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The Globe's Finest Foot Site

Caring for your feet is extremely important, you are going to learn ways to take good care of feet and have the right information close to hand relating to all foot complications or diseases, including Calcaneal Apophysitis (Sever's Disease), Hallux Rigid

Addressing Fallen Arches

July 1, 2017
Overview

Acquired Flat Foot

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.

Causes

Infants and young children naturally have flat feet. The arch should develop over time. Sometimes, the arch does not develop. It is not always clear why this happens. Flat feet may develop because of ruptured or damaged tendon that supports the arch, medical conditions that affect muscles or nerves in the foot, degenerative changes in certain foot joints, Ligament damage in the foot.

Symptoms

The primary symptom of flatfeet is the absence of an arch upon standing. Additional signs of flatfeet include the following. Foot pain. Pain or weakness in the lower legs. Pain or swelling on the inside of the ankle. Uneven shoe wear. While most cases of flatfeet do not cause problems, complications can sometimes occur. Complications include the following, bunions and calluses, inability to walk or run normally, inflammation and pain in the bottom of the foot (plantar fasciitis), tendonitis in the Achilles heel and other ligaments, pain in the ankles, knees, and hips due to improper alignment, shin splints, stress fractures in the lower legs.

Diagnosis

Diagnosis of flat feet or fallen arches can be made by your health practitioner and is based on the following. Clinical assessment involving visual gait assessment, as well as biomechanical assessment. A detailed family and medical history. A pain history assessment determining the location of painful symptoms. Physical palpation of the feet and painful areas. Imaging such as MRI or x-ray can be used by your practitioner to assist in the diagnosis.

bestshoelifts

Non Surgical Treatment

Orthotics. Interpod orthotics re-align and support the foot; therefore reducing any excessive stress when walking or during activity. Orthotics can assist with maintaining arch profile and allow for more effective functioning of joints. Footwear. A strong supportive, well fitted shoe may assist with reducing excessive pronation and support the joints of your feet. A supportive shoe will also help maximise the function of your Interpod orthotic. Padding may be applied to your shoes or feet by your practitioner to reduce excessive stress. Specific taping techniques can be applied by your practitioner to improve foot function. Your practitioner may advise certain stretches or exercises to assist with maintaining foot function and reduce painful symptoms. Pain medication such as NSAIDs (ibuprofen) may be advised by your practitioner. If all conservative options have been exhausted, then surgical correction of flat feet may be undertaken.

Surgical Treatment

Acquired Flat Feet

A combination of surgical procedures can be used to reconstruct the flatfoot. Generally, these procedures can be separated into those that correct deformities of the bones and those that repair ligaments and tendons. Your orthopaedic surgeon will choose the proper combination of procedures for your foot. Surgery of the foot can be performed under regional anesthesia, which is numbing the foot and ankle with a nerve or spinal block, or general anesthesia, which may require a breathing tube. A nerve block is often placed behind the knee to reduce pain after surgery.

Prevention

Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.

After Care

Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.

Heel Serious Pain

June 30, 2017
Overview

Painful Heel

Heel pain is one of the most common conditions to affect the foot. It is usually felt as an intense pain when the affected heel is used. The pain is usually worse when you get out of bed in the morning or after a long period of activity. In most cases, only one heel is affected. After walking, the pain usually improves. However, it is common for it to be painful when you first take a step after a period of rest. The pain often worsens by the end of the day. Most cases of heel pain are caused by damage and thickening of the plantar fascia. Sometimes, the surrounding tissue and the heel bone also become inflamed (swollen).

