Foot & Ankle Pain
Where does it hurt?
Foot & Toe Conditions:
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Osteoarthritis is more than just ‘wear and tear’ of your joints. There are many other factors at play including physiological changes related to your natural aging process.
The many small joints of your midfoot are particularly prone to Osteoarthritic changes as many small bones collectively bear several times your body weight with every step.
When the joints in your foot do not work in unison or if they are placed under excessive stress, it can lead to inflammation of the joints (arthritis) and excessive wear and tear. This can go on for years before it becomes painful. Both high arches and flat feet can lead to extra stress on the middle of your foot.
Osteoarthritis of the arch and midfoot can be treated using orthotic insoles to support the function of the bones and joints.
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Cuboid syndrome, sometimes called cuboid subluxation, occurs when the cuboid bone is out of place, causing pain on the outside of your foot. This pain is often described as a “vague” pain and can run down to your two outside toes or up into your ankle.
Cuboid syndrome can be treated with physical therapy and exercises. Sometimes orthotics may be needed for a while to help your Cuboid stay in place while your ligaments recover.
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A Ganglion is the name given to a bump on the top of your foot. These are usually of a soft tissue type.
A true Ganglion is a collection of nerve tissues.
Once the nature of your Ganglion has been ascertained it can be treated accordingly.
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Your foot contains over 100 ligaments. Tight bands of tissue, like elastic bands, holding your bones together.
You have over 30 tendons in your foot. These tendons attach your muscles to your joints so they can move.
An injury to the foot ligaments or tendons can change the function and integrity of your foot. This will not only hurt the foot but may cause you to change the way you walk or run putting increased stress on other parts of your body.
Foot ligament or tendon injuries can be treated with a combination of orthotic insoles and stretch/strengthening exercises.
Top of the Foot
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Arthritis of the Big Toe joint is when the head of the long bone (Metatarsal) leading to your big toe becomes enlarged. This reduces the joint space and range of motion and can become inflamed and painful.
Hallux rigidus (bony restriction of big toe function) or limitus (soft tissue restrictions) is often misdiagnosed as a bunion because it causes a bony lump to arise from the top of the big toe joint.
Your Hallux Limitus can be treated by restoring the function of your foot and taking the stress off the soft tissue of your big toe.
Using orthotic insoles we can allow better function around your Hallux Rigidus reducing your pain while taking the compensatory stress off your foot or even your knee.
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A Bunion (Hallux Abducto Valgus) is a bony enlargement on the big toe joint that forms when the bone leading up to your big toe moves way from the others creating an uneven pull between muscles in the foot and big toe.
Bunions can not be treated with toe straighteners as the toe shape change is only the ‘end result’ of the condition, not the cause.
Bunions can be treated with a combination of orthotic insoles and stretching/strengthening exercises
The function and pain from your Bunion can be improved with a combination of orthotic insoles and physical therapies aimed at the cause of your bunion not just your big toe joint. However, the size of your bunion may not be affected by measures to reduce the cause.
If you have had a bunion for years and it starts to change shape it is highly recommended to seek a biomechanical assessment to see what is causing this new change.
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A big toe fracture is when you overload the bone of your great toe. Your bone overload may be as the result of an impact or sudden shock or as the result of a change to your biomechanics, causing more work to be taken by your big toe each step.
Big toes are notoriously difficult to splint while you recover. Orthotics can ease the pressure allowing your toe to heal.
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Gout is a metabolic disorder causing a build up of salts in your joints, primarily the big toe joint. This may change the function of your big toe joint.
Gout can be treated using Orthotic insoles to improve your function and pain at the big toe joint, though you may have to take medication to deal with the underlying metabolic disorder.
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Sesamoiditis is the inflammation of two small bones that sit under your big toe joint.
These two ‘floating’ bones under the ball of your big toe move as your big toe propels you, taking up to 300 times your body weight with each step. If they become stuck, crushed, or injured, they cause pain under the ball of your big toe.
Sesamoiditis can be treated with a combination of physical therapies and orthotic insoles to restore the balance and function of your sesamoids.
Big Toe
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Foot Callus is your skin’s response to pressure and friction resulting from poor biomechanics.
Foot Corns are the result of Callus becoming harder and deeper if the stress is not removed.
The position and make up of your callus can be a telltale sign of how you walk or run.
Callus and Cors can be treated using Orthotic insoles to improve your foot and leg function resolving your hard skin issues.
