Foot Health Centre

Achilles Tendinitis

Achilles Tendonitis

The Achilles Tendon is the largest tendon in the body, and is responsible for propelling your entire body weight forward and up during activity. It can take forces up to 12 times body weight during a sprint! This tendon does not have a rich blood supply, so it is more susceptible to injury, causing irritation, in­flammation and leading to pain and swelling. In severe cases, this can result in complete rupture of the tendon.

Symptoms

  • Pain over the back of the heel.
  • Significant pain after periods of inactivity.
  • Pain during activities involving pushing off or jumping.
  • Sensation of “fullness” in the lower leg, or may develop a hard nodule of tissue.

Causes

Achilles Tendinitis most commonly results from a series of stresses causing a chronic condition over time, but can result from a single incident. Some causes include:

  • Foot mechanics: Flat, pronated feet can stretch the Achilles tendon in a “bow and arrow” type manner, while high arched, rigid feet result in a tight Achilles tendon.
  • Muscular Factors: Tight lower leg muscles pull more on the Achilles tendon.
  • Activities: Changes or increases in athletic training, participating in activities involving a negative heel strike (walking or running uphill, hiking, soccer), sudden starting and stopping, and jumping can all contribute to this condition.
  • Footwear: Continuous use of high heels can contribute to a tight Achilles tendon.
  • Individual: Weight gain and increased age also put you at risk for Achilles tendinitis.

Prevention

In order to prevent Achilles tendinitis, try these stretches before engaging in any physical activity:

  • Stretch until a tightness or resistance is felt, then hold.
  • Do not go to the point of pain. Stretching should not be painful.
  • Stretching should be done slowly and with control.
  • Repeat stretches 3 times per leg by taking the stretch a little further and holding.
  • Stretches should be held for a minimum 45 seconds or until resistance is no longer felt.
  • Stretches must be done at least 2 times a day every day to see results.

Whats the next step?

Treatment recommendations:

  • Adequate rest, and icing of the area for 15-20 minutes, allowing at least 45 minutes for the area to warm before icing again (most effective up to 48hrs following injury).
  • Custom foot orthotics work in cases where there is a mechanical cause for the Achilles Tendinitis. Orthotics help alleviate strain on the Achilles from sports and daily activities, and can prevent the condition from recurring.
  • Achilles tendon night splints act to hold the foot in a flexed position overnight, so the tendon is fully stretched and can heal in an uncompromised position.
  • Heel lifts in shoes can help shorten the length of the tendon and ease the pain, but it is important to eventually get the tendon back to full length and range of motion.
  • Anti-inflammatory drugs can help ease the pain and reduce swelling, including topical treatments such as analgesic balms.
  • Physiotherapy and massage therapy can also help with recovery.

For more reading on Achilles tendinitis, read more from Kintec:

Bunions

Bunions

The big toe of the foot is called the Hallux. When the Hallux begins to deviate inward in the direction of the baby toe, this condition is called “Hallux Valgus”. As the toe moves more in this direction, a bony prominence starts to develop on the outside of the big toe, over the metatarsal bone. This is called a Bunion.

Tight-fitting footwear like high-heels and narrow-toed shoes can often increase the risk of bunion formation. Excessive pronating or rolling inwards of the ankles may also be factors causing bunions.

Symptoms and Causes

Symptoms can start with pain at the joint at the base of the big toe when wearing certain shoes. This can be accompanied by redness, tenderness or swelling and eventually the big toe begins to change shape, curving inwards and restricting joint motion.

  • Foot Mechanics: A foot that over pronates, or rolls inward has a greater chance of developing Hallux Valgus as the foot creates an imbalance between the muscles and tendons around the big toe joint.
  • Muscle Factors: Rigid or tight intrinsic toe muscles and tendons can lead to a compromised gait, putting more pressure on the outside area of the big toe as you push off.
  • Footwear: Shoes that are too narrow can put excessive pressure on the big toe area, and the forward tilting effect of high heels can as well.
  • Individual: Although bunions are not necessarily hereditary, genetics can make you more susceptible to developing bunions. It is not inevitable however, as it is the foot type, not the bunion that is inherited and measures are available to prevent bunion formation.

