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February 26 2016

audreyleuenthal

For Leg Length Discrepancy Podiatrists Prefer Shoe Lifts

There are not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital means you are born with it. One leg is anatomically shorter than the other. As a result of developmental stages of aging, the brain picks up on the gait pattern and recognizes some difference. Your body usually adapts by dipping one shoulder over to the "short" side. A difference of less than a quarter inch is not very irregular, does not need Shoe Lifts to compensate and mostly doesn't have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes mainly undiagnosed on a daily basis, however this issue is simply solved, and can reduce a number of incidents of lumbar pain.

Treatment for leg length inequality usually consists of Shoe Lifts. Many are economical, frequently costing less than twenty dollars, compared to a custom orthotic of $200 or maybe more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Chronic back pain is the most widespread ailment impacting people today. Around 80 million people suffer from back pain at some point in their life. It is a problem that costs businesses vast amounts of money yearly because of lost time and output. Fresh and improved treatment methods are continually sought after in the hope of decreasing the economical impact this issue causes.

Leg Length Discrepancy Shoe Lift

People from all corners of the earth suffer from foot ache as a result of leg length discrepancy. In a lot of these situations Shoe Lifts are usually of very useful. The lifts are capable of eliminating any pain in the feet. Shoe Lifts are recommended by many professional orthopaedic orthopedists.

So that they can support the body in a healthy and balanced fashion, your feet have a significant part to play. Inspite of that, it is often the most overlooked region in the human body. Some people have flat-feet meaning there is unequal force exerted on the feet. This causes other body parts including knees, ankles and backs to be affected too. Shoe Lifts make sure that suitable posture and balance are restored.
Tags: Shoe Lifts

September 29 2015

audreyleuenthal

What Can Cause Posterior Calcaneal Spur

Heel Spur

Overview

A heel spur occurs when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping. Heel spurs often cause no symptoms but can be associated with intermittent pain, especially while walking, jogging, or running. Sharp pain in the heel can also be experienced when standing after sitting for a long period of time. Heel spurs can be a result of plantar fasciitis.

Causes

Everyone can be affected by heel spurs, however, certain groups of people have an increased risk. For example, Plantar Fasciitis is a common running injury. People who walk a lot are much more likely to have heel spurs or people who play golf or play tennis. Over-weight people are also more at risk for heel bone spurs as our feet are not designed to carry around extra weight. As a result the ligaments under the foot are placed under constant stress, which inevitably will lead to foot problems.

Calcaneal Spur

Symptoms

Bone spurs may cause sudden, severe pain when putting weight on the affected foot. Individuals may try to walk on their toes or ball of the foot to avoid painful pressure on the heel spur. This compensation during walking or running can cause additional problems in the ankle, knee, hip, or back.

Diagnosis

Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.

Non Surgical Treatment

Since heel spurs are not an indication of pain themselves unless fractured, treatment is usually aimed at the cause of the pain which in many cases is plantar fasciosis. Treatment of plantar fasciiosis includes; rest until the pain subsides, special stretching exercises and if required orthotics may be prescribed.

Surgical Treatment

In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.

Prevention

o help prevent heel and bone spurs, wear properly designed and fitted shoes or boots that provide sufficient room in the toe box so as not to compress the toes. They should also provide cushioning in appropriate areas to minimize the possibility of the irritation and inflammation that can lead to bone spurs in the feet. If needed, use inserts that provide arch support and a slight heel lift to help ensure that not too much stress is placed on the plantar fascia. This helps to reduce the possibility of inflammation and overstress. Wearing padded socks can also help by reducing trauma. Peer-reviewed, published studies have shown that wearing clinically-tested padded socks can help protect against injuries to the skin/soft tissue of the foot due to the effects of impact, pressure and shear forces. Also consider getting your gait analyzed by a foot health professional for appropriate orthotics. If you have heel pain, toe pain or top-of-the-foot pain, see your doctor or foot specialist to ensure that a spur has not developed.

September 27 2015

audreyleuenthal

What Can Cause Posterior Calcaneal Spur

Inferior Calcaneal Spur

Overview

A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as "heel spur syndrome." Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot. Treatments for heel spurs and associated conditions include exercise, custom-made orthotics, anti-inflammatory medications, and cortisone injections. If conservative treatments fail, surgery may be necessary.

Causes

Each time we take a step forward, all of our body weight first rests on the heel of one foot. As our weight moves forward, the entire foot begins to bear the body's weight, and the foot flattens and this places a great deal of pressure and strain on the plantar fascia. There is very little ?give? to the plantar fascia, so as it stretches only slightly, it pulls on its attachment to the heel. If the foot is properly aligned this pull causes no problems. However, if the foot is ?pronated?(the foot rolls outward at the ankle, causing a break down of the inner side of the shoe), the arch falls excessively, and this causes an abnormal stretching of the relatively inflexible plantar fascia, which in turn pulls abnormally hard on the heel. The same pathology occurs with ?supination? (the rolling inward of the foot, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible; usually have a high arch, and a short or tight plantar fascia. Thus as weight is transferred from the heel to the remainder of the foot, the tight plantar fascia hardly stretches at all, and pulls with great force on its attachment to the heel. In both cases, the abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain, inflammation, and possibly swelling. If this process continues, the plantar fascia partially tears away from the heel. The body will fill in this torn area with calcium; eventually it becomes bone, and a heel spur results.

Posterior Calcaneal Spur

Symptoms

Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.

Diagnosis

Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.

Non Surgical Treatment

Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve pain, reduce friction and transfer pressure from your sensitive foot areas. By eliminating the cause of the heel spur and plantar fasciitis (i.e. better shoes, orthotics to fix your gait, losing weight) will help reduce the pressure put on your fascia and heel and can reduce the inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery your only option.

Surgical Treatment

Surgery, which is a more radical treatment, can be a permanent correction to remove the spur itself. If your doctor believes that surgery is indicated, he will recommend an operation - but only after establishing that less drastic methods of treatment are not successful.

Prevention

There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.

August 22 2015

audreyleuenthal

Healthy Treatment For Bursitis Foot

Overview

Bursitis is the painful inflammation of the bursa, a padlike sac found in areas subject to friction. Bursae cushion the movement between the bones, tendons and muscles near the joints. Bursitis is most often caused by repetitive movement and is known by several common names including weaver's bottom, clergyman's knee, and miner's elbow, depending on the affected individual's occupation and area of injury.

