What Causes Hammer Toes

Hammer ToeOverview
Hammer Toe, Claw and Mallet Toe are similar conditions, all caused by deformity of the toe joints. They usually develop slowly from wearing poor fitting shoes, but can also be due to muscle or nerve damage. Muscle imbalance causes the toes to bend into odd positions which can be extremely painful, limiting walking and activity. They become more common with aging and affect approximately 10-15% of the population. Women are five times more likely to suffer from hammer, claw or mallet toe than men.

Causes
This condition is greatly influenced by the footwear we choose. Ladies who wear high heels are a perfect example. High heels force the toes to overlap and bend at the middle joint of the toe, resulting in hammertoe. But high heels are not the only culprits. Anyone who wears shoes that are too tight is increasing their risk of developing hammertoe. This progressive condition, which will only get better with treatment, can cause pain as the toes are forced to bend unnaturally.

Hammer ToeSymptoms
The most obvious symptoms of this injury will be the the middle toe joint is permanently bent at an angle. In the beginning movement may still be possible but as time passes and the injury worsens the toe will be locked in place and possible require hammer toe correction surgery to fix. Another key indicator of hammer toe is that a lump or corn will form on top of the toe. The toe joint will be painful and walking can cause severe discomfort. Occasionally a callus may form on the sole of the injured foot. If you see any of these symptoms together or have been enduring pain for some time, seeing a podiatrist should be your next step.

Diagnosis
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment
There are several treatment options. These are based on how severe the problem has become. The sooner a person seeks treatment, the more options that person may have. Wear properly fitting shoes; this does not necessarily mean expensive shoes. Padding any prominent areas around the bony point of the toe may help to relieve pain. Medication that reduces inflammation can ease the pain and swelling. Sometimes a doctor will use cortisone injections to relieve acute pain. A podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammer toe from getting worse. Your doctor may recommend foot exercises to help restore muscle balance. Splinting the toe may help in the very early stages.

Surgical Treatment
If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery. Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.

Is Over-Pronation Of The Feet Uncomfortable

Overview

While a slight amount of pronation is the proper means to absorb shock naturally, too much pronation (over-pronation) can potentially contribute to many maladies, which can sideline a runner. A foot that pronates excessively is one that continues to roll inward past a neutral position after the shock of impact has been absorbed. Uncorrected and repeated, this motion may lead to repetitive stress related injuries of the feet and legs. More times than not, the runner who over-pronates needs a shoe that reduces excess pronation and guides the foot along a neutral path.Overpronation

Causes

There are many biomechanical issues that can contribute to excessive pronation, including weak foot intrinsic muscles, limited ankle dorsiflexion mobility and calf flexibility, weak ankle invertor muscles (e.g. posterior tibialis), weak forefoot evertor muscles (peroneus longus), poor hip strength and control, Anterior pelvic tilting, heel InversionIn a person who overpronates, the heel bone goes into an everted position meaning that it turns out away from the midline of the body. The opposite motion of eversion is inversion. Inversion is a motion that needs to be controlled to prevent the foot from excessively pronating.

Symptoms

Common conditions that develop with prolonged overpronation typically include plantar fasciitis, achilles tendonitis, shin splints, posterior tibial stress syndrome and even IT band syndrome. With long term neglect you may see the development of bunyons, foot deformities and early onset of hip and knee arthritis.

Diagnosis

One of the easiest ways to determine if you overpronate is to look at the bottom of your shoes. Overpronation causes disproportionate wear on the inner side of the shoe. Another way to tell if you might overpronate is to have someone look at the back of your legs and feet, while you are standing. The Achilles tendon runs from the calf muscle to the heel bone, and is visible at the back of the ankle. Normally it runs in a straight line down to the heel. An indication of overpronation is if the tendon is angled to the outside of the foot, and the bone on the inner ankle appears to be more prominent than the outer anklebone. There might also be a bulge visible on the inside of the foot when standing normally. A third home diagnostic test is called the ?wet test?. Wet your foot and stand on a surface that will show an imprint, such as construction paper, or a sidewalk. You overpronate if the imprint shows a complete impression of your foot (as opposed to there being a space where your arch did not touch the ground).Pronation

Non Surgical Treatment

Not all over pronation is treated. Although, when it appears to be a causitive factor that is contributing to pain,or development of structural deformities, there are various degrees of treatment.In some cases specific shoes may be all that is required. In other cases, paddings or strapping, are prescribed and where necessary orthotic therapy. A podiatric assesment would be advised to asses this.

