Knowledgeable and experienced physicians, therapists and nurses work in concert to cover the total spectrum of foot and ankle musculoskeletal care. Our Foot, Ankle & Lower Leg Center includes diagnostic imaging, physical therapy, on-site MRI, and surgical treatments.
Whether tendon, ligament, bone injuries, arthritis, or acute/chronic conditions, Florida Orthopaedic Institute surgeons are fellowship trained and have extensive knowledge in the management of all conditions affecting this region of the body. Thankfully, many of these problems require conservative management before requiring surgery. Shoe modifications, bracing, physical therapy, and medications are only a part of what is offered. When surgery is indicated, the operative experience of the surgeon is critical. With the largest combined experience in Florida, the Florida Orthopaedic Institute team has performed tens of thousands of these procedures including flat foot corrections, ankle and subtalar fusions, midfoot osteotomies, bunion surgery, soft tissue reconstructions, as well as fracture reconstruction.
SYMPTOMS & CONDITIONS WE TREAT
When patients suffer from shoulder pain, the cause can be due to any number of conditions. Our specialists help patients find relief from:
Inflammation of the Achilles tendon is known as Achilles tendinitis or tendonitis.
The Achilles tendon is a tough band of fibrous tissue that runs down the back of your lower leg and connects your calf muscle to your heel bone. The tendon is used when you walk, climb, jump, run and stand on your tip toes.
Flatfoot is a deformity where the arch of the foot collapses to the ground or is not formed at all resulting in pain in the foot and difficulty with walking/running. The condition is mostly seen during the first few years of life in the children. Orthopaedic Associates of West Florida, FL provides expert diagnosis and individualized non-operative and operative treatments for flatfoot in West Florida, FL. Contact Orthopaedic Associates of West Florida, FL’s team for an appointment today!
Arthritis is inflammation resulting from the degeneration of cartilage in the joint causing pain, swelling, and stiffness in the joints resulting in restricted movements.Arthritis of the foot and ankle joint can occur due to fracture, dislocation, inflammatory disease, or congenital deformity. The foot joints most commonly affected by arthritis are:
- The joint between the shin bone (tibia) and ankle bone (talus)
- The three joints of the foot that include the heel bone, the inner mid-foot bone, and the outer mid-foot bone
- The joint of the great toe and foot bone
Shoes not only protect your feet during movement, but are a major performance determining factor in sports. Athletic shoes are designed to withstand the increased pressures that sporting activities place on the feet, ankles and legs. They prevent injuries, and improve performance and comfort.
Having a clear idea of the type of foot (especially the arch of your foot) you have and how your foot works during different activities is important in choosing the best fit. While walking, your feet roll from your heel to your toe and there is more time that both feet spend on the ground. This distributes your weight evenly on different parts of each foot and on both feet. To facilitate this movement, walking shoes must provide good shock absorption, stability throughout the arch of your feet (underneath the midfoot), and flexible forefoot support.
Bowed legs are a bony deformity resulting in outward curvature of one or both knees of the lower legs. It is commonly seen in toddlers and overweight adolescents.
Children under 2 years of age may present with bowed legs (physiologic), which usually corrects itself by the age of 3 to 4. Bowed legs may be associated with Blount’s disease (an abnormality of growth plates present at the ends of long bones) and rickets (bone disease due to deficiency of vitamin D, calcium and phosphorus).
Ankle injuries are the most common sports-related injury. An ankle fracture is a break in one or more bones that make up the ankle joint. Sometimes ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accident, rolling or twisting of ankle, and by tripping or falling. People participating in sports such as basketball, football, soccer and skiing are at a high risk of developing ankle fractures.
Common symptoms of an ankle fracture include pain and swelling around the ankle, bruising, tender to touch, inability to walk on the leg, and deformity if the ankle is dislocated.
Chronic lateral ankle pain is a longstanding or recurring pain in the outer aspect of the ankle that is often experienced after an acute ankle injury such as rolled ankle or sprained ankle.
Chronic lateral ankle pain is usually characterized by a dull and constant ache in the outer ankle region that makes it difficult for you to walk, run, or participate in sports. The intensity of the ankle pain is often increased with walking on uneven ground or wearing high heel shoes. Symptoms that might accompany chronic lateral ankle pain include ankle stiffness, swelling, and instability.
Claw toe is a deformity, where a toe bends and appears like a bird’s claw. The affected toe is bent upward from the joint at the ball of foot, and downward at the joints in the middle and tip of the toe to curl under the foot. Hard thick skin called corns may develop under the ball of the foot or on the top of the affected toe, causing pain while walking.
Claw toe can occur in the four toes other than the big toe due to nerve damage, which weakens the muscles. They may be present at birth or acquired later due to other disorders such as rheumatoid arthritis, cerebral palsy and brain injury. Women are affected more often than men since claw toe can also form by wearing very tight or high-heeled shoes.
Clubfoot is a term used to describe a foot deformity in newborns. The name is derived from the appearance of an untreated adult foot, which resembles a club. Typically, the foot is turned inward and downward. It affects both feet in half of all patients.
Several types of clubfeet exist. A positional clubfoot is one where the foot has the characteristic appearance but is quite flexible, secondary to in-utero crowding and not abnormal development. This is the mildest and most easily treated form. The most common form of a clubfoot is the idiopathic variety. “Idiopathic” means that we do not know the cause. A teratologic clubfoot is a more severe form and is associated with a known neuromuscular abnormality like spina bifida.
A corn is a circular area of thickened skin developed as a result of continuous friction or pressure. They usually develop on the soles of feet, or on the top or sides of toes, and appear as yellowish dead tissue surrounding an area of tenderness. Pain and discomfort may be present with walking, which can get more painful without treatment.
Ill-fitting shoes are the main reason for corns. Tight shoes apply pressure on the foot, while loose shoes cause your feet to rub against it. High heeled or pointed toed shoes can squeeze and localize pressure on one part of the foot. Corns can develop over bone deformities such as hammer toe and claw toe, where the joints are abnormally bent.
Diabetes is a chronic condition that is characterized by high blood glucose (sugar) levels. Diabetic patients are at a high risk for developing chronic wounds, especially in the feet. If left untreated, these wounds can cause serious problems that can lead to infections and eventually gangrene, which may require amputation.
Flatfoot, also known as “fallen arches” or Pes planus, is a deformity in children’s feet in which the arch that runs lengthwise along the sole of the foot has collapsed to the ground or not formed at all. Flatfoot is normal in the first few years of life as the arch of the foot usually develops between the age of 3 and 5 years. Flatfoot can be rigid or flexible. Flexible flatfoot usually resolves without any treatment needed unless pain is involved. Rigid pediatric flatfoot however can cause joint pain in the leg when walking or an aching pain in the feet and usually requires intervention.
Foot pain occurs from distress induced by certain factors in the foot. Foot pain is a common problem experienced by young athletes involved in different activities such as running and jumping.
The foot is composed of different structures including bones, ligaments, tendons, and muscles. As feet bear the weight of our body, they are more prone to injury and pain. Normally foot pain can be treated through home treatments and may take time to heal. However, in cases of severe injury, adequate evaluation and treatment is required.
The talus is a small bone at the ankle joint that connects the heel bone and the two bones of the lower leg, enabling the up and down movement of the foot. Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or twisting of the ankle. The symptoms include severe ankle pain, inability to walk, swelling and tenderness.
When you present to the clinic with these symptoms, your doctor will perform a thorough physical examination and order an X-ray or CT-scan to diagnose the location and severity of the fracture. Talus fractures are treated by either non-surgical or surgical methods.
The talus is a small bone at the ankle joint that connects the heel bone and the two bones of the lower leg, enabling the up and down movement of the foot. Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or twisting of the ankle. The symptoms include severe ankle pain, inability to walk, swelling and tenderness.
When you present to the clinic with these symptoms, your doctor will perform a thorough physical examination and order an X-ray or CT-scan to diagnose the location and severity of the fracture. Talus fractures are treated by either non-surgical or surgical methods.
The calcaneus or heel bone is a large bone found at the rear of the foot. A fracture is a break in a bone from trauma or various disease conditions. The types of fracture to the calcaneus depend on the severity and include stable fractures, displaced fractures, open fractures, closed fractures and comminuted fractures.
A fracture of the calcaneus is most commonly due to a traumatic event such as falling from a height, twisting injuries, motor vehicle accidents and ankle sprains. The commonly seen signs and symptoms of calcaneal fractures include pain, swelling, bruising and inability to walk or bear weight on the foot.
Hammertoe is a deformity in which there is downward bending of the middle joint (proximal interphalangeal joint or PIP joint) of the toe. Although it can affect any toe, hammertoe most commonly forms in the second toe. It may be present at birth or result from wearing shoes that are too tight, which forces the toe to bend forward. Over time, you may lose flexibility of the toe and not be able to straighten it. With constant rubbing from ill-footing footwear, the top region of the toe may form a corn and the sole may form a callus. Wearing shoes and walking usually becomes painful. Hammer toe can be treated by straightening and splinting the toe, performing stretching exercises or undergoing surgery for severe cases.
The talus is a small bone at the ankle joint that connects the heel bone and the two bones of the lower leg, enabling the up and down movement of the foot. Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or twisting of the ankle. The symptoms include severe ankle pain, inability to walk, swelling and tenderness.
