Help Guide

Information Help Sheets Bunion Surgery Devices Dislocated Toe Exercises Flat Foot Surgery Hallux Limitus Heel Pain Metatarsalgia Neuroma Toe Deformities Pes Cavus

Booking

To book an appointment with us:

Phone: 08700 410 448 (Marina)

Email: marina@thetagoeclinic.co.uk

Complete our Online Enquiry Form

Also introducing our new telephone number: 0844 988 9100

Common reasons for referral to The Tagoe Clinic

Pain in the foot and/or ankle

This may be general and difficult to place, or it may be at a particular site or during a certain movement.

Possible reasons may include: arthritic change, a response to injury or trauma, nerve entrapment, a systemic cause e.g rheumatoid arthritis or diabetes, soft tissue inflammation or an unstable foot and/or ankle perhaps due to an underlying biomechanical problem.

Management: The cause of the pain would require diagnosis and then treatment options would be explained to the you (should we put this section in the as though the reader is the patient) patient and and treatment plan agreed

Hallux valgus (bunion)

A bunion (hallux valgus) is the movement of the 1st metatarsal away from the 2nd with the big toe drifting towards the second toe.  Most patients complain of pain, a prominent joint and the inability to wear shoes comfortable.  Bunions are considered to be a progressive condition.  The cause of  bunion’s is unknown but possible factors include a family history, foot function and footwear.

Before and after hallux valgus surgery

This is a clinical diagnosis made by examining the foot.  While the diagnosis can be made clinically the severity of the condition is assisted by an X-ray.  There is no direct correlation between the size of the deformity and the degree of symptoms experienced.

Click for further information onto the Pt inform sheet regarding this condition see infor sheet

Hallux rigidus (limited or painful movement at the big toe joint)

Is a stiff and painful big toe joint as a result of wear and tear (osteoarthritis). Symptoms vary from sharp shooting, cramp burning or gnawing pain are often brought on by walking or kneeling with the big toe bent. Typically, symptoms may fluctuate, having good and bad periods

The Xray shows complete obliteration of the big toe joint.

Hammer toes

      
Here the toe is bent causing possible causing it to rub against adjacent toes or be irritated by your footwear.  Symptoms include soreness between the toes, over the joint or on the tip of the toe.  Hard skin or corns may form and there can be associated toenail damage.  Symptoms tend to be relived by wider/deeper or open toe shoes, or temporarily by chiropody treatment. Surgery would straighten the toe and therefore alleviate the problem.

Click for further information onto the Pt inform sheet regarding this condition see infor sheet

Metatarsalgia (A term covering pain affecting the balls of your feet)
         
Neuroma

Most patients with plantar digital neuritis/neuroma (a painfully enlarged nerve) complain of a sharp shooting pain affecting the ball of the foot radiating into the toes.  Some patients also experience numbness.  The symptoms are often brought on by wearing tight fitting shoes and normally occur after prolonged walking or driving.  The pain can often be relieved by taking the shoe off and resting. The cause of neuromas is not clear although local irritation has been suggested.

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• Synovitis (Inflammation of the lesser metatarsal heads)
• Fracture
• Arthritis
• Skin conditions eg Verrucae
• Midfoot pain
• Midfoot arthritis
• Fractures
• Tendon injuries

                     

 Avascular necrosis 3rd       fracture of the 4th                 prominent metatarsal heads & callous

metatarsal head                 metatarsal

 

 

Heel Pain

Plantar fasciitis

This is inflammation of the plantar fascia, a soft tissue structure on the sole of your foot that runs from the heel to the toes and helps support your arch. Patients often complain of:

Pain and tenderness beneath the heel that radiates into the arch of the foot.

• Stiffness and discomfort on rising in the morning or after long periods of sitting

This condition affects 10% of the population and normally resolves within 10 months irrespective of treatment.  It is classified as a chronic condition when symptoms persist past 6 months. Within this chronic classification there are a minority of patients (estimated at 10%), who develop persistent and often disabling symptoms which continue for more than a year.

Posterior heel pain

Inflammation of the back of the heel.  This can be due to a exostosis on the back of the heel that projects into the achilles tendon causing soft tissue pain, or inflammation of Achilles tendon

A severe example of an exostosis	The achilles on the left side is enlarged & painful (non insertional achilles tendonitis)

Ankle Pain

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• Bursitis
• Trapped nerve
• Bony outgrowth
• Ankle
• Tendons
• Achilles tendon
• Tibialis posterior
• Peroneals
• Ankle ligaments             

Flat feet

This can be a concern for children and their parents, as well as adults. Usually, this is perceived to be a flatter than normal arch on the inside of the foot. This can be a normal finding and is very commonly observed in children requiring no more than reassurance. In a small number of cases, the foot can assume a position in which the joints, tendons and muscles are under an abnormal degree of stress, causing pain in the foot which can radiate into the leg.

Management: The flat foot is often managed by supportive footwear with or without orthoses inside the shoe. Exercises may also help. Surgery is reserved for those with very severe mal alignment perhaps due to a torn tendon who don’t respond to conservative care.  In these cases the alignment and stability of the foot is restored with a combination of bone and soft tissue techniques.

Click for further information onto the Pt inform sheet regarding this condition see infor sheet

Pes cavus (high arched feet)

Diabetic foot

         
All forms of diabetes may lead to damage to the circulation and to the nerves. This is particularly common in the extremities of the body. The foot is a vulnerable area because it is enclosed in a shoe and it can be difficult to see and check regularly. If some sensation is lost in the foot because of nerve damage, pain may not alert the person that damage has occurred. Problems such as broken areas of skin around the foot can easily arise, but these can be difficult to heal. Prevention is therefore very important and following the appropriate advice is vital.

Management: This will involve regular check-ups to ensure good foot health. Prompt treatment for any foot problems is also important. Prevention of possible long-term problems may also be appropriate, with the use of modified footwear, orthoses and surgery to correct deformity.  In cases where severe infection or lack of circulation are prevelant then salvage surgery might e required to re-estabilish the circulation or restrict the spread of infection by amputation

Rheumatological problems

Joint problems are very common in the foot because of the impact incurred during walking and other activities. Wear and tear occurs in the foot as the skeleton ages, but may also be the result of sudden or repeated trauma e.g a heavy object dropped on the foot or a repeated stress e.g going on points. Age-related wear and tear in the ankle is rare, although may be secondary to injury.

The foot and ankle are sites which may be affected by some systemic conditions, such as rheumatoid arthritis or gout. A swollen painful joint(s) which has appeared without a history of injury should always be investigated further. This is likely to require blood tests, as well as examination and imaging of the joint(s). A positive family history can also be relevant.

Sports injuries

Many sports place considerable stresses on the foot and ankle and these are common sites of injury. Trauma may cause soft tissue inflammation (tears in tendons, muscles and ligaments), stress fractures as well as joint problems.

Some people have a foot or ankle ‘type’ that may predispose them to a greater incidence or severity of injuries.. An unstable foot and/or ankle, a tight muscle group, or a functional characteristic during standing or walking will lead to increased stress and can lead to an an overuse or an acute injury.

Management: Dependent on the cause. Common techniques used in sports injuries include strapping, external supports, physiotherapy, orthoses, advice e.g training, footwear, anti-inflammatory therapies (ice and medication) and in certain cases surgery.

Acute injuries

There are many ways to injure the foot and ankle. These range from ankle strains/sprains and fractures to stepping on a foreign body e.g a needle or nail, a hair, or a splinter. Sports injuries are also often acute i.e require immediate attention e.g Achilles tendon rupture