What are some of the weirdest/strangest ailments of the legs?
The feet are the foundation of our bodies, and they assist us in some of the most basic functions of living. Each foot contains 26 bones, which are controlled by multiple ligaments, muscles, and tendons. Through activities of living, the feet can change structurally over time, causing a reshaping of the feet. This can give rise to a number of medical conditions and deformities. In addition, the feet are susceptible to infections—including bacterial, fungal, and viral infections. Systemic illnesses can also affect and change the feet, which can limit daily activity and quality of life.
The image shows gangrene of the first to fourth toes of the right foot in a person with diabetes.
High Arch Foot or Pes Cavus
In a normal foot, the gait cycle (walking) begins with the arch in a flattened position, allowing the foot to be loose enough to adapt to the terrain. When the leg is perpendicular to the ground, the arch begins to rise to allow the foot to lock and support the weight of the body as it is propelled forward. In individuals with a flat foot (pes planus), the foot stays loose and unlocked. In those with a high arch (pes cavus), the arch does not flatten with weight bearing and the foot stays locked—the foot is not flexible and thus pounds the ground as the person walks. Neurologic conditions, such as cerebral palsy and Charcot-Marie-Tooth (CMT), can result in a structurally high arched foot. Many patients with a pes cavus can develop calluses and pain at the heel and ball of the foot.Treatment requires an accommodation to help absorb the increased pressures in these regions, such as different inserts to pad the foot rather than control its movement.
Flat Foot or Pes Planus
The opposite of a high arched foot is a flat foot (pes planus), which, due to its structure, is “loose.” Flat foot is among the most common structural deformities of the foot, in which the medial arch is collapsed or begins to collapse at some point. This deformity can be congenital or acquired if ligaments can no longer support the foot structure because they are injured (posterior tibial tendon dysfunction) or become mal-aligned later in life. For a person with a congenital foot deformity of this nature, there are increased strains on ligaments and tendons, resulting in medial arch pain and overuse injuries (eg, tibial stress fractures). Treatment requires providing support to the foot in order to control the motion of the foot. These supports may include supportive shoes, inserts, or prescription orthotic devices. In severe cases, surgical interventions may also be necessary.
Hammer Toes and Claw Toes
Hammer toes and claw toes are also common foot deformities named for their appearance. In a normal lesser toe (toes not including the big toe), there are three phalanges connected by two joints. When the joint closest to the foot, the proximal joint, contracts, it is referred to as a hammer toe. If the joint closer to the nail, the distal joint, is contracted, the deformity is referred to as a claw toe. In addition, there may be a rotation of the toe, referred to as an adducto varus deformity, which is commonly seen in the fourth and fifth toes. Early on in a toe deformity, discomfort from an ill-fitting shoe may result in redness and soreness to that area. Over time, this condition can worsen, resulting in calluses that may cause additional discomfort. Initial treatments include shoe gear changes (such as those with a higher toe box), protective padding, and/or reduction of the callus to help accommodate the deformities. If the initial therapy doesn’t help and pain persists, surgical intervention may be required. Hammer toes and claw toes can be flexible (the toes can be manually straightened) or rigid (the joints are fused and no longer function). A flexible deformity may require only soft-tissue correction, whereas a rigid deformity most likely requires bone reconstruction in order to straighten the toe and reduce the painful symptoms.
Read more about the 19 uncommon foot disorders and their symptoms
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