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July 05 2017

fortunateinform68

How You Can Diagnose Fallen Arches

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Flat Feet

The appearance of flat feet is normal and common in infants, partly due to "baby fat" which masks the developing arch and partly because the arch has not yet fully developed. The human arch develops in infancy and early childhood as part of normal muscle, tendon, ligament and bone growth. Training of the feet, especially by foot gymnastics and going barefoot on varying terrain, can facilitate the formation of arches during childhood, with a developed arch occurring for most by the age of four to six years. Flat arches in children usually become proper arches and high arches while the child progresses through adolescence and into adulthood.

Causes

Fallen arches in adults are caused by several things. Below are some of the most common causes. Abnormalities present from birth. Torn or stretched tendons (resulting from foot injuries or foot strains). Inflammation or damage of the PTT (posterior tibial tendon). The PTT is responsible for connecting the middle of the arch to the ankle and lower leg. Dislocated or broken bones (also as a result of injury). Health problems like rheumatoid arthritis. Nerve problems. Other factors like diabetes, obesity, aging and pregnancy (these factors are known to increase the risk of fallen arches).

Symptoms

Fallen arches may induce pain in the heel, the inside of the arch, the ankle, and may even extend up the body into the leg (shin splints), knee, lower back and hip. You may also experience inflammation (swelling, redness, heat and pain) along the inside of the ankle (along the posterior tibial tendon). Additionally, you may notice some changes in the way your foot looks. Your ankle may begin to turn inward (pronate), causing the bottom of your heel to tilt outward. Other secondary symptoms may also show up as the condition progresses, such as hammertoes or bunions. You may also want to check your footprint after you step out of the shower. (It helps if you pretend you?re in a mystery novel, and you?re leaving wet, footprinty clues that will help crack the case.) Normally, you can see a clear imprint of the front of your foot (the ball and the toes) the heel, and the outside edge of your foot. There should be a gap (i.e. no footprinting) along the inside where your arches are. If your foot is flat, it?ll probably leave an imprint of the full bottom of your foot-no gap to be had. Your shoes may also be affected: because the ankle tilts somewhat with this condition, the heel of your shoes may become more worn on one side than another.

Diagnosis

Diagnosis of flat feet or fallen arches can be made by your health practitioner and is based on the following. Clinical assessment involving visual gait assessment, as well as biomechanical assessment. A detailed family and medical history. A pain history assessment determining the location of painful symptoms. Physical palpation of the feet and painful areas. Imaging such as MRI or x-ray can be used by your practitioner to assist in the diagnosis.

best arch support insoles for plantar fasciitis

Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Common indications for surgery are cerebral palsy with an equinovalgus foot, to prevent progression and breakdown of the midfoot. Rigid and painful Pes Planus. To prevent progression, eg with a Charcot joint. Tibialis posterior dysfunction, where non-surgical treatment is unsuccessful. Possible surgical procedures include Achilles tendon lengthening. Calcaneal osteotomy, to re-align the hindfoot. Reconstruction of the tibialis posterior tendon. For severe midfoot collapse of the arch, triple arthrodesis may be indicated.

Prevention

Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.

After Care

Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.

June 30 2017

fortunateinform68

Leg Length Discrepancy Hip Pain Therapy

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Leg length discrepancies are differences between the lengths of your legs. Not only can the actual difference vary from person to person but also how much it affects daily life. Small discrepancies often go unnoticed and do not need to be treated. Larger differences may affect posture or cause a limp during walking. The discrepancy may be from the upper leg bone (femur) or the lower leg bone (tibia).Leg Length Discrepancy

Causes

LLDs are very common. Sometimes the cause isn?t known. But the known causes of LLD in children include, injury or infection that slows growth of one leg bone. Injury to the growth plate (a soft part of a long bone that allows the bone to grow). Growth plate injury can slow bone growth in that leg. Fracture to a leg bone that causes overgrowth of the bone as it heals. A congenital (present at birth) problem (one whole side of the child?s body may be larger than the other side). Conditions that affect muscles and nerves, such as polio.

Symptoms

The symptoms of limb deformity can range from a mild difference in the appearance of a leg or arm to major loss of function of the use of an extremity. For instance, you may notice that your child has a significant limp. If there is deformity in the extremity, the patient may develop arthritis as he or she gets older, especially if the lower extremities are involved. Patients often present due to the appearance of the extremity (it looks different from the other side).

