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Sep242015

Identifying Inferior Calcaneal Spur

Inferior Calcaneal Spur


Overview


Heel spurs occur in at least half the people who have plantar fasciitis, a painful condition involving the thick tissue that runs between your heel bone and your toes. In the past, doctors often performed surgery to remove heel spurs, believing them to be the cause of the pain associated with plantar fasciitis. In treating plantar fasciitis now, doctors rely more on ice, arch supports, physical therapy and pain medications, and surgery is rarely performed.


Causes


Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.


Calcaneal Spur


Symptoms


The vast majority of people who have heel spurs feel the asscociated pain during their first steps in the morning. The pain is quite intense and felt either the bottom or front of the heel bone. Typically, the sharp pain diminishes after being up for a while but continues as a dull ache. The pain characteristically returns when first standing up after sitting for long periods.


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


In some cases, heel spur pain may not be resolved through conservative treatment options. In those cases, cortisone injections may be used to reduce inflammation associated with the condition, helping to reduce discomfort. However, treatment options such as these must be discussed in detail with your physician, since more serious forms of treatment could yield negative side effects, such as atrophy of the heel's fat pad, or the rupture of the plantar fascia ligament. Although such side effects are rare, they are potential problems that could deliver added heel pain.


Surgical Treatment


In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.


Prevention


To prevent this condition, wearing properly fitted shoes with good arch support is very important. If a person is overweight, weight loss can help diminish stress on the feet and help prevent foot problems. For those who exercise frequently and intensely, proper stretching is always necessary, especially when there is an increase in activities or a change in running technique. It is not recommended to attempt to work through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long-lasting and painful episode of the condition.

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Aug262015

Cure For Bursitis In Ball Of Foot

Overview


Retrocalcaneal bursitis is a painful inflammation of the soft tissues at the attachment of the Achilles tendon to the back of the heel bone. The retrocalcaneus identifies the ?retro? or behind and ?calcaneus? or heel bone. Bursitis relates to inflammation of a bursa in the retrocalcaneal region. A bursa anatomically is a fluid filled sack that is located around tendinous attachments in the body. The retrocalcaneal bursa as identified in the photo 1 protects the Achilles tendon just prior to its insertion to the retrocalcaneal region. The retrocalcaneal bursa cushions the Achilles tendon and normally allows pain free motion of the Achilles tendon over the calcaneus.


Causes


The most common cause of bursitis is repeated physical activity, but it can flare up for no known reason. It can also be caused by trauma, rheumatoid arthritis, gout, and acute or chronic infection.


Symptoms


A dull ache under the heel when not weight bearing. Sometimes severe pain when walking. Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again. Throbbing under the heel. Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself. Tingling under the heel as swelling affect the plantar nerves. Pains shooting into the foot or up the leg.


Diagnosis


Plain radiographs of the calcaneus may reveal a Haglund deformity (increased prominence of the posterosuperior aspect of the calcaneus). However, on weight-bearing lateral radiographs, the retrocalcaneal recess often appears normal even in patients with retrocalcaneal bursitis, limiting its usefulness in making this diagnosis.Radiographs may be used as a diagnostic measure to support a clinician?s diagnosis of retrocalcaneal bursitis. Individuals with retrocalcaneal bursitis may have an absence of the normal radiolucency (ie, blunting) that is seen in the posteroinferior corner of the Kager fat pad, known as the retrocalcaneal recess or bursal wedge. This may occur with or without an associated erosion of the calcaneus.


Non Surgical Treatment


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


Prevention


Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.

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Aug192015

Hammer Toe Disorder

Hammer ToeOverview


A Hammer toes is a deformity of the middle joint of a toe, producing a clenched, clawlike appearance in the affected digit. The tendons in the toe become abnormally contracted, causing the toe to bend downward, which, in turn, forces the joint to protrude upward. A mallet toe is a deformity in which the end joint of a toe becomes bent downward, so that the toe curls underneath itself. In either case the affected joints are stiff, and often the toe cannot be straightened out. Constant rubbing against shoes may furthermore cause a painful corn (a round patch of rough, thickened, calloused skin) to develop over the joint or at the tip of the affected toe. Hammer and mallet toes may occur in any toe, although the second toe is the most common site. These deformities are often painful and limit the toe?s range of motion-sometimes requiring surgery.