Surgical Treatment

HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.

Dealing With Severs Disease

Overview

Sever?s is described as a traction apophysitis. In childhood our bones are made of a cartilage mould of the bone, which over time as we grow slowly turns into a full bone. The reason for this is that it is easier to grow cartilage to the length required, and then back fill with bone later than it is to actually grow new bone. Most bones have a least two growth of bone centres, one by the joint and one making the main body of the bone. In the growing heel bone (calcaneus) the posterior part has a separate growth area where the Achilles tendon attaches. When playing lots of sport, especially football, rugby and hockey, the two areas of bone can be pulled apart, producing pain. Recent evidence has also suggested that the appearance of this condition on MRI (magnetic resonance imaging), appears to indicate that Sever?s is a type of stress fracture. Whether that fatigue stress is from compression or tension remains in debate, and is probably a combination of both.

Causes

Predisposing Hereditary Factors: These are a biomechanical defect that one may be born with, which increases the chances of developing Sever’s Disease. Short Achilles Tendon, When the Achilles Tendon is short from birth, it will exaggerate the tightness of this tendon that occurs during a child’s growing years. This makes the pull of the Achilles Tendon on the heel’s growth plate more forceful than normal, causing inflammation and pain, and eventually Sever’s Disease. Short Leg Syndrome, When one leg is shorter than the other, the foot on the short leg must plantar flex (the foot and toes bend down) in order to reach the ground. In this way, the body tries to equalize the length of the legs. In order for the foot to plantar flex, the Achilles Tendon must pull on the heel with greater force than if the leg was a normal length. Thus the heel on the short leg will be more susceptible to Sever’s Disease during the foot’s growing years. Pronation. Is a biomechanical defect of the foot that involves a rolling outward of the foot at the ankle, so that when walking, the inner side of the heel and foot bears more of the body’s weight than is normal (click here for more information about pronation). Pronation thus causes the heel to be tilted or twisted. In order for the Achilles Tendon to attach to the heel, it must twist to reach its normal attachment site. This will shorten or tighten the Achilles Tendon and increase the force of its pull on the heel’s growth plate. This will increase the tightness of the Achilles Tendon during the foot’s growing years, and may help to initiate bouts of Sever’s Disease. Flat Arches and High Arches. Both of these biomechanical foot defects effect the pitch, or angle of the heel within the foot. When the heel is not positioned normally within the foot due to the height of the arch, the Achilles Tendon’s attachment to the heel is affected. This may produce a shortening or tightening of the Achilles Tendon, which increases the force of its pull on the heel’s growth plate. During the foot’s growing years, abnormal arch height may contribute to the onset of Sever’s Disease.

Symptoms

Sever’s disease usually develops gradually. The pain from Sever’s disease is often intermittent and localized to the area where the Achilles tendon attaches to the calcaneus. Swelling may be noted in this area. There can be tenderness on squeezing the calcaneus or pain when trying to stretch the calf muscles. Occasionally there is night pain. As Sever’s disease progresses there can be continuous pain.

Diagnosis

A doctor or other health professional such as a physiotherapist can diagnose Sever?s disease by asking the young person to describe their symptoms and by conducting a physical examination. In some instances, an x-ray may be necessary to rule out other causes of heel pain, such as heel fractures. Sever?s disease does not show on an x-ray because the damage is in the cartilage.

Non Surgical Treatment

The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment for Sever’s disease is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain. As directed by the doctor, a child should cut down on or avoid all activities that cause pain until all symptoms are gone, especially running barefoot or on hard surfaces because hard impact on the feet can worsen pain and inflammation. The child might be able to do things that do not put pressure on the heel, such as swimming and biking, but check with a doctor first.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

Flexible Flat Feet In Adults

Overview
Another common term for this condition is Posterior Tibial Tendon Dysfunction (PTTD). There is a cause-effect relationship between pronation, flatfoot deformity and subsequent tenosynovitis of the posterior tibial tendon. Mechanical irritation of the tendon may lead to synovitis, partial tearing and eventually full rupture of the tendon. Other structures, including ligaments and the plantar fascia, have also been shown to contribute to the arch collapsing. As the deformity progresses, these structures have been shown to attenuate and rupture as well. In later stages, subluxation of various joints lead to a valgus rearfoot and transverse plane deformity of the forefoot. These deformities can become fixed and irreducible as significant osteoarthritis sets in.
Adult Acquired Flat Foot

