Each of your feet has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. No wonder a lot of things can go wrong. Here are a few common problems:

• Bunions - hard, painful bumps on the big toe joint
• Corns and calluses - thickened skin from friction or pressure
• Plantar warts - warts on the soles of your feet
• Fallen arches - also called flat feet

Ill-fitting shoes often cause these problems. Aging and being overweight also increase your chances of having foot problems.

General or unspecified injuries involving the foot.

Fourteen of the 26 bones in your feet are in your toes. The toes, particularly your big toe, help you move and keep your balance. Playing sports, running, stubbing your toe, and dropping something on your foot can damage your toes. Wearing shoes that are too loose or too tight can also cause toe problems. Certain diseases, such as severe arthritis, can cause toe problems and pain. Gout often causes pain in the big toe.

Common toe problems include

• Corns and bunions
• Ingrown toenails
• Sprains and dislocations
• Fractures

Treatments for toe injuries and disorders vary. They might include shoe inserts or special shoes, padding, taping, medicines, rest, and in severe cases, surgery.

Your legs are made up of bones, blood vessels, muscles, and other connective tissue. They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures.

These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg problems. For example, knee osteoarthritis, common in older people, can cause pain and limited motion. Problems in your veins in your legs can lead to varicose veins or deep vein thrombosis.

Heel problems are common and can be painful. Often, they result from too much stress on your heel bone and the tissues that surround it. That stress can come from

• Injuries
• Bruises that you get walking, running or jumping
• Wearing shoes that don't fit or aren't made well
• Being overweight

These can lead to tendinitis, bursitis, and fasciitis, which are all types of inflammation of the tissues that surround your heel. Over time the stress can cause bone spurs and deformities. Certain diseases, such as rheumatoid arthritis and gout, can also lead to heel problems. Treatments for heel problems might include rest, medicines, exercises, taping, and special shoes. Surgery is rarely needed.

Your ankle bone and the ends of your two lower leg bones make up the ankle joint. Your ligaments, which connect bones to one another, stabilize and support it. Your muscles and tendons move it.

The most common ankle problems are sprains and fractures. A sprain is an injury to the ligaments. It may take a few weeks to many months to heal completely. A fracture is a break in a bone. You can also injure other parts of the ankle such as tendons, which join muscles to bone, and cartilage, which cushions your joints. Ankle sprains and fractures are common sports injuries.

Foot drop syndrome describes the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot. As a result, individuals with foot drop scuff their toes along the ground or bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a “steppage gait."

Foot drop can be unilateral (affecting one foot) or bilateral (affecting both feet). Foot drop is a symptom of an underlying problem and is either temporary or permanent, depending on the cause.

Causes include:

• Neurodegenerative disorders of the brain that cause muscular problems, such as multiple sclerosis, stroke, and cerebral palsy
• Motor neuron disorders such as polio, some forms of spinal muscular atrophy and amyotrophic lateral sclerosis (commonly known as Lou Gehrig's disease)
• Injury to the nerve roots, such as in spinal stenosis
• Peripheral nerve disorders such as Charcot-Marie-Tooth disease or acquired peripheral neuropathy
• Local compression or damage to the peroneal nerve as it passes across the fibular bone below the knee
• Muscle disorders, such as muscular dystrophy or myositis

Treatment depends on the specific cause of foot drop. The most common treatment is to support the foot with lightweight leg braces and shoe inserts, called ankle-foot orthotics. Exercise therapy to strengthen the muscles and maintain joint motion also helps to improve gait. Devices that electrically stimulate the peroneal nerve during footfall are appropriate for a small number of individuals with foot drop. In cases with permanent loss of movement, surgery that fuses the foot and ankle joint or that transfers tendons from stronger leg muscles is occasionally performed.

Foot drop caused by trauma or nerve damage usually has partial or even complete recovery. For progressive neurological disorders, foot drop will be a symptom that is likely to continue as a lifelong disability. People with foot drop are more likely to fall.

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy

• Examine your feet regularly
• Wear comfortable shoes that fit
• Wash your feet daily with soap and lukewarm water
• Trim your toenails straight across and not too short

Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure.

Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

The distal extremity of the leg in vertebrates, consisting of the tarsus (ANKLE); METATARSUS; phalanges; and the soft tissues surrounding these bones.

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose can't get into your cells as quickly as usual. The glucose builds up in your blood and causes high blood sugar levels.

How does diabetes cause foot problems?

Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.

If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot. A wound like that could get infected. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet.

Having an infection and poor blood flow can lead to gangrene. That means the muscle, skin, and other tissues start to die. If you have gangrene or a foot ulcer that does not get better with treatment, you may need an amputation. This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life.

But there's a lot you can do to prevent a foot wound from becoming a major health problem.

How can I protect my feet if I have diabetes?

The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy.

