Methodist Orthopedic Specialists

What are the different types of foot problems?

Foot pain is often caused by incorrect foot function. Shoes that don't fit well can make foot problems worse and, in some cases, cause them. Shoes that fit correctly and give good support can prevent irritation to the foot joints and skin. There are many types of foot problems that affect the heels, toes, nerves, tendons, ligaments, and joints of the foot.

The symptoms of foot problems may look like other health conditions and problems. Always see your doctor for a diagnosis.

What are heel spurs?

A heel spur is a bone growth on the heel bone. It's often located on the underside of the heel bone where it attaches to the plantar fascia. This is a long band of connective tissue running from the heel to the ball of the foot. This connective tissue holds the arch together and acts as a shock absorber during activity. The plantar fascia can be overstretched from running, wearing poor-fitting shoes, or being overweight. Then pain can result from the stress and inflammation of the tissue pulling on the bone. Over time, the body builds extra bone in response to this stress, causing heel spurs. Treatment methods may include:

• Rest.
• Cold packs.
• Anti-inflammatory medicine, such as ibuprofen.
• Correct stretching before activity.
• Correct footwear or shoe inserts.
• Achilles stretching.
• Corticosteroid shots (injections).
• Surgery (for more severe, prolonged conditions).

What is a corn?

Corns are yellowish, callus growths that occur on top of the toes. Corns develop because of irritation or stress. Often, a corn develops where a toe rubs against a shoe or another toe. Corns can cause extreme discomfort and pain. Treatment may include:

• Trimming the corn by shaving the layers of dead skin.
• Applying pads around the corn area.
• Wearing larger shoes to comfortably fit your foot without rubbing.
• Surgery.

To prevent corns, always buy shoes that fit correctly.

What is a bunion?

A bunion is a bulge of bone or tissue around the joint of the great toe or small toe. Bunions may occur at the base of the great toe or at the base of the little toe. They often occur when the joint is stressed over a period of time. Women get bunions more often than men do because they may wear tight, pointed, and confining shoes. Bunions can also be a result of arthritis, which often affects the big toe joint.

Treatment of bunions may vary depending on the pain and deformity. Treatment may include:

• Wearing comfortable, well-fitting shoes (particularly shoes that conform to the shape of the foot and don’t cause pressure areas).
• Surgery (for pain, not for cosmetic reasons).
• Applying pads to the affected area.
• Medicine, such as ibuprofen.

What is Morton neuroma?

Morton neuroma is a buildup of noncancer (benign) tissue in the nerves running between the long bones of the foot. Morton neuroma occurs when 2 bones rub together and squeeze the nerve between them. Most often, neuromas develop between the bones leading to the third and fourth toes. Morton neuroma often causes swelling, tenderness, and pain. If the pain becomes severe, it may cause tingling, numbness, and burning in the toes. It often occurs after standing or walking for a long period of time. Treatment for this condition may involve rest or a change in footwear that doesn't restrict the foot. If the problem persists, cortisone injections or surgery may be considered.

What are hammertoes?

A hammertoe is when the toe bends or curls downward. This causes the middle joint of the affected toe to poke out. Tight-fitting shoes that put pressure on the hammertoe often make this condition worse. Often a corn develops at this site. Treatment for hammertoes may include:

• Applying a toe pad specially placed over the bony protrusion.
• Changing your footwear to accommodate the deformed toe.
• Surgical repair.

What is an ankle sprain?

An ankle sprain is an injury to the ligaments in the ankle. Ligaments are tough bands of elastic tissue that connect bones to each other. Ankle sprains may occur if the ankle rolls, turns, or twists beyond its normal range of motion. Ankle sprains may be caused by awkward foot placement, irregular surfaces, weak muscles, loose ligaments, or wearing shoes with spiked heels.

The symptoms of a sprain will depend on how severely the ligaments are stretched or torn, but usually include swelling, pain, or bruising. Treatment will depend on the severity of the sprain, but may include:

• Resting the ankle.
• Wrapping the ankle with elastic bandage or tape.
• Using an ice pack application (to reduce inflammation).
• Keeping the ankle raised.
• Taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen to help reduce pain and inflammation.
• Returning slowly to walking and exercise.
• Using a walking boot (for moderate sprains).
• Having surgery (rarely for severe sprains).
• Getting physical therapy.

What is a foot fracture?

With 26 bones in a single foot, almost any of them can be broken. Many breaks or fractures don't need surgery, or even a cast. They will heal on their own with some support. When a foot is fractured, the site of the fracture usually is painful and swollen. The site of the fracture will determine the course of treatment, if needed, including:

• Ankle joint fractures
• Metatarsal bone fractures
• Sesamoid bone fractures
• Toe fractures

What are some common knee problems?

Many knee problems are a result of the aging process and continual wear and stress on the knee joint (such as arthritis). Other knee problems are from an injury or a sudden movement that strains the knee. Common knee problems are:

Sprained or strained knee ligaments or muscles.

A sprained or strained knee ligament or muscle is usually caused by a blow to the knee or a sudden twist of the knee. Symptoms often include pain, swelling, and trouble walking.

Torn cartilage.

Trauma to the knee can tear the menisci. These are pads of connective tissue that act as shock absorbers and also enhance stability. Cartilage tears can often occur with sprains. Treatment may involve wearing a brace during an activity to protect the knee from further injury. Surgery may be needed to repair or remove the tear.

Torn ligaments.

