 Certain foot shapes: A high arch can put extra pressure on the metatarsals. Pes Cavus as this is called causes the metatarsal shaft to angle down toward the ground at an increased angle increasing the pressure on the metatarsal heads. So can having a second toe that's longer than the big toe, which causes more weight than normal to be shifted to the second and smaller metatarsal head.

 Hammertoe: This foot problem can develop when high heels or too-small shoes prevent your toes from lying flat. As a result, one of your toes - usually the second - curls downward because of a bend in the middle toe joint. This contraction increases pressure on the metatarsal heads.

 Bunion: This is a swollen, painful bump at the base of your big toe. Sometimes the tendency to develop bunions is inherited, but the problem can also result from wearing high heels or too-small shoes. Bunions are much more common in women than in men. A bunion can weaken your big toe, putting extra stress on the ball of your foot. Sometimes surgery to correct a bunion can also lead to metatarsalgia.

 Excess weight: Because most of your body weight transfers to your forefoot when you move, even a few extra pounds mean more pressure on your metatarsals. Sometimes losing weight reduces or eliminates symptoms of metatarsalgia.

 Poorly fitting shoes: High heels, which cause more weight to be transferred to the front of the foot, are one of the most common causes of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lack support and padding also can contribute to metatarsal problems.

 Stress fractures: Small breaks in the metatarsals or toe bones caused by overuse can be painful and change the way you put weight on your foot.

 Morton's neuroma: This non-cancerous growth of fibrous tissue surrounding the plantar nerves most often occurs between the third and fourth metatarsal heads. It causes symptoms that are similar to metatarsalgia and can also contribute to metatarsal stress. Morton's neuroma frequently results from wearing high heels or too-tight shoes that put pressure on your toes. It can also develop after high-impact activities such as jogging and aerobics.

 Aging: As you grow older, the fat pads on the balls of your feet become thinner. This makes the metatarsal bones more susceptible to injury.

KNEE PROBLEMS IN WOMEN...An in depth look.

Men are from Mars, women are from Venus may not be exactly right but when it comes to foot and leg problems, it's pretty close to the truth. Men and women differ from each other in some obvious and some not so obvious ways but when it comes to footwear and training, what is right for one may not be right for the other. Walk into your local mall and go into any "chain" sneaker store. You are literally bombarded with hundreds of styles and colors from dozens of brands. Which specific one is right for you is probably not a question that is going to be answered by the 16 year old behind the counter while he's texting his girlfriend. Women have different mechanics that contribute to different needs when it comes to footwear.

It is important to remember to choose stability footwear that provides lateral support. Cushioning is also important but look for stability first. It is well known that significant anatomical differences exist between men and women's bodies beyond the reproductive system. These differences may have an effect on how male and female athletes should condition their individual bodies safely. Research literature indicates that anterior cruciate ligament (ACL) injuries may be anywhere from 3 to 10 times more likely in women. Speculation as to the reasons include the anatomical, hormonal and physiological differences that exist between men and women.

• Female athletes are up to eight times more likely to suffer knee injuries during their careers than males, and now researchers may be closer to understanding why.
• A recent study from the Eastern Virginia Medical school suggests that the fluctuations in hormone levels associated with a female's menstrual cycle may have a bearing on the incidence of knee injuries.
• A recent study of 10 female and 10 male NCAA athletes completed within the Department of Biomedical Engineering at the Cleveland Clinic found that female athletes tend to land from a jump with a more flexed ankle, the foot rolling outward with an elevated arch, and more knee abduction and knee internal rotation compared to male athletes.
• When fatigued, differences between women and men in these movements and loads were even larger, possibly explaining why females may be at greater risk of non-contact anterior cruciate ligament (ACL) injury during landing.

Women are more prone to several sports injuries than men based simply on biomechanical differences. One such difference is a wider pelvis in women then men. Many sports medicine experts have linked a wider pelvis to a larger "Q" (Quadriceps ) Angle - the angle at which the femur (upper leg bone) meets the tibia (lower leg bone). This wider angle tends to destabilize the entire kinetic structure of the leg.

On average this angle is degrees greater in women than in men. It is thought that this increased angle places more stress on the knee joint, as well as leading to increased foot pronation in women. This is why it is important to stabilize the foot with proper footwear and orthotics.

Custom foot orthotics work in a few different ways. First, orthotics stabilize the lower leg by reducing inversion and eversion (rolling in or out). Secondly, orthotics reduce sub-talar joint motion. The sub-talar joint is the most important joint of the foot. This is the joint where the talus meets the calcaneous. (heel bone). Also custom orthotics work to cushion the foot and body against shock. While there may be other factors that lead to increase risk of injury in women athletes (strength, skill, hormones, etc.), an increased Q-angle has been linked to:

Patellofemoral pain syndrome
A high Q-angle causes the quadriceps to pull on the patella and leads to poor patellar tracking. Over time, this may cause knee pain. Stretching and quad strengthening is important.

Chondromalacia of the Knee (Runner's Knee)
This wearing down of the cartilage on the underside of the patella leads to degeneration of the articular surfaces of the knee.

ACL injuries (Anterior Cruciate)
Women have considerably higher rates of ACL injuries than men. An increased Q-angle appears to be one factor that causes the knee to be less stable and under more stress.

Ligament injury

Trauma can cause injury to the ligaments on the inner portion of the knee (medial collateral ligament), the outer portion of the knee (lateral collateral ligament), or within the knee (cruciate ligaments). Injuries to these areas are noticed as immediate pain but are sometimes difficult to pinpoint. Usually, a collateral ligament injury is felt on the inner or outer portions of the knee. A collateral ligament injury is often associated with local tenderness over the area of the ligament involved. A cruciate ligament injury is felt deep within the knee. It is sometimes noticed with a "popping" sensation with the initial trauma. A ligament injury to the knee is usually painful at rest and may be swollen and warm. The pain is usually worsened by bending the knee, putting weight on the knee, or walking. The severity of the injury can vary from mild (minor stretching or tearing of the ligament fibers, such as a low grade sprain) to severe (complete tear of the ligament fibers). Patients can have more than one area injured in a single traumatic event.