Good foot care for people with diabetes includes:

• Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub. Make sure to check the bottoms of your feet too.
• Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection. If you use lotion, don't apply it between your toes.
• Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers.
• Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist (foot doctor) do it for you.
• Always wearing well-fitting shoes and socks or slippers to protect your feet when walking. You don't want to walk barefoot, even indoors. And be sure your shoes are smooth inside. A seam or pebble could rub your skin raw.
• Protecting your feet from heat and cold. Use sunscreen on exposed skin and don't walk barefoot at the beach. In cold weather, wear warm socks instead of warming your feet near a heater or fireplace.
• Keeping the blood flowing in your feet. Put your feet up when you're sitting. Wiggle your toes and circle your feet throughout the day. Don't wear tight socks. And get plenty of activity that's not too hard on the feet, such as walking.
• Getting your feet checked at your health care visits. Even if you haven't noticed a problem, it's good to have your health care provider look at your feet.

When should I see my health care provider about diabetic foot problems?

Serious foot problems can develop quickly. See your health care provider right away if you notice:

• A cut, blister, or bruise on your feet that doesn't start to heal in a few days
• Red, warm, or painful skin on your feet
• A callus with dried blood inside
• A foot infection that becomes black and smells bad that could be gangrene

Remember, controlling your blood sugar and caring for your feet every day are the best steps you can take to prevent serious diabetic foot problems.

A bunion, known technically as hallux valgus, is a bony bump on the side of the foot at the base of the big toe. Bunions develop slowly as pressure on the joint at the base of the big toe causes the toe to move out of place, leaning inward toward the second toe. Because this joint carries a lot of weight during activities like standing and walking, bunions can cause foot pain, stiffness, redness, and swelling. Calluses may form where the big toe and second toe rub together or on the ball of the foot. Unless they are treated, bunions get worse over time, and it may become difficult to wear regular shoes or walk without pain. Bunions can occur in one or both feet.

In most cases, bunions develop in adulthood. Rarely, children may be born with bunions (known as congenital hallux valgus) or develop them later in childhood (juvenile or adolescent hallux valgus).

Corns and calluses are caused by pressure or friction on your skin. They often appear on feet where the bony parts of your feet rub against your shoes. Corns usually appear on the tops or sides of toes while calluses form on the soles of feet. Calluses also can appear on hands or other areas that are rubbed or pressed.

Wearing shoes that fit better or using non-medicated pads may help. While bathing, gently rub the corn or callus with a washcloth or pumice stone to help reduce the size. To avoid infection, do not try to shave off the corn or callus. See your doctor, especially if you have diabetes or circulation problems.

Warts are growths on your skin caused by an infection with humanpapilloma virus, or HPV. Types of warts include :

• Common warts, which often appear on your fingers
• Plantar warts, which show up on the soles of your feet
• Genital warts, which are a sexually transmitted disease
• Flat warts, which appear in places you shave frequently

In children, warts often go away on their own. In adults, they tend to stay. If they hurt or bother you, or if they multiply, you can remove them. Chemical skin treatments usually work. If not, various freezing, surgical and laser treatments can remove warts.

Warts are non-cancerous (benign) skin growths that develop on different parts of the body and come in various forms. They are caused by viruses. Warts are contagious and very common: Most people will have one at some point in their lives. Although they can affect people at any age, warts are most common among children and teenagers.

Most warts are harmless and will go away on their own within a few weeks or months. But they can be bothersome and unattractive, and some people feel ashamed. There are a number of different treatments that can make warts go away more quickly – but they don't always work.

Viral warts aren't the same as “senile warts” (seborrheic keratosis), which usually first appear in older age and aren't contagious. Senile warts are also quite harmless, but permanent. This information is about viral warts only.

Warts are very common, especially among children and teenagers. Various studies have shown that up to 33% of children and teenagers have warts. They are estimated to be much less common in other age groups, affecting only about 3 to 5% of adults.

Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. Symptoms include itching, burning, and cracked, scaly skin between your toes.

You can get athlete's foot from damp surfaces, such as showers, swimming pools, and locker room floors. To prevent it

• Keep your feet clean, dry, and cool
• Wear clean socks
• Don't walk barefoot in public areas
• Wear flip-flops in locker room showers
• Keep your toenails clean and clipped short

Treatments include over-the-counter antifungal creams for most cases and prescription medicines for more serious infections. These usually clear up the infection, but it can come back.

Athlete’s foot (tinea pedis) is a skin infection caused by a type of fungus called a dermatophyte. Athletes foot is the most common dermatophyte infection seen and can affect anyone. People with compromised immune systems are especially vulnerable to infections caused by these organisms.

Athlete’s foot, or tinea pedis, is an infection of the skin and feet that can be caused by a variety of different fungi. Although tinea pedis can affect any portion of the foot, the infection most often affects the space between the toes. Athlete’s foot is typically characterized by skin fissures or scales that can be red and itchy.