Diagnosis

A qualified musculoskeletal expert will first take a medical history and conduct a physical exam. Other tests may include X-rays, MRI, or CT scan to diagnose the root cause.

Non Surgical Treatment

To begin a path torwards a balanced foundation and reduce pain from leg length discrepancy, ask your doctor about these Functional Orthotics and procedures. Functional Orthotics have been shown to specifically reduce pain from leg length inequality, support all three arches of the foot to create a balanced foundation, maximize shock absorption, add extra propulsion, and supply more stability, enable posture correction and long-term preventive protection. Will improve prolonged effectiveness of chiropractic adjustments. Shoe or heel Lifts, Correct the deficiencies that causes imbalances in the body.

Leg Length Discrepancy

shoe lifts for height

Surgical Treatment

Lengthening is usually done by corticotomy and gradual distraction. This technique can result in lengthenings of 25% or more, but typically lengthening of 15%, or about 6 cm, is recommended. The limits of lengthening depend on patient tolerance, bony consolidation, maintenance of range of motion, and stability of the joints above and below the lengthened limb. Numerous fixation devices are available, such as the ring fixator with fine wires, monolateral fixator with half pins, or a hybrid frame. The choice of fixation device depends on the desired goal. A monolateral device is easier to apply and better tolerated by the patient. The disadvantages of monolateral fixation devices include the limitation of the degree of angular correction that can concurrently be obtained; the cantilever effect on the pins, which may result in angular deformity, especially when lengthening the femur in large patients; and the difficulty in making adjustments without placing new pins. Monolateral fixators appear to have a similar success rate as circular fixators, especially with more modest lengthenings (20%).
fortunateinform68

What Are The Causes Of Heel Serious Pain

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Pain At The Heel

The heel is the first bone to contact the ground when walking and takes the full force of impact and the resulting shock of bearing weight during motion. The primary symptom is pain in the heel area that varies in severity and location. The pain is commonly intense when getting out of bed or a chair. The pain often lessens when walking. The most common cause of heel pain is plantar fasciitis. Plantar fasciitis is a stretching of the plantar fascia, a ligament that runs from the ball of foot through the arch and is attached to the heel. It is that attachment which becomes aggravated and typically causes pain after being on your feet for lengths of time. Abnormal motion of the foot (pronation) is one cause of plantar fasciitis. Heel spurs, which are abnormal bone growths coming off the heel, can also cause heel pain. Other causes include repetitive stress or shock to the heel, standing for prolonged periods or osteoarthritis. To prevent heel pain, always wear properly fitting shoes, place insoles or inserts in your shoes to help control abnormal foot motion, maintain a healthy weight, exercise and do foot stretches as they have been shown to decrease the incidence of heel pain.

Causes

One of the most common heel pain causes is a condition called plantar fasciitis. The tendons, ligaments, muscles, and joints in the feet all work together to allow you to move your feet to walk or run. When the plantar fascia, or the arch of the foot, is overused or injured, pain is felt in the heel. The most common heel pain causes include plantar fasciitis, Achilles tendonitis, Bursitis, Fibromyalgia, Bone fracture, Heel spurs, Arthritis, Tarsal tunnel syndrome, Sever?s Disease.

Symptoms

The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Diagnosis

A podiatrist (doctor who specializes in the evaluation and treatment of foot diseases) will carry out a physical examination, and ask pertinent questions about the pain. The doctor will also ask the patient how much walking and standing the patient does, what type of footwear is worn, and details of the his/her medical history. Often this is enough to make a diagnosis. Sometimes further diagnostic tests are needed, such as blood tests and imaging scans.

Non Surgical Treatment

Heel pain often goes away on its own with home care. For heel pain that isn't severe, try the following. Rest. If possible, avoid activities that put stress on your heels, such as running, standing for long periods or walking on hard surfaces. Ice. Place an ice pack or bag of frozen peas on your heel for 15 to 20 minutes three times a day. New shoes. Be sure your shoes fit properly and provide plenty of support. If you're an athlete, choose shoes appropriate for your sport and replace them regularly. Foot supports. Heel cups or wedges that you buy in the drugstore often provide relief. Custom-made orthotics usually aren't needed for heel problems. Over-the-counter pain medications. Aspirin or ibuprofen (Advil, Motrin IB, others) can reduce inflammation and pain.

