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Stomp Out Foot Problems

By Abbott Kagan II, MD
And Jim Marshall, ATC/L

The foot is a very important structure in the body. It functions to absorb forces with walking, running and jumping. The foot also supports one�s body weight. Bones, muscles and ligaments form three separate arches, which absorb shock and assist in weightbearing. Unfortunately, is vulnerable to many injuries or conditions. Some of the most common problems observed are plantar fasciitis, bunion, turf toe and metatarsal stress fractures.

Plantar Fasciitis is an inflammation of the plantar fascia, which is a broad band of tissue that runs the length of the bottom of the foot. Plantar fasciitis is seen both in the athletic and non-athletic populations. Several factors are thought to cause this condition, such as inflexibility of the longitudinal arch, tightness of gastrocnemius-soleous unit (calf muscles) and insufficient arch support in shoes. The most common complaint is pain in the undersurface of the foot with the first steps in the morning. It is pertinent for one who has symptoms to consult an orthopedic surgeon. Plantar fasciitis can be treated by splinting at night, stretching exercises and physical therapy treatments.

Hallux valgus deformity (bunions) generally involve a bony structure of the big toe, which becomes misaligned and may overlap the second toe. Often bunions occur from wearing shoes that are too pointed, too narrow, too short or have high heels. One may experience pain, swelling and tenderness over the side of the big toe. The type of shoes worn plays a key role in the treatment of bunions. Shoes that are of a proper width decrease the amount of irritation. Surgery is common in later stages of hallux valgus to correct the deformity.

"Turf toe," as it is commonly called, is a hyperextension injury to the big toe that proves to be very debilitating. Turf toe is somewhat of a misnomer because it is not limited to turf but can occur on any surface. This injury occurs when the big toe is forced backward. Reasons this may occur are because the forefoot of the shoe is too flexible or as a result of kicking an unyielding object. Flat insoles, which have thin sheets of steel in the forefoot, are sometimes available commercially. With more severe sprains, the person should see an orthopedic surgeon for further evaluation and treatment. It may take three to four weeks for the pain to subside.

Another common injury is metatarsal stress fractures, which usually involve one or more of the metatarsal (toe) bones. Mostly affected are the second and third toes during sudden changes in training patterns of runners. An athlete who has hallux valgus, flat feet or a short first metatarsal bone is more likely to incur a stress fracture. A radiographic examination may not always detect this type of fracture; therefore, a bone scan may be needed. The athlete may experience pain over the second and/or third metatarsal and should consult an orthopedic surgeon.

In closing, foot injuries can be extremely painful, but with early intervention, loss of time from activities can be reduced. Remember that shoes should always be fitted by a qualified person, and the correct shoe should be worn for the type of activity in which you are participating, Good shoes and good fitting equal good feet.