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July 02 2017

karolynflegel

Fallen Arches Explained

http://karolynflegel.soup.io Overview

Flat Foot

A quarter of Americans have flat feet. While most people with flat feet don't have serious problems as a result, for some, flat feet can cause disabling foot pain as well as knee pain, shin splints, Achilles tendinitis, and plantar fasciitis. A person with foot or leg pain should pay particular attention to whether one foot is flatter than the other.

Causes

Family history, experts say fallen arches can run in families. Weak arch, the arch of the foot may be there when no weight is placed on it, for example, when the person is sitting. But as soon as they stand up the foot flattens (falls) onto the ground. Injury, arthritis, tibialis posterior (ruptured tendon), pregnancy, nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida. Tarsal Coalition, the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. Most commonly diagnosed during childhood. Diabetes. Age and wear and tear, years of using your feet to walk, run, and jump eventually may take its toll. One of the eventual consequences could be fallen arches. The posterior tibial tendon may become weakened after long-term wear a tear. The postario tibial tendon is the main support structure of the arch of our feet. The tendon can become inflamed (tendinitis) after overuse - sometimes it can even become torn. Once the tendon is damaged, the arch shape of the foot may flatten.

Symptoms

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

heelsncleavage

Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Surgical procedures for flat feet vary depending on the root cause of the condition. Surgical correction to control pronation may include bone implants or Achilles tendon lengthening. Tendon transfer, which is a procedure to re-attach a tendon to another area of bone, may also be used to reduce pronation and improve foot function.

Prevention

Sit up straight in a chair with your feet flat on the ground. Scrunch up the toes of one foot as if you are trying to grab hold of the floor then use your toes to drag your foot a small distance forwards. Do this a couple of times on each foot, but don?t use your leg muscles to push your foot forward -- the movement should come solely from the muscles in your feet. Sit in a chair and place a cleaning cloth, towel or small ball on the floor at your feet. Use the toes of one foot to grasp the object and lift it off the floor. This action will require you to clench your toes and contract your arch. Once you have lifted the object a little way off the floor, try to throw it in the air and catch it by stretching your toes and arch out and upwards. Repeat the exercise several times on both feet. Sit on the floor with your legs straight out in front of you then bend your knees out to either side and place the soles of your feet together so your legs form a diamond. Hold on to your ankles and, keeping your heels together at all times, separate your feet so your toes point out to either side. Open and close your feet in this way several times, making sure your little toes stay in contact with the floor throughout the exercise. Starting in the same position, try separating your heels, keeping your toes together at all times.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.

July 01 2017

karolynflegel

Leg Length Discrepancy Measurement Methods

http://karolynflegel.soup.io Overview

Many people undergo surgery for various reasons - arthritis, knee replacement, hip replacement, even back surgery. However, the underlying cause of leg length inequality still remains. So after expensive and painful surgery, follow by time-consuming and painful rehab, the true culprit still remains. Resuming normal activities only continues to place undue stress on the already overloaded side. Sadly so, years down the road more surgeries are recommended for other joints that now endure the excessive forces.Leg Length Discrepancy

Causes

From an anatomical stand point, the LLD could have been from hereditary, broken bones, diseases and joint replacements. Functional LLD can be from over pronating, knee deformities, tight calves and hamstrings, weak IT band, curvature in the spine and many other such muscular/skeletal issues.

Symptoms

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

Diagnosis

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

Non Surgical Treatment

A properly made foot orthotic can go a long way in substituting additional millimeters or centimeter on the deficient side. Additional full length inserts are added to the shorter side bringing the runner closer to symmetrical. Heel lifts do not work in runners because when you run you may land on your heel but the rest of the time you are on your forefoot then your toes pushing off. The right custom-made, biomechanical orthotic can address the underlying cause of your pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and are designed with your specific body weight, leg length discrepancy, and activity in mind. The restoration of correct mechanical function takes the abnormal stress from the uneven side and allows the body to heal naturally.

Leg Length Discrepancy Insoles

can gym help in increasing height?

Surgical Treatment

Large leg length inequalities can be treated by staged lengthenings or by simultaneous ipsilateral femoral and tibial lengthenings. Additionally, lengthenings can be combined with appropriately timed epiphysiodesis in an effort to produce leg length equality. Staged lengthenings are often used for congenital deficiencies such as fibular hemimelia, in which 15 cm or more may be needed to produce leg length equality. We typically plan for the final lengthening to be completed by age 13 or 14 years, and allow at least 3 years between lengthenings. Lengthening of both the tibia and femur simultaneously requires aggressive therapy and treatment of soft tissue contractures. Curran et al[57] reported the need for surgical release of soft tissue contractures in 3 of 8 patients treated with simultaneous ipsilateral femoral and tibial lengthenings. Lengthening over an IM nail can be done in an effort to decrease the amount of time the fixator needs to be worn and to prevent angular malalignment. This technique requires that the patient be skeletally mature and it carries a higher risk of osteomyelitis (up to 15%). Additionally, if premature consolidation occurs, a repeat corticotomy is more difficult.

