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March 25 2015

tamathawessinger

What Is The Cause For Adult Aquired Flat Foot

Overview

Adult acquired flatfoot is a progressive disorder that involves a compromise of soft tissue supports of the medial arch. The condition most commonly affects middle aged women and is characterized by lowering of the arch, turning out of the forefoot, and a sideways angulation of the heel. There are five stages of the disorder that becomes progressively disabling. The end stage can potentially compromise the ankle joint along with the joints in the hindfoot.Acquired Flat Foot



Causes

As discussed above, many different problems can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to support the arch of your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat. The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch. An injury to the tendons or ligaments in the foot can cause the joints to fall out of alignment. The ligaments support the bones and prevent them from moving. If the ligaments are torn, the foot will become flat and painful. This more commonly occurs in the middle of the foot (Lisfranc injury), but can also occur in the back of the foot. Injuries to tendons of the foot can occur either in one instance (traumatically) or with repeated use over time (overuse injury). Regardless of the cause, if tendon function is altered, the forces that are transmitted across joints in the foot are changed and this can lead to increased stress on joint cartilage and ligaments. In addition to tendon and ligament injuries, fractures and dislocations of the bones in the midfoot can also lead to a flatfoot deformity. People with diabetes or with nerve problems that limits normal feeling in the feet, can have collapse of the arch or of the entire foot. This type of arch collapse is typically more severe than that seen in patients with normal feeling in their feet. In addition to the ligaments not holding the bones in place, the bones themselves can sometimes fracture and disintegrate without the patient feeling any pain. This may result in a severely deformed foot that is very challenging to correct with surgery. Special shoes or braces are the best method for dealing with this problem.



Symptoms

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



Diagnosis

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



Non surgical Treatment

The adult acquired flatfoot is best treated early. There is no recommended home treatment other than the general avoidance of prolonged weightbearing in non-supportive footwear until the patient can be seen in the office of the foot and ankle specialist. In Stage I, the inflammation and tendon injury will respond to rest, protected ambulation in a cast, as well as anti-inflammatory therapy. Follow-up treatment with custom-molded foot orthoses and properly designed athletic or orthopedic footwear are critical to maintain stability of the foot and ankle after initial symptoms have been calmed. Once the tendon has been stretched, the foot will become deformed and visibly rolled into a pronated position at the ankle. Non-surgical treatment has a significantly lower chance of success. Total immobilization in a cast or Camwalker may calm down symptoms and arrest progression of the deformity in a smaller percentage of patients. Usually, long-term use of a brace known as an ankle foot orthosis is required to stop progression of the deformity without surgery. A new ankle foot orthosis known as the Richie Brace, offered by PAL Health Systems, has proven to show significant success in treating Stage II posterior tibial dysfunction and the adult acquired flatfoot. This is a sport-style brace connected to a custom corrected foot orthotic device that fits well into most forms of lace-up footwear, including athletic shoes. The brace is light weight and far more cosmetically appealing than the traditional ankle foot orthosis previously prescribed.

Flat Feet



Surgical Treatment

For patients with a more severe deformity, or significant symptoms that do not respond to conservative treatment, surgery may be necessary. There are several procedures available depending on the nature of your condition. Ligament and muscle lengthening, removal of inflamed tendon lining, transferring of a nearby tendon to re-establish an arch, and bone realignment and fusion are examples of surgical options to help with a painful flatfoot condition. Surgery can be avoided when symptoms are addressed early. If you are feeling ankle pain or notice any warmth, redness or swelling in your foot, contact us immediately. We can create a tailored treatment plan to resolve your symptoms and prevent future problems.

March 06 2015

tamathawessinger

Precisely What Might Cause Tendinitis In The Achilles ?

Overview

Achilles TendonAchilles tendinitis occurs when the band of tissue that connects the calf muscles at the back of the lower leg to the heel bone, the Achilles tendon, becomes inflamed. This condition is a result of overuse from intense exercise, jumping, running, and other activities that strain the tendon and calf muscles.

Causes

When you place a large amount of stress on your Achilles tendon too quickly, it can become inflamed from tiny tears that occur during the activity. Achilles tendonitis is often a result of overtraining, or doing too much too soon. Excessive hill running can contribute to it. Flattening of the arch of your foot can place you at increased risk of developing Achilles tendonitis because of the extra stress placed on your Achilles tendon when walking or running.

