Common Foot and Lower Limb Conditions

Metatarsalgia is a non-specific diagnosis for pain at the front of the foot. This can include metatarsal phalangeal joint capsulitis (inflammation of the ball of the foot), bunions, morton’s neuroma (inflammation / irritation of a nerve), metatarsal stress fracture, hallux limitus / rigidus (lack of adequate movement in the big toe), and many other conditions.

In most cases, symptoms include pain or discomfort at the ball of the foot when standing, walking, or running. These symptoms often improve when you are off your feet. A number of factors can contribute to metatasalgia, which may include:

• – Poor foot mechanics (collapsed metatarsal arch)
• – Excessive ligament laxity
• – Improper or ill-fitting footwear
• – Overuse
• – Arthritis
• – Tight calf musculature

Treatment may include:

• – Custom made orthotics (with increased metatarsal arch support)
• – Proper footwear (size and style)
• – Stretching and strengthening programs

There are many different types of ankle pain. The location and severity of pain can differ depending on the tissue that is damaged. Common injuries that occur to tendons around the ankle joint include: Achilles Tendonitis, Tibialis Posterior Tendonitis, and Peroneal Tendonitis which involve pain, and possible swelling, to the posterior, medial, and lateral part of the ankle, respectively. Potential causes and contributing factors of tendonitis may include:

• – Overuse / overtraining
• – Poor foot and ankle mechanics
• – Muscle weakness or tightness

Ligament sprains, usually occurring to the lateral ankle, are also a common ankle injury. Ankle sprains are often an acute injury, but have the potential to become a more chronic, reoccurring issue. In severe sprains, pain can be accompanied by significantly swelling and bruising. An ankle sprain often occurs as an unlucky sports injury or fall, but there are a few factors that could contribute to the likelihood of a sprain occurring. Including:

• – Improper footwear
• – Poor foot and ankle mechanics
• – Muscle weakness or tightness

Treatment of ankle pain may include:

• – Custom made orthotics (to correct any foot mechanics contributing to condition)
• – Bilateral Achilles lift
• – Muscle strengthening and stretching programs
• – Bracing
• – Taping
• – Ice

There are many different types of knee pain which can include patellofemoral pain syndrome, iliotibial band friction syndrome, osteoarthritis, ligament and meniscal damage, and others. The cause and treatment for knee pain can vary significantly, depending on the specific diagnosis.

Patellofemoral pain syndrome is the most common injury to the knee and is especially common for runners. Symptoms include pain in the front of the knee, due to poor tracking of the patella within the groove of the femur. Pain often worsens with activity. Iliotibial band friction syndrome involves pain on the lateral aspect of the knee due to excessive rubbing from the IT band. Both PFPS and ITBS can potentially be caused by:

• – Biomechanical factors (over pronation of the foot, over rotation of the tibia / femur)
• – Muscle weakness / tightness
• – Overuse / overtraining
• – Anatomical differences

Treatment may include:

• – Custom made orthotics (to reduce knee rotation or offload specific knee compartment)
• – Strengthening and stretching programs

Medial tibial stress syndrome, also known as shin splints involves the tibialis posterior muscle ripping away from its attachment on the tibia. Pain often develops along the inside of the shin bone, which is usually worse before and after activity. This is a common running injury and unless properly treated, the pain worsens and small stress fractures could form. Potential causes and contributing factors of MTSS include:

• – Muscle weakness (tibialis posterior and soleus are the primary ankle stabilizing muscles)
• – Poor foot and ankle mechanics
• – Overuse / overtraining

Treatment may include:

• – Muscle strengthening program
• – Custom made orthotics
• – Icing