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September 23 2015

myrnasnodderly

What Can Lead To Inferior Calcaneal Spur

Posterior Calcaneal Spur

Overview

Heel spur is a hook of bone that forms on the heel bone. The condition itself is not the most painful; it is the inflammation and irritation that cause the heel pain. Often times, plantar fasciitis is a cause of heel spurs. When the ligaments are pulled away, calcium deposits form on the hooked bone. An orthotic will help relieve the pain associated with heel spurs.

Causes

A bone spur forms as the body tries to repair itself by building extra bone. It generally forms in response to pressure, rubbing, or stress that continues over a long period of time. Some bone spurs form as part of the aging process. As we age, the slippery tissue called cartilage that covers the ends of the bones within joints breaks down and eventually wears away (osteoarthritis). Bone spurs due to aging are especially common in the joints of the spine and feet.

Inferior Calcaneal Spur

Symptoms

The spur itself is not painful, however, if it is sharp and pointed it can poke into soft tissue surrounding the spur itself. As the bone spur irritates the tissue, inflammation and bruising can occur leading to heel pain. Heel spurs can affect your ability to do your usual work and/or activities, and can also trap and irritate the nerves in your heel area. They can change the way you walk, and can lead to knee, hip and low back injuries. If severe, they may require medical intervention.

Diagnosis

Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.

Non Surgical Treatment

If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.

Surgical Treatment

Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the plantar fascia. This surgery is commonly paired with tarsal tunnel release surgery. Surgery is successful for the majority of people.

Prevention

You can help prevent heel spur symptoms from returning by wearing the proper shoes. Customized orthotics and insoles can help relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.

August 26 2015

myrnasnodderly

Bursitis In The Foot And Ankle

Overview

Bursae (two or more bursa) are small, fluid-filled sacs that cushion the bones, tendons and muscles surrounding your joints. They contain a lubricating fluid that reduces friction, allowing tissues in the body to glide past each other smoothly. Imagine the bursa as a protective layer that helps keep a tendon or muscle from fraying or getting aggravated as it eases over a bone or around a corner. Bursitis is a condition that occurs when a bursa becomes inflamed: irritated, red and filled with more fluid than normal.

Causes

A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. Possible causes are too much walking, running, or jumping. This condition is usually linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Risks for this condition include starting an aggressive workout schedule, or suddenly increasing activity level without the right conditioning.

Symptoms

Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).

Diagnosis

After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.

Non Surgical Treatment

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

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.

June 24 2015

myrnasnodderly

Do Hammertoe Straighteners Work

Hammer ToeOverview

A hammertoes is commonly mistaken as any type of toe deformity. The terms claw toe, or mallet toe, although technically different than a hammer toe, are commonly referred as such. The toe may be flexible with movement at the joints, or it may be rigid, especially if it has been present for a long time. With a true hammertoe the deformity exists at the proximal interphalangeal joint only.

Causes

Poorly fitting shoes and muscle imbalances are the most common causes of hammertoe. When shoes are too narrow or do not accommodate the shape and size of your feet, they often contort the position of your toes. Choosing a shoe that fits is very important when it comes to avoiding foot problems like bunions or hammertoe. Having your toes bent for an extended period of time in a shoe that is too narrow or small forces your toes to adapt to the cramped space. With time, the muscles in your feet become accustomed to holding the flexed position of your toes, making it harder, or even impossible to straighten them.

Hammer ToeSymptoms

Common symptoms of hammertoes include pain or irritation of the affected toe when wearing shoes. corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location. Inflammation, redness, or a burning sensation. Contracture of the toe. In more severe cases of hammertoe, open sores may form.

Diagnosis

The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Non Surgical Treatment

If your toe is still flexible, your doctor may recommend that you change to roomier and more comfortable footwear and that you wear shoe inserts (orthotics) or pads. Wearing inserts hammertoe or pads can reposition your toe and relieve pressure and pain. In addition, your doctor may suggest exercises to stretch and strengthen your toe muscles. These may include picking up marbles or a thin towel off the floor with your toes.

Surgical Treatment

Surgery to correct for a hammertoe may be performed as an outpatient procedure at a hospital, surgery center, or in the office of your podiatrist. There are multiple procedures that can be used depending on your individual foot structure and whether the deformity is flexible or rigid. There may be a surgical cut in the bone to get rid of an exostosis, or a joint may be completely removed to allow the toe to lay straight.

HammertoePrevention

As you get older, feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy such that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the sole or twisted side to side is generally too flimsy.
Tags: Hammertoe

June 04 2015

myrnasnodderly

What Actually Causes Feet To Over Pronate

Overview

As with the "normal pronation" sequence, the outside of the heel makes the initial ground contact. However, the foot rolls inward more than the ideal fifteen percent, which is called "overpronation." This means the foot and ankle have problems stabilizing the body, and shock isn't absorbed as efficiently. At the end of the gait cycle, the front of the foot pushes off the ground using mainly the big toe and second toe, which then must do all the work.Foot Pronation

Causes

Excess stress on the inner surface of the foot can cause injury and pain in the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg.

Symptoms

Over-Pronation may cause pain in the heel of the foot, the foot arch, under the ball of the foot, in the ankle, knee, hip or back. The symptoms may be localized to one particular area of the foot or may be experienced in any number of combinations. Standing for long periods of time, walking and running may become difficult due to the additional stress and/or discomfort accompanied with these activities. Upon Visual Inspection, when standing the heels of the foot lean inward and one or both of the knee caps may turn inward.

