Foot diseases and malpositions impair the function of our feet. In addition to foot pain and problems walking, other symptoms can also occur, the cause of which is often not easy to determine. An appointment with a foot specialist enables a precise diagnosis and cause-oriented treatment - with or without surgery.
The foot surgeon Dr. Tonio Gottlieb is there to help you with all your questions about foot health and foot surgery. Whether initial diagnosis or second opinion - he examines you with the utmost care.
How is the human foot constructed?
The human foot is a biomechanical marvel consisting of almost 28 bones, 35 joints and numerous muscles, ligaments and tendons. Anatomically, the foot is divided into the tarsus, metatarsus and toes.
The feet bear our entire weight - when standing, walking and running, balancing on tiptoe, hopping and jumping. The forces acting on them are cushioned both by the fat body of the sole of the foot and by the arch of the foot, which is stretched by muscles and ligaments.
The fact that this permanent load sometimes leads to problems also has evolutionary reasons: The foot was originally a gripping organ whose architecture was designed more for mobility than for carrying static loads. In addition, the change from quadrupedalism to an upright gait has doubled the load on the feet; the high centre of gravity means an additional static challenge.
Causes of foot diseases: This is how foot diseases can develop
There are various causes that can throw the complex architecture of the foot out of balance. Most foot diseases and foot malpositions are caused by:
- genetic predisposition
- Incorrect footwear that increases the load on the foot
- Overloading due to standing for long periods of time and/or heavy carrying
- severe obesity
- Weakening of the foot muscles due to lack of movement and immobilisation of the feet in shoes
- Weakening of connective tissue and ligaments - hormonal during pregnancy, age-related, as a result of congenital diseases or as a side-effect of certain medications.
- Accidents or illnesses, especially torn ligaments, torn tendons, tendovaginitis or rheumatism.
- Chronic diseases, e.g. diabetes
How can foot disorders affect the body's statics?
The feet are the basis of the musculoskeletal system. Foot diseases and malpositions are therefore not just a foot problem, but can affect the entire musculoskeletal system. Consequences of this are, for example:
- Musculoskeletal imbalances - axial displacement of upper and lower leg, pelvic obliquity, misalignments of the spine
- Knee and hip complaints due to premature joint wear (wear and tear of the cartilage layer) as a result of excessive and/or uneven loading.
- Intervertebral disc problems due to reduced step cushioning, especially in the case of a bent-lower splayfoot
- Muscle tension, especially in the back and neck
- Back, neck and headaches
- oblique red lines with angles indicating deviation from normal position -> slightly oblique vertically to lower & upper thigh + spine, horizontally to pelvis
- red, concentric circle as pain symbol for knee, hip, lumbar spine, neck and head
Especially when the complaints do not first appear in the feet themselves but in other parts of the body, the actual cause often remains undetected. Many of the patients that Dr. Gottlieb has been able to treat successfully have previously experienced a veritable odyssey through various medical practices and clinics. Only referral to an orthopedic foot and ankle surgeon often enables a clear and correct diagnosis if the cause of the complaints cannot be located where the pain occurs.
Clinical pictures: which foot diseases and foot deformities are there?
Some malpositions and diseases of the foot are limited to the toes or the forefoot, while others affect the entire arch of the foot. A distinction is made between
- Axial malpositions of the lower leg (varus or valgus arthrosis of the upper ankle joint)
- Arthrosis (degenerative wear and tear of the joints) of the upper and lower ankle joints, the tarsus and the metatarsophalangeal joint of the big toe.
- Ligament instabilities of the upper ankle joint
- Charcot foot (diabetic neuropathic osteoarthropathy)
- Diabetic foot syndrome (diabetic angio- and neuropathy)
- Heel spur (calcaneal spur) associated with inflammation of the tendon plate under the foot (plantar fasciitis)
- Ganglion (tumour on the joint capsule or tendon sheath)
- Haglund's heel (Haglund's exostosis, dorsal heel spur)
- Hallux valgus (bunion, malposition of the metatarsophalangeal joint)
- Hallux rigidus or Hallux Limitus (stiffening of the metatarsophalangeal joint)
- Hallux varus (malposition of the metatarsophalangeal joint)
- Hollow foot (Pes cavus, Pes cavovarus, Pes equino-cavo-varus)
- Small toe deformities: Hammer toes (Digitus malleus), claw toes, claw toes
- Clubfoot (Pes equino-varus)
- Bending-countersunk splayfoot (Pes plano-valgus)
- Metatarsal pain (metatarsalgia)
- Morton's neuralgia (Morton's neurinoma)
- Tailor's bunion (Digitus quintus varus)
- Sickle foot (Pes adductus)
- (Pes equinus) shortening of the Achilles tendon
- Hypertrophy (exostosis, bone growth)
- Adhesions of the tarsal bones (coalitio, especially between the talus and navicular bone - coalitio talo-navicular or talus and calcaneus - coalitio talo-calcaneare).
