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Monday, 16 March 2015 00:00

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

Friday, 06 March 2015 00:00

Ankle/Foot Orthotics for Athletes

Ankle/foot Orthotics (AFOs) are custom-made devices, molded to fit inside a shoe, and designed to correct an abnormal or irregular walking gait. Orthotics come in both customized and over the counter models. Custom made Orthotics should be prescribed through a podiatrist, who specializes in foot pathology, as well as performing surgery if required, or a pedorthist, who specializes in customized footwear and orthotics management and design. AFOs are commonly used by athletes, such as professional track and field runners, cyclists, hockey players, professional dancers, ice skaters and golfers. Athletes benefit greatly from custom made AFOs, both when recovering from an injury and to help prevent future problems from occurring. These devices keep the foot aligned to allow the bones, ligaments and muscles to heal, restoring the patient to optimum performance.

AFOs are designed for shock absorption to help release the pressure and stress from painful parts of the foot and ankle, and to allow for the correct positioning of the feet. Custom-made AFOs relieve pain in the hip and lower back, while restoring balance and improving an athlete’s performance. The AFO controls the motion of the ankle and foot, which helps in alleviating pain. The brace comes in various heights and profiles, for high and low top shoes and boots. Braces are fabric lined and are made of light weight material to easily embrace the ankle, for a better fit inside the footwear.

With this type of orthotic, athletes can continue to play in comfort and stability. A custom made ankle/foot orthotic is designed by a podiatrist or an orthotic specialist, to help treat ailments, i.e., tendon maladies, flat foot problems, spurs, arthritis of the ankle and/or foot, ankle sprains, ankle weakness and drop foot (a patient cannot raise their foot at the ankle joint or at the least, has limited ability to raise their foot). An orthotics specialist will put a patient through a complete muscular workup, using digital or ultrasound equipment, followed by the ankle and foot being cast and fitted for the proper orthotics. Depending upon the final evaluation, a stretching treatment is designed, with specific shoe fitting discussions. In a couple of weeks, after the AFOs are fitted to the shoes that the patient was required to bring, any needed adjustments are made to ensure a perfect fit.

Following the fittings, evaluations are set up for the patient over the following weeks. AFOs are also available over the counter for improving basic comfort. If an athlete has general low aches or pains in the ankle/foot or lower back, an over-the-counter orthotic arch support, which slips inside the shoes, can be purchased without a prescription. The arch supports help to spread an athlete’s weight evenly throughout the bottom of the foot. But when a medical condition occurs, i.e., an injury, arthritis, problems with an illness, or poor circulation, then a specialist's prescription will be required. Over-the-counter arch supports can be purchased in local retail or sport stores, as well as in drug store pharmacies.  In all cases, a skilled podiatrist will offer the best recommendation on which medical device is suited to handle the patient’s particular needs.

Wednesday, 25 February 2015 13:02

Getting the Right Shoe Size

Are your shoes the right size? Many people are walking around with ill-fitting shoes. Picking the right shoe size is not rocket science, but there are a few things to remember when selecting your next pair.

Most shoe stores and department stores have rulers for measuring your feet, and these can give you an exact size. Be sure to measure with your shoe on. Measuring your foot will give you a different size than your shoe. If you do measure your foot size, you will need to add 1-2 inches to get the proper sizing.

Wiggle room is the most important factor when selecting shoes. Make sure that your toes are not cramped and that you can wiggle them. A rule of thumb is that there should be one inch between your toes and the tip of your shoe. If your shoes are not properly sized, you can experience foot pain, knee pain, blisters and swelling.

Don’t assume that you will always wear the same size in a shoe. Often manufacturers size shoes differently. The size you wear with one company may not be the same as the size you wear with another. Make sure that the company you buy from has a return policy. No one needs a closet full of shoes which they cannot wear.

It is advisable not to buy your shoes in the morning, but rather late in the day. Your feet actually swell as the day goes on and you need plenty of room to walk comfortably. Buying shoes in the morning that are snug is sure to cause problems once the day is done. Also, make sure that you are buying the right sizes for both feet. It is not uncommon for one foot to be larger than the other, and some people have to buy two separate sizes to accommodate different sized feet.

