Foot & Ankle Pain

The Importance of the Foot

The foot is responsible for four major functions. It must be able to serve as a shock absorber, a lever for propulsion, adapt to uneven surfaces and translate forces generated by the hip. The muscles and tendons work together with the bones, joints, and ligaments to achieve these functions. If one part is not functioning properly, the entire foot can be affected.

The Anatomy of the Foot

The foot is comprised of three main parts: the hindfoot, midfoot and forefoot. There are also many ligaments, tendons, and muscles in the human foot, which help with mobility.

The hindfoot helps shape the heel of the foot. The heel bone (the calcaneus) is the largest bone in the foot. The hindfoot, specifically the heel, connects to the Achilles tendon and is attached to the calf muscle. The Achilles tendon is a cord-like structure needed for an upright motion. The heel, Achilles tendon, and calf allow for jumping, running, climbing and walking.
The midfoot is between the hindfoot and forefoot. The bones found in the midfoot help shape your arch and contribute a great deal to your ability to balance.
The forefoot contains the five toes (phalanges) and the five long bones (metatarsals). The metatarsal bones run from the arch of the foot to the toe joints.

What Causes Foot Pain?

There are many reasons you may have foot pain. Foot pain can be caused by different diseases, deformities, biomechanical conditions, improper footwear or injuries. Athletes are particularly susceptible to foot or ankle injury, from the sports they play to the footwear they wear. If you play a sport, it’s important to always make sure your footwear fits properly to avoid injury.

There are different areas of the foot where foot pain can occur: in the ball of the foot, heel, arch, toes or outer edge of the foot. These are the primary areas where foot pain can occur. Below are some conditions that can occur in these areas:

There are several types of injuries that can cause foot pain in the ball of your foot. Some of these conditions include:

  • Metatarsalgia: Pain and inflammation at the ball of the foot.
  • Morton’s neuroma: Thickening of the tissue around the nerves between the toes, in most cases between the third and fourth toes. This condition can also cause numbness over the ball of the foot.
  • Sesamoiditis: Injury and inflammation of the tendons around the big toe. This is also a form of tendinitis.

If the pain is in the heel, you may have a condition called “Plantar Fasciitis.” In this condition, there is irritation or inflammation of the band of tough tissue that connects the heel bone to the toes. Other types of conditions that could occur in the heel are:

  • Heel spurs: Abnormal growth of the bone at the bottom of your foot
  • Stone bruise: Deep bruise in the fat pad at the heel or ball of the foot
  • Heel fracture: High-impact injury possibly from a fall

There are two main conditions that can cause arch pain, these conditions include:

  • Plantar fasciitis: The most common cause of foot pain that originates in the arch of the foot. This condition can affect the heel, arch or both. This is an irritation or inflammation of these areas.
  • Fallen arches (Flat feet): Arch of the foot is flat, causing foot pain and other problems.

Common conditions causing pain that originates in the toes include:

  • Gout: A form of arthritis. Crystals collect in the joints and cause pain and swelling, most commonly affecting the big toe.
  • Bunion: A bony bulge along the edge of the foot, next to the big toe. Individuals with bunions can also develop a condition called hammertoe
  • Hammertoe: The second, third or fourth toe bends at the joint, causing it to look somewhat like a hammer. This condition can develop due to muscle imbalance.
  • Claw toe: The toe points up or down instead of straight. This condition can be caused due to nerve damage, mainly caused by diseases such as diabetes or alcoholism, which weaken the muscles in the foot.
  • Ingrown toenail: Skin grows over the toenail, leading to potential infection.
  • Turf toe: Pain in the base of your big toe. This can also be a form of Sesamoiditis, or a sesamoid fracture.
  • Toe sprain: Damage the tendon or soft tissue, easily caused by jamming or stubbing the toe.
  • Toe fracture/broken bone: Often caused by trauma or severe injury. Read this article on finding out if you have the symptoms of a broken toe.
  • Hallux rigidus: Type of arthritis.
  • Corns or calluses: Thick buildups of tough skin.
  • Sesamoid fracture: Breaking a small bone near the tendon attached to the big toe.