Causes

There are many possible causes of heel pain. Most commonly it is a chronic, long-term pain that results of some type of faulty biomechanics (abnormalities in the way you walk) that place too much stress on the heel bone and the soft tissues that attach to it. Chronic pain is a common result of standing or walking too many hours in the course of a day, working on concrete, being overweight, wearing poorly-constructed shoes, having an overly-pronated foot type (where the arch collapses excessively) or the opposite--having too high an arch. Women seem to get this slightly more often than men, and while any age can be affected, it usually occurs between 30 and 50 years of age. The other type of heel pain is the sort you get from an acute injury--a bruise to the bone or soft tissue strain resulting from a strenuous activity, like walking, running, or jumping, or from some degree of trauma. While there are dozens of possible causes to heel pain, I will review some of the more common causes. Arch Pain/Plantar Fasciitis. One of those often-painful soft tissue that attaches to heel spurs at the bottom of the foot is called "plantar fascia". Fascia, located throughout the body, is a fibrous connective tissue similar to a ligament. You can see fascia as some of that white, connective tissue attaching to bones, when you pull apart meat. The "plantar" fascia in our bodies is that fascia which is seen on the bottom (or plantar portion) of the foot, extending from the heel bone to the ball of the foot. Compared to other fascia around the body, plantar fascia is very thick and very strong. It has to be strong because of the tremendous amount of force it must endure when you walk, run or jump. But while the plantar fascia is a strong structure, it can still get injured, most commonly when it is stretched beyond its normal length over long periods of time. Plantar Fascitis. When plantar fascia is injured, the condition is called "plantar fasciitis", pronounced "plan-tar fash-I-tis". (Adding "-itis" to the end of a word means that structure is inflamed.) It is sometimes known more simply as 'fasciitis'. Plantar fasciitis is the most common type of arch pain. Symptoms of plantar fasciitis may occur anywhere along the arch, but it is most common near its attachment to the heel bone.

Symptoms

The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they?ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Diagnosis

The diagnosis of plantar fasciitis is generally made during the history and physical examination. There are several conditions that can cause heel pain, and plantar fasciitis must be distinguished from these conditions. Pain can be referred to the heel and foot from other areas of the body such as the low back, hip, knee, and/or ankle. Special tests to challenge these areas are performed to help confirm the problem is truly coming from the plantar fascia. An X-ray may be ordered to rule out a stress fracture of the heel bone and to see if a bone spur is present that is large enough to cause problems. Other helpful imaging studies include bone scans, MRI, and ultrasound. Ultrasonographic exam may be favored as it is quick, less expensive, and does not expose you to radiation. Laboratory investigation may be necessary in some cases to rule out a systemic illness causing the heel pain, such as rheumatoid arthritis, Reiter's syndrome, or ankylosing spondylitis. These are diseases that affect the entire body but may show up at first as pain in the heel.

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

Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a removal of a neuroma or other soft-tissue growth.

Where is a heel spur located?

Prevention

Painful Heel

You can try to avoid the things that cause heel pain to start avoid becoming overweight, where your job allows, minimise the shock to your feet from constant pounding on hard surfaces, reduce the shocks on your heel by choosing footwear with some padding or shock-absorbing material in the heel, if you have high-arched feet or flat feet a moulded insole in your shoe may reduce the stresses on your feet, if you have an injury to your ankle or foot, make sure you exercise afterwards to get back as much movement as possible to reduce the stresses on your foot and your heel in particular, If you start to get heel pain, doing the above things may enable the natural healing process to get underway and the pain to improve.

How To Calculate Leg Length Discrepancy At Home

June 27, 2017
Overview

The two major categorizations of LLD are structural and functional. A third more minor category is environmental. In structural LLD there is an actual anatomical difference in the bones of the lower extremities where one side becomes shorter than the other. This type of LLD may be genetic, where the person is born in this way. In other cases it may be due to injury or infection through the growth phases of early childhood or adolescence. Some spinal abnormalities like scoliosis can also cause this condition. Functional LLD is where the bones are not the cause of difference but a muscle or pelvic condition has the effect of weakening the leg on one side. Conditions that can cause this are muscle inflexibility, adduction contractures and pelvic obliquity (amongst others). The third less severe category of environmental LLD is caused by discrepancies in the surface that the feet and legs are resting or walking on. Banked, uneven or curved surfaces can all cause environmental LLD. In LLD the asymmetric nature of the legs in relation to hips and back caused the centre of gravity to shift from its natural position. This then results in the body attempting to compensate by either tilting the pelvic areas towards the shorter side, increased knee flexing on the longer side, flexion of the ankle plantar and foot supination towards the shorter side.Leg Length Discrepancy

