Feet, Ankles and Legs

There are a number of problems that can affect the feet, ankles and legs. Years of wear and tear can take their toll. So can disease, poor circulation, improperly trimmed toenails and wearing shoes that don't fit properly. Problems with our feet, ankles and legs can also be the first sign of more serious medical conditions such as arthritis, diabetes and even heart disease. (Read about "Arthritis & Rheumatic Diseases" "Diabetes" "Coronary Heart Disease")

If you have healthy feet and legs, you can help them stay that way by taking care of them. It's important to get the right amount of exercise, for both fitness and circulation. (Read about "Getting Started on Fitness") Good nutrition can help build strong bones. (Read about "Calcium") The National Institute on Aging (NIA) says wearing comfortable shoes that fit well is also important. Remember that the size of your feet changes as you grow older, so always have your feet measured before buying shoes. NIA says you should look for shoes made of leather, with thick non-slippery soles and low heels.

Some problems of the feet, ankles and legs can be diagnosed after a physical examination by your doctor.

Joint problems of the feet, ankles and legs can sometimes be diagnosed with arthrography, a special type of x-ray (Read about "X-rays") that uses a contrast material to get a better look at the joint. Arthroscopy is another procedure that can be used to look inside a joint. An arthroscope is a device that has lights and a small camera lens at the end that is inserted via small incisions. The camera magnifies the scene and displays it on a television screen. (Read about "Arthroscopy") Other diagnostic tests that can be used include a bone scan, computed tomography scan or magnetic resonance imaging. (Read about "CT Scan - Computerized Tomography" "MRI - Magnetic Resonance Imaging")

The National Institutes of Health say there are many diseases and conditions that can affect the feet, ankles and legs, including but not limited to the following:

Achilles Tendinitis / Rupture

The Achilles tendon is located at the back of the ankle. It connects one of the calf muscles to the heel bone. Achilles tendinitis is the inflammation that causes redness, soreness and swelling of the Achilles tendon. It can result from stretching the tendon too much or too far. It can also happen with a lot of jumping, for example during sports. Untreated, the tendon can get worse or even rupture. If the tendon ruptures or tears, the ankle may be immobilized with a cast. Surgery may be needed as well. (Read about "Tendinitis & Bursitis")

Ankle sprain / knee sprain

A sprain is a stretch and/or tear of a ligament (a band of fibrous tissue that connects two or more bones at a joint). One or more ligaments can be injured at the same time. The severity of the injury will depend on the extent of injury (whether a tear is partial or complete) and the number of ligaments involved.

Although sprains can occur in both the upper and lower parts of the body, the most common site is the ankle. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), more than 25,000 individuals sprain an ankle each day in the United States. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls or lands on the ankle after a jump. This type of sprain is called an inversion injury. The knee is another common site for a sprain. A blow to the knee or a fall is often the cause; sudden twisting can also result in a sprain. (Read about "Sprains")

Anterior Cruciate Ligament (ACL) Injury

The anterior cruciate ligament of the knee is crucial in keeping the shinbone from sliding beneath the thighbone. It is a fairly common injury among athletes, especially women athletes. (Read about "The Knee")

Arthritis

Arthritis and rheumatic diseases can cause pain, swelling and loss of function in joints and/or connective tissue throughout the body. If arthritis develops in the ankle or knee, your balance and your ability to walk may be affected. (Read about "Arthritis & Rheumatic Diseases")

Athlete's Foot

Athlete's foot is a fungal infection, usually between the toes. The fungus causes dry skin, redness, blisters, itching, and peeling. (Read about "Tinea: Ringworm, Jock Itch & Athlete's Foot")

Bone Diseases and Conditions

Bone diseases and conditions that can affect the bones of the feet, ankles and legs include Paget's disease of bone, bone tumors, bone cancer, osteoporosis and many others. (Read about "Skeletal System" "Paget's Disease of Bone" "Bone Cancer" "Bone Tumors - Benign" "Osteoporosis")

Bunions

Bunions develop when the joints in your big toe no longer fit together as they should and become swollen and tender. Bunions tend to run in families. Women who wear high-heeled shoes can also develop bunions. Bunions can get bigger over time. They can also get quite painful, or lead to arthritis. (Read about "Arthritis & Rheumatic Diseases") If a bunion is not severe, the National Institute on Aging says wearing shoes cut wide at the instep and toes can help. Taping the foot, or wearing pads that cushion the bunion, may also ease the pain.

Other treatments include physical therapy (Read about "Rehabilitation") and wearing orthotic devices or shoe inserts. A doctor can also prescribe anti-inflammatory drugs and cortisone injections for pain. Sometimes surgery is needed to relieve the pressure and repair the toe joint.

