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Flat Foot

By definition, this is a collapse of the longitudinal foot arch. In general, flat foot is connected with crooked heel (valgus hindfoot), i.e. looking at the foot from behind, the heel leans towards the inside. Bear in mind that in small children, flat foot is a physiological condition, i.e. it is normal. Only at the age of 4-5 is the longitudinal arch developed; therefore, abnormal structure related to the lowering of the longitudinal arch be can only be discussed over this age. Flat foot is generally associated with excessive joint laxity (hypermobility) in the area of the feet only or in the whole osteoarticular system. Flat foot in children can manifest itself through diffuse pain or fatigability in the feet. In adults, pain is localised around the medial malleolus and the lateral malleolus. Flat foot combined with valgus hindfoot may also be the cause of crooked and painful knees.

Transversal Arch Collapse

Foot deformation involving a collapse of the metatarsal. It manifests itself through pain on the sole at the forefoot (just behind the toes), epidermal thickening, calluses and corns.

High Arch / Hollow Foot

Foot with "high instep". The longitudinal arch of the foot is strongly arched, raised upwards. It is often associated with pain on the sole, heel spurs, recurrent inflammation of the Achilles tendon.


Hallux valgus - Bunion

Hallux rigidus - Stiff Big Toe

Degenerative changes of the metatarsophalangeal (MTP) joint of the big toe. It manifests itself mainly through restricted mobility of the big toe, pain, swelling and inflammation in the surrounding area. In more advanced stages, deformation can be seen around the MTP joint.

Hammertoe

Deformation of the toe, which leads to dorsiflexion (upward) at the first MTP joint, to plantar flexion (downward) at the proximal interphalangeal (PIP) joint. It usually occurs in the second and third toe. The cause of this disease is disturbance of muscle balance between the short and long muscles, toe flexors and extensors, excessive length of the second and third toes - i.e. 'Greek foot structure' (Morton's foot), where the second toe is the longest and is often squeezed by shoes.

Morton's Neuroma

Although it is the most scarcely occurring of disturbance described by Morton, in Poland exclusively, this condition is associated with his name. The cause of it is usually a congenital anatomical anomaly, when the lateral branch of the plantar nerve connects to the medial branch, causing an increase in size of the transverse nerve. These nerves are located superficially on the sole of the foot in the subcutaneous tissue, just under the fat pad. During walking, the ground exerts pressure from below onto the branches of the nerve, while the ligament compresses from above, causing compression of the expanded neural structures. The disease reveals itself most often in connection with the collapse of the transverse arch at around age 50. This involves stinging foot pain, especially during loading, between the third and fourth toes, but can also occur between other toes. Sometimes there is a palpable node in the sole of the foot, usually between the third and fourth toes.

Morton's Foot

This is an inherited birth defect involving the shortening and hypertrophy of the first metatarsal. As seen under examination and X-ray, the MTP joint of the second toe is situated more peripherally than the first, and under clinical examination, the first MTP joint is "closer" to the heel than the second, while the first interphalangeal space is longer than the second. There is often coexistence of hypermobility of the first metatarsal ray (big toe) and characteristic calluses and thickening observed on the soles of the feet - between the second and third metatarsal as well as on the medial surface of the big toe. In terms of symptoms, there is pain at the head of the first metatarsal under exerted pressure, metatarsal pain when walking and standing, and painful skin calluses. An overly long second metatarsal causes a number of irregularities in the dynamics of walking, leads to crooked feet, hallux valgus (bunions), and overloading of the knee and hip joints. It can cause pain throughout the entire lower limb during the mechanism of straining the piriformis muscle in the so-called piriformis syndrome. Treatment requires the construction of individually-moulded corrective insoles, enabling support of the first metatarsal and pushing off the big toe during walking.

Hyperpronation Foot (PME Foot)

PME foot is associated with developmental disorder of the foot during the fetal period. Despite the similarity of its name to the severe foot defect described above, it does not require surgery. It is the result of an abnormal process of alignment of the head and neck of the talus, which results in abnormal contact with the top of the heel bone. Incorrect alignment of the talus causes further disfunctions, effectively leading to hallux elevation, insufficient support, and lowering of the vertical height of the head of the first metatarsal. This results in disfunctions of:
  • the foot itself,
  • the osteo-skeletal system and soft tissues of the upper levels of the musculoskeletal system,
  • impairment of proprioceptive and deep sensations, including incorrect information and stimulation of the central nervous system.

 

Calluses / corns


Calluses

This is an area of increased, excessive keratosis (hyperkeratosis). A large, flat cluster of keratinised skin of yellow colour, round or oval in shape. It arises from uneven loading of the feet, friction or constant pressure on certain areas of the skin. Unremoved calluses can lead to the emergence of corns.

Corns

They are the size of a pea and look like a hardened lesion projecting above the surface. Usually round, pale yellow.

These points of hardened, compressed skin produce the root of the corn. This root presses onto underlying nerve endings, causing acute pain.

Removal is important because they can cause inflammation. By removing the corn, most often we do not remove the cause of its formation. Permanent changes in the skeletal system of the foot predispose to successive formation of corns. Therefore, it is important to change shoes to appropriate ones, use individual orthoses, and visit a podological clinic.

The most common cause of calluses and corns are skeletal deformities in the feet, wearing improper footwear, obesity, and excessive removal of keratinised skin.

Recommendations

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