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Feet / Toes

Wednesday, 01 February 2017 11:12

Sever’s Disease

in Feet / Toes

What is Sever’s Disease?

Sever’s disease is a condition that causes pain in the heel of children and adolescents. While it can be quite painful, it is a self-limiting condition that doesn’t usually cause any long-term problems. Sever’s disease is quite common and is actually the leading cause of heel pain in children and young adolescents. Also known as calcaneal apophysitis, Sever’s disease involves overload of the growth plate of the heel. A growth plate is the area of bone where bone is produced in the growing skeleton, and is often weaker than other bony areas. Repeated or excessive stress on this area can cause it to become and inflamed and painful.

What are the symptoms?

Children might complain of heel pain that is worse when walking, running or jumping. This may be present following an increase in activity or after a growth spurt. Pain may also be felt when walking on heels.

Wednesday, 29 June 2016 12:41

Plantar Fasciopathy

in Feet / Toes

Plantar fasciopathy is the most common cause of pain at the rear of the foot. The plantar fascia is a fibrous tissue that originates on the heel bone and inserts into the toes, helping to provide stability and support to the arches of the foot.

Plantar fasciopathy is the breakdown of the tissues of the plantar fascia, usually in the area that attaches to the heel. The cells within the tissue become disarrayed, changing the direction of pull and weakening the tendon, which can eventually lead to micro-tearing of the fascia.


Plantar Fasciopathy is characterised by gradual onset of pain at the base of the heel. The pain may be worse in the morning and eases throughout the day. Aggravating activities include standing, being inactive; stretching the foot, and the area will be painful to touch. In the early stages, activities such as running

or dancing may ease the pain and only be painful afterwards, however as the condition develops further, pain may also be felt during exercise.



This condition usually develops slowly over time. Sudden heel pain following a traumatic incident is not usually classified as plantar fasciopathy. Poor foot biomechanics, such as over pronation or supination (a kind of twisting movement within the foot) during walking or running places stress through the tendon. If this continues over time, the tendon begins to break down, causing pain.

Common activities that contribute to plantar fasciopathy include walking with inappropriate or unsupportive footwear, running, and dancing. Other factors that may contribute to plantar fasciopathy are lower limb muscle tightness, leg length discrepancy or muscle imbalance.



There are various strategies your physio can use to assist with pain relief of the foot. Following a thorough examination of the lower limbs, your

physio will decide if you require specific muscle stretching or strengthening. Often there will be a biomechanical abnormality in the gluteal or calf muscles that require attention. Once an exercise program is underway, strapping or orthotics, may be used to support the painful tissue. Generally, a stretching routine for the bottom of the foot will be prescribed, and tissue release using a golf or tennis ball may be added to the exercise regime.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Friday, 26 February 2016 01:59


in Feet / Toes

What is Metatarsalgia?

Metatarsalgia is a medical term used to describe pain that occurs in the ball of the foot. This occurs due to rubbing of the long bones of the foot, called metatarsals, causing inflammation. Build-up of inflammation in the ball of the foot compresses the small nerves that run between the toes and along the foot. Inflammation and compression of these small nerves is painful.

The pain can involve one or more joints of the foot including the big toe, second toe and third toe. It is unlikely to include the fourth or fifth joints. On occasion, the pain may involve the entire foot, or larger parts of the foot.

The pain or symptoms may be made worse when bearing weight through the foot, such as walking or running. In severe cases, just standing or even wearing tight footwear can affect the foot.

How does it happen?

Metatarsalgia can be caused by a number of things. An abrupt change in posturing of the lower back or pelvis may alter the way the foot is loaded, and cause rubbing of the long bones. Altered loading of the foot may also be caused arthritic conditions that affect the knees, hips or pelvis and carrying extra weight.

Unavoidable factors, which may lead to the development of metatarsalgia, include increased age, and the physical shape of the foot and toe. As your body ages, the ligaments of the foot may loosen or weaken. Therefore, the bones of the foot move differently leading to altered positioning and loading of the foot.

Avoidable factors, which may lead to the development of metatarsalgia, include wearing inappropriately fitting footwear, and the type of exercise performed. Metatarsalgia is more highly associated with high impact-type exercise such as running or gymnastics.

What are the signs and symptoms of Metatarsalgia?

The signs and symptoms of metatarsalgia may vary from person to person. Generally, a complaint of pain is common. This may range from mild to severe, or may be described as burning or shooting pain in the foot or toes. Another common description is a tingling sensation in the foot or toes.

Typically, symptoms worsen when weight bearing and improve once weight is removed from the foot.

How can Physio help?

Your physio will determine the cause of the metatarsalgia pain and assist you with adapting your posture, or improving the loading pattern of your foot. You may be advised to unload the foot by reducing or stopping exercise, changing the shoe you wear, or strengthening certain muscles in your legs.

Electrotherapeutic modalities such as icing, ultrasound or interferential therapy may be of assistance to reduce pain and inflammation in the beginning stages of treatment as well.