In addition, there are injuries to the foot due to overloading, impact or falling:
- Achilles tendon injuries (Achillodynia)
- Ligament injuries
- Bone fractures, especially of the calcaneus (calcaneal fracture), tarsus (tarsal fracture), metatarsus (metatarsal fracture), talus (talus fracture) or ankle (OSG fracture).
- Lisfranc joint injuries
- Syndesmosis injuries (injury to the connective tissue bone connection in the ankle joint)
As an expert in foot surgery and foot operations, Dr Tonio Gottlieb is a leading foot doctor in Berlin. Contact his practice today and make an appointment to have your complaints examined by the whole foot specialist.
Kink-lowering spreader fus
This combined foot malposition is also colloquially known as 'flat foot'. In this case, the longitudinal and transverse arches of the foot are lowered, the metatarsal bones are spread wide open and the calcaneal tuberosity is bent outwards.
A splayfoot often leads to a malposition of the first metatarsal and the big toe, also called a 'bunion': The ball of the toe (or big toe bunion) pushes inwards, is often thickened and prone to inflammation; the toe itself becomes crooked on the outside, pressed against the other toes and sometimes twisted.
This disease affects the metatarsophalangeal joint between the metatarsal bone and the big toe. The increasing wear of the cartilage layer leads to a decrease in mobility and eventually to stiffening of the joint.
Small toe deformities
Deformities of the little toes usually accompany splayfoot. A distinction is made between different deformities - for example, claw toe and hammer toe, depending on the curvature of the three toe joints. It also happens that toes push over each other.
What symptoms can occur with foot diseases?
Foot diseases often make themselves felt through pain in the feet, especially after standing or walking for a long time. Foot malpositions, however, throw the entire musculoskeletal system out of balance, so that knee, hip and back problems can also occur.
Symptoms of a splayfoot
- Pain when walking on uneven ground and when climbing stairs, first on the inner and later also on the outer ankle
- Feeling of instability
- Reduced efficiency of the feet
- Pressure sores, calluses and corns
- Knee, hip and back pain due to the shifted body statics
Read more about the clinical picture of a bent, flat and splayed foot >>
Symptoms of hallux valgus
- Pain at the joint of the big toe/bunion of the big toe, especially with exertion
- Pain under the forefoot or the metatarsal bones of the small toes as a result of typical overloading of these regions.
- Corns, pressure sores and reddened skin
Read more about the clinical picture of hallux valgus >>
Symptoms of hallux rigidus
- Decreased mobility, swelling pain of the big toe joint
- Pain when walking, especially when rolling
- Walk or limp, rolling over the outer edge of the foot
Read more about the clinical picture of hallux rigidus >>
Symptoms of small toe deformities
- Pain in the little toes
- Calluses and pressure sores
- Growth disorders of the toenail
Read more about the clinical picture of small toe deformities >>
Treatment of foot diseases: These options are available
The effective treatment of foot diseases requires a precise diagnosis. In view of the often difficult-to-localise symptoms and the complex interaction of bones, muscles and joints, expert knowledge is required here!
Dr. Gottlieb specialises in the treatment of foot diseases. He attaches great importance to always considering the entire foot and the musculoskeletal system that rests on it. Every foot is different - and so it always has to be decided individually whether foot surgery is the ideal course of treatment or whether non-surgical treatment promises success.
Have foot diseases treated surgically
With Dr. Gottlieb, you are in the best hands if surgical correction of the foot is required. As a specialist in orthopedic foot and ankle surgery, he operates with extensive specialist knowledge and years of experience. Each operation is planned individually to achieve an optimal result taking into account the entire body statics. Depending on the need, the foot expert corrects
- Joint capsules and/or
- Foot bones.
State-of-the-art imaging techniques (X-ray, ultrasound, MRI) are used for diagnosis and treatment planning. The foot surgery itself is performed in a minimally invasive way - this accelerates wound healing and makes you fit for everyday life again quickly.
Are you looking for a specialist to clarify the cause of your foot complaints? Would you like to get a second opinion on an existing diagnosis? Do you have questions about foot malpositions or other foot diseases? Dr Tonio Gottlieb is an experienced specialist in foot and ankle surgery and a specialist for the whole foot. He always keeps the entire musculoskeletal system in mind when diagnosing and planning treatment and will be happy to advise you personally.
Foot diseases treated without surgery
In many cases, a foot malposition or foot disease can be successfully treated without the need for surgery. Often several therapy approaches are combined:
- Foot gymnastics to train the muscles
- Physiotherapy or physiotherapy
- orthopaedic insoles
- Splints or bandages
- Tape bandages
The human foot is a complex construct and thus every foot disease requires individual, cause-oriented treatment. The foot specialist Dr. Gottlieb attaches great importance to careful diagnosis and always decides in the patient's best interest whether surgery is necessary or whether a non-surgical therapy can provide lasting relief from the symptoms.