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June 25 2015

donellamenino

Hammer Toe Non Surgical Treatment

Hammer ToeOverview

A hammertoe is a toe that's curled due to a bend in the middle joint of a toe. Mallet toe is similar, but affects the upper joint of a toe. Otherwise, any differences between hammertoe and mallet toe are subtle. Both hammertoe and mallet toe are commonly caused by shoes that are too short or heels that are too high. Under these conditions, your toe may be forced against the front of your shoe, resulting in an unnatural bending of your toe and a hammer-like or claw-like appearance. Relieving the pain and pressure of hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a more severe case of hammertoe or mallet toe, you may need surgery to experience relief.

Causes

People who have a high-arched feet have an hammertoe increased chance of hammer toes occurring. Also, patients with bunion deformities notice the second toe elevating and becoming hammered to make room for the big toe that is moving toward it. Some patients damage the ligament that holds the toe in place at the bottom of the joint that connects the toe and foot. When this ligament (plantar plate) is disrupted or torn, the toe floats upward at this joint. Hammer toes also occur in women wearing ill-fitting shoes or high heels, and children wearing shoes they have outgrown.

HammertoeSymptoms

Pain on the bottom of your foot, especially under the ball of your foot, is one of the most common symptoms associated with hammertoes. Other common signs and symptoms of hammertoes include pain at the top of your bent toe from footwear pressure. Corns on the top of your bent toe. Redness and swelling in your affected area. Decreased joint range of motion in your affected toe joints.

Diagnosis

Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.

Non Surgical Treatment

Pad it. Mild cases of hammertoe can be treated with corn pads or felt pads available in the pharmacy. Toe caps, the small, padded sleeves that fit around the tip of the toe, may relieve hammer toe pain. Change your shoes. Wear wide shoes with resilient soles. Avoid shoes with pointed toes. Exercise. Certain exercises such as moving and stretching your toe gently with your hands and picking small or soft objects such as marbles or towels can keep your toe joints flexible. Also, while you are watching television or reading, you can also put a towel flat under your feet and use your toes to crumple it. This simple exercise can stretch and strengthen your muscles. Use ice. If your hammer toe becomes painful, applying an ice pack several times a day can help relieve the soreness and swelling.

Take medications. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen or naproxen may be helpful in minimizing pain and inflammation. Use orthotic devices. Place a custom orthotic device in your shoe. This will help control the muscle/tendon imbalance.

Surgical Treatment

Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz) procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty procedure, where a small, false joint is inserted into place. There are several other procedures, as well.

HammertoePrevention

Few people realize that their feet grow over the years: actually, the heel stays the same, but the front of the foot becomes wider and longer. The result, most women wear shoes that fit at the heel but are much too narrow in the front. Buy shoes that fit the longer foot. For two out of three people, one foot is significantly bigger than the other. Have both feet measured whenever you buy shoes. Have your feet measured while you're standing, and buy shoes that fit the larger foot. Shop at the end of the day, when foot swelling is greatest. No shoe should feel tight. Don't go by numbers. You may think of yourself as a size 8B, but size varies from shoe to shoe. There is no standardization, so pick the shoes that fit best. Limit high-heel use. These shoes increase pressure on the front of the foot by at least 50 percent, so wear them only for special occasions. Flat shoes are more comfortable than high heels, but they, too, can be hard on your feet, especially if they are thin-soled. Change your shoes. If your shoes are too short or too narrow, get another pair. This is especially important for children going through periods of rapid growth. The toe area should be high enough so that it doesn't rub against the top of your toes-especially if hammer toes have started to develop.
Tags: Hammer Toe
donellamenino

Hammer Toes Static Correction

Hammer ToeOverview

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with changes in shoe styles and foot care products. But if left untreated, hammertoes can become more rigid and painful. Corns are more likely to develop as time goes on-and corns never really go away, even after trimming. In more severe cases of Hammer toe, corn lesions may evolve into severe ulcerations. These lesions frequently occur in patients who have vascular disease or are Diabetic with neuropathy. The ulcerations can extend to the bone and result in infection and possible loss of digit or amputation.

Causes

Certain risk factors increase your likelihood of developing a hammertoe. These include a family history of hammertoes, wearing tight or pointy-toed shoes, wearing shoes that are too small, having calluses, bunions, or corns (thickened layers of skin caused by prolonged/repeated friction) Wearing shoes that are too small can force the joint of your toes into a dislocated position. This makes it impossible for your muscles to stretch out. Over time, the practice of wearing improperly fitting shoes increases your risk of developing hammertoes, blisters, bunions, and corns.

HammertoeSymptoms

The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened Hammer toe skin (calluses) may also appear on the bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.

Diagnosis

A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.

Non Surgical Treatment

Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. (Note: For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Or, a shoe specialist (Pedorthist) may be able to stretch the toe box so that it bulges out around the toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.

Surgical Treatment

If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery. Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.
Tags: Hammertoe

June 06 2015

donellamenino

Bunions All You Need To Know

Overview
Bunion pain Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment. A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion?s ?bump.? Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

Causes
By far the most common cause of bunions is the prolonged wearing of poorly fitting shoes, usually shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position. Bunions also may be caused by arthritis or polio. Heredity often plays a role in bunion formation. But these causes account for only a small percentage of bunions. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.

Symptoms
Symptoms include redness, swelling and pain which may be present along the inside margin of the foot. The patients feet may become too wide to fit into their normal size shoes and moderate to severe discomfort may occur when the patient is wearing tight shoes. A "hammer toe" may occur at the 2nd toe. This is when the toe contracts and presses on the shoe. Subsequently, this may cause a corn on top of the 2nd toe.

Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).

Non Surgical Treatment
If you suspect a bunion, it is essential that you confirm your suspicions by consulting with a podiatric physician. Don?t try to treat the problem yourself, even by using conservative measures. Many conditions have similar symptoms, and only a professional can tell the difference. Once a diagnosis is obtained, it is essential to begin treatment immediately. Your podiatric physician will advise you on the most effective means. If caught early enough, good foot care, shoes that fit properly, and/or orthoses may eliminate the need for any further intervention. Certain over-the-counter remedies, such as felt or foam pads, applied to specific areas of the foot to relieve pressure and friction, will protect the bunion. Elevating the foot and icing the area for 20 minutes an hour may help to relieve pain. Bunions

Surgical Treatment
Severe cases may require, along with surgery, cast immobilization and prolonged avoidance of weight-bearing activity. You should know that undergoing surgery for this health problem does not guarantee a cure or even a beneficial health outcome. Bunions, like many other foot conditions, should always be approached from a prevention standpoint, or therapy should be directed at slowing the progression of your deformity.
Tags: Bunions

May 29 2015

donellamenino

Do You Know The Chief Reasons For Overpronation

Overview

You know when we walk in the sand on the beach? Well, that?s how nature meant us to walk! You will notice how the sand forms a complete support under the foot. Unfortunately, instead of soft natural surfaces, we walk mainly on hard surfaces like pavements and floors. These hard surfaces cause the foot to roll inwards and the arches to flatten to gain ground contact. This condition is called ?over-pronation? and it affects an estimated 70% of the population. Over-pronation can lead to various foot problems such as heel pain and ball of foot pain. Because our feet are the foundation of our body, poorly aligned feet may also cause problems in other parts of the body, resulting in shin pain, aching legs, knee pain, even lower back pain.Over Pronation

Causes

Over-pronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding additional stress to other parts of the foot. Therefore over-pronation can often lead to a case of Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions. There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. People with flat feet often do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

Symptoms

Overpronation can lead to injuries and pain in the foot, ankle, knee, or hip. Overpronation puts extra stress on all the bones in the feet. The repeated stress on the knees, shins, thighs, and pelvis puts additional stress on the muscles, tendons, and ligaments of the lower leg. This can put the knee, hip, and back out of alignment, and it can become very painful.