Symptoms

Signs and symptoms of Achilles Tendinitis generally include pain and stiffness along your achilles tendon, especially in the morning. Pain in the back of your heel that gets worse with activity. Severe pain the day after exercising. Swelling that gets worse with activity. If you feel a pop in the back of your heel or bottom of you calf, you may have ruptured or torn you achilles tendon.

Diagnosis

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

Nonsurgical Treatment

Treating Achilles tendinitis rarely requires much professional intervention. Ease the pain with OTC pain killers. Stretch and strengthen the Achilles tendon. Stop the condition from happening again. Doctors treating Achilles tendinitis will recommend the following options for accomplishing this. Pain Killers - Generally ibuprofen (Advil) or naproxen (Aleve) will ease the mild pain. Physical Therapy, Stretches and exercises devised to lengthen and strengthen the Achilles tendon will help reduce pain and prevent future recurrence. Orthopedic Supports, Heel-elevating insoles or other orthotic devices can reduce the strain on the Achilles tendon, helping ease the inflammation and pain.

Achilles Tendonitis

Surgical Treatment

Following the MRI or ultrasound scan of the Achilles tendon the extent of the degenerative change would have been defined. The two main types of operation for Achilles tendinosis are either a stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon (known as a debridement) or a major excision of large portions of the tendon, the defects thus created then being reconstructed using either allograft (donor tendon, such as Wright medical graft jacket) or more commonly using a flexor hallucis longus tendon transfer. In cases of Achilles tendonosis with more minor degrees of degenerative change the areas can be stimulated to repair itself by incising the tendon, in the line of the fibres, which stimulates an ingrowth of blood vessels and results in the healing response. With severe Achilles tendonosis, occasionally a large area of painful tendon needs to be excised which then produces a defect which requires filling. This is best done by transferring the flexor hallucis longus muscle belly and tendon, which lies adjacent to the Achilles tendon. This results in a composite/double tendon after the operation, with little deficit from the transferred tendon.

Prevention

Regardless of whether the Achilles injury is insertional or non-insertional, a great method for lessening stress on the Achilles tendon is flexor digitorum longus exercises. This muscle, which originates along the back of the leg and attaches to the tips of the toes, lies deep to the Achilles. It works synergistically with the soleus muscle to decelerate the forward motion of the leg before the heel leaves the ground during propulsion. This significantly lessens strain on the Achilles tendon as it decelerates elongation of the tendon. Many foot surgeons are aware of the connection between flexor digitorum longus and the Achilles tendon-surgical lengthening of the Achilles (which is done to treat certain congenital problems) almost always results in developing hammer toes as flexor digitorum longus attempts to do the job of the recently lengthened tendon. Finally, avoid having cortisone injected into either the bursa or tendon-doing so weakens the tendon as it shifts production of collagen from type one to type three. In a recent study published in the Journal of Bone Joint Surgery(9), cortisone was shown to lower the stress necessary to rupture the Achilles tendon, and was particularly dangerous when done on both sides, as it produced a systemic effect that further weakened the tendon.

January 18 2015

tamathawessinger

What Is Heel Pain And Tips To End It

Feet Pain

Overview

Plantar fasciitis is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot, and supports the arch of your foot.



Causes

There are a number of plantar fasciitis causes. The plantar fascia ligament is like a rubber band and loosens and contracts with movement. It also absorbs significant weight and pressure. Because of this function, plantar fasciitis can easily occur from a number of reasons. Among the most common is an overload of physical activity or exercise. Athletes are particularly prone to plantar fasciitis and commonly suffer from it. Excessive running, jumping, or other activities can easily place repetitive or excessive stress on the tissue and lead to tears and inflammation, resulting in moderate to severe pain. Athletes who change or increase the difficulty of their exercise routines are also prone to overdoing it and causing damage. Another common cause of plantar fasciitis is arthritis. Certain types of arthritis can cause inflammation to develop in tendons, resulting in plantar fasciitis. This cause is particularly common among elderly patients. Diabetes is also a factor that can contribute to further heel pain and damage, particularly among the elderly. Among the most popular factors that contribute to plantar fasciitis is wearing incorrect shoes. In many cases, shoes either do not fit properly, or provide inadequate support or cushioning. While walking or exercising in improper shoes, weight distribution becomes impaired, and significantly stress can be added to the plantar fascia ligament.



Symptoms

Pain is the main symptom. This can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cm forward from your heel, and may be tender to touch. The pain is often worst when you take your first steps on getting up in the morning, or after long periods of rest where no weight is placed on your foot. Gentle exercise may ease things a little as the day goes by, but a long walk or being on your feet for a long time often makes the pain worse. Resting your foot usually eases the pain. Sudden stretching of the sole of your foot may make the pain worse, for example, walking up stairs or on tiptoes. You may limp because of pain. Some people have plantar fasciitis in both feet at the same time.