Treatment

Treatment depends on the degree of deformity. The only way to actually remove a bunion is through surgery. However, there are other non-invasive methods to correcting, managing, and preventing bunions:

  • For relief of pain, bunion cushions and shields are sometimes effective.
  • Wearing shoes with a wide and deep toe box allows room for the bunion, easing pressure on it.
  • Custom-made orthotics can redistribute pressure, relieving the bunion as well as stopping it from progressing. At Kintec, we have a variety of custom orthotics created for your specific biomechanical and activity needs.
  • Hallux Valgus night splints are also an over the counter option, as they stretch tight tendons and intrinsic toe muscles overnight, sometimes resulting in the correction of Hallux Valgus.
  • Toe separators can by worn during the day and at night to stretch the intrinsic muscles of the big toe to relieve pressure on the bunion.
  • Stretching exercises to reduce tension and swelling on the joint of a bunion.
  • Corticosteroid injection or consumption of anti-inflammatory drugs can used to help relieve swelling and pain.
  • Bunion Surgery for those whose bunions cause consistent pain or discomfort.

Prevention

Bunions can be prevented by avoiding poor-fitting shoes with narrow toe boxes.

Whats the next step?

If the bunion:

  • Continues to cause pain even after home care treatments
  • Prevents you from doing routine activities
  • Shows signs of infection like redness or swelling

Doctors will typically base their diagnosis on symptoms and findings from special tests. X-rays are often taken to determine the integrity of the joints in the foot and to test for arthritis.

For more reading on bunions, read more from Kintec:

Diabetic Foot Care

Diabetic Foot Ulcer

Diabetes causes your blood sugar levels to be unstable and can be higher or lower than normal. Over time, high blood sugar levels can damage the blood vessels and nerves in your body. Damage to your nerves means that you may have burning pain or lose feeling in a part of your body. This is often referred to as Diabetic Neuropathy Damage to the blood vessels in your feet, and means that your feet may not be getting a proper blood supply.

People with diabetes have to be very careful with their feet, because decreased circulation and other diabetic conditions could affect overall health of the foot. Diabetes affects the immune and circulation systems. This weakens the body’s capacity to heal itself. Diabetes can also injure sensory nerves in the foot. The risk of developing a large range of foot-related problems can increase with nerve damage and poor circulation.

Prevention & Treatment

Diabetic Socks – The first line of protection for your feet is a sock that is specifically designed for the unique needs of people with diabetes. These socks have these key features:

  • Seamless, constriction-free design prevents the friction and irritation that can cause a blister or sore
  • Moisture management system that wicks away excess moisture because moisture can act as a breeding ground for infection-causing bacteria

A Human Kinetic Specialist at Kintec Footlabs can help you to find the best sock to meet your needs. These diabetic socks help reduce foot and leg swelling by increasing blood flow. This non-constricting sock promotes circulation and alleviates muscle fatigue, helping you feel revitalized and energetic throughout the day.

Proper Footwear

  • Have your shoes fitted properly by a trained specialist such as a Canadian Certified Pedorthist.
  • Key features for diabetic footwear include soft uppers with minimal seams, deep and wide toe boxes to reduce abnormal pressure, firm but cushioned soles, removable insoles, a strong heel counter, and a rockered sole.
  • Lace up shoes offer a versatile fit and should be used if possible or alternatively use Velcro closures if tying laces is difficult.
  • Avoid slip-on and restrictive footwear such as high heels with pointed toes or shoes that are narrow in style as they depend on a tight fit to stay on the foot.

Orthotics for Diabetes – Uniform and improved pressure distribution is paramount to avoiding injury to the diabetic foot.

Soft, full contact orthotics are required to provide optimal pressure distribution.

Kintec’s F-Scan system can pick up subtle pressure points between the foot and shoe or insole that the practitioner cannot otherwise see. Find our more about Kintec’s orthotics.