The biggest concern in buying shoes is comfort. Oftentimes people will buy shoes that are not the most comfortable in the store. People think that the shoes simply need to be “broken in”. If a shoe does not fit in the store, it will not fit at home either. Comfort should be the ultimate goal when purchasing a pair of shoes; your feet will thank you.

Let’s face it; we all walk a lot, some of us more than others. Selecting the best shoes for your particular lifestyle is essential. By properly sizing your shoes and buying the proper comfort level, your feet will be dancing all day long.
Thursday, 12 February 2015 15:02

Causes Symptoms and Treatment for a Broken Foot

One out of ten broken bones is reported in the feet. When an object crushes, bends, or stretches the bone beyond acceptable ranges, bones break. A break in the foot is either a fracture or a straight break.

The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked; hard and with great force. Heel breaks almost always are as a result of an improper landing from great height. Twists or sprains are the other two frequent occurrences, and as with all usual breaks, result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time—repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break—stress fractures occur from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.

Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high—as are a few other particular bones. As the severity of the broken foot increases, symptoms like; blueness, numbness, cold, misshaping of the foot, cuts, or deformities will crop up and indicate the requirements of a medical professional with access to an x-ray facility.

Prior to this severe point however, reduction of pain and swelling at home should be the first priority. Elevate and stabilize the foot, don’t move it. Immobilization of the foot is the next priority, so jury-rigging a homemade splint is acceptable. Keep in mind while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and alleviate pain symptoms.

When dealing with a medical center, the patient should note that the treatment will be different from what is stated dependent on which foot bone has been fractured and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bone or bones.  
Thursday, 05 February 2015 09:02

Plantar Fasciitis Treatment

A study conducted by Luca M. Sconfienza, M.D., of the University of Genoa in Italy focused on a relatively new treatment option combines steroid injections and ultrasound waves. This form of treatment was found to be 95% effective in plantar fasciitis patients in the study.

The plantar fascia is a connective tissue that stretches the bottom length of your foot from the heel. The condition of plantar fasciitis is an inflammation of this connective band, known for causing discomfort and pain while standing or walking. Although the condition can be treated, conservative methods may take up to a year before they become effective.

Conventional treatments include certain exercises, night splints, arch support, staying off your feet and overall rest. Previously the cure for plantar fasciitis was shockwave therapy, which directs sound waves to the area where pain is being experienced. Despite the treatment’s success it is considered painful and requires several sessions before any notable results occur. It is also fairly expensive and does not cure the pain for every plantar fasciitis patient.

Dr. Sconfienza examined the effects of a new technique that combined ultrasound-based methods similar to shockwave therapy, applying a steroid injection directly to the plantar fascia. This form of treatment is a one-time outpatient procedure that involves a small dose of local anesthesia. A needle punctures the affected area and causes a nominal amount of bleeding that assists the fascia in healing. This technique is known as dry-needling.

Dr. Sconfienza found that 42 of the 44 patients that were involved in the new procedure had their symptoms disappear completely within a three week timespan, including pain. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza said. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.” 

Stress fractures occur in the foot and ankle when muscles in those areas are weakened from too much or too little use. When this happens, they stop cushioning the foot and ankles from the impact of hitting the ground. Because there is nothing to protect them, the bones of the foot begin to absorb the full impact of each step someone takes. The added stress causes little cracks to form in the bones that are under the most pressure. These cracks are called stress fractures.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Individuals who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intensive high impact work out may get stress fractures. This is because their muscles are not strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

The pain from these fractures will occur in the general area of the fracture. It may be intermittent or constant, and will cause sharp or dull pain along with swelling and tenderness. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture. This is a much more serious problem, and will probably prevent you from applying any pressure on the foot at all.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

In order to avoid getting stress fractures, make sure to get plenty of calcium and Vitamin-D. They will help to keep your bones strong, and make them less likely to break under pressure. If your new exercise regimen is running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. For example, if you plan to walk every day, you could ride a bike on some days to take the stress off of your feet. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms do not go away, see an orthopedic specialist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.

