Sprains & Strains
Sprains and strains are injuries to the body, often resulting from physical activity. These injuries are common and can range from minor to severe, depending on the incident. Most sprains and strains are minor and don’t require medical attention.
Sprains occur at joints and affect ligaments, which connect bone to bone. Strains affect muscles or tendons, which connect muscle to bone. They most often occur at the calf, thigh, or groin.
Nerve Entrapment Syndrome
Nerve compression syndrome or compression neuropathy, also known as entrapment neuropathy, is a medical condition caused by direct pressure on a single nerve. It is known colloquially as a trappednerve, though this may also refer to nerve root compression (by a herniated disc, for example).
It is the most common cause of heel pain. The plantar fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk.
Plantar fasciitis is common in middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet.
Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if:
- Your feet roll inward too much when you walk (excessive pronation).
- You have high arches or flat feet.
- You walk, stand, or run for long periods of time, especially on hard surfaces.
- You are overweight.
- You wear shoes that don’t fit well or are worn out.
- You have tight Achilles tendons or calf muscles.
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time.
If you have foot pain at night, you may have a different problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome.
Ligamentous laxity is a term given to describe “loose ligaments.”
Ligament laxity is a cause of chronic body pain characterized by loose ligaments. When this condition affects joints in the entire body, it is called generalized joint hypermobility, which occurs in about five percent of the population, and may be genetic. Loose ligaments can appear in a variety of ways and levels of severity. It also does not always affect the entire body. One could have loose ligaments of the feet, but not of the arms.
Someone with ligamentous laxity, by definition, has loose ligaments. Unlike other, more pervasive diseases, the diagnosis does not require the presence of loose tendons, muscles or blood vessels, hyperlax skin or other connective tissue problems. In heritable connective tissue disorders associated with joint hypermobility (such as Marfan syndrome and Ehlers-Danlos syndrome types I-III, VII, and XI), the joint laxity usually is apparent before adulthood. However, age of onset and extent of joint laxity are variable in Marfan syndrome, and joint laxity may be confined to the hands alone, as in Ehlers-Danlos syndrome type IV.
Gait abnormality is a deviation from normal walking (gait). Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion.
A hammertoe is a contracture—or bending—of the toe at the first joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down V when looked at from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammertoes are more common to females than males.
There are two different types:
These are less serious because they can be diagnosed and treated while still in the developmental stage. They are called flexible hammertoes because they are still moveable at the joint.
This variety is more developed and more serious than the flexible condition. Rigid hammertoes can be seen in patients with severe arthritis, for example, or in patients who wait too long to seek professional treatment. The tendons in a rigid hammertoe have become tight, and the joint misaligned and immobile, making surgery the usual course of treatment.
Bunion/ Hallux Valgus Deformity
Valgus malformation of the great toe, commonly known as a bunion, is a very common and potentially painful and debilitating condition of unclear etiology. This topic review will provide an overview of the relevant anatomy, pathophysiology, diagnosis, and management of hallux valgus. Toe and foot injuries are discussed elsewhere.
Synovitis is inflammation of the tissues that line a joint. It is commonly associated with specific diseases such as arthritis or gout, but may also be the result of overuse or trauma. Symptoms of synovitis may include redness, swelling, warmth, and pain with joint motion.
Evaluation by a foot and ankle surgeon will help confirm the diagnosis, and help rule out other possible concerns such as fractures or infections. The surgeon may sample fluid from the joint to analyze for inflammatory cells, or may order xrays or other advanced imaging tests to better evaluate the affected joint.
Treatment for synovitis includes rest, ice, immobilization and oral nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and may include steroid injections into the joint. Surgery may be indicated in longstanding cases.
Tarsal Tunnel Syndrome
The tarsal tunnel is a space in the foot formed between bones and overlying fibrous tissue. Within the tarsal tunnel lies a nerve called the posterior tibial nerve. The tarsal tunnel is walled on one side by sturdy bones, and on the other by tough fibrous tissue.
What is tarsal tunnel syndrome?
Tarsal tunnel syndrome results when the posterior tibial nerve is compressed within the tarsal tunnel.
A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.
The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.
Inflammation of nerves. There are many causes of neuritis, including various viruses and local irritation of a nerve by adjacent tissues.
Turf toe is not a term you want to use when talking to a head football coach about his star running back or the ballerina before her diva debut. “Turf toe” is the common term used to describe a sprain of the ligaments around the big toe joint. Although it’s commonly associated with football players who play on artificial turf, it affects athletes in other sports including soccer, basketball, wrestling, gymnastics, and dance. It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.