Causes

The causes and risk factors of retrocalcaneal bursitis are listed below. Identifying the underlying reason the bursa is inflamed will help set a course for treatment. Repetitive use of the ankle. Retrocalcaneal bursitis is often caused by frequent "mini-traumas." These mini-traumas are often due to excessive walking, jumping, or running. Running uphill, which causes the foot to flex considerably, can be especially irritating to the retrocalcaneal bursae. People who suddenly intensify their exercise programs without adequate stretching and muscle conditioning may get retrocalcaneal bursitis. In general, it is often associated with over use of the Achilles attachment, the area where the Achilles tendon fibers attach to the heel.

Symptoms

A dull ache under the heel when not weight bearing. Sometimes severe pain when walking. Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again. Throbbing under the heel. Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself. Tingling under the heel as swelling affect the plantar nerves. Pains shooting into the foot or up the leg.

Diagnosis

Medical examination is not necessarily required in light cases where the tenderness is minimal. In all cases where smooth improvement is not experienced, medical attention should be sought as soon as possible to exclude a (partial) rupture of the Achilles tendon or rupture of the soleus muscle. This situation is best determined by use of ultrasound scanning, as a number of injuries requiring treatment can easily be overlooked during a clinical examination (Ultrasonic image). Ultrasound scanning enables an evaluation of the extent of the change in the tendon, inflammation of the tendon (tendinitis), development of cicatricial tissue (tendinosis), calcification, inflammation of the tissue surrounding the tendon (peritendinitis), inflammation of the bursa (bursitis), as well as (partial) rupture.

Non Surgical Treatment

Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.

Surgical Treatment

Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.

June 22 2015

audreyleuenthal

Natural Treatment For Hammer Toes

HammertoeOverview

hammertoes is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Hammertoes usually start out as Hammer toes mild deformities and get progressively worse over time. In the earlier stages, hammer toes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammer toes can become more rigid and will not respond to non-surgical treatment. Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

Causes

Hammertoes are usually structural in nature. Many times this is the foot structure you were born with and other factors have now made it so that symptoms appear. The muscles in your foot may become unbalanced over time, allowing for a deformity of the small bones in each toe. With longstanding deformity the toe may become rigid. Sometimes one toe is longer than another and this causes a buckling of the digit. A hammertoe may also be caused by other foot deformities such as a bunion. Trauma or other surgery of your foot may predispose you to having the condition if your foot structure is altered.

Hammer ToeSymptoms

The most obvious symptom of hammer, claw or mallet toe is the abnormal toe position. This is usually combined with pain: the abnormal foot position leads to excessive friction on the toe as it rubs against any footwear which can be extremely painful. Corns & Calluses: repeated friction can result in the formation of a foot corn or callus on top of the toes. Stiffness, the joints become increasingly stiff. In the early stages, the toes can usually be straightened out passively using your hands, but if allowed to progress, the stiffness may be permanent.

Diagnosis

Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.

Non Surgical Treatment

Early on, when a hammertoe first starts and is still flexible, here are some ways it might be treated. Your healthcare provider may splint or tape the toe into the correct, normal position. You can use your fingers to stretch your toes and toe joints toward a more normal position. Exercise your toes by trying to pick up marbles with them or by wadding up a towel on the floor with your toes. Padding may be used to change where your weight falls when you walk on the foot.

Surgical Treatment

Several surgical procedures are available to the podiatric physician. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain. Severe hammertoes, which are not fully reducible, may require more complex surgical procedures. Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatric physician.
Tags: Hammer Toes

June 04 2015

audreyleuenthal

How To Spot Bunions

Overview
Bunions hard skin The term hallux valgus actually describes what happens to the big toe. Hallux is the medical term for big toe, and valgus is an anatomic term that means the deformity goes in a direction away from the midline of the body. So in hallux valgus the big toe begins to point towards the outside of the foot. As this condition worsens, other changes occur in the foot that increase the problem. One of those changes is that the bone just above the big toe, the first metatarsal, usually develops too much of an angle in the other direction. This condition is called metatarsus primus varus. Metatarsus primus means first metatarsal, and varus is the medical term that means the deformity goes in a direction towards the midline of the body. This creates a situation where the first metatarsal and the big toe now form an angle with the point sticking out at the inside edge of the ball of the foot. The bunion that develops is actually a response to the pressure from the shoe on the point of this angle. At first the bump is made up of irritated, swollen tissue that is constantly caught between the shoe and the bone beneath the skin. As time goes on, the constant pressure may cause the bone to thicken as well, creating an even larger lump to rub against the shoe.

Causes
A bunion is more common in women than men due to women wearing tighter fitting shoes. This condition can cause a variety of different soft tissue and bony complaints which may result in severe pain.

Symptoms
The initial symptom may be pain at the joint prominence when wearing certain shoes. The joint capsule may be tender at any stage. Later symptoms may include a painful, warm, red, cystic, movable, fluctuant swelling located medially (adventitial bursitis) and swellings and mild inflammation affecting the entire joint (osteoarthritic synovitis), which is more circumferential. With hallux limitus or rigidus, there is restriction of passive joint motion, tenderness at the dorsolateral aspect of the joint, and increased dorsiflexion of the distal phalanx.

Diagnosis
Physical examination typically reveals a prominence on the inside (medial) aspect of the forefoot. This represents the bony prominence associated with the great toe joint ( the medial aspect of the first metatarsal head). The great toe is deviated to the outside (laterally) and often rotated slightly. This produces uncovering of the joint at the base of the big toe (first metatarsophalangeal joint subluxation). In mild and moderate bunions, this joint may be repositioned back to a neutral position (reduced) on physical examination. With increased deformity or arthritic changes in the first MTP joint, this joint cannot be fully reduced. Patients may also have a callus at the base of their second toe under their second metatarsal head in the sole of the forefoot. Bunions are often associated with a long second toe.

Non Surgical Treatment
Wide toe box, bunion pads, orthotics, or a combination. Mild discomfort may lessen by wearing a shoe with a wide toe box or with stretchable material. If not, bunion pads purchased in most pharmacies can shield the painful area. Orthotics can also be prescribed to redistribute and relieve pressure from the affected articulation. If conservative therapy fails, surgery aimed at correcting abnormal bony alignments and restoring joint mobility should be considered. If the patient is unwilling to wear large, wider shoes to accommodate the bunion because they are unattractive, surgery can be considered; however, patients should be told that orthotic devices should be worn after surgery to reduce the risk of recurrence. For bursitis, bursal aspiration and injection of a corticosteroid are indicated. For osteoarthritic synovitis, oral NSAIDs or an intra-articular injection of a corticosteroid/anesthetic solution reduces symptoms. For hallux limitus or hallux rigidus, treatment aims to preserve joint mobility by using passive stretching exercises, which occasionally require injection of a local anesthetic to relieve muscle spasm. Sometimes surgical release of contractures is necessary. Bunions callous

Surgical Treatment
The main goal of surgery is to realign the big toe joint in order to relieve symptoms, correct deformity and restore function. Surgery to remove a bunion is known as a bunionectomy. There are many variations of this operation and the type of surgery performed will vary depending on factors such as the degree of deformity, the strength of the bones, the person's age and the surgeon?s preferred approach. Most surgery involves the removal of the bony outgrowth (exostosis) and the realignment of the bones of the joint. Soft tissue structures such as the ligaments and tendons may be repositioned and the bursa may be removed. The insertion of screws and pins may be required to stabilise the bones in their new, realigned position.
Tags: Bunions

May 31 2015

audreyleuenthal

The Causes And Treatments Of Overpronation

Overview

In order to understand overpronation it is important to first know what pronation in the feet actually is. Pronation is a term used to describe the rolling mechanism of the feet when they make contact with the ground. Pronation is a natural process and is important to help deal with the forces which are generated when walking and running.Foot Pronation

Causes

Generally fallen arches are a condition inherited from one or both parents. In addition, age, obesity, and pregnancy cause our arches to collapse. Being in a job that requires long hours of standing and/or walking (e.g. teaching, retail, hospitality, building etc) contributes to this condition, especially when standing on hard surfaces like concrete floors. Last, but not least unsupportive footwear makes our feet roll in more than they should.

Symptoms

If you overpronate, your symptoms may include discomfort in the arch and sole of foot, your foot may appear to turn outward at the ankle, your shoes wear down faster on the medial (inner) side of your shoes. Pain in ankle, shins, knees, or hips, especially when walking or running are classic symptoms of overpronation. Overpronation can lead to additional problems with your feet, ankles, and knees. Runners in particular find that overpronation can lead to shin splints, tarsal tunnel syndrome, plantar fasciitis, compartment syndrome, achilles tendonitis, bunions or hallux valgus, patello-femoral pain syndrome, heel spurs, metatarsalgia.

Diagnosis

You can test for pronation by looking at the leg and foot from the back. Normally you can see the Achilles Tendon run straight down the leg into the heel. If the foot is pronated, the tendon will run straight down the leg, but when it lies on the heel it will twist outward. This makes the inner ankle bone much more prominent than the outer ankle bone.Pronation

Non Surgical Treatment

Anti-Pronation Insoles provide a unique foot support system that aligns the lower body. The major cause of foot and leg pain is over pronation (rolling over of the feet) which causes excessive pressure on the muscles, ligaments and bones of the lower body. Running insoles treat the underlying cause of over pronation and prevent future occurrences of the associated foot or leg condition. A project conducted at the NIKE Sport Research Laboratory studied the effects of orthotics on rear foot movement in running. Nine well-trained runners who wore orthotics were chosen as subjects. The results of the study indicated that orthotics reduced rear foot movement by roughly one degree or approximately nine percent of the amount found in runners not using orthotics. The average reduction of the maximum velocity of pronation was fifteen percent. Thus this study indicates that orthotics and insoles control over pronation which will treat and prevent many sporting injuries.

Surgical Treatment

The MBA implant is small titanium device that is inserted surgically into a small opening between the bones in the hind-mid foot: the talus (ankle bone) and the calcaneus (heel bone). The implant was developed to help restore the arch by acting as a mechanical block that prevents the foot from rolling-in (pronation). In the medical literature, the success rate for relief of pain is about 65-70%. Unfortunately, about 40% of people require surgical removal of the implant due to pain.

May 19 2015

audreyleuenthal

Is It Possible To Treat Severs Disease At Home ?

Overview

Sever?s disease is similar to Osgood-Schlatter disease of the knee in that they both involve a partial detachment or tearing of the tendon from the bone. The difference is location: Osgood-Schlatter occurs at the knee, and Sever?s occurs at the ankle. In Sever?s disease, which usually occurs in children from the ages of 8 to 14, the Achilles tendon begins to tear away from its insertion into the calcaneus or heel bone. This injury can be very painful and affect highly active to somewhat inactive children. Symptoms include pain that increases with activity, localized pain in the back of the foot, tenderness to the touch, and swelling. Treatment includes rest, ice, compression, elevation, and nonsteroidal anti-inflammatory medication as necessary.

Causes

Severs disease arises due to a traction of the Achilles Tendon from the heel bone or from excessive impact forces to the area during peak growing periods. Most children will present with one or many of the following backgrounds. Recent periods of rapid growth/changes of body mass/strength. Overuse, Multiple sporting clubs, multiple sports, high intensity of training. Poor footwear (insufficient heel height). Training errors. Tight surrounding muscles. Osseous growth proceeds that of the soft tissue. Poor biomechanics and posture (excessive pronation/flat feet).

Symptoms

Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the child to limp when walking. One or both heels affected.

Diagnosis

A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.

Non Surgical Treatment

A doctor, sports therapist or physiotherapist can apply a plaster cast or boot if the child is in severe pain. This may be worn for a few days or even weeks and should give relief of pain for a while. Carry out a full biomechanical assessment. This may help to determine if any foot biomechanics issues are contributing to the condition. Orthotics or insoles can be prescribed to help correct over pronation or other biomechanics issues. Prescribe anti-inflammatory medication such as ibuprofen to reduce pain and inflammation. This will not be prescribed if asthma the child has asthma. In persistent cases X-rays may be taken but this is not usual. A doctor, sports therapist or physiotherapist will NOT give a steroid injection or operate as these are not suitable treatment options. The condition will usually settle within 6 months, although it can persist for longer.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.
audreyleuenthal

Is It Possible To Treat Severs Disease At Home ?

Overview

Sever?s disease is similar to Osgood-Schlatter disease of the knee in that they both involve a partial detachment or tearing of the tendon from the bone. The difference is location: Osgood-Schlatter occurs at the knee, and Sever?s occurs at the ankle. In Sever?s disease, which usually occurs in children from the ages of 8 to 14, the Achilles tendon begins to tear away from its insertion into the calcaneus or heel bone. This injury can be very painful and affect highly active to somewhat inactive children. Symptoms include pain that increases with activity, localized pain in the back of the foot, tenderness to the touch, and swelling. Treatment includes rest, ice, compression, elevation, and nonsteroidal anti-inflammatory medication as necessary.

