Wed

23

Sep

2015

The Best Ways To Protect Against Inferior Calcaneal Spur

Posterior Calcaneal Spur

Overview

If you suffer from heel pain, you know that it affects every step you take. And by the time you take off your shoes in the evening, your feet are really suffering. The pain you?re feeling could be caused by heel bone spurs. Heel bone spurs are common in people who walk, stand or run on hard surfaces such as concrete or tile floors-and that?s most of us! This kind of frequent, intense impact on hard surfaces overstretches and can even tear the ligaments on the bottom of the foot, a condition known as plantar fasciitis. In extreme cases, these ligaments begin to pull away from the bone. Heel bone spurs are created because of this injury to the foot. They are not painful by themselves, but they do irritate surrounding tissues, which causes heel pain.

Causes

Causes for heel spurs (and related plantar fasciitis) include increase or change in activity, lack of arch support or poor shoe choice, injury, inflexibility in Achilles tendon and calf muscles, and spending hours daily on the feet. Also, arthritis from aging is often a common cause of bone loss and natural cushioning under the heel. Tarsal tunnel syndrome can also be to blame. Ultimately, in the United States, the most likely cause of this pain is being overweight. With more than 60% of the nation obese or morbidly obese, foot pain related to excessive weight is most likely. Dietary changes are most likely to cause long-term relief for bone spurs and plantar fasciitis.

Calcaneal Spur

Symptoms

Heel spurs may or may not cause symptoms. Symptoms are usually related to the plantar fasciitis. You may experience significant pain. Your heel pain may be worse in the morning when you first wake up or during certain activities.

Diagnosis

Your doctor will review your medical history and examine your foot. X-rays are used to identify the location and size of the heel spur.

Non Surgical Treatment

Only in rare cases do the symptoms of heel spurs fail to be resolved through conservative treatment. Conservative treatment, although not 100% effective, is successful in most cases and should be given ample time to work. In many cases, conservative methods should be utilized as long as a year depending on the rate at which your body responds to the treatment. When treatment is unsuccessful, surgery may be considered. A common surgical procedure for this condition is plantar fascia release surgery. In this procedure, the tension of the plantar fascia ligament is released, lessening tension in the heel and helping to prevent damage.

Surgical Treatment

When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. The procedure may also include removal of heel spurs.
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Mon

24

Aug

2015

Bursitis Of The Foot Bursa Sac

Overview

Whenever tissues rub against one another, a bursa forms to allow for smooth gliding. A bursa is a fluid-filled sac and occurs normally throughout the body. Only a few cell layers thick, a bursa is filled with a lubricating fluid. However, when irritated, a bursa can become markedly thickened and painful. This is often referred to as bursitis. The retrocalcaneal bursa is positioned to allow the Achilles tendon to glide over the back part (posterior aspect) of the heel bone. When this bone becomes enlarged, inflammation of the retrocalcaneal bursa occurs. This inflammation results in exquisite tenderness along the posterior aspect of the heel.

Causes

Overuse of the ankle joint may cause irritation of the bursa such as excessive walking, running or jumping. Poor biomechanics and foot function may ultimately lead to heel bursitis due to pulling on the back of the heel by the Achilles tendon.

A sudden increase in physical activity without adequate rest may result in heel bursitis. Excessive standing and walking bare foot on hard surfaces.

Symptoms

Pain at the back of the heel, especially with jumping, hopping, tip-toeing, walking or running uphill or on soft surfaces. If tendonitis is also present, the pain can radiate away from the bursa. Direct pressure on the bursa will exacerbate the pain and should be avoided if possible. Tenderness and swelling which might make it difficult to wear certain shoes on the feet. As the bursa becomes more inflamed you will experience swelling and warmth. In severe cases, the bursa will appear as a bump, called a "pump bump", and is usually red, and extremely tender. Swelling can cause difficulties moving as the range of motion in the ankle can be affected. Limping due to the pain may occur. If you press on both sides of the inflamed heel, there may be a firm spongy feeling. Weakness in the tendons and muscles surrounding the bursa can develop as the pain worsens and the inflammation in the area spreads. Possibly a fever if you are suffering from septic bursitis (You will need to see a doctor for medication to get rid of the infection). Pain at the back of the heel makes it difficult to continue wearing shoes, especially high heels with straps or shoes that don't fit properly.

