An orthotic device is a pad or insert placed in a shoe that helps shape the way a person walks. These can be purchased over the counter or custom made to treat a variety of disorders of the foot and ankle. Orthotics can help align and support the foot and ankle, prevent or correct deformities, and improve overall function.

Fractures (broken bones) occur when bone is not strong enough to sustain the force exerted on it. Because the ankle and foot support the body during most day-to-day activities, and because the foot in particular contains very small bones, fractures in these areas are common. The four most frequent types of fractures are complete, incomplete, compound and simple. In a complete fracture the bone breaks all the way through into two or more parts, while in an incomplete fracture it does not break all the way through. A compound fracture occurs when the bone breaks through the skin, and a simple fracture happens when there is no open wound.

There are a variety of treatments for fractures based on their severity. Following diagnosis, treatment can involve rest, cold therapy, compression and elevation, as well as immobilization using casts or splints and prescription pain and anti-inflammatory medications. For some fractures, surgery may be needed to repair the broken bones along with other injuries like soft-tissue damage.

Chronic wounds of the foot and ankle can stem from infection, traumatic injury, obesity, diabetes, immobilization and many other conditions. When such wounds don't heal by themselves and continue to cause pain, redness, swelling and tenderness, advanced wound care management typically is required. The treatment of chronic wounds can entail specific bandaging techniques, more frequent changing of dressings, and surgical debridement. Debridement, often performed on an outpatient basis, involves the removal of dead or unhealthy tissue from a wound to expedite healing.

EPAT is the application of pressure in waves that generate a vascular response from the foot to stimulate and reactivate the body's natural repair mechanisms. This procedure is noninvasive and can be used to treat a wide range of musculoskeletal ailments providing anti-inflammatory pain relief. EPAT promotes the regeneration of soft tissue and bone with improvements in blood supply.

These minimally invasive surgical procedures are used to examine and repair damage to the ankle joint, and other structures in the foot. In arthroscopy a surgical tool called an arthroscope, a soft fiberoptic tube with a camera on the end, is inserted through a small incision. The arthroscope allows the physician to view the damaged structures to repair the injury without having to completely expose the tissue. Laser surgery uses heated beams to remove damaged or out of place tissue with extreme precision.

Tendons and ligaments, called connective tissues, are made of collagen fibers that provide strength and stability to a joint. Torn or damaged tendons and ligaments can be repaired surgically. A surgeon can use sutures to connect the ends of torn connective tissues. When the tissue is too damaged and cannot be repaired with sutures a graft may be used to replace the injured tendon or ligament.

Unloader braces are used to reduce the amount of pressure or stress that is enacted on the damaged part of a joint. Most braces of this type are used with patients who are not ready to undergo surgery due to extenuating factors, or who have recently undergone surgery and require extra support. These braces provide stability when moving and can be used for walking, standing, or during physical therapy exercises. Most unloader braces are hinged to provide the best support by distributing the force placed on a joint.

Fractures that do not require surgery for realignment can be stabilized and held in place by a cast. Most casts consist of a soft cotton interior encased in a hard outer shell that protects the damaged limb from outside forces.

Surgical procedures can be used to treat bunions, to relief pain and improve function. These procedures require removing bony growths and realigning the toe. Wide or loose fitting footwear can reduce the changes of surgical failure. Most surgeries are successful at relieving pain.

Joints are located throughout the body at the ends of two or more bones. Joints connect these bones with tendons, ligaments, and cartilage to enable the body to move. Joints can be damaged by wear from age or overuse, or by the various forms of arthritis. Joints that are severely damaged may need to be replaced to enable the patient to sustain their ability to move. The shoulder, hip, and knee joints are most commonly replaced.

This cutting edge treatment utilizes targeted near infrared beams to destroy fungus in a nail to remove presistant infections. This treatment is highly advanced and can remove fungus quickly and painlessly.