When you present to the clinic with these symptoms, your doctor will perform a thorough physical examination and order an X-ray or CT-scan to diagnose the location and severity of the fracture. Talus fractures are treated by either non-surgical or surgical methods.
Plantar fasciitis is a common problem that causes pain under the heel bone often with lengthy walks and prolonged standing. It is most often seen in middle-aged men and women.
Plantar fascia is a thick band of tissue that lies at the bottom of the foot. It runs from the heel bone to the toe and forms the arch of the foot. The plantar fascia functions as a shock absorber and also supports the arch of the foot.
Morton’s neuroma refers to a nerve injury between the toes, usually the third and fourth toes, which causes pain and thickening of the nerve tissue. Compression or chronic irritation of this interdigital nerve is the main cause of Morton’s Neuroma. Excess pressure is exerted on the nerves due to narrowing of the gap between the toe bones causing thickening of the nerve tissue from scar tissue formation. This causes swelling of the nerve and the surrounding tissue.
Morton’s neuroma is more common in women than in men. The associated symptoms include:
- Burning pain in the ball of the foot (may also radiate to the toes)
- Numbness in the affected toes
- Inability to walk
The Lisfranc joint connects the bones of the midfoot and forefoot, and is supported by the Lisfranc ligament. Injuries to this area may cause the ligament to stretch or tear, or bones to fracture or get displaced. Lisfranc fractures may occur as a result of a blow, forceful twisting motions, dropping something heavy on the foot and is more common in runners, military personnel, football players and horseback riders.
Symptoms include pain on standing or applying pressure on the area, swelling over the midfoot, bruising on the undersurface of the foot, and if severe, inability to bear weight.
Intoeing also called “pigeon-toed”, is an abnormal condition characterized by inward facing of the toe or feet instead of being straight. Parents may observe their children having intoeing at an early age when they start walking. But usually intoeing corrects itself without any specific treatment as the child grows up to around 8 years of age. .
Intoeing is normally painless and should not be considered an indication of arthritis. Children of different age groups may have intoeing due to various reasons. Severe deformity (intoeing) may cause misstep in young children while walking or running. Children having intoeing associated with any pain and swelling should be evaluated by an orthopedic surgeon.
Warts are harmless outgrowths on the skin caused by human papilloma virus (HPV) infection. They grow on all body parts including face, fingers, feet, legs, hands, knees, inside your mouth, and on the genital and rectal areas.
Plantar warts are warts that appear on the bottom or soles of your feet as light brown bumps with tiny black dots in them.
All warts can spread from one person to another with skin contact. Warts may also spread by using towels or other personal items which have been used by a person with warts. Warts can bleed if picked or cut and can cause pain, especially plantar warts.
The posterior tibial tendon passes through the ankle to attach the calf muscle with the bones of the mid foot. It provides stability to the arch and supports the foot while walking. Inflammation or a tear of this tendon as a result of injury may cause dysfunction, leading to pain and the development of flatfoot.
Symptoms of flatfoot include pain on the inside of the ankle that may be accompanied by swelling. Flatfoot may cause the heel to shift outwards causing pain on the outside of the ankle as well. Activities such as walking, running, and standing on your toes may aggravate pain. If treatment is delayed there may be rigidity and development of arthritis. You may have trouble walking or wearing shoes.
Rheumatoid arthritis or RA is a chronic inflammatory arthritis that can affect any joint in the body. It typically affects the small joints of the hands and feet in the early stages but may later progress to involve larger joints such as the shoulders, elbows, knees and hips. The cervical spine or neck area may be involved in later stages of the disease. Rheumatoid arthritis is symmetrical meaning the same corresponding joint on the other side of the body is also affected. The affected joints present with swelling, pain and stiffness resulting in limited motion. Nodules made of firm solid tissue may occur under the skin of the arms in severe cases. Other symptoms may include fatigue, fever and weight loss. If not treated early and aggressively rheumatoid arthritis results in joint deformity and disability.
RA can occur at any age but is more common in people between 40-60 years of age. Women are more likely to develop it than men. Smoking and a family history of rheumatoid arthritis increases the risk of developing the disease.
Sesamoiditis is an inflammation of the sesamoid bone and the associated tendons. It is commonly seen in ballet dancers, sprinters and basketball players. It is an overuse injury caused by an increased pressure over the sesamoid bones resulting in a chronic inflammation.
Sesamoids are a special type of bone that are found in the knee, wrist and behind the big toe. Unlike other bones of the body, these bones do not articulate with other bones but are present under the tendons or embedded in the muscles. They provide a smooth surface over which the tendon can glide, increasing their ability to transmit muscle force. The knee cap or patella is the largest sesamoid bone in the body. Two small sesamoid bones are found on the underside of the big toe.
