Foot & Ankle Conditions

/Foot & Ankle Conditions
Foot & Ankle Conditions 2018-04-27T13:28:02+00:00

I have particular expertise in being able to help with the following:


Are you frustrated with not being able to fit your foot comfortably into a shoe, or maybe you’re fed up with your achy big toe? Have you been cramming your feet into shoes for a while now, and are now finding that even that’s now working for you? Or perhaps your toes are overlapping, and you just don’t like the look of your feet, and you’d rather not have then on show?

Simple foot wear treatment options, exist but when these are not enough it is helpful to assess the best approach using the opinion of a skilled Podiatric Surgeon. An x-ray is often the starting point to assess the joint position, bone structure, and any wear and tear within the joint. Sometimes toe straightening surgery is the best way forward, with predictable results and very good outcomes.

Bunion surgery may look very simple and straightforward, but is actually very complicated. You need the skills of an experienced and specialist clinician, who understands the function of your foot, and who can tailor the surgery according to your specific needs. There are 128 different surgical procedures to choose from in terms of bunion surgery, but there will always be one which suits you best. This is why the experience and skill of your surgeon is paramount, so that the right choice is made.

I have operated on thousands of patients with problematic feet, which means that I can carefully select the right surgery for you, rather than the approach of ‘one procedure to fit all’, which may not be the best option for you.

Heel pain

Heel pain is extremely common and extremely uncomfortable. It is often helped with changes to shoes, insoles, stretches and medication, in the very early stages. Not all heel pain is a due to a condition called plantar fasciitis, and whilst it can be, it’s very important to go through a proper assessment and have an accurate diagnosis made.

My approach is to carefully listen to the history of your symptoms, and I’ll look at how you stand and walk, as well closely examining the areas of your heel which are a problem or painful for you. Sometimes heel pain can be presentation of a condition called tibialis posterior tendinopathy, or it may be pain generated by the subtalar joint, which is a joint below the ankle joint.

In other words, it’s not always as straightforward as it seems, and so if you’re struggling, it’s important to have a specialist opinion. It may be that you might additionally need an ultrasound or MRI scan to help confirm the diagnosis, as well as some specialist interventions to treat the condition.

I aim to ensure that my advice is clear and concise. You can expect an approach that puts you first with a treatment plan to suit your needs.

I use a range of interventions to help. In addition to advanced surgical procedures, I use state of the art diagnostic techniques to examine the function of your foot and the prescription of In-shoe orthoses to enhance the way your foot work

When surgery is necessary, the foot and ankle procedures I use are based on a tried and tested approach. I use the latest techniques and the latest equipment to ensure that the surgical procedure tailored for you gives you the best result possible. You can rest assured that whatever the treatment option you choose,  I’ll put you at the centre of decision-making process all the way through.

My practice staff will help you from your initial enquiry right through to discharge – we encourage patients to tell us how they are getting on with treatment.

My aim is for you to be comfortable with our plans for getting your foot problem resolved successfully.

Need help with other conditions?

If you would like to know more, simply click on the list of conditions below for an introduction and downloadable information sheet.

Often a result of overuse or pressure from boots or shoes, this condition can be helped with localised treatment, insole use and stretching. Where this is not enough a small procedure to stimulate the tendon to heal provides good results.

Arthritis is a common condition affecting many joints in the body. Where they effect the foot, the problem can be helped with simple insoles medication or small procedures to replace or tidy up the joint.

Pain in this area of the foot can be extremely debilitating. When a nerve or joint lining is injured, simple methods or medication can help. More definitive treatment options in the form of a small operation are also effective at relieving the problem.

Small boney limps, ganglions and cysts are common in the foot. Simple procedures to remove them are often straightforward and simple to achieve.

Flat feet are not always problematic but when they are it is helpful to quickly asses whether the problem is new or old the result of a tendon injury or arthritis and what can be done to help. Treatment is often a combination of physiotherapy, in shoe insoles designed for you and surgery if needed.

General foot pain affects many people. It can be simply due to overuse of the foot of a sign of wear and tear within the joints. Whatever the cause, our practice provides all the required skill and imaging examinations needed to form an opinion of diagnosis and treatment.

Many sports injuries require a functional approach to getting better. This combines advanced examination and diagnostic imagine (MRI) approaches to finding out what is wrong, why it is wrong and how to get you better as soon as possible whilst keeping you in the sport or activity you enjoy.

What is the Accessory Navicular?

The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area.

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What is an Ankle Sprain?

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue – like rubber bands – that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.

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Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

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What is Capsulitis of the Second Toe?

Ligaments surrounding the joint at the base of the second toe form a “capsule,” which helps the joint to function properly. Capsulitis is a condition in which these ligaments have become inflamed.

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What is the Achilles Tendon?

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the “heel cord,” the Achilles tendon facilitates walking by helping to raise the heel off the ground.

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What is Flatfoot?

Flatfoot is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch.

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What is a Ganglion Cyst?

A ganglion cyst is a sac filled with a jellylike fluid that originates from a tendon sheath or joint capsule. The word “ganglion” means “knot” and is used to describe the knot-like mass or lump that forms below the surface of the skin.

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What is Haglund’s Deformity?

Haglund’s deformity is a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).

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What is Hallux Rigidus?

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. ‘Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

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What is Hammertoe?

Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

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Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst.

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What is an Ingrown Toenail?

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

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What is a Neuroma?

A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. “Intermetatarsal” describes its location in the ball of the foot between the metatarsal bones. Neuromas may also occur in other locations in the foot.

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What is Osteoarthritis?

Osteoarthritis is a condition characterized by the breakdown and eventual loss of cartilage in one or more joints. Cartilage (the connective tissue found at the end of the bones in the joints) protects and cushions the bones during movement. When cartilage deteriorates or is lost, symptoms develop that can restrict one’s ability to easily perform daily activities.

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What are the Peroneal Tendons?

A tendon is a band of tissue that connects a muscle to a bone. The two peroneal tendons in the foot run side-by-side behind the outer ankle bone. One peroneal tendon attaches to the outer part of the midfoot, while the other tendon runs under the foot and attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains.

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What is the Plantar Fibroma?

A plantar fibroma is a fibrous knot (nodule) in the arch of the foot. It is embedded within the plantar fascia, a band of tissue that extends from the heel to the toes on the bottom of the foot. A plantar fibroma can develop in one or both feet, is benign (non-malignant), and usually will not go away or get smaller without treatment. Definitive causes for this condition have not been clearly identified.

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What is a Plantar Wart?

A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. Plantar warts most commonly occur in children, adolescents, and the elderly.

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What Is PTTD?

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot.

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What is a Sesamoid?

A sesamoid is a bone embedded in a tendon. Sesamoids are found in several joints in the body. In the normal foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint.

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What is a Tailor’s Bunion?

Tailor’s bunion, also called a bunionette, is a prominence of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot. The prominence that characterizes a tailor’s bunion occurs at the metatarsal “head,” located at the far end of the bone where it meets the toe. Tailor’s bunions are not as common as bunions, which occur on the inside of the foot, but they are similar in symptoms and causes.

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  • What is a Talar Dome Lesion?

    The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. The top of the talus is dome-shaped and is completely covered with cartilage — a tough, rubbery tissue that enables the ankle to move smoothly. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.

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The structure of the foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.

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