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July 04 2017

brittany0mccarthy

Tips On How To Care For Pes Planus

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Flat Foot

Fairly common in infants and small children, but also prevalent in adults, flat feet becomes a problem if pain or discomfort is present in the foot or even around the knee and lower leg area. Pain around the knee and lower leg areas can arise because flat feet can alter proper foot and leg alignment, which will put unusual strain on the knee. Adults can develop the condition as the result of injury or even from normal wear and tear due to the natural aging process.

Causes

The arches of most individuals are fully developed by the age of 12 to 13. While some people are born with flat arches, for others, the arches fall over time. The tibial tendon, which runs along the inside of the ankle from above the ankle to the arch, can weaken with age and with heavy activity. The posterior tendon, main support structure for the arch, can become inflamed (tendonitis) or even tear if overloaded. For women, wearing high heels can affect the Achilles tendon and alter the structure and function of the ankle. The posterior tibial tendon may compensate for this stress and break down, causing the arches to fall. Obesity is another contributing factor, as well as a serious injury to the ankle or foot, arthritis and bad circulation such as occurs with diabetes.

Symptoms

It?s possible to have fallen arches and experience no symptoms whatsoever. But many people do notice some problems with this condition. Their feet, back and legs ache. Standing on their toes is difficult, if not impossible, and they note swelling around the arch and heel.

Diagnosis

People who have flat feet without signs or symptoms that bother them do not generally have to see a doctor or podiatrist about them. However, if any of the following occur, you should see your GP or a podiatrist. The fallen arches (flat feet) have developed recently. You experience pain in your feet, ankles or lower limbs. Your unpleasant symptoms do not improve with supportive, well-fitted shoes. Either or both feet are becoming flatter. Your feet feel rigid (stiff). Your feet feel heavy and unwieldy. Most qualified health care professionals can diagnose flat feet just by watching the patient stand, walk and examining his/her feet. A doctor will also look at the patient's medical history. The feet will be observed from the front and back. The patient may be asked to stand on tip-toe while the doctor examines the shape and functioning of each foot. In some cases the physician may order an X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan.

What causes pes planus?

Non Surgical Treatment

If the flat foot is rigid and causing problems, you will be referred to a foot specialist. Talk with your doctor about the best treatment plan for you. Options include the following. Physical Therapy and Exercises. Physical therapy may relieve discomfort. You may be given a specific stretching and strength program. You may also have treatment to help manage the discomfort. Exercises can help with the strength of the surrounding muscles. It may relieve some of the pressure in the foot. Orthotics are shoe inserts that support the foot. These inserts may help to reduce pain and disability in some people. In mild cases, a well-fitting pair of shoes with arch support may be all that is needed. Flat feet caused by nerve or muscle disease may need special braces. Fallen arches are usually treated using stretching exercises, physical therapy and medication (to reduce inflammation). In extreme cases however, surgery is recommended.

Surgical Treatment

Flat Foot

Generally one of the following procedures is used to surgically repair a flat foot or fallen arch. Arthrodesis. One or more of your bones in the foot or ankle are fused together. Osteotomy. Correcting alignment by cutting and reshaping a bone. Excision. Removing a bone or a bone spur. Synovectomy. Cleaning the sheath that covers the tendon. Tendon transfer. Using a piece of one tendon to lengthen or replace another. Arthroereisis. placing a small device in the subtalar joint to limit motion. For most people, treatment is successful, regardless of the cause, although the cause does does play a major role in determining your prognosis. Some causes do not need treatment, while others require a surgical fix.

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.

June 30 2017

brittany0mccarthy

Heel Pain And Discomfort All It Is Best To Know Heel Painfulness

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Feet Pain

Heel pain is one of the most common conditions treated by podiatrists. It is often a message from the body that something is in need of medical attention. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we have suffered. The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular sporting activities and those significantly overweight and on their feet a lot. Heel pain can also occur in children, usually between 8 and 13, as they become increasingly active in sporting activities.

Causes

Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis. The inflammation maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis. An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.

Symptoms

Pain typically comes on gradually, with no injury to the affected area. It is frequently triggered by wearing a flat shoe, such as flip-flop sandals. Flat footwear may stretch the plantar fascia to such an extent that the area becomes swollen (inflamed). In most cases, the pain is under the foot, toward the front of the heel. Post-static dyskinesia (pain after rest) symptoms tend to be worse just after getting out of bed in the morning, and after a period of rest during the day. After a bit of activity symptoms often improve a bit. However, they may worsen again toward the end of the day.

