December 2024

Orthotics are shoe inserts that are meant to correct an irregular walking gait or provide cushioning to the feet.  Orthotics come in a variety of different models and sizes, including over-the-counter and customizable variants. Customizable orthotics can be shaped and contoured to fit inside a specific shoe and are typically prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

Orthotics are beneficial because they can help prevent injuries from occurring and provide cushioning to keep pain levels down to a minimum. They also allow for the correct positioning of the feet. Orthotics can act as shock absorbers to help remove pressure from the foot and ankle. Therefore, orthotics can make bodily movements, such as walking and running, become more comfortable as well as help prevent the development of certain foot conditions.

Orthotics alleviate pain and make the foot more comfortable by slightly altering the angle at which the foot strikes the ground surface, therefore controlling the movement of the foot and ankle. Orthotics come in different variants and can be made of various materials. To determine what type of orthotic is most suited to your feet and your needs, it is best to consult your podiatrist. He or she will be able to recommend a type of orthotic that can help improve your foot function or prescribe a custom orthotic to best fit your feet.  

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.

In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.

The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.

While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.

Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries.