January 2023

A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.

The following are specifics about a few of these conditions:

-    Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.

-    Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.

-    Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.

-    Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.

-    Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.

-    Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.

Broken ankles are a serious injury that can lead to an inability to walk, function, and also cause a significant amount of pain. A broken ankle is a break in one of the three bones in your body that connect at the ankle joint: the tibia, the fibula, and the talus. The tibia and fibula are your two primary leg bones that connect at the knee, which sit directly upon the talus bone. This is protected by a fibrous membrane that allows for movement in the ankle joint. A broken ankle is usually caused by the foot rolling under or twisting too far, causing one of these three bones to snap.

A broken ankle is different from an ankle sprain, which occurs when the ankle ligaments are ripped or torn but no bones have been broken. A sprain can still be very severe, causing bruising in the foot and an inability to hold your own weight, much like a broken ankle would. If you’re unable to stand, and suspect that you have a broken ankle, the first thing to do would be to get an immediate X-ray to determine the severity of the break.

A common cause of broken ankles is when the ankle is rolled over with enough pressure to break the bones. This usually happens during exercise, sports, or other physical activity. Another common cause is a fall or jump from a tall height.

One immediate treatment for pain relief is elevating the foot above your head to reduce blood flow to the injured area. You can also apply ice packs to your ankle to help reduce swelling, redness, inflammation, and pain. After these initial steps, getting a cast and staying off your feet as much as possible will aid in the recovery of the broken ankle. The less movement and stress the ankle has to endure, the more complete it will heal. A doctor can determine if surgery is needed in order to heal correctly. In these cases, an operation may be the only option to ensure the ability to walk properly again, followed by physical therapy and rehabilitation.

It is highly important to determine if surgery is needed early on, because a broken ankle can become much more severe than you realize. If not professionally treated, the broken ankle will inhibit your walking, daily functioning, and produce a large amount of pain. Treating your broken ankle early on will help prevent further damage to it.

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.