What Can Induce Inferior Calcaneal Spur

28 Sep 2015 
Inferior Calcaneal Spur


Overview


A heel spur is a deposit of calcium on the heel bone. This calcification takes the form of a bony protrusion, which can cause considerable pain when standing and walking. This foot problem is closely related to plantar fasciitis, a condition in which the band of fibrous tissue on the bottom of the foot becomes over-stressed. It pulls away from the heel and causes the calcium deposits to form. For this reason, treating a heel spur involves treating the plantar fascia as well.


Causes


Fctors that increase the risk of developing heel spurs include a high body mass index (BMI), regular vigorous activity, and intensive training routines or sports. Factors such as these are believed to increase the incidence of repetitive stress injuries that are associated with the formation of heel spurs. When a heel spur forms, extremely sharp pain along with the feeling that a part of the heel is trying to burst through the skin usually occurs. If left untreated, an individual may eventually begin to struggle to perform simple activities such as walking.


Calcaneal Spur


Symptoms


Heel spurs can be quite painful, but can just as likely occur with no symptoms at all. Plantar fasciitis is a contributing condition to heel spurs. The cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. The feeling has been described as a knife or pin sticking into the bottom of your feet when you first stand up after sitting or laying down for a long period of time - a pain that later turns into a dull ache.


Diagnosis


Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.


Non Surgical Treatment


Acupuncture and acupressure can used to address the pain of heel spurs, in addition to using friction massage to help break up scar tissue and delay the onset of bony formations. Physical therapy may help relieve pain and improve movement. The Feldenkrais method could be especially helpful for retraining some of the compensation movements caused by the pain from the spur. Guided imagery or a light massage on the foot may help to relieve some of the pain. Other treatments include low-gear cycling, and pool running. Some chiropractors approve of moderate use of aspirin or ibuprofen, or other appropriate anti-inflammatory drugs. Chiropractic manipulation is not recommended, although chiropractors may offer custom-fitted shoe orthotics and other allopathic-type treatments.


Surgical Treatment


Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.
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Simple Methods To Prevent Inferior Calcaneal Spur

25 Sep 2015 
Heel Spur


Overview


Bone spurs (retrocalcaneal spur, or exostosis) can develop not only on the back of the heel, but also on the toes, mainly around the fifth (small) toe. Most often, they occur next to the toenail on the outside of the toe; on the inside of the toe near the tip, where the fifth toe presses against the fourth toe; and on the inside of the base of the toe. Bone spurs can also occur on the sides of the toes. This is usually due to wearing shoes that are too tight in the toe box, which causes the toes to press against each other. Bone spurs may also develop in the arch area of the top of the foot; this area becomes painful when you tie your shoelaces tightly or exert other pressure on that part of the foot. Formation of spurs in this area is often associated with arthritis.


Causes


Over-pronation (flat feet) is a common cause of heel spurs, 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.


Inferior Calcaneal Spur


Symptoms


Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.


Diagnosis


A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.


Non Surgical Treatment


The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight, wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion to the heel, and reduce the amount of shock and shear forces experienced from everyday activities.


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.
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Bursa Foot Surgery Treatment

26 Aug 2015 
Overview


Bursitis occurs when a bursa is irritated from frequent pressure and it becomes inflamed. Due to the location close the Achilles tendon, Achilles bursitis is often mistaken for tendinitis. Achilles bursitis is a common overuse injury in runners, ice skaters and other athletes.


Causes


Your ankle bursitis may have been caused by one or more of the following Pressure on your ankle and heels. This is often caused by running or exercising on uneven ground. The way that you exercise may also cause ankle bursitis or make it worse. It may be caused by wearing poorly fitting shoes that constantly rub against the heel. Direct, hard hit to your heel. Infection (in-FEK-shun). Medical problems such as rheumatoid (ROO-ma-toid) arthritis (ahr-THREYE-tis) or gout. Overusing your ankles. This is caused by doing activities or sports that use the same motions (movements) over and over again. Examples of repeating motions are running, walking, or jumping. Sometimes people do not know how they developed ankle bursitis.


Symptoms


You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts worse when you run, walk up hill or wear high heels.


Diagnosis


If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.


