experts suspect that many factors contribute to the manifestation of this condition. Some of the factors include:
• trauma to the bone
• anatomical defects in the bone before the condition appears
• nutrient deficiencies
• rapid growth
• heredity predisposition

In animals, this condition is related to a boron deficiency.

Treatment and Prevention

Osteochondrosis may heal on its own without any intervention.

Treatment should include providing the body with an adequate mineral supply, and all the nutrients needed for proper cartilage and bone formation: calcium, magnesium, boron, phosphorus, vitamin D, manganese, vitamin C, silica, and zinc.

Supporting the foot during the healing process is important. If there are any biomechanical problems with the foot, the use of orthotic inserts and arch supports may help considerably.

Osteomyelitis

Definition

Osteomyelitis is an infection that spread to the bone. The infection may have started in any other part of the body, but because blood is re-circulated every hour, an infection in the upper part of the body could end up in the foot causing an infection in the toe!

Osteomyelitis may occur in any bone of the body, but it is more common for the bones of the feet, spine, and pelvis to develop this condition. When osteomyelitis occurs, there is a lot of pain in the body since bones have receptors that give off pain signals. Fever, swelling, heat sensations and redness will also occur.

Cause

There is only one cause of osteomyelitis: an infection of the soft tissues – skin, muscles, tendons or ligaments. This can be induced by trauma but it may happen without trauma. There are many different conditions that can predispose a person to develop osteomyelitis:
1. Weakened condition, such as protein calorie malnutrition
2. Weakened immunity
3. Diabetes
4. Prior injury to a bone leaving that bone in a weakened state
5. Occasionally, the use of certain prescription medications may be linked with the development of osteomyelitis.

Treatment and Prevention

When there is a possibility of osteomyelitis, medical attention should be sought immediately. Infections of the bone can result in parts of the bone ‘eaten away’ by the infection with areas of dying tissue, and as a result, necessitate surgery involving bone grafts if the condition becomes grave. In some unfortunate cases, amputation is necessary. Seeking medical attention early in the game is the best way to prevent further tragedy.

Medical treatment involves eliminating the infection as soon as possible by using medications and IV drips if necessary.

In cases of osteomyelitis, the nutrition of the patient should be immediately attended to. To recover from an infection, higher levels of protein and calories as well as specific nutrients such as vitamin A, C, E and D are needed.

If the osteomyelitis affects the bones of the foot, the swelling will prevent the usual shoes from being worn.

Over-Pronation

Definition

Over-Pronation is a term applied to the foot and refers to what happens as a person is walking. Does the foot hit the ground in a perfectly balanced position, or does most of the body weight end up on the medial aspect of the foot? If the weight is supported primarily on the medial part of the foot, the ankle has turned to make this happen – and it’s called over-pronation. When the ankle turns, there is a sharp angle at the location of where the foot meets the legs.

Turning the foot inward more than 15 degrees during walking or running is the actual definition of over-pronation. When it occurs, the big toe and heel get more wear and tear than what they’re supposed to and as a result, are more prone to injury. Observing the feet from the back, someone who over-pronates the feet will appear to have feet that are more laterally deviated than someone with normal pronation. This means that the big toe doesn’t point straight forward, but instead, it points off to the side.

Cause

The cause of Over-Pronation is primarily flat feet. Thus, anything that contributes to the creation of arch instability or falling arches, such as walking barefoot or in shoes that are improper fits for the foot, especially shoes with a negative heel, where the heel is lower than the rest of the shoe, or shoes that are flat without any support.

It’s also possible that someone could have developed as a child without developing arches and the feet remain flat. This will lead to over-pronation. Babies are born with flat feet and as they begin to grow, their arches in their feet begin to form.

Treatment & Prevention

Orthotic Arch Supports create the proper ergonomics needed for the body to walk and run without injury is essential to treat this condition. Once an over-pronated foot is placed in shoes with these orthotics and arch supports, an immediate difference is felt. The person will not feel as much fatigue and the feet will not be painful or burning. If the person is a runner or walks long distances, then they will be able to increase their distance without additional fatigue.

Orthotics may also include heel support since someone who over-pronates the foot does not stress the heel equally in all directions as it normally should happen in someone with a normal 15 degree pronated foot.

Prevention of over-pronation symptoms is possible by looking at the way one’s shoes wear. If the shoes wear at the lateral heel and big toe positions more than any other part of the sole, the person is over-pronating the foot during walking. Check out our Orthotic Arch Supports, Flat-Feet/Low Ached Orthotics, or Childrens Orthotic Arch Supports.

Overlapping of the Toes

Definition

Overlapping of the toes is a condition where the toes are out of alignment. Instead of them all facing forward like soldiers lined up straight in a row, one of them – usually the big toe – starts moving toward the second toe. If this continues over time, then the big toe starts ‘climbing over’ the second toe, as if it had a mind of its own.

The condition is serious and the toes line up as they were meant to line up. If allowed to overlap each other, they will have difficulty fitting into any shoes, and the problem worsens with friction burns, corns, calluses, the formation of other conditions.

Cause

Anytime the toes start to approach each others, there is a threat of developing overlapping toes. The condition is caused by:
• Bunions
• Ill-fitting shoes
• Structural problems such as Pes metatarsovalgus – twisting of the tibia (needs surgery)
• Hammer toes
• Arthritis
• Injuries

Treatment and Prevention

A podiatrist or a medical doctor must evaluate the foot to determine the cause and treat it appropriately. In some cases, toe spacers can keep the toes separated until the main problem is alleviated. Orthotic arch supports with heel cups and possibly heel lifts can realign the major bones of the foot so that the big toe may not be secondarily misaligned.

Avoiding any tight-fitting shoes that cramp the toes together is very important in the treatment of this condition. Shoes with a wide toe box and a tall toe box are equally important.

Treatment may include toe braces or surgery in severe cases.

Overuse Injuries of the Foot

Definition

Overuse injuries of the foot is defined as a general term for injuries that occur in the foot after too much activity and use of the muscles has occurred.

Overuse injuries of the foot vary from person to person, simply because there can be hundreds of biomechanical faults of the foot, and each one can be related to the development of different injuries.

Cause

The cause of overuse injuries is too much walking, marching, running, or jumping that aggravate a pre-existing structural abnormality in the foot, ankle, leg, hip or back. All parts of the body are related and when activity increases, any areas that suffer from an abnormality – or an old non-healed injury – are subject to stresses that lead to injuries of the foot.

For example, overpronation or oversupination of the foot can predispose the foot muscles to stretch or contract more than they normally should. These are conditions where the foot rolls to the inside or the outside during walking. As the foot rolls, the body weight is now compressing on the muscles in ways that should not occur. When the muscles tire, they become susceptible to injury.

Other structural abnormalities of the foot that can lead to overuse injuries include plantar fasciitis, Achilles tendonitis, Morton’s toe, Morton’s neuroma, sesamoiditis, and bunions, but this list is not all-inclusive.

Treatment and Prevention

Treatment of overuse injuries involves:
1. Cessation or decrease in activity of the foot such as in running
2. Providing healing nutrients for the feet to heal themselves
3. Correcting the abnormality that led to the development of the issue in the first place

Shoes that adequately support the foot are the first place to start. If the feet suffer from faulty biomechanics, adding orthotic arch supports, heel pads, heel lifts and / or cushioning insoles is important.

Old shoes no longer support the foot and should be replaced. Runners believe that the average life of a shoe is 250 miles; after that, the shoe can’t absorb the compressive forces of the body enough to provide support.

Palmoplantar Keratoderma

Definition

Palmoplantar keratoderma is a thickening of the soles of feet and the palms of the hands.

The thickening may be symmetrical and found in infants during their first few months of life. It may also appear as a snakeskin or have a waxy appearance in infants.

Palmoplantar keratoderma may also appear as big masses of keratin similar looking as calluses. The keratin areas may be lined up on the sole or overlap each other. They may appear on pressure areas of the foot.

In another form of the disorder, small lesions may appear on the soles of the feet. They can appear in groups and may be in one location on the sole instead of diffused throughout the entire sole. In some cases, the area afflicted looks like a glove or stocking has been placed on the foot, involving the sole.

Cause

Palmoplantar keratoderma is most likely a hereditary condition. Some of the congenital disorders that lead to its development include:
• Charcot-Marie-Tooth disease
• Acral keratoderma
• Keratosis follicularis
• Keratosis palmoplantar nummularis
• Tylosis
• Unna-Thost disease

In some cases, repeated friction can create a worsening of the thickening of the skin on the soles of the feet in those with these genetic disorders.

Palmoplantar keratoderma may also be an acquired condition, although no one knows why it occurs in those without the genetic predisposition for the condition.

Treatment and Prevention

Hardened areas on the sole are often treated with lotions that can soften them. Some podiatrists and medical doctors may use vitamin A or vitamin D ointments which appear to have some effectiveness, or vitamin A retinoids taken orally. Also, agents that can dissolve the hardened area – such as ones with salicylic acid may be part of the treatment.

Cushioned insoles are very important for this condition. And as always, if there are any other structural abnormalities of the foot, orthotic insoles and arch supports, heel cups, heel lifts, or metatarsal pads may be indicated.

Patellar Tendonitis

Definition

Patellar tendonitis is the inflammation of the tendon that contains the patella. This condition is also called Jumper’s Knee, Patellar Tendonitis, Patellar Tendinopathy, or Sinding-Larsen-Johansson disease.

This condition is seen most often in children between the ages of 10 and 16 years old.

Patellar tendonitis is a cause of aching pain in the lower part of the patella. It is especially found in athletes who jump a lot, such as those involved in basketball and volleyball. However, patellar tendonitis may also be found in those playing ultimate Frisbee, football, tennis, skateboarding and snowboarding. Even kickboxing and jumping rope may predispose a person to develop this.

The condition progresses from pain felt during jumping and activity to pain felt 24/7 whenever using the knee at all.

Cause

It’s the repetitive motion that causes patellar tendonitis. The repeated trauma causes micro-tears in the tendon that aren’t healed if additional tears continue to occur.

Treatment and Prevention

Patellar tendonitis may need surgical repair if it is in the later stages of progression.

Early in the disorder, it’s good to rest from the activity that is causing the problem, ice the area, use a compression bandage, and elevate the leg as much as possible.

Strengthening the muscles and tendons that support the knee is highly recommended.

One of the most obvious ways to prevent this disorder is to check the shoes that one is wearing before starting sports activity. Are the shoes worn? If so, they should be replaced with ones that support the feet. The use of orthotic arch supports to biomechanically support the foot is also recommended as this will prevent any patellar alignment problems that are more likely to induce the injury.

The act of jumping requires strong arches of the foot, thus arch supports are an important part of prevention.

Pes Cavus

Definition

Pes cavus is a foot that has a very high arch. Often it is thought that a high arched foot is the best type of foot to have; however, a high arch can create just as many foot disorders as a foot without an arch (flat foot). Some of the results of pes cavus include claw toes, calluses, ankle arthritis, plantar fascitis, Achilles tendonitis and hammertoes.

With a very high arch, the ball of the foot and the heel must absorb more pressure when walking, which leads to pain and instability or the feeling that the ankle is “giving in.”

Cause

Pes cavus may result from a neurological disorder, infectious disease or congenital deformity such as clubfoot, cerebral palsy, muscular dystrophy or other dystrophies, Freidrich’s ataxia, polio, stroke, Charcot-Marie-Tooth disease or spina bifida. In some of these conditions, the condition will worsen.

Symptoms may include dragging the affected foot because the muscles of the foot and ankle become weak, which occurs in some of the above-mentioned neurological disorders. When this happens, the foot dragging is called foot drop. Tripping may also occur.

Treatment and Prevention

Depending on the severity of the pes cavus, a brace may be needed. Whenever there are any type of arch problems with the foot, high arched orthotics or sensitive feet insoles are necessary. When these devices include heel support and arch supports, they can lessen the pain of the condition.

Wide shoes and shoes with a high toe box will help prevent hammertoes and claw toes from developing.

In some cases, surgery may be necessary to correct the condition.

Plantar Fasciitis

Definition

Plantar fasciitis is a condition of the foot where the plantar muscles and connective tissue on the bottom of the foot are inflamed.

