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Midfoot Pain

Innovation Podiatry  >  Conditions  >  Midfoot Pain

Common midfoot pain conditions, symptoms and treatments are outlined below.

Osteoarthritis (OA) (click to open/close)

Overview

Osteoarthritis in the foot can be very painful and disabling. It’s often neglected when it comes to clinical trials and medical funding. However, recent studies show medial mid-foot OA (affecting the big toe side of your foot) to be far more common than previously thought, with prevalence in the older population at 88% and 7.8% in the younger community.

It causes pain in the mid-foot and arch, particularly during the propulsive phase of walking, and may continue into the night and disturb your sleep. As well as pain, you may notice changes to foot shape, foot position, and increased callus due to higher plantar pressures. Intermittent swelling may also occur.

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Often, patients are told nothing can be done to treat Osteoarthritis. However, there is a range of therapies that can help reduce pain and improve mobility. These include joint mobilisation, strapping, footwear advice, western medical acupuncture and foot orthotics with design features to support the joints and stabilise the heel.

To read more about osteoarthritis click here 

Top of foot pain/Dorsal Midfoot Interosseous Compression Syndrome

Overview

This condition causes significant and consistent pain in the top of the foot (dorsal surface) during weight-bearing activity. Repetitive trauma at the surface of the dorsal mid-foot joints results in inflammation in the capsular ligaments. Barefoot or low-heeled shoes may exacerbate the pain, while shoes with a slightly higher heel may reduce symptoms.

If you are a runner who prefers to forefoot strike and/or run in minimalist footwear, you may find that you are more prone to ‘top of foot pain’ as the dorsiflexion movements of the forefoot on the rear-foot are increased.

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Treatment involves reducing the inflammation (Ice therapy, anti-inflammatories) and eliminating the biomechanical factors causing the increased compression forces. This can involve stretching exercises, mobilisation, dry needling, footwear advice, heel lifts and/or foot orthotics.

For runners, reviewing running techniques and training load – whether temporarily or permanently – may be beneficial, as may the above-mentioned therapies.

Flat Feet

Overview

Flat feet, or over pronation, is a common biomechanical problem that occurs in the walking process when a person’s arch collapses upon weight bearing. Pronation refers specifically to the natural inward flexing motion of the arch and ankle. Running, walking and standing cause the ankle joint to pronate which helps the body to absorb shock and control balance. This motion can cause extreme stress or inflammation of the plantar fascia, possibly causing severe discomfort and leading to other foot problems.

There are many causes of flat feet, including:

  • Obesity
  • Pregnancy
  • Tendon dysfunction
  • Genetics
  • Repetitive pounding on hard surfaces.

People with flat feet often do not experience discomfort immediately and some never suffer any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Treatment for flat feet includes:

  • Custom made foot orthotics
  • Over-the-counter orthotics
  • Arch support and/or
  • Medial rearfoot posting
  • Supportive footwear with a firm heel counter.
Lisfranc Joint Injury

Overview

The Lisfranc joint is part of the transverse and longitudinal arch and the ligament spans from the medial cuneiform to the base of the second metatarsal. When this is injured it is classified as either stable or unstable. This can occur from a fall from a height, a motor vehicle accident or a direct crush or twist like in netball or other competitive sports. When you have this, the top of your foot will appear swollen and the bottom of your foot, often under your arch will be bruised and you will find walking painful on the effected foot as the foot rolls in.

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Although the occurrence of these injuries is not common, when they do occur, they are associated with high levels or morbidity and require urgent treatment. The treatment is to stabilise this joint and initially, you will be advised to not put weight through the effected foot for several weeks and apply ice and take over the counter pain medication. Once the injury has been rested, you will progressively commence weight bearing. Long term treatment of this condition includes footwear recommendation and functional foot orthoses. Your podiatrist will continue to rehabilitate you with working on range of motion, balance and load bearing.

Sometimes this injury will require surgery to stabilise it, and if so your podiatrist will work closely with orthopedic surgeons to ensure that a quality outcome is achieved with the multidisciplinary team.

The process for rehabilitation of a Lisfranc injury is a long one and outcomes vary.

Plantar Fibromas

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Instep Fasciitis and Fascial Tear

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Charcot Neuroarthropathy of the Midfoot

Overview

Click Here

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

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Avulsion Fracture of the 5th Metatarsal

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Kohler's Disease

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Accessory Navicular

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Navicular Stress Fracture

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Tarsal Coalition

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

Cuboid Syndrome

Overview

Coming Soon

To diagnose this condition and identify the painful structure and likely causative factors, we will conduct an in-depth assessment, including:

  • Thorough history
  • Strength and range of motion testing
  • Biomechanical and gait assessment
  • Evaluation of work, leisure activities and training programs that may exacerbate the condition
  • Evaluation of footwear
  • Referral for appropriate imaging (x-ray, ultrasound, MRI, CT etc.).

Treatment

Coming soon

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