Foot & Ankle Surgery
The foot and ankle carry your entire body weight over roughly ten thousand steps a day, across twenty-six bones and more than thirty joints. Problems here are frequently dismissed as ordinary aches, treated with rest and painkillers for months, and only assessed properly once walking has become genuinely difficult. Most foot and ankle conditions respond well to non-surgical treatment — provided the diagnosis is right.
- Foot Deformities (Bunions, Flat Foot)
- Achilles Tendon Disorders
- Ankle Arthroscopy & Ligament Repair
- Diabetic Foot Care
Why foot and ankle problems are so often mistreated
Pain in the foot is a poor guide to its own cause. Heel pain can come from the plantar fascia, the Achilles tendon, a nerve, or a stress fracture — and each needs a different treatment. Pain on the outer ankle after a twist may be a ligament sprain or a fracture that does not show clearly on an initial X-ray. Because the structures sit so close together, a careful examination usually tells more than a scan does, and it is what determines whether you need a simple insole or an operation.
Bunions and flat foot: when is surgery justified?
A bunion is a deformity of the joint at the base of the big toe, and it is progressive — it does not correct itself, and no splint or exercise reverses an established one. That said, a bunion only needs surgery when it hurts, when footwear has become a genuine problem, or when the deformity is beginning to affect the neighbouring toes. A painless bunion, however prominent, is not by itself a reason to operate. Adult flat foot is treated similarly: supportive footwear, orthotics and strengthening of the supporting tendons come first, and surgery is reserved for feet that stay painful or where the deformity is progressing and the tendon on the inner side is failing.
What causes persistent heel pain?
The commonest cause is plantar fasciitis — inflammation where the thick band of tissue under the foot attaches to the heel bone. The signature is pain in the first few steps out of bed in the morning, easing as you move and returning after periods of sitting. It responds to stretching of the calf and plantar fascia, appropriate footwear, heel cushioning and activity modification in the large majority of cases, though it can take months rather than weeks. Heel spurs seen on X-ray are usually a consequence rather than the cause, and removing them is rarely the answer. Pain at the back of the heel is a different problem, involving the Achilles insertion, and needs a different approach.
Achilles tendon problems
The Achilles is the strongest tendon in the body and it fails in two quite different ways. Gradual-onset pain and thickening (tendinopathy) is an overuse problem, treated with a structured loading programme — eccentric strengthening in particular — alongside footwear changes and activity modification. A sudden rupture is different: patients typically describe a sensation like being kicked or struck in the back of the ankle, sometimes with an audible snap, followed by difficulty pushing off. A rupture needs prompt assessment, because the choice between surgical repair and functional bracing depends partly on how early it is seen.
Ankle sprains that never settle
Most ankle sprains recover with rest, ice, compression and a progressive rehabilitation programme. A meaningful minority do not, and those are worth investigating rather than enduring. Persistent pain or a feeling of giving way months after a sprain may indicate chronic ligament instability, a missed fracture, damage to the cartilage surface of the talus, or a tendon injury on the outer side of the ankle. Repeated giving-way episodes progressively damage the joint surface, which is the reason not to simply live with it.
Diabetic foot: why early review matters
Diabetes affects the foot in two compounding ways — reduced sensation, so injuries go unnoticed, and reduced blood supply, so they heal poorly. A minor blister or a small ulcer can progress silently and quickly. Anyone with diabetes should have their feet examined regularly, check them daily for breaks in the skin, and treat any new ulcer, colour change, swelling or unexplained warmth as needing prompt review rather than a wait-and-see approach. Early intervention here prevents the outcomes that matter most.
Frequently Asked Questions
Do bunions always need surgery?
No. Surgery is considered when the bunion is painful, when it makes normal footwear difficult, or when the deformity is starting to affect the neighbouring toes. A prominent but painless bunion does not need an operation. Wider footwear, padding and orthotics help symptoms, though they do not reverse the deformity itself.
Why does my heel hurt most on the first steps in the morning?
That pattern is characteristic of plantar fasciitis. The plantar fascia tightens overnight, and the first steps stretch it abruptly. Pain typically eases as you walk and returns after sitting. Most cases settle with calf and fascia stretching, supportive footwear and activity modification, though recovery is measured in months rather than weeks.
How do I know if my ankle sprain is actually a fracture?
Features that point towards a fracture include inability to bear weight for four steps immediately after the injury and afterwards, and tenderness directly over the bone at the back edge or tip of either ankle bone. These signs warrant an X-ray. Swelling and bruising alone do not distinguish the two, since severe sprains swell dramatically.
Can flat feet be corrected in adults?
Flexible flat feet that cause no pain need no treatment. When they are painful, supportive footwear, orthotics and strengthening of the tibialis posterior tendon are the first steps. Surgery is reserved for feet that remain painful despite this, or where the deformity is progressing and the supporting tendon is failing.
Why do people with diabetes need special foot care?
Diabetes can reduce both sensation and blood supply in the feet, so injuries are felt less and heal more slowly. A small blister or ulcer can worsen without being noticed. Daily self-checks, regular professional examination and prompt review of any new ulcer, swelling or colour change substantially reduce the risk of serious complications.
Read more on heel pain and plantar fasciitis or telling an ankle sprain from a fracture. See foot & ankle surgery with Dr. Ghag, or book a consultation.