Causes

Severs disease arises due to a traction of the Achilles Tendon from the heel bone or from excessive impact forces to the area during peak growing periods. Most children will present with one or many of the following backgrounds. Recent periods of rapid growth/changes of body mass/strength. Overuse, Multiple sporting clubs, multiple sports, high intensity of training. Poor footwear (insufficient heel height). Training errors. Tight surrounding muscles. Osseous growth proceeds that of the soft tissue. Poor biomechanics and posture (excessive pronation/flat feet).

Symptoms

Pain in the lower calf and heel area which may be worse when applying pressure either side. Pain worse on activity especially those involving running or jumping. In severe cases this may cause the child to limp when walking. One or both heels affected.

Diagnosis

A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot.

Non Surgical Treatment

A doctor, sports therapist or physiotherapist can apply a plaster cast or boot if the child is in severe pain. This may be worn for a few days or even weeks and should give relief of pain for a while. Carry out a full biomechanical assessment. This may help to determine if any foot biomechanics issues are contributing to the condition. Orthotics or insoles can be prescribed to help correct over pronation or other biomechanics issues. Prescribe anti-inflammatory medication such as ibuprofen to reduce pain and inflammation. This will not be prescribed if asthma the child has asthma. In persistent cases X-rays may be taken but this is not usual. A doctor, sports therapist or physiotherapist will NOT give a steroid injection or operate as these are not suitable treatment options. The condition will usually settle within 6 months, although it can persist for longer.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

April 14 2015

audreyleuenthal

Does Posterior Tibial Tendon Dysfunction Always Necessitate Surgery ?

Overview
Chronic posterior tibial tendon insufficiency can result in acquired adult flatfoot deformity. This is a chronic foot condition where the soft-tissues (including the posterior tibial tendon, deltoid and spring ligaments) on the inside aspect of the ankle are subject to repetitive load during walking and standing. Over time these structures may become painful and swollen ultimately failing. When these supporting structures fail the result is a change in the alignment of the foot. This condition is typically associated with a progressive flatfoot deformity. This type of deformity leads to increased strain on the supporting structures on the inside of the ankle and loading through the outer aspect of the ankle and hind-foot. Both the inside and outside of the ankle can become painful resulting significant disability. This condition can often be treated without surgery by strengthening the involved muscles and tendons and by bracing the ankle. When non-operative treatment fails, surgery can improve the alignment replace the injured tendon. Alignment and function can be restored, however, the time to maximal improvement is typically six months but, can take up to a year. Flat feet

Causes
There are numerous causes of acquired adult flatfoot, including fracture or dislocation, tendon laceration, tarsal coalition, arthritis, neuroarthropathy, neurologic weakness, and iatrogenic causes. The most common cause of acquired adult flatfoot is posterior tibial tendon dysfunction.

Symptoms
At first you may notice pain and swelling along the medial (big toe) side of the foot. This is where the posterior tibialis tendon travels from the back of the leg under the medial ankle bone to the foot. As the condition gets worse, tendon failure occurs and the pain gets worse. Some patients experience pain along the lateral (outside) edge of the foot, too. You may find that your feet hurt at the end of the day or after long periods of standing. Some people with this condition have trouble rising up on their toes. They may be unable to participate fully in sports or other recreational activities.

Diagnosis
The diagnosis of posterior tibial tendon dysfunction and AAFD is usually made from a combination of symptoms, physical exam and x-ray imaging. The location of pain, shape of the foot, flexibility of the hindfoot joints and gait all may help your physician make the diagnosis and also assess how advanced the problem is.

Non surgical Treatment
Patients can be treated non-surgically with in-shoe devices and braces to hold their feet in the correct position. This can reduce pain and damage and assist with walking. Physical therapy is also given to improve muscle strength and help prevent injury to the foot. Surgery can be performed if the patient doesn?t find any relief. Acquired flat feet

Surgical Treatment
Although non-surgical treatments can successfully manage the symptoms, they do not correct the underlying problem. It can require a life-long commitment to wearing the brace during periods of increased pain or activity demands. This will lead a majority of patients to choose surgical correction of the deformity, through Reconstructive Surgery. All of the considerations that were extremely important during the evaluation stage become even more important when creating a surgical plan. Generally, a combination of procedures are utilized in the same setting, to allow full correction of the deformity. Many times, this can be performed as a same-day surgery, without need for an overnight hospital stay. However, one or two day hospital admissions can be utilized to help manage the post-operative pain. Although the recovery process can require a significant investment of time, the subsequent decades of improved function and activity level, as well as decreased pain, leads to a substantial return on your investment.

March 23 2015

audreyleuenthal

Adult Aquired FlatFeet Treatment And Cause

Overview

One in four adults in the U.S. has adult acquired flatfoot deformity, which may begin during childhood or be acquired with age. The foot may be flat all the time or may lose its arch when the person stands. The most common and serious cause of flat foot is Posterior Tibial Tendon Dysfunction, in which the main tendon that supports the arch gradually weakens.Flat Foot



Causes

Adult acquired flatfoot is caused by inflammation and progressive weakening of the major tendon that it is responsible for supporting the arch of the foot. This condition will commonly be accompanied by swelling and pain on the inner portion of the foot and ankle. Adult acquired flatfoot is more common in women and overweight individuals. It can also be seen after an injury to the foot and ankle. If left untreated the problem may result in a vicious cycle, as the foot becomes flatter the tendon supporting the arch structure becomes weaker and more and more stretched out. As the tendon becomes weaker, the foot structure becomes progressively flatter. Early detection and treatment is key, as this condition can lead to chronic swelling and pain.



Symptoms

Pain and swelling around the inside aspect of the ankle initially. Later, the arch of the foot may fall (foot becomes flat), this change leads to walking to become difficult and painful, as well as standing for long periods. As the flat foot becomes established, pain may progress to the outer part of the ankle. Eventually, arthritis may develop.



Diagnosis

Diagnostic testing is often used to diagnose the condition and help determine the stage of the disease. The most common test done in the office setting are weightbearing X-rays of the foot and ankle. These assess joint alignment and osteoarthritis. If tendon tearing or rupture is suspected, the gold standard test would be MRI. The MRI is used to check the tendon, surrounding ligament structures and the midfoot and hindfoot joints. An MRI is essential if surgery is being considered.