Diagnosis

So, how can you tell if you have overpronation, or abnormal motion in your feet, and what plantar fasciitis treatment will work to correct it? Look at your feet. While standing, do you clearly see the arch on the inside of your foot? If not, and if the innermost part of your sole touches the floor, then your feet are overpronated. Look at your (running/walking) shoes. If your shoes are more worn on the inside of the sole in particular, then pronation may be a problem for you. Use the wet foot test. Wet your feet and walk along a section of pavement, then look at the footprints you leave behind. A normal foot will leave a print of the heel connected to the forefoot by a strip approximately half the width of the foot on the outside of the sole. If you?re feet are pronated there may be little distinction between the rear and forefoot.Over Pronation

Non Surgical Treatment

Solutions typically presented will include physical therapy sessions, prolonged prescription drug regimens, occasionally non-traditional approaches like holistic medicine and acupuncture. These options can provide symptom relief in the short term for some patients. However, these treatment methods cannot correct the internal osseous misalignment. Ligaments are not effective in limiting the motion of the ankle bone when excessive joint motion is present. Furthermore, there is not a single, specific ligament that is "too tight" that needs to be "stretched out." The muscles supporting the bones are already being "over-worked" and they cannot be strengthened enough to realign these bones. There is no evidence to suggest that any of these measures are effective in re-establishing or maintaining the normal joint alignment and function.

Surgical Treatment

Depending on the severity of your condition, your surgeon may recommend one or more treatment options. Ultimately, however, it's YOUR decision as to which makes the most sense to you. There are many resources available online and elsewhere for you to research the various options and make an informed decision.

May 18 2015

donellamenino

Tips On How To Treat Calcaneal Apophysitis?

Overview

It is important to know that foot pain is not only limited to grown-ups. Often active, healthy children will complain of pain in one or both heels shortly after walking, running, engaging or playing sports. The pain is usually felt at the back of, or under the heel. The cause of heel pain in children is usually a condition called calcaneal apophysitis or Sever's Disease, normally reported by 8 to 14 year olds.

Causes

There is no specific known cause of Sever?s disease. However, there are several common factors associated with the condition including. Tight calf muscles. Pronated foot type (rolled in towards the ankle). Children who are heavier. Puberty/growth spurts. External factors, e.g. hard surfaces or poor footwear. Increase in physical activity levels.

Symptoms

This syndrome can occur unilaterally or bilaterally. The incidence of bilaterally is approximately 60%. Common signs and symptoms include posterior inferior heel pain (over the medial and lateral surface of the bone). Pain is usually absent when the child gets up in the morning. Increased pain with weight bearing, running or jumping (= activity-related pain). The area often feels stiff. The child may limp at the end of physical activity. Tenderness at the insertion of the tendons (= an avascular necrosis of the arthropathy). Limited ankle dorsiflexion range secondary to tightness of the Achilles tendon. Hard surfaces and poor-quality or worn-out athletic shoes contribute to increased symptoms. The pain gradually resolves with rest. Reliability or validity of methods used to obtain the ankle joint dorsiflexion or biomechanical malalignment data are not commented upon, thus reducing the quality of the data. Although pain and limping are mentioned as symptomatic traits, there have been no attempts to quantify the pain or its effect on the individual.

Diagnosis

This can include physical examination and x-ray evaluation. X-rays may show some increased density or sclerosis of the apophysis (island of bone on the back of the heel). This problem may be on one side or bilateral.

Non Surgical Treatment

Although most cases do get better on their own, recovery typically takes several weeks or months. Adolescents can continue to play sports if the activity does not cause discomfort, but staying active does prolong the recovery period without treatment. As a result, rest and avoidance of athletic activity is usually recommended, along with medication for pain and swelling.

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 16 2015

donellamenino

Acquired Flat Foot Deformity

Overview
Adult acquired flat foot was first described in the late 1960s as something that occurred after trauma, as a result of a tear to the tibial posterior tendon. However, by 1969 two doctors called Kettlekamp and Alexander described cases in which no trauma had taken place. They referred to the condition as "tibial posterior tendon dysfunction" and this became known as the most common type of adult acquired flat foot. Flat feet

Causes
Rheumatoid arthritis This type of arthritis attacks the cartilage in the foot, leading to pain and flat feet. It is caused by auto-immune disease, where the body?s immune system attacks its own tissues. Diabetes. Having diabetes can cause nerve damage and affect the feeling in your feet and cause arch collapse. Bones can also fracture but some patients may not feel any pain due to the nerve damage. Obesity and/or hypertension (high blood pressure) This increases your risk of tendon damage and resulting flat foot.

Symptoms
The symptoms of PTTD may include pain, swelling, a flattening of the arch, and inward rolling of the ankle. As the condition progresses, the symptoms will change. For example, later, as the arch begins to flatten, there may still be pain on the inside of the foot and ankle. But at this point, the foot and toes begin to turn outward and the ankle rolls inward. As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The tendon has deteriorated considerably and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle. Symptoms, which may occur in some persons with flexible flatfoot, include. Pain in the heel, arch, ankle, or along the outside of the foot. ?Turned-in? ankle. Pain associated with a shin splint. General weakness / fatigue in the foot or leg.

Diagnosis
Posterior Tibial Tendon Dysfunction is diagnosed with careful clinical observation of the patient?s gait (walking), range of motion testing for the foot and ankle joints, and diagnostic imaging. People with flatfoot deformity walk with the heel angled outward, also called over-pronation. Although it is normal for the arch to impact the ground for shock absorption, people with PTTD have an arch that fully collapses to the ground and does not reform an arch during the entire gait period. After evaluating the ambulation pattern, the foot and ankle range of motion should be tested. Usually the affected foot will have decreased motion to the ankle joint and the hindfoot. Muscle strength may also be weaker as well. An easy test to perform for PTTD is the single heel raise where the patient is asked to raise up on the ball of his or her effected foot. A normal foot type can lift up on the toes without pain and the heel will invert slightly once the person has fully raised the heel up during the test. In early phases of PTTD the patient may be able to lift up the heel but the heel will not invert. An elongated or torn posterior tibial tendon, which is a mid to late finding of PTTD, will prohibit the patient from fully rising up on the heel and will cause intense pain to the arch. Finally diagnostic imaging, although used alone cannot diagnose PTTD, can provide additional information for an accurate diagnosis of flatfoot deformity. Xrays of the foot can show the practitioner important angular relationships of the hindfoot and forefoot which help diagnose flatfoot deformity. Most of the time, an MRI is not needed to diagnose PTTD but is a tool that should be considered in advanced cases of flatfoot deformity. If a partial tear of the posterior tibial tendon is of concern, then an MRI can show the anatomic location of the tear and the extensiveness of the injury.