Diagnosis

Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past. The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.



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.

Plantar Fascia



Surgical Treatment

The most common surgical procedure for plantar fasciitis is plantar fascia release. It involves surgical removal of a part from the plantar fascia ligament which will relieve the inflammation and reduce the tension. Plantar fascia release is either an open surgery or endoscopic surgery (insertion of special surgical instruments through small incisions). While both methods are performed under local anesthesia the open procedure may take more time to recover. Other surgical procedures can be used as well but they are rarely an option. Complications of plantar fasciitis surgery are rare but they are not impossible. All types of plantar fasciitis surgery pose a risk of infection, nerve damage, and anesthesia related complications including systemic toxicity, and persistence or worsening of heel pain.



Prevention

An important part of prevention is to perform a gait analysis to determine any biomechanical problems with the foot which may be causing the injury. This can be corrected with orthotic inserts into the shoes. If symptoms do not resolve then surgery is an option, however this is more common for patients with a rigid high arch where the plantar fascia has shortened.

January 16 2015

tamathawessinger

What Leads To Pain In The Heel And Ways To Overcome It

Feet Pain

Overview

Plantar fasciosis is a foot condition characterized by heel pain and pain in your plantar fascia-a strong and dense connective tissue structure on the sole of your foot that supports your foot arch. This condition has historically been called plantar fasciitis because it was believed that plantar fascia inflammation was the principle underlying cause. Plantar fasciosis is a more accurate name for this condition because it involves degeneration-microtears, cell death-of your plantar fascia, not inflammation. Active men between the ages of 40 and 70 are most commonly affected by this health problem.



Causes

Plantar fasciitis is usually not the result of a single event but more commonly the result of a history of repetitive micro trauma combined with a biomechanical deficiency of the foot. Arthritic changes and metabolic factors may also playa part in this injury but are unlikely in a young athletic population. The final cause of plantar fasciitis is "training errors." In all likelihood the injury is the result of a combination of biomechanical deficiencies and training errors. Training errors are responsible for up to 60% of all athletic injuries (Ambrosius 1992). The most frequent training error seen with plantar fasciitis is a rapid increase in volume (miles or time run) or intensity (pace and/or decreased recovery). Training on improper surfaces, a highly crowned road, excessive track work in spiked shoes, plyometrics on hard runways or steep hill running, can compromise the plantar fascia past elastic limits. A final training error seen in athletics is with a rapid return to some preconceived fitness level. Remembering what one did "last season" while forgetting the necessity of preparatory work is part of the recipe for injury. Metabolic and arthritic changes are a less likely cause of plantar fasciitis among athletes. Bilateral foot pain may indicate a metabolic or systemic problem. The definitive diagnosis in this case is done by a professional with blood tests and possibly x-rays.



Symptoms

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as arthritis , or a nerve problem such as tarsal tunnel syndrome.



Diagnosis

Plantar fasciosis is confirmed if firm thumb pressure applied to the calcaneus when the foot is dorsiflexed elicits pain. Fascial pain along the plantar medial border of the fascia may also be present. If findings are equivocal, demonstration of a heel spur on x-ray may support the diagnosis; however, absence does not rule out the diagnosis, and visible spurs are not generally the cause of symptoms. Also, infrequently, calcaneal spurs appear ill defined on x-ray, exhibiting fluffy new bone formation, suggesting spondyloarthropathy (eg, ankylosing spondylitis, reactive arthritis. If an acute fascial tear is suspected, MRI is done.



Non Surgical Treatment

Stretching is the best treatment for plantar fasciitis. It may help to try to keep weight off your foot until the initial inflammation goes away. You can also apply ice to the sore area for 20 minutes three or four times a day to relieve your symptoms. Often a doctor will prescribe a nonsteroidal anti-inflammatory medication such as ibuprofen or naproxen. Home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treatment and reduce the chance of recurrence.

Plantar Fascia



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.



Stretching Exercises

While it's typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning, and three times during the day. Achilles Tendon Stretch. Stand with your affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot, and lean into a wall. Bend the front knee and keep the back knee straight, heel firmly planted on the floor. Hold for a count of 10. Plantar Fascia Stretch. Sit down, and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot--you should feel tension. Hold for a count of 10.

