Heel Spurs
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. A heel spur is a bony protrusion on the underside of the heel bone, which may not be visible to the naked eye.
Lisfranc (Midfoot) Injury
The tarsometatarsal joint or Lisfranc joint is the region in the middle of the foot formed by the articulation of the tarsal bones (a cluster of seven bones) and metatarsal bones (a group of five long bones). This region supports the arch of the foot. Lisfranc or midfoot fractures are breaks in the bones of the midfoot.
Ankle Rheumatoid Arthritis
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.
Cavus Foot Deformity
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.
Bunionette
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.
Ganglion and Soft Tissue Tumors
Soft tissue tumors are lumps beneath the skin of your foot and ankle that occur due to the overgrowth of tissue (fat cells) within or between the muscles, tendons, nerves or blood vessels.
Foot Rheumatoid Arthritis
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.
Midfoot Arthritis
Midfoot arthritis is pain and inflammation of the midfoot. It occurs due to damage of cartilage or tissues around the joints. The damage may occur due to injury, aging or autoimmunity. The foot bones are the phalanges, the metaphalanges, and the tarsal bones. The midfoot consists of 5 bones called lesser tarsal bones.
Achilles Tendinitis
The Achilles tendon is a tough band of fibrous tissue that runs down the back of your lower leg and connects your calf muscle to your heel bone. The tendon is used when you walk, climb, jump, run and stand on your tip toes.
Hallux Rigiditis
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.
Lesser Toe Deformities
Lesser toes in your foot are those other than the big toes and together stabilize your foot while standing and help in balancing the body. Lesser toes are susceptible to various deformities that can affect their position and cause other complications of the toes.
Ankle Sprain
A sprain is the stretching or tearing of ligaments. Ligaments connect adjacent bones and provide stability to a joint. An ankle sprain is a common injury that occurs when you suddenly fall or twist the ankle joint, or when you land your foot in an awkward position after a jump.
Achilles Tendon Rupture
The Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. The Achilles tendon ruptures most often in athletes participating in sports that involve running, pivoting and jumping.
Plantar Fasciitis
Plantar fasciitis refers to the inflammation of the plantar fascia, a thick band of tissue that is present at the bottom of the foot. It runs from the heel bone to the toes and forms the arch of your foot.
Ankle Fractures
Ankle injuries are very common in athletes and individuals performing physical work; often resulting in severe pain and impaired mobility. Pain after ankle injuries can either be from a torn ligament (ankle sprain) or broken bone (ankle fracture).
Ankle Instability
The joints of the ankle are held in place and stabilized by strong bands of tissue called ligaments. Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains, which are injuries to the ligaments.
Osteochondral Injuries of the Ankle
The ankle joint is formed by the articulation of the end of the tibia and fibula (shinbones) with the talus (heel bone). Osteochondral injuries, also called osteochondritis dissecans, are injuries to the talus bone. It is characterized by damage to the bone as well as the cartilage covering it. Sometimes, the lower end of the tibia or shinbone may also be affected.
Heel Fractures
The calcaneus or heel bone is a large bone found at the rear of the foot. A heel fracture is a break in the heel bone due to trauma or various disease conditions.
Lisfranc (Midfoot) Fracture
The Lisfranc joint or tarsometatarsal joint refers to the region in the middle of the foot. It is a junction between the tarsal bones (bones in the foot arch) and metatarsal bones (five long bones in the foot). Lisfranc fractures can occur due to a fall from a height or a traumatic motor vehicle accident.
Talus Fractures
The talus is a small bone at the ankle joint that connects the heel bone and the shinbones, enabling up and down movement of the foot.
Foot Fracture
Trauma and repeated stress can cause fractures in the foot. Extreme force is required to fracture the bones in the hindfoot. The most common type of foot fracture is a stress fracture that occurs when repeated activities produce small cracks in the bones.
Foot and Ankle Trauma
Foot and ankle trauma refers to injuries that most commonly occur during sports, exercise or any other physical activity. Trauma may be a result of accidents, poor training practices or use of improper gear.
Ankle Ligament Injury
An ankle ligament injury, also known as an ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. When stretched beyond its limit, the ligament may partially or completely tear.
Foot and Ankle Arthritis
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.
Achilles Tendon Bursitis
Achilles tendon bursitis or retrocalcaneal bursitis is a condition that commonly occurs in athletes. It is a painful condition caused by the swelling of the bursa, a fluid-filled sac that is located at the back of the heel under the Achilles tendon.
Athlete's Foot
Athlete's foot, also known as tinea pedis, is a fungal infection that forms on the skin of the foot. It is characterized by itchy, moist, white, scaly lesions between the toes that can spread to the sole of the foot.
Forefoot Pain
Forefoot pain, also referred to as metatarsalgia, is a type of pain that occurs in the ball of the foot (along the ends of the metatarsal bones). Generally, forefoot pain is associated with aging.
Morton's Neuroma
Morton’s neuroma refers to a nerve injury that occurs between the toes, usually the third and fourth toes. This causes pain and thickening of the nerve tissue.
Flatfoot
Flatfoot, also known as “fallen arches” or Pes planus, is a deformity in children’s feet where the arch that runs along the sole of the foot collapses to the ground or is not formed at all. Flatfoot is normal in the first few years of life as the arch of the foot usually develops between the age of 3 and 5 years.
Sesamoiditis
Sesamoids are two small, pea-shaped bones located in the ball beneath the big toe joint at the bottom of the foot. Sesamoid bones are connected to muscles and other bones by tendons that envelop these bones. Sesamoids help the big toe move normally and absorb the weight placed on the ball.
Foot Spasms
Foot spasms, also known as foot cramps, occur due to the involuntary contraction of the foot muscles. These cramps are usually harmless and will get better on their own; however, sometimes they may need medical attention.
Congenital Limb Deformities
Congenital deformities of the lower limbs are developmental disorders that cause alterations in the shape and appearance of the legs. Several factors, including genetics, influence the fetal growth in the womb, and exposure to teratogenic drugs and chemicals can increase the risk of congenital deformities.
Sever's Disease
Sever’s disease is a painful inflammation of the growth plate in the heel. Growth plates are areas at the end of children’s bones that undergo changes so bone growth can occur.
Mallet Toe
Mallet toe is a deformity where the toe abnormally bends downward, resembling a hammer or mallet. The bones at the tip of the toe are connected by the distal interphalangeal joint (DIP).
Metatarsal and Phalangeal (Forefoot) Fractures
The forefoot is the anterior or front portion of the foot that functions in weight-bearing and maintaining balance while standing, walking or running. It is formed by 5 metatarsal bones, 14 phalange bones, and various soft tissues.
Sesamoid Fracture
A sesamoid fracture is a break in the sesamoid bone. Sesamoids are two small, pea-shaped bones located in the ball beneath the big toe joint at the bottom of the foot. Sesamoid bones are connected to muscles and other bones by tendons that envelop these bones.
Diabetic Foot Conditions
Diabetes is a chronic condition that is characterized by high blood glucose (sugar) levels. Diabetic patients are at high risk for developing chronic wounds, especially in the feet. If left untreated, these wounds can cause serious problems that can lead to infections and eventually gangrene, which may require amputation.
Posterior Tibial Tendon Dysfunction
The posterior tibial tendon passes through the ankle to attach the calf muscle with the bones of the midfoot. It provides stability to the arch and supports the foot while walking.
Foot Inflammation
Foot inflammation is the result of a person’s immune response towards various irritants or injuries to the foot. Based on the type of response, the inflammation can be classified as acute when it occurs suddenly, or chronic, occurring gradually as a result of a long-term disorder.
Stress Fractures of Foot and Ankle
A stress fracture is described as a small crack in the bone which occurs from an overuse injury of a bone. It commonly develops in the weight-bearing bones of the lower leg and foot.
Bunionette (Tailor's Bunion)
Bunionette, also called Tailor’s bunion, is a bony lump formed along the outside of the little toe at the base. It occurs when the very bottom bone (fifth metatarsal bone) of the little toe enlarges or shifts outward.
Achilles Tendinitis
The Achilles tendon is a tough band of fibrous tissue that runs down the back of your lower leg and connects your calf muscle to your heel bone. The tendon is used when you walk, climb, jump, run and stand on your tip toes.
Metatarsalgia
Metatarsalgia is a condition in which pain and inflammation are caused due to overuse or injury to the ball of the foot - the area between the toes and the arch. This condition mainly affects the joints at the base of the five-toe bones.
Osteochondral Lesions of the Ankle
The tibia and the fibula bones of the lower leg join with the talus bone to form the ankle joint. The talus bone is an important bone located between the tibia and fibula and the heel bone (calcaneus).
Overlapping or Underlapping Toe
An overlapping or underlapping toe is an abnormal condition in which a toe overlaps or underlaps the toe next to it. Although this can happen with any toe, it usually affects the fifth and second toes.
Stiff Big Toe (Hallux Rigidus)
A stiff big toe, also called hallux rigidus, is a form of degenerative arthritis affecting the joint where the big toe (hallux) attaches to the foot. The toe typically becomes stiff at the base and is sometimes called a “frozen joint”.
Tarsal Tunnel Syndrome
The tarsal tunnel is a narrow passageway that lies on the inside of your ankle and runs into the foot. It encloses arteries, veins, tendons and nerves that supply the foot. The tunnel holds very limited space as it is formed between bones and overlying fibrous tissues.
Internal and External Fixation of Foot and Ankle Fractures
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 orthopedic hardware.
Brostrom Repair
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).
Foot and Ankle Examination
Foot and Ankle conditions typically occur due to injury of the muscles, ligaments or bones, due to aging, or certain disorders including gout, bunion, arthritis, claw toes, bursitis, hammertoes, stress fracture, etc.
Foot Injections
Foot injections are steroids that are injected into your foot to relieve pain and inflammation. Cortisol is a hormone that is produced in the human body and functions to reduce stress and inflammation. Steroids are synthetic drugs that resemble cortisol and are used in treating joint pain.
Neurolysis
Neurolysis is a procedure that involves injecting chemical agents into nerve fibers to reduce nerve pain by destroying the damaged nerves. These agents degenerate the nerve fibers blocking the transmission of pain signals.
