1. Foot and Toe Pathologies

Lowering of the medial longitudinal arch.

pes planus

What are causes of pes planus?

Congenital factors, acute trauma, “spring” ligament sprain, rupture of plantar fascia, accessory navicular fracture, and biomechanical factors

What are the two classifications of pes planus?

Rigid (structural) and supple (flexible)

What injuries/issues have an increased risk with pes planus?

Metatarsal stress fractures, low back pain, ACL tears, PFPS, and other musculoskeletal issues of the spine and lower extremity

What are interventions for pes planus?

Shoe inserts and arch taping

What is pes cavus commonly associated with?

A congenital foot deformity

What characteristics are associated with pes cavus?

Generalized stiffness and impaired ability to absorb ground contact forces

What happens to pressure loads during running with pes cavus?

Increased pressure loads on the forefoot and rearfoot

What injuries are associated with increased risk in pes cavus?

Metatarsal, tibial, and femoral stress fractures; it may also be associated with spinal scoliosis

What are interventions for pes cavus?

Soft orthotics and shoes with soft midsoles

What is Morton’s toe? What does Morton’s toe cause during push-off?

A shorter 1st metatarsal. Increased force transfer along the 2nd ray

What is the deformity pattern of claw toes?

Hyperextension of the MTP joint with flexion of the PIP and DIP joints

What condition is claw toe commonly associated with?

Pes cavus

What is the deformity pattern of hammer toes?

Extension of the MTP and DIP joints with flexion of the PIP joint

What can cause hammer toes?

Improperly fitting shoes, hereditary factors, and elongation or rupture of the plantar fascia

What can happen to the 1st and 2nd toes with hallux valgus? What condition is hallux valgus associated with?

They may overlap. Pes planus

What causes pain and dysfunction with hallux valgus?

A bunion or secondary dislocation of the sesamoids

What is a bunion? What is a bunionette?

Development and inflammation of a bursa on the medial aspect of the 1st MTP joint. Inflammation on the lateral aspect of the 5th MTP joint

Where does an ingrown toenail most often occur? What can an ingrown toenail cause?

The great toe. Infection and pain

What are the key characteristics of plantar warts?

Point tenderness and masking of the normal skin markings