Causes


Flat feet can result in hammertoes, this is due to poor mechanics off the foot. High arched feet can also result in buckling toes. A major cause is in hereditary, all the toe conditions mentioned could be acquired due in hereditary factors. Bunions are a major cause of hammertoes. Claw toes are usually the result of a shoe that is too short. For many people, the second toe is actually longer than the great toe, and if shoes are sized to fit the great toe, the second (and maybe even the third toe) will have to bend to fit into the shoe. Shoes that are pointed make matters even worse. Combine pointed shoes with high heels, the foot is under similar pressure as if it was constantly being pushed downhill into a wall. Rheumatoid arthritis can also lead to bunions, which in turn can lead to hammer toes.


Hammer ToeSymptoms


Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be treated conservatively and/or with surgery.


Diagnosis


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


Non Surgical Treatment


In the earlier stages of hammer toe, when the toes can still be manually straightened, then conservative treatment is appropriate. This means wearing shoes which are a half size bigger than normal and which are not narrow around the toes. Exercises to stretch the toes out and strengthen the muscles under the foot which balances the tightness of the top tendons are important. Padding or corn plasters can be used to ease the discomfort of any associated corns and calluses.


Surgical Treatment


Surgical correction is necessary in more severe cases and may consist of removing a bone spur (exostectomy) removing the enlarged bone and straightening the toe (arthroplasty), sometimes with internal fixation using a pin to realign the toe; shortening a long metatarsal bone (osteotomy) fusing the toe joint and then straightening the toe (arthrodesis) or simple tendon lengthening and capsule release in milder, flexible hammertoes (tenotomy and capsulotomy). The procedure chosen depends in part on how flexible the hammertoe is.


HammertoePrevention


If you notice the beginning signs of hammertoe, you may be able to prevent the tendons from tightening by wearing toe-friendly shoes, by flattening your toes regularly, and by soaking your feet every day in warm water, then stretching your toes and ankles by pointing your toes. Foot exercises also can help to maintain or restore the flexibility of the tendons. One simple exercise is to place a small towel on the floor and then pick it up using only your toes. You also can grasp at carpet with your toes or curl your toes up and down repeatedly.

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Jun232015

Hammer Toe Treatment In Your Own Home

Hammer ToeOverview


hammertoes a bending and hardening of the joints of the second, third, fourth, or fifth toes. If you look down at your feet and you can?t see the tips of the toenails, you might suffer from hammertoe. Early signs of hammertoe are a bend in the joint of any toe except the big toe. The bend in the joint causes the top of the toe to appear to curl under as if it?s ?hammering? into the floor.


Causes


Most hammertoes are caused by wearing ill-fitting, tight or high-heeled shoes over a long period of time. Shoes that don't fit well can crowd the toes, putting pressure on the middle toes and causing them to curl downward. The condition may be more likely when the second toe is longer than the first toe or when the arch of the foot is flat. Hammertoe can also be present at birth (congenital). Hammertoe also can be caused by a bunion, which is the knobby bump that sometimes develops at the side of the big toe. A bunion causes the big toe to bend toward the other toes. The big toe can then overlap and crowd the smaller toes. Occasionally, a hammertoe is inherited or caused by arthritis in the toe joint.


Hammer ToeSymptoms


Patients with hammer toe(s) may develop pain on the top of the toe(s), tip of the toe, and/or on the ball of the foot. Excessive pressure from shoes may result in the formation of a hardened portion of skin (corn or callus) on the knuckle and/or ball of the foot. Some people may not recognize that they have a hammer toe, rather they identity the excess skin build-up of a corn.The toe(s) may become irritated, red, warm, and/or swollen. The pain may be dull and mild or severe and sharp. Pain is often made worse by shoes, especially shoes that crowd the toes. While some hammer toes may result in significant pain, others may not be painful at all. Painful toes can prevent you from wearing stylish shoes.


