Menu
header photo

Tyrones Weblog

Webpage With Regards To All Sorts Of Things

Addressing Fallen Arches

July 1, 2017
Overview

Flat Feet

Pes planus is a condition in which the arch or instep of the foot collapses and comes in contact with the ground. In some individuals, this arch never develops while they are growing. Alternative names include pes planovalgus, flat feet, fallen arches, pronation of the feet.

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

Determining whether you have fallen arches may be as easy as looking at the shape of the middle bottom of your foot. Is there any kind of arch there? If you cannot find any kind of arch, you may have a flat foot. There are, however, other ways to decide in case you're still not sure. Another way to figure out if you have flat feet is to look at a few pairs of your shoes. Where do you see the most wear on the heels? If you notice significant wear in the heel and the ball of the foot extending to the big toe, this means you are overpronating. Overpronators roll their feet too far inward and commonly have fallen arches. To figure out if you have flat feet, you can also do an easy test. Get the bottoms of your feet wet and then step on to a piece of paper carefully. Step off the paper and take a look at the print your foot made. If your print looks like the entire bottom of a foot, your feet are flat. People with an arch will be missing part of the foot on their print since the arch is elevated off of the paper. Regular visits to your podiatrist are highly recommended.

fallen arches insoles

Non Surgical Treatment

Switch activities for a little while. If you?re a super athlete, you don?t want to hear that you need to take a break, but there?s no way around it. You need to lay off the high impact sports like basketball, tennis and running. Don?t panic-there?s no shortage of alternatives. Find a high school track that?s open to the public and try going for a run. Many athletic programs use spongy synthetic materials to pave tracks instead of concrete. This is much easier on all the joints and tendons, not only in your feet but your legs and ankles. You can also try running on dirt trails or stable grassy areas. Take up swimming for a little while. This is actually an ideal activity for your arches. The buoyancy of water takes weight off our feet, but still allows for aerobic activity. Many gyms and activity centers also offer various water sport classes. In no time flat, you?ll be on your way to healthier feet.

Surgical Treatment

Acquired Flat Foot

Since there are many different causes of flatfoot, the types of flatfoot reconstruction surgery are best categorized by the conditions. Posterior tibial tendon dysfunction. In this condition, the tendon connecting the calf muscle to the inner foot is torn or inflamed. Once the tendon is damaged it no longer can serve its main function of supporting the arch of the foot. Flatfoot is the main result of this type of condition and can be treated by the following flatfoot reconstruction surgeries. Lengthening of the Achilles tendon. Otherwise known as gastrocnemius recession, this procedure is used to lengthen the calf muscles in the leg. This surgery treats flatfoot and prevents it from returning in the future. This procedure is often combined with other surgeries to correct posterior tibial tendon dysfunction. Cleaning the tendon. Also known as tenosynovectomy, this procedure is used in the earlier and less severe stages of posterior tibial tendon dysfunction. It is performed before the arch collapses and while the tendon is only mildly affected. The inflamed tissue is cleaned away and removed from the remaining healthy tendon. Tendon transfer. This procedure is done to correct flatfoot and reform the lost arch in the foot. During the procedure, the diseased tendon is removed and replaced by tendon from another area of the foot. If the tendon is only partially damaged, the inflamed part is cleaned and removed then attached to a new tendon. Cutting and shifting bones. Also called an osteotomy, this procedure consists of cutting and reconstructing bones in the foot to reconstruct the arch. The heel bone and the midfoot are most likely reshaped to achieve this desired result. A bone graft may be used to fuse the bones or to lengthen the outside of the foot. Temporary instrumentation such as screws and plates can also be used to hold the bones together while they heal.

Prevention

Flatfeet in children are often an inherited family trait, but it may be possible to prevent the condition in some cases. Recent research has shown that there are several social or cultural factors that can cause flatfeet. These factors include the following, obesity, overweight, unnecessary orthopedic treatments, wearing rigid shoes at a young age, In 1992, a study in India of 2300 children aged 4-13 demonstrated a significant difference in the rate of flatfeet among those who wore shoes regularly and those who did not. In this study, wearing inflexible, closed-toe shoes in early childhood was shown to have a negative effect on the normal development of arches. Children who were allowed to go barefoot or who wore light sandals and slippers had a much lower rate of flatfeet. In 1999, a study in Spain of 1181 children aged 4-13 revealed that the use of orthopedic shoes for treatment of flatfeet in children not only failed to correct the problem, but actually worsened the condition by preventing the normal flexing and arch development of bare or lightly protected feet. Finally, in 2006, a study of 835 children aged 3-6 showed significant differences in the rate of flatfeet based on weight, with normal-weight children having lower rates of flatfeet than children who were overweight or obese. Among adults, flatfeet due to injury, disease, or normal aging are not preventable. However, when flatfeet are related to lifestyle factors, such as physical activities, shoe selection, and weight gain, careful attention to these factors may prevent the development of flatfeet.