Diagnosis

A quick way to see if you over-pronate is to look for these signs. While standing straight with bare feet on the floor, look so see if the inside of your arch or sole touches the floor. Take a look at your hiking or running shoes; look for wear on the inside of the sole. Wet your feet and walk on a surface that will show the foot mark. If you have a neutral foot you should see your heel connected to the ball of your foot by a mark roughly half of width of your sole. If you over-pronate you will see greater than half and up to the full width of your sole.Overpronation

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

Duck stance: Stand with your heels together and feet turned out. Tighten the buttock muscles, slightly tilt your pelvis forwards and try to rotate your legs outwards. You should feel your arches rising while you do this exercise.

Calf stretch:Stand facing a wall and place hands on it for support. Lean forwards until stretch is felt in the calves. Hold for 30 seconds. Bend at knees and hold for a further 30 seconds. Repeat 5 times.

Golf ball:While drawing your toes upwards towards your shins, roll a golf ball under the foot between 30 and 60 seconds. If you find a painful point, keep rolling the ball on that spot for 10 seconds.

Big toe push: Stand with your ankles in a neutral position (without rolling the foot inwards). Push down with your big toe but do not let the ankle roll inwards or the arch collapse. Hold for 5 seconds. Repeat 10 times. Build up to longer times and fewer repetitions.

Ankle strengthener: Place a ball between your foot and a wall. Sitting down and keeping your toes pointed upwards, press the outside of the foot against the ball, as though pushing it into the wall. Hold for 5 seconds and repeat 10 times.

Arch strengthener: Stand on one foot on the floor. The movements needed to remain balanced will strengthen the arch. When you are able to balance for 30 seconds, start doing this exercise using a wobble board.

May 22 2015

myrnasnodderly

What Exactly Is Severs Disease?

Overview

One of the more common limitations to children enjoying their youthful energy is Sever?s Disease. Sever?s Disease is a pathology that affects the heels of children in their high growth years (usually around 9-15), and it can be quite painful. It usually occurs due to repetitive trauma or impact at the heel. This means that if your child spends a lot of time running around (in sports, or just with friends) the continuous impact of his or her heel to the ground can cause this! Usually, most children will complain of heel pain specifically when they are active; these are considered milder cases. In more severe cases the pain may never cease, whether the child is active or not.

Causes

Sever's disease can result from standing too long, which puts constant pressure on the heel. Poor-fitting shoes can contribute to the condition by not providing enough support or padding for the feet or by rubbing against the back of the heel. Although Sever's disease can occur in any child, these conditions increase the chances of it happening. Pronated foot (a foot that rolls in at the ankle when walking), which causes tightness and twisting of the Achilles tendon, thus increasing its pull on the heel's growth plate, flat or high arch, which affects the angle of the heel within the foot, causing tightness and shortening of the Achilles tendon, short leg syndrome (one leg is shorter than the other), which causes the foot on the short leg to bend downward to reach the ground, pulling on the Achilles tendon, overweight or obesity, which puts weight-related pressure on the growth plate

Symptoms

As a parent, you may notice your child limping while walking or running awkwardly. If you ask them to rise onto their tip toes, their heel pain usually increases. Heel pain can be felt in one or both heels in Sever's disease.

Diagnosis

Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.

Non Surgical Treatment

The initial treatment is rest, relieve the pain and treat the underlying cause. The foot and ankle should be rested so that the apophysis it is not being continually ?injured?. A small heel (sorbothane heel insert) raise can used to raise the heel and take the stretch off the Achilles tendon. It may be sufficient to stop your child playing sport but some children require a short period of bed or couch rest. Some children find resting very difficult and require the use of braces or plasters or boots to slow them down. Using crutches is advised. Severs is usually caused by tight muscles. A stretching program should be followed usually supervised by a physiotherapist. The stretching program may need to be undertaken up to 5 times a day. If flat feet are a problems orthotics (insoles) should be used. The pain should be controlled by rest (limiting activity) and ice (icing the painful area 3-4 times a day - making sure the skin is not burnt), Simple pain killers can be used such as paracetamol as well as anti-inflammatory tablets and cream. Severs disease usually goes away with time. When your child stops growing, the pain and swelling should go away because the growing (weak) area fuses and becomes solid bone which is very strong.

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

myrnasnodderly

Acquired Flat Foot Tibialis Posterior Muscle

Overview
Adult flatfoot refers to a deformity that develops after skeletal maturity is reached. Adult flatfoot should be differentiated from constitutional flatfoot, which is a common congenital non-pathologic foot morphology. There are numerous causes of acquired adult flatfoot, including fracture or dislocation, tendon laceration, tarsal coalition, arthritis, neuroarthropathy, neurologic weakness, and iatrogenic causes. Flat feet

Causes
There are numerous causes of acquired Adult Flatfoot, including, trauma, fracture, dislocation, tendon rupture/partial rupture or inflammation of the tendons, tarsal coalition, arthritis, neuroarthropathy and neurologic weakness. The most common cause of acquired Adult Flatfoot is due to overuse of a tendon on the inside of the ankle called the posterior tibial tendon. This is classed as - posterior tibial tendon dysfunction. What are the causes of Adult Acquired flat foot? Trauma, Fracture or dislocation. Tendon rupture, partial tear or inflammation. Tarsal Coalition. Arthritis. Neuroarthropathy. Neurological weakness.

Symptoms
In many cases, adult flatfoot causes no pain or problems. In others, pain may be severe. Many people experience aching pain in the heel and arch and swelling along the inner side of the foot.

Diagnosis
Examination by your foot and ankle specialist can confirm the diagnosis for most patients. An ultrasound exam performed in the office setting can evaluate the status of the posterior tibial tendon, the tendon which is primarily responsible for supporting the arch structure of the foot.