January 12 2015

tamathawessinger

What Brings About Plantar Fasciitis To Flare Up

Plantar Fasciitis

Overview

The plantar fascia is a thick, ligamentous connective tissue that runs from the heel bone to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. Thus, tremendous stress is placed on the plantar fascia, often leading to plantar fasciitis- a stabbing or burning pain in the heel or arch of the foot. Plantar fasciitis is particularly common in runners. People who are overweight, women who are pregnant and those who wear shoes with inadequate support are also at a higher risk. Prolonged plantar fasciitis frequently leads to heel spurs, a hook of bone that can form on the heel bone. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is the primary problem.



Causes

Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.



Symptoms

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



Diagnosis

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

If conservative treatments fail, and the symptoms of plantar fasciitis have not been relieved, the doctor may recommend one of the following treatments. Cortisone, or corticosteroids, is medications that reduce inflammation. Cortisone is usually mixed with local anesthetics and injected into the plantar fascia where it attaches to the heel bone. In many cases this reduces the inflammation present and allows the plantar fascia to begin healing. Local injections of corticosteroids may provide temporary or permanent relief. Recurrence of symptoms may be lessened by combining steroid injections with other forms of treatment such as orthotics, changes in shoe gear, weight loss, stretching exercises, and rest. Repeated cortisone injections may result in rupture of the plantar fascia, thinning of the heel's fat pad, and other tissue changes. Extracorporeal Shock Wave Therapy (ESWT) devices generate pulses of high-pressure sound that travel through the skin. For reasons that are not fully understood, soft tissue and bone that are subjected to these pulses of high-pressure energy heal back stronger. There is both a high-energy and low-energy form of ESWT; and both forms of shock wave therapy can be used in the treatment of plantar fasciitis. Research studies indicate ESWT is a safe and effective treatment option for plantar fasciitis. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery.

Plantar Fasciitis



Surgical Treatment

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



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

tamathawessinger

What Exactly May Cause Heel Discomfort

Heel Discomfort

Overview

Plantar fasciitis, or better termed chronic plantar heel pain, is likely caused by a combination of heel Compression, from standing with weight distributed on the heels. Abnormal stress on the foot, from decreased ankle flexibility, pronation, or a high BMI. Footwear, particularly a rigid sole and toe spring, which interferes with foot muscle activity, restricts circulation, and hinders the plantar fascia’s ability to absorb forces. Contrary to popular belief, the condition is not caused by inflammation in the traditional sense, and supportive footwear is possibly more likely to contribute to the problem than help it. Plantar fasciitis doesn’t develop from overuse or too much stress on plantar fascia. It happens when the wrong kind of stress replaces the good kind of stress that the foot needs to remain healthy. The aim of treatment therefore should not be reducing stress on the arch. Instead, treatment should focus on changing the types of stresses being applied and encouraging normal function of the foot.



Causes

It is common to see patients with Plantar Fasciitis who have been wearing shoes that are too soft and flexible. The lack of support can be stressful on the heel for those patients who’s feet aren’t particularly stable. If these ill fitting shoes are worn for long enough, the stress will lead to Heel Pain as the inflammation of the fascia persists. Footwear assessment and advice will be essential in order to get on top of the Plantar Fasciitis. It may surprise some people to learn that high heeled shoes are not the cause of Plantar Fasciitis, although they can cause tight calf muscles. High arches can lead to Plantar Fasciitis. This is due to the lack of contact under the sole of the foot. Even sports shoes which appear to have good arch support inside are often too soft and not high enough to make contact with the arch of the foot. Hence, the plantar fascia is unsupported. This can lead to Heel pain and Plantar Fasciitis. Flat feet can lead to Plantar Fasciitis. Flat feet is caused by ligament laxity and leads to foot instability. Other structures such as muscles, tendons and fascia work harder to compensate for this instability. Heel pain or Plantar Fasciitis arises when the instability is too great for these other structures to cope with. The strain on the fascia is too severe and the inflammation sets in. Over stretching can lead to Plantar Fasciitis. Certain calf stretches put the foot into a position that creates a pulling sensation through the sole of the foot. This can cause Plantar Fasciitis which can cause pain in the arch of the foot as well as Heel Pain.



Symptoms

The most obvious symptom of plantar fasciitis is a sharp pain on the bottom of the foot, near the heel. Here are some signals that this pain may be plantar fasciitis. The pain is strongest first thing in the morning but gets better after a few minutes of walking around. The pain is worse after standing for a long time or after getting up from sitting. The pain develops gradually and becomes worse over time. The pain is worse after exercise or activity than it is during activity. It hurts when stretching the foot. It hurts when pressing on the sides of the heel or arch of the foot.



