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Inflammation of the tendons- The foot has many tendons, all of which can
become painful as a result of overuse or poor foot wear. We see athletes
frequently who jump too much early in the season and irritate the Achilles
tendon. They can occasionally tear the Achilles tendon, but this is usually
in the older athlete, after age 35. The tendons to the toes are often irritated
by shoes which are too small or tight causing a rubbing. This is especially
common on the top of women's feet from tight pumps. The
large tendon on the inner-side of the foot (posterior tibialis tendon)
becomes inflamed due to over-use, rubbing or too flat a foot and suffering
foot strain. The diagnosis is made for all these problems by looking for
a tender area with swelling. Some times there is a gritty feeling as the
tendon moves. Treatment is usually rest, anti-inflammatory medications,
changing the shoes and occasionally using arch supports (orthotics).

Acute over stretching of the ankle ligaments. This is usually due to a
twisting injury. The ligaments on the outer side of the ankle are stretched
too far and become inflamed or may actually tear.
Sometimes the injury can be so severe that the ankle becomes unstable,
or tends to give away on uneven ground. The diagnosis is usually obvious
due to the pain and swelling on the outer side of the ankle. It may be
too painful to walk. Treatment includes rest, elevation, ice and compression
with an elastic bandage. We encourage early return to weight bearing and
resumption of sports as quickly as possible. We often issue braces to protect
the ligaments as they heal. If the ankle remains unstable or painful we
occasionally have to operate to repair torn ligaments.

Deformity of the 1st toe- This problem is more common in women. In this
condition the first toe angles outward and the foot may be too wide for
the shoes. This causes pressure on the inside of the foot where it rubs
on the shoe. The rubbing causes
pain and a bursitis over the inside of the foot. The toe deformity seem
to be related to the type of shoes women wear and is also inherited. Some
families have more of a problem, often mothers and daughters. Treatment
includes changing the shoe wear, ( ugly, wide shoes), stretching the shoes,
various pads and surgery if the condition is too painful. At the time of
surgery, we straighten the 1st. toe and often try to narrow the foot by
breaking (an osteotomy) the metatarsal. Good pain free results are usually
obtained.

Thickened skin on a toe- Corns result from the smaller toes rubbing against
the shoes or other toes. This may be a result of a hammer toe (the middle
of the toe curls upward) rubbing against the shoe or due to a bone spur
rubbing against a toe next to it. Treatment usually includes various types
of pads, shaving the corn, stretching the shoes and occasionally surgery
to straighten the toes and remove spurs.

A painful condition occurring in the web space between the 3rd and 4th
toes. The plantar nerve becomes caught under the metatarsal bones and after
repeatedly being stepped
on, a small nerve tumor forms. We see it frequently in people who work
on hard floors, especially in thin soled shoes. The condition causes pain,
burning and occasionally numbness in the 3rd and 4th toes. Treatment includes
pads, cortisone injections and often surgical removal.
For more information, please contact:

HAQ ORTHOPAEDIC HOSPITAL
18 Sanda Road, Lahore
Pakistan.
Phone:92-42-7312860 to 2
Email: info@haq-ortho.com
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