Foot Complications – For those with diabetes, small foot problems, when left untreated, can turn into serious problems or infections that could lead to amputation. It is important to monitor for the following foot complications:

  • Ulcers
  • Corns
  • Bunions
  • Dry skin, cracked heels
  • Calluses
  • Hammertoes
  • Blisters
  • Ingrown toenails

Footcare Tips

  • Don’t wear shoes without socks.
  • Don’t wear sandals or other open-toed shoes.
  • Avoid high-heeled shoes and shoes with pointed toes.
  • Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores. 
  • Wash your feet in lukewarm water. Keep your feet clean by washing them daily using a soft washcloth or sponge.
  • Moisturize your feet. Use a lotion/cream daily to keep dry skin from cracking or itching
  • Cut nails carefully. Don’t cut nails too short. This could lead to development of ingrown toe nails. If you have neuropathy or circulation problems, get a foot-care nurse to cut them for you.
  • Wear clean, dry socks. Change them daily. Avoid tight elastic bands that reduce circulation in the foot.
  • Never walk barefoot. Always wear shoes or slippers to avoid getting a scratch or cut.
  • Take care of your diabetes. Keep your blood sugar levels under control.
  • Get periodic foot exams. Ask your doctor to inspect your feet at every diabetes-related visit. In addition, ask to be screened for neuropathy and loss of circulation at least once a year.

Consult a Doctor if:

  • If you have swelling, redness or pain in your legs and/or feet.
  • If you have any corns, calluses, in-grown toenails, warts or slivers, it is important to let a health care professional treat these conditions. Never attempt to treat them yourself.
  • Patients with diabetes should see their doctors regularly to monitor their ongoing treatment program and the advancement of the disease.

For more reading on Diabetes, read more from Kintec:

Foot Arthritis

Arthritis

Arthritis is a condition that can occur at any age. Arthritis means “pain within a joint.” There are 28 bones and more than 30 joints in the foot. Ligaments are what keep the bones and joints in place. Should arthritis develop in one or more of these joints, simple tasks like walking and balancing may become difficult and very painful.

Symptoms

Depending on the joints affected, the signs and symptoms of arthritis of the foot will vary. Common symptoms include tenderness, restricted motion, swelling, foot deformities, and soreness in the soles and heels of the feet when walking.

Treatment

There are several different types of treatment for treating pain that arthritis may cause. The treatment may depend on the location, type and degree of pain that arthritis may cause in the foot.

  • Medication to help reduce the swelling (ie: pain killers and anti-inflammatory drugs)
  • Custom orthotics specifically designed for those with Arthritis. These orthotics offer balance between support and cushioning to provide maximum comfort. Find out more about Kintec’s orthotics.
  • Shoes with shock-absorbing rubber soles and supportive heels and soles.
  • Custom Shoes for Arthritis. Some helpful features include: stiff soles, rocker bottom, and spacious toe boxes to accommodate swollen toes.
  • Physiotherapy and exercises are one of the best ways to reduce symptoms and improve the range of motion in the joints.
  • Icing your feet will help reduce the swelling and helps to maintain and improve range of motion.
  • Weight control
  • Surgery if arthritis does not respond to non-surgical treatments or home care

What’s the next step?

See a doctor and based on your medical history, symptoms, and examination results, he/she can prescribe the proper treatment for you and the arthritis pain in your feet.

For more reading on Arthritis, read more from Kintec:

Forefoot Pain

Forefoot Pain

Metatarsalgia (forefoot pain) is a general term for pain felt at the ball of the foot. A Neuroma is inflammation or enlargement of the sheath surrounding the nerve. Neuromas can occur along any nerve but usually appear at the ball of the foot in between the 3rd and 4th toes.

Symptoms

Metatarsalgia pain usually appears as a dull ache or burning sensation around the ball of the foot. Neuromas can cause numbness or tingling in the toes, or sharp electric-like shocks that shoot up into the leg or down into the toes. The pain usually increases with prolonged standing, walking or running, and subsides when the shoes are removed from the feet. People suffering from metatarsalgia also tend to have clawing or hammering of the toes.

Causes

Foot Mechanics: Normal feet have an arch across the ball of the foot called the metatarsal (or transverse) arch. When this arch falls it places additional pressure on the middle three bones. This fallen arch can also cause these bones to be squeezed together, pinching the soft tissues (nerves and tendons) that are in between and surrounding the bones.