Causes
The posterior tibial tendon, which connects the bones inside the foot to the calf, is responsible for supporting the foot during movement and holding up the arch. Gradual stretching and tearing of the posterior tibial tendon can cause failure of the ligaments in the arch. Without support, the bones in the feet fall out of normal position, rolling the foot inward. The foot’s arch will collapse completely over time, resulting in adult acquired flatfoot. The ligaments and tendons holding up the arch can lose elasticity and strength as a result of aging. Obesity, diabetes, and hypertension can increase the risk of developing this condition. Adult acquired flatfoot is seen more often in women than in men and in those 40 or older.

Symptoms
Initially, flatfoot deformity may not present with any symptoms. However, overtime as the tendon continues to function in an abnormal position, people with fallen arches will begin to have throbbing or sharp pain along the inside of the arch. Once the tendon and soft tissue around it elongates, there is no strengthening exercises or mechanism to shorten the tendon back to a normal position. Flatfoot can also occur in one or both feet. If the arch starts to slowly collapse in one foot and not the other, posterior tibial dysfunction (PTTD) is the most likely cause. People with flatfoot may only have pain with certain activities such as running or exercise in the early phase of PTTD. Pain may start from the arch and continue towards the inside part of the foot and ankle where the tendon courses from the leg. Redness, swelling and increased warmth may also occur. Later signs of PTTD include pain on the outside of the foot from the arch collapsing and impinging other joints. Arthritic symptoms such as painful, swollen joints in the foot and ankle may occur later as well due to the increased stress on the joints from working in an abnormal position for a long period of time.

Diagnosis
First, both feet should be examined with the patient standing and the entire lower extremity visible. The foot should be inspected from above as well as from behind the patient, as valgus angulation of the hindfoot is best appreciated when the foot is viewed from behind. Johnson described the so-called more-toes sign: with more advanced deformity and abduction of the forefoot, more of the lateral toes become visible when the foot is viewed from behind. The single-limb heel-rise test is an excellent determinant of the function of the posterior tibial tendon. The patient is asked to attempt to rise onto the ball of one foot while the other foot is suspended off the floor. Under normal circumstances, the posterior tibial muscle, which inverts and stabilizes the hindfoot, is activated as the patient begins to rise onto the forefoot. The gastrocnemius-soleus muscle group then elevates the calcaneus, and the heel-rise is accomplished. With dysfunction of the posterior tibial tendon, however, inversion of the heel is weak, and either the heel remains in valgus or the patient is unable to rise onto the forefoot. If the patient can do a single-limb heel-rise, the limb may be stressed further by asking the patient to perform this maneuver repetitively.

Non surgical Treatment
Because of the progressive nature of PTTD, early treatment is advised. If treated early enough, your symptoms may resolve without the need for surgery and progression of your condition can be arrested. In contrast, untreated PTTD could leave you with an extremely flat foot, painful arthritis in the foot and ankle, and increasing limitations on walking, running, or other activities. In many cases of PTTD, treatment can begin with non-surgical approaches that may include. Orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may provide you with an ankle brace or a custom orthotic device that fits into the shoe. Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while. Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Shoe modifications. Your foot and ankle surgeon may advise changes to make with your shoes and may provide special inserts designed to improve arch support.
Adult Acquired Flat Foot

Surgical Treatment
Good to excellent results for more than 80% of patients have been reported at five years’ follow up for the surgical interventions recommended below. However, the postoperative recovery is a lengthy process, and most surgical procedures require patients to wear a plaster cast for two to three months. Although many patients report that their function is well improved by six months, in our experience a year is required to recover truly and gain full functional improvement after the surgery. Clearly, some patients are not candidates for such major reconstructive surgery.

What Causes Adult Aquired Flat Foot ?