With this condition there are symptoms that may include:
• pain in the foot, especially the heel upon weight-bearing
• pain worsens when heel is pressed down or when walking on the balls of the foot
• eventual disability

Cause

When any one of the three arches of the foot starts to collapse, the pain and symptoms of plantar fasciitis begin. Experts estimate that up to 70% of those with plantar fasciitis have heel spurs.

The arches of the foot are meant to absorb most of the shock of the body weight on the foot when we walk, stand, jump or hop. However, once the arches collapse, the tendons and ligaments have to absorb the shock of the body weight – and they weren’t created with this function in mind. Muscles and tendons are not strong enough to do this and will fatigue, causing further issues.

Flat feet are associated with the development of plantar fasciitis.

Treatment & Prevention

Treatment of plantar fasciitis involves icing the foot to decrease the inflammation. This method of treatment starts out with a cool footbath where ice is slowly added to decrease the temperature of the water. Only five minutes may be enough to decrease inflammation found in plantar fasciitis.

A second part of treatment is night splints. Many podiatrists will recommend these, which help keep the foot in the proper position so the foot muscles don’t cramp up during the night. Cramping of the foot muscles worsens the condition as the muscles are even more stressed and even more overburdened to accept any stresses of body weight on the foot.

A third part of treatment is the use of Orthotic Arch Supports. For High Arches check our our High Arched Orthotic Arch Supports and for Flat-Feet/Low Arched Orthotic Arch Supports. By supporting the foot’s arches and the heel with this type of orthotic. The muscles and tendons can rest a little and start to recover. Someone with plantar fasciitis is making a big mistake if orthotic supports are not used.

A fourth part of treatment for plantar fasciitis is extracorporeal shock wave therapy. This one is called ESWT for short. It is a method that is not used by doctors until all other methods fail. The method re-injures the heel so that an overall healing reaction can occur in the foot.

Over 90 percent of those with plantar fascitis are healed in one year, using conservative treatment and no surgery.

Plantar Fibroma

Definition

A plantar fibroma is a pea-sized nodule that is found in the plantar fascia, a stretch of connective tissue from the toes to the heels. Generally a plantar fibroma is found in the arch of the foot. This nodule is not cancerous but may enlarge. It is sometimes found in both feet.

Pain may or not occur with a plantar fibroma. If the location of the fibroma is not in an area where there is pressure on the foot from walking, there will be no pain. However, when the fibroma is located in the arch of the foot where there’s pressure from walking, there will be pain with every step.

Cause

No one knows why plantar fibromas occur.

Treatment and Prevention

Since the fibroma may increase in size – and the pain increases with it – it’s important to seek medical attention. The more mass that is disrupted by the fibroma, the more complicated the condition can become.

Treatment begins with a thorough medical evaluation and imaging techniques to see how much tissue has been affected. Medical treatment may include corticosteroid injections; however, these have been associated with fat pad atrophy, which can cause further problems with the foot, as the foot’s natural cushioning ‘material’ is dissolved.

Surgery may not be a solution because it can lead to the development of other foot conditions such as hammertoes, flat feet, bunions, and other issues. Also, plantar fibromas have a high reoccurrence rate when surgery is performed.

Supporting the foot with orthotic devices customized to the foot is essential. For an over-the-counter insole consider a sensitive foot insole or cushioned insoles.

Plantar Wart

Definition

A plantar wart is a wart that develops on the bottom part of the foot. It may look like a small growth and eventually spread to form a colony of warts. The skin may start to thicken and possibly look similar to a callus.

On the surface of the wart, there may be a black dot. Warts are accompanied by pain over the area of the wart whenever the wart is disturbed, such as during walking.

Cause

Warts are caused by the human papilloma virus (HPV), which enters the skin through a tiny cut or tear and begins infecting the skin of the foot.

Warts develop more easily in those who are immuno-compromised. They are common in the elderly, children and adolescents.

Treatment and Prevention

Warts die when subjected to cold treatments so doctors often freeze a wart off the foot. They may also use different types of medication that will kill a wart. However, warts will return unless the underlying immunity is addressed.

Immune system boosting herbs and supplements can address the immunity. Herbs such as astragalus and cat’s claw boost immune system function while supplements such as vitamin A, vitamin C, vitamin D, selenium and zinc can be added to one’s diet and enhance the immune system response. Whenever these nutrients are low, the immunity is compromised. When levels are restored, viral infections clear up. It’s best to see a qualified nutritionist to help determine why the immune system may be compromised by nutrient deficiencies.

Since warts do take time to heal, it’s important to have cushy inserts and possibly metatarsal pads or other orthotic aids to relieve the pain and pressure of the wart.

Polydactyly

Definition

Polydactyly is a condition whereby an individual is born with an extra toe(s) or extra tissue that looks like the start of the formation of a toe.

Polydactyly is found in 2 out of every 1000 live births. One form of it is more commonly found in blacks – ten times more often, and found in males more than females.

The world record for more toes than the usual number is 10 toes on each foot, found in a boy born in India in the year 2010. He also had 7 fingers on each hand.

Some famous people who have had the condition include a former queen of England, Anne Boleyn and a professional baseball player, Antonio Alfonseca.

Cause

Polydactyly can be an inherited genetic disorder or can result from the mutation of the LMBR1 gene. The condition can occur by itself or with other conditions.,/p>

Treatment and Prevention

This condition needs extra wide shoes, and in some cases specially made shoes to accommodate all the toes. A podiatrist should be consulted to evaluate the biomechanics of the foot and make appropriate orthotic suggestions.

Post-Tib Tendonitis

Definition

Post-tib tendonitis is inflammation of the posterior tibial muscle tendon, a tendon important for providing structure of the arch of the foot. As with any inflammation, there will be pain and swelling. When this tendon is stressed, it’s easy for the arch to collapse. Once the arch support is lost, the feet flatten and pain worsens. The condition can progress to create plantar fascitis and heel spurs.

Cause

Flat feet may cause post-tib tendonitis, as will overusing the foot muscles which happens when a runner quickly increases the distance he runs. The longer that a person has flat feet, the more prone a person is to develop post-tib tendonitis.

Treatment and Prevention

Treatment involves altering the over-pronation that is occurring in the foot. This is easily accomplished with proper orthotic arch supports, shoe inserts and possibly heel lifts or heel cups. The purpose of the heel support is to properly line up the bones in the foot so that they don’t over-pronate.

Prevention involves an examination of the types of activities you are doing. If contributing to the post-tib tendonitis with overuse, this needs to stop immediately so healing can begin.

Posterior Tibial Tendonitis

Definition

Posterior tibial tendonitis is a condition where the posterior tibial tendon, attached to the calf muscle on the inside of the foot, is inflamed and tender. The purpose of this tendon is to hold up the arch of the foot when you walk or run. When the tendon is inflamed, it cannot hold up the foot in its proper position and the arch flattens out. Swelling may result.

The pain with posterior tibial tendonitis is greater with activity and is located over the area of the tendon and on the inside or outside of the ankle.

This condition can be identified by the pain pattern along with the observation of the foot from the back. When the person is asked to stand straight, the toes are not pointing straight forward, but rater off towards the outside of the foot.

Cause

A traumatic injury such as stepping in a hole or falling can result in tears of this tendon. This is a major cause of posterior tibial tendonitis. The tendon may also be inflamed as a result of overworking the muscle/tendon.

Overworking the posterior tibial tendon is common in those who participate in sports such as track and field events, tennis, football, basketball, or soccer.

Women are more prone to this condition than men. Also, certain diseases make this condition more likely to occur: diabetes, high blood pressure, and obesity.

Treatment and Prevention

All cases of inflammation found in the foot require rest, elevation, and the application of ice. Some may need a walking cast for up to 8 weeks to stabilize the area. Orthotics and braces may be quite helpful. The orthotics will support the arches of the feet.

Rehabilitation exercises will strengthen the muscles of the lower leg and foot to further support the foot.

In extreme cases, surgical repair may be necessary; however, surgery doesn’t prevent the problem from returning. The extremeness of a case involves the determination of the degree that the foot has collapsed.

Puncture Wounds of the Foot

Definition

A puncture wound is a wound that occurs when a pointed object pierces the skin. The object damages tissues deep inside the foot. Usually the object is a nail or may be a staple from a staple gun, insulin needle or seashell. A bullet will also create a puncture wound.

A puncture wound is accompanied by pain, bleeding, and inflammation. The problem with this type of wounds is that whatever caused the puncture may have been contaminated with bacteria, fungi, or other microbes and this contamination may easily set up an infection in the deeper tissues of the body. If the contamination is great enough, the infection may become systemic and is carried throughout the rest of the body.

Signs of contamination include redness that may spread, heat in the area, swelling and sometimes the production of pus.

Cause

The cause of puncture wounds is stepping on a sharp object or becoming the victim of a sharp object in a work, home or other type of situation.

Treatment and Prevention

Any puncture wound needs prompt medical treatment. Cover the wound and bandage the foot before you get to the doctor. Don’t walk on the foot; keep weight off the foot to prevent further injury. Check out our Spenco 2nd Skin Bandages & Dressing Kits.

It is easier to prevent infection in the early stages than later; thus antibiotics will be administered. Depending on the object that punctured the foot, a tetanus shot may be given.

Medical treatment may involve surgery if the damage done to the internal tissues is severe.

Raynaud’s Disease

Definition

Raynaud’s Disease is also called Primary Raynaud’s Phenomenon. It’s a condition that can affect the toes and feet, as well as other parts of the body, leaving them cold and numb. The toes or one toe will also change color from normal color to white, blue or red, and there could be pain in them at times, as well. When this happens, it’s called an attack. The attacks last up to several hours.

The condition is more likely to occur in women and those who live in cold climates.

Cause

Experts are still trying to determine why this condition exists, but now believe that it is the result of a vasospasm, which is a spasm of the blood vessels. No one knows why the spasms occur in the body, although it is known that stress can precipitate an attack.

When exposed to cold temperatures, the response of the body is to draw blood from the circulation in the toes and fingers in towards the center of the body to keep the core warm.

Raynaud’s disease can also appear when the person has other diseases such as scleroderma, lupus, rheumatoid arthritis, Sjogren’s syndrome, thyroid diseases, heart disease, and carpal tunnel syndromes. However, in these cases, it’s not called Raynaud’s disease but rather secondary Raynaud’s phenomenon.

Use of medications for high blood pressure or beta blockers can also cause the vasospasms to occur. A smoking habit is another way to cause spasms in the arteries. In both these conditions, Raynaud’s is considered secondary Raynaud’s phenomenon.

Another cause is from exposure to vinyl chloride. (secondary Raynaud’s Phenomenon)

Treatment and Prevention

Lifestyle changes such as increasing blood circulation via regular exercise is a good way to start self-treatment. Other habits that need to be addressed include:
• alcohol use
• caffeine habit
• smoking

To prevent future attacks, consider eliminating the above-mentioned habits, move to a warm climate, get regular foot massages, and check to make sure that your shoes aren’t constricting blood flow, too.

Medications may be prescribed to increase the circulation in the body, but all medications do have the risk of causing side effects. Medical treatments such as surgery are only a temporary solution. In these surgeries, nerve blocks are used. However, the condition returns after a few years.

Natural healing professionals also have herbs that are used to increase circulation in the body, without side effects.

Those who have diabetes and Raynaud’s Disease should monitor themselves daily for any signs of gangrene. Consider our ProThotics Comfort Gel Insole for cushioned foot support.

Rheumatoid Arthritis of the Foot

Definition

Rheumatoid arthritis is an autoimmune disorder that can affect the foot. The joints of both feet may be affected and he first signs are swelling, redness and pain in the toes or ankles. This pain can be excruciating and may not resolve itself during the day, as does osteoarthritis.

In the joints is a lining called synovium which makes synovial fluid that lubricates the joints so the bones don’t erode away from movement. However, in rheumatoid arthritis, the synovium becomes inflamed to the point where the joint itself starts to “fall apart” and deformities start to form. The cartilage is eroded in the process and parts of the bone itself are often eroded.

This can happen in the heel part of the foot, causing a flat foot which leads to other foot disorders, or on the middle of the foot where the arch collapses. If joint damage occurs in the toes, a bunion, hammer toe or claw toe can form.

Cause

Rheumatoid arthritis may be caused by an infectious agent or may be genetic in nature. It’s also possible that an overactive immune system can be at the root of the disorder, which may indicate that nutritional deficiencies and imbalances are involved.

Treatment and Prevention

When the pain is severe, ice packs may calm down the inflammation and decrease the pain temporarily. Doctors often prescribe anti-inflammatory drugs and painkillers, but these do nothing to prevent the condition from progressing.

An orthotic insole can be prescribed to decrease the additional pressure put on the foot from new faulty biomechanics of the foot caused by the disease. Arch supports can help alleviate some of the pressure from flat feet caused by joint collapse in the mid foot. Or consider our Arthritic & Diabetic Insoles.

Surgery may be needed if extensive cartilage damage is occurring; in these cases, joint fusion is the preferred treatment of choice. However, once a deformity has occurred, it may not be possible to correct.

Rheumatoid Foot

Definition

A rheumatoid foot is a foot that has joint damage that is often irreparable from rheumatoid arthritis. The joints affected may be in the toes, the midfoot or the ankles. A rheumatoid foot may also be the term used for a deformed foot resulting from rheumatoid arthritis.

Cause

The cause of the deformity and joint destruction in a rheumatoid foot is the disease itself. Rheumatoid arthritis may be caused by an overactive immune system, a genetic disorder, or it may have an infectious origin.

Treatment and Prevention

The only treatment for a rheumatoid foot – to prevent the deformity from occurring – is to eliminate the rheumatoid arthritis. Unfortunately, there are very few cases reported in medical literature where this happened. One case occurred in John Christopher, a resident in Utah, who used consecutive series of internal organ cleansing with herbs for more than five years to eliminate the disease.

Prevention of the deformity from worsening may occur with the proper use of orthotic arch supports, insoles, cushioning, metatarsal pads, heel cups and pads, and other devices.

Rigid Toe (Hallux Rigidus)

Definition

Hallux rigidus is a condition where the big toe becomes stiff and unable to move up or down. As a result, walking becomes harder and harder – and painful. There may be swelling and a callus or bunion may form.

The callus may form on top of the big toe because the inflamed toe is rubbing against the top of the shoe. Also, a callus may form on other toes as the person starts to shift their weight to the outside of the foot just to make it easier to walk with an inflamed big toe.

The joint most affected is the joint between the part of the big toe closest to the foot and the long bone of the big toe found in the mid foot. This joint is called the metatarsophalangeal joint.

This condition most commonly afflicts people after the age of 30.

Cause

Experts still don’t understand what causes hallux rigidis. It may be due to a previous big toe injury that damages the cartilage or faulty biomechanics of the foot.

Bunion sufferers report that wearing certain pairs of shoes result in greater stiffness of this same joint, so it is possible that footwear may contribute to the development of hallux rigidus.

Treatment and Prevention

Since the big toe joint is inflamed in this disorder, self-treatment with ice is a good way to decrease inflammation and pain.

Wearing cushioned arch supports or a sensitive foot insole can only help the condition and lessen the pain.

Sesamoiditis

Definition

Sesamoiditis is the inflammation of the very small, jelly bean-like floating bones of the foot. These bones are found inside the tendon itself of the metatarsal bones and their purpose is to eliminate some of the stress on the bones themselves by acting as a pulley-type device.

A common symptom of sesamoiditis is pain in the ball of the foot, right directly over the location of the sesamoid bone.

Cause

Faulty biomechanics of the foot is usually at fault for the development of sesamoiditis. Running and dancing can be done without pain, but when the foot bones are misaligned due to flat feet or overpronation, the foot becomes susceptible to new compressive forces placed on these tiny bones. However, it’s not just flat feet that can be problematic – even those with high arched feet can develop sesamoiditis.

Dancing involves a lot of activity with the body’s weight on the balls of the foot, and this added stress may be enough to inflame the sesamoid bones. After the third or fourth dance lesson or dance outing, you may begin to notice an aching in the ball of your foot. This will get progressively worse, and pain will be felt if you press in on the sesamoid bone itself.

Wearing high heels also places the majority of the weight of the body on the balls of the feet, making women more prone to develop sesamoiditis.

Runners may also experience sesamoiditis, especially if they are not following the general guidelines to prevent injury, such as easing into distance increases, not running on hard pavement and never running uphill.

Fat pad atrophy is another cause.

Treatment and Prevention

Sesamoiditis won’t go away until the activities that caused it in the first place are stopped, at least until the condition is healed. The stress on the sesamoid bone may be relieved with a simple metatarsal pad. This is a pad placed on the ball of the foot which may or may not have a hole for the sesamoid bone. With padding surrounding the inflamed sesamoid bone, the elevated padding absorbs the shock and pressure on the sesamoid bone. This allows the bone time to heal.

As with other inflammatory conditions, the application of ice, and the use of heat, ultrasound or cold laser therapy may accelerate recovery.

Prevention involves monitoring the length of time one participates in activities where the weight is on the ball of the foot, restricting the wearing of high heels, and always using orthotic arch supports, Ball of Foot Pads, and/or a cushioned insole to counter faulty biomechanics or faulty anatomy of the foot.

Sever’s Disease

Definition

Children between 8 and 14 years old may develop inflammation of the heel at the area of the growth plate. The growth plate is the place where new bone growth forms at the back of the heel.

As with any inflammation, there is pain with this condition, especially upon walking. The inflammation can occur in one or both heels. Symptoms also include limping and walking on the balls of the feet. Pain is felt if the heel is squeezed.

Cause

When the stress on the growth plate is too great for the heel to handle, pain and inflammation result, bringing the diagnosis of Sever’s Disease. Too much walking, running, sprinting or other athletic activity may be a precipitating factor in this disorder.

Obesity may also add to the compressive forces placed on the heel and cause this disorder.

Faulty biomechanics of the foot such as a foot with no arch or a high arch or a tight Achilles tendon may also be a cause.

Treatment and Prevention

Treatment must always include the following:
1. A cast in severe cases
2. Children’s orthotic Arch Supports to support the heel and restore proper biomechanics
3. Heel support which is cushioned to lessen the forces on the foot
5. Physical therapy
6. Painkillers and possibly anti-inflammatory drugs for a short time period only

Prevention involves not increasing athletic activity quickly and correcting any faulty biomechanics of the foot with orthotic inserts in the shoes.

Shin Splints

Definition

Shin splints refers to pain in the lower leg, and is most commonly found near or on the shin bone. The pain is accompanied by small tears in the muscles or tendons where they are attached to the bone. The muscles or tendons affected can surround the shin bone at any angle – front, back or side.