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.

All The Things You Want To Understand About Heel Serious Pain

June 29, 2017
Overview

Pain On The Heel

Heel pain is pain in the heel area that can vary in severity and location. It is most common in adults. The heel is the first bone to contact the ground when walking and takes the full force of impact and the resulting shock of bearing weight during motion.

Causes

Here are a few in-depth explanations of heel pain causes and potential remedies for those that are afflicted Plantar Fascitis, One of the most well-known causes of heel pain, plantar fascitis occurs when the thick tissue along the arch of the foot becomes tight and inflamed. The foot itself can feel cramped when this tissue is inflamed, causing the afflicted person to feel as if they have a muscle cramp that flexing the foot doesn?t seem to alleviate. Plantar fascitis is most common among men over the age of 40. Warning Signs, The first steps in the morning are extremely painful. Pain flares up after activities like stair or steep hill climbing. Pain continues to occur regardless of the type of shoes or lack of shoes worn.

Symptoms

Plantar fasciitis is a condition of irritation to the plantar fascia, the thick ligament on the bottom of your foot. It classically causes pain and stiffness on the bottom of your heel and feels worse in the morning with the first steps out of bed and also in the beginning of an activity after a period of rest. For instance, after driving a car, people feel pain when they first get out, or runners will feel discomfort for the first few minutes of their run. This occurs because the plantar fascia is not well supplied by blood, which makes this condition slow in healing, and a certain amount of activity is needed to get the area to warm up. Plantar fasciitis can occur for various reasons: use of improper, non-supportive shoes; over-training in sports; lack of flexibility; weight gain; prolonged standing; and, interestingly, prolonged bed rest.

Diagnosis

Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot - this could be a sign of nerve damage in your feet and legs (peripheral neuropathy), your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection, you have stiffness and swelling in your heel - this could be a sign of arthritis. Possible further tests may include, blood tests, X-rays - where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.

Non Surgical Treatment

Depending on the underlying cause, treatment can include. Rest from activities that stress the heel (such as running and jumping). Ice packs. Regular foot massage, concentrating on the arch of the foot. Professional strapping. A splint worn at night. Flexibility exercises. Ultrasound therapy. Anti-inflammatory medicine (topical or oral). Checking your posture and walking style, to correct imbalances and gait abnormalities that may contribute to the pain. Shoe inserts (orthoses) to help support the foot. In some cases, surgery may be recommended to treat conditions including neuroma, bursitis and heel spurs.

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).

heel pain treatment

Prevention

Feet Pain

Flexibility is key when it comes to staving off the pain associated with these heel conditions. The body is designed to work in harmony, so stretching shouldn?t be concentrated solely on the foot itself. The sympathetic tendons and muscles that move the foot should also be stretched and gently exercised to ensure the best results for your heel stretches. Take the time to stretch thighs, calves and ankles to encourage healthy blood flow and relaxed muscle tension that will keep pain to a minimum. If ice is recommended by a doctor, try freezing a half bottle of water and slowly rolling your bare foot back and forth over it for as long as is comfortable. The use of elastic or canvas straps to facilitate stretching of an extended leg can also be helpful when stretching without an assistant handy. Once cleared by a doctor, a daily regimen of over-the-counter anti-inflammatory medication like Naproxen Sodium will keep pain at bay and increase flexibility in those afflicted by heel pain. While this medication is not intended to act as a substitute for medical assessments, orthopedics or stretching, it can nonetheless be helpful in keeping discomfort muted enough to enjoy daily life. When taking any medication for your heel pain, be sure to follow directions regarding food and drink, and ask your pharmacist about possible interactions with existing medications or frequent activities.