Causes

The causes of LLD may be divided into those that shorten a limb versus those that lengthen a limb, or they may be classified as affecting the length versus the rate of growth in a limb. For example, a fracture that heals poorly may shorten a leg slightly, but does not affect its growth rate. Radiation, on the other hand, can affect a leg's long-term ability to expand, but does not acutely affect its length. Causes that shorten the leg are more common than those that lengthen it and include congenital growth deficiencies (seen in hemiatrophy and skeletal dysplasias ), infections that infiltrate the epiphysis (e.g. osteomyelitis ), tumors, fractures that occur through the growth plate or have overriding ends, Legg-Calve-Perthes disease, slipped capital femoral epiphysis (SCFE), and radiation. Lengthening can result from unique conditions, such as hemihypertrophy , in which one or more structures on one side of the body become larger than the other side, vascular malformations or tumors (such as hemangioma ), which cause blood flow on one side to exceed that of the other, Wilm's tumor (of the kidney), septic arthritis, healed fractures, or orthopaedic surgery. Leg length discrepancy may arise from a problem in almost any portion of the femur or tibia. For example, fractures can occur at virtually all levels of the two bones. Fractures or other problems of the fibula do not lead to LLD, as long as the more central, weight-bearing tibia is unaffected. Because many cases of LLD are due to decreased rate of growth, the femoral or tibial epiphyses are commonly affected regions.

Symptoms

In addition to the distinctive walk of a person with leg length discrepancy, over time, other deformities may be noted, which help compensate for the condition. Toe walking on the short side to decrease the swaying during gait. The foot will supinate (high arch) on the shorter side. The foot will pronate (flattening of the arch) on the longer side. Excessive pronation leads to hypermobility and instability, resulting in metatarsus primus varus and associated unilateral juvenile hallux valgus (bunion) deformity.

Diagnosis

A qualified musculoskeletal expert will first take a medical history and conduct a physical exam. Other tests may include X-rays, MRI, or CT scan to diagnose the root cause.

Non Surgical Treatment

The object of treatment for leg length discrepancy is to level the pelvis and equalize the length of the two limbs. Inequalities of 2-2.5 centimeters can be handled with the following. Heel lifts/ adjustable heel lifts can be used inside a shoe where shoes have a full heel counter. Heel lifts may be added to the heel on the outside of the shoe along with an internal heel lift. Full platforms along the forefoot and rearfoot area of a shoe can be added. There are many different adjustable heel lifts available on the market. For treatment of a leg length discrepancy, consult your physician. They may refer you to a Physiotherapist or Chiropractor for determination of the type of LLD. A Certified Pedorthist (Canada) will treat a structural leg length discrepancy with a heel lift or in larger discrepancies a footwear modification.

Leg Length Discrepancy

what is a shoe lift?

Surgical Treatment

For discrepancies over five centimeters, more aggressive surgical procedures-specifically leg lengthening procedures-are typically required. The specifics of this operative procedure are beyond the scope of this informational page, but your child's physician will be able to discuss the details in reference to your child's specific problems when considered appropriate.

What Causes Mortons Neuroma

May 31, 2017
Overview

MortonA morton's neuroma (or an "inter-digital" neuroma) is found between the toes of the foot, most commonly the third and fourth toes. It can also occur between the metatarsal bones (the long bones in the forefoot). It is basically an entrapped nerve, which becomes inflamed due to constant irritation from the surrounding bony structures.

