ANKLE PAIN & INSTABILITY
Ankle pain is usually associated with arthritis, impingement, or instability. Chronic ankle arthritis, like knee arthritis, usually develops slowly over time and is usually caused by an injury or deformity. Local swelling, stiffness, aching pain, and symptoms worsening with activity are hallmarks of ankle arthritis. Sometimes rheumatic conditions can lead to more acute pain and swelling. Ankle impingement presents in similar fashion, but is less predictable and more specific in its location. Instability is linked to anterolateral pain and feelings of looseness or “giving out.” Frequently other conditions such as FHL or peroneal tendonitis can cause ankle pain. This pain is usually more of a sharp burning pain and usually courses along the tendon.
FOREFOOT PAIN & DEFORMITY
Forefoot pain can be caused by many problems, however, most are related to deformities of the toes and metatarsal bones. Bunions (hallux valgus) cause pain at the great toe prominence, but also cause pain under the second and third toes (metatarsalgia). Congenitally long metatarsals and tight Achilles tendons contribute to this problem. Hammertoes cause pain and make it difficult to find appropriate footwear, and are also associated with bunions. Corns and callouses are usually markers of the above problems but can exacerbate pain and discomfort. Great toe arthritis (hallux rigidus) is also very common, causing stiffness and achiness of the big toe. Diabetes, neuropathy, and nerve entrapments can cause either burning foot pain or loss of sensation.
HINDFOOT PAIN & DEFORMITY
Hindfoot symptoms occur just under the ankle and are often confused with ankle pain. Problems such as posterior tibial tendon insufficiency cause flat feet and pain. Pain can occur on the inside or outside of the hindfoot. This also causes feelings of weekness and instability around the ankle (hindfoot). Other people have cavo-varus feet (high-arch) which cause associated problems such as peroneal tendonitis, ankle instability, and stress fractures. Arthritis can also affect the hindfoot, leading to stiffness, dull pain, and later deformity.
Heel pain is probably one of the most common symptoms and complaints of otherwise healthy middle-aged adults. If the pain is under the heel then plantar fasciitis is likely. If it occurs above the heel then Achilles tendonitis is more probable. Common symptoms of plantar fasciitis include; first-step morning heel pain, cramping of the plantar arch, and calf tightness. Achilles tendonitis usually presents with swelling at the Achilles insertion or in the tendon itself and pain related to increased activity. Other heel symptoms can be caused by nerve compression or foot deformities.