Functional Leg Length Discrepancy Heel Lift

June 28, 2017
Overview

The majority of people in the world actually have some degree of leg length discrepancy, up to 2cm. One study found that only around 1/4 of people have legs of equal lengths. LLD of greater than 2cm is relatively rare, however, and the greater the discrepancy, the greater the chances of having a clinical problem down the road. A limp generally begins when LLD exceeds 2cm and becomes extremely noticeable above 3cm. When patients with LLD develop an abnormal gait, one of the debilitating clinical features can be fatigue because of the relatively high amount of energy needed to walk in the new, inefficient way. Poliomyelitis, or polio, as it is more commonly known, used to account for around 1/3 of all cases of LLD, but due to the effectiveness of polio vaccines, it now represents a negligible cause of the condition. Functional LLD, described above, usually involves treatment focused on the hip, pelvis, and/or lower back, rather than the leg. If you have been diagnosed with functional LLD or pelvic obliquity, please ask your orthopaedic surgeon for more information about treatment of these conditions.Leg Length Discrepancy

Causes

The causes of LLD are many, including a previous injury, bone infection, bone diseases (dysplasias), inflammation (arthritis) and neurologic conditions. Previously broken bones may cause LLD by healing in a shortened position, especially if the bone was broken in many pieces (comminuted) or if skin and muscle tissue around the bone were severely injured and exposed (open fracture). Broken bones in children sometimes grow faster for several years after healing, causing the injured bone to become longer. Also, a break in a child?s bone through a growth center (located near the ends of the bone) may cause slower growth, resulting in a shorter extremity. Bone infections that occur in children while they are growing may cause a significant LLD, especially during infancy. Bone diseases may cause LLD, as well; examples are neurofibromatosis, multiple hereditary exostoses and Ollier disease. Inflammation of joints during growth may cause unequal extremity length. One example is juvenile rheumatoid arthritis. Osteoarthritis, the joint degeneration that occurs in adults, very rarely causes a significant LLD.

Symptoms

The effects of a short leg depend upon the individual and the extent of discrepancy. The most common manifestation if a lateral deviation of the lumbar spine toward the short side with compensatory curves up the spine that can extend into the neck and even impacts the TMJ. Studies have shown that anterior and posterior curve abnormalities also can result.

Diagnosis

The only way to decipher between anatomical and functional leg length inequalities (you can have both) is by a physical measurement and series of biomechanical tests. It is actually a simple process and gets to the true cause of some runner?s chronic foot, knee, hip and back pain. After the muscles are tested and the legs are measured it may be necessary to get a special X-ray that measures both of your thighs (Femurs) and legs (Tibias). The X-ray is read by a medical radiologist who provides a report of the actual difference down to the micrometer leaving zero room for error. Once the difference in leg length is known, the solution becomes clear.

Non Surgical Treatment

You may be prescribed a heel lift, which will equal out your leg length and decrease stress on your low back and legs. If it?s your pelvis causing the leg length discrepancy, then your physical therapist could use your muscles to realign your pelvis and then strengthen your core/abdominal region to minimize the risk of such malalignment happening again. If you think that one leg may be longer than the other and it is causing you to have pain or you are just curious, then make an appointment with a physical therapist.

LLL Shoe Insoles

how to increase height after 21

Surgical Treatment

Surgical options in leg length discrepancy treatment include procedures to lengthen the shorter leg, or shorten the longer leg. Your child's physician will choose the safest and most effective method based on the aforementioned factors. No matter the surgical procedure performed, physical therapy will be required after surgery in order to stretch muscles and help support the flexibility of the surrounding joints. Surgical shortening is safer than surgical lengthening and has fewer complications. Surgical procedures to shorten one leg include removing part of a bone, called a bone resection. They can also include epiphysiodesis or epiphyseal stapling, where the growth plate in a bone is tethered or stapled. This slows the rate of growth in the surgical leg.

What Causes Mortons Neuroma

June 3, 2017
Overview

intermetatarsal neuromaA Morton's neuroma is a benign (noncancerous) swelling along a nerve in the foot that carries sensations from the toes. The reason the nerve starts to swell is unknown. But once swelling begins, the nearby bones and ligaments put pressure on the nerve, causing more irritation and inflammation. This produces burning pain, numbness, tingling and other abnormal sensations in the toes. A Morton's neuroma also is called an interdigital neuroma, intermetatarsal neuroma or a forefoot neuroma.

Causes

Poorly fitted footwear can be a cause. Shoes that have a tight and narrow toe box can cause the never to become entrapped causing the pain. High heeled shoes abnormally place the metatarsals under extreme pressure which can cause Morton?s Neuroma. In cases of abnormal pronation, there can be significant motion between the 3rd and 4th metatarsals which can cause an irritation to the nerve that runs between them. This inflammation causes the pain.