Surgical Treatment

Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on several areas, remove the bone spur (if one is present), release the plantar fascia (plantar fasciotomy), release pressure on the small nerves in the area. Usually the procedure is done through a small incision on the inside edge of the foot, although some surgeons now perform this type of surgery using an endoscope. An endoscope is a tiny TV camera that can be inserted into a joint or under the skin to allow the surgeon to see the structures involved in the surgery. By using the endoscope, a surgeon can complete the surgery with a smaller incision and presumably less damage to normal tissues. It is unclear whether an endoscopic procedure for this condition is better than the traditional small incision. Surgery usually involves identifying the area where the plantar fascia attaches to the heel and releasing the fascia partially from the bone. If a small spur is present this is removed. The small nerves that travel under the plantar fascia are identified and released from anything that seems to be causing pressure on the nerves. This surgery can usually be done on an outpatient basis. This means you can leave the hospital the same day.

deelsonheels

Prevention

Painful Heel

Wear shoes that fit well, front, back and sides and have shock-absorbent soles, rigid uppers and supportive heel counters. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm-up before running or walking, and do some stretching exercises afterward. Pace yourself when you participate in athletic activities. If overweight, try non weight-bearing activities such as swimming or cycling. Your podiatrist may also use taping or strapping to provide extra support for your foot. Orthoses (shoe inserts) specifically made to suit your needs may be also be prescribed.

June 01 2017

fortunateinform68

What Is Mortons Neuroma

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interdigital neuromaAlso known as Morton's Interdigital Neuroma, Morton's Metatarsalgia, Morton's Neuralgia, Plantar Neuroma, Intermetatarsal Neuroma) What is a Morton's neuroma? Morton's neuroma is a condition characterized by localized swelling of the nerve and soft tissue located between two of the long bones of the foot (metatarsals - figure 1), which can result in pain, pins and needles, or numbness in the forefoot or toes.

Causes

There are orthoses and corrective shoes that can effectively alleviate disturbances to foot mechanics. A podiatric physician can prescribe the best corrective footwear and shoe inserts for all activities, work, exercise, play, walking, shopping and more, based on an analysis of the patient?s foot and his or her lifestyle. Improper footwear. Podiatric physicians have long believed that constricting, narrow, poor-fitting shoes with a tight or pointed toe box tend to compress the end of the foot, leading to abnormal motion of the foot and to excessive pressure in the area of the nerve. High-heeled shoes are a particular culprit here, since they put pressure on the area around wearer?s toes and the ball of the foot.

Symptoms

Episodes of pain are intermittent. Patients may experience 2 attacks in a week and then none for a year. Recurrences are variable and tend to become more frequent. Between attacks, no symptoms or physical signs occur. Two neuromas coexist on the same foot about 2-3% of the time. Other diagnoses should be considered when 2 or more areas of tenderness are present.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis of Morton's neuroma is based on your description of the type and location of pain and discomfort in the foot. The diagnosis will be confirmed by a physical exam of the foot, including checking for mechanical abnormalities in the foot, squeezing the side of the foot, which will usually cause pain when Morton's neuroma is present. Examination of your shoes to check for excess wear in parts of the shoe, check to see whether the shoes are too tight. Imaging tests evaluate the foot and surrounding structures. This may be done with X-ray, MRI scan, Ultrasound. Injections of local anesthetic can also be used for diagnosis.

Non Surgical Treatment

Treatment for Morton?s Neuroma usually begins conservatively, with a change in lifestyle choices. People suffering from the condition may find pain relief by reducing activity levels, changing footwear, using orthopedic supports, reducing weight. Medications are also available to help relieve the pain of Morton?s Neuroma. Over-the-counter medications are sometimes very helpful in reducing pain and inflammation. Your health care provider can also provide you with anesthetic or corticosteroid injections. These help to numb the area affected by the neuroma, and reduce inflammation.Morton

Surgical Treatment

For those who are suffering severely with Morton?s Neuroma, surgery is a possibility. An orthopedic surgeon can remove the growth and repair your foot relatively easily. However, Morton?s Neuroma surgery is associated with a lengthy recovery time and there is a possibility that the neuroma may return.