Overview

Adult acquired flatfoot deformity (AAFD or AAF) is a progressive, symptomatic deformity resulting from gradual stretch of the posterior tibial tendon as well as other ligaments supporting the arch of the foot. AAFD develops after skeletal maturity, May also be referred to as posterior tibial tendon dysfunction (PTTD), although due to the complexity of the disorder AAFD is more appropriate. Significant ligamentous rupture occurs as the deformity progresses. Involved ligaments include the spring ligament, the superficial deltoid ligament, the plantar fascia, and the long and short plantar ligaments. Unilateral AAFD is more common than bilateral AAFD.Acquired Flat Foot


Causes

As discussed above, many health conditions can create a painful flatfoot. Damage to the posterior tibial tendon is the most common cause of AAFD. The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf, travels down the inside of the lower leg and attaches to the bones on the inside of the foot. The main function of this tendon is to hold up the arch and support your foot when you walk. If the tendon becomes inflamed or torn, the arch will slowly collapse. Women and people over 40 are more likely to develop problems with the posterior tibial tendon. Other risk factors include obesity, diabetes, and hypertension. Having flat feet since childhood increases the risk of developing a tear in the posterior tibial tendon. In addition, people who are involved in high impact sports, such as basketball, tennis, or soccer, may have tears of the tendon from repetitive use. Inflammatory arthritis, such as rheumatoid arthritis, can cause a painful flatfoot. This type of arthritis attacks not only the cartilage in the joints, but also the ligaments that support the foot. Inflammatory arthritis not only causes pain, but also causes the foot to change shape and become flat. The arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch.


Symptoms

Posterior tibial tendon insufficiency is divided into stages by most foot and ankle specialists. In stage I, there is pain along the posterior tibial tendon without deformity or collapse of the arch. The patient has the somewhat flat or normal-appearing foot they have always had. In stage II, deformity from the condition has started to occur, resulting in some collapse of the arch, which may or may not be noticeable. The patient may feel it as a weakness in the arch. Many patients initially present in stage II, as the ligament failure can occur at the same time as the tendon failure and therefore deformity can already be occurring as the tendon is becoming symptomatic. In stage III, the deformity has progressed to the extent where the foot becomes fixed (rigid) in its deformed position. Finally, in stage IV, deformity occurs at the ankle in addition to the deformity in the foot.


Diagnosis

Perform a structural assessment of the foot and ankle. Check the ankle for alignment and position. When it comes to patients with severe PTTD, the deltoid has failed, causing an instability of the ankle and possible valgus of the ankle. This is a rare and difficult problem to address. However, if one misses it, it can lead to dire consequences and potential surgical failure. Check the heel alignment and position of the heel both loaded and during varus/valgus stress. Compare range of motion of the heel to the normal contralateral limb. Check alignment of the midtarsal joint for collapse and lateral deviation. Noting the level of lateral deviation in comparison to the contralateral limb is critical for surgical planning. Check midfoot alignment of the naviculocuneiform joints and metatarsocuneiform joints both for sag and hypermobility.


Non surgical Treatment

The adult acquired flatfoot is best treated early. Accurate assessment by your doctor will determine which treatment is suitable for you. Reduce your level of activity and follow the RICE regime. R – rest as often as you are able. Refrain from activity that will worsen your condition, such as sports and walking. I – ice, apply to the affected area, ensure you protect the area from frostbite by applying a towel over the foot before using the ice pack. C – compression, a Tubigrip or elasticated support bandage may be

applied to relieve symptoms and ease pain and discomfort. E – elevate the affected foot to reduce painful swelling. You will be prescribed pain relief in the form of non-steroidal antiinflammatory medications (if you do not suffer with allergies or are asthmatic). Immobilisation of your affected foot – this will involve you having a below the knee cast for four to eight weeks. In certain circumstances it is possible for you to have a removable boot instead of a cast. A member of the foot and ankle team will advise as to whether this option is suitable for you. Footwear is important – it is advisable to wear flat sturdy lace-up shoes, for example, trainers or boots. This will not only support your foot, but will also accommodate orthoses (shoe inserts).

Flat Foot


Surgical Treatment

In cases where cast immobilization, orthoses and shoe therapy have failed, surgery is the next alternative. The goal of surgery and non-surgical treatment is to eliminate pain, stop progression of the deformity and improve mobility of the patient. Opinions vary as to the best surgical treatment for adult acquired flatfoot. Procedures commonly used to correct the condition include tendon debridement, tendon transfers, osteotomies (cutting and repositioning of bone) and joint fusions. (See surgical correction of adult acquired flatfoot). Patients with adult acquired flatfoot are advised to discuss thoroughly the benefits vs. risks of all surgical options. Most procedures have long-term recovery mandating that the correct procedure be utilized to give the best long-term benefit. Most flatfoot surgical procedures require six to twelve weeks of cast immobilization. Joint fusion procedures require eight weeks of non-weightbearing on the operated foot – meaning you will be on crutches for two months. The bottom line is, Make sure all of your non-surgical options have been covered before considering surgery. Your primary goals with any treatment are to eliminate pain and improve mobility. In many cases, with the properly designed foot orthosis or ankle brace, these goals can be achieved without surgical intervention.

