A clubfoot is a birth abnormality that is reasonably common compared to other birth defects. A clubfoot is when the foot in turned downwards and inward at birth. It can be an isolated problem or part of a wider syndrome.

Most cases of clubfoot respond well to a routine of stretching and casting with only a few needing to go on to surgery.

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This was an ancient tradition, mostly in rural China, that meant that the feet of young girls were very tightly bound to prevent the foot from growing. It was very painful and disabling, but a much higher price could be demanded for a bride with smaller feet. It existed to please males.

While the tradition is now dead in China, women these days are still putting there feet into tight shoes to please males! It is now responsible for a lot of foot problems in those that do it.

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Bunions are a very common problem. especially in females. They are due to a combination of poor foot biomechanics and poorly fitting footwear along with an inherited predisposition.

The only way to make bunions go away is with surgery. All the conservative treatment can do is offer symptomatic relief, which is fine, but the problem will always exist.

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While plantar fasciitis is the most common cause of pain under a heel a less common cause on a nerve entrapment, commonly called Baxters Neuritis or Baxters Nerve Entrapment. The symptoms of this is similar to plantar fasciitis and a careful assessment is needed to tell them apart.

The treatment of this entrapment is usually conservative. A surgical treatment is usually quite successful if the conservative treatment fails.

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Running barefoot and doing away with running shoes was a new trend a few years ago, but seems to have died down a bit now. The rationale was that barefoot running would change the running form to a technique that resulted in less overuse injuries.

The reason that the hype has died off is that barefoot running has not lived up to all the hype and it appears that the injury rate is just the same.

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The Vibram Five Fingers are a popular shoe with those who prefer to run in shoes that do not support or cushion the foot.

The biggest problem with the Vibram Five Fingers is they do take time to get used to running in and the adaptation period can be prolonged. Vibram are also facing some legal issues due to the injury claims that they made. An attempt to dismiss the Vibram class action was rejected.

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There are many surgical procedures for bunions. Once of the more popular one is the Austin Bunionectomy.

The basics of the Austin procedure is the removal of a wedge of bone to change the alignment of the metatarsal. It can be used in combination with other procedures or as a stand-alone procedure. The complication of this procedure are relatively low.

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Ankylosing Spondilitis is a condition related to rheumatoid arthritis, but mainly affects the low back and spine (ie ‘spondilitis’). The joints are also affected.

What is common in Ankylosing Spondilitis os pain at the insertion of teh achilles tendon and the plantar fascia, giving rise to posterior and plantar heel pain. These are part of the disease process of the condition which is known as enthesitis (an inflammation of the insertion of ligaments and tendons onto bone.

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The Achilles tendon takes a significant load and crosses two joints. If there is any weakness in the tendon at the same time as the two joints (knee and ankle) that the tendons and muscles cross move in different directions at the same time, then there is a high risk for a rupture. The rupture is usually ‘heard’ and is usually very obvious what has happened.

The treatment for an achilles tendon rupture is either a surgical repair or a plaster cast. The research shows almost similar outcomes between the two approaches, so there is no clear reason to have one over the other.

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Toe walking is common in children and can occasionally be the sign of a more serious underlying problem.

As conditions like cerebral palsy, muscular dystrophy and autistic spectrum disorders are some of the conditions that can cause toe walking, then each child that walks on their toes do need to be checked out for these sorts of conditions. The range of motion at the ankle joint needs to be checked, the neurological system thoroughly checked out and a history taken to determine if the child met all the usual developmental milestones. If all these are normal, then the toe walking is most likely just something teh child likes to do and is of no consequences.

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