Diagnosis

Plantar fasciitis is one of many conditions causing "heel pain". Some other possible causes include nerve compression either in the foot or in the back, stress fracture of the calcaneus, and loss of the fatty tissue pad under the heel. Plantar fasciitis can be distinguished from these and other conditions based on a history and examination done by a physician. It should be noted that heel spurs are often inappropriately thought to be the sole cause of heel pain. In fact, heel spurs are common and are nothing more than the bone's response to traction or pulling-type forces from the plantar fascia and other muscles in the foot where they attach to the heel bone. They are commonly present in patients without pain, and frequently absent from those who have pain. It is the rare patient who has a truly enlarged and problematic spur requiring surgery.



Non Surgical Treatment

A steroid (cortisone) injection is sometimes tried if your pain remains bad despite the above 'conservative' measures. It may relieve the pain in some people for several weeks but does not always cure the problem. It is not always successful and may be sore to have done. Steroids work by reducing inflammation. Sometimes two or three injections are tried over a period of weeks if the first is not successful. Steroid injections do carry some risks, including (rarely) tearing (rupture) of the plantar fascia. Extracorporeal shock-wave therapy. In extracorporeal shock-wave therapy, a machine is used to deliver high-energy sound waves through your skin to the painful area on your foot. It is not known exactly how it works, but it is thought that it might stimulate healing of your plantar fascia. One or more sessions of treatment may be needed. This procedure appears to be safe but it is uncertain how well it works. This is mostly because of a lack of large, well-designed clinical trials. You should have a full discussion with your doctor about the potential benefits and risks. In studies, most people who have had extracorporeal shock-wave therapy have little in the way of problems. However, possible problems that can occur include pain during treatment, skin reddening, and swelling of your foot or bruising. Another theoretical problem could include the condition getting worse because of rupture of your plantar fascia or damage to the tissues in your foot. More research into extracorporeal shock-wave therapy for plantar fasciitis is needed. Other treatments. Various studies and trials have been carried out looking at other possible treatments for plantar fasciitis. Such treatments include injection with botulinum toxin and treatment of the plantar fascia with radiotherapy. These treatments may not be widely available. Some people benefit from wearing a special splint overnight to keep their Achilles tendon and plantar fascia slightly stretched. The aim is to prevent the plantar fascia from tightening up overnight. In very difficult cases, sometimes a plaster cast or a removable walking brace is put on the lower leg. This provides rest, protection, cushioning and slight stretching of the plantar fascia and Achilles tendon. However, the evidence for the use of splint treatment of plantar fasciitis is limited.

Plantar Fascitis



Surgical Treatment

Surgery for plantar fasciitis can be very successful in the right patients. While there are potential complications, about 70-80% of patients will find relief after plantar fascia release surgery. This may not be perfect, but if plantar fasciitis has been slowing you down for a year or more, it may well be worth these potential risks of surgery. New surgical techniques allow surgery to release the plantar fascia to be performed through small incisions using a tiny camera to locate and cut the plantar fascia. This procedure is called an endoscopic plantar fascia release. Some surgeons are concerned that the endoscopic plantar fascia release procedure increases the risk of damage to the small nerves of the foot. While there is no definitive answer that this endoscopic plantar fascia release is better or worse than a traditional plantar fascia release, most surgeons still prefer the traditional approach.



Stretching Exercises

While it's typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning, and three times during the day. Achilles Tendon Stretch. Stand with your affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot, and lean into a wall. Bend the front knee and keep the back knee straight, heel firmly planted on the floor. Hold for a count of 10. Plantar Fascia Stretch. Sit down, and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot--you should feel tension. Hold for a count of 10.

January 03 2015

tamathawessinger

Symptoms Of Bunions

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

Orthotics are shoe insoles, custom-made to guide the foot into corrected biomechanics. Orthotics are commonly prescribed to help with hammer toes, heel spurs, metatarsal problems, bunions, diabetic ulcerations and numerous other problems. They also help to minimize shin splints, back pain and strain on joints and ligaments. Orthotics help foot problems by ensuring proper foot mechanics and taking pressure off the parts of your foot that you are placing too much stress on. Dr. Cherine's mission is to help you realize your greatest potential and live your life to its fullest.

Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

The spur occurs where the plantar fascia attaches, and the pain in that area is really due to the plantar fascia attachment being irritated. However, there are many people with heel spurs who have no symptoms at all. Haglund's deformity is a bony growth on the back of the heel bone, which then irritates the bursa and the skin lying behind the heel bone. Achilles tendinopathy is degeneration of the tendon that connects your calf muscles to your heel bone. Stress fractures are common in military training.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

Went to Podiatrist after receiving pain pills to move, got MRI and he told me I have severe tear in plantor faciitis tendon. Have swelling or what I call a fatty feeling, as I have always had on ball of foot below left most two toes. And it seems to feel a little more fatty since I walked for the first time today after putting on a good pair of ankle boots. Any idea what the fatty feeling is on ball of foot. Lastly, I took the boot off at my stairs into my house 2 days ago and took a step using ball of left foot and it did not pop.

December 16 2014

tamathawessinger

Regarding Achilles Tendinitis

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

Like any muscle or tendon in the body, the older we get, the more likely we are to sustain an injury. So middle-aged men and women are most at risk, with a slightly higher risk factor attributed to males. Those who participate in more intense athletic activities like high impact sports (tennis, running, basketball) are most susceptible to the injury. Certain underlying medical conditions can also be a contributing factor. Diabetics are more at risk of suffering from Achilles Tendinitis, as are those who are not in great physical shape. Some antibiotics, particularly fluoroquinolones can make one more likely to suffer a strained Achilles Tendon.



Symptoms

There will be a gradual onset of achilles tendon pain over a period of weeks, or even months. The pain will come on during exercise and is constant throughout the training session. Pain will be felt in the achilles tendon when walking especially up hill or up stairs. This is because the achilles is having to stretch further than normal. There is likely to be stiffness in the Achilles tendon especially in the morning or after a long period of rest. This is thought to be due to adhesions between the tendon sheath and the tendon itself. Nodules or lumps may be found in the achilles tendon, particularly 2-4cm above the heel and the skin will appear red. Pain and tenderness will be felt when pressing in on the achilles tendon which is likely to appear thickened or swollen. A creaking sensation may be felt when press the fingers into the sides of the tendon and moving the ankle.This is known as crepitus.



Diagnosis

Confirming Achilles tendonitis may involve imaging tests. X-rays provide images of the bones of the foot and leg. Magnetic resonance imaging (MRI) is useful for detecting ruptures and degeneration of tissue. Ultrasound shows tendon movement, related damage, and inflammation.



Nonsurgical Treatment

The main treatments for Achilles tendinitis do not involve surgery. It is important to remember that it may take at least 2 to 3 months for the pain to go away. Try putting ice over the Achilles tendon for 15 to 20 minutes, two to three times per day. Remove the ice if the area gets numb. Changes in activity may help manage the symptoms. Decrease or stop any activity that causes you pain. Run or walk on smoother and softer surfaces. Switch to biking, swimming, or other activities that put less stress on the Achilles tendon. Your health care provider or physical therapist can show you stretching exercises for the Achilles tendon. They may also suggest the following changes in your footwear, a brace or boot or cast to keep the heel and tendon still and allow the swelling to go down, heel lifts placed in the shoe under the heel, shoes that are softer in the areas over and under the heel cushion. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can help with pain or swelling. Talk with your health care provider. If these treatments do not improve symptoms, you may need surgery to remove inflamed tissue and abnormal areas of the tendon. Surgery also can be used to remove the bone spur that is irritating the tendon. Extracorporeal shock wave therapy (ESWT) may be an alternative to surgery for people who have not responded to other treatments. This treatment uses low-dose sound waves.

Achilles Tendinitis



Surgical Treatment

Surgery can be done to remove hardened fibrous tissue and repair any small tendon tears as a result of repetitive use injuries. This approach can also be used to help prevent an Achilles tendon rupture. If your Achilles tendon has already ruptured or torn, Achilles tendon surgery can be used to reattach the ends of the torn tendon. This approach is more thorough and definitive compared to non surgical treatment options discussed above. Surgical reattachment of the tendon also minimizes the change of re-rupturing the Achilles tendon.



Prevention

A 2014 study looked at the effect of using foot orthotics on the Achilles tendon. The researchers found that running with foot orthotics resulted in a significant decrease in Achilles tendon load compared to running without orthotics. This study indicates that foot orthoses may act to reduce the incidence of chronic Achilles tendon pathologies in runners by reducing stress on the Achilles tendon1. Orthotics seem to reduce load on the Achilles tendon by reducing excessive pronation,
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