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Feet Trouble Solved

Pes Planus What To Look For

Overview

Acquired Flat Foot

Flat feet can also develop as an adult ("adult acquired flatfoot") due to injury, illness, unusual or prolonged stress to the foot, faulty biomechanics or as part of the normal aging process. This is most common in women over 40 years of age. Known risk factors include obesity, hypertension and diabetes.Flat feet can also occur in pregnant women as a result of temporary changes, due to increased elastin (elasticity) during pregnancy. However, if developed by adulthood, flat feet generally remain flat permanently.

Causes

There are many reasons why flat feet develop. Here?s a look at some of the most common causes. Genetics, weak arches, injury, arthritis, diabetes, age, wear and tear on feet, tibialis posterior (ruptured tendon). Nervous system or muscle diseases such as cerebral palsy. Weakness and tightness of other muscles and tendons higher up in the lower extremity. The way our arches form depends on several factors. Our feet are complex structures that comprise twenty-six bones, thirty-three joints, and more than 100 muscles, tendons, and ligaments each. Each foot forms two arches. The arch that runs from the heel to the toe is known as the longitudinal arch, while the one that runs the width is known as the transverse arch. Ligaments (fibrous tissues) give our arches their shape and hold our bones together. The plantar fascia (the long, strong band of connective tissue that runs along the sole of your foot) and muscles add secondary support. There are also foot pads that absorb impact and assist with weight-bearing functions. How these things intertwine and work together determines the formation of our arches. A structural abnormality or injury to one of these components can result in flatfoot.

Symptoms

A symptom is something the patient feels and reports, while a sign is something other people, including the doctor may detect. An example of a symptom may be pain in the ankle, while a sign may be a swelling. Symptoms may vary and generally depend on the severity of the condition. Some have an uneven distribution of bodyweight and find that the heel of their shoes wears out more rapidly and more on one side than the other. The most common signs or symptoms of flat feet are pain in the ankle (inner side), there may also be swelling of the foot in general, swelling in the arch of the foot, the calf, knee, the hip, the back, the general lower leg area. People with flat feet may also experience stiffness in one or both feet. One or both feet may be flat on the ground (either no arch, or very slight arch). Shoes may wear unevenly.

Diagnosis

You can always give yourself the ?wet test? described above to see whether you have flat feet. Most people who do not notice their flat feet or have no pain associated with them do not think to see a foot doctor. Flat feet can lead to additional problems such as stiffness or pain, however, especially if the condition appears out of nowhere. If you think you may have flat feet, you should seek medical attention to ensure there are no additional issues to worry about. Your doctor will be able to diagnose you with a number of tests. For example, he or she may have you walk around, stand still, or stand on your tiptoes while you are being examined. Your doctor may also examine your foot?s shape and functionality. It?s important to let your foot doctor know about your medical and family history. In some cases, your doctor may order imaging tests such as x-rays or an MRI (magnetic resonance imaging) to determine a cause of your flat foot. If tarsal coalition is suspected in children, a CT scan is often ordered.

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Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Procedures may include the following. Fusing foot or ankle bones together (arthrodesis). Removing bones or bony growths, also called spurs (excision). Cutting or changing the shape of the bone (osteotomy). Cleaning the tendons' protective coverings (synovectomy). Adding tendon from other parts of your body to tendons in your foot to help balance the "pull" of the tendons and form an arch (tendon transfer). Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening).