Footwear: Footwear plays an important role. High-heeled shoes place additional weight on the ball of the foot and narrow pointed shoes squeeze the toes together. Footwear like this aggravates these conditions and should be avoided.

Rigid High Arch Feet: This places excessive pressure on the balls of the feet. This foot type can be prone to metatarsalgia and neuroma.

Flexible Flat Feet: With flexible flat feet as the arch of your foot falls, the foot lengthens. This causes excess shearing forces underneath and between the metatarsal bones. This foot type can be prone to metatarsalgia and neuroma.

Individual and Muscular Factors: As we age, much of the protective fat pad under the ball of the foot is lost. Weak foot muscles can cause the transverse (metatarsal) arch to collapse. Tight calf muscles promote early heel lift during walking. This places more stress on your forefoot. Weight gain also increases the stress on the ball of the foot.

Activities & Training Methods

In some sports, athletes are made to spend additional time on the balls of their feet. Ballerinas and sprinters are particularly susceptible, as are football players as they crouch on the line of scrimmage.

Treatment

Early treatment is essential. You should combine as many treatments as possible to obtain the best results. If poor foot function is involved, then long-term treatment is generally aimed at reducing the pressure on the forefoot and supporting the metatarsal arch. In the event of a severe neuroma, surgery may be required. It is usually done only as a last resort.

Medication

Such as anti-inflammatories (NSAID) may be prescribed by your doctor to reduce the pain and inflammation.

Proper Footwear

Proper footwear eliminate high heels and narrow pointed toed shoes. Look for lower, wider fitting shoes that stretch easily to relieve pressure across the ball of the foot. Shoes that offer increased cushioning will help to protect your feet.

Metatarsal Pads

These pads can be placed in your shoes to re-establish the transverse arch. They can improve the alignment and help to relieve pressure on the nerves and soft tissues.

Custom Foot Orthotics

Orthotics play an important role when the cause of the pain is the result of poor foot function. They help to support and align your foot in a mechanically correct position and alleviate stress on the metatarsal heads and joints. This helps to protect your foot from damage caused by simple daily activity. Frequently, metatarsal pads are placed directly into the orthotic.

Physiotherapy

Can also help reduce the pain and inflammation. Specific exercises may be prescribed to help strengthen any weak foot muscles.

Prevention

Early recognition and treatment can prevent the condition from progressing. If you are experiencing pain, consult your physician. They may refer you for a biomechanical assessment of your feet to start conservative treatment early.

For more reading on forefoot pain, read more from Kintec:

Patellofemoral Syndrome

Patellofemoral Syndrome

Also called Chondromalacia Patellae or Runner’s Knee—is the inflammation of the cartilage of the kneecap (patella), which prevents it from gliding smoothly within the femoral groove, found at the end of your thighbone (femur). When inflamed, the now softened cartilage of the patella doesn’t track properly in this groove, causing a roughening of the patella’s under surface and discomfort in the knee.

Symptoms

The most common symptoms of Runner’s Knee are pain un­der and around the kneecap. It may be a sharp pain or dull ache made worse by kneeling down, by walking down stairs, by prolonged sitting, and/or during sporting activities that require squats or deep knee bends. Cracking or clicking sensations around the knee­cap may also be experienced.

Causes

  • Foot Mechanics: Excessive rolling-in (over-pronation) of the feet can cause the lower leg to rotate inward (tibial torsion), thus placing the knee in a compromised position.
  • Muscular Factors: Weak inner thigh muscles and tight hip, thigh and‑calf muscles can all contribute to Patel­lofemoral Syndrome.
  • Skeletal Factors: Asymmetrical kneecaps, knock knees, and a large Q-angle (wide hips) can contribute to Runner’s Knee. For this reason, women are more susceptible to this injury.
  • Training Methods: Training too much too soon and over­use are key causal factors. Excessive mileage and uphill / downhill running also increase your risk.
  • Trauma: Repeated or direct stress on your knee, as well as a history of Runner’s Knee, also makes this injury more likely.

