Henry C. Hilario, DPM 

Frank Aviles Jr., PT, CWS, FACCWS, CLT-LANA, ALM, AWCC, DAPWCA

June 2018

The feet are the foundation of the human body. They provide support, locomotion, and balance. Unlike the foundation of a house, our feet must provide us with static support — for when we are upright and stationary — as well as dynamic support — for when we are active. Much like a home’s foundation, however, if something is not correct or is distorted within the body’s framework, problems will migrate while becoming more noticeable and severe over time. This article will discuss the anatomy of the foot, the intricacies of gait, and the impact that foot deformity and diabetes have on foot biomechanics and overall health. Treatment strategies and methods of pain relief will also be shared.

ANATOMY OF THE FOOT & FOOT DEFORMITY 

As a baseline, understanding the anatomy and function of the foot is imperative, as is knowing how the shape and function of the foot is altered by deformity and disease (Figure 1). One of the most complex structures on the body, the foot has many moving parts, including 26 bones; 33 joints; and more than 100 muscles, tendons, and ligaments. A network of blood vessels is also present. Anatomically speaking, the foot can be divided into the following sections: 

What is an ingrown toenail?

An ingrown toenail occurs when the nail edge is damaged, and the nail no longer fits properly into the side groove. The nail curls downward and digs into the skin, causing pain, swelling, redness, and drainage. Sometimes a piece of nail (called a lateral pointing spicule) becomes embedded in the side tissue, and the tissue becomes heaped up (hypertrophied).

What causes an ingrown toenail?

There are many causes for ingrown nails, but the two most common causes are poorly fitting shoes and improperly trimmed nails. Tight shoes compress the side of the nail and alter the fit of the nail in the groove. When nails are peeled off or torn, the edge of the nail can extend down into the corner of the nail groove. A torn nail can irritate the skin next to the nail, producing inflammation (swelling, pain, and redness) and sometimes infection.

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At Propel Physiotherapy, we often recommend our clients try shockwave therapy for plantar fasciitis. Due to its low-intensity nature, treatment can be observed with little, to no, side effects.

Shockwave Therapy is a non-invasive therapeutic device that works by delivering acoustic waves to the site of injury. The machine uses kinetic energy to reach the target area via a small applicator at the head of the SWT handle. This energy penetrates the skin sending a radial wave as deep as 7 centimetres into the body, with the highest pressure felt at the surface of the body.

Fractures are not all the same, and neither are their treatments. A broken toe, for example, can be much simpler to treat than a compressed vertebrae or shattered leg. Sometimes, caring for a fracture requires more than a splint or cast. 

What kind of treatment your fracture needs depends on the type of injury you've sustained. But first — what is a fracture?

What is a ligament injury?

A ligament is a band of tough, flexible fibrous connective tissue which connects two bones or cartilages, or holds a joint together. When overstretched, tearing can occur in the ligaments.

One of the most commonly affected joints for torn ligaments is the knee, and there are three types of ligaments around the knee which may be injured.

The anterior cruciate ligament (ACL) is one of the major stabilizing ligaments in the knee. It is a strong rope-like structure located in the centre of the knee, running from the femur to the tibia. When this ligament tears unfortunately it doesn’t heal and often leads to the feeling of instability in the knee.

The posterior cruciate ligament (PCL), situated in the back of the knee, is another ligament that connects the femur to the tibia. The PCL’s job is to keep the tibia from moving backwards too far.

Collateral ligaments are located at the sides of the knee, with the medial (inside) collateral ligament (MCL) connecting the femur to the tibia while the lateral (outside) collateral ligament (LCL) connects the femur to the fibula. These ligaments control the sideways movement of the knee joint.

What causes ligament injury?

Ligament injuries may be caused by twisting or landing awkwardly, and they are most common when the ligaments around a joint are stretched fully, causing them to tear away from the bone.

A ligament is a tough band of fibrous tissue that connects bone to bone or bone to cartilage. While ligaments are extremely strong, they can be stretched or even torn, resulting in different grades of sprains.

A ligament tear usually occurs due to extreme force to a joint such as with a fall or another high-impact event. Common ligament tears are to the ankle, knee, wrist, thumb, neck, or back ligaments.

Ligament injuries in the knee -- such as an anterior cruciate ligament (ACL) -- can put you on the sidelines -- fast. They hurt a lot and may limit what you can do.

But more often than not, a comeback may still be possible. Treatment is more successful than it once was.

Ligaments are tough bands of tissue that connect the bones in your body. There are four ligaments in the knee that are prone to injury: