Monday, 20 July 2015 00:00

Morton's Neuroma

Morton's Neuroma also called Intermetatarsal Neuroma or Plantar Neuroma is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes to become thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot that will often be sensationalized in the toes will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes, or relieving stress from the foot. The earlier the foot is examined and treated, the less chance there will be for needing surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill fitting shoes that cause pressure to the toes, such as high-heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet, which causes excessive pressure and irritates the tissue. At times, people are affected for no apparent reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain, and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling, and the podiatrist may devise a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area, and may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was the cause. Preventative measures are important so the condition does not return.

Monday, 13 July 2015 00:00

Flat Feet

Affecting about 20-30% of the population, flat feet is a condition in which the foot’s arch either drops or never develops. Flat feet is relatively common in babies and small children as a result of the arch not developing. Adults can develop flat feet as a result of injury or pregnancy due to increased elasticity. However, in adults flat feet is usually a permanent condition.

 

Flat feet can make walking difficult since it places undue stress on the ankles. This stress throws off the general alignment of the legs since flat feet cause the ankles to move inward, causing discomfort. Flat feet can also affect the knees since arthritis is a common condition in that area. Fortunately, in many cases flat feet do not directly cause any pain.

 

When it comes to runners, there are specific shoes that can help realign the ankles and provide more support while lessening the amount of pronation involved. Running often causes weight shifting very quickly, so it’s important to be informed whether or not you are affected by flat feet. Knowledge about flat feet is crucial, especially when it comes to preventing injuries.

 

To be able to diagnose flat feet, a test commonly used is known as the wet footprint test. In the wet footprint test, the individual places a flat foot on a surface to generate a footprint. If there is no indication of an arch or any indentations, that person could have flat feet. In any case, if there is a possibility of having flat feet, a podiatrist should be consulted.

 

Once flat foot has been diagnosed, it can be treated by wearing insoles. There are two types of flat feet. The first type is rigid, where the feet appear to have no arch even if the affected person is not standing. The other condition, known as flexible flat feet, occurs when the arch seems to ‘go away’ when someone is standing but appears while sitting. In the case of flexible flat feet, unless pain is caused by the condition, there is no need for treatment. However, in the case of rigid flat feet or pain involved in flexible flat feet, orthotic insoles and exercises are prescribed to help the arches develop.

Monday, 06 July 2015 00:00

Effect of High-Heels on the Feet

For hundreds of years, women have been wearing various kinds of high-heels for mostly aesthetic reasons. Women who wear high-heels appear to be taller and to have longer and thinner legs, and the wearer’s gait and posture changes. Though high-heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

 

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high-heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen, which can cause problems when shoes without heels are worn.

 

By putting a great deal of pressure on the ball of the foot, by forcing the toes into a small toe box, high-heels can cause or may worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

 

Not only does wearing very high-heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high-heels. High-heels causes the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like this. By limiting the natural motion of the foot during walking, high-heels also cause an increased in stress on the knees.

 

Similarly, the back may also be affected by high-heels because it causes the back to go out of alignment. If high-heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

 

However, this is not to say that high-heels can never be worn. If worn occasionally, they will not cause serious problems. They should not be worn every day in order to avoid the long-term physical health problems of the feet, knees, ankles, and back like mentioned above.

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

Monday, 22 June 2015 00:00

Sport Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sport are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly they can lead to permanent disability.

Plantar fasciitis is a painful condition. It is inflammation of the plantar fascia, the thick fibrous band of tissue running from the heel to the base of the toes. There are several effective treatments for this ailment. Doctors often proscribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery usually in that order. The most effective treatment for plantar fasciitis is orthotics, such as foot supports. Surgery is occasionally used as a last resort.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount and intensity of stress placed on it. It can either be treated non-surgically with rest, ice or anti-inflammatory medication or surgery may be required. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require arthroscopic or reconstructive surgery followed by rehabilitation

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled, licensed medical professional.

Monday, 15 June 2015 16:04

Barefoot Running

Barefoot running is becoming a popular running trend that has been permeating through the running and jogging communities. The act of running without shoes changes more about the motions of your stride than you may think, and choosing to run without shoes is not the only adjustment you will have to make.

 

Whenever you run normally, with shoes, your heel strikes the ground first as you land while you roll over the ball of your foot and push off with the front part and toes. Barefoot runners actually land on the front part of their feet and not their heels, shifting the impact from the back to the front of the foot. In order to do this safely and without much injury, runners need to reduce their stride to create softer landings.

 

One of barefoot running’s biggest advantages is the reduced risk of injury. Landing on the front of your foot with a reduced stride lessens the stress placed on the back of the foot, heels, and ankles. It also works out many muscles in the feet, ankles, and lower legs that you do not normally get to strengthen because of the different motion. Your posture and balance are also improved with barefoot running, as is your sensory input from your feet to the rest of your body. Studies have shown that ironically, countries that have large populations of people who do not wear shoes every day are at lower risk for foot and ankle injuries and complications.

 

However, there is still some skepticism behind barefoot running because of some disadvantages it brings. One of these is the complete lack of protection for your feet while running. Bruises, scrapes, cuts, and even blisters can easily form when you have no protection from sharp or rough objects on the ground. Landing on the front of your feet can also cause Achilles tendonitis because of the overuse of the Achilles tendon.

 

Despite this, barefoot running can be made safe and enjoyable if you make a slow transition from your normal running routine into barefoot running. You cannot simply start the activity out of the blue one day, but instead gradually work your way from walking to jogging to running, increasing the distance each time. It is also recommended to start off on flat, even surfaces that do not contain sharp or dangerous objects because your feet are now unprotected. Minimalist running shoes are a great middle ground to start with because they combine the protection of shoes with the fit and feel of barefoot running.