Non Surgical Treatment


You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping. Ice. Place a plastic bag with ice on the foot for 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications. Compression. Lightly wrap an elastic bandage from the toes to mid calf, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold. Elevate. Make sure to elevate the ankle above heart level. To improve symptoms of plantar calcaneal bursitis after the acute phasetry the baked bean tin stretch, using a baked bean tin roll the foot backwards and forwards. 2 minutes in the morning before putting the foot to the floor. 5-10 minutes every evening. Contrast foot baths. 10 minutes warm water. 10 minutes cool water morning and evening (morning may be missed if time is restricted). Stretches. Start with 10 stretches per day, holding the stretch for 30 seconds, then relax and then repeat. Continue this stretch daily until you can no longer feel it pulling on the heel, then progress to stretch. Do 10 per day holding for 30 seconds per stretch. When you can no longer feel it pulling on the heel proceed to stretches. Do 10 per day holding for 30 seconds on every stretch.


Surgical Treatment


Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.
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Hammer Toe Treatment Rehab

02 Jul 2015 
HammertoeOverview


Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A Hammer toes is a toe that bends down toward the floor at the middle toe joint. It usually happens in the second toe. This causes the middle toe joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the joints where the toes and the foot meet. They bend down at both the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often happens to the second toe, but it may happen in the other toes as well. The toe bends down at the joint closest to the tip of the toe.


Causes


Hammer toe may also be caused by other medical conditions such as rheumatoid arthritis, osteoarthritis, or stroke because these forms of illnesses involve affectation of the person's muscles and nerves. Diabetes is also a causative factor for hammer toes due to diabetic neuropathy, which often times accompanies advanced instances of diabetes. Injury to a person's toes may also cause hammer toes, particularly if the injury involves breaking Hammer toes of the toes. In some instances, hammer toes may be hereditary. Some people may be genetically predisposed to develop the condition because of the natural structure of their bodies.


HammertoeSymptoms


The most obvious sign of hammertoes are bent toes, other symptoms may include pain and stiffness during movement of the toe. Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box. Painful calluses on the bottoms of the toe or toes. Pain on the bottom of the ball of the foot. Redness and swelling at the joints.


Diagnosis


Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.


Non Surgical Treatment


What will a doctor do? Treat any foot complaints such as corns, calluses by periodically reducing the lesion and applying appropriate pads and dressings. Recommend the silicone toe prop. If an infection is present, then anti-septic dressings, antibiotics and pads to redistribute pressure away from the lesion may be necessary. In the case of a mallet toe, trigger toe or claw toe. If a corn occurs at the end of the toe, a silicone or leather prop may be used to straighten the toe. In a hammertoe deformity, a silicone prop to redistribute pressure away from a corn may be necessary. The doctor may give footwear advice. In severe cases, corrective surgery may be necessary. The doctor may recommend orthosis to correct a mechanical complaint of the foot, such as 3/4 length silicone insoles.


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


To help prevent hammertoe, wear roomy, low-heeled shoes that allow plenty of width and length for the toes. The Mayo Clinic recommends wearing shoes that have at least 1/2 inch of space between the shoe and the longest toe.
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Could Hammer Toes Result In Foot Tingling

28 Jun 2015 
Hammer ToeOverview


hammertoes is a painful deformity wherein a toe bends unnaturally and becomes clawlike. This happens because the tendons of the toe contract abnormally, forcing the toe to bend downward and the middle joint of the toe to protrude upward. Although any toe may be affected, hammertoe usually affects the second toe. The toe assumes a clawlike position and cannot be straightened out. When someone with hammertoe wears shoes, the toe is constantly rubbed, so walking may become especially painful if a callus on the sole of the foot or a corn on the top of a toe develops.


Causes


Hammer toe usually affects the second toe. However, it may also affect the other toes. The toe moves into a claw-like position. The most common cause of hammer toe is wearing short, narrow shoes that are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter. Hammer toe is more likely to occur in women who wear shoes that do not fit well or have high heels and children who keep wearing shoes they have outgrown. The condition may be present at birth (congenital) or develop over time. In rare cases, all of the toes are affected. This may be caused by a problem with the nerves or spinal cord.


HammertoeSymptoms


People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.


Diagnosis


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


Non Surgical Treatment


There are several treatment options. These hammertoe are based on how severe the problem has become. The sooner a person seeks treatment, the more options that person may have. Wear properly fitting shoes; this does not necessarily mean expensive shoes. Padding any prominent areas around the bony point of the toe may help to relieve pain. Medication that reduces inflammation can ease the pain and swelling. Sometimes a doctor will use cortisone injections to relieve acute pain. A podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammer toe from getting worse. Your doctor may recommend foot exercises to help restore muscle balance. Splinting the toe may help in the very early stages.


Surgical Treatment


Several surgical procedures are available to the podiatric physician. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain. Severe hammertoes, which are not fully reducible, may require more complex surgical procedures. Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatric physician.