Treatment

While there are many effective treatments for Runner’s Knee, you should combine as many treatment options as possible to hasten the healing and recovery process:

  • Rest your knee as much as possible, using pain as your guide. If you feel pain or mild discomfort in your knee then rest is necessary. Switch to activities that avoid plac­ing direct weight on your bent knee, such as swimming.
  • Ice your knee for 15 minutes twice daily and after activ­ity to reduce pain and inflammation. A bag of frozen peas works well.
  • Medication such as aspirin, ibuprofen or other anti-inflammatory drugs may be prescribed by your doctor to reduce inflammation.
  • Custom Foot Orthotics can play an important role in the rehabilitation of Runner’s Knee. By correcting faulty foot mechanics, orthotics improve your lower leg and knee alignment, allowing the muscles around your knee to function properly while reducing soft tissue strain on the knee. At Kintec, we have a variety of custom orthotics created for your specific biomechanical and activity needs.
  • Correct mechanical alignment also increases the effectiveness of strengthening exercises and other physiotherapy activities
  • Proper Footwear should not be overlooked as your feet are the foundation for your body and can affect the functioning of your entire muscular-skeletal system
  • Sport Medicine Products such as patellar stabilizing braces and athletic taping supplies can help to maintain normal patellar tracking.

Prevention

Consult your physiotherapist before starting any therapeutic strengthening and stretching exercise program. For your reference, here are some exer­cises that will help balance the musculature around your knee and help prevent further injury.

IlioTibial Band Stretches: Stand near a wall with the left leg crossed in front of the right. Lean the trunk towards the left and extend the right arm over the head. The goal is to feel a stretch over the right hip and down the outside of the right leg. Hold this stretch for at least 30 seconds. Repeat this on the opposite side and alternate 5 times each session. Perform this routine twice daily for the best results.

Quadriceps Stretch: Using a strap wrapped around the lower leg, bring it up until you feel a gentle stretch down the front of the thigh. Remember to remain standing straight pushing the hips forward. Hold this stretch for 20-30 seconds and repeat on the opposite side. Alternate 5 times per session and perform this routine at least twice a day.

Static Quad Extension: Sit on the floor with a pillow or rolled-up towel under your knee. With your toe pointed towards the midline of your body, push your thigh into the floor and lift your heel off the ground. Hold for five seconds and repeat 15 times per leg. Perform this exercise at least twice daily.

Shallow Squats: Using an exercise ball against a wall, do a controlled squat keeping your knees directly over your feet and in line with your second toe. Repeat 10-20 times per session and perform several times a day. To en­hance the effect of this exercise place a firm nerf ball or pillow between the knees, holding it there while performing the movement

What’s the next step?

Often, doctors will recommend a combination of physiotherapy and proper footwear. Orthotics can also help to ensure proper foot/leg alignment.

For more reading on patellofemoral syndrome, read more from Kintec:

Plantar Fasciitis

Plantar Fasciitis

Plantar fasciitis is the inflammation, fraying and/or tearing of the plantar fascia, resulting from excessive stress/tension on the tendon. The plantar fascia is a thick fibrous band of tissue that originates from the heel and fans across the bottom of the foot in a V-shape. It maintains the shape of the arch in your foot. Plantar Fasciitis is one of the most common causes of foot pain. It is a painful condition that can strike at any age and linger on for quite some time.

Symptoms

Plantar fasciitis is a common foot problem characterized by pain under the heel or arch on one or both of your feet. It starts as a dull ache, which may become more painful if left untreated. Other symptoms include sharp heel or arch pain during your first few steps in the morning, or with increased walking, running and sports activities.

Causes

  • Foot Mechanics: Flat, pronated feet can stretch the plantar fascia, while high, arched and rigid feet naturally possess a tight plantar fascia.
  • Muscular Factors: Tight calf muscles pull more tension on the heel bone, which strains the plantar fascia.
  • Activities: Carrying heavy loads, walking or running on hills, or standing for long periods can all create additional plantar fascia strain.
  • Footwear: High heels, worn-out or improper shoes can excessively stress the plantar fascia.
  • Individual: Weight gain and increasing age also place you at a greater risk.