This condition occurs when the arch of the foot appears to disappear when the foot is placed on a flat surface, like when standing. Most children outgrow flexible flatfoot without problems, because the foot retains strong muscle function and mobility. If flexible flatfoot continues into adolescence pain and discomfort can develop along the bottom of the foot. The tendons in the foot can also become rigid, causing the condition to develop into rigid flatfoot. In these instances treatment would be necessary to alleviate pain.

Symptoms

• Feet that appear flat with no arch
• Discomfort
• Pain during physical activities
• Fatigue of the leg and foot

Treatment

• Stretching
• Exercise
• Orthotic devices

If flexible flatfoot continues into adolescence it can develop into painful progressive flatfoot. Pain and discomfort typically occur along the bottom of the foot. The tendons in the foot can also become rigid, causing the foot to become stiff and difficult to move of flex. This condition would begin to interfere in everyday activities, and would require treatment.

Symptoms

• Feet that appear flat with no arch
• Discomfort
• Pain during physical activities
• Fatigue of the leg and foot

Treatment

• Stretching
• Exercise
• Orthotic devices
• Physical therapy
• Casting
• Surgery

A tarsal coalition occurs when an abnormal connection develops between the tarsal bones, which are located in the back of the foot. The connection is typically composed of bone, cartilage, or fibrous tissue and leads to lack of mobility and pain in the affected foot. This condition usually occurs during fetal development, when the bones do not form properly.

Symptoms

• Pain when walking or standing
• Tired or fatigued legs
• Muscle spasms in the leg
• Flatfoot
• Limping
• Stiffness and difficulty walking

Treatment

• Anti-inflammatory medication
• Physical therapy
• Steroid injections
• Orthotic devices
• Surgery

Cavus foot is a condition where the arches in the foot are significantly higher than a normal arch. This causes the heel to point inward and the toes to flex. Children with this condition typically develop it slowly from the time they begin to walk until 10 years old. Most often this condition occurs in conjunction with another musculoskeletal or nervous system disorder.

Symptoms

• Visibly high arch
• Pain in the top and middle of the foot
• Calluses
• Ankle pain
• Bent toes

Treatment

• Surgery
• Arch supports
• Orthotic devices

A Heel spur is a bonelike growth that originates from the heal bone of the foot. High levels of stress to the heel bone cause the body to calcify the soft tissue in the heel. This condition is common in older athletes who run a significant amount.

Symptoms

• Pain in the heel
• Inflammation of the heel
• Tenderness throughout the heel

Treatment

• Heat and elevation to alleviate the pain
• Foam pad in heel of shoe
• Ultrasound and whirlpool therapy
• Taping of the foot
• Stretching the affected area
• Surgery to remove the growth

Plantar Fasciitis is the inflammation of a band of tissue that connects the heel bone to the toes. Inflammation originates from tightening of the Plantar Fascia, which will tear instead of flexing as the foot moves. Complications with the knees, hip, or back are common because inflammation changes the athletes walking motion, stressing other joints. Pain is common after exercise, when getting out of bed, or after rising from periods of inactivity.

Symptoms

• Sharp pain in heel or foot
• Heightened pain after waking
• Pain after sitting or standing for prolonged periods of time

Treatment

• Rest & Ice
• Keep weight off the foot until the pain and inflammation subsides
• Avoiding running, jumping, or walking without any support or cushioning
• Use of Orthotics
• Anti-inflammatory medication when necessary
• Stretching exercise

Shin splints are caused by inflammation of the periostium of the tibia. Common in athletes whose sports involve a lot of running, the force of the lower leg muscles causes friction on the periostium resulting in inflammation and sharp shin pain.

Symptoms

• Pain on the inside of the shin
• Pain that eases as exercise is continued
• Pain when toes or foot are bent downwards
• Lumps or bumps may be felt when feeling the inside of the shin bone

Treatment

• Rest and ice the area of the injury
• Applying heat prior to exercise will reduce pain
• Wearing proper footwear
• Anti-inflammatory medications
• Physical therapy

A bunion occurs when the big toe bends inward toward the other toes. This causes a bony growth, and the collection of fluid to develop on the edge of the big toe. Bunions can be caused by abnormal bone development, or by wearing shoes that are too narrow or high.

