Posts for: April, 2018
Do you have pain associated with the base of your big toe but don’t think it is a bunion deformity? Sesamoiditis may be your problem!
The sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. They act as a pulley for tendons by providing leverage when the big toe pushes off while walking, running and jumping. The sesamoids also act as a weight bearing surface for the long bone, called the first metatarsal, connected to the big toe. Although many people become affected with it due to increased activity levels, it is most common in runners and dancers because they push off the ball of their foot so much.
Frequently wearing high-heeled shoes can also be a contributing factor to Sesamoiditis – which is an overuse injury with chronic inflammation of the sesamoid bones and tendons surrounding those bones. It is possible to fracture a sesamoid bone – either acutely with a direct blow or chronically with a hairline fracture from repetitive stress. After examining the foot and radiographic evaluation, Dr. Mendoza will help you decide the best course of action. Sometimes oral medications such as ibuprofen will be enough to cut the pain. Other options include steroid injections to reduce the inflammation, or even a surgical procedure to remove part or all of the affected sesamoid bone.
Click here or call our office today at 615-452-8899 to schedule your appointment with Dr. Mendoza today!
A plantar fibroma is a benign nodule that grows on the bottom of the foot that usually appears in adults. It is typically slow growing and measures less than an inch in size. More invasive, rapid-growing and multiplanar fibromas are considered plantar fibromatosis. Both are benign tumors made up of cells found in ligaments called fibrocytes. Fibromas can also occur in the palmar fascia of the hands – often called trigger finger.
Symptoms consist of a painful mass on the bottom of the foot, roughly in the middle of the arch. The mass may be painful with pressure or shoe wear. The cause is unknown but is thought to have a genetic component. Trauma to the foot does not seem to be a factor. Plantar fibromas reside in the deep fascia of the foot between the skin and the first (superficial) layers of muscle. Asymptomatic fibromas may be left untreated, whereas painful fibromas may be treated with an off-loading insole, anti-inflammatory injection, or surgical excision as a last resort.
Click here or call our office at 615-452-8899 to schedule your appointment with Dr. Mendoza today!
As opposed to the tibialis posterior tendon that runs inside the ankle, there are two peroneal tendons that run side-by-side behind the outer ankle bone. The peroneal brevis tendon attaches to the outer part of the fifth metatarsal at the middle of the foot, and the peroneal longus tendon runs under the foot and attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains.
Peroneal tendon injuries most commonly occur in individuals who participate in sports that involve repetitive ankle motion, and those with higher arches. Tendonitis and tendonosis (degenerative tears) are usually due to overuse, whereas acute tears can be caused by a traumatic event. Subluxation is when one or both tendons have slipped out of their normal position. It can be due to a variation in the shape of the bone or muscle that a person is born with, or it occurs following a trauma (such as an ankle sprain). Damage or injury to the tissues that stabilize the tendons (retinaculum) can lead to chronic tendon subluxation. As in all peroneal tendon injuries, symptoms of a subluxating tendon include: pain, swelling, warmth, and weakness or instability of the ankle. What sets subluxation apart from other peroneal injuries is a snapping feeling of the tendon around the ankle bone. Early treatment of a subluxation is critical, since a tendon that continues to sublux is more likely to tear or rupture.
Radiographs or an MRI may be needed to fully evaluate the ankle. Treatment options depend on the type of peroneal tendon injury that Dr. Mendoza diagnoses: immobilization, anti-inflammatories, RICE, bracing, and surgery to repair the tendon or tendons are all options.
Click here or call our office at 615-452-8899 to schedule your appointment today!