Treatments And Causes Of Achilles Tendonitis Pain And discomfort

Overview

Achilles TendonThe Achilles tendon is the largest tendon in the body. Tendons are long, tough cords of tissue that connect muscle to bone. The Achilles tendon is located in the back of the foot and connects your heel bone to your calf muscle. It helps you to walk, run and jump. The Achilles tendon is able to endure stress, but sometimes injury can occur to the tendon when overly stressed. Overuse of the Achilles tendon may cause the tendon to swell, become irritated, inflamed and cause pain. This is Achilles tendinitis. It is a common sports injury related to running, but can happen to anyone who puts a lot of stress on their feet (e.g.: basketball players and dancers). If you do not get treatment for Achilles tendinitis, the problem can become chronic and make it difficult for you to walk.

Causes

The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon. Much like a bungee cord is made up of tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this, treatment options should start with ways to address this.

Symptoms

Achilles tendonitis is an injury that occurs when your Achilles tendon — the large band of tissues connecting the muscles in the back of your lower leg to your heel bone — becomes inflamed or irritated. The signs and symptoms of Achilles tendonitis often develop gradually. You’ll feel pain and stiffness in your Achilles, especially when you first get out of bed. The pain lessens as you warm up, and may even disappear as you continue running. Once you stop, the pain returns and may feel even worse. You may also notice a crackling or creaking sound when you touch or move your Achilles tendon.

Diagnosis

The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems. An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.

Nonsurgical Treatment

Achilles tendonitis will often respond to rest or changes in activity, stretching, or ice after activity. Non-steroidal anti- inflammatory drugs (NSAIDs), such as ibuprofen or naproxen may also help. Physical therapy focusing on stretching and strengthening, massage, alternating hot and cold baths, and ultrasound or sound waves can also help with healing and comfort. The temporary use of a heel lift or the insertion of an arch support, called an orthotic, into the shoe or sneaker can also help. Although seldom necessary, the ankle may be kept in a short leg cast or splint. Surgery is rarely needed but can remove bone spurs or the bony prominence of the heel bone. The injection of corticosteroids such as cortisone into the area of the Achilles tendon is usually avoided because it may cause the tendon to rupture.

Achilles Tendinitis

Surgical Treatment

Not every Achilles tendon injury or condition requires surgery. It is generally understood by doctors and surgeons, that surgery will introduce more scar tissue into the Achilles tendon. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If not dealt with properly, your ankle and Achilles tendon could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.

Prevention

Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the following precautions. Getting a variety of exercise – alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the Achilles tendon is under less tension. Limit certain exercises – doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing them when worn – making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn’t provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually increasing the intensity of a workout – Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your muscles time to loosen up and puts less pressure on the tendon.

What Is Plantar Fasciitis And Learn How To Deal With It

Heel Discomfort

Overview

Foot pain affects nearly all people at one time or another. It can also lead to other musculoskeletal problems such as ankle, knee and back pain (Hill et al., 2008). This pain negatively affects one’s quality of life and ability to enjoy workouts and/or maintain a regular program of exercise. One of the most common sources of foot pain is plantar fasciitis, a condition where the connective tissue on the underside of the foot becomes irritated and painful as a result of an injury, overuse or misuse. The plantar fascia is a system of connective tissue that runs from your heel to just behind your toes. During weightbearing activities, such as walking or running, your body weight is transferred onto your foot from your heel to your toes (which results in your toes moving away from your heel). This spreading out of the foot places tension on the plantar fascia because it connects those two parts. If the tension on this structure is too great or is not dispersed evenly, the plantar fascia can develop microtears and become irritated and painful, resulting in a condition called plantar fasciitis.


Causes

As a person gets older, the plantar fascia becomes less like a rubber band and more like a rope that doesn’t stretch very well. The fat pad on the heel becomes thinner and can’t absorb as much of the shock caused by walking. The extra shock damages the plantar fascia and may cause it to swell, tear or bruise. You may notice a bruise or swelling on your heel. Other risk factors for plantar fasciitis include being overweight and obesity. Diabetes. Spending most of the day on your feet. Becoming very active in a short period of time. Being flat-footed or having a high arch.


