An interdigital neuroma is an irritation of the nerves as they travel down your foot towards your toes. It can occur in between any of the toes, although the most common location is between your third and fourth toes.

The condition has been linked with tight footwear and changes in your gait which increase pressure on the ball of your feet. Neuromas are more commonly seen in women, and those who wear high heels.

Interdigital neuromas can cause tingling and numbness in the toes. Sometimes the pain can be a sharp pain like an electric shock. Symptoms are present during standing and walking, and ease with rest. Symptoms are exacerbated by tight footwear and relieved when removing the shoes.

The treatment for an interdigital neuroma focuses on reducing the pressure being applied to your affected nerve. Your initial treatment may include modifying your insoles with padding to decompress the nerve, and soft tissue techniques to reduce the pressure on the ball of your foot.

In conjunction with relieving pressure on the nerve, we will work with you to strengthen the foot to better distribute the load across the forefoot.

• Tarsal tunnel syndrome
• Freiberg’s infarction
• Plantar plate tear
• Intermetatarsal bursitis

Stress fractures are hairline cracks in the bone that occurs when the load applied exceeds the current capacity of your bone – this can occur when you start a new activity or when you rapidly increase the intensity of your current activity.

Stress fractures can also occur as the result of medical conditions such as osteoporosis which reduces the bone’s overall tolerance to load. The good news is that regardless of the reason for the loss of tolerance your bone strength can be improved to avoid future stress injuries.

Stress fractures can cause swelling and tenderness over the site of the fracture. You may also have an aching pain that increases with an activity that lingers when you rest.

Treatment for your stress fracture will initially focus on reducing the load to allow healing to occur. As the bone begins to heal you will slowly begin to reintroduce load to strengthen the bone.

The main goal following restrengthening is to prevent future stress fractures, to do this we need to determine what caused the fracture initially. We will work with you to uncover the true cause and then help you to prevent future stress fractures with an individualised program specific to your needs.

• Fracture
• Osteochondrosis
• Bone tumour
• Bone infection
• Capsulitis
• Plantar plate rupture/tear

The plantar plate is a ligamentous structure that sits beneath your toes and helps to maintain the stability and integrity of your toes during activity.

Direct trauma or repetitive stress applied to the ball of your foot can lead to the development of a partial or full tear of the plantar plate.

The second toe is most commonly injured, especially if it is your longest toe.

A plantar plate tear will feel like you are walking on a bruise under the second toe, and you may also experience a dull ache in the area.

In addition to the pain, you may notice your toe start to spread apart from the neighbouring toes, or gradually elevate which can progress to a hammer toe.

Strapping and padding techniques are used initially to help realign your toe and reduce the stress placed on your ligament whilst it heals.

To protect against future occurrences your treatment will include techniques to improve your ankle motion and foot strength to reduce the repetitive strain being applied to the ligaments.

• Freiberg’s infarction
• Interdigital neuroma
• Capsulitis
• Stress fracture

Hallux limitus is a condition characterised by limited motion at your big toe, which can change the way you walk or move. As a result of these changes increased pressure is applied to your joint when walking which can lead to alterations in your walking pattern.

Hallux limitus may cause pain or swelling at the big toe joint, with reduced range of motion.

The goal of treatment for hallux limitus is to restore the motion of your big toe, through the use of soft tissue release, joint mobilisation and joint stabilization.

Symptoms of hallux rigidus include pain and swelling of the joint. You may also notice a lump around the top of the joint, which restricts the joint’s range of movement.

Treatment for hallux rigidus focuses on reducing the inflammation around your joint and then reducing the pressure applied during walking. This will be achieved through the use of in-shoe modifications and taping techniques.

• Hallux limitus
• Hallux abducto valgus/bunions
• Sesamoiditis
• Turf toe

A bunion refers to the angle created between the two bones that make up your big toe joint. When your big toe starts to deviate towards your second toe, you can develop hammering of the 2nd toe or a plantar plate injury.

Contrary to popular belief, bunions are not hereditary. They are considered to be more familial as risk factors such as hypermobility (flexible joints) may be passed on through your family. These risk factors do not predispose you to develop a bunion but instead place you at a greater risk of developing a bunion compared to someone with a more stable big toe joint.

Lifestyle changes such as footwear that is too tight at the toes or too high in the heel can exacerbate the development of a bunion.

Bunions will present as a lump on the side of your big toe, with a deviation of the big toe towards the second toe.

You may experience pain, swelling and reduced motion of the big toe. You may also find it difficult to wear certain types of footwear as a result of your bunion.

The treatment of your bunion will depend on the severity of the condition. Some cases benefit from conservative treatments such as taping, toe spacers, naturally shaped footwear, orthoses, foot mobilisation or foot strengthening; while other cases may be best suited to investigating surgical options.

Regardless of which option is required for your bunions, the use of toe spacers and foot strengthening can be used to help reduce the pain and symptoms associated with your bunion.

• Hallux limitus
• Hallux rigidus
• Turf toe

The sesamoids are two tiny bones that sit beneath the big toe joint, embedded in a tendon, similar to how your kneecap sits within your knee joint. These tiny bones have an important role in stabilising your big toe and providing shock absorption.

Sesamoiditis occurs when the tendons become inflamed, as a result of prolonged periods of time spent on the ball of your feet, such as in dancing.

Sesamoiditis may start as a mild ache, and progress to a throbbing pain under the ball of your foot, just behind the big toe joint.

You may also notice a reduction in your big toe joint range of motion. The symptoms can develop as a result of activities where a lot of time is spent on the ball of your feet, such as running, or high-impact sports.

Your sesamoid pain will respond well to reducing the pressure under your big toe joint, and relieving any tightness in the muscles under your feet.

Once the pain has settled, we will work with you to build a stable big toe joint which will allow the sesamoids to work the way they are designed to function.

• Fracture of the sesamoids
• Hallux limitus
• Hallux rigidus
• Turf toe
• Hallux abducto valgus/bunions