Your first toe or “big” toe is medically referred to as the
hallux, and is the hardest working toe of your foot because
it pushes you off the ground as you walk and run.

A bunion, also called a hallux valgus, is a bony prominence
on the inside of the big toe, caused by a misalignment of
the joint. The overlying skin maybe swollen, red and
tender. Bunions are often painful and can limit what shoes
you can wear.

More than 50% of Women in the UK have bunions,
therefore is a common deformity. The problem often runs
in families although tight narrow shoes and high heels are
often blamed. We offer

bunion surgery

to help with this problem.

The most common site of arthritis in the foot is at the base
of the big toe. This joint is called the metatarsophalangeal,
or MTP joint. It's important because it has to bend every
time you take a step. If the joint starts to stiffen, walking
can become painful and difficult.

In the MTP joint, as in any joint, a smooth articular
cartilage covers the ends of the bones. If wear-and-tear
or injury damages the articular cartilage, the raw bone
ends can rub together. A bone spur, or overgrowth, may
develop on the top of the bone. This overgrowth can
prevent the toe from bending as much as it needs to when
you walk. The result is a stiff big toe, or hallux rigidus.

Hallux rigidus usually develops in adults between the ages
of 30 and 60 years. No one knows why it appears in some
people and not others. It may result from an injury to the
toe that damages the articular cartilage or from differences
in foot anatomy that increase stress on the joint.

In the early stages there is pain on motion (dorsiflexion
and/or plantar flexion), often with limitation. Symptoms
will be aggravated by exercise levels and footwear (either
unsupportive shoes, shoes with an increased heel or short
shoes causing back pressure into the joint). With time
motion becomes more limited and shoes can show
deformation of the upper around the joint. Diagnosis is
primarily through clinical examination although x-rays help
to grade the extent.

The job of the nail is to protect the terminal phalanx of
the toe (the end bone) and as such nails bear the brunt
of daily activities. Walking, running, wearing shoes or
participating in sports are just a few of the stresses and
strains the feet much endure. All or a portion of the nail
plate can be damaged when the feet are injured or
abused.

Nail problems are commonly caused by improper cutting,
minor injuries or repeated traumas.

Proper nail care on a regular basis and the wearing of well
fitted shoes can keep the toe nails in good condition.

The symptoms of an ingrown nail are usually redness,
swelling and infection and the toe is very painful. Toe
injuries that change the contour of the nail can also lead
to an ingrown toe nail. Toe deformities such as a bunion
that forces the big toe to lean toward the second toe,
high-heeled, narrow or pointed shoes can put pressure
between the nail and soft tissue thus forcing the nail to
grow into the skin.

An ingrown nail occurs when the skin on one or both sides
of a nail grows over the edges of the nail, or when the nail
itself grows into the skin. Redness, pain and swelling at
the corner of the nail may result and infection may soon
follow. Sometimes a small amount of pus can be seen
draining from the area.

Ingrown nails can also be accompanied by other
toe disorders such as excess surrounding tissues
(hypergranular tissue) or an outgrowth of bone
beneath the nail (exostosis).

Morton’s neuroma is one cause of metatarsalgia – pain in
the ball of the foot. It is due to inflammation and thickening
of a digital nerve in the foot. “Neuroma” means nerve
tumour, which is this instance simply means a benign
enlargement of the nerve, and not malignancy.

The cause of nerve enlargement is thought to be repeated
injury. The nerve becomes compressed in between the
metatarsal heads when standing and walking. This most
often occurs in tight shoes, high heels or thin hard soles.
It usually occurs most commonly between the 3rd and 4th
toes or 2nd and 3rd toes, and can occur in both feet.
The incidence is 8-10 times more common in women.

The symptoms are pain and numbness in a specific spot in
the ball of the foot, sometimes radiating into the toes. At
times, the pain may be absent and at other times severe
enough to cause you to stop and take off the shoe. It may
feel like a marble or a stone under the foot moving around
and sometimes causing a sharp “snap” to be felt. The
examining orthopaedic surgeon can sometimes feel this
by pressing on the foot. Testing with a pin may reveal
numbness in the toes.

Plantar fasciitis (heel spur syndrome) is a common problem
among people who are active in sports, particularly
runners. It starts as a dull intermittent pain in the heel,
which may progress to a sharp persistent pain. Classically
it is worse in the morning with the first few steps, after
prolonged sitting, or after standing or walking and at the
beginning of sporting activity. The plantar fascia is a thick
fibrous material on the bottom of the foot. It is attached
to the heel bone then fans forward towards the toes and
acts like a bowstring to maintain the arch of the foot.

Problems can occur when part of this inflexible fascia is
repeatedly placed under tension, as in running. Tension
causes an overload that produces inflammation usually at
the point where the fascia is attached to the heel bone,
the result of which is pain. Plantar fascia injury may also
occur at the mid sole or near the toes. Since it is difficult to
rest the foot the problem gradually becomes worse as the
condition is aggravated with every step. In severe cases
the heel is visibly swollen. The problem can progress
rapidly and therefore treatment must be started as soon
as possible.

You're more likely to get the condition if you're a woman, if
you're overweight, or if you have a job that requires a lot
of walking or standing on hard surfaces. You're also at risk
if you walk or run for exercise, especially if you have tight
calf muscles that limit how far you can flex your ankles.
People with very flat feet or very high arches are also more
prone to plantar fasciitis. Contributing factors include: poor
shoe support, running, increasing age, sudden weight
gain, sudden increase in activity and a family tendency.

The condition starts gradually with mild pain at the heel
bone often referred to as a stone bruise. You're more likely
to feel it after (not during) exercise. The pain classically
occurs again after arising from a midday lunch break.

The London Orthoapedic Clinic boasts extremely
experienced traumatologists which will diagnose
and treat a wide variety of Fractures.

All fractures of the Upper and Lower limb are extremely
common and a regular occurrence. Our consultants will
be available, especially with our after hours/emergency
service to fix all fractures.