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Hammer toe and Claw toe is when the muscles working your digits are pulling out of balance resulting in the change of your toe shape.
The result of poor balance in your use of the muscles working your toes. Either overloading the joints or muscles being used for the wrong job.
Hammer and Claw toes can be treated using Orthotic insoles to restore your muscle balance in flexible toes and take the pressure off your arthritic toes.
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When you fracture a toe, it is notoriously difficult to splint. Orthotics can ease the pressure allowing your toe to heal.
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Metatarsalgia is the medical description of painful swelling of your forefoot and metatarsal bones.
This description is an umbrella term to describe pain in the front part of your foot. Common Metatarsalgia conditions include Morton’s Neuroma/Neuritis; Capsulitis and/or Synovitis.
A thorough assessment of your foot is needed to discover which Metatarsalgia pain you have so the right treatment can be given to resolve your pain.
Metatarsalgia can be treated using orthotic insoles.
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Morton’s Neuroma is a benign swelling on the nerve between your 3rd and 4th metatarsals.
Morton’s Neruroma causes a burning sensation, classically between toes 3 and 4 toe region which is caused by biomechanical irritation leading to inflammation around nerve cells.
A thorough assessment of the functioning of your foot is needed to find the cause of your neuroma pain so the correct treatment can be given to take the stress off your nerve.
Morton’s Neuroma can be treated using orthotic insoles and strengthening/stretching exercises.
Lesser Toes
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A pulled arch muscle is caused when your muscle is overworked or stretched. This can be a ‘one off’ injury or an overuse of your muscle over time.
Several muscles run under your arch and attach to your heel (e.g Flexor Hallucis brevis, Flexor Digitorum brevis, and Abductor Hallucis). Inflammation to one or more of these muscles will cause heel pain, often misdiagnosed as plantar fasciitis.
Pulled arch muscles can be treated with a combination of taping, orthotic insoles, and strengthening exercises.
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Several nerves run around or under your ankle, if the nerves are damaged, it can cause shooting or burning pain in your ankles and feet.
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Plantar fasciitis is a thicking or fraying of a thick band of tissue (the plantar fascia) that connects your heel to your big toe joint. Plantar fasciitis is also know as Plantar fasciosis, plantar fasciopathy, or jogger's heel.
Plantar fasciitis is often used as an umbrella term for many other types of heel pain (over 40 at our last count) so often people have tried the wrong treatment because their plantar fasciitis has been misdiagnosed.
True plantar fasciitis is caused by damage and stress to the thick tissue called fascia running under your foot that helps to hold your arch height. Heel pain syndrome is an umbrella term for pain when rising, which then passes, only to return later in the day which is not the definitive symptom for plantar fasciitis.
Plantar fasciitis can be treated with a combination of orthotic insoles and stretching/strengthening exercises.
Your heel pain will need to be thoroughly assessed to ascertain which heel pain you are suffering so an appropriate treatment plan can be developed with you.
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A collapsed arch (Adult Acquired Flat Foot) is a condition where your muscles no longer function to hold your arch height. This then has the effect of stretching your ligaments and other soft tissue in your arch allowing your arch to become progressively lower over time.
Sometimes the term ‘collapsed arch’ is used to describe over pronation.
Normal pronation involves the rolling inward of your ankle and rolling outwards of your heel, allowing you to absorb shock and adapt to the ground you walk on. Problems occur when pronation is too fast causing stress on the muscles, or too late causing your arch to collapse. This gives the appearance of a low arch.
Collapsed arches can be treated with a combination of orthotic insoles and strengthening exercises.
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Flat feet are when the arch profile of your foot looks lower than the average.
To lower your arches your foot has to go through a movement called pronation.
Normal pronation involves the rolling inward of your ankle and rolling outwards of your heel, allowing you to absorb shock and adapt to the ground you walk on.
Over Pronation problems occur when pronation is too fast causing stress on the muscles or too late causing your arch to collapse.
Over pronation can be treated with orthotic insoles and strengthening/stretching exercises.
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High arches are when the arch profile of your foot looks higher than the average.
As your foot contacts the ground, it rolls in (pronation). If your foot and ankle have a smaller than average range of motion to pronate you will be left with a higher looking arch.
Supination is the opposite to pronation, it allows you to stabilise your foot and have a solid platform to spring off. High arches occur when your foot is unable to pronate enough to lower your arch that reduces shock absorption and gives you a stiff foot.