July 01 2015

fortunateinform68

Hammer Toe Pain Running

HammertoeOverview

Hammer toes are classified based on the mobility of the toe joints. There are two types. Flexible and rigid. In a flexible Hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

Causes

Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. A mallet toe occurs when the joint at the end of the toe cannot straighten. Excessive rubbing of the mallet toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort. Arthritis can also lead to many forefoot deformities including mallet toes. Mallet toes can cause extreme discomfort, and can be aggravated if restrictive or improperly fitting footwear is worn for a prolonged period of time.

Hammer ToeSymptoms

A toe stuck in an upside-down "V" is probably a hammertoe. Some symptoms are, pain at the top of the bent toe when putting on a shoe. Corns forming on the top of the toe joint. The toe joint swelling and taking on an angry red colour. Difficulty in moving the toe joint and pain when you try to so. Pain on the ball of the foot under the bent toe. Seek medical advice if your feet regularly hurt, you should see a doctor or podiatrist. If you have a hammertoe, you probably need medical attention. Ask your doctor for a referral to a podiatrist or foot surgeon. Act now, before the problem gets worse.

Diagnosis

Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.

Non Surgical Treatment

You should seek medical advice if you have a hammer toe. Here are some things you can do in the meantime. None of these things will cure the hammer toe, but they may relieve the pain and discomfort. Only wear shoes that are high and broad across the toes. There should be at least 1.5 cm of space between your longest toe and the tip of the shoe. Keep in mind that this could be either your big toe or your second Hammer toes toe. Don't wear heels higher than 5 cm. Wear the appropriate shoe for the activity you are doing. You can buy non-medicated hammer toe pads. They fit around the pointy top of the toe joint and help relieve painful pressure. Gently massaging the toe may help relieve pain. Put ice packs wrapped in cloth on the hammer toe to reduce painful swelling.

Surgical Treatment

Surgery to correct for a hammertoe may be performed as a day procedure. There are several different types of procedures that can be used depending on the foot structure and if the deformity is flexible or rigid.
Tags: Hammertoe

June 27 2015

fortunateinform68

Hammer Toes Cause And Treatment Method

HammertoeOverview

A hammertoe is a deformity of the second, third or fourth toe in which the toe becomes bent at the middle joint; hence, it resembles a hammer. Claw toe and mallet toe are related conditions. While a hammer toe is contracted at the first toe joint, a mallet toe is contracted at the second toe joint, and a claw toe is contracted at both joints. According to the 2012 National Foot Health Assessment conducted by the NPD Group for the Institute for Preventive Foot Health, 3 percent of U.S. adults age 21 and older (about 7 million people) have experienced hammer toe or claw toe. The condition is significantly more prevalent in females than in males.

Causes

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

Hammer ToeSymptoms

Hammer, claw, and mallet toes can cause discomfort and pain and may make it hard to walk. Shoes may rub on your toes, causing pain, blisters, calluses or corns, or sores. Sores can become infected and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease. If you have one of these health problems and sores develop, contact your doctor.

Diagnosis

First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

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

Surgical correction is needed to bring the toe into a corrected position and increase its function. Correction of the hammer toes is a simple outpatient surgery, with limited downtime. The best option is to fuse the deformed and contracted toe into a hammertoes straight position. This limits the need for future surgery and deformity return. A new pin that absorbs in the bone or small screw is used by the Foot and Ankle Institute to avoid the need for a metal pin protruding from the toe during recovery. Although the absorbable pin is not for everyone, it is much more comfortable than the pin protruding from the end of the toe. In certain cases, a removal of a small area of bone in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an arthroplasty is the best option.
Tags: Hammer Toe

June 02 2015

fortunateinform68

Will Over-Pronation Need To Have Surgery

Overview

During a normal gait cycle, the forward movement is a result of the body's mass being displaced, putting the body in a forward-falling position. At this time, the lead foot hits the ground preventing the fall, followed by the rear leg as it swings forward, and the cycle repeats with each step.Over Pronation

Causes

There may be several possible causes of over pronation. The condition may begin as early as birth. However, there are several more common explanations for the condition. First, wear and tear on the muscles throughout the foot, either from aging or repetitive strain, causes the muscles to weaken, thereby causing the foot to turn excessively inward. Also, standing or walking on high heels for an extended period of time also places strain and pressure on the foot which can weaken the tissue. Lastly, shoes play a very common factor in the development of over pronation. Shoes that fail to provide adequate support through the arch commonly lead to over pronation.