Non surgical Treatment

Initial treatment for most patients consists of rest and anti-inflammatory medications. This will help reduce the swelling and pain associated with the condition. The long term treatment for the problem usually involves custom made orthotics and supportive shoe gear to prevent further breakdown of the foot. ESWT(extracorporeal shock wave therapy) is a novel treatment which uses sound wave technology to stimulate blood flow to the tendon to accelerate the healing process. This can help lead to a more rapid return to normal activities for most patients. If treatment is initiated early in the process, most patients can experience a return to normal activities without the need for surgery.

Flat Feet



Surgical Treatment

In cases where cast immobilization, orthoses and shoe therapy have failed, surgery is the next alternative. The goal of surgery and non-surgical treatment is to eliminate pain, stop progression of the deformity and improve mobility of the patient. Opinions vary as to the best surgical treatment for adult acquired flatfoot. Procedures commonly used to correct the condition include tendon debridement, tendon transfers, osteotomies (cutting and repositioning of bone) and joint fusions. (See surgical correction of adult acquired flatfoot). Patients with adult acquired flatfoot are advised to discuss thoroughly the benefits vs. risks of all surgical options. Most procedures have long-term recovery mandating that the correct procedure be utilized to give the best long-term benefit. Most flatfoot surgical procedures require six to twelve weeks of cast immobilization. Joint fusion procedures require eight weeks of non-weightbearing on the operated foot - meaning you will be on crutches for two months. The bottom line is, Make sure all of your non-surgical options have been covered before considering surgery. Your primary goals with any treatment are to eliminate pain and improve mobility. In many cases, with the properly designed foot orthosis or ankle brace, these goals can be achieved without surgical intervention.

March 04 2015

audreyleuenthal

What Is The Big Cause Of Achilles Tendinitis ?

Overview

Achilles TendonitisTendinitis is the inflammation of a tendon. Tendons are thick cords of tissue that connect muscles to bone. Achilles tendinitis, or an inflammation of the Achilles tendon, is one of the most common causes of foot or ankle pain. Other types of foot/ankle tendinitis include posterior tibial tendinitis and peroneal tendinitis.

Causes

Some of the causes of Achilles tendonitis / tendinosis include. Overuse injury - this occurs when the Achilles tendon is stressed until it develops small tears. Runners seem to be the most susceptible. People who play sports that involve jumping, such as basketball, are also at increased risk. Arthritis - Achilles tendonitis can be a part of generalised inflammatory arthritis, such as ankylosing spondylitis or psoriatic arthritis. In these conditions both tendons can be affected. Foot problems - some people with over pronated feet (Flat Feet) or feet that turn inward while walking are prone to Achilles tendonitis. The flattened arch pulls on calf muscles and keeps the Achilles tendon under tight strain. This constant mechanical stress on the heel and tendon can cause inflammation, pain and swelling of the tendon. Being overweight can make the problem worse. Footwear - wearing shoes with minimal support while walking or running can increase the risk, as can wearing high heels. Overweight and obesity - being overweight places more strain on many parts of the body, including the Achilles tendon.

Symptoms

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more severe pain may occur after prolonged running, stair climbing or sprinting. You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity. If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.

Diagnosis

There is enlargement and warmth of the tendon 1 to 4 inches above its heel insertion. Pain and sometimes a scratching feeling may be created by gently squeezing the tendon between the thumb and forefinger during ankle motion. There may be weakness in push-off strength with walking. Magnetic resonance imaging (MRI) can define the extent of degeneration, the degree to which the tendon sheath is involved and the presence of other problems in this area, but the diagnosis is mostly clinical.

Nonsurgical Treatment

Treatment will focus on relieving the pain and preventing further injury. Your podiatrist may create shoe inserts or a soft cast to effectively immobilize the affected area for a period of time. (Often, a couple of weeks are needed for the tendon to heal.) Medication can help too. Your podiatrist may recommend or prescribe oral medication.

Achilles Tendon

Surgical Treatment

Treating this surgically, there are numerous methods to repair the tendon. Most commonly, Achilles tendon is exposed through an incision at the back of the ankle. After identifying both ends of ruptured tendon, the edges got trimmed and then both ends were sutured together with optimal tension. To get a better outcome with fixation, an anchor may have to be in place in calcaneus, provided the rupture is very low. Care must be taken to avoid injuries to the nerves located adjacent to the tendon.

Prevention

Achilles tendinitis cannot always be prevented but the following tips will help you reduce your risk. If you are new to a sport, gradually ramp up your activity level to your desired intensity and duration. If you experience pain while exercising, stop. Avoid strenuous activity that puts excessive stress on your Achilles tendon. If you have a demanding workout planned, warm up slowly and thoroughly. Always exercise in shoes that are in good condition and appropriate for your activity or sport. Be sure to stretch your calf muscles and Achilles tendon before and after working out. If you suffer from Achilles tendinitis make sure you treat it properly and promptly. If self-care techniques don?t work, don?t delay. Book a consultation with a foot care expert or you may find yourself sidelined from your favourite sports and activities.

February 06 2015

audreyleuenthal

Diabetic Foot Treatment

Happich M, Breitscheidel L, Meisinger C: Cross-sectional analysis of adult diabetes type 1 and type 2 patients with diabetic microvascular complications from a German retrospective observational study. Hurley L, Kelly L, Garrow AP, Forsberg RC, Davignon DR, Smith DG: A prospective study of risk factors for foot ulceration: the West of Ireland Diabetes Foot Study. Reiber G, Vileikyte L, Boyko E: Causal pathways for incident lower extremity ulcers in patients with diabetes from two settings. Holzer S, Camerota A, Martens L: Costs and duration of care for Lower extremity ulcers in patients with diabetes. Sun JH, Tsai JS, Huang CH, Lin CH, Yang HM, Chan YS, Hsieh SH, Hsu BR, Huang YY: Risk factors for lower extremity amputation in diabetic foot disease categorized by Wagner classification. Ashok S, Ramu M, Deepa R: Prevalence of neuropathy in type 2 diabetic patients attending a diabetes centre in South India. Pat your feet dry, don't rub them. Check your feet daily.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back PainPlantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

We understand that prevention needs to be a combination of systemic disease control and self foot-care, which includes proper foot hygiene, foot inspection and proper foot gear. As health care professionals, we are at a loss for effective methods to influence behaviors in our patients, especially because behaviors are difficult to address in the short period of time we have with them. Apparently intelligence has little to do with an inability to care for one's self, as many high functioning adults may have rather questionable personal habits. The study looked at 302 type II diabetics from the VA healthcare system in Taiwan divided into two groups; 155 received group lectures in addition to routine healthcare, and 147 received only routine care. A retrospective review of medical records and a structured interview were conducted to determine the foot care quality among the two groups. Epidemiology and prevention.