A stiff big toe, also called hallux rigidus, is a form of degenerative arthritis affecting the joint where the big toe (hallux) attaches to the foot. The toe typically becomes stiff at the base and is sometimes called a “frozen joint”.
Degenerative arthritis is a medical condition characterized by the chronic breakdown of cartilage in the joints leading to painful inflammation and stiffness.
sprain is stretching or tearing of ligaments, which connect adjacent bones in a joint and provides stability to the joint. An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular. Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle.
The diagnosis of an ankle sprain is usually made by asking the history of injury and physical examination of the ankle. X-ray of your ankle may be needed to confirm if a fracture is present.
The lower leg is made up of two long bones called the tibia and fibula that extend between the knee and ankle. The tibia or shinbone is the larger of the two bones. It bears most of the body’s weight and helps form the ankle joint and knee joint.
A crack or break in the tibia is referred to as a tibial fracture. The tibia is the most frequently fractured long bone of the body. It normally takes a great amount of force for a fracture of the tibia to occur.
Fractures of the tibia vary depending on the force involved and are classified based on the location of the fracture, the pattern of the fracture, and exposure of the fracture site.
A stress fracture is described as a small crack in the bone which occurs from an overuse injury of a bone. It commonly develops in the weight bearing bones of the lower leg and foot. When the muscles of the foot are overworked or stressed, they are unable to absorb the stress and when this happens the muscles transfer the stress to the bone which results in stress fracture.
Stress fractures are caused by a rapid increase in the intensity of exercise. They can also be caused by impact on a hard surface, improper footwear, and increased physical activity. Athletes participating in certain sports such as basketball, tennis or gymnastics are at a greater risk of developing stress fractures. During these sports the repetitive stress of the foot strike on a hard surface causing trauma and muscle fatigue. An athlete with inadequate rest between workouts can also develop stress fracture.
The forefoot is the front of the foot that includes the toes. Fractures occurring in this part of the foot are painful but very often not disabling. There are 2 types of fractures namely, traumatic fracture and stress fracture. Traumatic fractures occur when there is a direct impact of your foot on a hard surface. Stress fractures are tiny hair line cracks in the bone, most commonly caused due to repeated stress. The symptoms of toe and forefoot fractures include pain, bruising, swelling and inability to walk.
TREATMENTS
A bunion, also called a hallux valgus, is an enlargement of bone or soft tissues around the joint at the base of the big toe that results in the formation of a bump. The bone that joins the big toe with the first metatarsal bone thickens and enlarges, tightening the tendons, which in turn causes the base of the big toe to angle out resulting in a painful bony deformity.
A foot injury or foot surgery may leave you immobile for a period of time. In order to return to your regular activities and more strenuous recreational activities, it is necessary for you to follow a well-planned activity and exercise program.
You are encouraged to start walking with crutches or a walker following your surgery. Your doctor will help structure and supervise an exercise routine that is ideal for you.A good exercise program to rehabilitate foot and ankle conditions focuses on strengthening and stretching the muscles and tendons of the lower leg, feet, and ankles in order to relive pain and soreness, keep the muscles flexible, provide stability and prevent future injury.
Comfort and durability are important when selecting footwear. A shoe must conform to the shape of your foot and not vice versa. If your activities include walking long distances or standing for a long time, you must purchase shoes appropriate to those activities. Ill-fitting shoes that lack support can stress the feet, ankles, hip and spine, and lead to pain and deformities that prevent you from participating in your regular activities.
Shoes for children should accommodate the growth of the feet, and not apply pressure on the developing muscles and tendons around the ankle. Soft-soled, low-cut shoes with adequate space for the toes to wiggle are recommended. Women’s shoes should not have heels higher than 2 1/4 inches as that increases pressure on the underside of theforefoot. Regular use of pointed shoes compresses the toes and can cause deformities such as bunions and hammertoes.
Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to heel bone. It is used when you walk, run and jump. When the Achilles tendon becomes thin, weak, or if it is not used, it may be susceptible to injury or damage. Achilles tendon rupture occurs most often in middle-aged athlete participating in sports that involve running, pivoting, and jumping. Recreational sports that may cause Achilles rupture include tennis, racquetball, basketball, and badminton.
If Achilles tendon is ruptured you will experience severe pain in the back of your leg, swelling, stiffness, and difficulty to stand on tiptoe and push the leg when walking. A popping or snapping sound is heard when the injury occurs. You may also feel a gap or depression in the tendon, just above heel bone.
Qualified Providers that Can Help
Matthew J. Swick, MD
Orthopaedic Surgery, Foot and Ankle Surgery and Sports Medicine