Aching feet: Aching feet usually arise due to intrinsic muscles (Muscles with origin and insertion in the feet) or extrinsic muscles having to work harder than normal to stabilize the feet. In essence the muscles in question are suffering from fatigue. Orthotics work to gradually stabilize how the feet are working so that the function returns to normal.

Bunion: A Bunion (Hallux valgus) is considered to be a medial deviation of the first metatarsal shaft and lateral deviation and/or rotation of the big toe (hallux) with or without medial soft tissue enlargement of the first metatarsal head. This condition can also lead to pain in the joint with movement and/or difficulty with footwear. This condition can arise for a variety of reasons from, ill-fitting footwear to a musculoskeletal imbalance or as a consequence of a systemic disorder. Usually pain is the main reason for seeking help though occasionally it’s an inability to find comfortable footwear

Bursitis: Acute or chronic bursitis is an inflammation of a bursa. A bursa is a saclike cavity filled with synovial fluid and located at tissue sites where friction occurs, such as where tendons or muscles pass over bony prominences so allowing for normal movement and reducing friction between moving parts of the body. Generally, it is difficult to determine the actual cause. The most common sites are the back of the heel, around the knee, and in the hip as well as the elbow and shoulder.

Calf pain: This is pain arising at the back of the leg between the back of the knee to the in the insertion point of the Achilles tendon on the calcaneum i.e. the heel bone of the foot. Usually a muscle has gone into intense spasm due to a functional misalignment arising from how the leg was moving. It may be due to falling over, being knocked off balance or stumbling. If the forces involved are excessive, muscles my tear or completely rupture.

Clumsiness: Awkward in movement or action. There can be psychological as well physical factors that need to be addressed.

Cold feet:  There are a variety of causes which induce cold feet. These range from inappropriate clothing to peripheral vascular diseases like Raynaud’s disease. The approach is multi-factorial; from the insulating properties of the orthotics through to changes in an individual’s way of dressing.

Collapsed Ankles: The most common causes of collapsed ankles are either a hypermobile inside arch of the foot or misalignment of the muscle contractions of the leg. It is resolved by realigning the leg and gradually stabilizing all the joints in the leg and foot.

Chronic Sport injuries These are those aches and pains which arise frequently over a period of time. Often in the short term can be ignored however eventually the activity has to be stopped for a while or professional help is needed to give some relief.

Destroying shoes This manifests in several ways; heels wear down very quickly – weeks instead of months; side of the footwear splits between upper and sole; a split develops across the ball of the feet on the sole of the footwear. Whatever the cause footwear does not last and frequently is uncomfortable.

Dyspraxia This is the partial loss of the ability to perform coordinated movements. People often seem clumsy.

Feet changing shape: Some people are born with odd shaped feet. However the majority are caused by imperceptible changes as consequence of bad habits and or inappropriate footwear. Structures in the feet are over loaded and usually the forefoot spreads and/or toes twist and buckle.

Hallux rigidus: Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the big toe, and with time it gets increasingly harder to bend the toe. "Hallux" refers to the big toe, while "rigidus" indicates that the toe is rigid and cannot move. In acute phases it may become increasingly more painful. When the joint is virtually rigid pain usually goes away however an adjacent joint frequently then starts to cause pain and discomfort. The causes of this condition are multifactorial; varying direct trauma e.g. stubbed toe or ill fitting footwear to a body that is musculo-skeletally out of balance.

Hammer Toe: This is a lesser toe deformity (excludes the big toe which is known as the hallux) that usually occurs on the second and third toes. There are three bones in the lesser toes. With this condition, the first bone sticks up (dorsiflexion) and the bone in the middle goes down (plantarflexion), making the joint between the two more prominent. The joint misalignment may over time become fixed. Initially they are usually trouble free however when fixed, painful conditions may occur; both at the joint and the base of the toe.

This condition may arise from local trauma, conditions associated with base of the toe (metatarsal head) however it is usually associated with a forefoot instability and is frequently seen when there is a bunion (hallux abductovalgus).

Hip aches and pains: These issues tend to arise when the range of motion of hip joint is markedly reduced. The causes can be variable enough often interlinked. Poor posture in sitting standing and moving is a common connection between most of them. A thorough assessment, totally involving the individual both from an understanding and implementation perspective, is essential.

Heel pain Pain and inflammation under the heel which typically affects those in middle age who increase their activity, have prolonged standing and/or recent weight gain.

In growing toe nails: An ingrown toenail is one where the edge or corner of the nail grows down and cuts into the adjacent skin of the toe, leading to your toe becoming red, swollen and tender (inflamed). The big toe is most likely to be affected, either on one or sometimes both sides. If left untreated, the inflammation can spread to the rest of the toe and the area becomes infected and ooze pus.

Iliotibial Band Syndrome This is a thickening of the fascia lata, extending from the iliac crest to the knee, most often where pain is present.

Knee pain: This is pain arising within or around the knee. Identifying the precise location, duration, and intensity is essential. Injuries arising from accidents or bad habits are common in acute cases. Unless an individual takes a responsible active role in ensuring complete recovery, then the knee pain will become chronic, leading to constant pain due to structural damage to the actual joint itself. Addressing the underlying issues how the legs are aligned and function are of prime importance.

Low back pain: Pain in the lower back area, may relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area.

Mallet Toe: A lesser toe deformity that affects the distal bone in the 2nd and 3rd toes, though may also affect the 4th. The distal bone points downward (planaflexed). Often arises from having short footwear or a long toe.

Morton’s Neuroma This is the entrapment of the second and third plantar digital nerve. Usually caused by excess pressure on the base of the toes the pain can become severe.

Painful toe joints: This can occur in any of the joints in the toes. The causes may be divided into four groups: Anatomical, e.g. a particularly long toe; Biomechanical, e.g.. how the body moves; Style of footwear; Bad habits.

Plantar Fasciitis: Plantar Fasciitis is the term for when pain is experienced in the middle of a foot. There are a variety of causes, all of which invariably involve over loading the forefoot in someway. The end result is damage at the surface of a bone which invokes an inflammatory reaction and hence pain due to primarily swelling in the area which has been affected.

Shin splints: Shin splints are when you experience pain along the shin bone (the bone at the front of the lower leg between the knee and the ankle), caused by inflammation and tiny fractures (microfractures) in the surface of the bone. Shin splints are common in any sport involving running and are usually caused by too much training too soon. They can be caused by running on a hard surface or by running in shoes that do not have enough support for the foot and ankle.

Swollen feet: There are numerous causes of swelling in the feet. Circulation is impaired. This could be from a narrowing in an artery in the leg or possibly an indication of a heart problem to wearing socks in which the elastic is too tight above the ankle. It is important that your GP arranges for all the usual tests to be done. After that the focus is to make changes so that the muscles in the legs and thighs have to contract more intensely so widening the pressure differential between the arterial supply into the feet and the venous return out.

Tennis Toe: Chronic traumatic toenail injury leading to a blood blister under the nail (subungual haematoma) and/or damage to the nail due to rapid pivotal movements of the toe against the side of the footwear. Also seen in netball players and joggers.

Tight Hamstrings: These are three muscles that arise in the buttock and insert below the knee. The most common reason for them to shorten and go tight is sedentary life style, i.e. sitting too often and for too long. The situation is often exacerbated by poor posture. From an ergonomic perspective, chairs, desks and tables are often not the correct height and size for an individual so compensations are made, which over time lead to problems like tight hamstrings.

Turf Toe: Caused by direct trauma to the big toe (hallux), e.g. stubbing the toe. Often there is already limited movement in the joint and additional trauma gives rise to marked inflammation, which is frequently very painful.

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