Symptoms

• Red, calloused skin on the toe
• A visible bony bump on the toe
• Pain in the joint
• Big toe visibly turns toward the other toes

Treatment

• Wear wide-toed shoes
• Surgery to realign the toe
• Surgery to remove the bony growth

Achilles tendonitis occurs due to overuse of the Achilles tendon. Acute Achilles tendonitis can happen when an athlete suddenly increases his or her training. This type of tendonitis normally fades with rest, but can become chronic Achilles tendonitis if untreated. Chronic Achilles tendonitis can be caused by increased activity, lowered recovery time, new footwear, or weakened calf muscles.

Symptoms

• Pain behind the ankle increasing over time
• Pain at the beginning of exercise but disappearing slowly during the activity
• Achilles tendon is tender to touch

Treatment

• Rest and apply ice to injury
• Anti-inflammatory medication if necessary
• Sports massage or ultrasound

Hallux Rigidus is a disorder of the big toe that creates stiffness and restricts movement. This disorder can be disabling if the activity of the big toe interferes with the ability to walk. Hallux Rigidus affects the joint located at the base of the big toe, through degenerative arthritis that wears away the cartilage in the joint. The condition is progressive, and symptoms will worsen over time.

Symptoms

• Pain and stiffness in the big toe
• Symptoms aggravated by cold or damp conditions
• Difficulty with physical activities
• Swelling and inflammation around the joint
• Pain wearing certain shoes
• Limping

Treatment

• Changes in footwear
• Orthotics
• Anti-inflammatory medication
• Corticosteroid injections
• Physical therapy
• Surgery

Calcaneal Apophysitis usually affects 8-14 year olds. Also known as Sever's disease, this is the most common cause of heel pain in children. This condition is caused inflammation of the growth plate in the heel due to muscle strain and repetitive stress

Symptoms

• Pain and tenderness in the back and bottom of the heel
• Pain when walking
• Heel is tender to the touch
• Limping
• Walking on the toes

Treatment

• Orthotics
• Anti-inflammatory medication
• Corticosteroid injections
• Physical therapy
• Bracing
• Surgery

A neuroma is thickened nerve tissue that develops throughout the body. In the foot, the most common neuroma is a Morton's Neuroma, which is found at the base of the third and fourth toes, on the ball of the foot between the metatarsal bones. Nerve thickening is the result of compression and irritation of the nerves in a specific area.

Symptoms

• A sensation of tingling, burning, or numbness
• Pain at the ball of the foot
• A sensation that something is disturbing the ball of the foot

Treatment

• Ice and rest
• Orthotics
• Change to wider footwear
• Anti-inflammatory medications
• Corticosteroid injections
• Surgery

A hammertoe is the abnormal bending of one or all of the joints in the toes. This bending puts pressure on the toe when wearing shoes that can cause pain and discomfort. This condition is progressive, and over time the toes will become rigid and difficult to flex.

Symptoms

• Pain in the affected toe(s) when wearing shoes
• Corns on the affected toe(s)
• Calluses on the bottom of the toe or ball of the foot

Treatment

• Change footwear for more flexibility
• Orthotics
• Corticosteroid injections
• Anti-inflammatory medications
• Splinting
• Surgery

A fungal infection of the toenails occurs when fungi begin to develop and growth underneath the nail. This can be painful and unsightly. Nail fungal infections can be difficult to treat because these fungi thrive in warm, moist environments like shoes.

Symptoms

• Nails become thick
• Nails are brittle, and ragged
• Nails are distorted in shape
• Nails darken in color

Treatment

• Prescription medication
• Topical medications
• Surgery to remove the nail
• Laser treatment

Often people who suffer from diabetes experience a loss of sensation and feeling in their limbs. This lack of feeling can become a serious problem if pressure builds up, and wounds or ulcers develop and go undetected because the patient does not notice any pain. At times, patients require a limb amputation if these sores have become infected or pressure is restricting blood flow.

Symptoms

• Lack of feeling in the foot
• Sores develop
• Pressure and swelling

Treatment

• Computerized gait and pressure analysis
• Surgery