The Achilles tendon is the largest and strongest tendon in the body. It connects the calf muscles to your heel bone, providing the power to walk, run, climb stairs, jump, and stand on tiptoes. Achilles tendonitis is a general term that describes inflammation of the tendon, causing pain.
Arthritis is inflammation in a joint as a result of cartilage degeneration causing joint pain, swelling, stiffness, and restricted movement. Arthritis of the foot and ankle joint can occur due to fractures, dislocation, inflammatory disease, or congenital deformity.
An ankle sprain is one of the most common injuries around the foot and ankle. ‘Sprain’ refers to stretching of the ligaments that provide stability to the ankle. Different mechanisms of injury include an ‘inversion’ injury when the ankle rolls inside, ‘eversion’ injury when it rolls outside or a twisting injury as shown in the illustration below.
Arthritis refers to ‘wear and tear’ of a joint. This may occur at the base of the big toe. A common medical term for this condition is ‘hallux rigidus’, Latin for ‘stiff big toe’. The exact cause is unknown but is associated with those who are active, or have suffered gout, or other inflammatory conditions such as rheumatoid disease.
Bunionette also referred to as a tailor’s bunion is a bony lump that grows on the outside of the foot at the base of your little toe. The deformity got its name as q tailor’s bunion when tailors once sat with their legs crossed all day, with the outside edge of their feet rubbing on the ground.
Cavus foot also referred to as a high arch, is a condition in which the arch on the bottom of the foot that runs from the toes to the heel is arched more than normal. Because of this, excessive weight falls on the ball and heel of the foot when walking or standing, causing pain and instability.
Arthritis is the inflammation of joints as a result of degeneration of the smooth cartilage that lines the ends of bones in a joint. This degeneration of the cartilages leads to painful rubbing of the bones, swelling, and stiffness in the joints, resulting in restricted movements.
Arthritis is inflammation in the joint resulting from the degeneration of cartilage causing joint pain, swelling, and stiffness resulting in restricted movements. Arthritis of the foot and ankle joint can occur due to fractures, dislocation, inflammatory disease, or congenital deformity.
Hallux Rigiditis is a form of degenerative arthritis at the metatarsophalangeal or MTP joint where the base of your big toe attaches to the foot. Arthritis is the inflammation of joints as a result of degeneration of the smooth cartilage that lines the ends of bones in a joint.
Heel pain is a common symptom of excessive strain placed on the structures that form the heel. The heel is made up of the calcaneus bone and supported by a network of muscles, tendons, ligaments and soft tissues, which together support the weight of the body and stress during movement.
This is a painful benign swelling or irritation of the digital nerve that runs between the metatarsal bones of the foot. Entrapment of this nerve causes pain in the ball of the foot that radiates to the toes and is sometimes described as feeling like walking on a pebble or marble.
Tendons are the soft tissues connecting muscle to bone. The Achilles tendon is the longest tendon in the body and is present behind the ankle, joining the calf muscles with the heel bone. Contraction of the calf muscles tightens the Achilles tendon and pulls the heel, enabling the foot and toe movements necessary for walking, running and jumping.
Ankle joint replacement, also known as total ankle arthroplasty, is a surgical procedure performed to relieve pain and immobility due to severe end-stage arthritis that has not responded to non-surgical treatments. The goal of ankle joint replacement surgery is to eliminate your pain and increase the mobility of your ankle joint.
Ankle ligament reconstruction may be performed arthroscopically under general anaesthesia. Your surgeon will make small incisions in your ankle. A tiny camera and a few special instruments are inserted through the incisions to repair and strengthen the ligaments. Stretched or torn ligaments will be shortened and stitched as needed.
Ankle tenotomy is a surgical procedure to lengthen the Achilles tendon, enabling the ankle to flex upward and allowing the heel to be placed flat on the floor. It is indicated in if you have an abnormally developed Achilles tendon or one that has become shortened and is difficult to stretch.
Brostrom repair is a surgical procedure that involves the repair and reconstruction of injured ligaments on the outside of the ankle to treat ankle instability. The two ligaments of the ankle that are commonly injured are the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL).
Custom inserts are specially designed and highly customized shoe inserts a doctor will prescribe to treat certain conditions of the foot. Also called “insoles or foot orthotics”, they are made specifically for you to wear inside your shoes to correct biomechanical problems of your foot or heel.
The foot is composed of different structures including bones, ligaments, tendons, and muscles. As the feet bear the weight of our body, they are more prone to injury and pain. A foot injury or foot surgery may leave you immobile for a period of time.
A good exercise program to rehabilitate foot and ankle conditions focuses on strengthening and stretching the muscles and tendons of the lower leg, feet, and ankles to relieve pain and soreness, keep the muscles flexible, provide stability and prevent future injury.