Causes

Occupational hazards. Individuals whose jobs place undue stress on their forefeet (with or without wearing improper footwear) are among those who complain of neuromas. Podiatric physicians report that individuals who work on ladders, or who perform activities on their knees (such as doing landscaping, carpeting, flooring, or other work on the ground) are at risk for this problem, too, since these activities cause stress to the nerve near the ball of the foot. Those who engage in high-impact activities that bring repetitive trauma to the foot (running, aerobics, etc.) have a better than average chance of developing a neuroma at the site of a previous injury. To put it more simply, if you have sustained a previous injury to your foot (a sprain, stress fracture, etc.), that area of your foot will be more prone to neuroma development than an area that has not been injured. However, sports injuries aren?t automatically a ticket to neuromas. Trauma caused by other forms of injury to the foot (dropping heavy objects, for example) can also cause a neuroma to develop at the site of the previous injury. Much though we hate to say it, sometimes neuromas just develop and nobody knows why. The patient doesn?t have a previous injury, is wearing properly fitted shoes, and doesn?t stress his/her feet with any specific activity but the neuroma develops anyway. It is important to remember that some of the factors listed above can work alone, or in combination with each other, to contribute to the formation of neuroma.

Symptoms

Symptoms include tingling in the space between the third and fourth toes, toe cramping, a sharp, shooting, or burning pain in the ball of the foot and sometimes toes, pain that increases when wearing shoes or pressing on the area, pain that gets worse over time. In rare cases, nerve pain occurs in the space between the second and third toes. This is not a common form of Morton neuroma, but treatment is similar.

Diagnosis

A GP (general practitioner, primary care physician) or a podiatrist (foot specialist doctor) will ask the patient to describe the pain as well as its intensity, when symptoms started, what types of shoes are worn, as well as some questions about their job, lifestyle and hobbies. The doctor will then examine the foot and try to locate the affected nerve. This may involve attempting to reproduce symptoms by manipulating the foot. In order to get a detailed image of the inside of the food, one of the following scans may be ordered. X-ray, this is a type of high-energy radiation. In low doses they are used to diagnose diseases and condition by making pictures of the inside of the body. In higher doses they are used to treat cancer. This procedure is non-invasive and painless. Ultrasound scan, high frequency sound waves are pointed at a specific part of the body, which in this case is the foot. The ultrasound waves bounce of tissues; their echoes are then converted into a picture, called a sonogram. This allows the doctor to get an inside view of the foot. This procedure is non-invasive and painless. MRI (magnetic resonance imagining) a device that uses a magnetic field and radio waves to create detailed images of the body. Unlike CT scanning or general x-ray studies, no ionizing radiation is involved with an MRI. This procedure is non-invasive and painless. The doctor will have to rule out other conditions which may have similar symptoms, including capsulitis, bursitis, or Freiberg's disease.

Non Surgical Treatment

Wear shoes with plenty of room for the toes to move, low heels, and laces or buckles that allow for width adjustment. Wear shoes with thick, shock-absorbent soles, as well as proper insoles that are designed to keep excessive pressure off of the foot. High-heeled shoes over two inches tall should be avoided whenever possible because they place undue strain on the forefoot. Resting the foot and massaging the affected area can temporarily alleviate neuroma pain. Use an ice pack to help to dull the pain and improve comfort. Use over-the-counter shoe pads. These pads can relieve pressure around the affected area.interdigital neuroma

Surgical Treatment

Majority of publications including peer review journal articles, surgical technique description and textbooks promote surgical excision as a gold standard treatment. Surgical excision is described as the most definitive mode of treatment for symptomatic Morton?s neuroma with reported success rates varying between 79% and 93%. Various surgical techniques are described, essentially categorised as dorsal versus plantar incision approaches. Beyond this the commonest technical variation described as influencing the outcome of surgery involves burying and anchoring transacted nerve into soft tissue such as muscle.