Tinea pedis is spread through contact with infected skin scales or contact with fungi in damp areas (for example, showers, locker rooms, swimming pools). Tinea pedis can be a chronic infection that recurs frequently. Treatment may include topical creams (applied to the surface of the skin) or oral medications.

When the foot comes into contact with the ground during walking, running, or jumping activities, the impact of the body weight puts a tremendous amount of pressure and force on the foot. During running, the force applied to each foot as it contacts the ground can be up to 2.5 times your body weight. The bones, joints, ligaments, and muscles of the foot absorb this force, thus greatly reducing the amount of shock that is passed superiorly into the lower limb and body. The arches of the foot play an important role in this shock-absorbing ability. When weight is applied to the foot, these arches will flatten somewhat, thus absorbing energy. When the weight is removed, the arch rebounds, giving “spring” to the step. The arches also serve to distribute body weight side to side and to either end of the foot.

The foot has a transverse arch, a medial longitudinal arch, and a lateral longitudinal arch. The transverse arch forms the medial-lateral curvature of the mid-foot. It is formed by the wedge shapes of the cuneiform bones and bases (proximal ends) of the first to fourth metatarsal bones. This arch helps to distribute body weight from side to side within the foot, thus allowing the foot to accommodate uneven terrain.

The longitudinal arches run down the length of the foot. The lateral longitudinal arch is relatively flat, whereas the medial longitudinal arch is larger (taller). The longitudinal arches are formed by the tarsal bones posteriorly and the metatarsal bones anteriorly. These arches are supported at either end, where they contact the ground. Posteriorly, this support is provided by the calcaneus bone and anteriorly by the heads (distal ends) of the metatarsal bones. The talus bone, which receives the weight of the body, is located at the top of the longitudinal arches. Body weight is then conveyed from the talus to the ground by the anterior and posterior ends of these arches. Strong ligaments unite the adjacent foot bones to prevent disruption of the arches during weight bearing. On the bottom of the foot, additional ligaments tie together the anterior and posterior ends of the arches. These ligaments have elasticity, which allows them to stretch somewhat during weight bearing, thus allowing the longitudinal arches to spread. The stretching of these ligaments stores energy within the foot, rather than passing these forces into the leg. Contraction of the foot muscles also plays an important role in this energy absorption. When the weight is removed, the elastic ligaments recoil and pull the ends of the arches closer together. This recovery of the arches releases the stored energy and improves the energy efficiency of walking.

Stretching of the ligaments that support the longitudinal arches can lead to pain. This can occur in overweight individuals, with people who have jobs that involve standing for long periods of time (such as a waitress), or walking or running long distances. If stretching of the ligaments is prolonged, excessive, or repeated, it can result in a gradual lengthening of the supporting ligaments, with subsequent depression or collapse of the longitudinal arches, particularly on the medial side of the foot. This condition is called pes planus (“flat foot” or “fallen arches”).

Call your health care provider right away if you have

• a cut, blister, or bruise on your foot that does not start to heal after a few days
• skin on your foot that becomes red, warm, or painful—signs of a possible infection
• a callus with dried blood inside of it,which often can be the first sign of a wound under the callus
• a foot infection that becomes black and smelly—signs you might have gangrene

Ask your provider to refer you to a foot doctor, or podiatrist, if needed.

The ankle is formed by the talocrural joint (image). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg (crural = “leg”). The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations with the medial malleolus of the tibia and the lateral malleolus of the fibula, which prevent any side-to-side motion of the talus. The ankle is thus a uniaxial hinge joint that allows only for dorsiflexion and plantar flexion of the foot.

Additional joints between the tarsal bones of the posterior foot allow for the movements of foot inversion and eversion. Most important for these movements is the subtalar joint, located between the talus and calcaneus bones. The joints between the talus and navicular bones and the calcaneus and cuboid bones are also important contributors to these movements. All of the joints between tarsal bones are plane joints. Together, the small motions that take place at these joints all contribute to the production of inversion and eversion foot motions.

Like the hinge joints of the elbow and knee, the talocrural joint of the ankle is supported by several strong ligaments located on the sides of the joint. These ligaments extend from the medial malleolus of the tibia or lateral malleolus of the fibula and anchor to the talus and calcaneus bones. Since they are located on the sides of the ankle joint, they allow for dorsiflexion and plantar flexion of the foot. They also prevent abnormal side-to-side and twisting movements of the talus and calcaneus bones during eversion and inversion of the foot. On the medial side is the broad deltoid ligament. The deltoid ligament supports the ankle joint and also resists excessive eversion of the foot. The lateral side of the ankle has several smaller ligaments. These include the anterior talofibular ligament and the posterior talofibular ligament, both of which span between the talus bone and the lateral malleolus of the fibula, and the calcaneofibular ligament, located between the calcaneus bone and fibula. These ligaments support the ankle and also resist excess inversion of the foot.