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
Until recently, operative treatment was indicated for most patients with stage 2 deformities. However, with the use of potentially effective nonoperative management , operative treatment is now indicated for those patients that have failed nonoperative management. The principles of operative treatment of stage 2 deformities include transferring another tendon to help serve the role of the dysfunctional posterior tibial tendon (usually the flexor hallucis longus is transferred). Restoring the shape and alignment of the foot. This moves the weight bearing axis back to the center of the ankle. Changing the shape of the foot can be achieved by one or more of the following procedures. Cutting the heel bone and shifting it to the inside (Medializing calcaneal osteotomy). Lateral column lengthening restores the arch and overall alignment of the foot. Medial column stabilization. This stiffens the ray of the big toe to better support the arch. Lengthening of the Achilles tendon or Gastrocnemius. This will allow the ankle to move adequately once the alignment of the foot is corrected. Stage 3 acquired adult flatfoot deformity is treated operatively with a hindfoot fusion (arthrodesis). This is done with either a double or triple arthrodesis - fusion of two or three of the joints in hindfoot through which the deformity occurs. It is important when a hindfoot arthrodesis is performed that it be done in such a way that the underlying foot deformity is corrected first. Simply fusing the hindfoot joints in place is no longer acceptable.

March 23 2015

donellamenino

The Cause Of Adult Aquired Flat Feet

Overview

The posterior tibialis muscle originates on the bones of the leg (tibia and fibula). This muscle then passes behind the medial (inside) aspect of the ankle and attaches to the medial midfoot as the posterior tibial tendon. The posterior tibial tendon serves to invert (roll inward) the foot and maintain the arch of the foot. This tendon plays a central role in maintaining the normal alignment of the foot and also in enabling normal gait (walking). In addition to tendons running across the ankle and foot joints, a number of ligaments span and stabilize these joints. The ligaments at the medial ankle can become stretched and contribute to the progressive flattening of the arch. Several muscles and tendons around the ankle and foot act to counter-balance the action of the posterior tibial tendon. Under normal circumstances, the result is a balanced ankle and foot with normal motion. When the posterior tibial tendon fails, the other muscles and tendons become relatively over-powering. These muscles then contribute to the progressive deformity seen with this disorder.Acquired Flat Foot



Causes

As the name suggests, adult-acquired flatfoot occurs once musculoskeletal maturity is reached, and it can present for a number of reasons, though one stands out among the others. While fractures, dislocations, tendon lacerations, and other such traumatic events do contribute to adult-acquired flatfoot as a significant lower extremity disorder, as mentioned above, damage to the posterior tibial tendon is most often at the heart of adult-acquired flatfoot. One study further elaborates on the matter by concluding that ?60% of patients [presenting with posterior tibial tendon damage and adult-acquired flatfoot] were obese or had diabetes mellitus, hypertension, previous surgery or trauma to the medial foot, or treatment with steroids?.



Symptoms

The symptoms of PTTD may include pain, swelling, a flattening of the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. For example, when PTTD initially develops, there is pain on the inside of the foot and ankle (along the course of the tendon). In addition, the area may be red, warm, and swollen. Later, as the arch begins to flatten, there may still be pain on the inside of the foot and ankle. But at this point, the foot and toes begin to turn outward and the ankle rolls inward. As PTTD becomes more advanced, the arch flattens even more and the pain often shifts to the outside of the foot, below the ankle. The tendon has deteriorated considerably and arthritis often develops in the foot. In more severe cases, arthritis may also develop in the ankle.



Diagnosis

The adult acquired flatfoot, secondary to posterior tibial tendon dysfunction, is diagnosed in a number of ways with no single test proven to be totally reliable. The most accurate diagnosis is made by a skilled clinician utilizing observation and hands on evaluation of the foot and ankle. Observation of the foot in a walking examination is most reliable. The affected foot appears more pronated and deformed compared to the unaffected foot. Muscle testing will show a strength deficit. An easy test to perform in the office is the single foot raise. A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet - the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.



Non surgical Treatment

Because of the progressive nature of PTTD, early treatment is critical. If treated soon enough, symptoms may resolve without the need for surgery and progression of the condition can be stopped. If left untreated, PTTD may create an extremely flat foot, painful arthritis in the foot and ankle, and will limit your ability to walk, run, and other activities. Your podiatrist may recommend one or more of these non-surgical treatments to manage your PTTD. Orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may recommend an ankle brace or a custom orthotic device that fits into your shoe to support the arch. Immobilization. A short-leg cast or boot may be worn to immobilize the foot and allow the tendon to heal. Physical therapy. Ultrasound therapy and stretching exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Shoe modifications. Your foot and ankle surgeon may recommend changes in your footwear.

Flat Foot



Surgical Treatment

If cast immobilization fails, surgery is the next alternative. Treatment goals include eliminating pain, halting deformity progression and improving mobility. Subtalar Arthroereisis, 15 minute outpatient procedure, may correct flexible flatfoot deformity (hyperpronation). The procedure involves placing an implant under the ankle joint (sinus tarsi) to prevent abnormal motion. Very little recovery time is required and it is completely reversible if necessary. Ask your Dallas foot doctor for more information about this exciting treatment possibility.

March 05 2015

donellamenino

What Should We Do About Achilles Tendinitis ?

Overview

Achilles TendonitisIf you have pain along the back of your leg near your heel, you may have Achilles tendonitis. Achilles tendonitis is an overuse injury that commonly occurs in runners and ?weekend warriors?. The Achilles tendon is the largest tendon in the body. Named after a tragic hero from Greek mythology, it connects your calf muscle to your heel bone to allow you to jump, run and walk. Achilles tendonitis is most common in middle-aged men, but it can happen to anyone who has a sudden increase in physical activity. The risk is increased if you also have tight calf muscles and/or a flat arch in your foot. Other risk factors include running in worn out shoes, cold weather, frequently running uphill or if you suffer from medical conditions such as diabetes or high blood pressure. There are two main types of Achilles tendinitis: insertional and noninsertional. Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches to the heel bone. Noninsertional Achilles tendinitis is when the fibers in the middle portion of the tendon have started to break down with tiny tears, swell, and/or thicken. This type is more often seen in younger, active people. Both types can also cause bone spurs. Achilles tendonitis should be diagnosed by your doctor. However, if you experienced a sudden ?pop? in the back of your calf or heel, this might be something more serious like a ruptured or torn Achilles tendon. If this happens, see your doctor immediately.

Causes

Achilles tendonitis is an overuse injury. Too much too soon is the common cause of overuse injuries, however other factors can contribute to developing the condition. An increase in activity, either distance, speed or a sudden change to running up hills. As a rule of thumb distance runners should increase their mileage by no more than 10% per week. A change of footwear or training surface for example suddenly running on soft sand can cause the heel to drop lower than normal making the tendon stretch further than it is used to. Weak calf muscles can tighten or go into partial spasm which again increases the strain on the achilles tendon by shortening the muscle. Running up hills - the achilles tendon has to stretch more than normal on every stride. This is fine for a while but will mean the tendon will fatigue sooner than normal. Overpronation or feet which roll in when running can place an increased strain on the achilles tendon. As the foot rolls in (flattens) the lower leg also rotates inwards which places twisting stresses on the tendon. Wearing high heels constantly shortens the tendon and calf muscles. When exercising in flat running shoes, the tendon is stretched beyond its normal range which places an abnormal strain on the tendon.

