Foot and ankle problems usually fall into the following categories:

• Acquired from improper footwear, physical stress, or small mechanical changes within the foot.
• Arthritic foot problems, which typically involve one or more joint.
• Congenital foot problems, which occur at birth and are generally inherited.
• Infectious foot problems, which are caused by bacterial, viral, or fungal disorders.
• Neoplastic disorders, usually called tumors, which are the result of abnormal growth of tissue and may be benign or malignant.
• Traumatic foot problems, which are associated with foot and ankle injuries.

Forefoot pain can happen after you have an injury or because of problems that you grew up with, essentially, what you inherited through your genes. One of the ones that are often talked about is a bunion, which is a bump next to your big toe that gradually gets bigger in time. While everyone notices the bump, the deformity you have actually starts in the bone surrounding the foot, and as a result, it’s unlikely to get better if the bones remain out of place.

However, bunions are common and many of them don’t need any surgery. Because there’s a bump there and it irritates some shoes. The way to get around this is to make sure that you get good shoe advice to make sure that shoes that might irritate it – you don’t buy, and you can make sure, hopefully, they can remain fashionable and also remain pain free.

So as you get older, your foot can deteriorate and it can get more deformed. When you get a bunion this bone here goes out of place and twists off to the side. This bone here deforms and the bump that’s seen is this part of the bone pushing up against the skin.

When you get clotters these joints here – they're quite far down in your foot – dislocate and then you can get other deformities where these joints here get tight and end up bending so that you can't straighten them again.

These can be accommodated in your shoes, but on occasion, the shoe wear modifications are no longer able to keep up with the deformity so the foot needs to be straightened out.

The key to getting rid of a large bunion or protuberance of this bone is to make sure that it’s shorted its space, either by cutting the bone here, or by taking out this joint here and making sure that it heals with the foot straight.

Because the joints have got deformed in time they end up being tight on this side and loose on this side. And when the joint is corrected in its position the surgeon will need to release this side of the joint and tighten it up on this side so that your foot goes straight and stays straight.

So there’s a number of ways that bunions can hurt and that surgery can help you if you fail to resolve your discomfort with other things such as shoes and inserts. These are best coordinated through your family doctor or another practitioner, but if things deteriorate then you might consider asking for a referral to an orthopedic surgeon so that your foot can be addressed to see if surgery would be beneficial for you.

Presenter: Dr. Alastair Younger, Orthopaedic Surgeon, Vancouver, BC

Now Health Network  Local Practitioners: Orthopaedic Surgeon

A dancer's fracture or a fracture of the fifth metatarsal of the foot, is the most common acute fracture seen in dancers, hence the name. Essentially it is a fracture in the outermost bone of the foot, and it occurs most commonly from landing badly from a jump and rolling the foot inwards, resulting in an impact along this bone.

A dancer will experience immediate pain, usually with associated swelling, may even hear the break as it occurs, and be unable to weight bear generally right after the incident. The type and severity of fracture will determine whether or not the bone will heal on its own with immobilization or whether or not it needs to go to surgery. So an X-ray is needed to confirm the diagnosis, and to determine where and how the bone was broken.

In the acute phase, rest, ice and limiting weight bearing will be the mainstays of therapy. Following, a period of immobilization, which may be anywhere from six to eight weeks. It is important that a course of physiotherapy be started to restore balance, strength and mobility, both of the foot and the ankle.

If you feel you've suffered a dancer's fracture or have further questions regarding this condition, please feel free to seek the advice of your local family physician or sports medicine physician. Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.  Presenter: Dr. Larissa Roux, Sports Medicine Physician, Vancouver, BC

Local Practitioners: Local Orthopedic Surgeon

If you've got a fracture in your foot, or your lower leg, you have to determine what type of walker boot you need. If you've got a fracture that's in the forefoot, be it fifth metatarsal fracture, a stress fracture, maybe a bunion surgery recovery, the ankle walkers are a great product for this.

There's a variety of different models that are available. We really like this one because it's got a nice rocker profile on the bottom, three straps, and a nice wide base for support.

If you've got a lower leg fracture or a rear foot fracture, malleolar fracture, talus fracture, one of the things you want to look for is a longer boot that offers more support through the rear foot or leg, with the three straps on the front, again a nice wide base on the bottom and a great rocker profile.

When you're ready to try on a walker boot, it's really important to try some different ones on, they range in price quite dramatically, go to an experienced store and let them help determine what type of walker boot.

Presenter: Mr. Dale Harris, Bracing & Equipment Specialist, Vancouver, BC

Local Practitioners: Bracing & Equipment Specialist