Symptoms

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

Diagnosis

At some point you may find the pain to much or become frustrated. So what are you options? Chances are your overpronation has led to some type of injury if there's pain. Your best bet is to consult with someone who knows feet. Start with your pediatrist, chiropodist or chiropractor. They'll be able to diagnose and treat the injury and give you more specific direction to better support your feet. One common intervention is a custom foot orthotic. Giving greater structural support than a typical shoe these shoe inserts can dramatically reduce overpronation.Over Pronation

Non Surgical Treatment

Overpronation of the feet can be corrected in some cases and in others it can be effectively managed. Overpronators can train themselves to change their running gait, wear arch supports, orthotic insoles or specialist shoes for overpronators. In order to determine exactly what is happening during the stride, it is necessary to have a gait analysis conducted by a professional. The extent of overpronation can then be determined, and the causes can be identified and corrected directly. The main corrective methods used for excessive pronation are orthotics. Orthotics are the most straightforward and simplest solution to overpronation. Orthotics are devices which can be slipped into shoes which will offer varying degrees of correction to the motion of the foot. Orthotics help to support the arches and distribute the body weight effectively, and are usually the best treatment choice for moderate to severe overpronation. Orthotics may require existing insoles to be removed from your shoes to accommodate them; although most running shoes will have a removable insole to accommodate an orthotic insole.

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.

May 14 2015

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Rehab And Severs Disease

Overview

Sever?s disease is particularly prevalent among active children between ages 8 and 15. Young boys and girls who play soccer and other sports in which footwear is inappropriate-i.e. too narrow in the toe box, too rigid, etc. are most commonly affected. Sever?s disease usually appears during the adolescent growth spurt-the 2-year period in early puberty where children grow the quickest. The adolescent growth spurt occurs between the ages of 8 and 13 in girls and 10 and 15 in boys. Teenagers over 15 years old rarely experience this heel problem, as heel bone growth is usually complete by this age. Sever?s disease usually self-resolves within 6 months of onset, though it can last longer.

Causes

The spontaneous development of pain in children generally indicates some form of injury to the growth plate of a growing bone. This can occur without a specific memorable event. When pain occurs in the heel of a child the most likely cause is due to injury of the growth plate in the heel bone. This is called Sever's disease. A condition that may mimic Seiver's disease is Achilles tendonitis. Achilles tendonitis is inflammation of the tendon attached to the back of the heel. A tight Achilles tendon may contribute to Sever's disease by pulling excessively on the growth plate of the heel bone. It is frequently seen in the active soccer, football or baseball player. Sport shoes with cleats seem to aggravate the condition. It is believed that the condition is due to an underlying mechanical problem with the way the foot functions.

Symptoms

Pain is usually felt at the back of the heel and around the sides of the heel. If you squeeze the back of the heel from both sides simultaneously and pain is experienced Sever?s disease is more than likely present.

Diagnosis

A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot. The doctor may order an x-ray because x-rays can confirm how mature the growth center is and if there are other sources of heel pain, such as a stress fracture or bone cyst. However, x-rays are not necessary to diagnose Sever?s disease, and it is not possible to make the diagnosis based on the x-ray alone.

Non Surgical Treatment

Orthotics or special shoe inserts can also be used to cushion the heel and reduce pain. Physical Therapy. If avoiding physical activities fails to clear up Sever?s disease Genesis Orthopedics & Sports Medicine may proceed with physical therapy. Physical therapy strengthens the muscles and tendons in the heel, releasing pressure and eventually reducing pain.

Prevention

The best way to prevent Sever's disease is to make sure that your child wears shoes that fit properly. The heel portion of the shoe should not be too tight, and there should be good padding in the heel. It may help to put extra heel pads in your child's shoes. Some children simply get too much physical activity. For example, they may play on too many teams or practice for too long. Their heel pain is a message to slow down.

April 29 2015

fortunateinform68

Achilles Tendon Rupture Symptoms Treatment

Overview
Achilles tendon The Achilles tendon is found in the back of the leg above the heel, and is the largest tendon in the body. It connects the calf muscles to the heel bone and is used when walking, running and jumping. A rupture of the tendon is a tearing and separation of the tendon fibers. When a rupture of the tendon occurs, the tendon can no longer perform its normal function. A common issue related to a tear is the inability to point your toe.

