Jayson Goo, ATC, MA, CKTI, a National Athletic Board Certified Athletic Trainer, graduated from the University of Hawaii and earned his master's degree in human performance with a specialty in corrective therapy from San Jose State University. Jayson also is an active Certified Kinesio Taping Instructor.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Pain and point tenderness are
the immediate indicators that something is wrong in a specific area. The onset
of pain, whether suddenly or over time, is an important indicator of the cause of the
problem. The following questions are also important.
Bones of the foot are joined together by ligaments. A sprain occurs when
the ligaments that hold the bones together are overstretched and the fibers
tear. Point tenderness and looseness of a joint are indicators of a sprain.
Injury to the bones of the foot can be caused by a single blow or twist to the
arch or also by repetitive trauma that can result in a stress fracture.
Fractures are indicated by a focal point of pain that may be exquisitely tender
on the bone. There may be a distinguishable lump or gap at the site of the
fracture. A rotated toe or forefoot may also be a sign of a fracture.
Muscle and tendons move the body tissues around the joints. A strain occurs when a muscle or group of muscles are stressed to the point where there is tearing of the muscle fibers. The muscles and tendons of the foot may be strained by overstretching, overuse, overloading, bruising, or even being lacerated. Weakness in contraction of a joint, difficulty in stabilizing body parts, and pain working against resistance are signs of muscle problems. Swelling, tenderness, loss of function, and discoloration over and around the injury of can be symptoms of a strain.
Bruises are most commonly the result of a direct impact injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage such as fractured bone.
Pain and tenderness associated with planter fascia strains are usually felt on the bottom of the foot between the heel and the base of the toes and may occur either as a specific or general area of tenderness. Plantar fascia pain may be increased or decreased by stretching of the arch. In mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot "warm up," however, pain may increase as use of the foot increases. In more severe cases of plantar fasciitis, pain may increase when the arch is stressed. Often the sufferer of plantar fasciitis will feel pain in the morning until the plantar fascia warms up. Foot pain at night
may be a sign of plantar fasciitis but may indicate another problem.
A sensation of rubbing or burning on the surface of the foot
is usually the first signs of a blister. Itching and burning sensations between
the toes or around the foot indicate a skin infection or athlete's foot. Pain
and redness at the edge of a toenail are usually the result of an ingrown
toenail.
As discussed above, foot pain may have a variety of different causes.
Proper evaluation and diagnosis of foot pain is essential in planning a
treatment. A good general guideline is to compare the injured side to the
uninjured side. Injury may present itself as distinguishable lump or gap felt at
that location or a "crunchy" feeling on that spot caused by inflammation. The types, causes, and severity sharp pain versus a dull ache also are good indicators of the seriousness of the injury.
Four grades of pain
During activity
Before and after, and
not affecting performance
Before, during, and after athletic activity,
affecting performance
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Common warts are skin growths causes by the human papillomavirus. There are many types of warts, including plantar warts, common hand warts, warts under the nails, mosaic wars, and flat warts. Over-the-counter treatments typically involve the use of salicylic acid products.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Corns and calluses are sometimes painful areas of thickened skin that appear between the toes and fingers or on the soles of the feet. Abnormal foot anatomy, ill-fitting footwear, and unusual gait can put increased pressure in specific areas, causing corns and calluses. Treatment may involve using over-the-counter salicylic-acid products, visiting a podiatrist to be fitted with an orthotic device, or surgical removal.
The common bunion, an enlargement of the inner portion of the joint at the base of the big toe, primarily affects women. The signs and symptoms of bunions include inflammation, redness, tenderness, and pain of the first metatarsophalangeal joint. The little toe may also develop a bunion (tailor's bunion). Rest, walking shoes, stretching, cold packs, and antiinflammatory medications may alleviate pain. Surgery is also a treatment option.
A broken toe is one of the most common fractures among individuals. There are many causes of a broken toe, whether it is the big toe, middle toes, or little toe (pinky). Common symptoms of a broken toe include pain, swelling, stiffness, and bruising. A broken toe can be treated with buddy taping the toe. There are instances where a physician should be consulted for a broken toe.
Shin splints result from inflammation from injury to the tendon and adjacent tissues in the front of the outer leg. Shin splints commonly occur in runners or aggressive walkers, causing pain and discomfort. An increase in workout intensity, weak ankles and pronation may be to blame for shin splints. Stretching, strengthening, and icing the affected area are effective treatments for shin splints. Rest and anti-inflammatory medications are also advised.
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Bone spurs are pointy outgrowths of bone that develop in areas of inflammation or injury. They commonly occur on the heel and spine and may be the result of reactive arthritis, ankylosing spondylitis, or diffuse idiopathic skeletal hyperostosis. Symptoms include pain, numbness, and tenderness. Treatment focuses on decreasing inflammation and avoiding re-injury.
A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin. The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body's response to the injury. Treatments include applying an ice pack and pressure to the area by hand.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
Ingrown toenails are caused by the growth of the toenail into the surrounding nail fold. Symptoms include toe pain, swelling, redness, and yellow drainage. Treatment at home involves soaking the affected foot in diluted white vinegar or Epsom salts, elevating the foot, and trimming the nails straight across. Surgery is also an option for severe cases. Prevent ingrown toenails by wearing shoes with a wider toe box and avoiding repeated injury to the toenails. Avoid curving or cutting the nails short at the edges.
A Morton's neuroma is an inflamed nerve between the bones at the ball of the foot. Symptoms include a burning, sharp pain on the bottom of the foot. Treatment involves resting the foot, wearing better-fitting shoes, ice packs, and cortisone injection.
Diabetes-related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Turf toe is a sprain to the ligaments around the big toe joint. Symptoms and signs include pain, swelling, a popping sound, and limited range of motion. Treatment may involve taking ibuprofen, immobilizing with tape, cast, or a walking boot.
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