Common Foot Injuries

The foot is a body part that is made of a large number of small bones that are connected by many different ligaments and are supported by surrounding tendons and muscles. In addition, the foot is central to any weightbearing sport or physical activity. Because the foot is put under so much load and because of its complex structure, foot injuries are common in sport and work activities. Overuse foot injuries are prevalent in sports that involve running and jumping such as long distance running, basketball, track and field and dance. Traumatic foot are more common in contact sports such as football and soccer. Work that involves prolonged walking and standing commonly causes overuse foot injuries.

Plantar Fasciitis

Inflammation at the base of the heel where the plantar fascia attaches. The plantar fascia is a band of tissue that extends from the heel, into the arch of your foot to the base of your toes; its function is to help keep the shape or your arch. Plantar fasciitis typically occurs from a combination of overuse (running, walking, jumping, etc.), biomechanical issues (e.g., flat feet, weak ankle and foot muscles, tightness), running gait technique abnormalities, and improper shoes. Symptoms include pain at the bottom of your heel especially the first few steps upon rising in the morning and with weight-bearing exercise, and sometimes local swelling. Besides acute injury management, treatment includes physiotherapy, chiropractic, massage therapy, home strengthening and stretching exercises, orthotics (custom arch supports), night splints, better footwear, improving running technique, and sometimes requires specialized injections.  Learn more from this blog post.

Achilles Tendonitis

Inflammation at the back of the heel where the Achilles tendon attaches to the heel bone. Typically caused by overuse in athletes that do a lot of running, jumping or walking, in combination with biomechanical issues (muscle tightness and weakness), techniques problems and improper footwear. Symptoms include pain at the back of the heel, swelling and tightness. Besides acute injury management, treatment typically includes physiotherapy, chiropractic, massage therapy, better footwear, technique changes. Injections are NOT typically done for this injury.

Stress Fracture

Microscopic cracks in the bone(s) of the foot caused by overuse and repetitive stress on the bones. Most commonly involves the long bones of the foot (metatarsal bones) but can also involve the midfoot and heel bones, and typically seen in physical activities that involve a lot of running, jumping or walking. Symptoms include mainly pain and swelling. Treatment typically often requires a period of immobilization in a boot-cast, followed by physiotherapy, massage therapy and chiropractic to address any biomechanical problems; treatment also requires correcting running and jumping technique issues, better footwear, training adjustments and optimizing nutrition and bone health.

runner holding ankle in pain
holding ankle injury with both hands

High Ankle Sprain (Syndesmotic Sprain)

Special type of ankle sprain that can be more difficult and troublesome. This sprain occurs a bit higher up in the ankle than the typical ankle sprain, involving the ligaments that hold the leg bones (tibia and fibula) together. Typically occurs from a forceful twist of the ankle and foot into external rotation and dorsiflexion, and is the most common ankle sprain in hockey players. Symptoms include pain and swelling that is just above the ankle joint, feeling unstable and difficulty weight-bearing. Besides acute injury management, treatment often includes a period of immobilization in a boot-cast, followed by physiotherapy to regain strength, range of motion and balance sense. Surgery is needed in severe cases.

Ankle Instability

Looseness of the ankle resulting in recurrent ankle sprains. Typically results from having had many ankle sprains in the past or just having had one severe ankle sprain causing ligament tearing. May also be related to having loose ligaments genetically. Other contributing factors include poor balance sense and weakness of the muscles in the ankle (especially the peroneal tendons). Treatment includes physiotherapy to address biomechanical problems (especially peroneal muscle weakness and poor balance sense), ankle bracing, and sometimes surgery is needed to stabilize the ankle.

Ankle Fracture

Break in one of the bones of the ankle, most commonly the fibula but also can involve the tibia and talus bones. Caused by a traumatic injury involving a twist, a fall, or an impact to the ankle. Symptoms include severe pain, swelling which is often rapid, and inability to walk or bear weight. Besides acute injury management (LINK), treatment includes immobilization in a cast or a walking boot followed by intensive physiotherapy to regain range of motion, strength and balance sense. Surgery is sometimes needed, occasionally on an urgent basis, depending on the type of break and which bone is involved.

