FEET are a sadly overlooked and little cared for area of our bodies.

Each foot is an exquisite arrangement of 28 bones and 33 joints.

These joints carry us around for many years and take such a pounding but we rarely offer them much in return.

It is only when we run into problems that we truly appreciate how disabling a foot problem can be.

As often in clinical practice, patients attend in waves with similar complaints and recently I have been deluged by foot problems.

As has always happened we do have to point out to a frightening number of people that we are chiropractors and not chiropodists.

The joints of the foot undergo degenerative changes like any other joint and considering the shoes many of us abuse them with they do an amazing job despite all odds.

In addition to the normal weight bearing activities of simple day-to-day walking, we place huge additional strains on them when we enjoy a game of tennis, squash or just pound the streets for our run each night.

The stop-start and highly dynamic changes of foot position during a squash game can put feet under great threat of injury. This is where excellent fitting and appropriate footwear is key.

If you enjoy running, again invest in the right shoe for your surface.

A road running shoe is different to an off road one if you run on the moors.

Biomechanically, road running exposes your joints to harder impact.

Concrete is the worst, tarmac slightly better, level grass is better still and although not easy to find around here - a sandy beach is a great surface.

Running on the moors is a kinder surface than the roads, but due to it's uneven nature there is a higher risk of ankle injury.

Don't suddenly decide to go for a run and stick on your six year old pumps! Get a good pair of the right shoes.

There are many problems that commonly affect the foot and ankle.

Most people will have heard of plantar fasciitis. This is characterised by pain mainly under the heel towards the middle of the foot and is due to a strain of the fibrous band that stretches between the heel and the base of the toes.

Typically, pain is felt first thing in the morning after getting out of bed but eases after about 30 minutes as the band is stretched and warms up easing the inflammation.

This can be successfully treated with chiropractic treatment in some cases, depending on severity and chronicity can require injection with corticosteroids.

Another common problem is metatarsalgia. This is pain under the joints of the toes at the metatarsal heads.

This can be agonising and can be associated to wearing high heels for long periods.

The weight of the body is loaded on these small areas and results in earlier atrophy of the natural fat pads that cushion these joints.

Once these fat pads have atrophied they can only be assisted externally by the use of orthotics and wearing more sensible and supportive shoes.

I work with a podiatrist as a multifactorial approach is often required to resolve this kind of problem.

The case history of one of my recent patients highlights how an injury acquired many years before can eventually return to haunt you.

This 68-year-old man fell off a wall in his thirties dislocating ankle.

It was not cast but supported for several weeks and no manual treatment was administered.

It appeared to recover well and was forgotten about for many years.

In the past couple of years the right ankle had become stiff and this patient had recently seen a podiatrist who had prescribed orthotics.

The right foot had become painful over the previous four months and appeared to be worsening.

This clearly required some manual treatment as orthotics had already been employed.

On examination the right ankle appeared obviously enlarged and severely inverted.

The hind foot and mid foot were severely pronated and incredibly restricted.

The foot and ankle had clearly sustained a previous injury, which had led to degenerative changes in the ankle joint and foot.

There was some swelling noted on the top of the ankle mortice joint.

This type of problem can result in an altered gait pattern and limping even short term can create a whole host of other imbalances and joint restrictions in other areas of the skeleton.

Treatment consisted of soft tissue techniques, ultrasound and mobilisation techniques.

Some direct gentle manipulation of the affected joints restored some movement that had not been present for a considerable period of time.

The extra movement allowed the swelling to resolve and a sequence of exercises will maintain the new joint motion.

Over two weeks, the pain is reduced and movement is improved.

This is very satisfying to see especially considering the degree of degeneration present in the ankle.

Call me with any questions or suggestions on 01943 605060 or email ilkleychiropractic@tiscali.co.uk