Foot Rehabilitation Following Surgery
A foot injury or foot surgery may leave you immobile for a period of time. To return to your regular activities and more strenuous recreational activities, it is necessary for you to follow a well-planned activity and exercise program.
Foot Reconstruction
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness. Ideally, any foot surgery for reconstruction is done to improve the appearance and function of the foot so that you can maintain your quality of life.
Ankle Joint Replacement
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.
Subtalar Arthrodesis
The subtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone. The subtalar joint allows side-to-side movement of the foot.
Ankle Arthroscopy
Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.
Fifth Metatarsal Fractures
The metatarsal bones are the long bones in your feet. There are five metatarsal bones in each foot. The fifth metatarsal is the long bone that is located on the outside of the foot and connects to the small toe. The fifth metatarsal bone is more commonly fractured.
Minimally Invasive Foot Surgery
Minimally invasive foot surgery (MIFS) uses the latest advanced technology to treat foot and ankle pain caused by a variety of conditions. Special surgical instruments, devices, and advanced imaging techniques are used to visualize and perform the surgery through small incisions.
Treatment of Foot and Ankle Sports Injuries
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.
Cavovarus Foot Correction
To support the entire body’s weight on your two feet, the inner middle portion of each foot (midfoot) is raised off the ground to form an arch. A cavovarus foot deformity is characterized by a higher-than-normal arch of the inner midfoot.
Flatfoot Reconstruction
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.
Achilles Tendon Repair
The Achilles tendon is often injured during sports activities, resulting in an inflammatory condition called tendonitis, which is characterized by swelling and pain. In some cases, severe injury results in a tear or rupture of the Achilles tendon, requiring immediate medical attention.
Ankle Arthrodesis
Ankle arthrodesis is the surgical fusion of bones that form the ankle joint. The ankle joint is formed by the tibia, talus, and the fibula bones.
Ankle Ligament Reconstruction
A sprain is the stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
Lesser Toe Surgery
Lesser toe surgery is an operation to correct deformities of the lesser toes other than the big toe. Some of the common lesser toe deformities include hammer toe, claw toe, and mallet toe.
Metatarsal Surgery
Metatarsal surgery is a surgical procedure performed on the metatarsal bones, the long bones in the feet that connect to the toe bones. It is usually performed to correct a bunion deformity and is mainly done on the first metatarsal bone behind the big toe.
Ankle Tenotomy
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.
Ankle Instability Surgery
Ankle instability is a chronic condition characterized by the recurrent slipping of the outer side of the ankle. Instability is generally noticed during movement of the ankle joint, but can also occur while standing.
Complex Foot and Ankle Surgeries
Complex foot and ankle surgeries are procedures employed to treat foot and ankle structures with deformities, injuries, structural issues, and damage from diseases like diabetes or arthritis.
Bunionectomy
A bunionectomy is a surgical procedure to remove a bunion. A bunion, also called a hallux valgus, is an enlargement of bone or soft tissues around the joint at the base of the big toe that results in the formation of a bump.
Osteochondral Allograft Transplantation System (OATS) of the Ankle
OATS of the ankle is a surgical procedure to treat Osteochondral Lesions of the Talus (OCL) or Osteochondritis Dissecans (OCD). It involves the transfer of healthy cartilage to replace the damaged cartilage and restore the normal function of the foot. The cartilage can be taken from your ankle joint (autograft) for smaller defects.
Tendon Transfer
In a tendon transfer procedure, a healthy tendon is transferred to replace the damaged tendon and restore the normal movement of the foot.
Charcot Foot Reconstruction
Charcot foot reconstruction is a surgery performed to repair damage to the bones, ligaments, tendons and other structures in a foot affected by a condition called Charcot foot, which is characterized by loss of sensation in the foot.
Charcot Reconstruction
Charcot foot and ankle is a condition characterized by gradual weakening of the bones, joints and soft tissues, and loss of sensation in the foot and ankle. It is caused by nerve damage (neuropathy) in the foot and ankle or due to diabetes.
Foot & Ankle Deformity Correction
Foot and ankle deformity is the structural abnormality caused by misalignment of the bones of the foot and ankle.
Foot and Ankle Conditioning Programs
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.
Foot and Ankle Rehabilitation
A Foot and Ankle orthopedic surgeon is a medical doctor (MD or DO) who specializes in the diagnosis and treatment of musculoskeletal disorders involving the human musculoskeletal system, including the nerves, ligaments, tendons, muscles, joints, and bones in the feet and ankles.
What is a Foot and Ankle Orthopaedic Surgeon?
A Foot and Ankle orthopedic surgeon is a medical doctor (MD or DO) who specializes in the diagnosis and treatment of musculoskeletal disorders involving the human musculoskeletal system, including the nerves, ligaments, tendons, muscles, joints, and bones in the feet and ankles.
Non-Surgical Treatment for Foot and Ankle Pain
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. Normally, foot pain can be treated with home treatments but may take time to heal. However, in cases of severe injury, adequate evaluation and treatment is required.
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.