Ankle Sprain

Tearing or overstretching of the ligaments that give stability to your ankle. Typically occurs by suddenly twisting or “rolling” your ankle while running or jumping especially when changing directions or being thrown off-balance. Common in athletes in sports such as soccer, basketball, volleyball, football, etc. Symptoms include pain (location of pain depends on the type of sprain), swelling, bruising, instability and difficulty weight-bearing. Acute injury management is very important for acute ankle sprains, and seeing a physiotherapist early-on is key to a safe and faster recovery. The physiotherapist will also guide your rehab to regain full strength, range of motion, balance sense and prevention strategies. Bracing, taping and sometimes a walking boot-cast may be needed. Ankle sprains only rarely require surgery and typically only if there is chronic severe looseness in the ankle.

Metatarsal Fracture

Break in the long bones of the foot (metatarsal bones) that typically occur from a direct impact to the foot or twisting trauma. Symptoms include pain, swelling and difficulty putting weight on the foot. Besides acute injury management, treatment typically includes using a boot-cast, and surgery in some cases if the fracture is displaced. Physiotherapy is often done once out of the boot-cast so that you can regain full strength, range of motion and balance.

back view of person going over on their left ankle

Morton's Neuroma (Interdigital Neuritis)

Inflammation or mechanical irritation of a nerve between the toes, most commonly involving the third and fourth toes. Caused by compression and irritation of the nerve often caused by foot biomechanics, improper footwear (e.g. shoes too tight) and overuse (e.g., running, walking, jumping). Symptoms include forefoot and toe pain, burning sensation, numbness and tingling in the toes. Treatment includes physiotherapy, better footwear, orthotics, forefoot pads, anti-inflammatory creams, toe flexor retraining exercises, and sometimes requires special injections or surgery.

Metatarsalgia

Mechanical irritation, and sometimes inflammation, at the ball of the foot, a part of the foot known as the metatarsal heads. Caused by abnormal foot biomechanics, improper footwear and overuse (e.g., running, walking, jumping). Symptoms include pain in the ball of your foot, often feeling like you are stepping on a small stone. Treatment includes physiotherapy, better footwear, orthotics, forefoot pads, anti-inflammatory creams, toe flexor retraining exercises.

Osteoarthritis

Degeneration of the cartilage layer which acts like a shock absorber, and can affect any of the joints in the foot and toes. Contributing factors include older age, genetics, previous serious injuries), and certain professions or activities that put abnormal straining on the foot. Symptoms include pain, swelling, mechanical symptoms (e.g., grinding, catching, clicking), stiffness, and decreased range of motion. Treatment is multi-factorial and includes losing excessive weight, strengthening, appropriate exercise, pain medication and creams, anti-inflammatories, physiotherapy, bracing, supplements, orthotics, footwear modifications, and sometimes injections and surgery.

Turf Toe

Strain or inflammation of the joint at the base of your big toe, typically caused by a traumatic hyperextension mechanism. Common in sports such as football, especially if playing on artificial turf. Symptoms include pain, swelling and stiffness of the big toe. The pain may be so severe that you have difficulty walking. Besides acute injury management, treatment includes physiotherapy, orthotics, taping, stiff soled shoes or a carbon fibre plate insert, and sometimes requires a period of immobilization in a cast-boot.

Bunion (Hallux Valgus)

Deformity or bump at the inner (medial) side of the base of the big toe, commonly resulting in the big toe veering off to the outside (lateral) side of the foot. Typically caused by genetics, biomechanical abnormalities, and improper footwear (such as tight shoes). Symptoms include pain and bump or swelling at the inner part of the base of your large toe and difficulty weightbearing especially the push-off phase of gait. Treatment includes physiotherapy to correct biomechanical issues, footwear modifications, orthotics and other foot implements. Sometimes surgery is needed.

Heel Spur

Often associated with plantar fasciitis and Achilles tendonitis, a bone spur is a bony outgrowth in the heel bone. Bone spurs often occur without there being any pain and are typically not treated unless they are mechanically causing a problem. Treatment typically involves treating the underlying condition such as plantar fasciitis or Achilles tendonitis.

Individual treatments may vary based on the specific diagnosis and severity of the injury. Seeking professional medical advice for an accurate diagnosis and a tailored treatment plan is recommended for optimal recovery.

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