Cartilage Injuries

Cartilage is the hard but slippery tissue that covers the ends of bones where they meet to form a joint. Cartilage cushions your knee, and acts to absorb shock during movement. Torn cartilage in the knee is not uncommon. (Read about "The Knee")

Cellulitis

Cellulitis is a serious bacterial infection of your skin. (Read about "Microorganisms" "Skin") The skin may be hot, swollen and tender, and you may also have a fever. The lower legs are the part of the body that is often affected. If you have an area of swollen red skin, you should see your doctor at once. (Read about "Cellulitis")

Chondromalacia

Chondromalacia is the softening of the articular cartilage of the kneecap. Cartilage is the hard but slippery tissue that covers the ends of bones where they meet to form a joint. The disorder is often experienced among young adults. This is sometimes called runners knee. (Read about "The Knee")

Clubfoot

When a baby is born with an abnormality of the foot or ankle, it can be referred to as clubfoot. Clubfoot is one of the most common birth defects. Treatment options include manipulation, casts and surgery. (Read about "Clubfoot")

Corns and Calluses

Corns and calluses are caused by friction and pressure when the bony parts of your feet rub against your shoes. If you have corns or calluses, see your doctor. Sometimes wearing shoes that fit better or using special pads solves the problem.

Cramps

The feet and legs are common sites for muscle cramps. Muscles normally contract and relax as we use our bodies. When the muscles cramps, the contraction is involuntary and the muscle doesn't relax. The cramp can last from a few seconds, to a few minutes or even longer. Cramps can involve one muscle or a group of them. They can be caused by injury or simply by doing a lot of exercise. They can develop at night for no apparent reason.

They can often be caused by dehydration. (Read about "Dehydration") Cramps can also be related to abnormal levels of certain minerals in your bloodstream, such as calcium (Read about "Calcium"), magnesium or potassium. (Read about "Vitamins & Minerals") They can be a sign of heat stroke. (Read about "Heat Stroke") Muscle cramps can be caused by medications. (Read about "Medicine Safety") Cramps can also be result from certain diseases, such as neuromuscular diseases or kidney disease. (Read about "Neuromuscular Diseases" "Kidney Disease")

If you get leg cramps when you're walking, it could be a sign of peripheral arterial disease or PAD, a condition caused by the narrowing of the arteries in the leg. (Read about "Peripheral Arterial Disease")

Some cramps may respond to simple changes, such as stretching, gentle massage or drinking more fluids. If cramps are severe, or if you're getting them often, you should see your doctor.

Diabetic Foot Concerns

Diabetes causes two problems that can hurt your feet. One problem is damage to the nerves in your legs and feet. With damaged nerves (diabetic neuropathy), you might not be aware of pain in your legs and feet. (Read about "Peripheral Neuropathy") As a result, ulcers (open sores) or infections can get worse. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. If you have or suspect you have diabetes, it's important that you keep it under control. (Read about "Diabetes")

Dry, Cracked Skin

Dry skin can cause itching and burning. Use mild soap in small amounts and a moisturizing cream or lotion on your legs and feet every day. Be careful about adding oils to bath water since they can make your feet and bathtub very slippery. (Read about "Skin Care")

Fractures

Bone fractures can range from small stress fractures to simple fractures to compound fractures. The severity of the fracture usually depends on what caused it. For example, running may cause small stress fractures in the ankle or legs, whereas a car crash can cause the bone to shatter or even break through the skin. (Read about "Bone Fractures")

Fungal and Bacterial Infections

Fungal and bacterial infections can cause dry skin, redness, blisters, itching and peeling. (Read about "Microorganisms")Athlete's foot is a fungal infection, usually between the toes. (Read about "Tinea: Ringworm, Jock Itch & Athlete's Foot")

Fungus can also infect the toenails. There are topical and oral medications for toenail infections, but sometimes the entire nail must be removed. Bacterial infections can also develop on the feet and legs.

Cellulitis can result in an area of skin that is red and swollen. (Read about "Cellulitis") A common bacterium is staphylococcus (Read about "Staph and MRSA") which can cause impetigo (Read about "Impetigo") and other skin infections. If not treated right away, an infection may be hard to cure. In the case of cellulitis, it can spread and be deadly.

To prevent infections, keep your feet - especially the area between your toes - clean and dry. If you have a cut or cracked skin, keep it clean and protected. (Read about "Wound Care") If a skin ulcer or sore is not healing, see your doctor.

Diabetics need to be especially vigilant in taking care of their feet and legs, to avoid bacterial and fungal infections; if such infections are allowed to persist, it can lead to gangrene and amputation. (Read about "Diabetes")

Gout

Gout is a form of arthritis that most often attacks small joints such as the big toe in sudden severe episodes. It results from deposits of crystals of uric acid in joints and/or connective tissue. (Read about "Gout")

Hammertoe

Hammertoe is caused by a shortening of the tendons that control toe movements. The knuckle of the affected toe or toes gets enlarged, drawing the toe back. Over time, the whole joint enlarges and stiffens as it rubs against shoes. Corns and calluses may form on the top of the toes. There can be pain and your balance may be affected as well.