Non surgical Treatment
This condition may be treated with conservative methods. These can include orthotic devices, special shoes, and bracing. Physical therapy, rest, ice, and anti-inflammatory medication may be prescribed to help relieve symptoms. If the condition is very severe, surgical treatment may be needed. Flat feet

Surgical Treatment
The indications for surgery are persistent pain and/or significant deformity. Sometimes the foot just feels weak and the assessment of deformity is best done by a foot and ankle specialist. If surgery is appropriate, a combination of soft tissue and bony procedures may be considered to correct alignment and support the medial arch, taking strain off failing ligaments. Depending upon the tissues involved and extent of deformity, the foot and ankle specialist will determine the necessary combination of procedures. Surgical procedures may include a medial slide calcaneal osteotomy to correct position of the heel, a lateral column lengthening to correct position in the midfoot and a medial cuneiform osteotomy or first metatarsal-tarsal fusion to correct elevation of the medial forefoot. The posterior tibial tendon may be reconstructed with a tendon transfer. In severe cases (stage III), the reconstruction may include fusion of the hind foot,, resulting in stiffness of the hind foot but the desired pain relief. In the most severe stage (stage IV), the deltoid ligament on the inside of the ankle fails, resulting in the deformity in the ankle. This deformity over time can result in arthritis in the ankle.

March 25 2015

myrnasnodderly

Adult Aquired FlatFoot

Overview

A variety of foot problems can lead to adult acquired flatfoot deformity (AAFD), a condition that results in a fallen arch with the foot pointed outward. Most people - no matter what the cause of their flatfoot - can be helped with orthotics and braces. In patients who have tried orthotics and braces without any relief, surgery can be a very effective way to help with the pain and deformity. This article provides a brief overview of the problems that can result in AAFD. Further details regarding the most common conditions that cause an acquired flatfoot and their treatment options are provided in separate articles. Links to those articles are provided.Flat Foot



Causes

Obesity - Overtime if your body is carrying those extra pounds, you can potentially injure your feet. The extra weight puts pressure on the ligaments that support your feet. Also being over weight can lead to type two diabetes which also can attribute to AAFD. Diabetes - Diabetes can also play a role in Adult Acquired Flatfoot Deformity. Diabetes can cause damage to ligaments, which support your feet and other bones in your body. In addition to damaged ligaments, uncontrolled diabetes can lead to ulcers on your feet. When the arches fall in the feet, the front of the foot is wider, and outer aspects of the foot can start to rub in your shoe wear. Patients with uncontrolled diabetes may not notice or have symptoms of pain due to nerve damage. Diabetic patient don?t see they have a problem, and other complications occur in the feet such as ulcers and wounds. Hypertension - High blood pressure cause arteries narrow overtime, which could decrease blood flow to ligaments. The blood flow to the ligaments is what keeps the foot arches healthy, and supportive. Arthritis - Arthritis can form in an old injury overtime this can lead to flatfeet as well. Arthritis is painful as well which contributes to the increased pain of AAFD. Injury - Injuries are a common reason as well for AAFD. Stress from impact sports. Ligament damage from injury can cause the bones of the foot to fallout of ailment. Overtime the ligaments will tear and result in complete flattening of feet.



Symptoms

The symptom most often associated with AAF is PTTD, but it is important to see this only as a single step along a broader continuum. The most important function of the PT tendon is to work in synergy with the peroneus longus to stabilize the midtarsal joint (MTJ). When the PT muscle contracts and acts concentrically, it inverts the foot, thereby raising the medial arch. When stretched under tension, acting eccentrically, its function can be seen as a pronation retarder. The integrity of the PT tendon and muscle is crucial to the proper function of the foot, but it is far from the lone actor in maintaining the arch. There is a vital codependence on a host of other muscles and ligaments that when disrupted leads to an almost predictable loss in foot architecture and subsequent pathology.



Diagnosis

First, both feet should be examined with the patient standing and the entire lower extremity visible. The foot should be inspected from above as well as from behind the patient, as valgus angulation of the hindfoot is best appreciated when the foot is viewed from behind. Johnson described the so-called more-toes sign: with more advanced deformity and abduction of the forefoot, more of the lateral toes become visible when the foot is viewed from behind. The single-limb heel-rise test is an excellent determinant of the function of the posterior tibial tendon. The patient is asked to attempt to rise onto the ball of one foot while the other foot is suspended off the floor. Under normal circumstances, the posterior tibial muscle, which inverts and stabilizes the hindfoot, is activated as the patient begins to rise onto the forefoot. The gastrocnemius-soleus muscle group then elevates the calcaneus, and the heel-rise is accomplished. With dysfunction of the posterior tibial tendon, however, inversion of the heel is weak, and either the heel remains in valgus or the patient is unable to rise onto the forefoot. If the patient can do a single-limb heel-rise, the limb may be stressed further by asking the patient to perform this maneuver repetitively.



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 Feet



Surgical Treatment

If conservative treatment fails surgical intervention is offered. For a Stage 1 deformity a posterior tibial tendon tenosynovectomy (debridement of the tendon) or primary repair may be indicated. For Stage 2 a combination of Achilles lengthening with bone cuts, calcaneal osteotomies, and tendon transfers is common. Stage 2 flexible PTTD is the most common stage patients present with for treatment. In Stage 3 or 4 PTTD isolated fusions, locking two or more joints together, maybe indicated. All treatment is dependent on the stage and severity at presentation with the goals and activity levels of the patient in mind. Treatment is customized to the individual patient needs.
Tags: Flat Feet

March 05 2015

myrnasnodderly

What Can I Do About Achilles Tendinitis Pains ?

Overview

Achilles TendonThe Achilles tendon camera.gif connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run. The two main problems are, Achilles tendinopathy. This includes one of two conditions, Tendinitis. This actually means "inflammation of the tendon." But inflammation is rarely the cause of tendon pain. Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon. These tears are caused by overuse. In most cases, Achilles tendon pain is the result of tendinosis, not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury. Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears in the tendon that have happened over time. Achilles tendinopathy is likely to occur in men older than 30. Most Achilles tendon ruptures occur in people 30 to 50 years old who are recreational athletes ("weekend warriors"). Ruptures can also happen in older adults.

