As the term indicates, flat feet occur when little or no space exists beneath the arch of the foot when you are in a standing position.
Young children will usually have flatter feet because the arch isn’t fully formed until they mature.
Some individuals will have flatter feet than others. If both feet have the same profile, and no problems arise, this can be completely normal.
If one foot is flatter than the other and leads to foot or leg pain, however, this can be a result of tendon issues at the arch or arthritis at the heel. Some flat-footed individuals may also suffer from tarsal tunnel syndrome or peroneal tendon issues.
Flat feet occur for several reasons:
- A childhood condition named ‘tarsal coalition’, in which the bones fuse in such a way that the foot becomes stiff and flat, can affect some people
- Hindfoot or midfoot arthritis
- Tibialis posterior tendon dysfunction
Several issues arise from having flat feet including:
- Experiencing pain when running or walking, particularly on the inner ankle and foot
- Ankle swelling
- Damage to the nerves in the foot on the inside of the ankle, causing numbness or a tingling sensation
- Without treatment, the foot can lose flexibility and the problem can become harder to put right and cause arthritis, so getting an early diagnosis is key
Your consultant will ask you to describe your symptoms and will then normally organise X-rays and an MRI scan to assess any bone or tendon damage.
If your foot retains enough flexibility and the problem is caught early, flat feet can normally be treated with a course of physiotherapy, together with supporting your foot correctly by wearing insoles. Maintaining a healthy body weight and taking anti-inflammatory painkillers, as advised by your doctor, are other measures that will help keep the problem in check. In cases where the foot is significantly misshapen, stiff, or arthritic, your consultant may advise that flat foot surgery or foot fusion surgery is necessary.
A ganglion is an innocuous fluid-filled cyst, or little lump, which is normally found close to a joint or tendon. Ganglions occur most often in women aged 20-40.
The cause of ganglions is uncertain, but it is known that they can occur when the synovial fluid around a joint or tendon leaks, creating a lump or sac beneath the skin.
Swelling, pain or discomfort are all common symptoms. Ganglions can grow, making wearing your everyday shoes difficult. Should the ganglion be close to a nerve, numbness in the area around it can result and when it’s embedded in the foot the surrounding area may ache.
At your initial appointment your consultant will go through your symptoms with you and will then normally proceed to perform X-rays and an MRI scan to investigate any bone damage or evidence of arthritis.
Your consultant will discuss the range of treatments available and advise you to help you select the most appropriate one. It may be possible, depending on the ganglion’s position, to treat the condition non-surgically through taking painkillers and wearing comfortable footwear. Alternatively, it may be best to have the fluid drained or aspirated, but in about 50% of cases, the ganglion can grow back. Surgery can be successful, but even so a ganglion can still grow back in 30-40% of the time.
This condition occurs when the toenail’s sharp sides embed themselves into the skin at the side, or end of the toe, resulting in inflammation and pain. The big toe is most commonly affected.
- Toenails being trimmed too short or the toenail’s edges being cut
- Restrictive footwear, tights and socks
- Stubbing the toe
- The nail can thicken as a result of fungal nail infections
- Losing a nail
It may be that you feel pain when pressure is placed on the affected toe, causing discomfort when wearing your usual footwear. Inflammation and swelling may occur too, and, it may also get infected or bleed.
Ensuring your footwear is comfortable and fits properly is key. Cleanliness and changing socks or tights regularly are essential to avoid infection. Should infection occur, antibiotics may be prescribed. Trimming the toenails straight across can also stop the problem worsening. Depending on the extent of the issue, surgery to remove the toenail may be necessary. Post-operatively, the nail should return, provided that the nail bed has not been removed.