Heel Pain (ACHILLES TENDONITIS)
Achilles tendonitis, or inflammation of the achilles tendon, is generally caused by overuse of the affected limb and is more common among athletes training in under less than ideal conditions. The achilles tendon does not have good blood supply or cell activity, so this injury can be slow to heal. Tight calf muscles or poor biomechanics can cause this. If untreated can lead to tears or partial tears of the tendon. Treatment could include orthotic therapy, medication, physical therapy.
Bunions (HALLUX VALGUS)
A bunion (hallux valgus) is a deformity of the big toe joint. Bunion surgery is the most common procedure performed by Dr Hugo. There is often a bony protrusion combined with the toe deviating sideways. Bunions often worsen with time and can result in irreversible arthritic changes to the joint. Podiatric Surgeons often blame poor foot posture for their formation, and that could relate to genetics. Treatments range from supportive shoes containing orthoses (special insoles) to corrective surgery. Surgery can be performed under local nerve block as a day surgery procedure. There are many different surgical options for bunions so please make an appointment to discuss all options.
Dr Hugo is happy to discuss these options and respects your right not to proceed with surgery. Its your right to fact find and choose what is best for your lifestyle. Its always good to obtain a second opinion prior to surgery.
Stiff big toe (HALLUX RIGIDUS / LIMITUS)
Arthritis and stiffness due to bone spurs that affects the big toe joint. This can be a very painful condition since when we walk, run and squat we put much pressure through our big toe joint. When there is jamming of the joint due to arthritis then these bending forces cause much pain. There are a number of ways to alleviate this pain. If untreated the joint usually becomes more arthritic and stiff with time until it doesn’t bend at all! Sometimes early surgical treatment is the best option to restore movement and function of the joint.
Heel pain (PLANTAR FASCIOPATHY, HEEL SPUR)
Plantar fasciitis (PF) dscribes a painful inflammatory process of the plantar fascia, the connective tissue inside the bottom surface of the foot. It is often caused by excessive tightness of the PF or injury relating to poor foot posture, footwear or activities. It is one of the most common conditions treated by podiatrists. The PF is a thick fibrous band of connective tissue (ligament) originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. The pain is usually felt on the underside of the foot around the heel and is often most intense with the first steps after sitting, or the first few steps in the morning. Foot orthoses (orthotics) are commonly used to help rest the ligament and help it repair. Steroid injections and or anti-inflamatory medication can help settle pain in the short term. Dr Hugo can perform a simple and safe surgical technique called an Instep Fasciotomy that can provide long term (possibly permanent) relief for those who have exhausted all other options. You can walk immediately after, however will have 2-3 sutures that will need removing after about 2 weeks.
Forefoot pain (METATARSALGIA)
Metatarsalgia is a general term used to refer to any painful foot condition affecting the bony knuckles of the foot (metatarsal heads ball of the foot). This commonly effects the 1st and 2nd knuckles and can be very painful. it is not a very helpful term to use since many conditions can be described as metatarsalgia. To be able to treat this pain correctly it is necessary to understand the exact cause. it is usually due to excessive pressures from bony misalignment or loss of fatty pad tissue. It is commonly thought that by the age of 50 we have lost 50% of the fatty cushioning beneath our knuckles. many elderly complain of feeling like they are walking on the bones of their feet, and they literally are! treatments range from cushioning insoles, orthotic therapy and surgery.
Intoeing, Pigeon toed (METATARSUS ADDUCTUS)
Also called metatarsus varus, metatarsus adductus, in-toe gait, intoeing or false clubfoot, is a condition which causes the toes to point inward when walking. It could be due to the hip, lower leg, or foot. To obtain adequate care then a correct diagnosis of where the deformity is coming from is necessary.
Out-toeing. Could be due to hip, lower leg, or foot deformity or muscle weakness. To obtain the most appropriate care then a correct diagnoses of where the deformity is coming from is necessary.
Flat feet (PES PLANUS)
flat feet (also called pes planus or fallen arches) is a reference to a medical condition where the arch of the foot collapses, with the entire sole of the foot coming into complete or near-complete contact with the ground. In some individuals (an estimated 20–30% of the general population) the arch simply never develops in one foot (unilaterally) or both feet (bilaterally). When the foot collapses this way, it can affect knee, hip, pelvis, and back posture. Your posture starts from the ground just like the foundations of a house.
Pain under the big toe (SESAMOIDITIS)
This occurs on the bottom of the foot, just underneath the large toe joint. There are normally two small bones underneath the big toe joint that work similar to the knee cap. These form a joint and can become inflamed and/or arthritic. Its amazing these small bones don’t cause more trouble since we stand on them every day!
Heel pain in children (SEVER'S DISEASE)
sever’s disease or calcaneal apophysitis is the most common cause of heel pain in the growing child and is due to overuse, repetitive microtrauma of growth plates of the calcaneus (heel bone). Sometimes it is due to poor foot posture. it occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 14 years of age. It is similar to Osgood-Schlatter disease which affects the knee rather than the heel/ankle.
Shin splints are a common injury affecting athletes who engage in running sports or basic activities such as cross country, football, or hiking. This condition is characterized by pain in the lower part of the leg between the knee and the ankle. It is thought to be caused by the muscle attachment at the lower leg bone becoming inflamed. Poor lower leg and foot posture can cause this. Foot orthotics combined with stretching exercises can often help.
This describes a condition where nerves are entrapped between the knuckles of the forefoot. The most common positions are between the 3/4 & the 2/3 knuckles. The nerves in that area often become thickened and the area around them inflamed (bursitis). Pain can be intermittent and exacerbated by certain shoes and activities. Many people put up with this type of pain for too long feeling it will go away. Treatments offered: Steroid injection, ethanol ablation, radiofrequency ablation and surgical excision. Correct diagnoses is important since there are many other conditions that cause similar pain.