Symptoms

Most cases of Achilles tendonitis start out slowly, with very little pain, and then grow worse over time. Some of the more common symptoms include mild pain or an ache above the heel and in the lower leg, especially after running or doing other physical activities, pain that gets worse when walking uphill, climbing stairs, or taking part in intense or prolonged exercise, stiffness and tenderness in the heel, especially in the morning, that gradually goes away, swelling or hard knots of tissue in the Achilles tendon, a creaking or crackling sound when moving the ankle or pressing on the Achilles tendon, weakness in the affected leg.

Diagnosis

Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury, although evaluation may help to rule out some of the other possibilities in the differential diagnosis. Imaging studies. Plain radiography: Radiographs are more useful for ruling out other injuries than for ruling in Achilles tendon ruptures. Ultrasonography: Ultrasonography of the leg and thigh can help to evaluate the possibility of deep venous thrombosis and also can be used to rule out a Baker cyst; in experienced hands, ultrasonography can identify a ruptured Achilles tendon or the signs of tendinosis. Magnetic resonance imaging (MRI): MRI can facilitate definitive diagnosis of a disrupted tendon and can be used to distinguish between paratenonitis, tendinosis, and bursitis.

Nonsurgical Treatment

With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating Achilles tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation.

Achilles Tendon

Surgical Treatment

Chronic Achilles tendon tears can be more complicated to repair. A tendon that has torn and retracted (pulled back) into the leg will scar in the shortened position over time. Restoring normal tendon length is usually not an issue when surgery is performed within a few weeks of the injury. However, when there has been a delay of months or longer, the treatment can be more complicated. Several procedures can be used to add length to a chronic Achilles tear. A turndown procedure uses tissue folded down from the top of the calf to add length to the Achilles tendon. Tendon transfers from other tendons of the ankle can also be performed to help restore function of the Achilles. The results of surgery in a chronic situation are seldom as good as an acute repair. However, in some patients, these procedures can help restore function of a chronically damaged Achilles.

Prevention

There are several things you can do to reduce the risk of Achilles tendinitis, warm up every time before you exercise or play a sport. Switch up your exercises. Slowly increase the length and intensity of your workouts. Keep your muscles active and stay in shape all year-round. When you see symptoms of Achilles tendinitis, stop whatever activity you are doing and rest.

January 17 2015

donellamenino

What Is Heel Discomfort And The Best Ways To Heal It

Plantar Fascia

Overview

Plantar fasciitis is a painful condition causing heel pain and many people with the condition also have heel spurs. It affects the band of tissue (plantar fascia) that supports the middle part of the foot and runs along the sole of the foot from the heel to the ball of the foot. Usually the plantar fascia is strong and flexible but due to certain factors it can become irritated and inflamed where the plantar fascia joins the bone in the foot. Heel spurs occur when there's constant pulling of the fascia at the heel bone. This leads to a bony growth or spur. The symptoms of plantar fasciitis are pain in the arch of the foot or heel. This pain is usually worse in the morning after rest when the plantar fascia tightens and shortens. Heel spurs cause a stabbing pain at the bottom or front of the heel bone.



Causes

The cause of plantar fasciitis is poorly understood and is thought to likely have several contributing factors. The plantar fascia is a thick fibrous band of connective tissue that originates from the medial tubercle and anterior aspect of the heel bone. From there, the fascia extends along the sole of the foot before inserting at the base of the toes, and supports the arch of the foot. Originally, plantar fasciitis was believed to be an inflammatory condition of the plantar fascia. However, within the last decade, studies have observed microscopic anatomical changes indicating that plantar fasciitis is actually due to a non-inflammatory structural breakdown of the plantar fascia rather than an inflammatory process. Due to this shift in thought about the underlying mechanisms in plantar fasciitis, many in the academic community have stated the condition should be renamed plantar fasciosis. The structural breakdown of the plantar fascia is believed to be the result of repetitive microtrauma (small tears). Microscopic examination of the plantar fascia often shows myxomatous degeneration, connective tissue calcium deposits, and disorganized collagen fibers. Disruptions in the plantar fascia’s normal mechanical movement during standing and walking (known as the Windlass mechanism) are thought to contribute to the development of plantar fasciitis by placing excess strain on the calcaneal tuberosity.



Symptoms

The typical presentation is sharp pain localized at the anterior aspect of the calcaneus. Plantar fasciitis has a partial association with a heel spur (exostosis); however, many asymptomatic individuals have bony heel spurs, whereas many patients with plantar fasciitis do not have a spur.



Diagnosis

Plantar fasciitis is usually diagnosed by a health care provider after consideration of a person’s presenting history, risk factors, and clinical examination. Tenderness to palpation along the inner aspect of the heel bone on the sole of the foot may be elicited during the physical examination. The foot may have limited dorsiflexion due to tightness of the calf muscles or the Achilles tendon. Dorsiflexion of the foot may elicit the pain due to stretching of the plantar fascia with this motion. Diagnostic imaging studies are not usually needed to diagnose plantar fasciitis. However, in certain cases a physician may decide imaging studies (such as X-rays, diagnostic ultrasound or MRI) are warranted to rule out other serious causes of foot pain. Bilateral heel pain or heel pain in the context of a systemic illness may indicate a need for a more in-depth diagnostic investigation. Lateral view x-rays of the ankle are the recommended first-line imaging modality to assess for other causes of heel pain such as stress fractures or bone spur development. Plantar fascia aponeurosis thickening at the heel greater than 5 millimeters as demonstrated by ultrasound is consistent with a diagnosis of plantar fasciitis. An incidental finding associated with this condition is a heel spur, a small bony calcification on the calcaneus (heel bone), which can be found in up to 50% of those with plantar fasciitis. In such cases, it is the underlying plantar fasciitis that produces the heel pain, and not the spur itself. The condition is responsible for the creation of the spur though the clinical significance of heel spurs in plantar fasciitis remains unclear.



Non Surgical Treatment

Treatment for heel pain usually involves using a combination of techniques, such as stretches and painkillers, to relieve pain and speed up recovery. Most cases of heel pain get better within 12 months. Surgery may be recommended as a last resort if your symptoms don't improve after this time. Only 1 in 20 people with heel pain will need surgery. Whenever possible, rest the affected foot by not walking long distances and standing for long periods. However, you should regularly stretch your feet and calves using exercises such as those described below. Pain relief. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to help relieve pain. Some people also find applying an ice pack to the affected heel for 5-10 minutes can help relieve pain and inflammation. However, do not apply an ice pack directly to your skin. Instead, wrap it in a towel. If you do not have an ice pack, you can use a packet of frozen vegetables.

Heel Pain



Surgical Treatment

When more conservative methods have failed to reduce plantar fasciitis pain, your doctor may suggest extracorporeal shock wave therapy, which is used to treat chronic plantar fasciitis. Extracorporeal shock wave therapy uses sound waves to stimulate healing, but may cause bruises, numbness, tingling, swelling, and pain. When all else fails, surgery may be recommended to detach the plantar fascia from the heel bone. Few people need surgery to treat the condition.