Overstressing the muscles attached to the shin is what causes the pain. Thus, pain doesn’t usually exist until activity starts, such as walking or running.

Cause

Shin splints is caused by the stresses of improper running technique, such as running on concrete surfaces or running uphill. It can also be found in ballerinas who are constantly on the balls of their feet and jumping frequently as they dance.

Athletes who are wearing improperly-fitted athletic shoes also may develop shin splints. Worn-out shoes have lost their support and ability to absorb some of the compressive forces the foot deals with in everyday life – and make it easy to develop shin splints.

Flat feet or high arched feet may also predispose a person to this condition, as can over-pronation.

Treatment and Prevention

The first line of defense against shin splints is proper shoe wear, proper running techniques, and proper orthotic arch supports in the shoes. If over-pronation is the cause of shin splints, seek medical care or at least additional help in determining what to do to customize the shoe to your foot to correct the biomechanics.

Since shin splints involves inflammation and torn tissue, using ice packs and eating properly to regenerate the tissue is a must to totally heal the shin splints. Cold laser treatment, ultrasound therapy, massages with trigger point release, and hot packs may also speed up recovery.

Stretching before activities that can be hard on the muscles and tendons attaching to the shin bone may also help, but avoiding activities that caused the shin splints is important for healing to begin. Strengthening the muscles of the lower leg also may be quite helpful, as this can correct any biomechanical issues that arise from muscle imbalance.

Split Hand Foot Malformation (Ectrodactyly)

Definition

Split hand foot malformation, also called ectordactyly, is a condition where the hand and/or foot is missing one or more fingers or toes. When a finger or toe is missing, the hand or foot takes on the appearance of a lobster claw.

There have been cases reported where a hand is only made of a thumb and one finger. However, those who have this condition can still write in cursive, sew by hand with needle and thread, and do other normal daily tasks, including tying one’s own shoes.

Some famous people who have had ectrodactyly include a chess world champion named Mikhail Tai and the actress Bree Walker from the television show, Nip/Tuck.

Cause

Split hand foot malformation is a genetic disease, passed down from parents with the trait, or the condition can occur if there’s a mutation in the DLX5 gene. The problem may occur on chromosome 7 and when it does, the person may also have hearing loss.

The expression of genetic disorders may occur because of nutrient deficiencies. However, experts still have much to learn about this disorder.

Treatment and Prevention

Those with ectrodactyly may require special orthopedic shoes or at the least, orthotic arch supports to provide some structure for the feet.

Stinky Feet

Definition

Stinky feet is a condition where the feet smell bad. In some cases, a person may wash his feet two or more times a day but still has stinky feet.

Stinky feet may occur in association with pain, but usually only if there is an infection along with the stinky feet.

Cause

Feet smell because of bacteria or fungi that are reproducing their numbers on the foot. If a foot sweats more than usual, then bacteria and fungi will reproduce faster and emit an odor.

Another cause of stinky feet is an actual infection found somewhere in the foot, such as one that is producing pus which emits a rancid odor.

Treatment and Prevention

Good personal hygiene is the first step in eliminating stinky feet. Washing the feet thoroughly at least once daily is critical to remove the bacteria and fungi which are killed with soap. Changing the socks as often as necessary during the day is also helpful.

Medicated foot powder may also help. The cause of sweaty feet may need to be determined, as this can result from peripheral neuropathy or other neurological disorders.

If the stinky feet are caused by infection, medical attention must be initiated, with proper medication to eliminate the infection.

Stress Fractures of the Foot

Definition

Stress fractures of the foot are tiny hairline cracks in a bone of the foot. They are not easily seen on x-rays. The bones most commonly affected are the weight-bearing bones.

The most common place to experience a stress fracture in the foot is at the second and third metatarsals, the heel, or the top of the foot over the long bones of the feet.

Symptoms include pain and tenderness over or near the site of the injury, especially during activity. The pain will lessen when the activity stops.

Cause

Stress fractures result from overuse because when the muscles are tired, they don’t effectively reduce the compressive forces on the feet. The bones then have to absorb some of these forces, and with enough force, they fracture.

Stress fractures also may result from increasing your activity too fast too soon.

Athletes in certain sports are more likely to experience stress fractures: ballerinas, cheerleaders, gymnasts, tennis players, runners, jumpers, and basketball players. It’s the jumping up and down and landing on the feet that can cause the stress fractures.

Wearing worn-out gym shoes that don’t absorb the shock of jumping is another cause of the problem, as is running on hard surfaces or running uphill.

Weakened bones from improper diet and nutritional deficiencies are another cause of stress fractures, as are any medical conditions that cause a low bone density.

Treatment and Prevention

Before your medical consultation, you may want to wait 48 hours. Stress fractures, or any fractures may not show up on an x-ray for the first two days after the injury.

Once a stress fracture is detected on x-ray or other imaging device, you’ll be asked to stop any activity that caused the fracture for the next 6 to 8 weeks. This doesn’t mean that you can’t exercise at all. You may be allowed to swim or ride a bicycle during that time.

When you do walk, you’ll need a shoe with a stiff sole. Some stress fractures require casts or surgery to heal. During surgery, the bones are pinned together.

Rehabilitation exercises may be recommended. These will help you ease back into a normal routine of exercise. Since re-injury is a major concern, it’s important to start back to exercise slowly. Discard worn-out running shoes. Building up the muscles around the site of injury is important. Consider an orthotic arch support for a proper foot foundation.

Supination (Under-Pronation)

Definition

Supination of the foot is also called under-pronation. In this condition, the foot does not turn inward 15 degrees during walking or running. The person walks as if they are avoiding any contact of the inner side of the foot or the big toe. In this case, most of the shock of the body weight hits the foot at the lateral heel and edge of the foot. The foot does not roll inward as it should during the walking – or running process. The weight stays on the outside of the foot during walking or running.

Cause

The cause of under-pronation or supination of the foot is a foot with a high arch. This puts extra pressure on the foot and makes it more prone to injury.

Treatment & Prevention

Surprisingly to some, a foot that has a high arch is not preferable to that of a normal arch. The high-arched foot may look prettier, but it can be related to the development of foot problems just as much as a foot that is flat.