Symptoms

Symptoms of plantar fasciitis include pain in the heel of the foot. Some people complain of a sharp stabbing pain especially with walking. Others describe the pain as a dull ache after prolonged standing. The pain of plantar fasciitis is often worst in the morning or following activity.


Diagnosis

A health care professional will ask you whether you have the classic symptoms of first-step pain and about your activities, including whether you recently have intensified your training or changed your exercise pattern. Your doctor often can diagnose plantar fasciitis based on your history and symptoms, together with a physical examination. If the diagnosis is in doubt, your doctor may order a foot X-ray, bone scan or nerve conduction studies to rule out another condition, such as a stress fracture or nerve problem.


Non Surgical Treatment

If conservative treatments fail, and the symptoms of plantar fasciitis have not been relieved, the doctor may recommend one of the following treatments. Cortisone, or corticosteroids, is medications that reduce inflammation. Cortisone is usually mixed with local anesthetics and injected into the plantar fascia where it attaches to the heel bone. In many cases this reduces the inflammation present and allows the plantar fascia to begin healing. Local injections of corticosteroids may provide temporary or permanent relief. Recurrence of symptoms may be lessened by combining steroid injections with other forms of treatment such as orthotics, changes in shoe gear, weight loss, stretching exercises, and rest. Repeated cortisone injections may result in rupture of the plantar fascia, thinning of the heel’s fat pad, and other tissue changes. Extracorporeal Shock Wave Therapy (ESWT) devices generate pulses of high-pressure sound that travel through the skin. For reasons that are not fully understood, soft tissue and bone that are subjected to these pulses of high-pressure energy heal back stronger. There is both a high-energy and low-energy form of ESWT; and both forms of shock wave therapy can be used in the treatment of plantar fasciitis. Research studies indicate ESWT is a safe and effective treatment option for plantar fasciitis. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery.

Plantar Fasciitis


Surgical Treatment

Like every surgical procedure, plantar fasciitis surgery carries some risks. Because of these risks your doctor will probably advise you to continue with the conventional treatments at least 6 months before giving you approval for surgery. Some health experts recommend home treatment as long as 12 months. If you can’t work because of your heel pain, can’t perform your everyday activities or your athletic career is in danger, you may consider a plantar fasciitis surgery earlier. But keep in mind that there is no guarantee that the pain will go away completely after surgery. Surgery is effective in many cases, however, 20 to 25 percent of patients continue to experience heel pain after having a plantar fasciitis surgery.


Prevention

Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain and stress on the plantar fascia by following these simple instructions: Avoid running on hard or uneven ground, lose any excess weight, and wear shoes and orthotics that support your arch to prevent over-stretching of the plantar fascia.

What Is Painful Heel

Plantar Fascia

Overview

There are many diagnoses within the differential of heel pain; however, plantar fasciitis is the most common cause of heel pain for which professional care is sought. Approximately 10% of the United States population experiences bouts of heel pain, which results in 1 million visits per year to medical professionals for treatment of plantar fasciitis. The annual cost of treatments for plantar fasciitis is estimated to be between $192 and $376 million dollars. The etiology of this condition is multifactorial, and the condition can occur traumatically; however, most cases are from overuse stresses.


Causes

Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult. You are more likely to get plantar fasciitis if you Have foot arch problems (both flat feet and high arches), run long distances, downhill or on uneven surfaces, are obese or gain weight suddenly, have a tight Achilles tendon (the tendon connecting the calf muscles to the heel), wear shoes with poor arch support or soft soles. Plantar fasciitis is seen in both men and women. However, it most often affects active men ages 40 – 70. It is one of the most common orthopedic foot complaints. Plantar fasciitis was commonly thought to be caused by a heel spur. However, research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.


Symptoms

Plantar fasciitis is the inflammation of the plantar fascia – a band of tough fibrous tissue running along the sole of the foot. It occurs when small tears develop in the plantar fascia, leading to inflammation and heel pain. The plantar fascia tissue branches out from the heel like a fan, connecting the heel bone to the base of the toes. When the foot moves, the plantar fascia stretches and contracts. The plantar fascia helps to maintain the arch of the foot in much the same way that the string of a bow maintains the bow’s arch. The most notable symptom of plantar fasciitis is heel pain. This is typically most severe in the middle of the heel though it may radiate along the sole of the foot. The pain is most often felt when walking first thing in the morning or after a period of rest. As walking continues the pain may decrease; however some degree of pain remains present on movement. The pain may disappear when resting, as the plantar fascia is relaxed. Redness, swelling and warmth over the affected area may also be noticed. The onset of plantar fasciitis is gradual and only mild pain may be experienced initially. However, as the condition progresses the pain experienced tends to become more severe. Chronic plantar fasciitis may cause a person to change their walking or running action, leading to symptoms of discomfort in the knee, hip and back.