Stretching Exercises

Stretching exercises for your foot are important. Do the stretches shown here at least twice a day. Don't bounce when you stretch. Plantar fascia stretch. To do the plantar fascia stretch, stand straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Calf stretch. Stand with your hands against a wall and your injured leg behind your other leg. With your injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Other exercises. You can also strengthen your leg muscles by standing on the ball of your foot at the edge of a step and raising up as high as possible on your toes. Relax between toe raises and let your heel fall a little lower than the edge of the step. It's also helpful to strengthen the foot by grabbing a towel with your toes as if you are going to pick up the towel with your foot. Repeat this exercise several times a day.

January 14 2015

donellamenino

What Leads To Heel Pain To Appear

Painful Heel

Overview

The plantar fascia is a thick fibrous band that runs the length of the sole of the foot. The plantar fascia helps maintain the complex arch system of the foot and plays a role in one's balance and the various phases of gait. Injury to this tissue, called plantar fasciitis, is one of the most disabling running injuries and also one of the most difficult to resolve. Plantar fasciitis represents the fourth most common injury to the lower limb and represents 8 -10% of all presenting injuries to sports clinics (Ambrosius 1992, Nike 1989). Rehabilitation can be a long and frustrating process. The use of preventative exercises and early recognition of danger signals are critical in the avoidance of this injury.



Causes

When some people stand/walk/run/jump their own anatomy in their ankle joint is not ‘sturdy’ enough to cope with the needed stabilisation of their ankle joint when they are weight bearing. So, their ankle rotates to find a point of stability. By the shin twisting in and the ankle rotating downwards to the inside (along with your body weight, the power of some muscles, and of course, gravity) a huge amount of stress is applied to the plantar fascia until it is stressed beyond it’s normal limits and it starts to ‘tighten up’. It is this tightening up of the plantar fascia under this stress that causes the damage that in turn leads to pain…eventually.



Symptoms

People with this condition sometimes describe the feeling as a hot, sharp sensation in the heel. You usually notice the pain first thing in the morning when you stand. After walking for a period of time, the pain usually lessens or even disappears. However, sharp pain in the center of the heel may return after resting for a period of time and then resuming activity.



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

To alleviate the stress and pain on the fascia, the person can take shorter steps and avoid walking barefoot. Activities that involve foot impact, such as jogging, should be avoided. The most effective treatments include the use of in-shoe heel and arch cushioning with calf-stretching exercises and night splints that stretch the calf and plantar fascia while the patient sleeps. Prefabricated or custom-made foot orthotics may also alleviate fascial tension and symptoms. Other treatments may include activity modifications, NSAIDs, weight loss in obese patients, cold and ice massage therapy, and occasional corticosteroid injections. However, because corticosteroid injections can predispose to plantar fasciosis, many clinicians limit these injections. For recalcitrant cases, physical therapy, oral corticosteroids, and cast immobilization should be used before surgical intervention is considered. A newer form of treatment for recalcitrant types of plantar fasciosis is extracorporeal pulse activation therapy (EPAT), in which low-frequency pulse waves are delivered locally using a handheld applicator. The pulsed pressure wave is a safe, noninvasive technique that stimulates metabolism and enhances blood circulation, which helps regenerate damaged tissue and accelerate healing. EPAT is being used at major medical centers.

Painful Heel



Surgical Treatment

Surgery may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.



Stretching Exercises

Exercises designed to stretch both your calf muscles and your plantar fascia (the band of tissue that runs under the sole of your foot) should help relieve pain and improve flexibility in the affected foot. A number of stretching exercises are described below. It's usually recommended that you do the exercises on both legs, even if only one of your heels is affected by pain. This will improve your balance and stability, and help relieve heel pain. Towel stretches. Keep a long towel beside your bed. Before you get out of bed in the morning, loop the towel around your foot and use it to pull your toes towards your body, while keeping your knee straight. Repeat three times on each foot. Wall stretches. Place both hands on a wall at shoulder height, with one of your feet in front of the other. The front foot should be about 30cm (12 inches) away from the wall. With your front knee bent and your back leg straight, lean towards the wall until you feel a tightening in the calf muscles of your back leg. Then relax. Repeat this exercise 10 times before switching legs and repeating the cycle. You should practise wall stretches twice a day. Stair stretches. Stand on a step of your stairs facing upstairs, using your banister for support. Your feet should be slightly apart, with your heels hanging off the back of the step. Lower your heels until you feel a tightening in your calves. Hold this position for about 40 seconds, before raising your heels back to the starting position. Repeat this procedure six times, at least twice a day. Chair stretches. Sit on a chair, with your knees bent at right angles. Turn your feet sideways so your heels are touching and your toes are pointing in opposite directions. Lift the toes of the affected foot upwards, while keeping the heel firmly on the floor. You should feel your calf muscles and Achilles tendon (the band of tissue that connects your heel bone to your calf muscle) tighten. Hold this position for several seconds and then relax. Repeat this procedure 10 times, five to six times a day. Dynamic stretches. While seated, roll the arch of your foot (the curved bottom part of the foot between your toes and heel) over a round object, such as a rolling pin, tennis ball or drinks can. Some people find that using a chilled can from their fridge has the added benefit of helping to relieve pain. Move your foot and ankle in all directions over the object for several minutes. Repeat the exercise twice a day.

January 10 2015

donellamenino

What Brings About Pain Under The Heel To Surface

Heel Pain

Overview

The plantar fascia is a band of connective tissue on the bottom of the foot that helps form the arch of the foot. Acute injury or cumulative trauma to the plantar fascia can be a cause of inflammation and heel pain. This is called plantar fasciitis.



Causes

Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if your feet roll inward too much when you walk ( excessive pronation ). You have high arches or flat feet. You walk, stand, or run for long periods of time, especially on hard surfaces. You are overweight. You wear shoes that don't fit well or are worn out. You have tight Achilles tendons or calf muscles.



Symptoms

If you have Plantar Fasciitis, you will most likely feel a sharp pain under the ball of you heel and it will often give pain when standing after a period of rest. For example when you get out of bed in the mornings or after being sat down. Some patients describe this feeling as a stone bruise sensation, or a pebble in the shoe and at times the pain can be excruciating. Patients with Plantar Fasciitis can experience pain free periods whereby the think they are on the mend, only for the heel pain to come back aggressively when they appear to have done nothing wrong. If your plantar fasciitis came on very suddenly and the pain is relentless, then you may have Plantar Fascial Tears. We will be able to differentiate between these 2 conditions, sometimes with ultra sound imaging. The treatment for each of these conditions will need to be very different.



Diagnosis

If you see a doctor for heel pain, he or she will first ask questions about where you feel the pain. If plantar fasciitis is suspected, the doctor will ask about what activities you've been doing that might be putting you at risk. The doctor will also examine your foot by pressing on it or asking you to flex it to see if that makes the pain worse. If something else might be causing the pain, like a heel spur or a bone fracture, the doctor may order an X-ray to take a look at the bones of your feet. In rare cases, if heel pain doesn't respond to regular treatments, the doctor also might order an MRI scan of your foot. The good news about plantar fasciitis is that it usually goes away after a few months if you do a few simple things like stretching exercises and cutting back on activities that might have caused the problem. Taking over-the-counter medicines can help with pain. It's rare that people need surgery for plantar fasciitis. Doctors only do surgery as a last resort if nothing else eases the pain.