Causes
The Achilles tendon is a strong bands of fibrous connective tissue that attaches the calf muscle to the heel bone. When the muscle contracts, the tendon transmits the power of this contraction to the heel bone, producing movement. The Achilles tendon ruptures because the load applied to it is greater than the tendon's ability to withstand that load. This usually occurs as a result of a sudden, quick movement where there is a forceful stretch of the tendon or a contraction of the muscles eg: jumping, sprinting, or pushing off to serve in tennis. This occurs most often in sports that require a lot of stopping and starting (acceleration-deceleration sports) such as tennis, basketball, netball and squash. The Achilles tendon is on average 15cm in length. Most ruptures occur 2-6cm above where the tendon inserts into the heel bone. This is the narrowest portion of the Achilles tendon and is also the area with the poorest blood supply. achilles tendon rupture is most common when the muscles and tendon have not been adequately stretched and warmed up prior to exercise, or when the muscles are fatigued. the Achilles tendon has a poor blood supply, which makes it susceptible to injury and slow to heal after injury. During exercise the amount of blood able to travel to the tendon is decreased, further increasing the risk of rupture. Most experts agree that there are no warning signs of an impending rupture. However, frequent episodes of Achilles tendonitis (tendon inflammation) can weaken the tendon and make it more susceptible to rupture.

Symptoms
Patients who suffer an acute rupture of the Achilles tendon often report hearing a "pop" or "snap." Patients usually have severe pain the back of the lower leg near the heel. This may or may not be accompanied by swelling. Additionally, because the function of the Achilles tendon is to enable plantarflexion (bending the foot downward), patients often have difficulty walking or standing up on their toes.

Diagnosis
If an Achilles tendon rupture is suspected, it is important to consult a doctor straight away so that an accurate diagnosis can be made and appropriate treatment recommended. Until a doctor can be consulted it is important to let the foot hang down with the toes pointed to the ground. This prevents the ends of the ruptured tendon pulling any farther apart. The doctor will take a full medical history, including any previous Achilles tendon injuries and what activity was being undertaken at the time the present injury occurred. The doctor will also conduct a physical examination and will check for swelling, tenderness and range of movement in the lower leg and foot. A noticeable gap may be able to be felt in the tendon at the site of the rupture. This is most obvious just after the rupture has occurred and swelling will eventually make this gap difficult to feel. One test commonly used to confirm an Achilles tendon rupture is the Thomson test. For this test the patient lies face down on an examination table. The doctor then squeezes the calf muscles; an action that would normally cause the foot to point like a ballerina (plantar flexion). When a partial rupture has occurred the foot's ability to point may be decreased. When a complete rupture has occurred, the foot may not point at all. Ultrasound scanning of the Achilles tendon may also be recommended in order to assist with the diagnosis.

Non Surgical Treatment
Your doctor will advise you exactly when to start your home physical therapy program, what exercises to do, how much, and for how long to continue them. Alphabet Range of Motion exercises. Typically, the first exercise to be started (once out of a non-removable cast). While holding your knee and leg still (or cross your leg), you simply write the letters of the alphabet in an imaginary fashion while moving your foot and ankle (pretend that the tip of your toe is the tip of a pencil). Motion the capital letter A, then B, then C, all the way through Z. Do this exercise three times per day (or as your doctor advises). Freeze a paper cup with water, and then use the ice to massage the tendon area as deeply as tolerated. The massage helps to reduce the residual inflammation and helps to reduce the scarring and bulkiness of the tendon at the injury site. Do the ice massage for 15-20 minutes, three times per day (or as your doctor advises). Calf Strength exercises. This exercise is typically delayed and not used in the initial stages of rehabilitation, begin only when your doctor advises. This exercise is typically done while standing on just the foot of the injured side. Sometimes, the doctor will advise you to start with standing on both feet. Stand on a step with your forefoot on the step and your heel off the step. The heel and forefoot should be level (neither on your tip toes nor with your heel down). Lower your heel very slowly as low as it will go, then rise back up to the level starting position, again very slowly. This is not a fast exercise. Repeat the exercise as tolerated. The number of repetitions may be very limited at first. Progress the number of repetitions as tolerated. Do this exercise one to two times per day (or as your doctor advises). Achilles tendinitis

Surgical Treatment
Surgery could allow for a quicker healing time. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the tissue, the repair may be reinforced with other tendons. As with any surgery, the main complication is the risk for infection, however, this risk is reduced by using smaller incisions.