Thursday, 01 January 2015 00:00

Treating Heel Pain with Shockwave Therapy

Heel pain shockwave therapy is a treatment option that helps to treat plantar fascia, which is a type of heel and foot inflammation that causes pain to the heel area. This type of injury is often caused by overworking and overusing the feet, and normally happens to people that exercise often such as runners, athletes, obese and overweight individuals, and individuals whose profession requires them to stand for long periods of time.

Since heel pain can be caused by a number of problems including poorly fitting shoes, exercise routines, work hazards, and many more, most plantar fascia treatments include very conservative techniques. Simple things like new shoes, taking ibuprofen, doing heel and foot exercises, and resting your feet can treat the problem. However, for the worst cases, using shockwave therapy is often the best treatment option.

For patients that have tried conventional treatment options, and failed at them, and who have been having heel pains for over six months, Shockwave treatment is often the next option. The concept behind this treatment is simple; shockwaves are generated from a device that delivers shockwaves to the outside of the patients body, and the shockwaves will cause the bodies repair mechanisms to work more efficiently and effectively, and in the end, start repairing the damage done to the heel area.

The goal of shockwave therapy is to eliminate the pain in the heel area, and this should happen because shockwaves trigger the body’s natural repair mechanisms. Basically, this therapy speeds up normal tissue healing in the body, and will also lead to a reduction in pain for the patient by working the pain transmission nerves located in the heel area.

The reason this treatment is gaining popularity is because it is less invasive than surgery, and eliminates the risk factors associated with surgery, such as anesthetic usage. Since this technique also works by helping the body to improve using natural healing techniques, the recovery time should be shorter than surgical processes.

This does not mean that there are not some discomfort issues that can arise out of this treatment for patients. Short term issues normally include skin bruising, minor pain during and after treatment, swelling of the heel, and discolored tissue. These side effects of shockwave therapy should be gone in a few days, giving the patient a fast recovery time which makes it easy to return to the routines of their daily life .

Like most types of treatments, surgeries, and medications, there are certain people that should not have shockwave therapy procedures performed on them. Potential patients with heart conditions and people with pacemakers should not be considered for this technique. People on certain types of medications, usually medications affecting blood clotting, would also be ineligible for this treatment option. And lastly, children and pregnant women should avoid this as well.

Overall, shockwave therapy could be a great option for heel pain because it is less invasive than surgery, helps to trigger the natural healing mechanisms of the body, and should be considered by people who have had long bouts of heel pain, who have tried conventional treatment options that failed, and who have the money to afford such a procedure.

Tuesday, 23 December 2014 13:27

Keeping Children's Feet Healthy

As a parent, your most important job is taking care of your children in every possible way. You watch what they eat, you protect them from harm, but it is important to be proactive in taking care of their health, especially when it comes to their feet. Having healthy, well taken care of feet in childhood is crucial in helping eliminate problems later in life, especially in the back and legs. As children grow, their feet require different types of care. Here are some ways you can help keep your children's feet healthy, from birth to school age.

 

Babies require a lot of care in general, but don't forget their feet. Since babies don't walk yet, their feet can be easy to overlook, but it is still important to take care of them. In the first year of life a baby's feet grow and change very much, so it is important that you do not put any tight shoes or socks on your baby's feet. Let your baby stretch and kick her feet so he or she can feel comfortable.

 

When a baby turns into a toddler, they are now on the move and it is important that your toddler has comfortable and protective shoes to walk in. Now is the time you may notice different things about your child's feet, but know that children at this age are just getting the feel for walking, so don't be alarmed if they seem to walk funny. It is normal for a toddler to be unsteady on their feet.

 

When your child gets older and leaves the toddler stage behind, it is now important that you teach them how to take care of their own feet. Show them proper cleaning and hygiene so that their feet do not develop fungus or infection. Since children are constantly running and playing, it is also important to watch out for injury or pain. Children are still growing, and certain injuries can effect the bones growth and development so it is vital to have all injuries checked by a doctor as soon as possible. Comfortable shoes that cushion the foot and provide protection from hours of rough play are highly recommended.

