Foot pain

Lis franc injury

A Lisfranc injury refers to damage to the Lisfranc joint complex, which is located in the midfoot, specifically at the junction where the metatarsal bones (the long bones of the foot) meet the tarsal bones (bones of the midfoot). This type of injury can range from sprains or fractures to more severe cases involving dislocations or fracture-dislocations. A Lisfranc injury is typically caused by a traumatic event or forceful impact, such as snagging your foot in a tree root whilst running.

Lis franc injury symptoms:

  • Severe pain in the midfoot (often around the arch or the top of the foot), especially with weight-bearing activities or when standing.

  • Swelling in the midfoot is common, and bruising may appear around the foot, toes, or sole of the foot.

  • Instability with a feeling of the foot being loose or wobbly during walking or standing.

  • Inability to Bear Weight:

  • Visible Deformity in severe cases:

  • Limited Range of Motion

Plantar plate

The plantar plate is a thick ligamentous structure located at the bottom of the foot. The plantar plate injury is commonly seen in the second toe but can affect any of the toes. The condition is typically caused by either acute trauma or repetitive strain, and it can lead to pain, instability, and in some cases, deformities such as hammertoes or floating toes.

Plantar plate signs and symptoms:

  • The most common symptom is pain in the ball of the foot, specifically around the MTP joints, with the pain often being worse when walking, running, or standing for long periods.

  • Swelling and tenderness may be felt on the bottom of the foot, particularly at the base of the affected toe.

  • Pain with Dorsiflexion - pain may worsen when the toe is bent upwards (dorsiflexed), such as when pushing off the ground during walking or running.

  • Instability or Weakness.

  • Toe Deformities such as hammer toes or floating toes

  • Limited Range of Motion.

Tibialis posterior tendinopathy

Tibialis posterior tendinopathy is a condition characterised by the inflammation or degeneration of the tibialis posterior tendon, which is a key tendon that helps support the arch of the foot and stabilises the ankle during movement.

TP tendinopathy symptoms:

  • Pain is usually felt along the inside of the ankle, just behind the medial malleolus (the bony prominence on the inside of the ankle). It may be sharp or aching and tends to worsen with activity or prolonged use of the foot.

  • Mild swelling may develop around the tendon, especially around the medial malleolus or the inner aspect of the ankle.

  • Weakness or difficulty performing movements that require the inversion of the foot

  • Flattening of the Arch

  • Pain with Weight-bearing Activities

  • Decreased foot flexibility

Plantar fasciopathy

Plantar fasciopathy, commonly known as plantar fasciitis, refers to the condition where the plantar fascia—a thick band of tissue that runs along the bottom of the foot from the heel to the toes—becomes inflamed or degenerative due to overuse, stress, or injury. This condition is one of the most common causes of heel pain and typically affects individuals who engage in activities that involve prolonged standing, walking, or running.

Plantar fasciitis symptoms:

  • Heel pain that is typically most intense first thing in the morning when getting out of bed or after periods of rest. This is known as "start-up pain" and occurs because the fascia tightens overnight, and the first steps cause it to stretch.

  • While pain is usually worse first thing in the morning, it can also worsen after prolonged activity, such as running, standing, or walking for long periods.

  • Pain with Prolonged Standing:

  • Tenderness and Swelling around the heel:

  • Pain Radiating to the Arch:

  • Decreased Range of Motion in the foot:

Mortons neuroma

Morton’s neuroma is a benign (non-cancerous) growth or thickening of the tissue around one of the nerves leading to the toes, most commonly between the third and fourth toes. This condition results in pain, discomfort, or a sensation of numbness or tingling in the forefoot, often described as walking on a stone or having a pebble in the shoe. It occurs as a result of nerve compression or irritation, leading to inflammation and thickening of the nerve sheath.

Morton’s neuroma symptoms:

  • The most common symptoms of Morton’s neuroma involve pain and discomfort in the ball of the foot, typically between the third and fourth toes.

  • Pain in the Forefoot:

  • Sensation of a Lump or Pebble in the Shoe:

  • Numbness or Tingling in the toes:

  • Pain that Worsens with Activity:

  • Pain Relief with Rest

Stress fracture

A foot stress fracture is a small, hairline crack or break in one of the bones of the foot, often caused by repetitive stress or overuse. These types of fractures are typically non-traumatic, meaning they develop over time rather than from a single traumatic event, and they are more common in athletes or individuals who engage in activities that involve repetitive impact, such as running, jumping, or dancing.

Common sites in the foot at risk of stress fracture:

  • The second metatarsal (very common for runners)

  • Navicular Bone (can be associated with complications such as avascular necrosis)

  • Calcaneus (less common):

  • Sesamoid Bones.

Stress fracture symptoms:

  • Pain: The pain usually starts as a dull ache and gradually worsens with activity.

  • Swelling: There may be swelling around the affected bone, which can worsen with activity and reduce with rest.

  • Tenderness: The affected area may be tender to touch, and the pain is often focused over the site of the stress fracture.

  • Bruising: In some cases, bruising may occur around the fracture site, although this is less common than with more acute fractures.

  • Pain with specific movements: Certain movements, such as pressing on the bone or pushing off the ground (in the case of metatarsal stress fractures), may exacerbate the pain.

  • Pain that worsens over time: If untreated, the pain may persist or worsen, making it difficult to perform daily activities or continue exercise.