Diagnosis

Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.

Non Surgical Treatment

When retrocalcaneal bursitis is associated with tendonitis, it may be necessary to immobilize the ankle for several weeks to allow the Achilles tendon to heal. This can be done by placing a cast on the ankle, which limits movement and allows the tendon to rest. Walking boots may also be used to limit ankle movement and allow people with retrocalcaneal bursitis to avoid putting pressure on the inflamed bursae.

Surgical Treatment

Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).
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Wed

01

Jul

2015

Hammer Toe Symptoms And Treatment

Hammer ToeOverview

Toe problems and toe deformities such as claw toe and hammertoe happen when the tendons (guiders) that move the toes get too tight or out of balance. The affected toe can rub on other toes and on the inside of your shoe, causing pressure and pain. Inflammatory arthritis, (swelling, pain, stiffness in joints), which, such as rheumatoid arthritis can damage the toe joints and this may make them come out of position (dislocate).

Causes

Medical problems, such as stroke or diabetes that affect the nerves, may also lead to hammertoe. For example, diabetes can result in poor circulation, especially in the feet. As a result, the person may not feel that their toes are bent into unnatural positions. The likelihood of developing hammertoe increases with age and may be affected by gender (more common in women) and toe length; for example, when the second toe is longer than the big toe, hammertoe is more likely to occur. Hammertoe may also be present at birth. Genetics may factor in to developing hammertoe, particularly if the foot is flat or has a high arch, resulting in instability.

HammertoeSymptoms

The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward. Thickening of the skin above or below the affected toe with the formation of corns or calluses. Difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment

Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include splinting the toe to keep it straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.

Surgical Treatment

If your hammer, claw, or mallet toe gets worse, or if nonsurgical treatment does not help your pain, you may think about surgery. The type of surgery you choose depends on how severe your condition is and whether the toe joint is fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be straightened without surgery. Surgery choices include Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone. Joint fusion (arthrodesis), in which the surgeon removes part of the joint, letting the toe bones grow together (fuse). Cutting supporting tissue or moving tendons in the toe joint. How well surgery works depends on what type of surgery you have, how experienced your surgeon is, and how badly your toes are affected.

Hammer ToePrevention

Good circulation is essential. When you're sitting down, put your feet up. If you've been sitting for a while, stretch your legs and feet. Give yourself a foot massage or trade foot massages with someone you love. A warm foot bath is also a good idea. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy shoes at the end hammertoe of the day, as feet tend to swell a bit and you will get a better sense of fit. When buying shoes, wear the socks that you will be using when wearing that shoe. For example, wear an athletic sock when buying athletic shoes and a dress sock when purchasing dress shoes. If the shoe does not feel good at the time of purchase, then it will never feel good.
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Sun

28

Jun

2015

Physical Therapy After Hammertoe Surgery

Hammer ToeOverview

Hammertoes are quite common and may range from mild to severe. A hammertoes is a contracture, or bending, of one or more toes, usually due to an imbalance between the muscles or tendons on the top and bottom of the toes. Over time, the affected toes lose flexibility, becoming rigid and fixed in a contracted position. The abnormal bend positions the knuckle of the toe upward, causing it to push against the top of the shoe leading to additional problems. The condition usually becomes progressively worse if not treated.

