Common Foot & Lowerlimb Problems & Exercises

Note: If you are experiencing pain, it is best to consult your family physician to explore the cause.

Metatarsalgia

Metatarsalgia is a general term describing forefoot pain. This typically occurs over time (chronic pain), but can sometimes be described as a sudden onset of pain in the forefoot (acute pain). The pain can be caused by a number of things including:

1. inflammation at the ball of the foot
2. sudden change of activity or irritation to the area
3. fat pad deterioration
4. arthritis
5. high arches
6. foot deformities

Signs and Symptoms:

1. pain in the ball of the foot when standing or during the push-off phase of walking
2. pain will typically get worse with activity
3. sometimes paired with a shooting pain into the toes or a numbing of the
   toes

How Can We Help?

1. Proper fitting shoes

• this is the number one cause of metatarsalgia.
• orthopaedic footwear with a wide, deep toe box that are properly shaped to fit your feet will typically relieve symptoms and prevent them from recurring

1. Activity specific shoes

• wearing shoes that properly support your feet based on your level and type of activity, for example, walking shoes for long walks.

1. Over the counter or specialty devices

• metatarsal pads to take pressure off the ball of the foot
• orthotics including a metatarsal pad

Plantar Fasciitis

Plantar Fasciitis is an inflammation of the plantar fascia, a band of tissue stretching across the bottom of the foot. Plantar Fasciitis is often the result of the following:

1. poor alignment and or mechanics of the lower limb
2. trauma to the plantar fascia region
3. weight gain
4. changes in activity

Signs and Symptoms:

1. heel or arch pain after sitting or resting for a long period of time, typically most painful during the first few steps in the morning
2. tight calf muscles

How Can We Help?

1. Custom Made Foot Orthotics

• a customized arch support which aligns the foot in its neutral position, taking the strain off the plantar fascia tendon

1. Off-the-Shelf Foot Orthotics

• a general arch support which also works toward aligning the foot in its
  neutral position, taking the strain off the plantar fascia

1. Splints and Other Assistive Devices

• night splints are used to prevent the plantar fascia from tightening over night
• gel heel cups provide shock absorption at the heel and give the heel a slight
  heel raise to reduce strain

1. Stretching and Activity Modification

• there are usually specific stretches or activity suggestions that a pedorthist
  can recommend in order to assist with the relief of symptoms associated with
  plantar fasciitis

Arthritis

There are two types of Arthritis; Osteoarthritis is caused by wear and tear of
cartilage or trauma to a joint, while Inflammatory arthritis includes Rheumatoid
arthritis or Gout.

Signs and Symptoms:

1. redness
2. swelling and inflammation
3. pain in joints

How Can We Help?

1. Proper Footwear/Modified Footwear

• modified orthopaedic footwear – often certain features in a shoe are recommended for those with arthritis. A pedorthist can help you look for the proper shoe, or modify your existing footwear to include these features
• orthotics - if necessary for lower limb alignment

• orthotics support the joints and help ease the pain

Diabetic Foot Conditions

Diabetes is characterized as an inability to produce adequate amounts of insulin.

Diabetic Foot Ailments:

1. Ulcers

• break in the skin leaving the foot vulnerable to infection

1. Peripheral Neuropathy

• lack of feeling in feet caused by a gradual loss of nerve function

1. Decrease in Circulation

• because of the lack of adequate circulation small wounds do not heal rapidly

How Can We Help?

1. A Canadian Certified Pedorthist can help select proper footwear to avoid
   rubbing and blistering, which can lead to ulcers.
2. Orthotics can provide a soft, smooth base of support, accommodating for the many ailments encompassing diabetes.