Diagnosis

Plantar fasciosis is confirmed if firm thumb pressure applied to the calcaneus when the foot is dorsiflexed elicits pain. Fascial pain along the plantar medial border of the fascia may also be present. If findings are equivocal, demonstration of a heel spur on x-ray may support the diagnosis; however, absence does not rule out the diagnosis, and visible spurs are not generally the cause of symptoms. Also, infrequently, calcaneal spurs appear ill defined on x-ray, exhibiting fluffy new bone formation, suggesting spondyloarthropathy (eg, ankylosing spondylitis, reactive arthritis. If an acute fascial tear is suspected, MRI is done.


Non Surgical Treatment

A doctor may prescribe anti-inflammatory medication such as ibuprofen to help reduce pain and inflammation. Electrotherapy such as ultrasound or laser may also help with symptoms. An X-ray may be taken to see if there is any bone growth or calcification, known as a heel spur but this is not necessarily a cause of pain. Deep tissue sports massage techniques can reduce the tension in and stretch the plantar fascia and the calf muscles. Extracorporeal shock wave therapy has been known to be successful and a corticosteroid injection is also an option.

Painful Heel


Surgical Treatment

Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.


Prevention

The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. Take care of your feet. Wear shoes with good arch support and heel cushioning. If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet. Do exercises to stretch the Achilles tendon at the back of the heel. This is especially important before sports, but it is helpful for non-athletes as well. Ask your doctor about recommendations for a stretching routine. Stay at a healthy weight for your height. Establish good exercise habits. Increase your exercise levels gradually, and wear supportive shoes. If you run, alternate running with other sports that will not cause heel pain. Put on supportive shoes as soon as you get out of bed. Going barefoot or wearing slippers puts stress on your feet. If you feel that work activities caused your heel pain, ask your human resources department for information about different ways of doing your job that will not make your heel pain worse. If you are involved in sports, you may want to consult a sports training specialist for training and conditioning programs to prevent plantar fasciitis from recurring.

Symptoms Of foot Blisters

Metatarsal pain, often referred to as metatarsalgia, can be caused by several foot conditions, including Freiberg’s disease, Morton’s neuroma and sesamoiditis. According to a 2003 article in the British Journal of Sports Bunions Callous Medicine,” a flat or high arch is one of many risk factors for lower extremity injuries including foot injuries. Poor circulation occurs when there is not enough blood supplied to an area to meet the needs of the cells.

U-Shaped portion surrounds sore callus and reduces pain by transferring pressure from callus to the cushion. Soft orthotics cushion the ball and arches of the feet and protect them from injury and pain, while rigid orthotics correct abnormal foot angles and movements that can cause or worsen pain in the ball of the foot. Many insoles fit inside of slippers so that people suffering from pain in the ball of the foot can walk more comfortably inside their homes as well as outside. In addition, some insoles include added deodorizers to help decrease foot odor. While gel or foam insoles are sold at pharmacies, grocery stores and sporting-goods stores, orthotics require a visit to a podiatrist, who will make a cast of the foot and build a custom-fit insole from the cast. Foam, gel and soft orthotics require replacement once a year or more as the cushioning wears out. Rigid orthotics rarely need replacement. Hip bone spur can cause a lot of discomfort.

If you see just a thin line connecting the ball of your foot to your heel, you have high arches. If you have flat feet or high arches, you’re more likely to get plantar fasciitis, an inflammation of the tissue along the bottom of your foot. Without proper arch support, you can have pain in your heels, arch, and leg. You can also develop bunions and hammertoes, which can become painful,” says Marlene Reid, a podiatrist, or foot and ankle doctor, in Naperville, IL. Shoes with good arch support and a slightly raised heel can help ward off trouble. Laces, buckles, or straps are best for high arches. See a foot doctor to get fitted with custom inserts for your shoes. Good running shoes, for example, can prevent heel pain, stress fractures , and other foot problems that can be brought on by running. A 2-inch heel is less damaging than a 4-inch heel. If you have flat feet, opt for chunky heels instead of skinny ones, Reid says.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