Non Surgical Treatment

Reducing inflammation in the plantar fascia ligament is an important part of treatment, though this does not address the underlying damage to the ligament. Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes three or four times a day to reduce swelling. You can also try reducing or changing your exercise activities. Using arch supports in your shoes and doing stretching exercises may also help to relieve pain. Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (i.e. Motrin or Advil) and naproxen (i.e. Aleve), are often used to reduce inflammation in the ligament. If home treatments and over-the-counter anti-inflammatory drugs don’t ease the pain, an injection of a corticosteroid directly into the damaged section of the ligament can be given. Your doctor can do this in his or her office. Your doctor may use an ultrasound device to help determine the best place for the injection. Corticosteroids can also be administered on the skin of your heel or the arch of your foot, and then a painless electrical current is applied to let the steroid pass through your skin and into the muscle. Physical therapy is an important part of treatment for planter fasciitis. It can help stretch your plantar fascia and Achilles tendons. A physical therapist can also show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia. If pain continues and other methods aren’t working, your doctor may recommend extracorporeal shock wave therapy. Sound waves are bombarded against your heel to stimulate healing within the ligament. This treatment can result in bruises, swelling, pain, and numbness, and has not been proven to be consistently effective in relieving symptoms.

Plantar Fascitis



Surgical Treatment

If treatment hasn't worked and you still have painful symptoms after a year, your GP may refer you to either an orthopaedic surgeon, a surgeon who specialises in surgery that involves bones, muscles and joints, a podiatric surgeon, a podiatrist who specialises in foot surgery. Surgery is sometimes recommended for professional athletes and other sportspeople whose heel pain is adversely affecting their career. Plantar release surgery. Plantar release surgery is the most widely used type of surgery for heel pain. The surgeon will cut the fascia to release it from your heel bone and reduce the tension in your plantar fascia. This should reduce any inflammation and relieve your painful symptoms. Surgery can be performed either as, open surgery, where the section of the plantar fascia is released by making a cut into your heel, endoscopic or minimal incision surgery - where a smaller incision is made and special instruments are inserted through the incision to gain access to the plantar fascia. Endoscopic or minimal incision surgery has a quicker recovery time, so you will be able to walk normally much sooner (almost immediately), compared with two to three weeks for open surgery. A disadvantage of endoscopic surgery is that it requires both a specially trained surgical team and specialised equipment, so you may have to wait longer for treatment than if you were to choose open surgery. Endoscopic surgery also carries a higher risk of damaging nearby nerves, which could result in symptoms such as numbness, tingling or some loss of movement in your foot. As with all surgery, plantar release carries the risk of causing complications such as infection, nerve damage and a worsening of your symptoms after surgery (although this is rare). You should discuss the advantages and disadvantages of both techniques with your surgical team. Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to, have a "numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).



Prevention

You can help to prevent plantar fasciitis by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch and cushion the heel. In people who are prone to episodes of plantar fasciitis, exercises that stretch the heel cord (known as the Achilles tendon) and the plantar fascia may help to prevent plantar fasciitis from returning. Ice massage also can be used on the bottom of the foot after stressful athletic activities. It is possible that strict control of blood sugar will prevent plantar fasciitis in people with diabetes, although this has not been proven.

January 05 2015

donellamenino

Symptoms Of Tingly Feet

If your High Arched Feet feels like a bruise or a dull ache, you may have metatarsalgia People with metatarsalgia will often find that the pain is aggravated by walking in bare feet and on hard floor surfaces. Pain in the ball of your foot can stem from several causes. Ball of foot pain is the pain felt in the ball of foot region. Metatarsalgia is a condition characterized by having pain in ball of foot. The average adult takes about 9,000 steps per day.

TOE CONDITIONS: Ingrown toenails, blood accumulation under the nail plate (subungual hematoma), corns and calluses are all often seen as a result of playing baseball. It is important that good foot hygiene be practiced with washing between the toes and drying the feet well after bathing. Topical antifungals work well to treat athletes foot. ORTHOPEDIC INJURIES: Most orthopedic baseball foot and ankle injuries are acute or sudden. If an individuals foot or ankle is injured, seek immediate evaluation with one of our doctors. If your athlete has a baseball related injury, call our specialists at Advanced Foot and Ankle Center in McKinney and Prosper Texas at 972-542-2155. However, toe numbness and pain occurring together is one such problem that you cannot afford to ignore. Common symptoms are flat feet knee problems , burning sensation, numbness.

When the tissue of the arch of the foot becomes irritated and inflamed, even simple movements can be quite painful. Plantar fasciitis is the name that describes inflammation of the fibrous band of tissue that connects the heel to the toes. Symptoms of plantar fasciitis include pain early in the morning and pain with long walks or prolonged standing. Arch pain early in the morning is due to the plantar fascia becoming contracted and tight as you sleep through the night. Bunions develop from a weakness in the bone structure of your foot.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

Rheumatoid arthritis causes forefoot deformity and often may cause displacement and even dislocation of the metatarsal joints themselves. Morton's Neuroma can also be a source of metarsalgia and is characterized by pain in the forefoot. Sesamoiditis is located on the plantar surface of the foot and will be located near the first metatarsal phalangeal joint.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.

November 15 2014

donellamenino

Ball Of Foot Pain (Metatarsalgia)

A foot pain is a common syndrome among the individuals and it can be acute in few cases if left unattended. Psoriatic arthritis can cause pain and swelling beyond the joints. Yes it takes spectacular efforts and extraordinary energy to become a successful athlete. Each foot contains 26 bones, which form two arches.

There are many conservative treatments for plantar fasciitis that when used accordingly are very successful. Your podiatric physician may refer you to a physical therapist to aid in your treatment and to teach you the most effective stretching techniques for your foot type and condition. You may also be advised to wear a night splint that stretches your tendons and fascia in your foot while you sleep. These treatments can significantly reduce the inflammation of your plantar fascia and thus reduce your pain. You should be wearing shoes that properly stabilize your foot and support your arch. Your podiatric physician can provide you with a prefabricated or custom orthotic that would give your achy foot the support it need. It takes time and therapy to improve the integrity of the tissue.

My web site has been designed to offer information about podiatric Foot care We want you to feel comfortable in ouroffice. Dr. Metzl breaks down what "Plantar Fasciitis" is, how to prevent it, and how to cure it. For 5 to 6 minutes perform as many sets of 15 Rows from Plank, 15 Push-ups, and 15 Sit-ups as possible. Dr. Metzl breaks down what "Runner's Knee" is, how to prevent it, and how to cure it. Dr. Metzl breaks down what IT Band Syndrome is, how to prevent it, and how to cure it. Feet and ankles are built tough, capable of sustaining two or three times our body weight. If your foot is too stiff to bear the impact, a tibial stress fracture could result.