Causes

Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance, or over-training excessive hill running or speed work, both of which stress the Achilles more than other types of running. Inflexible running shoes, which, in some cases, may force the Achilles to twist. Runners who overpronate (feet rotate too far inward on impact) are most susceptible to Achilles tendinitis.

Symptoms

Achilles tendonitis is an injury that occurs when your Achilles tendon -- the large band of tissues connecting the muscles in the back of your lower leg to your heel bone -- becomes inflamed or irritated. The signs and symptoms of Achilles tendonitis often develop gradually. You'll feel pain and stiffness in your Achilles, especially when you first get out of bed. The pain lessens as you warm up, and may even disappear as you continue running. Once you stop, the pain returns and may feel even worse. You may also notice a crackling or creaking sound when you touch or move your Achilles tendon.

Diagnosis

To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history, including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.

Nonsurgical Treatment

Treatment options might include anti-inflammatory medication such as ibuprofen which might help with acute achilles inflammation and pain but has not been proven to be beneficial long term and may even inhibit healing. If the injury is severe then a plaster cast might be applied to immobilize the tendon. Use of electrotherapy such as ultrasound treatment, laser therapy and extracorporeal shock wave therapy (ESWT) may be beneficial in reducing pain and encouraging healing. Applying sports massage techniques can mobilze the tissues or the tendon itself and help stretch the calf muscles. Some might give a steroid injection however an injection directly into the tendon is not recommended. Some specialists believe this can increase the risk of a total rupture of the tendon in future. One of the most effective forms of treatment for achilles tendonitis is a full rehabilitation program consisting of eccentric strengthening exercises. There is now considerable evidence suggesting the effectiveness of slow eccentric rehabilitation exercises for curing achilles tendon pain.

Achilles Tendonitis

Surgical Treatment

If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.

Prevention

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

January 18 2015

myrnasnodderly

What Exactly Triggers Plantar Fasciitis

Painful Heel

Overview

A common condition that affects people of all ages. Symptoms include heel pain that is worse upon arising in the morning or standing after prolonged sitting. The pain is caused by inflammation of the plantar fascia, the ligament that connects the heel bone to the toes.



Causes

Plantar fasciitis generally occurs over time, rather than being the result of a single event. Micro trauma from repetitive stress to the tissue often combines with a biomechanical deficiency of the foot to produce the condition. In addition, arthritic and metabolic factors may contribute to the development of this injury, (though they are unlikely to affect young athletes). A variety of training errors commonly lead to plantar fasciitis, particularly a rapid increase in either volume or intensity of athletic activity. Volume refers to the distance or time an athlete performs, while intensity refers to the pace of activity and/or the recovery time allowed following performance.



Symptoms

Symptoms of plantar fasciitis can occur suddenly or gradually. When they occur suddenly, there is usually intense heel pain on taking the first morning steps, known as first-step pain. This heel pain will often subside as you begin to walk around, but it may return in the late afternoon or evening. When symptoms occur gradually, a more long-lasting form of heel pain will cause you to shorten your stride while running or walking. You also may shift your weight toward the front of the foot, away from the heel.



Diagnosis

X-rays are a commonly used diagnostic imaging technique to rule out the possibility of a bone spur as a cause of your heel pain. A bone spur, if it is present in this location, is probably not the cause of your pain, but it is evidence that your plantar fascia has been exerting excessive force on your heel bone. X-ray images can also help determine if you have arthritis or whether other, more rare problems, stress fractures, bone tumors-are contributing to your heel pain.



Non Surgical Treatment

Careful attention to footwear is critical. Every effort should be made to wear comfortable shoes with proper arch support, fostering proper foot posture. Should arch supports prove insufficient, an orthotic shoe should be considered. Fortunately, most cases of plantar fasciitis respond well to non-operative treatment. Recovery times however vary enormously from one athlete to another, depending on age, overall health and physical condition as well as severity of injury. A broad period between 6 weeks and 6 months is usually sufficient for proper healing. Additionally, the mode of treatment must be flexible depending on the details of a particular athlete’s injury. Methods that prove successful in one patient, may not improve the injury in another. Early treatment typically includes the use of anti-inflammatory medication, icing, stretching activities, and heel inserts and splints. Cortisone injections may be necessary to achieve satisfactory healing and retard inflammation. In later stages of the rehabilitation process, typically after the first week, ice should be discontinued and replaced with heat and massage.

Heel Pain



Surgical Treatment

The majority of patients, about 90%, will respond to appropriate non-operative treatment measures over a period of 3-6 months. Surgery is a treatment option for patients with persistent symptoms, but is NOT recommended unless a patient has failed a minimum of 6-9 months of appropriate non-operative treatment. There are a number of reasons why surgery is not immediately entertained including. Non-operative treatment when performed appropriately has a high rate of success. Recovery from any foot surgery often takes longer than patients expect. Complications following this type of surgery can and DO occur! The surgery often does not fully address the underlying reason why the condition occurred therefore the surgery may not be completely effective. Prior to surgical intervention, it is important that the treating physician ensure that the correct diagnosis has been made. This seems self-evident, but there are other potential causes of heel pain. Surgical intervention may include extracorporeal shock wave therapy or endoscopic or open partial plantar fasciectomy.