There is in this case, a problem for the diabetic in telling the difference between sharp pain and a more dull pain. Consequently major cuts and wounds often go undetected and diabetic foot ulcers can become problematic. However without effective feedback from the nerves in your foot ot toe, then that adjustment is not adequately made.

Around 50% of our patients sought care due to wounds that had grown too large for home management. For them to take care of themselves, we needed padding readily available for all diabetics and easy to use; something patients could pick up at the drugstore. It also needed to be user friendly; I couldn't have my diabetic patients carving away at foam with a scalpel! Having this variety of shapes is important, as each wound is shaped differently and irregularly, and the padding must be applied to the borders of the wound, no matter where on the foot the wound is located.

There were significantly more amputations within a year for those with diabetic foot ulcers who did not have total contact casting when compared with those who did, according to results in the July issue of Advances in Skin & Wound Care. Total contact casting is vastly underutilized in DFU wound care settings, suggesting that there is a gap in practice for adequate off-loading,” the authors wrote. The Little Sisters of the Poor is not satisfied with the federal government's recent regulations and will continue its challenge against the Affordable Care Act's contraception mandate, the Catholic long-term care provider stated in a legal brief filed Monday. Though diabetes can produce a number of symptoms, many of its early signs can look quite similar to the symptoms of certain other health conditions. Diabetic patients experience constant hunger or an increase in appetite, if the body produces a high level of insulin in an attempt to bring down the level of blood sugar. It relieves the pain.

Drink at least 64 oz. of fluid each day to prevent dry skin and cracks. Diabetics are more likely to become dehydrated than those with stable blood glucose levels, which means a greater Pes Planus intake of water is necessary to keep the skin hydrated. The University of Iowa recommends wearing shoes at all times to prevent injury and infection of open sores or cracks.
Tags: Diabetic Foot

January 18 2015

audreyleuenthal

What Can Cause Plantar Fasciitis To Surface

Heel Pain

Overview

Plantar fasciitis is a common cause of heel pain in adults. The pain is usually caused by collagen degeneration (which is sometimes misnamed “chronic inflammation”) at the origin of the plantar fascia at the medial tubercle of the calcaneus. This degeneration is similar to the chronic necrosis of tendonosis, which features loss of collagen continuity, increases in ground substance (matrix of connective tissue) and vascularity, and the presence of fibro-blasts rather than the inflammatory cells usually seen with the acute inflammation of tendonitis. The cause of the degeneration is repetitive microtears of the plantar fascia that overcome the body's ability to repair itself.



Causes

Although plantar fasciitis may result from a variety of factors, such as repeat hill workouts and/or tight calves, many sports specialists claim the most common cause for plantar fasciitis is fallen arches. The theory is that excessive lowering of the arch in flat-footed runners in­creases tension in the plantar fascia and overload­s the attachment of the plantar fascia on the heel bone (i.e., the calcaneus). Over time, the repeated pulling of the plantar fascia associated with excessive arch lowering is thought to lead to chronic pain and inflammation at the plantar fascia’s attachment to the heel. In fact, the increased tension on the heel was believed to be so great that it was thought to eventually result in the formation of a heel spur.



Symptoms

The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs right after getting up in the morning and after a period of sitting. If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.



Diagnosis

To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.



Non Surgical Treatment

Biomechanical plantar fasciitis can be easily reduced by correcting misalignment of the feet. Wearing orthopedic shoes for plantar fasciitis and orthotic inserts is an easy, effective method of naturally realigning the foot. Worn consistently from first thing in the morning to last thing at night, orthotic support can reduce and sometimes eliminate plantar fasciitis. Biomechanical plantar fasciitis can be easily reduced by correcting misalignment of the feet. Wearing orthopedic shoes for plantar fasciitis and orthotic inserts is an easy, effective method of naturally realigning the foot. Worn consistently from first thing in the morning to last thing at night, orthotic support can reduce and sometimes eliminate plantar fasciitis. Preserve Your Arch with Strengthening Exercises. While seated and barefoot, squeeze your foot as if you have a small marble under the ball of your foot. If you just happen to have a few marbles handy, you can actually practice picking them up between your toes and ball of your foot - and then set them down again. This stretches and helps strengthen the muscles that run under metatarsals (the longest bones in the foot which create its arched shape). Slowly Increase Physical Activity. If you're a runner, a tried and true method of preventing over-use injuries is to only increase your mileage by 10% weekly, max. If you’re new to a walking program, the same caution should be exercised. Ice and Rest. After mild stretching, use a frozen water bottle to roll under the arch of your foot for 10-20 minutes. It may be possible to make an active recovery by wearing Orthaheel Technology to keep your feet naturally aligned, therefore reducing strain on the plantar fascia, while moving throughout your day.

Painful Heel



Surgical Treatment

The most common surgical procedure for plantar fasciitis is plantar fascia release. It involves surgical removal of a part from the plantar fascia ligament which will relieve the inflammation and reduce the tension. Plantar fascia release is either an open surgery or endoscopic surgery (insertion of special surgical instruments through small incisions). While both methods are performed under local anesthesia the open procedure may take more time to recover. Other surgical procedures can be used as well but they are rarely an option. Complications of plantar fasciitis surgery are rare but they are not impossible. All types of plantar fasciitis surgery pose a risk of infection, nerve damage, and anesthesia related complications including systemic toxicity, and persistence or worsening of heel pain.

January 15 2015

audreyleuenthal

What May Cause Heel Pain

Feet Pain

Overview

Plantar fasciitis is the most common cause of heel pain. Pain from plantar fasciitis is often most noticeable during the first few steps after getting out of bed in the morning. The plantar fascia is a thick band of tissue in the sole of the foot. Microtearing at the origin of the plantar fascia on the heel bone (calcaneus) can occur with repetitive loading. This microtearing leads to an inflammatory response (healing response) which produces the pain. Risk factors for plantar fasciitis include excessive standing, increased body weight, increasing age, a change in activity level, and a stiff calf muscle. Plantar fasciitis can be managed non-operatively in the vast majority of patients. The main components of an effective non-operative treatment program are: calf stretching with the knee straight, plantar fascia stretching, activity modification (to avoid precipitating activities), and comfort shoe wear.



