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Osteoarthritis (OA) occurs because cartilage in the joint wears down with repeated stress and use over time. The most common sites in the foot are the big toe. This ofen present as an overgrowth of bone in this area that appears as a bunion. The arch of your foot is another common site. The ankle joint itself is normally a robust and efficient joint is only affected by OA if there has been a severe sprain or fracture
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Achilles and peroneal tendinopathies are both common presentations. The most frquent is Achilles tendinopathy. Achilles tendonopathy is thought to be caused by repeated micro-traumas caused by overuse. Typically activities that include running or sudden stopping and starting combinned with sudden changes in direction are common denominators. The peroneal tendons are located on the outside of your lower leg and enable you to turn your foot outwards (this helps provide stability when you are standing). The condition is often typically characterised by someone involved in a sport that would generate high demands on the ankles.
The most common cause of shin pain is shin splints. Shin splints is a term used to describe pain specifically along the front of your lower leg between the knee and the ankle (i.e. the shin or tibia). It is typically an exercise-induced condition and it is therefore one of the most common presentations in people who play sport. Damage particularly occurs to a layer of connective tissue that covers the surface of the tibia (periosteum) and this then becomes inflamed.
Ankle sprains represent one the most common injuries to the ankle. The most frequent accident is when you turn your ankle over (known as an inversion injury) and this will damage the ligaments that help stabilise the outside of the ankle. The severity will depend on the force of the initial trauma.
Heel pain can occur for various reasons and plantar fasciitis is one of the most common. The plantar fascia is a thick band of strong connective tissue that connects and stretches from the heel to the the toes in your foot. If the stress in this structure becomes excessive and repetitive, small tears develop that lead to inflammation and irritation. This will then often manifest as plantar fasciitis. However if this injury persists for too long a bony heel spur will eventually develop (this is then termed a calcaneal heel spur).
The ankle joint comprises two bones called the tibia and talus that glide over and articulate with each other during movement patterns such as walking and running. Like all joints they have cartilage that helps cushion movement. During these movements the ankle approximates with the shinbone in a movement called ‘dorsiflexion’. This generates compressive forces at the front of the ankle joint. This can be characteristically tolerated but if these forces are excessive (common in some sports or in dancers especially) damage can occur that squashes the joint capsule at the front of the ankle. If this compression continues it can result in bony spurs forming as a result of the cumulative repetition. This condition is known as Anterior Ankle Impingement.