Prevention

Wear Supportive Footwear. Spend the money it takes to get proper fitting and quality footwear with good arch supports. Most sufferers of fallen arches and plantar fasciitis are born with high arches that sag as they get older. Good footwear can prevent this from becoming a problem. Flat feet, however, can become just as problematic. So, really we should all be wearing good footwear to avoid this potentially painful condition. Take It Easy. If your heel starts to hurt, take a rest. If the pain doesn?t go away after several days of resting, it may be time to see a podiatrist. Orthotics. Special insoles to support the arch of the foot can provide some much needed help. You can buy these at your local drugstore (not recommended), or you can have them specially made and custom fit for your feet. It can take awhile to get just the right one for your foot, but sometimes it can be just what you needed. Weight Control. Yes, maintaining a sensible diet with your ideal weight can be beneficial in many ways. It makes sense to think that the more weight your arches are supporting, the more easily they will fall and become painful.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.
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All The Things You Might Want To Know About

Overview

Heel Discomfort

The heel bone is the largest of the 26 bones in the human foot. But while it is a large, strong bone, it is often injured, and this pain can be quite disabling at times. Heel pain can occur in the front, back, sides or bottom of the heel. That the heel is commonly injured is not surprising, perhaps, given the amazing amount of stress it must endure during a day. Indeed, it is one of the most common injuries of the foot; we see some variation of heel pain in our offices an average of 5 or 6 times per day.

Causes

Age plays a large role in the development of heel pain, particularly among those over 40. Being active is also a common factor of heel pain. Over time, the elasticity of the tissue in our feet decreases with age, causing us to become prone to damage and also slowing the body's ability to heal damage. Adolescents are also not immune to heel pain. Those who are active in sports are particularly prone to excessively stretching or straining the plantar fascia or Achilles tendon, causing severe heel pain. In most cases, heel pain develops in only one heel. There are many risk factors that lead to heel pain. Abnormal gait and excessive, repetitive stress are common factors in the development of pain and damage. Among the other risk factors involved with the development of heel pain are repetitive exercise or activities, such as long distance running or jumping from activities such as basketball. Obesity. Walking barefoot on hard surfaces. Prolonged standing. Wearing poor fitting shoes, or shoes that do not provide enough support or cushioning. Not stretching properly or at all before and after exercise. Those who are on their feet for long periods of time.

Symptoms

Sever?s Disease. This is a condition that occurs in 10 - 15 year old children, predominantly boys and is associated with running and repetitive jumping. It is also associated with flimsy footwear that kids may wear. It occurs when the Achilles tendon continually pulls on the apophysis of the calcaneum and does not allow for it to fuse with the body of the calcaneum. Calcaneal enthesopathy. This occurs when there is repetitive trauma at the attachment of the Achilles tendon, resulting in a spur from the calcaneum up into the Achilles tendon. It is usually visualized on x-ray and may be tender if there is an associated bursitis or tendonitis. "Pump Bump". Also known as Haglund?s Deformity, this is a bony enlargement that exists on the back of the heel - usually related to a congenital abnormality or with chronic bursitis, causing a thickening. There may have already been trauma or pressure from footwear. Treatment is usually protection of the bump and correct footwear. Associated with a symmetrical swelling at the base of the Achilles tendon. It is usually related to repetitive trauma or inappropriate footwear. It is often red and hot in the early stages. Treatment is usually to correct the footwear, provide padding and treat the local symptoms e.g. ice, rest, physiotherapy and cortisone injection. Fat Pad Syndrome. Direct contact with the base of the heel may result in trauma to the fat pad. Related to obesity, training on hard surfaces, uneven grounds, poor shoes especially overlarge shoes which can cause shearing forces on the heel. These conditions are renowned for taking a long time to recover - usually many months.

Diagnosis

A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.

Non Surgical Treatment

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

Surgical Treatment

Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to have a "numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).

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Prevention

Feet Pain

Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.

Leg Length Discrepancy Subsequent To Knee Replacement Surgery

Overview

Leg length discrepancy is a condition where the length of one leg is different than the other (shorter or longer) because of either or both a functional (muscle/posture) or structural (bone/cartilage) abnormality. In the specific a functional leg length occurs when your legs are the same, but another condition such as pelvic tilt or piriformis shortening creates the appearance of one leg being longer or shorter than the other. A structural leg length inequality it means that there is a true difference. Osteopaths, chiropractors and physiotherapist should be able to determine the degree of leg length inequality using visual inspection and manual tests.Leg Length Discrepancy

Causes

Leg discrepancy can develop from a medical issue in any portion of the femur or tibia. One leg may lengthen, but leg shortening is much more common. Factors that can cause leg length discrepancy include inherited growth deficiencies. Infections. A bone infection can cause delayed growth in the affected limb. Injury. If your child breaks a leg, it may be shorter once it heals. This is most likely to happen if the fracture or break was complicated, an open fracture, or an injury that affected the growth plate near the end of the bone. Alternatively, a break can cause bones to grow faster after healing, making a leg longer. Tumors. Legg-Calve-Perthes disease. This is a condition that affects the ball (femoral head) of the hip joint. The femoral head may be friable and damage easily, sometimes leading to shortening of the thigh bone. Hemihypertrophy. In children with this condition, one side of the body grows more quickly than the other. Vascular malformations. These are abnormal clusters of veins and arteries that can form close to the bone and stimulate growth. Juvenile arthritis. Inflammation from arthritis can stimulate growth in the affected leg and cause discrepancy.

Symptoms

The symptoms of limb deformity can range from a mild difference in the appearance of a leg or arm to major loss of function of the use of an extremity. For instance, you may notice that your child has a significant limp. If there is deformity in the extremity, the patient may develop arthritis as he or she gets older, especially if the lower extremities are involved. Patients often present due to the appearance of the extremity (it looks different from the other side).

Diagnosis

A doctor will generally take a detailed medical history of both the patient and family, including asking about recent injuries or illnesses. He or she will carefully examine the patient, observing how he or she moves and stands. If necessary, an orthopedic surgeon will order X-ray, bone age determinations and computed tomography (CT) scans or magnetic resonance imaging (MRI).

Non Surgical Treatment

Treatment of leg length inequality involves many different approaches, such as orthotics, epiphysiodesis, shortening, and lengthening, which can be used alone or combined in an effort to achieve equalization of leg lengths. Leg length inequality of 2 cm or less is usually not a functional problem. Often, leg length can be equalized with a shoe lift, which usually corrects about two thirds of the leg length inequality. Up to 1 cm can be inserted in the shoe. For larger leg length inequalities, the shoe must be built up. This needs to be done for every shoe worn, thus limiting the type of shoe that the patient can wear. Leg length inequalities beyond 5 cm are difficult to treat with a shoe lift. The shoe looks unsightly, and often the patient complains of instability with such a large lift. A foot-in-foot prosthesis can be used for larger leg length inequalities. This is often done as a temporizing measure for young children with significant leg length inequalities. The prosthesis is bulky, and a fixed equinus contracture may result.

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Surgical Treatment

Surgery to shorten the longer leg. This is less involved than lengthening the shorter leg. Shortening may be done in one of two ways. Closing the growth plate of the long leg 2-3 years before growth ends (around age 11-13), letting the short leg catch up. This procedure is called an epiphysiodesis. Taking some bone from the longer leg once growth is complete to even out leg lengths. Surgery to lengthen the shorter leg. This surgery is more involved than surgery to shorten a leg. During this surgery, cuts are made in the leg bone. An external metal frame and bar are attached to the leg bone. This frame and bar slowly pull on the leg bone, lengthening it. The frame and bar must be worn constantly for months to years. When the frame and bar are removed, a leg cast is required for several months. This surgery requires careful and continued follow-up with the surgeon to be sure that healing is going well.

What Causes Mortons Neuroma

Overview

MortonMorton's Neuroma is a common problem in runners, and there are a number of simple fixes you can try before resorting more drastic solutions like sclerosing or surgery. A Morton's Neuroma normally causes a burning pain in the forefoot, just behind the 3rd and 4th toes (sometimes behind the 2nd and 3rd toes). The pain often radiates towards the toes, and sometimes there is numbness rather than pain. The underlying cause is inflammation of the nerve between the bones of the forefoot, often triggered by narrow or tight shoes. I have had good results with the simple fixes described below, and I have had reports of other runners with similar success.