Causes

Plantar fasciitis is usually not the result of a single event but more commonly the result of a history of repetitive micro trauma combined with a biomechanical deficiency of the foot. Arthritic changes and metabolic factors may also playa part in this injury but are unlikely in a young athletic population. The final cause of plantar fasciitis is "training errors." In all likelihood the injury is the result of a combination of biomechanical deficiencies and training errors. Training errors are responsible for up to 60% of all athletic injuries (Ambrosius 1992). The most frequent training error seen with plantar fasciitis is a rapid increase in volume (miles or time run) or intensity (pace and/or decreased recovery). Training on improper surfaces, a highly crowned road, excessive track work in spiked shoes, plyometrics on hard runways or steep hill running, can compromise the plantar fascia past elastic limits. A final training error seen in athletics is with a rapid return to some preconceived fitness level. Remembering what one did "last season" while forgetting the necessity of preparatory work is part of the recipe for injury. Metabolic and arthritic changes are a less likely cause of plantar fasciitis among athletes. Bilateral foot pain may indicate a metabolic or systemic problem. The definitive diagnosis in this case is done by a professional with blood tests and possibly x-rays.



Symptoms

Patients with plantar fasciitis typically experience pain underneath the heel and along the inner sole of the foot. In less severe cases, patients may only experience an ache or stiffness in the plantar fascia or heel that increases with rest (typically at night or first thing in the morning) following activities which place stress on the plantar fascia. These activities typically include standing, walking or running excessively (especially up hills, on uneven surfaces or in poor footwear such as thongs), jumping, hopping and general weight bearing activity. The pain associated with this condition may also warm up with activity in the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. In severe cases, patients may walk with a limp or be unable to weight bear on the affected leg. Patients with this condition may also experience swelling, tenderness on firmly touching the plantar fascia (often on a specific spot on the inner aspect of the heel) and sometimes pain on performing a plantar fascia stretch.



Diagnosis

The health care provider will perform a physical exam. This may show tenderness on the bottom of your foot, flat feet or high arches, mild foot swelling or redness, stiffness or tightness of the arch in the bottom of your foot. X-rays may be taken to rule out other problems.



Non Surgical Treatment

The good news is that plantar fasciitis is reversible and very successfully treated. About 90 percent of people with plantar fasciitis improve significantly within two months of initial treatment. If your plantar fasciitis continues after a few months of conservative treatment, your doctor may inject your heel with steroidal anti-inflammatory medications (corticosteroid). Cortisone injections have been shown to have short-term benefits but they actually retard your progress in the medium to long-term, which usually means that you will suffer recurrent bouts for longer. Due to poor foot biomechanics being the primary cause of your plantar fasciitis it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the development of a heel spur. Your physiotherapist is an expert in foot assessment and its dynamic biomechanical correction. They may recommend that you seek the advice of a podiatrist, who is an expert in the prescription on passive foot devices such as orthotics.

Painful Heel



Surgical Treatment

Most studies indicate that 95% of those afflicted with plantar fasciitis are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don't improve with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the inflammation of the ligament. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. While the success rate is very high following surgery, one should be aware that there is often a prolonged postoperative period of discomfort similar to the discomfort experienced prior to surgery. This pain usually will abate within 2-3 months. One should always be sure to understand all the risks associated with any surgery they are considering.

January 11 2015

audreyleuenthal

What Is Pain At The Heel

Heel Pain

Overview

Plantar fasciitis is an inflammation of the structures (of the plantar fascia) on the sole of the foot. The inflammation is caused by excess pressure on the structures on the sole of the foot. The plantar fascia becomes inflamed and tiny rips can occur where it attaches into the inside of the heel bone. It tends to be most painful first thing in the morning, or when standing up after sitting for a while. The area becomes inflamed and swollen, and it is the increase in fluid to the area that accumulates when weight is taken off the area, that then causes the pain on standing. Plantar Fasciitis usually starts gradually with pain on standing after rest. Pain is usually located under the heel or to the inside of the heel. Pain is usually at its worst on standing first thing in the morning. The pain will begin to ease once you get moving. Pain in the early stages tends to occur after activity rather than during activity. As plantar fasciitis continues the pain can become more constant and can then start to affect the way you walk.



Causes

Plantar fasciitis is usually not the result of a single event but more commonly the result of a history of repetitive micro trauma combined with a biomechanical deficiency of the foot. Arthritic changes and metabolic factors may also playa part in this injury but are unlikely in a young athletic population. The final cause of plantar fasciitis is "training errors." In all likelihood the injury is the result of a combination of biomechanical deficiencies and training errors. Training errors are responsible for up to 60% of all athletic injuries (Ambrosius 1992). The most frequent training error seen with plantar fasciitis is a rapid increase in volume (miles or time run) or intensity (pace and/or decreased recovery). Training on improper surfaces, a highly crowned road, excessive track work in spiked shoes, plyometrics on hard runways or steep hill running, can compromise the plantar fascia past elastic limits. A final training error seen in athletics is with a rapid return to some preconceived fitness level. Remembering what one did "last season" while forgetting the necessity of preparatory work is part of the recipe for injury. Metabolic and arthritic changes are a less likely cause of plantar fasciitis among athletes. Bilateral foot pain may indicate a metabolic or systemic problem. The definitive diagnosis in this case is done by a professional with blood tests and possibly x-rays.



Symptoms

Plantar fasciitis has a few possible symptoms. The symptoms can occur suddenly or gradually. Not all of the symptoms must be present at once. The classic symptom of plantar fasciitis is pain around the heel with the first few steps out of bed or after resting for a considerable period of time. This pain fades away a few minutes after the feet warm up. This symptom is so common that it symbols the plantar fasciitis disorder. If you have it then probably you have plantar fasciitis. If you don’t suffer from morning pain then you might want to reconsider your diagnosis. Pain below the heel bone at the connection of the bone to the fascia. As the condition becomes more severe the pain can get more intense during the day without rest. Plantar fasciitis symptoms include pain while touching the inside of the heel or along the arch. Foot pain after you spend long periods of time standing on your feet. Pain when stretching the plantar fascia. Foot pain that worsens when climbing stairs or standing on the toes. Pain that feels as though you are walking on glass. Pain when you start to exercise that gets better as you warm up but returns after you stop.



Diagnosis

A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose plantar fasciitis. Occasionally, further investigations such as an X-ray, ultrasound or MRI may be required to assist with diagnosis and assess the severity of the condition.



