Midfoot pain is concerned with the middle of the foot where the small tarsal bones are located. The most common cause of midfoot pain other than following a sprained ankle is a mid tarsal joint sprain. A stress fracture of the navicular bone is also common and should not be missed. Pain in the midfoot area for more than five days following injury then a Lisfranc joint sprain should be considered.
Cuboid syndrome occurs when the peroneus longus muscle in the lower leg applies excess traction onto the cuboid bone causing it to partially dislocate. The injury is often occurs in conjunction with peroneal tendonitis.
The term 'Tarsal fracture' is often taken to mean a broken foot in general. It does, however, specifically refer to the rare occurrence that one of the Tarsal bones in the rear of the foot are fractured. These bones are very rarely fractured individually.
A mid tarsal joint sprain is an injury to the ligaments holding the mid tarsal joint together causing pain in the outside middle of the foot.
A stress fracture can occur as a result of prolonged repeated loads on the legs. Long distance runners are susceptible to this type of injury. A stress fracture in athletes occurs mainly in the lower leg and foot (in the calcaneus, navicular and metatarsal bones).
The abductor hallucis muscle lies along the inside of the foot and runs from the heel bone inserting onto the side of the big toe.
Flexor tendonitis is inflammation of the flexor tendons in the foot which bend the big toes. They run down the inside of the ankle and under the foot to the toes.
Extensor tendinitis is inflammation of the extensor tendons which run along the top of the foot and straighten the toes. Pain is felt along the top of the foot.
A navicular stress fracture is one of the most common stress fractures affecting athletes, especially those in explosive events such as sprinting and jumping.
The plantar fascia or arch ligament is a band that runs from under the heel to the front of the foot. A strain or rupture to this is quite common. A plantar fascia strain might result from one single traumatic incident or may gradually occur over a period of time.
Tarsal coalition is a fusion or sticking together of the tarsal bones in the foot. The tarsals are 7 bones located at the back of the foot. It is a congenital disease meaning you are born with it.
The Peroneus Brevis tendon inserts into the 5th matatarsal bone on the outside of the foot. A strain or rupture of the tendon can occur at the point of insertion.
The tibialis posterior tendon passes down the back of the leg, inside of the ankle and under the foot. Injury or degeneration of the tendon where it inserts into the foot bones causes pain on the inside of the foot which may radiate along the length of the tendon.
When should I see a doctor?
When should you see a doctor with your foot pain? Often people do not want to bother their GP or A & E department but if you have any of the following symptoms you should seek further medical assistance.
- Severe pain, especially on walking
- Severe swelling (oedema)
- Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia) in the foot.
- Unable to complete normal daily activities after the initial 72 hours.
Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.
Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.