Causes

There are a number of common causes for Morton?s Neuroma, (though the condition can arise spontaneously for reasons still unknown). The Neuroma often occurs in response to irritation, pressure or traumatic injury to one of the digital nerves leading to the toes. A thickening of nerve tissue results as part of the body?s response to the irritation or injury. Abnormal foot movement used to compensate for bunions, hammertoes, flatfeet and other conditions can lead to irritation and development of Morton?s Neuroma. Pronation of the foot may cause the heads of the metatarsal bones to rotate slightly, thereby pinching the nerve running between the metatarsal heads. Chronic pressure or pinching causes the nerve sheath to enlarge, becoming increasingly squeezed, producing worsening pain over time, if not addressed. Morton?s Neuroma can be exacerbated when tight shoes providing little room for the forefoot are worn. Activities which over-pronate the foot (such as walking barefoot in sand) may increase the pain associated with Morton?s Neuroma, as will any high-impact activity, such as jogging.

Symptoms

Patients will complain of numbness, a ?pins and needles? type of tingling and loss of sensation in the toes. Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.

Diagnosis

The doctor will perform an examination of your feet as well. He or she may palpate your feet and flex them in specific ways that will indicate the presence of a neuroma. X-rays are often used to rule out other problems, such as fractures, bone spurs, arthritis or other problems with the bones in the toes or foot. In some cases, an MRI (magnetic resonance imaging) may be helpful to confirm the presence of a neuroma.

Non Surgical Treatment

The most important factor in the treatment of Morton's neuroma is changing footwear. Sometimes a cushioned dome pad can be worn inside the shoe and this helps spread the metatarsal heads and decrease pressure on the nerve. There are other products that can be worn between the toes with certain types of shoes or when the client is barefoot. These toe spacers will help reverse biomechanical patterns that aggravate the nerve compression. Massage can be helpful, but should not be performed with deep pressure between the metatarsal heads. Additional pressure in this region can aggravate the nerve compression and prolong the pathology.Morton

Surgical Treatment

Surgery to excise the neuroma is usually performed under general anaesthetic in a day surgery facility. After surgery you will have to keep your foot dry for two weeks. Generally neuroma surgery allows for early weight bearing and protection in some type of post op shoe gear. Some neuromas may reoccur, but this is rare. Most studies on patient satisfaction after neuroma surgery show approximately 90% reduction of pain and about 85% of all patients rated the overall satisfaction with the results as excellent or good.

Prevention

Wearing shoes that fit properly and that have plenty of room in the toe area may help prevent Morton's neuroma.
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Are Shoe Lifts The Answer To Leg Length Discrepancy

There are two unique variations of leg length discrepancies, congenital and acquired. Congenital indicates that you are born with it. One leg is structurally shorter in comparison to the other. As a result of developmental periods of aging, the brain picks up on the walking pattern and identifies some difference. Our bodies typically adapts by dipping one shoulder over to the "short" side. A difference of less than a quarter inch is not very excessive, require Shoe Lifts to compensate and normally doesn't have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes typically undiagnosed on a daily basis, yet this issue is easily corrected, and can reduce quite a few instances of upper back pain.

Therapy for leg length inequality typically consists of Shoe Lifts. Many are very reasonably priced, in most cases costing below twenty dollars, compared to a custom orthotic of $200 and up. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Chronic back pain is the most common ailment afflicting people today. Around 80 million people are affected by back pain at some point in their life. It's a problem that costs businesses millions of dollars every year because of lost time and output. New and improved treatment solutions are always sought after in the hope of decreasing the economical impact this issue causes.