 

Children and babies are constantly growing and developing, and it is your job as a parent to make sure that nothing is hindering their ability to mature at a normal rate. This includes properly taking care of the feet, as healthy feet are important in order to live a normal, fulfilling life.

Saturday, 20 December 2014 18:22

Barefoot Running

A new trend in running and jogging has popped up recently, called barefoot running. Barefoot running is a popular and growing trend that is just what it sounds – running without shoes. Before deciding to do any running without shoes, it's best to understand how this kind of running affects the feet.

Running without shoes changes the motion of running. Most running is done by landing on the heel of the feet. Running barefoot requires a different way of running; in a barefoot stride landing is done on the front part of the feet. Because of this, the impact shifts from the heels to the front feet. Runners also shorten their strides to create a softer landing.

Running barefoot does have its advantages. When running and landing on the front feet, the impact on the feet and ankle is reduced, which may reduce the incidence of stress injuries. It strengthens muscles in the feet, and also strengthens muscles in the ankles and lower legs that aren't usually worked. Overall balance of the body is improved and there is greater sensory input from the feet to the rest of the body, making overall position and motion less stressful on the body. It has been found that in countries in which some of the population regularly wear shoes and some do not, numbers of foot and ankle injuries are much higher in those who wear shoes.

People hearing about barefoot running for the first time are skeptical about it, and there are good reasons for skepticism. Running barefoot certainly has its drawbacks, the obvious being no protection of the feet when running. This makes it likely that when runners land on sharp or rough objects,  scrapes, bruises, and cuts on feet will result. Blisters will form when beginning this kind of running especially, you may have plantar fascia problems. Landing on the front feet constantly also increases the risk of getting Achilles tendonitis.

So what can runners do to make barefoot running safe? It’s best to make a slow transition from running shoes to barefoot running. The body is used to wearing shoes so to slowly transition to bare feet, start by walking barefoot for a distance and then increase walking distance. Once the feet begin to adjust, try walking and then jogging and gradually increase the distance. If you have foot problems talk to the doctor first before attempting barefoot running. When starting out, it may also be helpful to begin by running on pavement or other consistent surfaces to avoid sharp or rough objects. Minimalist running shoes may also be an option, as they allow for many of the benefits of barefoot running while also protecting the feet from cuts and scrapes.

Thursday, 11 December 2014 06:00

When Foot Surgery is Necessary

Foot surgery may be necessary for a variety of reasons, but it is normally reserved for cases in which less invasive procedures have failed to help with the problem. Cases in which surgery may be deemed necessary include, but are not limited to, surgically removing deformities of the foot (such as bone spurs and bunions), problems with arthritis that have caused severe bone issues within the foot, and reconstruction to attend to injuries caused by accidents and congenital malformation (such as club foot and flat feet). Foot surgery may be necessary for individuals of all ages and races.

 

If you find yourself in need of foot surgery, the reason why the surgery has been found to be necessary will dictate exactly what kind of surgery you need. If you have to have a growth, such as a bunion, removed, then you may undergo a bunionectomy. If your bones need to be realigned and fused together, then you may undergo a surgical fusion of the foot. If it is nerve pain and problems that you are enduring, then you may need to undergo surgery in which the tissue that surrounds the painful nerve is surgically removed. Normally other, less serious treatments are first applied when a problem is discovered, but if those treatments are found to be ineffective, surgical techniques are considered and used.

 

Even though surgery of the foot is usually reserved as a last resort by most physicians, there are some benefits if you and your doctor choose to use surgery to fix the problem. The first is that the pain associated with the issue is normally relieved, which means that you can finally resume the activities your foot problem was preventing you from participating in. The second benefit is that, once you have the surgery completed, the problem is generally eliminated since it has finally been addressed.

 

History of podiatry has shown that foot surgery techniques continue to advance every year. Endoscopic surgery is just one of the many advancements that have been made in the field of foot surgery. As technology improves, foot surgical techniques will also continue to improve. Many procedures can now be completed using a very small incision and smaller, more refined instruments. Because of these better tools, surgeries are becoming less invasive, and recovery time has become a great deal shorter. Shorter recovery periods mean that you will be back on your feet in no time.

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