Foot and Ankle
Our feet and ankles are being used everyday for various daily activities. Hence, injuries to the foot and ankle are very common.
The ankle is made up of 3 bones that meet at the ankle joint: the tibia (shinbone), fibula (smaller bone of the lower leg) and talus (small bone in between the tibia and fibula and the calcaneus). The ankle joint where these 3 bones meet are encased by a joint capsule, which contains synovial fluid. This synovial fluid is important as it allows for smooth movement of the joints. The ankle is surrounded by ligaments, which help to stabilise it.
The foot is a complex structure of the body, consisting of 26 bones, 33 joints, 107 ligaments, and 19 muscles. The bones can be categorised into 3 sections:
The forefoot consists of your toes (phalanges) and metatarsals
The midfoot consists of bones that make up the arch of your foot
The hindfoot consists of the heel and ankle, where the talus and the calcaneus (heel bone) are found.
Muscles, ligaments and tendons in the foot help stabilise your foot and allow for complex movement and motions. As there are many bones in the foot, fractures can occur at many locations in the foot, such as toe fractures, metatarsal fractures or calcaneus fractures. Another type of fracture that can occur in your foot is a stress fracture, which develop due to stress overtime.
WHAT IS FLAT FEET?
Flat feet, also known as fallen arches, are when there is no arch present in the feet or the arch is very low. This condition is usually painless, but having flat feet can cause pain when doing physical activity such as running.
Flat feet is a normal occurrence among infants, and this usually goes away when they turn 2 to 3 years old, when the ligaments and tendons in their feet start to become tighter and they start forming arches. However, when these arches fail to develop, it results in flat feet that lasts through adulthood.
WHAT ARE THE SYMPTOMS OF FLAT FEET?
Most people experience no symptoms associated with flat feet. However when there is pain involved, the most common symptom is pain at the base of the feet. Some may also experience pain in the lower legs and ankles, and in the heel and arch area which worsens with activity. There may also be some swelling inside the ankles.
WHAT ARE THE CAUSES AND RISK FACTORS OF FLAT FEET?
Apart from the arch not forming properly in babies, one of the causes of flat feet is the wear and tear that comes with age. As we grow older, our tendons in the feet that support your arch experience wear and tear and may cause the arch to collapse.
If you have a family history of flat feet, it is likely that you will get flat feet too. Foot injuries are also a risk factor of flat feet, and muscle conditions such as cerebral palsy also increases your risk of getting flat feet. People who are obese or have diabetes have increased risks as well.
WHAT IS THE DIAGNOSIS OF FLAT FEET?
Your doctor will observe your feet from different angles and get you to stand on your toes, to observe the condition of your feet which will help in the diagnosis.
Imaging tests such as an x-ray, CT scan or MRI scan may be ordered if needed for further examination of your feet.
WHAT ARE THE TREATMENT OPTIONS FOR FLAT FEET?
Should you experience pain due to your flat feet, the following treatment may be recommended:
- Orthotic devices and arch supports for pain relief caused by your flat feet
- Stretching exercises
- Shoes with the appropriate support, to help you walk and move about in comfort
- Physiotherapy to help you strengthen your feet muscles and increase flexibility
Should these treatment methods fail to relieve your pain due to flat feet, and if the pain is severe, foot surgery may be recommended. However, this is rarely done and most people experience relief with nonsurgical treatment methods.