Symptoms

Often, no outward signs (such as a lump or unusual swelling) appear from the condition. Neuroma pain is most often described as a burning discomfort in the forefoot. Aching or sudden shooting pain in the forefoot is also common. All running sports, especially distance running can leave an athlete vulnerable to Morton?s Neuroma, which may appear or flare up in the middle of a run or at the end. The sufferer often has the desire to remove his shoe and rub the afflicted foot. Should the Neuroma be of sufficient size, or if footwear is particularly tight or uncomfortable, the painful condition may be present during normal walking. Numbness in the foot may precede or accompany Neuroma pain.

Diagnosis

Your doctor will suspect that you have a Morton's neuroma based on the nature and location of your foot pain. He or she may ask questions about your shoes - what type of shoes you usually wear and whether these shoes have narrow toes or high heels. To rule out other causes of foot pain, your doctor may ask questions about your medical history, especially any history of arthritis, nerve and muscle problems or previous injury to your foot or leg.

Non Surgical Treatment

Most non-operative treatment is usually successful, although it can take a while to figure out what combination of non-operative treatment works best for each individual patient. Non-operative treatment may include the use of comfort shoe wear. The use of a metatarsal pad to decrease the load through the involved area of the plantar forefoot. A period of activity modification to decrease or eliminate activities, which maybe exacerbating the patient?s symptoms. For example, avoiding long periods of standing or other activities that result in significant repetitive loading to the forefoot can be very helpful. Wearing high heels should be avoided. Local corticosteroid injections can help decrease inflammation associated with the nerve. However, this does not necessarily address the underlying loading forces that maybe causing the injury to the nerve in the first place. It has been proposed that an alcohol injection in and around the nerve will cause a controlled death to the nerve and subsequently eliminate symptoms from the nerve. In theory, this may be helpful. In practice, adequate prospective studies have not demonstrated the benefit of this procedure above and beyond the other standard non-operative treatments available. In addition there is the concern that the alcohol will cause excessive scarring and death of other important structures in the area.interdigital neuroma

Surgical Treatment

Operative treatment of Morton?s neuroma should be entertained only after failure of nonoperative management. Standard operative treatment involves identifying the nerve and cutting (resecting) it proximal to the point where it is irritate/injured. This is usually done through an incision on the top (dorsal) aspect of the foot, although in rare instances, an incision on the sole (plantar) aspect of the foot maybe used. An incision on the sole of the foot works very well, unless an excessive scar forms in which case it can be problematic. Some physicians will attempt to treat Morton?s neuroma by releasing the intermetatarsal ligament and freeing the nerve of local scar tissue. This may also be beneficial.

Do Hammertoes Hurt

August 21, 2015
Hammer ToeOverview

Hammer toe 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

Certain risk factors increase your likelihood of developing a hammertoe. These include a family history of hammertoes, wearing tight or pointy-toed shoes, wearing shoes that are too small, having calluses, bunions, or corns (thickened layers of skin caused by prolonged/repeated friction) Wearing shoes that are too small can force the joint of your toes into a dislocated position. This makes it impossible for your muscles to stretch out. Over time, the practice of wearing improperly fitting shoes increases your risk of developing hammertoes, blisters, bunions, and corns.

Hammer ToeSymptoms

Hammer toes can cause problems with walking and lead to other foot problems, such as blisters, calluses, and sores. Pain is caused by constant friction over the top of the toe?s main joint. It may be difficult to fit into some shoe gear due to the extra space required for the deformed toe. In many cases there will be pain on the ball of the foot over the metatarsals along with callus formation. This is due to the toes not functioning properly, failing to properly touch the ground during hammertoe the gait cycle. The ball of the foot then takes the brunt of the ground forces, which causes chronic pain.

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

Hammertoes that are not painful (asymptomatic) and still flexible may not require treatment. In mild cases, open-toed, low-heeled, or wider shoes and foam or moleskin pads can provide symptomatic relief by reducing pressure. Taping (strapping) the affected toe can help to reduce deformity and pain. Physical therapy to instruct patients in exercises that passively stretch tight structures and strengthen weak foot intrinsic muscles is also helpful with mild cases. Periodic trimming (debridement) of corns (clavi, helomata) by a podiatrist can provide temporary relief. Corticosteroid injections are often very effective in reducing pain.

Surgical Treatment

he basis for hammer toe surgery most often involves removing s portion of bone within the toe, to reduce the joint contracture. Depending on the direction the toe is deviated, soft tissue procedures may be necessary along with pinning the toe with a surgical wire.

Hammer ToePrevention

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.

My Website

Customizing your website is easy. Just login and point your mouse at any content block on the page and an editor will come up allowing you to change or delete it.

To add more content, change your theme, or access other features, explore the toolbar at the top of the page.