Causes

Hammertoes are most common in women, and a big part of this is poor shoe choices, which are a big factor in the development of many foot problems. Tight toe boxes and high heels are the biggest culprits. Genetics certainly plays a role in some cases of hammertoes, as does trauma, infection, arthritis, and certain neurological and muscle disorders. But most cases of contracted toes are associated with various biomechanical abnormalities in how a patient walks. This causes the muscles and tendons to be used excessively or improperly, which deforms the toes over time.

Hammer ToeSymptoms

A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your hammertoe foot structure. As this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.

Diagnosis

Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).

Non Surgical Treatment

Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce this swelling. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot, check for fractures and determine the cause. The podiatrist may see you to take care of any corns that develop due to the bone deformities. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure. Padding techniques may be used to straighten the toe if the deformity is flexible, or pads may be used to lessen the pressure on the area of the corn or ulcer. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.

Surgical Treatment

Laser surgery is popular for cosmetic procedures, however, for hammer toe surgery it does not offer any advantage to traditional methods. Laser is useful for soft tissues (not bone), and because hammer toe surgery involves bone procedures, it is not effective. For cosmetic hammer toe surgery, patients should look for surgeons experienced in aesthetic foot surgery.

Hammer ToePrevention

There are several things you can do to help prevent hammer toes from forming or progressing. Wear supportive shoes to help prevent deformities. Hammer toes are often related to faulty foot mechanics, especially foot flattening. Wear custom orthotics prescribed by your podiatrist. Orthotics may slow the progression or prevent the development of hammer toes. Avoid shoes with narrow or pointed toe boxes that can compress the toes.
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Fri

05

Jun

2015

The Facts Related To Overpronation Of The Feet

Overview

Pronation is the way the foot rolls inward when you walk and run. It is part of the natural movement that helps the lower leg deal with shock. Some people pronate more (overpronation) or less (underpronation) than others. Though this is not bad in itself, it does affect the way you run and it may increase the likelihood of injury. This makes your pronation pattern an important factor in choosing the right shoes.Over Pronation

Causes

There are many possible causes for overpronation, but researchers have not yet determined one underlying cause. Hintermann states, Compensatory overpronation may occur for anatomical reasons, such as a tibia vara of 10 degrees or more, forefoot varus, leg length discrepancy, ligamentous laxity, or because of muscular weakness or tightness in the gastrocnemius and soleus muscles. Pronation can be influenced by sources outside of the body as well. Shoes have been shown to significantly influence pronation. Hintermann states that the same person can have different amounts of pronation just by using different running shoes. It is easily possible that the maximal ankle joint eversion movement is 31 degrees for one and 12 degrees for another running shoe.

Symptoms

Common conditions that develop with prolonged overpronation typically include plantar fasciitis, achilles tendonitis, shin splints, posterior tibial stress syndrome and even IT band syndrome. With long term neglect you may see the development of bunyons, foot deformities and early onset of hip and knee arthritis.

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.Foot Pronation

Non Surgical Treatment

An orthotic is a device inserted inside the shoe to assist in prevention and/or rehabilitation of injury. Orthotics support the arch, prevent or correct functional deformities, and improve biomechanics. Prescription foot orthoses are foot orthoses which are fabricated utilizing a three dimensional representation of the plantar foot and are specifically constructed for an individual using both weightbearing and nonweightbearing measurement parameters and using the observation of the foot and lower extremity functioning during weightbearing activities. Non-prescription foot orthoses are foot which are fabricated in average sizes and shapes in an attempt to match the most prevalent sizes and shapes of feet within the population without utilizing a three dimensional representation of the plantar foot of the individual receiving the orthosis.

Prevention

Wearing the proper footwear plays a key role as a natural way to help pronation. Pronated feet need shoes that fit well, provide stability, contain supportive cushioning, are comfortable and allow enough room for your foot to move without causing pain or discomfort. Putting special inner heel wedges, known as orthotics, into your shoes can support a flatfoot while lowering risks of developing tendinitis, according to the American Academy of Orthopaedic Surgeons. More extensive cases may require specially fitted orthopaedic shoes that support the arches.
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