Stretching Exercises

You may begin exercising the muscles of your foot right away by gently stretching them as follows. Prone hip extension, Lie on your stomach with your legs straight out behind you. Tighten up your buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Towel stretch, Sit on a hard surface with one leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds then relax. Repeat 3 times. When the towel stretch becomes too easy, you may begin doing the standing calf stretch. Standing calf stretch, Facing a wall, put your hands against the wall at about eye level. Keep one leg back with the heel on the floor, and the other leg forward. Turn your back foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. Sitting plantar fascia stretch, Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat 3 times. When you can stand comfortably on your injured foot, you can begin standing to stretch the bottom of your foot using the plantar fascia stretch. Achilles stretch, Stand with the ball of one foot on a stair. Reach for the bottom step with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin strengthening the top muscles of your foot. Frozen can roll, Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if done first thing in the morning. Towel pickup, With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel. Balance and reach exercises, Stand upright next to a chair. This will provide you with balance if needed. Stand on the foot farthest from the chair. Try to raise the arch of your foot while keeping your toes on the floor. Keep your foot in this position and reach forward in front of you with your hand farthest away from the chair, allowing your knee to bend. Repeat this 10 times while maintaining the arch height. This exercise can be made more difficult by reaching farther in front of you. Do 2 sets. Stand in the same position as above. While maintaining your arch height, reach the hand farthest away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 10. Heel raise, Balance yourself while standing behind a chair or counter. Using the chair to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the chair. Hold onto the chair or counter if you need to. When this exercise becomes less painful, try lowering on one leg only. Repeat 10 times. Do 3 sets of 10. Side-lying leg lift, Lying on your side, tighten the front thigh muscles on your top leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10.

January 16 2015

myrnasnodderly

What May Cause Pain On The Heel

Plantar Fasciitis

Overview

Plantar Fasciitis is a chronic pain in the heel that can just appear from nowhere but it is actually a long standing mechanical condition caused by prolonged stress on your foot. In most cases Plantar Fasciitis is a common, but very treatable, mechanical condition of the foot and responds positively to orthotics. A heel pain caused by prolonged stress on a ligament like structure in the arch that is very important in weigh-bearing activities. The tissue becomes damaged and needs to be helped to repair in order for the pain to go or subside to a manageable level. Orthotics for your feet can achieve this necessary healing for pain relief. It can be very painful, and even debilitating for sufferers.



Causes

Plantar fasciitis is the most common cause of heel pain, accounting for around four out of five cases. Plantar fasciitis is when the thick band of tissue that connects the heel bone with the rest of the foot (the plantar fascia) becomes damaged and thickened. Damage to the plantar fascia is thought to occur following sudden damage, for example, damaging your heel while jogging, running or dancing; this type of damage usually affects younger people who are physically active, gradual wear and tear of the tissues that make up the plantar fascia - this usually affects adults who are 40 years of age or over. You are at an increased risk of gradual wear and tear damaging your plantar fasciitis if you are overweight or obese, if you have a body mass index (BMI) of 30 or over, you are considered to be obese, have a job that involves spending long periods of time standing, wear flat-soled shoes, such as sandals or flip flops. Less common causes of heel pain are a stress fracture. A stress fracture can occur if your heel bone is damaged during an injury. Fat pad atrophy. Fat pad atrophy is where the layer of fat that lies under the heel bone, known as the fat pad, starts to waste away due to too much strain being placed on the pad. Women who wear high-heeled shoes for many years have an increased risk of developing fat pad atrophy. Bursitis. Bursitis is inflammation of one or more bursa (small fluid-filled sacs under the skin, usually found over the joints and between tendons and bones). It's possible to develop bursitis anywhere inside the body, not just in the foot. Tarsal tunnel syndrome. The nerves in the sole of your foot pass through a small tunnel on the inside of the ankle joint, known as the tarsal tunnel. If a cyst forms or the tunnel is damaged, the nerves can become compressed (squashed). This can cause pain anywhere along the nerve, including beneath your heel. Sever's disease. Sever's disease is a common cause of heel pain in children. It's caused by the muscles and tendons of the hamstrings and calves stretching and tightening in response to growth spurts. The stretching of the calf muscle pulls on the Achilles tendon. This pulls on the growing area of bone at the back of the heel (growth plate), causing pain in the heel. The pain is further aggravated by activities such as football and gymnastics. The pain often develops at the side of the heel, but can also be felt under the heel. Calf and hamstring stretches and, if necessary, heel pads are usually effective treatments for Sever's disease. Bone spurs. Bone spurs are an excess growth of bone that forms on a normal bone. Bone spurs can develop on the heel (a heel spur) and are more common in people with heel pain. However, they can also occur in people without heel pain. A heel spur does not cause heel pain.



Symptoms

When plantar fasciitis occurs, the pain is typically sharp and usually unilateral (70% of cases).Heel pain worsens by bearing weight on the heel after long periods of rest. Individuals with plantar fasciitis often report their symptoms are most intense during their first steps after getting out of bed or after prolonged periods of sitting. Improvement of symptoms is usually seen with continued walking. Numbness, tingling, swelling, or radiating pain are rare but reported symptoms. If the plantar fascia continues to be overused in the setting of plantar fasciitis, the plantar fascia can rupture. Typical signs and symptoms of plantar fascia rupture include a clicking or snapping sound, significant local swelling, and acute pain in the sole of the foot.



Diagnosis

Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot, this could be a sign of nerve damage in your feet and legs (peripheral neuropathy) your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection, you have stiffness and swelling in your heel, this could be a sign of arthritis. Possible further tests may include blood tests, X-rays - where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.



Non Surgical Treatment

In many instances, plantar fasciitis can be treated with home care. Changing your physical activities, resting the foot, and applying ice to the area are common remedies. Taking over the counter medications such as ibuprofen or acetaminophen can help reduce pain and inflammation that may have developed. An orthotic device placed in your shoes can also significantly help to reduce pain. In addition, orthotics can also help promote healing to reverse plantar fasciitis. If pain from plantar fasciitis continues despite conservative treatments, you may need to visit a doctor or podiatrist. It's important to seek medical advice before heel pain and damage becomes worse. If the condition is allowed to worsen, more serious or invasive forms of treatment may be required to stop pain. A visit to a doctor may reveal other conditions affecting the foot as well, such as Achilles tendonitis, heel spurs, or other heel pain conditions. An x-ray may also be taken, which can reveal the presence of a heel spur. In rare cases surgery may be required to release tension on the plantar fascia, or to remove a portion of a heel spur. But again, most heel pain conditions can be resolved using conservative treatment.