Ligament injuries are initially treated with ice packs and immobilization, with rest and elevation. It is generally recommended to avoid bearing weight on the injured joint, and crutches may be required for walking. Some patients are placed in splints or braces to immobilize the joint to decrease pain and promote healing. Arthroscopic or open surgery may be necessary to repair severe injuries.

What injuries can cause knee pain, and what other symptoms may accompany knee pain?

Injury can affect any of the ligaments, bursae, or tendons surrounding the knee joint. Injury can also affect the ligaments, cartilage, menisci (plural for meniscus), and bones forming the joint. The complexity of the design of the knee joint and the fact that it is an active weight-bearing joint are factors in making the knee one of the most commonly injured joints.

Tendinitis

Tendinitis of the knee occurs in the front of the knee below the kneecap at the patellar tendon (patellar tendinitis) or in the back of the knee at the popliteal tendon (popliteal tendinitis). Tendinitis is an inflammation of the tendon, which is often produced by a strain event, such as jumping. Patellar tendinitis, therefore, also has the name "jumper's knee." Tendinitis is diagnosed based on the presence of pain and tenderness localized to the tendon. It is treated with a combination of ice packs, immobilization with a knee brace as needed, rest, and antiinflammatory medications. Gradually, exercise programs can rehabilitate the tissues in and around the involved tendon. Cortisone injections, which can be given for tendinitis elsewhere, are generally avoided in patellar tendinitis because there are reports of risk of tendon rupture as a result of corticosteroids in this area. In severe cases, surgery can be required. A rupture of the tendon below or above the kneecap can occur. When it does, there may be bleeding within the knee joint and extreme pain with any knee movement. Surgical repair of the ruptured tendon is often necessary.

Fractures

With severe knee trauma, such as motor vehicle accidents and impact traumas, bone breakage (fracture) of any of the three bones of the knee can occur. Bone fractures within the knee joint can be serious and can require surgical repair as well as immobilization with casting or other supports.

Pain can occur in the knee from diseases or conditions that involve the knee joint, the soft tissues and bones surrounding the knee, or the nerves that supply sensation to the knee area. In fact, the knee joint is the most commonly involved joint in rheumatic diseases, immune diseases that affect various tissues of the body including the joints to cause arthritis.

Arthritis is inflammation within a joint. The causes of knee joint inflammation range from non-inflammatory types of arthritis such as osteoarthritis, which is a degeneration of the cartilage of the knee, to inflammatory types of arthritis (such as rheumatoid arthritis or gout). Treatment of the arthritis is directed according to the nature of the specific type of arthritis. Swelling of the knee joint from arthritis can lead to a localized collection of fluid accumulating in a cyst behind the knee. This is referred to as a Baker cyst and is a common cause of pain at the back of the knee.

Chondromalacia refers to a softening of the cartilage under the kneecap (patella). It is a common cause of deep knee pain and stiffness in younger women and can be associated with pain and stiffness after prolonged sitting and climbing stairs or hills. While treatment with antiinflammatory medications, ice packs, and rest can help, long-term relief is best achieved by strengthening exercises for the quadriceps muscles of the front of the thigh.

Bursitis of the knee commonly occurs on the inside of the knee (anserine bursitis) and the front of the kneecap (patellar bursitis, or "housemaid's knee"). Bursitis is generally treated with ice packs, immobilization, and antiinflammatory medications such as ibuprofen (Advil, Motrin) or aspirin and may require local injections of corticosteroids (cortisone medication) as well as exercise therapy to develop the musculature of the front of the thigh.

Meniscus tears

The meniscus can be torn with the shearing forces of rotation that are applied to the knee during sharp, rapid motions. The medial meniscus is more often involved than the lateral because there is generally more load applied to the medial column of the knee. This is especially common in sports requiring reaction and lateral body movements. There is a higher incidence with aging and degeneration of the underlying cartilage. More than one tear can be present in an individual meniscus. The patient with a meniscal tear may have a rapid onset of a popping sensation with a certain activity or movement of the knee. Occasionally, it is associated with swelling and warmth in the knee. It is often associated with locking or an unstable sensation in the knee joint. The doctor can perform certain maneuvers while examining the knee which might provide further clues to the presence.

Treatment Tips for Women:

Orthotics .
Custom-made, flexible orthotics decrease the Q-angle and reduce pronation., put less stress on the knee, and improve the Q angle. The simplest way to decrease a high Q-angle and lower stress on the knee is to prevent excessive pronation. orthotics.

Strengthening Exercises .
Reductions in ACL injuries have been seen with the implementation of the ACL Injury Prevention program designed for women. Strengthening the vastus medialis obliquus (the teardrop shaped muscle on the medial side of the quads) can also help increase the stability of the knee joint in women. Closed-chain exercises (such as wall squats), performed only to 30 degrees of flexion, are currently recommended.

Stretching Exercises .
Stretching of tight muscles and strengthening of weak areas should be included. Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band and gastrocnemius.

Knees take quite a pounding for the average person, let alone a runner but with the proper care your knees will take you a long way…comfortably.

I have bunions on both feet. Do orthotics help this condition?

My arches hurt after a long day. What could this be from?

Why do my feet hurt first thing in the morning when I get out of bed?

My heels are killing me. What could this be from?

The balls of my feet hurt and I feel as if I'm walking directly on the bones of my feet. What could this be from?