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Hello. This is Dr. James Ioli speaking. I am chief of podiatry at Brigham and Women's Hospital in Boston and served as the guest editor of a special section on the feet and foot problems in the August 2009 Harvard Health Letter.
Leonardo Da Vinci said the human foot is a work of art and a masterpiece of engineering. It's one of my favorite quotes. Even so, things go wrong with our feet. Normal wear-and-tear is partly to blame. But the shoes we wear, the way we walk -- they pus extra strain on certain parts of the foot. And that extra strain can inflame tissues and move bones out of alignment.
Here are four common foot conditions, their causes, and what you can do about them.
Normally, the thin metatarsal and phalanx bones that form the long part of the foot and the five toes are lined up, gracefully, in more or less a straight line.
A bunion occurs when the joint between the big toe's metatarsal bone and the proximal phalange falls out of alignment and angles out. Bunion comes from the French word for turnip. Often the end of the metatarsal bone enlarges and becomes misshapen. People get bunions because of poor arches and pronation -- a tendency to walk on the inside part of the foot. Wearing narrow shoes can also cause bunions by putting backward pressure on the big toe so it buckles out.
The metatarsalgia occurs when you stand or walk on the balls of your feet. As a result, the ends of the metatarsal bones get tender and sore. Some people walk up on the balls of their feet because of a naturally short Achilles tendon. But high heels are common cause of metatarsalgia. They position the feet so there is extra pressure on the front of the foot. And the higher the heel, the greater the pressure.
The plantar fascia is a band of tissue that attaches to the heelbone on one end to the toes on the other. It helps form the arch of the foot and with pushing off as you walk.
Plantar fasciitis is inflammation of the plantar fascia. The pain is often felt just near the underside heel but it can also come from the entire underside of the foot. Standing or walking for long periods can cause plantar fasciitis. Overpronation -- walking so you put weight along the inside the foot -- is another cause.
Posterior tibial tendon dysfunction
The posterior tibial tendon starts in the calf, wraps around the inside bump of your ankle and then along the inside of the arch of your foot. It is one of several structures that help your legs, ankles, and feet work together.
If this tendon is dysfunctional -- a catchall term for being weak, thick or inflamed -- you can have pain, difficulty getting up on your toes, and trouble walking normally. Being heavy can cause all kinds of foot problems -- including posterior tibial tendon dysfunction.