Painful Heel



Surgical Treatment

Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.

January 12 2015

myrnasnodderly

What Exactly Can Cause Pain Under The Heel

Plantar Fascia

Overview

The plantar fascia is made up of 3 distinct parts: the medial, central, and lateral bands. The central plantar fascia is the thickest and strongest section, and this segment is also the most likely to be involved with plantar fasciitis. In normal circumstances, the plantar fascia acts like a windlass mechanism to provide tension and support through the arch. It functions as a tension bridge in the foot, providing both static support and dynamic shock absorption.



Causes

Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following: Over-pronation (flat feet) which results in the arch collapsing upon weight bearing A foot with an unusually high arch A sudden increase in physical activity Excessive weight on the foot, usually attributed to obesity or pregnancy Improperly fitting footwear Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person's arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone. With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.



Symptoms

The most common symptom is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain is often worse in the morning when you take your first steps, after standing or sitting for awhile, when climbing stairs, after intense activity. The pain may develop slowly over time, or come on suddenly after intense activity.



Diagnosis

Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about your past health, including what illnesses or injuries you have had. Your symptoms, such as where the pain is and what time of day your foot hurts most. How active you are and what types of physical activity you do. Your doctor may take an X-ray of your foot if he or she suspects a problem with the bones of your foot, such as a stress fracture.



Non Surgical Treatment

Treatment for plantar fasciitis should begin with rest, icing, and over the counter medications. As mentioned above, an orthotic is a device that can be slipped into any pair of shoes and can often relieve pain and help to reverse the damage and occurrence of plantar fasciitis. They do this by adding support to the heel and helping to distribute weight during movement. In addition to orthotics, many people consider night splints for treating this condition. These devices are worn during the night while you sleep, helping to keep the plantar fascia stretched to promote healing. Physical therapy has also become a common option. With this conservative treatment alternative, a physical therapist designs a set of exercises that are intended to address your specific needs in order to promote healing.

Plantar Fascia



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

Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it's present. To prevent plantar fasciitis, run on soft surfaces, keep mileage increases to less than 10 percent per week, and visit a specialty running shop to make sure you're wearing the proper shoes for your foot type and gait. It's also important to stretch the plantar fascia and Achilles tendon.

January 08 2015

myrnasnodderly

What Leads To Heel Pain To Surface

Plantar Fascitis

Overview

Plantar fasciitis is characterized by stiffness and inflammation of the main fascia (fibrous connective [ligament-like] tissue) on the bottom of the foot. It is occasionally associated with a bone spur on the heel. Occasionally there may be a partial or complete tear of the fascia of the bottom of the foot. Bone spurs themselves usually do not cause symptoms.



Causes

Plantar fasciitis can be confused with a condition called tarsal tunnel syndrome. In tarsal tunnel syndrome, an important nerve in the foot, the tibial nerve, is trapped and pinched as it passes through the tarsal tunnel, a condition analogous to carpal tunnel syndrome in the wrist. This may cause symptoms similar to the pain of a plantar fasciitis. There are also other less common problems such as nerve entrapments, stress fractures, and fat pad necrosis, all of which can cause foot pain. Finally, several rheumatologic conditions can cause heel pain. These syndromes such as Reiter's syndrome and ankylosing spondylitis can cause heel pain similar to plantar fasciitis. If your symptoms are not typical for plantar fasciitis, or if your symptoms do not resolve with treatment, your doctor will consider these possible diagnoses.



Symptoms

Plantar fasciitis is characterized by the following signs and symptoms. Acute plantar fasciitis, pain is usually worse in the morning but may improve when activity continues; if the plantar fasciitis is severe, activity will exacerbate the pain, pain will worsen during the day and may radiate to calf or forefoot, pain may be described anywhere from "minor pulling" sensation, to "burning", or to "knife-like", the plantar fascia may be taut or thickened, passive stretching of the plantar fascia or the patient standing on their toes may exacerbate symptoms, acute tenderness deep in the heel-pad along the insertion of the plantar aponeurosis at the medial calcaneal tuberosity and along the length of the plantar fascia, may have localized swelling. Chronic plantar fasciitis, plantar fasciitis is classified as "chronic" if it has not resolved after six months, pain occurs more distally along the aponeurosis and spreads into the Achilles tendon.



Diagnosis

Your doctor will ask you about the kind of pain you're having, when it occurs and how long you've had it. If you have pain in your heel when you stand up for the first time in the morning, you may have plantar fasciitis. Most people with plantar fasciitis say the pain is like a knife or a pin sticking into the bottom of the foot. After you've been standing for a while, the pain becomes more like a dull ache. If you sit down for any length of time, the sharp pain will come back when you stand up again.