HammertoePrevention


elect and wear the right shoe for specific activities (such as running shoes for running). Alternate shoes. Don't wear the same pair of shoes every day. Avoid walking barefoot, which increases the risk for injury and infection. At the beach or when wearing sandals, always use sunblock on your feet, as you would on the rest of your body. Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one. It is critical that people with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they are more prone to infection.
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Causes Of Bunions

18 Jun 2015 
Overview
Bunions Hard Skin A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe ( metatarsophalangeal joint ). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallux Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Causes
Bunions are a result of complex biomechanical changes that occur in your feet. The type of footwear that you wear does cause bunions. We know that foot bunions occur in about 30% of the population of most Western countries but only 3% in Eastern countries. They are seen most commonly in women and become more common as people get older. Tight-fitting shoes are thought to be the main cause of bunions.. Shoes such as high heels and shoes with tight toe boxes (eg womens fashion shoes and cowboy boots) are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. The slope causes the front of the foot to bear your weight, which encourages your forefoot to widen. Also, the angle pushes your toes into the narrow toe box, causing the toes to become angled and squeezed together.

Symptoms
Just because you have a bunion does not mean you have to have pain. There are some people with very severe bunions and no pain and people with mild bunions and a lot of pain. Symptoms for a bunion may include pain on the inside of your foot at the big toe joint. Swelling on the inside of your foot at the big toe joint. Redness on the inside of your foot at the big toe joint. Numbness or burning in the big toe (hallux). Decreased motion at the big toe joint. Painful bursa (fluid-filled sac) on the inside of your foot at the big toe joint. Pain while wearing shoes, especially shoes too narrow or with high heels. Joint pain during activities. Other conditions which may appear with bunions include corns in between the big toe and second toe. Callous formation on the side or bottom of the big toe or big toe joint. Callous under the second toe joint. Pain in the second toe joint.

Diagnosis
The doctor considers a bunion as a possible diagnosis when noting the symptoms described above. The anatomy of the foot, including joint and foot function, is assessed during the examination. Radiographs (X-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes when taken in a standing position.

Non Surgical Treatment
The treatment of a bunion depends entirely on how uncomfortable it is. Realistically, there are only two ways to treat a bunion: either change the size and shape of the shoe or change the size and shape of the foot. Once a bunion gets to be irritating or painful and shoe wear is uncomfortable, surgery may be recommended. Bunion Pain

Surgical Treatment
To end persistent pain, your doctor may recommend a type of foot surgery called a bunionectomy to remove the bunion and perhaps to reshape the first toe joint. During the operation, the swollen tissue will be removed, the big toe will be straightened if necessary, and the bones of the affected joint may be reshaped or permanently joined. The goal of the surgery is to correct the cause of the bunion and to prevent the bunion from growing back. After surgery, pain medication will be prescribed, and you will be told when you can start moving your toes and ankle.

Prevention
Proper footwear may prevent bunions. Wear roomy shoes that have wide and deep toe boxes (the area that surrounds the toes), low or flat heels, and good arch supports. Avoid tight, narrow, or high-heeled shoes that put pressure on the big toe joint. Medicine will not prevent or cure bunions.
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Study Over-Pronation

01 Jun 2015 
Overview


Over-pronation describes a characteristic gait wherein a lack of sufficient support from the arch of the foot causes it to roll inwards as weight is placed on it. The long arch of the foot is actually a very important structure in terms of our gait and how we walk, it is responsible for ensuring that as our weight rolls from the heel to the balls of our feet it does so in a straight line that doesn?t place undue stress on the ankle or knees. Unfortunately when a person?s arch is not pronounced enough, or even simply not there (a condition called flat footedness), there isn?t enough arch support to maintain a healthy, forward motion of the foot.Pronation


Causes


A common cause of pronation is heredity - we can inherit this biomechanical defect. The second most common cause is due to the way our feet were positioned in the uterus while we were developing; this is called a congenital defect. In either instance, the following occurs in our feet during our development.


Symptoms


People with overpronation may suffer from pain in the knees, hips, and low back. Overpronation itself does not necessarily cause any other symptoms but is a contributing factor of many foot conditions such as Plantar Facsiitis, Heel Spur Syndrome, Posterior Tibialis Tendon Rupture or Tendonitis, Hallux Valgus, Bunion Deformities, Metatarsalgia, Hallux Limitus or Hallux Rigidus, Hammer Toes, and Morton?s Neuroma.


Diagnosis


When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.Overpronation


Non Surgical Treatment


Treatment with orthotics will provide the required arch support to effectively reduce excessive pronation and restore the foot and its posture to the right biomechanical position. It should be ensured that footwear has sufficient support, for example, shoes should have a firm heel counter to provide adequate control.


Surgical Treatment


Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%, depending on manufacturer. HyProCure Implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.
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