Shoe Lifts The Podiatrists Option For Leg Length Imbalances

February 20, 2016
There are not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital indicates you are born with it. One leg is structurally shorter than the other. As a result of developmental phases of aging, the human brain picks up on the step pattern and identifies some variation. Your body typically adapts by tilting one shoulder to the "short" side. A difference of less than a quarter inch is not really abnormal, demand Shoe Lifts to compensate and mostly doesn't have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes largely undiscovered on a daily basis, yet this condition is very easily solved, and can reduce quite a few incidents of chronic back pain.

Treatment for leg length inequality typically consists of Shoe Lifts. These are typically affordable, commonly costing under twenty dollars, compared to a custom orthotic of $200 plus. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Lower back pain is easily the most widespread ailment affecting men and women today. Around 80 million men and women are afflicted by back pain at some stage in their life. It is a problem which costs employers vast amounts of money annually on account of time lost and production. Innovative and better treatment methods are always sought after in the hope of reducing the economical impact this issue causes.

Leg Length Discrepancy Shoe Lift

People from all corners of the earth suffer the pain of foot ache as a result of leg length discrepancy. In a lot of these situations Shoe Lifts might be of very useful. The lifts are capable of decreasing any discomfort in the feet. Shoe Lifts are recommended by countless skilled orthopaedic practitioners".

So that they can support the body in a healthy and balanced manner, feet have got a vital task to play. Inspite of that, it is often the most overlooked zone of the human body. Some people have flat-feet which means there is unequal force placed on the feet. This will cause other areas of the body such as knees, ankles and backs to be impacted too. Shoe Lifts ensure that ideal posture and balance are restored.

What Causes Heel Spur

September 28, 2015
Heel Spur

Overview

A heel spur is a projection or growth of bone where certain muscles and soft tissue structures of the foot attach to the bottom of the heel. Most commonly, the plantar fascia, a broad, ligament-like structure extending from the heel bone to the base of the toes becomes inflamed, and symptoms of heel pain begin. As this inflammation continues over a period of time, with or without treatment, a heel spur is likely to form. If heel pain is treated early, conservative therapy is often successful, and surgery is usually avoided.

Causes

Causes of Heel Spur Syndrome are mostly due to your foot structure. Foot structure is due to hereditary for the most part, meaning it was the way you were when born. Other factors such as increase in weight, injury, improper shoes, or different activities may change the way your foot functions as well. If one leg is longer or shorter than the other, this may make your foot function improperly and be the cause of the heel spur syndrome. Improper shoes may be ones that are new or ones that are worn out and do not give good support. The higher priced shoes do not mean it's a better shoe. Pronation is a term used to describe a foot which allows the arch to fall more than normal and allows for the fascia along the bottom of the foot to put a tighter pull or a different angle of pull on the heel bone. Over time, this constant pull of the tight fascia can force the bone to enlarge and form a spur. It is not the heel spur that causes the pain directly. The spur may cause pressure against a nearby nerve causing a neuritis, or a bursa causing a bursitis.

Heel 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

A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.

Non Surgical Treatment

The most important part of treatment is to rest. Do not undertake activities which hurt the foot or aggravate symptoms as will only cause painful symptoms to persist. Apply an ice pack regularly for 10 minutes at a time every hour initially to reduce pain and inflammation of the surrounding tissues. As symptoms subside frequency of application can reduce to 2 or 3 times per day. Exercises and stretches to keep the foot and ankle strong and mobile are important as long as pain allows. Stretching the plantar fascia is important, especially if symptoms are worse in the morning. A plantar fasciitis night splint is excellent for stretching and preventing the plantar fascia tightening up over night. Anti-Inflammatory medicine (e.g. ibuprofen) may be prescribed by a doctor but always check with a medical professional first as taking some medications such as ibuprofen should not be done if the patient has asthma. Shoe inserts can help to take the pressure off of the spur and reduce pain. If these treatments do not significantly ease the symptoms then surgery may be an option.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

Prevention

You can prevent heel spurs by wearing well-fitting shoes with shock-absorbent soles, rigid shanks, and supportive heel counters; choosing appropriate shoes for each physical activity; warming up and doing stretching exercises before each activity; and pacing yourself during the activities. Avoid wearing shoes with excessive wear on the heels and soles. If you are overweight, losing weight may also help prevent heel spurs.

Do I Have Heel Spur

September 27, 2015
Calcaneal Spur

Overview

Heel Spurs should be called a traction spurs because they grow in the same direction that the tendons pull away from the heel bone, which is why it can occur on the bottom of the heel (Plantar Fasciitis) and on the back of the heel (Achilles Tendonitis). Some patients may only develop one type of heel spur, but both these problems are closely related so it's not unusual for a patient to have both heel spurs. It's important to note though that most heel spurs aren't the cause of your heel pain.

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.

Heel Spur

Symptoms

The Heel Spur itself is not thought to be painful. Patients who experience pain with Plantar Fasciitis are suffering from inflammation and irritation of the plantar fascia. This the primary cause of pain and not the Heel Spur. Heel Spurs form in some patients who have plantar fasciitis, and tend to occur in patients who have had the problem for a prolonged period of time. While about 70 % of patients with plantar fasciitis have a heel spur, X-rays also show about 50 % of patients with no symptoms of plantar fasciitis also have a heel spur.

Diagnosis

Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at all.

Non Surgical Treatment

The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night's sleep, the pain may feel worse as the plantar fascia suddenly elongates, which stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking. If you have heel pain that persists for more than one month, consult a health care provider. He or she may recommend conservative treatments such as stretching exercises, shoe recommendations, taping or strapping to rest stressed muscles and tendons, shoe inserts or orthotic devices, physical therapy. Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid may be done to relieve inflammation in the area.

Surgical Treatment

Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.

Prevention

Choose new shoes that are the right size. Have your foot measured when you go to the shoe store instead of taking a guess about the size. Also, try on shoes at the end of the day or after a workout, when your feet are at their largest. To ensure a good fit, wear the same type of socks or nylons that you would normally wear with the type of shoe that you are trying on.

Ideas On How To Treat Calcaneal Spur

September 27, 2015
Heel Spur

Overview

A heel spur is a buildup of calcium or a bone hook on the heel bone. This is typically the source of most heel pain. It usually takes an X-ray to see the heel spur protruding from the heel. Without proper heel spur treatment, a heel spur cause inflammation and lead to other ailments like plantar fasciitis and Achilles tendonitis. It is important to be examined by an orthopedic specialist.

Causes

One frequent cause of injury to the plantar fascia is pronation. Pronation is defined as the inward and downward action of the foot that occurs while walking, so that the foot's arch flattens toward the ground (fallen arch). A condition known as excessive pronation creates a mechanical problem in the foot, and the portion of the plantar fascia attached to the heel bone can stretch and pull away from the bone. This damage can occur especially while walking and during athletic activities.

Inferior Calcaneal Spur

Symptoms

Heel spur and plantar fasciitis pain usually begins in the bottom of the heel, and frequently radiates into the arch. At times, however, the pain may be felt only in the arch. The pain is most intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of walking, the pain usually becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this pain may radiate into the ankle. In the early stages of Heel Spurs and Plantar Fasciitis, the pain will usually subside quickly with getting off of the foot and resting. As the disease progresses, it may take longer periods of time for the pain to subside.

Diagnosis

The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.