Non Surgical Treatment

Rest until the pain resolves and you are feeling better. For most people with plantar fasciitis it is very difficult to rest as daily routine demands using their feet during the day for work or other activities. By using the painful foot you keep on hurting the plantar fascia, harming the foot and increasing inflammation. Rest as much as you can, reduce unnecessary activities and additional stress on the fascia. Cold therapy like applying ice to the bottom of your foot helps reduce pain and inflammation. Cold therapy can be used all the time until symptoms have resolved. Some patients prefer to roll their foot over an iced cold drink can or bottle taken out of the freezer. Physical therapy Exercises are good plantar fasciitis treatment. Stretching and other physical therapy measures may be used to provide relief. Stretching the plantar fascia is reported in scientific studies to be a very effective treatment technique. Gait analysis will determine if you overpronate or oversupinate. An expert may perform a test of the way you stand and walk to see if you step in a way that puts more stress on the plantar fascia. You can try to change the way you walk and stand according to the experts recommendation as part of your treatment. Exercise the foot muscles to make the muscles stronger. One good exercise is grabbing and lifting up a towel or marbles using your toes. You can do the same exercise without a towel as though you are grasping something with the toes of each foot. Another good exercise is walking as tall as you can on your toes and on the balls of your feet. Stretching the plantar fascia and the calf muscles several times a day is an important part of the treatment and prevention. There are many stretching exercises for the plantar fascia and the calf muscles that you can find. Long term treatment should not focus in reduction of pain and inflammation alone. This is a passive short term relief treatment. Stretching exercises results are longer and more flexible foot movement which can prevent another fascia injury. Plantar fasciitis taping technique can assist the foot getting rest and help it from getting injured again. Athletic tape is applied in strips on the skin on the bottom of the foot supporting the plantar fascia. The tape restricts the movement of the foot so the fascia can not be injured again. Taping supports the foot by putting the tired foot muscles and tendons in a physiologically more relaxed position. A night splint is worn during sleep. It holds the calf muscles and plantar fascia in a stretched position. Night splint treatment lets the fascia heal in a stretched position so it will not get bruised again when waking up and stretching it again while walking. Orthotics or inserts that your doctor may prescribe or custom made arch supports (orthotics) plantar fascia orthotic. help to distribute the pressure on your feet more evenly. Arch Support gives a little raise to the arch assisting the plantar fascia. There are also over-the-counter inserts that are used for arch support and heel cushioning. Heel cups and cradles provide extra comfort and cushion the heel. They reduce shock placed on the foot during everyday activities like Shock absorbers. Anti-inflammatory or Pain medication that a clinician may recommend can be a plantar fasciitis treatment. Non-steroidal anti-inflammatory drugs such as ibuprofen can reduce swelling and relieve pain. However, these medications may have many side effects and it is important to consider the potential risks and benefits. These medications may relieve the pain and inflammation but will not cure the fascia. Lose weight as much as you can. Extra weight puts more stress on your plantar fascia. Platelet Rich Plasma or PRP therapy, is a procedure which involves an injection of special plasma, made out of the patients own blood, to the injured area. Platelets are special blood components that have a major role in the body ability to heal itself. Blood is taken from the patient and separated into its components. The platelet rich part of the blood is than taken and injected into the injured area - in our case to the bottom of the foot. The special plasma helps the foot recovery process. The procedure is actually maximizing the body's natural healing response of the treated area. Extracorporeal shock wave therapy is a procedure which sound waves are targeted at the area of heel pain to encourage healing. It is mostly used for chronic plantar fasciitis which does not respond to conservative treatments. This procedure has many possible side effects like bruising, swelling, pain or numbness and has not proved to be consistently effective. Corticosteroid injection (or cortisone shots) into the painful area may provide relief in severe cases. This kind of medication is very efficient in inflammation reduction. Corticosteroid injections usually provide short-term relief from plantar fasciitis pain. Symptom relief from the corticosteroid injection lasts for 3 to 6 weeks, but the effect often deteriorates and symptoms return. Botox Injections (botulinum toxin) are used to relieve the pain of plantar fasciitis, assist foot function recovery and the ability to walk better. Although the use of Botox injections as heel pain treatment is relatively new, there are a number of medical studies that show significant good results.

Plantar Fasciitis



Surgical Treatment

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



Prevention

Plantar fasciitis can be a nagging problem, which gets worse and more difficult to treat the longer it's present. To prevent plantar fasciitis, run on soft surfaces, keep mileage increases to less than 10 percent per week, and visit a specialty running shop to make sure you're wearing the proper shoes for your foot type and gait. It's also important to stretch the plantar fascia and Achilles tendon.

January 01 2015

myrnasnodderly

Symptoms Of Ingrown Toe Nails

Pain across the bottom of the foot at any point between the heel and the ball of the foot is often referred to as "arch pain” Although this description is non-specific, most arch pain is due to strain or inflammation Plantar Fasciitis of the plantar fascia (a long ligament on the bottom of the foot). Wearing inappropriate footwear or foot problems like athlete's foot and Morton's neuroma are some of the factors that cause burning feet sensation.

If changing your shoes isn't helping to solve your foot pain, it is time for us to step in. Contact Dr. Jeff Bowman at Houston Foot Specialists for treatment that will keep your feet feeling great. Inserting arch support insoles in the shoes is also a good option.

If you see just a thin line connecting the ball of your foot to your heel, you have high arches. If you have flat feet or high arches, you're more likely to get plantar fasciitis, an inflammation of the tissue along the bottom of your foot. Without proper arch support, you can have pain in your heels, arch, and leg. You can also develop bunions and hammertoes, which can become painful,” says Marlene Reid, a podiatrist, or foot and ankle doctor, in Naperville, IL. Shoes with good arch support and a slightly raised heel can help ward off trouble. Laces, buckles, or straps are best for high arches. See a foot doctor to get fitted with custom inserts for your shoes. Good running shoes, for example, can prevent heel pain, stress fractures , and other foot problems that can be brought on by running. A 2-inch heel is less damaging than a 4-inch heel. If you have flat feet, opt for chunky heels instead of skinny ones, Reid says.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

Do not consume food items which you are allergic to. Keep dead skin off your lips by lightly scrubbing them at least twice a week using a mild, natural ingredient such as cornflour or a lemon juice-sugar pack. I had a long road workout two weeks ago and immediately after starting having pain on the ball of my foot in this area. I have also learned buying shoes online is easy.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

During the average lifetime our feet cover over 70,000 miles, the equivalent of walking four times around the world., so it's not surprising that problems can occur. Indeed around three-quarters of all adults will experience some sort of problem with their feet at some time. And without treatment most foot complaints will become gradually worse with time. This means people often endure painful conditions for far too long, and the problem can get worse. People often assume nothing can be done to help their condition, but in fact these conditions are extremely treatable. Swollen lump on big toe joint; lump may become numb but also make walking painful.