Treatment

Early treatment is essential. You should combine as many treatments as possible for the quickest, most effective recovery.

  • Medication such as anti-inflammatory pills (NSAID’s) may be prescribed by your Doctor to reduce inflamma­tion. With some long-term plantar fasciitis, cortisone injections can also help.
  • Custom foot orthotics work in cases where there is a mechanical cause for the plantar fasciitis, such as a flat, collapsed foot. Orthotics help alleviate strain on the plantar fascia from sports and daily activities, and can prevent the condition from recurring.
  • Proper footwear with a strong base, a deep heel counter and additional cushioning features help support the arch, cushion impact, and accelerate healing.
  • Rest is extremely important. Use pain as your guide: If your feet hurt while standing or walking, limit the time spent on your feet.
  • Ice the area under the heel and arch several times a day—especially after prolonged standing, walking and activity—to reduce inflammation and enable proper healing.

Suggested medical sports solutions

  • Gel heel cushions can help by absorbing the shock and ease the pressure on the heel. This is especially helpful for those with high arched, rigid feet.
  • Over the counter arch supports may also help in reducing the tension on the planter fascia. Always wear them in pairs.
  • Night splints help the foot heel in a stretched position while you sleep, reducing morning pain.

For more reading on plantar fasciitis, read more from Kintec:

Shin Splints

Shin Splits

Shin Splints can generally be described as pain at the front of the lower leg. The most common cause for the pain is inflammation of the periosteum of the tibia (sheath surrounding the bone).

At first signs, it is a good idea to have your doctor take a look as more serious conditions, such as anterior compartment syndrome can be disguised as shin splints.

Symptoms

  • Tenderness over the inside of the leg
  • Lower leg pain or aching
  • Possibly swelling
  • Lumps and bumps over the bone
  • Pain felt when toes pointed down
  • Redness over the inside of shin

Causes

This condition is usually an overuse or overtraining injury. This can be from either increasing the amount of activity you have been doing, increasing intensity of the training, or increase the frequency of the activity. It is very common to runners, especially when hills are involved. Other factors can lead to shin splints:

Foot Mechanics: Flatter feet that tend to overpronate, or roll inward, place more strain on adjoining muscles, while high arched feet may be very rigid and unable to absorb impact forces easily.

Muscular Factors: Inflexible and tight calf muscles add extra strain on the shins.

Activities: Although the forces involved in running cause it to be a popular source of shin splints, any high impact activity can lead to this condition.

Individual: Running style, such as running on your tip-toes or flat footed, can increase your chances of developing shin splints.

Footwear: Wearing old worn out shoes, shoes without good cushioning, or shoes with the wrong design for your foot mechanics make you more susceptible to shin splints

Treatment

Rest: Use pain as a guide, and add cross-training activities, such as swimming or cycling to give shins a chance to rest while still maintaining your cardiovascular fitness.

Stretching and strengthening calf muscles: Consider starting a weight training program, and stretching daily, especially after activity.

Ice: In the early stages, apply ice if very painful to area for 15-20 min allowing at least 45 min for the area to warm before icing again. Icing is most effective up to 48 hrs following an injury. Never ice before activity.

Heat: Apply heat for 15—20 min after the initial acute period (after 48 hrs), especially before training.

Orthotics: If inflammation and pain is caused by overpronation, custom made orthotics or arch supports can help correct your foot mechanics. Orthotics can also help increase shock absorption for high arched rigid feet. At Kintec, we have a variety of custom orthotics created for your specific biomechanical and activity needs.

Footwear: Making sure you are in well cushioned shoes, or adding a cushioned insole, will help absorb impact forces.

Taping: Some sports taping methods are helpful for taking pressure off the shins.

Sports massage and/or Physio: These methods can reduce recovery time, talk to your doctor before starting any rehabilitation program.

Anti-inflammatory drugs: Combined with rest and ice, these can reduce inflammation but underlying causes (such as muscle tightness or foot mechanics) should be addressed to eliminate a reoccurrence. Consult with your doctor before taking any medication.

For more reading on plantar fasciitis, read more from Kintec: