What kind of foot and ankle problems can we treat?
by Damian Moore M.Ost

Our feet put up with a lot; they have to be strong.  We rely heavily (bad pun intended) on their ability to take our weight and absorb the shocks and knocks of everyday life.  When things do go wrong the impact on our lives can be severe.  The lower extremity is designed as a unit to permit walking running, jumping etc and to transmit and safely dissipate the significant forces inherent in those activities, so when a problem arises it either results in loss of functions which are intrinsic to most of our everyday lives, or results in poor force transmission or dissipation which can lead to problems in other areas of the leg or even the back.

Sprained ankle

The classic sprained ankle is a tear or tears in one or more of the ligaments around the ankle.  The bad news is we can work no magic to repair the tear but what we can do is help provide the optimum conditions for that tear to heal by checking that the many joints in the foot and a key joint in the leg called the superior tibio-fibular joint are functioning properly and that there are no undue muscular tensions through the area, thus reducing the strain on the injured joint and giving it space to heal.  We can also look to understand why you sprained your ankle.  It may have been a simple accident, or, is it because of the way you walk?  Most importantly we can help you to retrain your nervous system to monitor and react to near sprains before they happen, improving proprioceptive feedback and reducing the chance of further sprains.


Plantar fasciitis and heel spurs

Plantar fasciitis is relatively common and is often the result of continuous excessive tension on the thick tissue beneath the skin of the sole of the foot, the plantar fascia.  The key to understanding why the irritation has occurred is understanding what has changed; posture, foot integrity, activities, footwear?   Is it as simple as one of the small joints in the foot is no longer functioning properly?  Is the problem the muscles in the back of the calf?  These attach to the calcaneal (achilles) tendon which, in turn, runs into the plantar fascia.  This direct link means that problems with these muscles can affect the plantar fascia and cause plantar fasciitis.                 Left untreated the plantar fascia can pull on the big bone at the back of the heel and a combination of this pulling and inflammation can cause heel spurs, little painful outgrowths of bone, so it is well worth getting it treated to prevent this.


Minor dysfunction

Sometimes the problem isn’t named but your feet are achy and/or have lost their spring.  This can be due to changes related to ageing but they may equally be due to joint or muscle dysfunction, either in the foot or in the leg, leading to changes in the way you walk.  These sort of problems may arise in patients who either have a loss of sensation in the feet, through something like use of early anti-retroviral drugs or diabetes, or may be secondary to a permanent disability that changes the forces put through the foot, or they must just be due to the demands you put on your foot.  Often these problems resolve easily and can provide a great deal of relief for the patient, although if there is an underlying condition the problem may recur


Other problems in the foot and ankle

If you have pain in your foot or ankle, such that you can't walk four steps, or that is worsening following an accident, or if you have unexplained pain or swelling in your leg or ankle following a flight or period of immobility please see your doctor or visit accident and emergency.