Common Forefoot Conditions

There are many common types of forefoot conditions that can cause foot pain. Some of these conditions include:

  • Bunion/Bunionette – a bunion is an enlargement of the bone on the side of the big toe joint. A Bunionette is an enlargement on the baby toe joint.
  • Hallux valgus deformity – shifting of the big toe, turning into the smaller toes.
  • Hallux limitus (HL) / hallux rigidus (HR) – Hallux Limitus is limited or reduced movement of the big toe. Hallux Rigidus is when the motion of the big toe decreases due to arthritis.
  • Morton’s neuroma (interdigital neuroma) – irritation, pressure or injury to one of the nerves that lead to the toes.
  • Metatarsal phalangeal joint capsulitis – local inflammation at the ball of the foot.
  • Metatarsal stress fractures (march fractures) – a small break in the bone caused by repetitive stress.
  • Freiberg’s disease – a lack of blood supply, resulting in permanent damage to the bone tissue at the second metatarsal.

The Importance of the Ankle

The ankle is important for your overall mobility – it allows you to walk, run or jump. Much like foot pain, health issues in the ankles can make routine daily activities difficult. If you are experiencing pain or difficulty walking, it’s important to get your feet or ankles examined by an orthopedic physician. At Coastal Orthopedics, our orthopedic physicians are recognized as the best in the country and are board-certified specialists.

The Anatomy of the Ankle

The ankle joint is comprised of three bones: the tibia, talus, and fibula.

The tibia, often referred to as the shinbone, is the larger and medial of the two bones located in the lower leg, the other being the fibula. It plays a critical role in weight-bearing and locomotion, serving as a primary point of attachment for several muscles and ligaments. Proximally, the tibia articulates with the femur at the knee joint, while distally, it connects with the ankle bones, primarily the talus.
The talus is a unique bone situated within the ankle joint. Serving as a pivotal bridge between the leg and the foot, it connects the tibia and fibula above with the calcaneus below. The talus is crucial for foot mobility, especially during movements like walking, running, and jumping. Due to its position and function, the talus plays a critical role in transferring weight and forces across the ankle joint.
The fibula is the slender bone located on the lateral side of the lower leg, parallel to the tibia. Although it is not directly involved in bearing the body’s weight, the fibula is essential for muscle attachment and provides lateral stability to the leg. At its proximal end, the fibula forms a joint with the tibia, and at its distal end, it plays a role in the ankle joint, articulating with the talus alongside the tibia. The prominence felt on the outer aspect of the ankle is the lateral malleolus, which is the distal end of the fibula.

What are the Types of Tests for Foot Pain?

There are many different conditions, injuries or diseases that can cause ankle or foot pain. To diagnose your foot pain, there are a few tests your foot doctor may perform. Some of these tests include:

  • Physical exam: Your doctor will look for any kind of swelling of the foot as well as deformity, pain, discoloration or skin changes.
  • X-rays: This imaging technique can help your doctor detect fractures or damage that could be caused by conditions like arthritis.
  • MRI scans: Short for “magnetic resonance imaging”, is an imaging machine that uses a powerful magnetic field and radio waves to produce detailed images of tissues, bone, and any other internal body structure.
  • CT scan: This imaging technique combines multiple x-rays, to give the doctor detailed images of the foot and ankle.

What are Some Treatments for Foot Pain?

person massaging their foot in discomfortOnce your doctor has diagnosed the cause of foot or ankle pain, they will explain all the possible treatments to relieve your pain. Treatments can be either surgical or non-surgical. Below is a list of some different treatments that your doctor could suggest:

  • Orthotics: Inserts for your shoes that can improve some conditions that cause foot and ankle pain.
  • Physical therapy: A variety of exercises to improve flexibility, strength, and support of the foot or ankle.
  • Surgery: For some conditions, such as a fracture, this treatment can relieve foot and ankle pain.
  • Pain medication: Medications that can relieve pain are available over-the-counter, though some medications may require a doctor’s prescription.
  • Antibiotics: When foot or ankle pain is caused by an infection or bacterial condition, you may be prescribed an antibacterial medication.
  • Antifungal medication: Conditions like athlete’s foot or any other type of fungal infection can be treated with antifungal medications.
  • Cortisone injection: Steroid injections can help reduce pain and swelling for certain foot and ankle conditions.