On the other hand, the surgical hip pain treatment includes total hip bone replacement surgery. Although it is always advisable to consult the doctor if you experience pain in the hip that lasts for more than a couple of hours, you can try some home remedies to temporarily get rid of the sharp hip pain. One should note that these home remedies are not to be substituted for proper medical treatment. Ice packs and cool compresses are helpful to ease pain and inflammation on various parts of the body. Rest and ice the sole of your feet.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Went to Podiatrist after receiving pain pills to move, got MRI and he told me I have severe tear in plantor faciitis tendon. Have swelling or what I call a fatty feeling, as I have always had on ball of foot below left most two toes. And it seems to feel a little more fatty since I walked for the first time today after putting on a good pair of ankle boots. Any idea what the fatty feeling is on ball of foot. Lastly, I took the boot off at my stairs into my house 2 days ago and took a step using ball of left foot and it did not pop.

Home Remedies For Gout Flare Ups

Before going to the podiatrist for hammertoe treatment, look at the easy and simple treatment options that will relieve you off the distress. Like hammer toe , claw toe is a foot deformity characterized by a permanent bending of the joints in the toes. Recovery from a hammertoe surgery can take around a few months. Hammer toes can cause pain in the ball of the foot.

Lack of sensation in the feet increases the risk for unnoticed foot injuries, which may lead to serious infections. Diabetic peripheral neuropathy can affect the muscle-related, or motor, nerves of the feet and lower legs. Damage to these nerves commonly causes weakness of the associated muscles, which can lead to foot deformities, notes the American College of Foot and Ankle Surgeons on the patient information website Foot Health Facts. Claw toe and hammertoe deformities, in which the toes curl rather than lying flat, frequently occur in people with diabetic motor neuropathy of the feet. These deformities often cause bunions, calluses and corns, which may lead to foot ulcers. The University of Chicago Center for Peripheral Neuropathy reports that pain, tingling or numbness of the hands can occur with diabetic peripheral neuropathy, affecting the sensory nerves of the hands. Claw toes result from an inherent muscle imbalance. A terrific skin care regime.

Other toe pain conditions, such as toe misalignment can be easily prevented and treated with the use of good quality Orthotic Foot Beds. What usually leads to such problems include poor posture, sitting for long periods without exercise or stretching, and arthritis. As a matter of fact, a simple correction of posture can provide relief from sciatic nerve pain. Dr. Marble discusses the problem of thick toe nails and its many etiologies. If you know anybody with drug or alcohol addiction and suffering from mental problems, dual diagnosis treatment can help them. Plantar fasciitis mostly occurs in people between 40 and 60 years of age.

Therefore flat shoes are a better option during pregnancy because it will keep you comfortable avoiding complications and dangerous consequences. But, there are some women who cannot even think of wearing flat shoes. Wearing flat shoes gives them the feeling of naked feet. For them, it is better to use heels of about 2 to 3 inches maximum. Common types of crooked toes are hammer toes, claw toes, and mallet toes.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

When a bunion worsens, it may cause associated problems in the so-called lesser toes, such as hammer toes, claw toes and crossover toes, said Dr Tan. More than 50 per cent of the time, people with lesser toe deformities have an underlying reason – that is, bunions,” said Dr Tan. One such deformity is the hammer toe, so-called because the abnormal bend at the middle joint makes it look like one. There is also the crossover toe, which, as the name suggests, occurs when one toe crosses over another. This is a toe that is bent upward from the joint at the ball of the foot and downward at the middle joint towards the sole, such that it resembles a claw. Before claw toes develop, most patients have pain under the ball of the foot.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Emotional and physical stress from both the surgery and recovery time changes your metabolism, which increases acid production. The use of both general and local anesthesia, pain medication, anti-inflammatory medications and other medications such as antibiotics will also introduce more acid to your system, lowering the alkalinity. To maintain your body’s proper pH, keep yourself well hydrated prior to and after surgery. These include: aspirin, ibuprofen (Advil, Motrin) and naproxen sodium (Aleve).Arrange for a ride home from surgery and for someone to look after you for at least the first 24 hours.Avoid long trips for at least two weeks after surgery.Avoid eating and drinking anything after midnight the night before surgery. After surgery you will receive pain medication and care instructions.

Sometimes a change in activity, shoes, or weight gain can make a bunion or hammertoe seem suddenly very painful. Orthotics, custom orthopedic foot supports, can help with mild hammer toes and bunions. Orthotics may slow down or perhaps prevent the progression of bunions and hammer toes.