Non Surgical Treatment

Many types of treatment have been used to combat plantar fasciitis, including injections, anti-inflammatory medications, orthotics, taping, manipulation, night splinting, and instrument-assisted soft-tissue manipulation (IASTM). IASTM begins with heat, followed by stretching. Stretching may be enhanced by applying ice to the plantar fascia. These stretches should be performed several times per day, with the calf in the stretched position. IASTM uses stainless-steel instruments to effectively access small areas of the foot. IASTM is believed to cause a secondary trauma to injured soft tissues as part of the healing process. Therapeutic modalities such as low-level laser, ultrasound, and electrical muscular stimulation may be effective in the reduction of pain and inflammation. Low Dye strapping or taping of the foot is an essential part of successful treatment of plantar fasciitis. Extracorporeal shock-wave therapy (ESWT) was introduced with great promise at one time. Recent studies have reported less favorable results. Some report no effect. Previous local steroid injection may actually have a negative effect on results from ESWT.

Painful Heel



Surgical Treatment

More invasive procedures to treat plantar fasciitis are usually sought only after other treatment has failed to produce favorable results. Corticosteroid injections deliver medicine into the injured fascia to reduce pain. However, this treatment may weaken the plantar fascia and result in further damage. In addition, extracorporeal shock wave therapy (ESWT) is a treatment where sound waves are sent through the damaged tissue in order to stimulate the damaged tissue and encourage healing. This method is relatively new in treating plantar fasciitis and your doctor will be able to tell you if it is the right method for you. Lastly, surgery is the last option for those suffering from chronic or severe plantar fasciitis.

January 07 2015

audreyleuenthal

What Is Heel Pain And Tips On How To Alleviate It

Heel Discomfort

Overview

Plantar fasciitis is the pain caused by degenerative irritation at the insertion of the plantar fascia on the medial process of the calcaneal tuberosity. The pain may be substantial, resulting in the alteration of daily activities. Various terms have been used to describe plantar fasciitis, including jogger’s heel, tennis heel, policeman’s heel, and even gonorrheal heel. Although a misnomer, this condition is sometimes referred to as heel spurs by the general public.



Causes

It usually starts following an increase in activity levels. Increase in weight. Standing for long periods. Poor footwear. Tight muscle groups. Abnormal pressure on the plantar Fascia can be caused by any of the above. The plantar fascia becomes inflamed and tiny rips can occur where it attaches into the inside of the heel bone. The area becomes inflamed and swollen, and it is the increase in fluid to the area that accumulates when weight is taken off the area that then causes the pain on standing.



Symptoms

Heel pain is the most common symptom associated with plantar fasciosis. Your heel pain may be worse in the morning or after you have been sitting or standing for long periods. Pain is most common under your heel bone, but you also may experience pain in your foot arch or on the outside aspect of your foot. Other common signs and symptoms of plantar fasciosis include mild swelling and redness in your affected area, tenderness on the bottom of your heel, impaired ability to ambulate.



Diagnosis

Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past. The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.



Non Surgical Treatment

Management options are usually conservative. Local injection of steroids, local anaesthetic may be useful to manage symptoms. Ultrasound-guided steroid injection has been shown to be effective in short-term (four-week) pain relief and reduced thickness of the plantar fascia at three months. A posterior tibial nerve block can be performed prior for a less painful plantar fascia injection. Specific plantar fascia stretching exercises performed daily have been shown to reduce short-term (8 weeks) and long-term (two years) pain. Other supportive measures include weight reduction in obese patients, rest, non-steroidal anti-inflammatory drugs (NSAIDs) and reduction of weight-bearing pressure (soft rubber heel pad, molded orthosis, or heel cup or soft-soled shoes).

Painful Heel



Surgical Treatment

Surgery should be reserved for patients who have made every effort to fully participate in conservative treatments, but continue to have pain from plantar fasciitis. Patients should fit the following criteria. Symptoms for at least 9 months of treatment. Participation in daily treatments (exercises, stretches, etc.). If you fit these criteria, then surgery may be an option in the treatment of your plantar fasciitis. Unfortunately, surgery for treatment of plantar fasciitis is not as predictable as a surgeon might like. For example, surgeons can reliably predict that patients with severe knee arthritis will do well after knee replacement surgery about 95% of the time. Those are very good results. Unfortunately, the same is not true of patients with plantar fasciitis.

January 05 2015

audreyleuenthal

Workout Routines For Pediatric Flatfoot

The causes of lip swelling could range from trauma and contact dermatitis to allergic reactions to certain medical conditions. I am a 44 year old Pe teacher who has been experiencing Fallen Arches since October. Vinegar has been used as a condiment for several centuries.

U-Shaped portion surrounds sore callus and reduces pain by transferring pressure from callus to the cushion. Soft orthotics cushion the ball and arches of the feet and protect them from injury and pain, while rigid orthotics correct abnormal foot angles and movements that can cause or worsen pain in the ball of the foot. Many insoles fit inside of slippers so that people suffering from pain in the ball of the foot can walk more comfortably inside their homes as well as outside. In addition, some insoles include added deodorizers to help decrease foot odor. While gel or foam insoles are sold at pharmacies, grocery stores and sporting-goods stores, orthotics require a visit to a podiatrist, who will make a cast of the foot and build a custom-fit insole from the cast. Foam, gel and soft orthotics require replacement once a year or more as the cushioning wears out. Rigid orthotics rarely need replacement. Hip bone spur can cause a lot of discomfort.

Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

On the other hand, the surgical hip pain treatment includes total hip bone replacement surgery. Although it is always advisable to consult the doctor if you experience pain in the hip that lasts for more than a couple of hours, you can try some home remedies to temporarily get rid of the sharp hip pain. One should note that these home remedies are not to be substituted for proper medical treatment. Ice packs and cool compresses are helpful to ease pain and inflammation on various parts of the body. Rest and ice the sole of your feet.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

The ezWalker® Custom Performance Insole can help relieve the pain and pressure of hammer toe by strategically supporting the medial, lateral, and trans-metatarsal arches to relieve pressure on the ball of the foot and therefore, release the action causing the hammer toe in the first place. Each ezWalker Performance Insole is custom molded to the specifications of each one of your feet, providing you with the support and comfort you need to relieve pain and produce comfort. Whether your hammer toe condition is due to genetics or not, ezWalker® Custom Performance Insoles can help you find relief from hammer toe and foot pain. The back of your ankle may feel tight and sore.
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