The human foot is divided into longitudinal and transverse arches and consists of 26 bones and over 30 joints. When pressure is placed on the foot, the longitudinal and transverse arches act like a suspension.

The ankle connects the foot to the lower leg. Together, the upper and lower ankle joints facilitate the mobility of the foot and consequently our upright gait. Due to its exposed position and the incredible load it has to bear, the ankle is prone to injuries such as twists and sprains.

Anatomy of the foot.


1. Distal phalanges
2. Phalanges
4. Cuneiform bones
5. Navicular bone
6. Talus bone
7. Calcaneus

Common problems & diseases

Here are some of the common problems and diseases that can affect the feet and ankles.

It is not a comprehensive list.

Heel spur

A heel spur is a thorn-like bony protrusion on the bottom of the heel bone. The associated pain is much more likely to be the result of excess strain on the very strong layers of tendons that connect to the heel bone. To heal the small tendons, the body deposits calcium on the injuries.

Various things can cause excess strain on the tendons. Certain shoes or walking on hard surfaces for several hours can certainly lead to inflammation. Shortened calf muscles or excess body weight can have the same effect. This disorder can also become chronic.

The most common symptom of a heel spur is pain in the heel of the foot. The greater the strain, the more intense the pain – and it can even continue when the foot is not in use. Surgical treatment is only considered necessary if medication and physiotherapy have failed to resolve the problem.

Bunions (hallux valgus)

Women in particular will be familiar with this problem: those fabulous shoes suddenly feel tighter and the joints in your toes hurt, even if you have not walked very far. Then if your big toe also starts protruding at an unnatural angle, the diagnosis is soon clear: hallux valgus, otherwise known as a bunion. The joint of the big toe presses outwards towards the edge of the foot and the first metatarsal is increasingly pushed inwards. The head of the first metatarsal bone becomes a painful bulge. The deformity prevents the big toe from properly supporting the foot and the neighbouring second metatarsal bone becomes chronically overworked as a result. This can lead to irritations such as an inflamed bursa, horny skin or calluses.

People with genetically inherited weak ligaments and connective tissue are more predisposed towards developing bunions. Women are affected more frequently than men and narrow shoes with high heels can also increase the risk.

Various surgical procedures are available for correcting and relieving the pain of a deformed metatarsal bone. Hallux valgus is usually only treated conservatively (without surgery) in the early stages of very mild cases, or if the patient is elderly and cannot or does not want to undergo an operation.

Osteoarthritis of the ankle

The thin layer of cartilage on the small joint surfaces in the ankle can absorb huge amounts of pressure, for example during sporting activities. Nevertheless the joint is susceptible to wear and tear, which can lead to damaged cartilage (osteoarthritis). Unlike the hip and knee joints, osteoarthritis of the ankle is often the result of an injury. For instance, a broken bone or ligament injury can lead to osteoarthritis two or three decades later.

Common symptoms of ankle osteoarthritis are pain when the joint initially starts moving, as well as swelling on the upper ankle joint. Depending on the severity of the osteoarthritis, the pain may continue as the person walks or it may improve with movement. Resting the joint can relieve the pain, however, after lots of physical activity the pain may even linger when the joint is not in use. Over time the joint can become stiff, which can have a major impact on quality of life.

In general, there are two treatments available:

  • Therapy without surgery: this is usually the main approach, although it only treats the symptoms and not the cause.
  • Operations on the ball of the joint either involve fusing the joint or replacing it with an artificial joint. However, there is also a relatively new surgical technique that retains the joint by means of ankle arthrodiastasis.


Orthopaedic services offered at Mediclinic City Hospital for foot and ankle joints includes conservative and surgical treatment for different types of conditions including arthritis of the different joints, different kind of feet and toes deformities.

our Foot and Ankle joint services includes:

  • Ankle Arthroscopy
  • Bunion and Fore-feet Surgery (Hallux Valgus): Read more here
  • Ankle Instability Surgery
  • Flat-Foot Reconstruction Surgery
  • Hind / mid-foot joint fusion Surgery
  • Ankle Joint Replacement