Immobilization of the foot is always indicated and depending on the degree of pain and its location determines how much immobilization. Again, it's the same old problem with the foot; every time you take a step you are re-injuring an injured area and so foot problems tend to take longer to heal compared to other areas of the body. It is important to mention the other type of tendinopathy is tendinosis which is a chronic pain occurring in a tendon with no overt inflammation but degeneration of the tendon instead. Both conditions will yield pain but the treatments offered in the previous paragraphs will only be effective in tendonitis because they attempt to reduce inflammation. The top of the foot will be very tender, mildly swollen, and possibly slightly red.

One of the most common causes is improper walking habits, i.e., exerting weight or pressure on the metatarsals while walking or running which can lead to pain at night. Symptoms include sharp pain in the middle part of the foot, callousing around the toes, and tingling sensation and severe pain while walking or standing. Pain in the middle of the leg, i.e. in the metatarsals is also one of the symptoms of arthritis.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

Movement of the foot is controlled by four groups of muscles in the leg. These muscles get a workout not only when our feet are visibly moving (such as when we walk or run) but even when we stand still, because they help keep us balanced and upright. And like nearly all muscles (the heart muscle is an exception), these muscles can become fatigued, decreasing their ability to properly support the feet and causing discomfort. Here are some common problems that cause foot pain, most often due to an overuse injury. Bad shoes cause foot and ankle problems.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

Roddy E, Muller S, Thomas E: Defining disabling foot pain in older adults: further examination of the Manchester Foot Pain and Disability Index. Ware JE Jr, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's Manual for the SF-36v2® Health Survey. Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic classification of osteoarthritis in commonly affected joints of the foot. Menz HB, Munteanu SE, Landorf KB, Zammit GV, Cicuttini FM: Radiographic evaluation of foot osteoarthritis: sensitivity of radiographic variables and relationship to symptoms. Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MI, Macfarlane GJ: The grading of hallux valgus. Cornwall MW, McPoil TG, Lebec M, Vicenzino B, Wilson J: Reliability of the modified Foot Posture Index.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

November 09 2014

donellamenino

Do You Have Hard Skin On The Bottom Of Your Foot?

There are different types of foot fungus that occur due to many factors both internally and externally, that can alter one's physical state, foot wise. Every day there are many women around the world that wish that they could change the way that their skin looks.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

Even if you scrub and moisturise your feet and trim nails, you may notice hard, thickened skin, which could be the beginning of a corn, making you self-conscious about baring your feet, and potentially causing you pain. A corn is an area of thickened skin that can occur anywhere on the foot due to pressure. It can be painful if left untreated, but there are simple treatment options available at major pharmacies and supermarkets. COMPEED® Corn Plasters are designed using a second skin technology to help relieve pain quickly and remove the corn. This causes the layer of the foot skin to become thick and hard, resulting in a condition known as foot callus.

You can also take a mineral supplement as the detoxification will pull out some of the minerals that are naturally bound with the heavy metals and toxins that are eliminated during the bath. However, others speculate that the color change occurs not because of toxins being released, but because of the salt reacting with the ionic cartridge, which would take place even without soaking your feet. There is no better way than coming home to a relaxing and soothing foot detox bath after a long, hard day at work.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

To prevent, try COMPEED® Corn Moisturising Plasters (pictured far left), which provide continuous moisturisation and cushioning to treat and help to stop pressure points developing into corns. Among all the parts of the body that are subjected to constant pressure and friction throughout the day, the feet bear most of the brunt. This condition occurs since the feet are constantly exposed to pressure. Areas such as the ball of the foot, the heel, and the big toe are the ones which get callused. These very calluses worsen the problem further since they do not sweat, thereby making the skin of the feet more dry. Therefore, a topical cream containing urea may help break the calluses, and thereby reduce the dryness and cracking of the feet. Urea cream is basically used for treating calluses, dry skin, and foot corns. Also, it is recommended for the treatment of hyperkeratotic conditions.

The actual serum secreted is also capable of repair the damages caused to the pores and skin by the UV solar radiation, pollution along with other ecological accidents or hazards. There is no definite way treatment that's effective to everyone. Widespread measures to avoid dry skin of your skin, including utilizing pores and skin moisturizers are suggested because regular lubrication of the skin may be the foundation of many cases for skin disorders. STEP 1: Remove old nail varnish with a nail varnish remover. Rinse thoroughly for beautifully soft feet.

November 03 2014

donellamenino

Learn About Feet

Diabetics often suffer foot and leg pain as a result of complications that are associated with the diabetes. The human foot is capable to adjust to irregular ground, in an extensive range of conditions. A detailed foot pain diagnosis is required if you are experiencing regular pain in the feet. Our feet function as a shock absorber and cushion during exercise on up to 1 million pounds of force. Are you on the hunt for ladies wide shoes?

Hand, foot and mouth disease is usually spread from person- to -person through faecal contamination (which can occur when changing a nappy or using the toilet and not properly washing hands afterwards), or spread through respiratory secretions (saliva, sputum, or nasal mucus) of an infected person. There is no clear evidence of risk to unborn babies from hand, foot and mouth disease. However, infected mothers can pass the infection onto newborn babies who rarely can have severe disease. Avoid sharing cups, eating utensils, items of personal hygiene (for example: towels, washers and toothbrushes), and clothing (especially shoes and socks). Children with hand, foot and mouth disease should be excluded from school or childcare facilities until their blisters have dried. Thus it helps loosen the hard and scaly skin.

Nationality can also influence foot structure: Many Mediterranean people, for instance, have particularly low arches, while many Northern Europeans tend to have high ones. One of your best precautions against foot pain is to be aware of both the hereditary factors (which you can't change) and the lifestyle and life-stage factors (which you can change or, at least, influence) that determine whether your feet are healthy or hurting. This article offers easy and helpful suggestions for treating many of the more common foot conditions people experience. However, there are certain foot problems that are so serious, you should seek a doctor's care immediately. Likewise, certain people should never attempt to self-treat a foot problem.

Go for those, which provide support, cushioning, and enough room for the toes to move. People with flexible flat feet have arches that disappear when they put weight on their feet, but which reappear when the feet are not weight-bearing, or when they go up on their toes. In fact, this reappearance of the arch while the foot is non-weight bearing is really what separates this type of flatfoot from other types. It's as though the arches take toe-standing as a general call of olly-olly-oxen-free: time to come out and tease the seeker about how great your hiding place was. Visit Cure Athlete's Foot In 7 Days.

When a patient suffers a foot or lower leg injury they should see a podiatrist as soon as possible to receive the appropriate advice and treatment. The podiatrist will need to understand the cause of the injury, any previous injuries and the level of activity prior to the injury occurring. A comprehensive biomechanical assessment of the patient walking or running will then be carried out to outline any issues with foot/knee or hip alignment that may be causing or contributing to the condition. Podiatrists care for any skin and nail problem involving the feet. The skin may turn red, and start peeling.