Running may seem like a simple thing to do, but in reality it is a complex movement that puts stress on the ligaments, bones, and joints of the body. Because of this, selecting the correct running shoe is important for increasing performance and avoiding risk of injury. Running shoes should be selected based on your foot type. Considerations such as trail versus road shoes are important, but your foot type dictates the degree of cushioning, stability and motion control you require. The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes. Professionals there can measure your arch type, stride and gait and let you know your shoe needs for future reference.

 

The design of running shoes is created around the idea of pronation. Pronation is the rolling of your ankle from outside to inside when your foot strikes the ground, which is natural. If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more. Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy. Those considered neutral runners pronate correctly and do not need running shoes that help correct their form. Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types. However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation and require running shoes that offer additional support.

 

Those who overpronate experience an over-abundance of ankle rolling. Even while standing, those who severely overpronate display ankles that are angled inward. It is not uncommon for them to have flat feet or bowed legs as well. The tendency to overpronate may cause many injuries. Areas that tend to become injured are the knees, ankles, and Achilles tendon. If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control. Motion-control shoes are straight and firm; shoes of this type do not curve at the tip. The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes.

 

A less common problem is underpronation. Underpronation, also called supination, is when the feet are unable to roll inward during landing. Those who underpronate have feet that lack flexibility and high arches. This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees. This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact. Those who underpronate need shoes with more cushioning and flexibility. If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped and develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot. The official medical term for corns is Helomas.


Corns are often confused with a callus, but there is a difference between them. Corns can be a raised bump that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.


Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should consult their doctor immediately.


According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn a white color after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can potentially lead to infection. If your corn gets infected, and you do not respond with medication, a visit to the doctor will be necessary.


Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes, thus fixing the way you walk. This will lower your chances of getting corns, and eliminate current corns, by reducing the friction.


Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.


To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.

Monday, 25 May 2015 17:40

How to Prevent Running Injuries

Many common running injuries are caused by overuse and overtraining. Several common injuries can occur due to running. When the back of the kneecap starts wearing away and starts causing pain in the knee, this is commonly referred to as runner’s knee. Runner’s knee can occur because of decreased strength in the quadricep muscles or shoes that do not offer proper support to the inside of the forefoot. Runner’s knee usually is treated with strengthening exercises focusing on the quad muscle and sports orthotic. To prevent runner’s knee, efforts should be focused on hip strengthening. Physical therapy is also beneficial in helping to learn the best exercises to heal runner’s knee. To prevent runner’s knee, strengthen the quad muscles to keep the kneecap aligned.

Overtraining is one cause of a common running injury called iliotibial band syndrome, which occurs when the iliotibial band gets irritated, causing pain and discomfort to the outside knee area. Another common running injury is known as plantar fasciitis, which occurs when the bone in the foot becomes inflamed and irritated. This injury primarily causes pain in the foot. Causes can include a high arch, incorrect footwear, tight muscles and flat feet. The best way to avoid plantar fasciitis is stretching and proper footwear.

Stress fractures are a common injury for runners. These fractures can occur because of overtraining, lack of calcium or running style. In runners, it is common for stress fractures to occur in several locations including the inner bone of the leg, the thighbone, the bone at the base of the spine and the toe bones in the foot. The best approach to preventing stress fractures are proper footwear maintenance and running on a surface with enough “give” to absorb some of the shock produced during running.

Besides overtraining, other causes of these common running injuries are poorly fitting footwear, irregular biomechanics, and lack of flexibility and strength. The best way to avoid running injuries is to prevent them. Fortunately, each of these common running injuries can be prevented. To avoid running injuries it is highly recommended to wear only footwear that fits properly and that suits your needs. Running shoes are the only protective gear that runners have to safeguard them from injury; therefore, choosing the correct footwear for running is important. It is important, too, to think about other aspects of your running routine like training schedules, flexibility and strengthening, and tailor them to your needs in order to minimize the possibility of injury. Regular stretching before and after running should be considered also when trying to avoid running injuries. Stretching keeps muscles limber resulting in greater flexibility.

A new treatment option which combines ultrasound waves and steroid injections was found to be effective in patients suffering from plantar fasciitis, according to a groundbreaking study from the University of Genoa in Italy.

The plantar fascia is a connective tissue in the heel that stretches the bottom length of your foot. Plantar fasciitis is the inflammation of this connective band, causing heel pain and overall discomfort while walking or standing. Although the condition is completely treatable, traditional methods can take up to a year to start being effective.

These conventional treatments include arch support, night splints, certain exercises, and overall rest and staying off your feet. The previous effective method for curing plantar fasciitis was shockwave therapy, in which sound waves are directed to the area where the pain is being experienced, often the heel. Despite the success of shockwave therapy, it could be considered somewhat slow, requires several sessions before any results are noticed, and is comparably expensive. However, even shockwave therapy does not cure the pain caused by plantar fasciitis in every patient.

The study, conducted by Luca M. Sconfienza, M.D., examined the effects of a new technique that combined ultrasound-guided methods, similar to shockwave therapy, with a steroid injection directly the plantar fascia. Because of the added steroid injection, the method becomes a one-time outpatient procedure involving a small amount of local anesthesia, in which a needle punctures the affected area and causes a small amount of bleeding that aids in the heeling of the fascia. This technique is referred to as dry-needling.

Dr. Sconfienza determined that 42 of the 44 patients involved in the new procedure had their symptoms, including pain, disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option."

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