Prevention of under-pronation includes examining the shoe and looking for the telltale signs of wear on the outside edge of the sole. If standing behind the person who is supinating their feet when they walk, you’ll see that the person’s foot doesn’t roll inward as it should.

The treatment for supination and/or a high arched foot is properly fitted orthotics and/or arch supports. In some cases, heel cups may be needed.

Check out our Orthotic Arch Supports, High Arched Orthotic Arch Supports, or Childrens Orthotic Arch Supports.

Talar Dome Lesion

Definition

Joints fit together perfectly so that movement can occur in many different ranges of motion. In many joints of the body, the ends of the bones are covered with cartilage. The cartilage prevents the actual bone from being destroyed from the movements of the joint. In talar dome lesion, the cartilage and the talus bone has been damaged by injury. The cartilage may break off and cause pain and swelling in the ankle.

Any clicking in the joint or locking of the joint may be related to the part of the cartilage that broke off.

Cause

The cause of a talar dome injury is an injury to the area, which may be an ankle sprain.

Treatment and Prevention

The treatment of talar dome injury needs medical evaluation and includes imaging tests to correctly diagnose the disorder. It’s possible that pieces of the cartilage may be removed by surgery, if the case is severe.

Proper shoe support is important. Supporting the instability of the heel with heel cups, and possibly orthotic arch supports may accelerate healing by removing reasons for additional inflammation to occur. A brace may also provide additional support.

Sometimes a cast may be necessary to immobilize the area. However, with any type of immobilization, it’s still important to move the foot. Researchers have discovered that when one part of the body is injured, exercising the opposite limb can cause crossover healing. Physical therapy may also be initiated to regain the movement back in the joint.

Whenever there is cartilage damage in the body, it’s always a good idea to increase the food sources of nutrients in the diet that support the cartilage: protein, vitamin C, zinc, vitamin A, and silica.

Tarsal Tunnel Syndrome

Definition

Tarsal tunnel syndrome is a medical condition where the nerve that travels through the tarsel tunnel of the foot is compressed. This causes a number of symptoms including numbness and pain in the foot which may be accompanied by feelings of heat, coldness, or tingling. The pain is usually in the ankle and / or toes.

Tarsal tunnel syndrome also causes pain on the bottom of the foot.

Cause

Here are some possible causes of tarsal tunnel syndrome:
• Swelling from a traumatic injury to the foot
• Sprained ankle
• Bone spurs or arthritic changes
• Tumors or cysts
• Nerve ganglion cysts
• Stress of any kind on the tarsal tunnel region

Even low back pain due to disk herniation may be a cause of tarsal tunnel syndrome.

Treatment and Prevention

Treatment for tarsal tunnel syndrome involves:
• resting the area, preventing further damage
• massage of the foot and/or chiropractic manipulation
• rehabilitation of the muscles of the lower leg and foot to rebalance the body
• cold packs on the area to decrease inflammation

Surgery may be needed in some cases.

The faulty biomechanics of the foot should be addressed with orthotic insoles, especially cushioned arch supports, and others as needed. These will relieve stress and pain.

Thickened Toe Nails

Definition

The normal toe nail is thin. When the toenail thickens, it indicates that there is a medical condition that needs to be addressed.

Usually associated with thickened toe nails are a discoloration of the nail, turning it yellow or brownish. The nail can also appear pitted or start to split. In some cases, depending on the cause, there may be a bad smell.

Cause

The most common reason for thickened toe nails is a fungal infection.

Treatment and Prevention

Generally, the types of fungi that attack the nail are opportunistic in nature, meaning that they only attack when the body’s health status is starting to worsen. For example, if the immune system is not fed properly with enough protein or the correct fats in the diet, then the immune system cannot do its work and ward off these fungi.

Toenail fungus that causes thickened toe nails can be highly communicable as well, in showers or nail tools that are shared with others. If one person has the infection and gives you their nail file, you can end up with the infection. The most common place to pick up these infections is the showers at the health club or local pool.

Toenail fungus is treated with topical ointments over a long period of time because often the fungal infection has extended down to the level of the nail bed. In cases of immune-compromised patients, oral medication may be necessary.

Good foot hygiene is especially important in treating thickened toe nails. After washing feet daily, dry the feet properly, including the area between the toes. Always wear clean socks. To Clear up a Dis-colored Nail, Spenco Here2Clear Nail Therapy can assist.

Avoiding ill-fitting shoes is also very important.

Tingling in the Feet

Definition

Tingling in the feet is a term that refers to abnormal sensations that are felt in the feet. These sensations may be likened to very light vibrations that are felt in the foot.

Cause

Tingling in the feet is a symptom that is associated with nerve problems. For example, sitting in one position for hours on end can result in compression pressure on the nerve roots that causes tingling. Standing in one position for hours on end may do the same thing.

Improper footwear can also cause tingling in the feet by compressing the nerves of the foot in between the toes or anywhere on the foot.

The compression of a nerve may result for a herniated disk in the spine, arthritic calcifications in the spine, or an injury where the nerve has been crushed or otherwise damaged. Tumors, infections, inflammation in the area of the nerve, or even scar tissue can result in compression that then causes tingling.

Another common cause of tingling in the feet is that of lessened blood flow to an area. For example, if someone has hardening of the arteries, the small capillaries that feed the feet their blood supply are often shriveled up or they die. When an area of the body does not receive blood supply with oxygen, it starts to die. This can also occur in those with diabetes. Diabetic neuropathy is a common cause for tingling in the feet.

One last cause of tingling in the feet is nervous system disorders, such as multiple sclerosis, seizures, stroke, or Raynaud’s phenomenon.

The nerves may also become dysfunctional, resulting in tingling in the feet from insect bites, certain medications, deficiency of vitamin B12 or other B vitamins, alcohol and drug abuse, or radiation therapy.

Treatment and Prevention

The cause of the tingling needs to be discovered in order to eliminate this condition. If the problem is a disk herniation, surgical disk repair may be the answer. There are new techniques for disk repair that may be done with microsurgery in an outpatient setting, resulting in less recovery time.

If the problem is infections, the infection must be treated. If there is a vitamin and/or mineral deficiency, then the appropriate lab tests must be ordered and a treatment plan developed. If the problem is a Herpes zoster prior infection (shingles), then this must be addressed.

Any medical treatment causing tingling in the foot should be treated.

The first place to start is to evaluate your personal habits. Are any of them contributing to the tingling in the feet? For example, are you sitting or standing without proper footwear? Are your shoes cramping your feet? Changing one’s footwear can be one of the easiest ways to stop tingling in the feet, if the cause is related to footwear. Consider a Sensitive Foot Insole for cushion comfort.

Toe Cramping at Night

Definition

Toe cramping at night is a painful spasm or contraction of a muscle in the foot of the body. The pain may last for a few seconds to a few minutes, with an intensity that may vary from a slight tic to an intense painful muscle contraction. Toe cramps affect people of all age groups and may strike anytime, at the middle of the night, during exercise, or even while walking.

Cause

Toe cramping at night can be caused by several different reasons. The simplest reason is that the foot is in a bad position during sleeping. For example, if the blankets on the bed are too heavy, they may push the foot into the plantar flexed position of pointing the toes. When this happens, the toe muscles may be contracted for extended periods of time, which causes cramping.

One primary reason is nutritional deficiency. Not having enough potassium, vitamin E, calcium, magnesium, or vitamin D can cause toe cramping at night.

Not drinking enough water is also another cause. Dehydration frequently causes cramps in several parts of the body.

Not having enough oxygen in the toes is also associated with toe cramping at night. This condition more commonly occurs in those who have heart problems or diabetes.

Toe cramping at night may also be associated with wearing shoes that are too tight during the daytime. Shoes that are not wide enough or tall enough in the toe box result in cramping of the toes which does not go away easily if it has been present for several hours.

Treatment and Prevention

The first thing to do is consider whether or not your habits are causing toe cramping at night. Are your blankets too heavy, pressing down on your foot during sleeping? Are your shoes too tight or not tall enough in the toe box area?

It’s relatively easy to replace shoes that are contributing to the toe cramping. Supportive shoes that are wide and have a tall toe box are the solution; however, each person’s foot is different and often someone’s right foot is different from their left foot. The use of customized ¾ orthotic inserts and arch supports is often necessary for people. The longer that a foot is left out of alignment, the more prone the person is to injury and the development of foot disorders.

If neither one of these causes – heavy blankets or improper shoes are not contributing to the toe cramping at night, then an evaluation by a medical professional is important. Lab tests can determine whether or not dehydration or vitamin deficiency is a cause. Lab reports also may indicate that diabetes or a heart condition is present and further tests will be ordered to confirm this suspicion.

Toenail Fungus

Definition

The term “toenail fungus” refers to a fungal infection that affects the toenail, causing yellowing, browning or whitening of the nail, crumbling of the nail, swelling, thickened nails, and eventually the loss of the toenail.

Toenail fungus is difficult to treat because toenails grow very slowly, and the infection may have spread down the nail to the nail bed.

Cause

We live in a world of fungus. Wherever conditions are warm and moist, there is fungus. The ideal spot is in the shower areas of public facilities such as school shower rooms, swimming pool showers and in health clubs.

Skin becomes weakened if tight fitting shoes are worn, making it more susceptible to develop cracks or tiny tears where the fungi may enter. The condition is easily spread via contact from one person to the next, and you may even spread the fungus yourself from one toe to the next.

If the immune system is compromised in any way, this will also create the right environment for fungi to live, and thus toenail fungus and other types of infections may result.

Treatment and Prevention

Medical treatment of toenail fungus is recommended because the nail may need to be removed to allow a new one to grow in. However, most of the time, treatment may not involve removing the nail. Fungal infections indicate a compromised immune system so oral medication may be prescribed.

Treatment should also include these preventative steps:
1. If showering at public facilities, always wear sandals.
2. Change socks frequently, especially if your feet are often sweaty.
3. Never borrow someone else’s towel.
4. Wash your hands after touching the infected toe.

Trench Foot

Definition

Trench foot is a condition of the foot where the foot becomes numb, turns either red or blue and starts to have the odor of dying flesh. It is common in those who are in the military. The term “trench foot” got its name from the great number of soldiers who were fighting in trenches in World War I who came down with the condition.

Trench feet can lead to swelling, blistering, open sores and if untreated, may result in gangrene. Gangrene is always a serious condition of the foot because it may lead to the amputation of the foot, which causes even more problems.

Cause

Trench foot is caused by prolonged exposure of feet to the elements, such as coldness (less than 50 degrees Fahrenheit, dampness, water immersion, or other unsanitary conditions along with constricting footwear. Prolonged exposure is defined as less than 12 hours in these conditions, which make it easy for fungi to grow and invade the foot.

Trench foot is worsened by sweaty feet.

Treatment and Prevention

Trench foot should be treated medically to prevent amputation.

Prevention involves keeping the feet warm and dry, which may be impossible for soldiers in extreme situations. Changing socks frequently is often the best preventive measure that can be taken.

Verruca

Definition

Verruca is the name of the species of viruses that causes plantar warts, flat warts located on the sole of the foot or on the toes.

Up to 10% of the population is infected with the Human Papillomavirus.

Cause

Plantar warts are caused by the human papillomavirus, which enters the skin through small cracks or tears in the skin on the bottom of the feet. The warts are a type of tumor that affects the skin and causes a callus type of skin to appear on the sole of the foot. Whenever pressure is applied to the wart, there is increased pain.

Warts may appear as a cauliflower growth with small black dots called petechiae in the center. They may bleed if irritated.

Treatment and Prevention

Salicylic acid may be obtained from the drug store or cryosurgery where the wart is frozen with liquid nitrogen. After freezing, the wart then begins to die. Another method used commonly to eliminate warts is electrodessication and surgical removal with laser, which is the most effective of all. Some treatments may leave scars. Get a second opinion if the doctor wishes to cauterize the wart, as this method may leave permanent keloids in the skin.

Newer treatments may use immunotherapy whereby antigens towards the mumps virus may be injected into the body to elicit an immune response to the Verruca virus. Also approaching this from a natural healing perspective and boosting the immunity with supplements may work over a longer time period.

While the wart is healing, an orthotic insert which includes a cushy insole will be a good choice to reduce pain experienced upon walking. Warts should be covered at all times so that they are not spread to others.

Prevention of warts includes keeping one’s immunity high and always wearing shoes or sandals, even when using public showers.

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