Leg Length Discrepancy Shoe Lifts

People from all corners of the world suffer from foot ache as a result of leg length discrepancy. In these types of situations Shoe Lifts are usually of very beneficial. The lifts are capable of reducing any discomfort and pain in the feet. Shoe Lifts are recommended by countless qualified orthopaedic practitioners".

So as to support the human body in a nicely balanced manner, your feet have got a vital role to play. In spite of that, it is often the most neglected zone in the body. Some people have flat-feet which means there may be unequal force exerted on the feet. This will cause other areas of the body including knees, ankles and backs to be affected too. Shoe Lifts guarantee that the right posture and balance are restored.

How Shoe Lifts Remedy Leg Length Difference

There are two unique variations of leg length discrepancies, congenital and acquired. Congenital indicates that you are born with it. One leg is structurally shorter compared to the other. As a result of developmental periods of aging, the brain picks up on the stride pattern and recognizes some variance. Our bodies usually adapts by dipping one shoulder over to the "short" side. A difference of under a quarter inch is not blatantly excessive, demand Shoe Lifts to compensate and typically does not have a profound effect over a lifetime.

Leg Length Discrepancy Shoe Lift

Leg length inequality goes mainly undiscovered on a daily basis, however this issue is very easily remedied, and can reduce many instances of back pain.

Therapy for leg length inequality typically involves Shoe Lifts. These are typically very reasonably priced, frequently being less than twenty dollars, compared to a custom orthotic of $200 or higher. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Mid back pain is easily the most common health problem afflicting men and women today. Around 80 million men and women have problems with back pain at some point in their life. It's a problem that costs companies millions year after year due to time lost and productivity. Innovative and better treatment methods are continually sought after in the hope of lowering economical impact this issue causes.

Leg Length Discrepancy Shoe Lift

People from all corners of the earth suffer from foot ache due to leg length discrepancy. In these types of cases Shoe Lifts might be of very useful. The lifts are capable of easing any pain in the feet. Shoe Lifts are recommended by numerous professional orthopaedic practitioners".

In order to support the body in a well-balanced manner, the feet have got a significant part to play. Irrespective of that, it can be the most overlooked region in the human body. Many people have flat-feet meaning there may be unequal force exerted on the feet. This will cause other areas of the body like knees, ankles and backs to be affected too. Shoe Lifts make sure that suitable posture and balance are restored.

Leg Length Discrepancy And Shoe Lifts

There are actually two unique variations of leg length discrepancies, congenital and acquired. Congenital means that you are born with it. One leg is anatomically shorter compared to the other. Through developmental stages of aging, the brain picks up on the step pattern and identifies some variance. Our bodies typically adapts by dipping one shoulder over to the "short" side. A difference of under a quarter inch is not blatantly excessive, require Shoe Lifts to compensate and generally won't have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes mainly undiscovered on a daily basis, however this condition is easily solved, and can eliminate numerous incidents of lower back pain.

Treatment for leg length inequality typically involves Shoe Lifts. Most are economical, in most cases priced at less than twenty dollars, compared to a custom orthotic of $200 or maybe more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Lower back pain is easily the most common ailment affecting men and women today. Over 80 million men and women are afflicted by back pain at some stage in their life. It's a problem that costs employers millions of dollars every year on account of lost time and production. Innovative and superior treatment solutions are always sought after in the hope of reducing the economical impact this issue causes.

Shoe Lifts

Men and women from all corners of the world suffer the pain of foot ache due to leg length discrepancy. In most of these situations Shoe Lifts are usually of worthwhile. The lifts are capable of easing any pain and discomfort in the feet. Shoe Lifts are recommended by many specialist orthopaedic orthopedists.

So that they can support the human body in a healthy and balanced fashion, your feet have got a crucial role to play. Irrespective of that, it's often the most overlooked zone of the human body. Many people have flat-feet meaning there is unequal force exerted on the feet. This causes other body parts such as knees, ankles and backs to be impacted too. Shoe Lifts make sure that correct posture and balance are restored.
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