Wearing shoes and stockings or socks with plenty of toe room can help hammertoe. Women should avoid high-heeled shoes. A physical therapist may be able to suggest exercises to stretch and strengthen the muscles of the foot. In very serious cases, surgery may be needed.

Hamstring Strains

A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is associated with a recent trauma or injury; it also can occur after improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse: prolonged, repetitive movement of the muscles and tendons. A common site for a strain is the hamstring muscle (located in the back of the thigh). Typical symptoms include pain, limited motion, muscle spasms, muscle weakness, swelling, cramping or inflammation. (Read about "Strains")

Iliotibial Band Syndrome

This is an overuse inflammatory condition due to friction (rubbing) of a band of a tendon over the outer bone of the knee. It can be caused by injury or overuse. It will sometimes be called runners knee. (Read about "The Knee")

Ingrown Toenails

Ingrown toenails occur when a piece of the nail breaks the skin - which can often happen if you don't cut your nails properly. Ingrown toenails can also be caused by shoes that are the wrong size. Trauma and problems in the nail's growth pattern can also lead to ingrown toenails.

The National Institute on Aging says ingrown toenails are very common in the large toes. The ingrown nail can cause swelling and tenderness in the skin around the nail. Infections can develop as well.

If the problem is not too bad, soaking the foot in warm weather, plus rest and elevation, can help. If it doesn't, see your doctor. A doctor can remove the part of the nail that is cutting into the skin. This allows the area to heal. If there is an infection, you may need antibiotics. (Read about "Antibiotics")

Unless the problem is due to an abnormally shaped nail, ingrown toenails can often be avoided by cutting the toenail straight across and level with the top of the toe.

Lateral Collateral Ligament (LCL) Injury

The lateral collateral ligament (LCL) connects the thighbone to the fibula and stabilizes the outer side of the knee. AAOS says the LCL is rarely injured. (Read about "The Knee")

Medial Collateral Ligament (MCL) Injury

The medial collateral ligament (MCL) attaches the thighbone to the shinbone. AAOS says this makes the inner side of the knee stable. Athletes, especially in contact sports, are especially vulnerable to this type of injury. (Read about "The Knee")

Osgood-Schlatter Disease

Osgood-Schlatter disease most commonly affects boys around 10-15 years old. It causes pain and/or a bony bump just below the knee joint. It can be caused by overuse or injury. (Read about "The Knee")

Osteochondritis Dissecans

Osteochondritis dissecans results from a loss of the blood supply to an area of bone underneath a joint surface and usually involves the knee. (Read about "The Knee")

Overuse Injury

Repetitive motion disorders (RMD's) result from repeated movements performed in the course of normal work or daily activities. RMD's are most common in the upper body, but can also affect the feet, ankles and legs.

The disorders are characterized by pain, tingling, numbness, visible swelling or redness of the affected area and the loss of flexibility and strength.

Treatment for RMD's usually includes reducing or stopping the motions that cause symptoms. Options include taking breaks to give the affected area time to rest, and adopting stretching and relaxation exercises. Applying ice to the affected area and using medications such as pain relievers, cortisone and anti-inflammatory drugs can reduce pain and swelling. Splints may be able to relieve pressure on the muscles and nerves. Physical therapy may relieve the soreness and pain in the muscles and joints. In rare cases, surgery may be required to relieve symptoms and prevent permanent damage. (Read about "Repetitive Stress")

Peripheral Arterial Disease (PAD) / Intermittent claudication

Intermittent claudication refers to pain and/or cramping that develops in your legs while you are walking or during other activities. It is the result of your leg muscles not getting enough oxygen from red blood cells, due to the narrowing of your arteries. There are serious complications that can develop, so PAD should never be ignored (Read about "Peripheral Arterial Disease")

Plantar Fasciitis

Plantar fasciitis (Read about "Plantar Fasciitis") is a painful condition at your heel. It is the result of inflammation of the plantar fascia, which is the rubber band-like tissue that runs from your heel to the ball of your foot. The American Academy of Family Physicians (AAFP) says that as we age, that tissue doesn't stretch the way it did when we were younger. In addition, the pad of fat that covers the heel portion tends to thin, offering less protection. The American Academy of Orthopaedic Surgeons (AAOS) calls it an overuse injury. (Read about "Repetitive Stress")

It has been known to affect many younger people as well, particularly athletes. Women have the greatest risk, according to AAOS. People who are overweight (Read about "Obesity") or have a job that requires them to stand or walk on hard surfaces are also at greater risk of getting plantar fasciitis. Others at risk include people who run or walk regularly, particularly if you have tight calf muscles, and people with either very flat or very high arches in their feet.