Since plantar fascia gets tightened while one is asleep, the sudden movement causes stretching of the ligament as one takes the first few steps. While structural foot abnormalities such as high arches or fallen arches can make one more susceptible to plantar fasciitis, wearing old worn-out shoes can also cause stress to the plantar fascia. Those suffering from plantar fasciitis are also at an increased risk of developing heel spurs. Heel spurs, also known as osteophytes, are abnormal bony outgrowths that may develop along the edges of the heel bone. Heel spurs form when the plantar fascia starts pulling at the heel bone or gets torn due to excessive stress. If the heel spurs start impinging on any of the surrounding nerves or the tissues, one is likely to suffer from pain. Plantar fasciitis and heel spurs surely affect one's ability to move about freely. This is the best way to support the arch of the foot. Pain then sets in and you may need surgery.

Avoid sharing personal items like towels, footwear and clothes with other people. Podiatry is a branch of medicine that is focused on the study, diagnosis and ultimately, the treatment of disorders that occur on the foot, ankle or lower leg. Podiatrists are able to easily identify, diagnose and treat a foot related problem that a person is suffering from. You can also prevent foot problems by some exercising and stretching.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

November 02 2014

donellamenino

Depth Report

Foot reflexology is a massage technique that is used as a complimentary therapy in some medical conditions to provide added benefits to the patient. Hand, foot and mouth disease is a common viral illness that mainly affects infants and children but can sometimes occur in adults. When seeing a podiatric physician for the first time, they almost always take x-rays. Clubfoot is a congenital deformity in which the foot is severely turned inward and pointed downward.

Hand, foot and mouth disease is usually spread from person- to -person through faecal contamination (which can occur when changing a nappy or using the toilet and not properly washing hands afterwards), or spread through respiratory secretions (saliva, sputum, or nasal mucus) of an infected person. There is no clear evidence of risk to unborn babies from hand, foot and mouth disease. However, infected mothers can pass the infection onto newborn babies who rarely can have severe disease. Avoid sharing cups, eating utensils, items of personal hygiene (for example: towels, washers and toothbrushes), and clothing (especially shoes and socks). Children with hand, foot and mouth disease should be excluded from school or childcare facilities until their blisters have dried. Thus it helps loosen the hard and scaly skin.

When this happens, the big toe will either bend up like a claw or slant severely toward the second toe. When a sesamoid bone is fractured in a sudden injury, surgery may be done to remove the broken pieces To remove the sesamoid on the inside edge of the foot, an incision is made along the side of the big toe. The soft tissue is separated, taking care not to damage the nerve that runs along the inside edge of the big toe. The tissues next to the sesamoid are stitched up. Then the soft tissues are laid back in place, and the skin is sewed together. Surgery is similar for the sesamoid closer to the middle of the foot. The only difference is that the surgeon makes the incision either on the bottom of the big toe or in the web space between the big toe and the second toe. The surgeon makes an incision along the inside edge of the main joint of the big toe. You should also pamper your feet.

Continue to the next page to get tips on treating calluses - a foot condition almost everyone experiences at one time or another. Foot Injuries : Find out how to avoid unpleasant injuries to your feet, or at least reduce pain and prevent infection after they occur, with these simple suggestions. How to Care for Your Feet : Learn how to keep your feet - and yourself - healthy and happy with these tips on caring for your feet, including selecting the right shoes. For ladies that love to wear high heel footwear, the physics are immutable.

A lot of professionals believe that common physical activity may be the answer to gout. You'll want to have an expert to look at the concerns with your feet. The feet might be experiencing pain for a lot of numerous reasons. The deep tissue massage is ideal for people experiencing chronic muscle pain on their upper and lower back, legs, and shoulders. A deep tissue massage frees our muscles of toxin build-up that is usually the main cause of pain and muscle immobility. Some massage therapists call it pressure therapy” since it involves applying pressure to specific points on the foot. A foot massage is a very relaxing way of addressing problems with your body's internal organs. A trained massage therapist can also put pressure on different meridians or energy lines on the sole and side of the feet to determine the cause of illness. A sports massage is ideal of active individuals that are engaged in sports or intensive work-outs. However, they may be contagious for weeks after symptoms go away.

Footwear can be modified with stretching over the protruded area to further reduce pressure and in extreme cases footwear can be modified with a balloon patch. In this case, the Pedorthist would cut a hole in the upper of the shoe at the bunion area and place a patch over the hole to create more space for the bunion. Orthotics in this case can help to bring the foot into a more neutral position therefore reducing pressure on the joint and resulting pain. It should be noted that orthotics should always be put into proper fitting footwear to achieve the best results. Proper footwear is the first step in the treatment of a neuroma.

Wear shoes that fit your feet well and allow your toes to move. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. Cover your feet (except for the skin between the toes) with petroleum jelly, a lotion containing lanolin, or cold cream before putting on shoes and socks. For persons with diabetes, the feet tend to sweat less than normal.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

October 26 2014

donellamenino

Cracked Heels Diagnosis And Treatment

Corns and calluses are common conditions of the feet that can be found in people of all ages, health, and activity levels. Calluses remover is our latest creation. Aside form loss of vision and problems with kidney, another important thing that diabetics should be very careful with is foot neuropathy. Corns and calluses are the terms given to patches of hard, thickened skin. Many people get affected by calluses on 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

Being the son of parents counted among the throng of Americans displaced by the Great Depression has given Devin a deep rooted passion for causes dealing with the poor and the working class. Just click here: and then select the orange Connect” button on the left-hand side of the page. Personally, I've had the pain of experiencing a miscarriage and I know how devastating it is. Our very first pregnancy, one that we planned for and wanted so badly, ended in a miscarriage shortly after our very first ultrasound in 2004. We talked to our doctors before trying to get pregnant. Some people don't understand that you can't just get over the death of your child. That pain never goes away, never gets easier to bear, and never subsides. We were fortunate enough to conceive our 2nd child (my 3 1/2 yr old son) just 8 weeks after our miscarriage, but having our son didn't change the fact that our first child wasn't with us anymore. Claw differs are occasionally designated.

Sometimes, the pressure of the corn or callus may cause inflammation, which can result in pain, swelling and redness. The body protects skin tissues from pressure or friction damage by producing an area of hard skin. So unless the cause of the pressure or friction is found and removed, calluses and corns will continue to form. Over-the-counter treatments, such as corn plasters, can damage the healthy surrounding skin if you use them incorrectly. Look at and feel each foot for signs of injury including bruises, blisters, broken or cracked skin, hot or cold areas, corns and calluses, and discolouration. If your eyesight is poor, get someone else to check your feet for you. Tinea is a contagious fungal infection of the skin. It usually develops between the toes and along the arch of the foot.

The author of the article recommends the patients suffering from any foot disorder to take services of Nagler Foot Center for satisfying results and reasonable charges. A plantar callus is a thickened amount of skin that can develop on the bottom of the foot where your heel bone connects to your toes. The skin forming the callus can be gray or yellowish in appearance, dry, hard, painful and flaky. To treat a plantar callus, a doctor can trim away the thick skin with a scalpel.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

Patients with poor vision cutting nails too deep beneath crease line can lead to skin breakage and in patients with poor blood flow to foot can lead to major amputation.Proper nail cutting techniques should be learnt,toe nails should be cut straight,not beneath creaseline. At the center of a corn is often a very dense knot of skin called a core, which is located over the area of greatest friction or pressure. Firm, dry corns that form on the upper surfaces of the toes are called hard corns. Pliable, moist corns that form between the toes are called soft corns.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
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