Diagnosis

Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as have you had this type of heel pain before? When did your pain begin? Do you have pain upon your first steps in the morning or after your first steps after rest? Is the pain dull and aching or sharp and stabbing? Is it worse after exercise? Is it worse when standing? Did you fall or twist your ankle recently? Are you a runner? If so, how far and how often do you run? Do you walk or stand for long periods of time? What kind of shoes do you wear? Do you have any other symptoms? Your doctor may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot. Surgery may be recommended in some cases.

Non Surgical Treatment

Calf stretch, silicone Heel cups, ice, night splint, physical therapy. Sometimes custom orthotics are beneficial in long standing cases. Steroid injections have been used and although they temporarily relieve the pain, the pain usually returns within a short period of time. Plantar fasciitis tends to go away in 90% of all people in time. It can take 12-18 months for all the pain to resolve. If the pain continues after adequate treatment, high frequency shock wave therapy (OssaTron) has been found to be beneficial, unfortunately most insurance companies do not cover this procedure.

Surgical Treatment

At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues. Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.

heel cushions for plantar fasciitis

Prevention

Foot Pain

It is not always possible to prevent heel pain, but there are measures you can take to help avoid further episodes. Being overweight can place excess pressure and strain on your feet, particularly on your heels. This increases the risk of damaging your feet and heels. If you are overweight, losing weight and maintaining a healthy weight by combining regular exercise with a healthy, balanced diet can be beneficial for your feet. You can calculate your body mass index (BMI) to find out whether you are a healthy weight for your height and build. To work out your BMI, divide your weight in kilograms by your height in metres squared. A BMI of less than 18.5 means that you are underweight, 18.5-24.9 means that your weight is healthy, 25-29 means that you are overweight, 30-40 means that you are obese, over 40 means that you are morbidly obese. You can also use the BMI healthy weight calculator to work out your BMI.

June 29 2017

brittany0mccarthy

Functional Leg Length Discrepancy Causes

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Many people don?t realise it, but one of their legs is longer (or shorter) than the other one. Over time, this can lead to degenerative osteoarthritis (OA) in the hip joint requiring a hip replacement. But the surgeon can?t just take the old hip joint out and put the new implant in. Careful planning, special surgical techniques, and adjusting of the implant component parts are important in preventing continuation or even worsening of the leg length discrepancy.Leg Length Discrepancy

Causes

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

Symptoms

Children whose limbs vary in length often experience difficulty using their arms or legs. They might have difficulty walking or using both arms to engage in everyday activities.

Diagnosis

The doctor carefully examines the child. He or she checks to be sure the legs are actually different lengths. This is because problems with the hip (such as a loose joint) or back (scoliosis) can make the child appear to have one shorter leg, even though the legs are the same length. An X-ray of the child?s legs is taken. During the X-ray, a long ruler is put in the image so an accurate measurement of each leg bone can be taken. If an underlying cause of the discrepancy is suspected, tests are done to rule it out.

Non Surgical Treatment

Treatments for limb-length discrepancies and differences vary, depending on the cause and severity of the condition. At Gillette, our orthopedic surgeons are experts in typical and atypical growth and development. Our expertise lets us plan treatments that offer a lifetime of benefits. Treatments might include monitoring growth and development, providing noninvasive treatments or therapy, and providing a combination of orthopedic surgical procedures. To date, alternative treatments (such as chiropractic care or physical therapy) have not measurably altered the progression of or improved limb-length conditions. However, children often have physical or occupational therapy to address related conditions, such as muscle weakness or inflexibility, or to speed recovery following a surgical procedure. In cases where surgical treatment isn?t necessary, our orthopedists may monitor patients and plan noninvasive treatments, such as, occupational therapy, orthoses (braces) and shoe inserts, physical therapy, prostheses (artificial limbs).

Leg Length

how can we increase our height?

Surgical Treatment

Lengthening is usually done by corticotomy and gradual distraction. This technique can result in lengthenings of 25% or more, but typically lengthening of 15%, or about 6 cm, is recommended. The limits of lengthening depend on patient tolerance, bony consolidation, maintenance of range of motion, and stability of the joints above and below the lengthened limb. Numerous fixation devices are available, such as the ring fixator with fine wires, monolateral fixator with half pins, or a hybrid frame. The choice of fixation device depends on the desired goal. A monolateral device is easier to apply and better tolerated by the patient. The disadvantages of monolateral fixation devices include the limitation of the degree of angular correction that can concurrently be obtained; the cantilever effect on the pins, which may result in angular deformity, especially when lengthening the femur in large patients; and the difficulty in making adjustments without placing new pins. Monolateral fixators appear to have a similar success rate as circular fixators, especially with more modest lengthenings (20%).

June 05 2017

brittany0mccarthy

What Is Mortons Neuroma

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Morton neuromaMorton?s Neuroma is a common foot condition characterized by pain and swelling in the ball of the foot, between the third and fourth toes. It?s caused by bones in your feet squeezing a nerve. Symptoms include a sharp, burning pain and possibly separation between the affected toes.

Causes

Morton's neuroma may be the result of irritation, pressure or injury. In some cases its cause is unknown. In the majority of cases only one nerve is affected. Having both feet affected is extremely rare. A high percentage of patients with Morton's neuroma are women who wear high-heeled or narrow shoes. Patients with Morton's neuroma may need to change their footwear, take painkillers or steroid injections, while others may require surgery to either remove the affected nerve or release the pressure on it.

Symptoms

While the condition may at first only appear during heavy repetitive stress or when wearing particular shoes which aggravate the foot, the Neuroma can become increasingly inflamed and produce more constant discomfort, lasting days or weeks. Runners may experience pain pushing off from starting blocks. Tight or narrow shoes as well as high heels likewise aggravate the Neuroma. A checklist of symptoms includes burning pain, occasionally numbness in the ball of the foot. Radiating pain from the ball of the foot to the toes. Intensifying pain during activity and when wearing shoes. Occasional numbness, discomfort, tingling or ?electrical shock sensation? in the toes. Pain between the third and fourth toes, often occurring from the outer side of one toe to the inner side of the adjoining toe. Pain upon leaving the starting blocks in running sports.

Diagnosis

Morton's neuroma is usually diagnosed by your doctor listening to your symptoms and examining your foot. Sometimes your doctor can feel the 'neuroma', or an area of thickening in your foot, which may be tender. Sometimes, your doctor may suggest an ultrasound scan or MRI scan to confirm the diagnosis but this is not always necessary. Some doctors inject a local anaesthetic into the area where you are experiencing pain. If this causes temporary relief of pain, burning and tingling, it can sometimes help to confirm the diagnosis and show the doctor where the problem is.

Non Surgical Treatment

Sclerosing alcohol injections are an increasingly available treatment alternative if the above management approaches fail. Dilute alcohol (4%) is injected directly into the area of the neuroma, causing toxicity to the fibrous nerve tissue. Frequently, treatment must be performed 2-4 times, with 1-3 weeks between interventions. An 60-80% success rate has been achieved in clinical studies, equal to or exceeding the success rate for surgical neurectomy with fewer risks and less significant recovery. If done with more concentrated alcohol under ultrasound guidance, the success rate is considerably higher and fewer repeat procedures are needed. Radio Frequency Ablation is also used in the treatment of Morton's Neuroma The outcomes appear to be equally or more reliable than alcohol injections especially if the procedure is done under ultrasound guidance.Morton

Surgical Treatment

If these non-surgical measures do not work, surgery is sometimes needed. Surgery normally involves a small incision (cut) being made on either the top, or the sole, of the foot between the affected toes. Usually, the surgeon will then either create more space around the affected nerve (known as nerve decompression) or will cut out (resect) the affected nerve. If the nerve is resected, there will be some permanent numbness of the skin between the affected toes. This does not usually cause any problems. You will usually have to wear a special shoe for a short time after surgery until the wound has healed and normal footwear can be used again. Surgery is usually successful. However, as with any surgical operation, there is a risk of complications. For example, after this operation a small number of people can develop a wound infection. Another complication may be long-term thickening of the skin (callus formation) on the sole of the foot (known as plantar keratosis). This may require treatment by a specialist in care of the feet (chiropody).

Prevention

While Morton?s Neuroma has been an ongoing topic of clinical investigation, the condition is in some cases difficult to either treat or prevent. Experimental efforts involving the injection of muscle or bone with chemicals such as alcohol, as well as suturing, and covering affected areas with silicone caps have been attempted, with varying success.
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