When a blow to the knee is bad enough, it can cause a complete tear to the ligaments. This injury most often occurs to the ACL (anterior cruciate ligament). Other ligaments that can tear are the PCL (posterior cruciate ligament), MCL (medical collateral ligament), and the LCL (lateral collateral ligament).

Bursitis.

This is when a bursa becomes inflamed. A bursa is a fluid-filled sac that helps a joint move. Direct trauma to a bursa or repetitive pressure, such as lengthy kneeling, can cause bursitis.

Tendonitis.

Inflammation of the tendons may result from overuse of a tendon during certain activities, such as running, jumping, or cycling. Tendonitis of the patellar tendon is called jumper's knee. This often occurs with sports, such as basketball, where the force of hitting the ground after a jump strains the tendon.

Arthritis.

Osteoarthritis is the most common type of arthritis that affects the knee. Osteoarthritis is a degenerative process where the cartilage in the joint gradually wears away. It often affects middle-age and older people. Osteoarthritis may be caused by excess stress on the joint, such as repeated injury or being overweight. Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. Rheumatoid arthritis often affects people at an earlier age than osteoarthritis.

How are knee problems diagnosed?

Your healthcare provider will ask about your medical history and do a physical exam. You may also need these tests for knee problems:

• X-ray
• MRI
• CT scan
• Arthroscopy
• Radionuclide bone scan

What are shoulder problems?

Shoulder pain and problems are common. There are many types of shoulder problems that are caused by injuries and sudden (acute) or long-lasting (chronic) inflammation of the shoulder joint. The shoulder is a complex joint that has great mobility. This ability to move also increases the chances that it can be injured.

What causes shoulder problems?

The shoulder is the most movable joint in the body. But it is also an unstable joint because of its range of motion. Because the ball of the upper arm is larger than the socket of the shoulder, it is at risk of injury. The shoulder joint is supported by soft tissues. These are the muscles, tendons, and ligaments. They are also subject to injury, overuse, and degeneration.

Progressive diseases that break down tissues in the body over time may also play a role in shoulder problems. Or they may cause pain that travels along nerves to the shoulder.

Common causes of shoulder problems include the following:

• Dislocation
• Separation
• Bursitis
• Impingement syndrome
• Tendinosis
• Rotator cuff tear
• Adhesive capsulitis (frozen shoulder)
• Fracture

What are the symptoms of shoulder problems?

Shoulder pain may be only in 1 area. Or it may spread to areas around the shoulder or down the arm. The location and type of symptoms depend on the injury or the location of the inflammation. Below are symptoms of some common shoulder problems.

A rotator cuff injury will often cause pain in the front or outside of the shoulder. The pain gets worse when you raise your arm or try to lift an object over your head. Rotator cuff pain can be severe. It can make even simple tasks impossible and wake you up at night.

If you have shoulder instability, pain can start suddenly, for example, just as you throw a ball. You may have numbness all the way down your arm. If the instability happens slowly, you may have mild pain only at certain times. Your shoulder might feel weak, sore when you move it, or “loose” in your joint. Shoulder instability is different than a shoulder dislocation.

The symptoms of a dislocated shoulder include intense pain, inability to move the joint, a visibly out-of-place shoulder, and swelling or bruising. The dislocation can cause numbness, tingling, or weakness near the injury or down your arm. A dislocated shoulder needs immediate medical care.

If shoulder pain is caused by inflammation, such as bursitis, it may feel stiff, achy, and hurt more when you move it. Sometimes it can look swollen or red.

How are shoulder problems treated?

The goals of treatment are to ease pain and restore your shoulder to normal function. To do this, a variety of treatments may be used, including:

• Changing how you do some daily activities (activity modification)
• Rest
• Physical therapy
• Medicines, such as ibuprofen, naproxen, and other nonsteroidal anti-inflammatory medicines (NSAIDs)
• An injection of anti-inflammatory steroids
• Surgery (when other options fail or are not advised for the injury or condition)

About sports medicine specialists

Sports medicine healthcare providers have special training to help injured people get moving again as soon as possible. They are experts in preventing illness and injury in active people. Sports medicine healthcare providers do work with professional athletes. But they also treat children and teens involved in sports and adults who exercise for personal fitness. They also treat people who have physically demanding jobs, like construction workers.

Sports medicine is not a medical specialty itself. Most sports medicine healthcare providers are certified in other specialties. These can be internal medicine or emergency medicine. They can also be family medicine, or another specialty. Then they get more training. Other providers specialize in treating injuries in children and teens. Their growing bodies can be quite different from those of adults. These specialists are usually board-certified in pediatrics or family medicine and also have training in sports medicine. Some sports medicine providers have surgical training., The training is usually as orthopedic surgeons.

Other experts who are not medical doctors may work with a sports medicine specialist to provide care including:

• Physical therapists. They help people rehabilitate and recover from injuries.
• Certified athletic trainers. These trainers provide rehab exercise routines to help people regain strength. They also develop conditioning programs to prevent future injury.
• Nutritionists. They may help with needed weight loss or weight gain. They can provide dietary advice to help people. 

Reasons to see a sports medicine specialist

Your child may see a sports medicine healthcare provider for an injury such as:

• Ankle sprain
• Fracture
• Knee and shoulder injury
• Tendonitis
• Exercise-induced asthma
• Heat illness
• Concussion
• Eating disorder
• Cartilage injury

Sports medicine healthcare providers give advice on nutrition and exercise. They can also advise supplements and ways to prevent injury.