December 16 2014

myrnasnodderly

Achilles Tendinitis

Overview

Achilles TendonitisAchilles tendinitis is very common among running athletes. The calf muscles attach to the calcaneus via the Achilles tendon. During running, the calf muscles help with the lift-off phase of gait. Repetitive forces from running combined with insufficient recovery time can initially cause inflammation in the tendon paratenon (fatty areolar tissue that surrounds the tendon). A complete tear of the Achilles tendon is a serious injury, usually resulting from sudden, forceful stress. Tendon tears can occur with minimal exertion in people who have taken fluoroquinolone antibiotics.



Causes

In some cases, Achilles Tendinitis can be caused by physical activity without a proper warm up or trauma, such as falling, to cause an overstressing of the muscle and tendon. Other causes include repetitive overuse syndrome, such as a job that required frequent heel lifting. Biomechanical causes such as pronation (or fallen arches) will cause the heel (calcaneus) to lean slightly, putting the undue stress on the Achilles tendon and the calf muscles. Most pain can be felt at the back of the heel or the point at which the calf muscle becomes a tendon three quarters of the distance down from the knee. Discomfort can be felt especially when jumping or when lifting the heel off the ground. Swelling and redness can often be seen at the back of the heel and touching the area would cause a tender sensation. In extreme cases, the tendon can become torn or rupture entirely which would cause bruising or an inability to put pressure on the foot.



Symptoms

Patients with this condition typically experience pain in the region of the heel and back of the ankle. In less severe cases, patients may only experience an ache or stiffness in the Achilles region that increases with rest (typically at night or first thing in the morning) following activities which place stress on the Achilles tendon. These activities typically include walking or running excessively (especially uphill or on uneven surfaces), jumping, hopping, performing heel raises or performing calf stretches. The pain associated with this condition may also warm up with activity in the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. Pain may also increase when performing a calf stretch or heel raise (i.e. rising up onto tip toes). In severe cases, patients may walk with a limp or be unable to weight bear on the affected leg. Patients with Achilles tendonitis may also experience swelling, tenderness on firmly touching the Achilles tendon, weakness and sometimes palpable thickening of the affected Achilles tendon when compared with the unaffected side.



Diagnosis

Examination of the achilles tendon is inspection for muscle atrophy, swelling, asymmetry, joint effusions and erythema. Atrophy is an important clue to the duration of the tendinopathy and it is often present with chronic conditions. Swelling, asymmetry and erythema in pathologic tendons are often observed in the examination. Joint effusions are uncommon with tendinopathy and suggest the possibility of intra-articular pathology. Range of motion testing, strength and flexibility are often limited on the side of the tendinopathy. Palpation tends to elicit well-localized tenderness that is similar in quality and location to the pain experienced during activity. Physical examinations of the Achilles tendon often reveals palpable nodules and thickening. Anatomic deformities, such as forefoot and heel varus and excessive pes planus or foot pronation, should receive special attention. These anatomic deformities are often associated with this problem. In case extra research is wanted, an echography is the first choice of examination when there is a suspicion of tendinosis. Imaging studies are not necessary to diagnose achilles tendonitis, but may be useful with differential diagnosis. Ultrasound is the imaging modality of first choice as it provides a clear indication of tendon width, changes of water content within the tendon and collagen integrity, as well as bursal swelling. MRI may be indicated if diagnosis is unclear or symptoms are atypical. MRI may show increased signal within the Achilles.



Nonsurgical Treatment

The aim of the treatment is to reduce strain on the tendon and reduce inflammation. Strain may be reduced by, avoiding or severely limiting activities that may aggravate the condition, such as running, using shoe inserts (orthoses) to take pressure off the tendon as it heals. In cases of flat or hyperpronated feet, your doctor or podiatrist may recommend long-term use of orthoses. I8nflammation may be reduced by, applying icepacks for 20 minutes per hour during the acute stage, taking non-steroidal anti-inflammatory drugs, placing the foot in a cast or restrictive ankle-boot to minimise movement and give the tendon time to heal. This may be recommended in severe cases and used for about eight weeks. Occasionally depot (slowly absorbed) steroid injections may be tried, particularly for peri-tendinitis, but great care needs to be taken to avoid injecting into the tendon. This should only be done by a specialist doctor. You may also be given specific exercises to gently stretch the calf muscles once the acute stage of inflammation has settled down. Your doctor or physiotherapist will recommend these exercises when you are on the road to recovery. Recovery is often slow and will depend on the severity of the condition and how carefully you follow the treatment and care instructions you are given.

Achilles Tendonitis



Surgical Treatment

Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas of your tendon and repairing them.



Prevention

As with all injuries, prevention is your best defense especially with injuries that are as painful and inconvenient as Achilles tendonitis. Options for how to prevent Achilles tendonitis include, stretching- Stretching properly, starting slowly, and increasing gradually will be critical if you want to avoid Achilles tendonitis. To help maintain flexibility in the ankle joint, begin each day with a series of stretches and be certain to stretch prior to, and after, any exercise or excessive physical activity. Orthotics and Heel Support- Bio-mechanically engineered inserts and heel cups can be placed in your shoes to correct misalignments or bolster the support of your foot and are available without a prescription. The temporary heel padding that these provide reduces the length that the Achilles tendon stretches each time you step, making it more comfortable to go about your daily routine. Proper Footwear- Low-heeled shoes with good arch support and shock absorption are best for the health of your foot. Look into heel wedges and other shoe inserts to make sure that your everyday foot mechanics are operating under ideal conditions.
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