April 26 2015

fortunateinform68

Posterior Tibial Tendon Dysfunction Surgery Recovery

Overview
Adult flatfoot may be due to multiple problems including a dysfunctional posterior tibial tendon (PTT), hypermobility and ligamentous laxity, or possibly a coalition that becomes symptomatic. For a vast majority of patients, posterior tibial tendon dysfunction (PTTD) is the cause of symptomatic flatfoot and is the main trigger of surgical reconstruction in flatfoot. The common presenting scenario for adult flatfoot is a case of unilateral flatfoot with pain. Patients will often confirm they ?always had flat feet? but have noticed increased pain and additional collapse in the past few months to years. They may also note increased swelling and a possible concern over one foot increasing in shoe size. After a comprehensive dermatologic, neurologic and vascular assessment, one should direct his or her attention to the musculoskeletal portion of the exam. It is key to examine the foot and leg as a whole in order to determine the proper procedure and consider each phase of the corrective surgery. Acquired flat foot

Causes
The cause of posterior tibial tendon insufficiency is not completely understood. The condition commonly does not start from one acute trauma but is a process of gradual degeneration of the soft tissues supporting the medial (inner) side of the foot. It is most often associated with a foot that started out somewhat flat or pronated (rolled inward). This type of foot places more stress on the medial soft tissue structures, which include the posterior tibial tendon and ligaments on the inner side of the foot. Children nearly fully grown can end up with flat feet, the majority of which are no problem. However, if the deformity is severe enough it can cause significant functional limitations at that age and later on if soft tissue failure occurs. Also, young adults with normally aligned feet can acutely injure their posterior tibial tendon from a trauma and not develop deformity. The degenerative condition in patients beyond their twenties is different from the acute injuries in young patients or adolescent deformities, where progression of deformity is likely to occur.

Symptoms
Symptoms of pain may have developed gradually as result of overuse or they may be traced to one minor injury. Typically, the pain localizes to the inside (medial) aspect of the ankle, under the medial malleolus. However, some patients will also experience pain over the outside (lateral) aspect of the hindfoot because of the displacement of the calcaneus impinging with the lateral malleolus. This usually occurs later in the course of the condition. Patients may walk with a limp or in advanced cases be disabled due to pain. They may also have noticed worsening of their flatfoot deformity.

Diagnosis
Your podiatrist is very familiar with tendons that have just about had enough, and will likely be able to diagnose this condition by performing a physical exam of your foot. He or she will probably examine the area visually and by feel, will inquire about your medical history (including past pain or injuries), and may also observe your feet as you walk. You may also be asked to attempt standing on your toes. This may be done by having you lift your ?good? foot (the one without the complaining tendon) off the ground, standing only on your problem foot. (You may be instructed to place your hands against the wall to help with balance.) Then, your podiatrist will ask you to try to go up on your toes on the bad foot. If you have difficulty doing so, it may indicate a problem with your posterior tibial tendon. Some imaging technology may be used to diagnose this condition, although it?s more likely the doctor will rely primarily on a physical exam. However, he or she may order scans such as an MRI or CT scan to look at your foot?s interior, and X-rays might also be helpful in a diagnosis.

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

Surgical Treatment
Surgery is usually performed when non-surgical measures have failed. The goal of surgery is to eliminate pain, stop progression of the deformity and improve a patient?s mobility. More than one technique may be used, and surgery tends to include one or more of the following. The tendon is reconstructed or replaced using another tendon in the foot or ankle The name of the technique depends on the tendon used. Flexor digitorum longus (FDL) transfer. Flexor hallucis longus (FHL) transfer. Tibialis anterior transfer (Cobb procedure). Calcaneal osteotomy - the heel bone may be shifted to bring your heel back under your leg and the position fixed with a screw. Lengthening of the Achilles tendon if it is particularly tight. Repair one of the ligaments under your foot. If you smoke, your surgeon may refuse to operate unless you can refrain from smoking before and during the healing phase of your procedure. Research has proven that smoking delays bone healing significantly.
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