The foot and ankle is a vital component to our everyday activities. Fortunately, most of us are able to get through each day with little appreciation for what we are able to accomplish with healthy, painless feet. However, all of us at some point in our lives will have an ailment with our feet or ankles that will remind us of their importance.
There are 26 bones in the foot and ankle. We place one and a half times our body weight with each step. This can rise to seven times our body weight with running. We walk about 1000 miles per year. Each foot has to cushion as much as one million pounds of pressure per hour during strenuous exercise.
Problems with the foot and ankle can be compartmentalized into pain or difficulty with shoe ware. These reasons can be divided into three categories, which can overlap: deformity, degeneration, or injury.
Deformity
Deformity can be present at birth (congenital) and usually will be present throughout the patient's life. However, there are some cases where the development of the skeletal system will allow the patient to grow into a better position. Most deformities are a result of a developmental cause where the deformity develops as the patient ages. Common examples of this are bunions and hammer toes. Finally, deformities can be the result of an injury that has not or could not heal in the original position. This can be caused from a fracture, tendon rupture, or joint dislocation.
Degeneration
The most common complaint in this category is wearing out of the cartilage surface on our joints that allows them to move freely and painlessly. This is more commonly known as arthritis, which causes pain and/or limited motion. Other structures such as tendons can also degenerate which can cause pain and deformity. The most common complaints are those of the achilles tendon at the heel and the posterior tibialis tendon (arch tendon) which can cause falling arches.
Injury
This is the most common reason for complaints about the foot and ankle. These can be overuse injuries such as shin splints, plantar faciatis, or stress fractures, or immediate injury such as a fracture or sprain.
Treatment
The best treatment is prevention. The proper treatment is based on the specific complaint and underlying cause. In the majority of cases, most foot and ankle problems can be treated with conservative measures such as physical therapy, activity modification, or pads. As a last resort, surgery may be needed.
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