Foot structure-Tarsals, Metatarsals, Phalanges

Proper understanding of foot structure and the role of each part of foot in our movement is required to take care of your foot. In simple terms foot structure consists of 3 parts

1. Heel
2. Sole
3. Toes

A heel is the bulged portion at the rear end of the foot. It rests on the ground. Heel pain is a common foot problem of all professionals mostly nurses and salesmen. Everyone should have a proper picture of the foot structure as 60% of the body weight is borne by heels

Sole is the bottom of the foot, referred to as plantar region. Sole is hairless and less pigmented compared to other parts of our body. Sole is made of the thickest layers of skin. Lots of nerve endings located in the sole, makes it a sensitive part of human body

Toes, the digits of the foot are similar to fingers of our hand. In foot structure Hallux , the great toe is the inner most toe, rest is index toe, middle toe, fourth toe,and finally the little toe

Foot Anatomy

Most of the common foot problems arise due to alteration in the foot bone structure. Foot bone structure is as follows:-
1. Tarsal
2. Metatarsals
3. Phalanges

Tarsal are seven in number, which forms the back part of the foot. Calcaneous or heel bone is the most important of them, rest are talus, cuneiform (3), cuboid and navicular.Cuneiforms are three in number-medial cuneiform,middle cuneiform and lateral cuneiform.

Metatarsals form the middle region of the foot structure, between the phalanges and heel. It consists of first metatarsal, second metatarsal, third metatarsal, fourth metatarsal and fifth metatarsal. Metatarsal pain is a common foot problem that affects our daily life.

Phalanges form the toes, which consists of distal, middle and proximal phalanges. There are 14 joints in the phalanges which makes it a vulnerable part in foot structure.

(Click on the image for a better view)

Joints
About 30 joints keep the skeletal structure of foot intact. Types of joints are tarsal-metatarsal joints, which combines tarsal and metatarsals, metatarsophalangial joints which connects metatarsals and phalanges, and inter phalangial joints which connects two phalanges

Arches
Arch of the foot is the curve at the bottom of the foot. Arches are of three types:-
1. Lateral
2. Middle
3. Medial
They form a significant part of the foot structure

Plantar fascia
Plantar fascia is the strong sheath of tissue that connects tibia to the Calcaneous or heel bone. Plantar fasciitis is a foot problem that hinders our day to day activities which we will discuss in foot problems

How to care foot?

Pity our poor feet….The joy of moving around is possible only with the help of foot, but foot is the most abused and strained part of our body. How to care of foot is a common question that everyone asks. I would like to look at how to care foot from two aspects, even though they complement each other.

a. Functional
b. Cosmetic

Functional foot care comprises of foot care advices and footwear advises. This part addresses how to care of foot from the functional aspect

Foot care advices

1. Avoid wearing high heels, higher the heel, the worse the strain
2. Tired legs need rest. Keep your foot in an elevated position while taking rest.
3. Sitting, legs crossed will lead to poor blood circulation and hence numbness and pain
4. If your profession demands too much walking (nurses, salesman)do take care of your feet wearing soft insoles inside your footwear
5. If your profession demands sitting for a long time, take a break in between to move around and give your feet exercise
6. Once in a while give your foot the luxury of a warm bubble bath
7. Cut your finger nails straight to avoid ingrown nails
8. Never use blade or sharp objects to remove corn or callus
9. Always clean your feet using lotion, do clean in between your fingers



Footwear Advices

1. Always buy proper fitting shoes. It should not be too tight or loose.
2. Buy shoes in the evening as feet swell a little in de evening
3. When you buy a shoes go for ones with cushioning and arch support
4. Buy shoes with square or rounded toes rather than pointed ones.
5. Go for soft leather, as other synthetic materials cause perspiration and blisters.

Beauty to the toes

For a chick look one has to be perfect from tip to toes. This part tells you how to care feet from the cosmetic outlook. Pedicure is done to give your foot a clean and beautiful appearance. In Latin pedis means foot and cura means cure. Pedicure can be done once in a month or twice a month depending on our requirement

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Home pedicure

1. Remove nail polish, using cotton and nail polish remover
2. Soak feet in a tub of warm soapy water for ten minutes. You can add shampoo instead of soap. Also add salt and essential oils. Salt acts as a germicide.
3. Scrub feet lightly using pumice stone. You can use a homemade foot scrub instead( homemade foot scrub given below)
4. Apply cream and massage foot for 5 minutes
5. Push back cuticle using cuticle pusher
6. Clip your toe nails straight across, rounding the tip
7. Apply nail polish

Homemade scrub

¤ Mix grinded rice in water. Add a drop of eucalyptus. This can be used as a scrub
¤ Mix grinded peas in honey and use as a scrub

Foot care products

A multitude of foot care products are available in the market both for functional and cosmetic aspect of foot care.Most of us are aware of the existence of foot care products but we are not sure about how effective they are or how they can be used.

Functional footcare products include orthotics such as insoles,heel cushions and arch supports. Insoles and heel cushions are mostly used to take care of heel pain,plantar fascitis and foot pain. Arch supports are used to correct deformities of foot such as flat foot. Most of these products are made of silicon, which is considered as effective in distributing body weight in the proper manner. Even a healthy person with no foot problems can wear soft insoles to protect his feet from too much pressure. This will be helpful for doctors, nurses and salesman who will be on their feet most of their work hours.Various toe or digit supports are also available which help us to manage the toe problems such as injuries of toe, hammer toes and bunions

Cosmetic foot care products consists of foot care kits for pedicure, foot scrubs, foot creams, foot sprays, foot lotions and foot massagers. These products are made from essential oils and natural extracts to protect against infections and odour. Foot massager eases the tired foot giving it gentle strokes in warm water

Common foot problems

Foot problems checklist

Foot Problem Callus
What it is?
Callus is thickened area of skin found on hands or feet
Symptoms
Skin becomes thick and painful
Causes
Repeated pressure or contact with tight shoes, Manual labour, Bony prominence
Remedy
Soft insoles, Proper fitting shoes (not tight fitting ones)

Foot Problem
Corn
What it is?
Corn is similar to callus but its more wide spread
Symptoms
Pain, Redness, Swelling
Causes
Repeated pressure in a particular region
Remedy
Soft insoles, Proper fitting footwear
Foot Problem
Flat foot
What it is?
Collapse of the arch of the foot
Symptoms
Severe pain
Causes
Obesity, Pregnancy, Repetitive pounding of feet no a hard surface
Remedy
Arch supports

Foot Problem
Metatarsalgia
What it is?
Pain in metatarsal region(area just before the toes)
Symptoms
Severe pain
Causes
Fatigue, Over weight, Obesity, Flat foot, Improper footwear
Remedy
Treatment of the root cause of metatarsalgia, Proper footwear, Metatarsal pads




Foot Problem<
Plantar Fascitis
What it is?
Plantar Fascia stretches and tears
Symptoms
Intense pain in the heel region
Causes
Flat foot, Highly arched foot, Too much strain on foot
Remedy
Reduce strain no foot, Proper footwear, Realignment of the foot

Foot Problem
Heel spur
What it is?
Abnormal growth in the heel bone, due to calcium deposits formed when plantar fascia pulls away from heel
Symptoms
Burning pain
Causes
Flat foot, Unusually high arches
Remedy
Rest, Stretching exercises, Heel cushions or heel cups

Foot Problem
Arch pain
What it is?
Inflammation and burning sensation in the arch
Symptoms
Burning pain
Causes
Plantar fascitis, Pronated foot, Overuse, Improper footwear
Remedy
Adaptive footwear, Arch supports

Foot Problem
Achilles tendonitis
What it is?
Inflammation of Achilles tendon, the tendon that attaches calf muscles to heel bone
Symptoms
Severe pain
Causes
Over use, Misalignment, Improper footwear,Accidents
Remedy
Rest, Muscle strengthening, Physical therapies,Orthotics
Foot Problem
Claw toe
What it is?
Toe joints curl inwards
Symptoms
Pain,Toes look odd
Causes
Tight shoes, poor blood circulation, rheumatoid arthritis
Remedy
Proper footwear, Supports or Cushions, Toe stretching exercises

Foot Problem
Hammer toe
What it is?
Toe contracted at toe joints
Symptoms
Severe pain, Toes look odd
Causes
Improper footwear, Pressure from bunion, Nerve disorder in the foot, High heeled shoes
Remedy
Proper footwear with enough toe space, Toe caps and shields

Foot Problem
Mortons neuroma
What it is?
Inflammation of the nerve at the ball of the foot between 3rd and 4th toe
Symptoms
Burning pain, Numbness of toes
Causes
Flat foot, Pressure, Injury
Remedy
Arch supports, Pain medication

Foot Problem
Overlapping toes
What it is?
One toe overlapping on another
Symptoms
Severe pain
Causes
Improper footwear
Remedy
Shoes with broad toe box, Toe separator, Toe caps

Baby born with club foot- Causes & Treatments

Club foot,otherwise known as Talipus equinovarus is a foot deformity in which the baby is born with a foot, where heel points downwards and fore foot inward. This starts in the first trimester of pregnancy. One in thousand babies will have club foot deformity, in which 50% will be affected in both feet. This deformity develops due to the abnormal development of foot bones, muscles, ankle joints and ligaments.

Causes of a baby born with club foot

Baby born with Club feet can be a result of genetic as well as environmental factors. If one parent has club foot there is a 3-4 % chance of a baby being born with club foot. If both parents have club foot the chance increases to 15%. Genetic causes of baby born with club foot can be bone infection or nerve and vascular lesions and intrauterine infection.Environmental causes can be infection, drugs or cigarette smoking.

Treatment for babies born with club foot

Treatment of babies born with club feet varies upon the severity of the condition. It can be gentle manipulation or surgery.Gentle manipulation involves gentle holding and stretching of foot into a more natural position and use of splints, strapping, plaster casts or special boots. Surgery is done in severe cases where bones, joints, muscles or ligaments are deformed. Surgery is done to correct soft tissues,bone deformities or to correct tendons. In soft tissue surgery the surgeon relaxes the tight soft tissues in the joints. Bone corrections involve shortening or lengthening of bones and bone fusion to fix a joint. Finally tendon correction is the movement of tendons to the correct position to rectify the deformity

Talipes cavus foot deformity

Talipes cavus foot deformity is a deformity characterised by abnormally high arch and fore foot eqines(long toes) resulting in tightness or lack of flexibility of foot. It is also known as claw foot

Causes of talipes cavus foot deformity can be genetic, nerve disorder or muscle disorder.

Treatment of talipes cavus foot deformity is surgery followed by right observation and use of orthosis. As the degree of flexibility is different for different patients treatment varies. In acute cases surgery is done. For children affected with talipes cavus foot deformity soft tissue procedures are done. In case of adults osteotomy(Bone is but to shorten or change alignment) is performed. If it is a rigid or arthritic talipes cavus foot deformity triple arthrodesis(surgical bone fusion) is advised.

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