High arches can be treated with orthotic insoles and physical therapy. The aim is seldom to support your high arch but rather to encourage the pronation movement to work better for you.
Arch
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Pain on the inside of your ankle is most likely related to either your Posterior Tibial tendon or Deltoid Ligament.
Together the Tibialus Posterior muscle and Deltoid ligaments provide the support and integrity for the inside of your ankle joint. If they become injured you may start to lose arch height.
Inner ankle pain can be treated with orthotic insoles and strengthening exercise
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A sprained ankle (twisted ankle) is when the ligaments that give stability to your ankle are stretched passed their limit.
The anterior talofibular ligament (ATFL) on the outside of your ankle is the most common ankle sprain but any of the ligaments on the inside or the outside of your ankle can become sprained.
Ankle sprains can be treated in the initial stages with Rest Ice Compression and Elevation. However, without appropriate exercises, your ankle sprain may remain vulnerable for many months and can turn into a chronic ankle instability.
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Chronic ankle instability is when you have had the effects of a sprained ankle for more than 12 weeks, or, if you have had repeated ankle sprains over time.
When you sprain your ankle ligaments they become vulnerable to spraining again more easily. The more times you sprain your ankle the more likely they are to do it again.
Chronic ankle instability can be treated with strength and conditioning exercises and may require orthotic insoles to help stabilise your ankle.
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An ankle strain is when you have pulled one or more of the muscles at your ankle.
Ankle strain can occur with, or as a result of, a sprained ankle. Chronic ankle instability will put more stress on the muscles of your ankle and make them more likely to become strained.
Ankle strains can be treated with strength and conditioning exercises and may require an orthotic insole to help stabilise your ankle.
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Osteoarthritis is more than just ‘wear and tear’ of your joints. There are many other factors at play including physiological changes related to your natural aging process.
Ankle arthritis is when the joints of your ankle become thinner and the bone becomes rough and inflamed.
The bones of your ankle joint are particularly prone to Osteoarthritic changes. You are more likely to have an arthritic ankle if you have had chronic ankle instability or if you have had surgery on your foot or ankle joints.
When the joints in your ankle do not work in unison or if they are placed under excessive stress, it can lead to inflammation of the joints (arthritis) and excessive wear and tear. This can go on for years before it becomes painful. Both high arches and flat feet can lead to extra stress on your ankle.
Arthritic ankles can be treated using orthotic insoles to support the function of the bones and joints often in conjunction with physical therapy to aid the mobility of your arthritic joint.
Your body will need to compensate at other joints for the lack of function caused by your arthritic ankle and left unaddressed this can increase the likelihood of injury in your knees, hips or back.
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Sinus Tarsi syndrome is an injury to the ligaments which live in a small tunnel between the joints just below your ankle.
Sinus tarsi injuries are often caused by ankle sprains, chronic ankle instability, or poor biomechanics. This causes the small tunnel between the two bones underneath the ankle to become too mobile, damaging soft tissue structures.
Sinus Tarsi syndrome can be treated with a combination of orthotic insoles and strengthening exercises.
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Tarsal Tunnel syndrome is when the nerve entering your foot becomes entrapped as it passes your ankle.
Flat feet, ankle injuries or chronic ankle instability can all cause the soft tissue tunnel that the Tibial nerve runs through to become ‘closed off’ causing a vague or shooting pain in or under the heel will occur. Tarsal tunnel syndrome is often mistaken for plantar fasciitis.
Tarsal tunnel syndrome can be treated with orthotic insoles and strengthening/stability exercises.
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Stiff ankles are when the bones of your ankle stop moving freely over or against each other, restricting one or more of the movements of your ankle.
Stiffness in your ankles is often most noticeable first thing in the morning or after a long period of sitting. Your ankles can be stiff for years before they actually become painful.
The main issue with stiff ankles is that your body will have to compensate in other joints for the lack of movement in your ankle. So if you have achy knees or a stiff back it’s worth considering how stiff your ankles have become.
Stiff ankles can be treated with a combination of physical therapy and mobility exercises. In some cases, orthotic insoles can be used to account for your changed walking or running gait to help you cope with stiff ankles.
Ankle
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Plantar fasciitis is a thicking or fraying of a thick band of tissue (the plantar fascia) that connects your heel to your big toe joint. Plantar fasciitis is also know as Plantar fasciosis, plantar fasciopathy, or jogger's heel.
Plantar fasciitis is often used as an umbrella term for many other types of heel pain (over 40 at our last count) so often people have tried the wrong treatment because their plantar fasciitis has been misdiagnosed.
True plantar fasciitis is caused by damage and stress to the thick tissue called fascia running under your foot that helps to hold your arch height. Heel pain syndrome is an umbrella term for pain when rising, which then passes, only to return later in the day which is not the definitive symptom for plantar fasciitis.
Plantar fasciitis can be treated with a combination of orthotic insoles and stretching/strengthening exercises.
Your heel pain will need to be thoroughly assessed to ascertain which heel pain you are suffering so an appropriate treatment plan can be developed with you.
For more discussion on treatment options for Plantar fasciitis check out our Blog
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Policeman’s Heel (Plantar calcaneal bursitis) is commonly mistaken for plantar fasciitis but is actually an inflammation of either the bursa or fat pad under your heel bone.
The protective fat pad under your heel can thin with certain conditions and age, which leaves the underlying structure damaged and the pad inflamed.
Policeman’s Heel can be treated with orthotic insoles used to protect your heel.
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Heel Spur syndrome is commonly mistaken for plantar fasciitis but is actually a bony protrusion from your heel caused by repeated overloading of the plantar fascia or other soft tissue that attaches into your heel. This leads to a prolonged cycle of damage and repair causing your body to grow extra bone.
Heel Spur can be treated with orthotic insoles to protect your heel bone and reduce the stress causing your spur to grow,
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A pull or tear to your arch muscle is caused when your muscle is overworked or stretched. This can be a ‘one off’ injury or an overuse of your muscle over time.
Three layers of muscles run under your arch and attach to your heel (e.g Flexor Hallucis brevis, Flexor Digitorum brevis, and Abductor Hallucis). Inflammation to one or more of these muscles will cause heel pain, often mistaken for plantar fasciitis.
Pulled arch muscles can be treated with a combination of taping, orthotic insoles, and strengthening exercises.
Several muscles run under your arch and attach to your heel. Inflammation to one or more of these muscles will cause heel pain.
Under Heel
Ankle & Heel Conditions:
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Insertional Achilles Tendonitis is when the tendon that attaches the calf muscle to the heel bone becomes swollen and inflamed.
Insertional Achilles Tendonitis can be treated with orthotic insoles then, once the swelling has reduced, stretching and strengthening exercises.
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A heel bone (Calcaneal) fracture is a break in the integrity of your heel bone structure.
You will experience pain every time you put your foot down with a fractured heel.
Fractured heel bones will take several weeks to recover. You may need to protect it with a heel support while it heals.
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Plantar fasciitis is a thicking or fraying of a thick band of tissue (the plantar fascia) that connects your heel to your big toe joint. Plantar fasciitis is also know as Plantar fasciosis, plantar fasciopathy, or jogger's heel.
Plantar fasciitis is often used as an umbrella term for many other types of heel pain (over 40 at our last count) so often people have tried the wrong treatment because their plantar fasciitis has been misdiagnosed.
True plantar fasciitis is caused by damage and stress to the thick tissue called fascia running under your foot that helps to hold your arch height. Heel pain syndrome is an umbrella term for pain when rising, which then passes, only to return later in the day which is not the definitive symptom for plantar fasciitis.
Plantar fasciitis can be treated with a combination of orthotic insoles and stretching/strengthening exercises.
Your heel pain will need to be thoroughly assessed to ascertain which heel pain you are suffering so an appropriate treatment plan can be developed with you.
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Hagland’s syndrome (deformity) is a thickening of the bone at the back of your heel where your Achilles tendon attaches to your heel bone. Haglands deformity is also known as retrocalcaneal exostosis, Mulholland deformity, and ‘pump bump’.
This bump will have formed over years and it is a result of an excessive pull of your Achilles tendon on the heel bone. This can be related to either high arches or flat feet.
Retrocalcaneal exostosis can become painful when it grows spurs into your Achilles tendon.
Hagland’s syndrome can be treated with physical therapy, and orthotic insoles and it often responds well to acupuncture treatments.
Back of Heel
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Achilles tendinitis is an umbrella term used to describe Irritation and stiffness in the tendon that attaches the calf muscles to the heel bone. It is often also called Achilles tendinopathy, Achilles tendonitis, or Achilles tenosynovitis.
As several conditions are named Achilles tendinitis you will need a thorough examination of your Achilles tendon to ascertain what is causing the pain in your Achilles.
Achilles tendinitis can be treated with a combination of strengthening, stretches and orthotic insoles depending on the type of Achilles pain you are suffering.
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Nodular Achilles tendinitis is a benign thickening of your Achilles tendon usually found a few cm higher than your heel bone.
This is a sign of poor function of the Achilles tendon over time causing it to produce thicker tendon tissue.
Achilles tendon nodules can be treated with a combination of strengthening exercises and orthotic insoles.
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Sever's disease is a calcaneus apophysitis, meaning an inflammation at the back of the heel
Unique to growing children, particularly active ones. The pull of the Achilles’ tendon is greater than the strength of its attachment to the heel and pain is felt at the Achilles.
Sever’s disease can be treated with the short term use of orthotic insoles and, once the condition has calmed down, stretching and strengthening exercises.
Achilles
Most Common Foot & Ankle Conditions:
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An ankle sprain is a common ankle injury that usually involves over-stretching and damage to one or more of the ligaments on the outside of your ankle. The ankle is a complex joint held together by a system of ligaments essential for transmitting movement and weight between your foot and the rest of your body. Ankle sprains happen if the ligaments around the ankle joint are damaged. Ligament damage is often graded as mild when a ligament is stretched; moderate when there is a partial tear and severe when a ligament is severed.
Symptoms of over-stretching or damage to the ligaments will include immediate pain and swelling. For more severe sprains, weight bearing may be difficult for a while and you may experience knee pain caused by the ankle sprain. Nerve damage after a severe sprain may occur if long-term swelling compresses the nerves around the ankle.
We will carefully assess your condition and will prescribe a suitable range of measures to aid your recovery, which may include one or a combination of stretches and exercises, Foot Manipulation Therapy and orthotics.
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When the joints in your foot do not work in unison or if they are placed under excessive stress, it may lead to inflammation, pain and swelling of the joints (arthritis). During normal daily activity your ankle does a tremendous amount of work. It is the key joint allowing you to pivot over your foot. Misaligned joint function or excessive stress from flat feet, high arches or even knee or hip problems can cause the ankle to ‘wear out’ and become arthritic. If your ankle is not working properly you will have to get the ‘pivot’ from somewhere else, making your foot, knees, hips or back work harder.
Pain and stiffness in the joint is a common symptom of an arthritic ankle which can make walking and activities difficult. Stretches and exercises, acupuncture, Foot Manipulation Therapy and orthotics can all bring relief to an arthritic ankle. At Norfolk's BxClinic we will discuss the best therapies for you and offer support and advice to help you manage your pain and help you continue your daily activities.
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A bony enlargement on the big toe joint that forms when the bone leading up to your big toe (metatarsal) moves away from the others creating an uneven pull between muscles in the foot and big toe. Over time, this action causes your big toe to pull towards your other toes eventually causing wear and tear to the joints, pain and arthritis. Poor lower body biomechanics will cause bunions to form, but those who run a lot or wear ill-fitting shoes are also at risk.
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Hallux rigidus (bony restriction of the big toe functions) or limitus (soft tissue restriction) is often mistaken for a bunion because it causes a bony enlargement on the top of your big toe joint. It’s extremely painful in the foot and even into your shin as your body tries to make up for the missing big toe joint function.
Surgery for removal of a bunion is often only undertaken in the most severe cases; it cannot guarantee you will be pain-free with a perfectly aligned foot and it can permanently reduce the flexibility of the foot. At Norfolk’s BxClinic, we will discuss with you some options that can greatly reduce your pain and discomfort without the need for surgery. Our client-specific stretches and exercises, Foot Manipulation Therapy and orthotics have repeatedly shown to provide great pain relief from painful bunions.
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The formation of a callus on the bottom of your foot is your skin’s response to pressure and friction, resulting from poor biomechanics. If the stress is not removed, it becomes a painful corn. Removing the callus and corn can provide a temporary remedy and reduce the pain. However, without permanently removing the cause of the pressure or friction the pain will come back every time, often very quickly. Foot Manipulation Therapy and orthotics can adjust the imbalance in your lower body biomechanics and bring long lasting pain relief.
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Cuboid problems occur when the cuboid bone (a square-shaped bone just in front of the heel bone) is out of place. A vague pain on the outside of your foot running down to your two outside toes is a classic symptom of a problem with the cuboid bone. A displace cuboid bone is sometimes found to be the cause of lingering pain after an ankle sprain. Foot Manipulation Therapy and precision made orthotics can alleviate the problem.
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A true flat foot is when the bones of your arch touch the ground when walking and standing, normally as a result of over-pronation.
Pronation is a normal movement occurring around your ankle characterised by the rolling inwards of your ankle and the rolling outwards of your heel bone and is your body’s natural shock absorption. People with flat feet simply pronate too much which can cause symptoms of heel pain, back pain and knee pain.
Flat feet can affect both adults and children and in both cases our precision made orthotics (inserts custom made to fit perfectly and comfortably into your shoes) will support your flat foot and the way you walk, reducing your discomfort. If you enjoy running we can make bespoke running orthotics. We can also prescribe stretches and exercises and Foot Manipulation Therapy, which are extremely beneficial.
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High Arches occur when you are unable to ‘pronate’ enough (the rolling inwards of your ankle and outwards of your heel bone). Supination (the reverse of pronation) is a normal movement occurring around the ankle joint, it is essentially the opposite of pronation and allows you to stabilise your foot and have a solid platform to spring off. Problems arise when you cannot lower your arch enough, which gives you ‘high arches’ and leaves you with less shock absorption, which adds stress to the heel and ball of the foot and even your hip and back. With high arches the shock of the heel striking the floor in the normal walking cycle causes foot pain and transfers pain into the hips, ankles, knees and lower back.
Our precision made orthotics (shoe insoles) will support your symptoms and give your high arched feet room to move in a more helpful way, reducing the shock impact and taking away your discomfort. If you find running difficult because of your high arches we can design precision orthotics (inserts) for you that will greatly increase your comfort when you run. Foot Manipulation Therapy and stretches and exercises are also very effective in helping the symptoms of high arches.
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Persistent inflammation (neuritis) occurs when the nerves that run between your metatarsals to your toes (the 3rd and 4th toe) are damaged due to excessive compression leading to symptoms of numbness or a burning sensation in the ball of the foot or toes. If the inflammation continues the cells around your nerve that help the nerve signal transmission become enlarged and less effective (Morton’s Neuroma).
Ill-fitting shoes are often a primary cause of compressing the nerve along with foot deformities like bunions and flat feet and repetitive irritation through sports such as running and court sports. At BxClinic, we will frequently advise a treatment course that will involve either Foot Manipulation Therapy, orthotics or acupuncture (or a combination) to help your recovery and provide you with pain relief.
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True plantar fasciitis is caused by damage and stress to the thick band of tissue called fascia that runs under your foot connecting the heel bone to the toes. The fascia also helps to support your arch as you push off the ground and takes multiple times your body weight through your step.
There are over 40 different heel pains that are commonly mistaken for plantar fasciitis. To get the right result for your heel you must understand which of these conditions you have.
Plantar fasciitis is damage and stress to the fascia that can cause inflammation and pain in the heel or bottom of the foot when standing or walking. To find out what is causing your plantar fasciitis pain we have to assess what has caused the excessive stress. Common causes can include a sudden increase in intense exercise particularly running, being overweight, constantly being required to stand for long periods, flat feet or high arches, tight Achilles, and ill-fitting shoes.
Our precision made orthotics often provide the ideal remedy for plantar fasciitis; the custom designed insole will fit into your shoe or boot and provide arch support. We are likely to recommend a combination of stretches and exercises, acupuncture and Foot Manipulation Therapy to help cure your pain and bring long-term relief to sore feet and heels.
Plantar Fasciitis is also a common ‘umbrella’ term used to describe heel pain in general. Classic symptoms of ‘heel pain syndrome’ include pain in the heel when rising which then passes, only to return again later in the day.
For more discussion on treatment options for Plantar fasciitis check out our Blog
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There are two ‘floating’ bones under the ball of your big toe. These bones move as your big toe propels you off the ground taking several hundred times your body weight with each step. If they become stuck or crushed, they cause intense ‘pin-point’ pain under the ball of your big toe.
At Norfolk's BxClinic will we carry out a detailed analysis of your foot which will show us if the bones are getting stuck or getting crushed. Once we have established this, we will get them moving for you if they are stuck or we will give them the freedom to move if they are getting crushed. We achieve this through effective use of Foot Manipulation Therapy, acupuncture and bespoke orthotics (individually created shoe insoles). These therapies should leave you pain-free without needing to undertake MRI scans or consider surgery.
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Sever’s Disease syndrome is a condition unique to growing children, particularly active ones. As a child grows, the heel bone is one of the first to reach full adult size. When the tendons, muscles and ligaments don’t grow as fast as the heel bone, they are stretched too tight causing the child to feel pain at the Achilles. Children who are involved in sports that involve a lot of running and jumping like football, gymnastics, dancing and basketball often experience Sever’s Disease.
Acupuncture, bespoke orthotics (custom-made shoe inserts), stretches and exercises and Foot Manipulation Therapy are all extremely effective in bringing relief and cure from Sever’s Disease and following assessment Norfolk's BxClinic will prescribe one of a combination of these to help your child.
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If your foot is unstable or your muscles weak, the function of your toes will be impaired and over time become fixed and possibly arthritic. The muscles that control your toes are divided into those that originate in the calf and the lower leg and those that originate in the foot. Lesser toe deformities such as claw toes and hammertoes are commonly caused by these muscles being used in the wrong way (poor biomechanics).
If your foot, ankle or general gait biomechanics are not working properly, the controlling toe muscles that originate in your lower leg can be recruited to help which pulls the toes out of position. The earlier this can be identified and treated the better, left untreated the toe joints become fixed which can be painful and harder to treat. Toe deformation also makes it very difficult to find shoes that fit and are comfortable. At Norfolk's BxClinic, we will assess the cause of your toe deformity and recommend a combination of Foot Manipulation Therapy, stretches and exercises, orthotics and acupuncture, all of which offer excellent pain management.
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Ehlers–Danlos syndrome (EDS) describes a group of (13) connective tissue disorders affecting everything from skin to scar formation.
Your feet and ankles can be particularly affected by a variety of EDS known as hypermobile Ehlers-Danlos syndrome (hEDS) or Type 3 EDS.
hEDS will make your feet more vulnerable to pretty much every condition on this page.
Not all Hypermobility is hEDS. You can have only a few or even one hypermobile joint causing that specific region to be more vulnerable to conditions like muscle, fascia (plantar fasciitis) and ligament injuries.
Hypermobile joints are more prone to becoming arthritic as they tend to be regularly put through a higher range of motion than they are designed to take.
hEDS and hypermobility can be treated using a combination of strengthening exercises and orthotic insoles.
EDS and hypermobility are one of the only times we advise orthotic insoles may be preventative of injury occuring.
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Rheumatoid arthritis is an auto-immune disease (meaning your body’s defenses are attacking themselves) that primarily affects the small joints.
Your feet have over 25 small joints so can be particularly affected by Rheumatoid arthritis.
Rheumatoid arthritis makes you more vulnerable to pretty much every condition you see on this page.
Rheumatoid arthritis of the feet can be treated using a combination of orthotic insoles to stabilise the small joints of the foot, and strengthening exercises to improve joint function.
Rheumatoid arthritis is one of the few conditions where we advice the use of orthotic insoles may be protective of your feet suffering other injuries.
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Posterior tibial tendon dysfunction (PTTD) also known as Posterior tibial tendonitis, or posterior tibial tendon insufficiency, is a condition where one of the main tendons supporting the function of your foot and ankles becomes injured.
Acute or early stage PTTD will cause your foot to flatten more and put more stress on your foot and ankle muscles and may lead to conditions like plantar fasciitis or Achilles tendonitis.
If left untreated PTTD will progress and your foot will become more flat against the ground and you will have a reduced ability to roll your ankle out (supinate your foot)
Posterior Tibial tendinitis can be treated with strengthening exercises and orthotic insoles in the early stages.
Posterior Tibial tendon dysfunction that has progressed further can be treated with Ankle Foot Orthoses along with strengthening exercises.
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Foot drop is a condition where the muscles in your shin are not able to hold your foot up while you walk.
Foot drop often causes you to drag your foot scraping your toes along the ground. This change to your gait greatly increases your risk of tripping and falling.
Foot drop can be as a result of muscle changes but is most commonly due to changes in the way your nerves function causing the muscles to have no power to pull your foot upwards.
Foot drop can be treated using a combination of strengthening exercises and ankle foot orthoses to aid the function of your foot and help your toes clear the ground when you walk.