Great toe replacement with synthetiic cartilage is a surgical procedure for the treatment of great toe arthritis in which damaged sections of the great toe joint are removed and replaced with an artificial component (synthetic cartilage implant).
High heels have been worn by many women for years to look taller and nowadays they are commonly worn as part of a fashion statement. Women wearing high heels appear taller with longer legs; however, this causes postural changes which bring a host of health issues when high heels are worn too frequently.
Foot and ankle fractures are breaks or cracks in any bone of your foot and ankle joint. Fixation of fractures is a surgical method of reconnecting the broken or cracked bones and fixing them in the correct place using orthopaedic hardware.
Shockwave treatment, also known as Extracorporeal Shock Wave Therapy (ESWT), is a conservative procedure to treat plantar fasciitis of the foot, where shockwaves are passed through the heel to stimulate healing of the inflamed plantar fascia tissues.
Injuries during sports are common. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. Injuries to the foot and ankle are common while playing sports such as football, hockey, skating and in weekend athletes.
What is the Normal Anatomy of the Foot and Ankle?
The foot and ankle form complex joints that are involved in movement and providing stability and balance to the body. The foot and ankle consist of 26 bones, 33 joints, and many muscles, tendons, and ligaments.
Bones of the Ankle
The ankle joint connects the leg with the foot and is composed of three bones: the tibia, fibula, and talus. The tibia or shinbone and fibula or calf bone are bones of the lower leg, which articulate with the talus or ankle bone, enabling up and down movement of the foot.
Three bony bumps present on the ends of the tibia and fibula form parts of the ankle joint:
- The medial malleolus, formed by the tibia, is found on the inside of the ankle.
- The posterior malleolus, also formed by the tibia, is found at the back of the ankle.
- The lateral malleolus, formed by the fibula, is found on the outer aspect of the ankle.
Bones of the Feet
The foot acts as a single functional unit, but can be divided into three parts: the hindfoot, midfoot and forefoot.
The hindfoot forms the ankle and heel, and is made up of the talus bone and calcaneus or heel bone. The heel bone is the largest bone in the foot.
The midfoot connects the hindfoot to the forefoot, and consists of one navicular bone, one cuboid bone, and three cuneiform bones. The navicular bone is found in front of the heel bone, and the cuneiform and cuboid bones are arranged in front of the navicular bone.
These bones are connected to five metatarsal bones of the forefoot that form the arch of the foot for shock absorption while walking or running. The forefoot is also made up of the toes or digits, formed by bones called phalanges - three in each toe, except the big toe, which has only two phalanges. The big toe has two additional tiny round sesamoid bones in the ball of the foot, which helps in upward and downward movements of the toe.
Ankle and Foot Joints
There are 33 joints in the ankle and foot. They include:
- Hinge joints in the ankle, which allow flexion (bending) and extension
- Gliding joints found in the hindfoot, which allow gliding movements
- Condyloid joints found in the forefoot and toes, which allow the flexion (bending) and extension, adduction, and abduction (sideward movement).
The joints of the foot and ankle provide stability and support the weight of your body, helping you to walk or run, and adapt to uneven grounds.
Soft Tissues of the Ankle and Foot
Our feet and ankle bones are held in place and supported by various soft tissues such as cartilage, ligaments, muscles, tendons, and bursae.
The joint surface of all the bones of the ankle and foot are lined by a thin, tough, flexible, and slippery surface called the articular cartilage, which acts as a shock absorber and cushion to reduce friction between the bones. The cartilage is lubricated by synovial fluid, which further enables smooth movement of the bones.
Ligaments are tough rope-like tissue that connect bones to other bones, and hold them in place, providing stability to the joints. The plantar fascia is the largest ligament in the foot, originating from the heel bone to the forefoot, it extends along the lower side of the foot and is involved in maintaining the arch of the foot. The plantar fascia ligament stretches and contracts to provide balance and strength to the foot. Lateral ligaments on the outside of the foot and medial ligaments on the inside of the foot provide stability and allow up and down movement of the foot.
The foot is made up of 20 muscles that help in movement. The main muscles include:
- Anterior tibial muscle, which allows up and down movement of the foot
- Posterior tibial muscle, which supports the arch
- Peroneal tibial muscle, which controls movement on the outside of the ankle
- Extensors, which enable the ankle to raise the toes just before stepping forward
- Flexors, which stabilize the toes against the floor
- Smaller muscles that help the toes to lift and curl
Tendons are soft tissues that connect muscles to bones. The largest and strongest tendon in the foot is the Achilles tendon, present at the back of the lower leg around the heel bone. Other tendons include peroneal and anterior and posterior tibialis.
Bursae are small fluid-filled sacs that decrease friction between tendons and bone or skin. They contain special cells called synovial cells that secrete a lubricating fluid.