Capsulitis

Capsulitis is a condition in which the ligaments within a joint capsule has become inflamed. Most commonly affect at the base of the second toe however can occur within the third, fourth and fifth toe. Capsulitis is a progressive disorder and usually worsen if not treated. The inflammation causes considerable amount of discomfort and can lead to weakening of the surrounding ligaments or dislocation of the joint itself if left untreated.

The causes of Capsulitis

• Your feet roll in
• You walk, stand or run for long periods of time more on the ball on the foot (especially on hard surfaces)
• You wear inappropriate or non-supportive footwear
• You are overweight
• You have high arched feet (there may be increased strain on ball of the foot)
• You have had a traumatic event resulting in excessive force through the ball of the foot
• Bunion deformity leading to abnormal pressure on the second toe.
• Tightness in calve muscles

Clinical signs of Capsulitis include:

Early stages

• Pain within the ball of the foot. May feel like marble, peddle or rock within the shoe or sock
• Potentially swelling in the area of pain.
• Pain with walking barefoot
• Difficulty with wearing footwear

Advanced stages

• Surrounding ligaments become weaken and fails to support and stabilise the joint of the toe which leads to the toe crossing over the big toe

To help relieve pain & speed up recovery, please do the following list of treatments

Short Term

1. Rest/reduce activity levels (especially running and jumping and high impact activities)
2. Wearing good supportive shoes most of the time
3. Purchase new shoes (with good arch support) if old ones show excessive wear
4. Icing – applying ice packs will help in reducing pain and swelling for 20mins.
5. Stretching: BOTH LEGS STRETCH FOR 30 SECONDS (Right and Left)
   1. Gastrocnemius (calf muscle) – feet hip with apart with one leg in front of the other. Push against a wall keeping your back leg straight and heel on the ground. You should feel a stretch at the back part of your leg
   2. Soleus – feet hip width apart with one leg slightly in front of the other. Drop down with most of your weight going on the back leg. Should feel the stretch down the outside of the lower leg
6. Strapping/Splinting – Taping the toe so it stays in correct position. This will help relieve pain and prevent further drifting of the toe. 1^st day will feel tight, 2^nd day will feel comfortable, 3^rd day will start becoming loose. (podiatrist will show you how to do)

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7. Anti-inflammatory medication; to reduce pain and inflammation (important to stop taking if causes stomach upsets. Contact GP if this occurs)
8. Therapeutic Ultrasound
9. Imaging; ultrasound, x-ray or bone scan
10. Corticosteroid Injections

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Long term:

• Achieved with the use of customized orthotics (insoles that go inside your shoes) to help support the arch and a metatarsal pad that distributes the weight away from the joint and reduce load through the forefoot.