AAOS says it is important to treat plantar fasciitis early; otherwise, it can turn into a chronic problem. Treatment usually starts out conservatively. Rest, keeping weight off the affected foot and ice three to four times a day are usually the first things a doctor will advise, according to AAOS. AAFP says if you are overweight, losing weight may help. (Read about "Losing Weight") In addition, people with flat feet or high arches might be helped by arch supports. People who are required to stand on a hard floor or one spot for long periods may want to consider some type of floor padding for where they stand. Often a doctor will suggest medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAID) to help with the inflammation. (Read about "Medicine Safety") Stretching exercises and rehabilitation are considered crucial to treating the condition and keeping it from returning. You should discuss the type of stretching exercises and how to do them with your healthcare provider. (Read about "Stretching & Health" "Rehabilitation")

If plantar fasciitis is not helped by rest, ice and other conservative treatment, a corticosteroid injection to the heel may be used to relieve inflammation. Sometimes a cast, orthotic device or splint will be used. Sound waves or shock waves may also be used to alleviate the pain. In some cases, surgery may be needed.

Plica Syndrome

Plica syndrome occurs when plicae (bands of synovial tissue, which line the joints) are irritated by overuse or injury. It can cause pain, swelling, weakness, clicking and locking of the knees (Read about "The Knee")

Posterior Cruciate Ligament (PCL) Injury

If you suffer from a PCL injury, your shinbone can sag backwards, disrupting the stability of the knee joint. Athletes are especially susceptible to this injury. (Read about "The Knee")

Shin Splints

Shin splints are another overuse injury. (Read about "Avoid Reptitive Stress") Shin splints can result in pain, swelling or soreness in your lower leg. They are common among runners and other athletes. Causes can include overtraining, improper footwear and too much downhill running.

You may, at first, notice the shin splint only during activity, but the pain can become more frequent. Shin splints will often respond to changes to a less strenuous exercise routine. Rest is important. Applying ice to the affected area can help. Using medications - such as pain relievers, cortisone and anti-inflammatory drugs - can also help.

Once the pain goes away, a physical therapist can recommend a program of strengthening and stretching (Read about "Stretching & Health") exercise to prevent their reoccurrence. If the pain does not go away, you should see your doctor.

Sleep Problems / Restless Legs Syndrome (RLS) / Periodic limb movement (PLM)

Sometimes when you sleep, you may experience unpleasant sensations in the legs described as creeping, crawling, tingling, pulling or pain. It's called restless legs syndrome (RLS) and it is a sleep disorder. A related sleep disorder, called periodic limb movement (PLM), is characterized by involuntary jerking or bending leg movements during sleep. (Read about "Sleep")

Spurs

Spurs are calcium growths that develop on bones. When they develop on your feet, they are often caused by muscle strain in the feet. Standing for long periods of time, wearing badly fitting shoes or being overweight (Read about "Obesity") can make spurs worse. Sometimes spurs are completely painless - at other times, they can be very painful. Treatments for spurs include using foot supports, heel pads and heel cups. Sometimes surgery is needed.

Swelling / Edema

Swelling in the feet, ankles or legs is called peripheral edema. It is the result of an abnormal buildup of fluid. It can be due to long periods of standing, long periods of sitting such as during travel, menstrual periods in women, pregnancy, varicose veins, kidney disease, excess weight, medications, injury or age. (Read about "Travel & Health" "Menstrual Disorders" "Healthy Pregnancy" "Preeclampsia" "Varicose Veins" "Kidney Disease" "Obesity" "Medicine Safety") Because swelling can be a sign of serious problems, such as heart failure (Read about "Congestive Heart Failure"), if swelling persists, you should see your doctor.

Ulcers of the Skin

Skin ulcers are open sores. They can develop on the feet due to a number of conditions including diabetes, poor circulation due to heart disease, or Raynaud's phenomenon. (Read about "Diabetes" "Coronary Heart Disease" "Raynaud's Phenomenon") Your doctor will do tests to see how deep the ulcer is and whether it is infected. (Read about "Wound Care")

Varicose Veins

Varicose veins are swollen and twisted veins that are visible just under the surface of the skin. They appear most commonly in the legs, but also can develop in other parts of the body. (Read about "Varicose Veins")

Warts

Warts are skin growths caused by viruses. They are sometimes painful and, if untreated, may spread. Since over-the-counter preparations rarely cure warts, see your doctor. A doctor can apply medicines, burn or freeze the wart off, or take the wart off with surgery. (Read about "Warts")

Remember, your feet, ankles and legs are important, so take good care of them.