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


There are many non-surgical treatments to help relieve symptoms of hammertoe. The first step for many people is wearing the right size and type of shoe. Low-heeled shoes with a boxy or roomy toe area are helpful. Cushioned insoles, customized orthopedic inserts, and pads can provided relief as well. Splints or straps hammertoe may be used to help correct toe position. Your doctor may show you toe stretches and exercises to perform. Your doctor can safely remove corns and calluses. You should not try to remove them at home.


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


You can avoid many foot, heel and ankle problems with shoes that fit properly. See your doctor if you have foot pain that's persistent and that affects your ability to walk properly and carry out other motions with your foot. Also, see your doctor if one or more of your toes has developed a clenched or claw-like appearance.

Admin · 139 views · 0 comments
Jun172015

Why Do I Have Hallux Valgus?

Overview
Bunion Pain Even though bunions are a common foot deformity, there are misconceptions about them. Many people may unnecessarily suffer the pain of bunions for years before seeking treatment. A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion?s ?bump.? Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones over the years and slowly producing the characteristic bump, which becomes increasingly prominent. Symptoms usually appear at later stages, although some people never have symptoms.

Causes
With prolonged wearing of constraining footwear your toes will adapt to the new position and lead to the deformity we know as a foot bunion. Footwear is not the only cause of a bunion. Injuries to the foot can also be a factor in developing a bunion. Poor foot arch control leading to flat feet or foot overpronation does make you biomechanically susceptible to foot bunions. A family history of bunions also increases your likelihood of developing bunions. Many people who have a bunion have a combination of factors that makes them susceptible to having this condition. For example, if you are a women over the age of forty with a family history of bunions, and often wear high-heeled shoes, you would be considered highly likely to develop a bunion.

Symptoms
A bulging bump on the outside of the base of your big toe. Swelling, redness or soreness around your big toe joint aggravated by footwear. Red, calloused skin along the inside edge of the big toe. Corns or calluses under the ball of the foot or where the first and second toes overlap. Persistent or intermittent pain. Restricted movement of your big toe.

Diagnosis
Physical examination typically reveals a prominence on the inside (medial) aspect of the forefoot. This represents the bony prominence associated with the great toe joint ( the medial aspect of the first metatarsal head). The great toe is deviated to the outside (laterally) and often rotated slightly. This produces uncovering of the joint at the base of the big toe (first metatarsophalangeal joint subluxation). In mild and moderate bunions, this joint may be repositioned back to a neutral position (reduced) on physical examination. With increased deformity or arthritic changes in the first MTP joint, this joint cannot be fully reduced. Patients may also have a callus at the base of their second toe under their second metatarsal head in the sole of the forefoot. Bunions are often associated with a long second toe.

Non Surgical Treatment
Wide shoes with plenty of space for the toes are the first place to start. Along these lines, a shoe can be focally stretched directly over the painful bunion using a device known as a ?ball and ring? shoe stretcher. Additionally, numerous commercial bunion braces and splints are available to help keep the big toe in better alignment. Bunion Pain

Surgical Treatment
Bunion surgery is usually done as an out patient procedure, so the patient does not have to stay in hospital overnight although it is usually performed under a general anesthetic. The procedure involves the surgeon making a cut on the inside of the big toe joint and removing excess bone whilst also repositioning ligaments and tendons. The joint may be fixed with screws or wires, which may be dissolve, or may be removed at a later date or in some cases, remain in the foot permanently. After the operation the foot will be immobilized, often in a cast for 4 to 8 weeks to keep the bones in alignment. Crutches will usually be issued to help the patient get around. After this period, the foot will be assessed to check the bones have healed correctly. At which point full weight bearing may be gradually introduced.

Prevention
The best way to reduce your chances of developing a bunion is to wear shoes that fit properly. Any shoe that is too tight or too high will force your toes together and may cause the condition to develop. Shoes need to be wide enough, so they aren't rubbing against the joint, and preferably made of leather. Avoid shoes with a lot elaborate stitching at the front, as this can also cause irritation. Heels should be no more than three to four inches and you should only wear them occasionally. Court shoes should seldomly be worn, as they do not give the foot any support. Be honest with yourself, you know if your shoes aren't fitting you comfortably. Do something about it, or you will suffer for your vanity.

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