Non Surgical Treatment

Bone spurs rarely require treatment unless they are causing frequent pain or damaging other tissues. Because heel spurs and plantar fasciitis are so closely related, they are usually treated the same way. Symptomatic treatment involves rest, especially from the activity that is contributing to the condition and making symptoms worse (although this may not be easy to discover, as problems can manifest several hours or days after the harmful activity has occurred). If you identify the offending activity, ice is recommended immediately following it. Stretching of the calf muscles after a short warm up is also a good idea and can be helpful. Stretching exercises that gently lengthen the calm muscle will relax the tissue surrounding the heel and should be done several times a day, especially in the morning and after prolonged sitting.

Surgical Treatment

Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be considered.

Does A Posterior Calcaneal Spur Hurt?

September 27, 2015
Heel Spur

Overview

While the term heel spur may create the impression of a sharp bony projection on the bottom of the heel that pokes the bottom of our foot causing our pain. Painful heel spurs are actually a result of damage to the soft tissue at the bottom of the foot. While this may be confusing, we'll try to explain. Heel spurs is the more common name for a condition that is medically referred to as plantar fascitiis or heel spur syndrome. Plantar fasciitis is a location oriented term that refers to the bottom of the foot(i.e. plantar warts). Fascia is a tough, inelastic band. 'itis'is a term used to describe something that is inflamed (i.e. tendonitis, bursitis).

Causes

A heel spur is a bony overgrowth on the bottom of your heel bone. The heel spur is usually a result of an inflamed ligament (plantar fascia) on the bottom of the foot that attaches to the heel bone. Constant abnormal pulling of this ligament irritates the heel bone and the body lays down a bone spur as a protective mechanism. The patient usually complains of pain with the first step in the morning, some relief following activity, but returning after extended amounts of time standing or walking.

Posterior Calcaneal Spur

Symptoms

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain, especially while walking, jogging, or running, if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning, a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

Diagnosis

Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.

Non Surgical Treatment

Since heel spurs are not an indication of pain themselves unless fractured, treatment is usually aimed at the cause of the pain which in many cases is plantar fasciosis. Treatment of plantar fasciiosis includes; rest until the pain subsides, special stretching exercises and if required orthotics may be prescribed.

Surgical Treatment

Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery with typically smaller incisions on each side of your foot.

Prevention

A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after running. Pace yourself when you participate in athletic activities. Don't underestimate your body's need for rest and good nutrition. If obese, lose weight.

Bursitis Of The Feet And Ankle

August 29, 2015
Overview

In the foot we have a unique situation in that between the shoes that we wear and the ground that we walk on various parts of the foot are constantly being ?micro? traumatized meaning that every time we take a step we do a small amount of damage to a particular part of the foot and eventually that part of the foot begins to hurt. The body?s response to this micro-trauma is to create a bursal sac to initially protect the area but if micro-traumatized enough the bursal sac itself becomes inflamed and we have a bursitis.

Causes

Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.

Symptoms

Below is a list of common signs and symptoms of retrocalcaneal bursitis. Recognizing and treating symptoms early can prevent retrocalcaneal bursitis from becoming chronic. Swelling. The retrocalcaneal bursa is located behind the Achilles tendon, just above where the tendon attaches to the heel bone. When the bursa is inflamed it will cause visible soft tissue swelling near the top of the heel bone. It is worth noting that bursitis of the retroachilles bursa, which is located between the Achilles tendon and skin, can manifest slightly differently: swelling may be more distinct, appearing as a hard lump behind the heel. Retroachilles bursitis is also more likely than retrocalcaneal bursitis to cause the skin at the back of the heel to turn red.

Diagnosis

Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.

Non Surgical Treatment

Physical therapy is also used to treat retrocalcaneal bursitis. People with this condition may be instructed to use ice on the heel and ankle several times each day. Ice should be applied for periods of 15 to 20 minutes. Prolonged use of ice is not recommended because it can stop blood flow if left in place for a long period of time. Exercises and stretches for the Achilles tendon can help to relieve some of the pressure on the bursae below the tendons. If physical activity must be limited due to a flare-up of this condition, other exercises can be done to maintain fitness. They include water aerobics and swimming.

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.

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