June 30 2017

karolynflegel

All You Will Need To Know About

http://karolynflegel.soup.io Overview

Heel Discomfort

Heel pain is a very common foot problem. The sufferer usually feels pain either under the heel (planter fasciitis) or just behind it (Achilles tendinitis), where the Achilles tendon connects to the heel bone. Even though heel pain can be severe and sometimes disabling, it is rarely a health threat. Heel pain is typically mild and usually disappears on its own; however, in some cases the pain may persist and become chronic (long-term). There are 26 bones in the human foot, of which the heel (calcaneus) is the largest. The human heel is designed to provide a rigid support for the weight of the body. When we are walking or running it absorbs the impact of the foot when it hits the ground, and springs us forward into our next stride. Experts say that the stress placed on a foot when walking may be 1.25 times our body weight, and 2.75 times when running. Consequently, the heel is vulnerable to damage, and ultimately pain.

Causes

Plantar Fasciitis is the most common form of heel pain. The tears and inflammation that develop along the plantar fascia ligament result in dull aching pain or a burning sensation along the bottom of the foot. Pain becomes particularly noticeable after periods of rest, such as during the first few steps after getting out of bed in the morning, or after getting up after a prolonged period of sitting. Another common form of heel pain is the development of a heel spur. A heel spur, as mentioned above, is the formation of a bony hook extending from the heel. Typically, these growths develop near the area where the plantar fascia connects to the heel bone. The repetitive pressure on the plantar fascia that results from stretching excessively away from the heel bone causes a response from our body that delivers calcium to the area. The heel pain that ensues develops from the nerves and sensitive tissue that become irritated when the bone fragment digs into the bottom of the heel. Pain may decrease after walking as the tissue in the heel gets used to the fragment and adjusts around it. However, pain will be particularly problematic following periods of rest. Strained muscle tissue may cause heel pain in several areas. A tight plantar fascia causes additional tension, particularly while exercising, placing runners and other athletes at risk if the ligament is not properly warmed up prior to exercise. Additionally, a tight Achilles tendon along the back of the foot can also add tension along the plantar fascia, resulting in possible damage, not to mention the damage and pain that can occur along the Achilles tendon itself (Achilles tendonitis). It is recommended that athletes properly stretch the foot as well as the calf in order to reduce tension on muscle and other tissue in the foot.

Symptoms

Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.

Diagnosis

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

Non Surgical Treatment

Heel pain often goes away on its own with home care. For heel pain that isn't severe, try the following. Rest. If possible, avoid activities that put stress on your heels, such as running, standing for long periods or walking on hard surfaces. Ice. Place an ice pack or bag of frozen peas on your heel for 15 to 20 minutes three times a day. New shoes. Be sure your shoes fit properly and provide plenty of support. If you're an athlete, choose shoes appropriate for your sport and replace them regularly. Foot supports. Heel cups or wedges that you buy in the drugstore often provide relief. Custom-made orthotics usually aren't needed for heel problems. Over-the-counter pain medications. Aspirin or ibuprofen (Advil, Motrin IB, others) can reduce inflammation and pain.

Surgical Treatment

Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to have a "numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).

deelsonheels

Prevention

Pain At The Heel

You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels. Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain. If you do a physical activity, such as running or another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly. Most experts recommend that sports shoes should be replaced after you have done about 500 miles in them. It is also a good idea to always stretch after exercising, and to make strength and flexibility training a part of your regular exercise routine.

June 27 2017

karolynflegel

Leg Length Discrepancy Surgical Treatment

http://karolynflegel.soup.io Overview

Differences of an inch-and-a-half to two inches may require epiphysiodesis (adjusting the growth of the longer side) or acute shortening of the other side. Differences greater than 2.5 inches usually require a lengthening procedure. The short bone is cut and an external device is applied. Gradual lengthening is done over months to allow the muscles and nerves accommodate the new length.Leg Length Discrepancy

Causes

LLDs are very common. Sometimes the cause isn?t known. But the known causes of LLD in children include, injury or infection that slows growth of one leg bone. Injury to the growth plate (a soft part of a long bone that allows the bone to grow). Growth plate injury can slow bone growth in that leg. Fracture to a leg bone that causes overgrowth of the bone as it heals. A congenital (present at birth) problem (one whole side of the child?s body may be larger than the other side). Conditions that affect muscles and nerves, such as polio.

Symptoms

Patients with significant lower limb length discrepancies may walk with a limp, have the appearance of a curved spine (non-structural scoliosis), and experience back pain or fatigue. In addition, clothes may not fit right.

Diagnosis

Limb length discrepancy can be measured by a physician during a physical examination and through X-rays. Usually, the physician measures the level of the hips when the child is standing barefoot. A series of measured wooden blocks may be placed under the short leg until the hips are level. If the physician believes a more precise measurement is needed, he or she may use X-rays. In growing children, a physician may repeat the physical examination and X-rays every six months to a year to see if the limb length discrepancy has increased or remained unchanged. A limb length discrepancy may be detected on a screening examination for curvature of the spine (scoliosis). But limb length discrepancy does not cause scoliosis.

Non Surgical Treatment

Treatment is based on an estimate of how great the difference in leg length will be when the child grows up, Small differences (a half inch or less) do not need treatment. Differences of a half to one inch may require a lift inside the shoe.

LLD Shoe Inserts

leg length discrepancy hip pain

Surgical Treatment

Surgical treatments vary in complexity. Sometimes the goal of surgery is to stop the growth of the longer limb. Other times, surgeons work to lengthen the shorter limb. Orthopedic surgeons may treat children who have limb-length conditions with one or a combination of these surgical techniques. Bone resection. An operation to remove a section of bone, evening out the limbs in teens or adults who are no longer growing. Epiphyseal stapling. An operation to slow the rate of growth of the longer limb by inserting staples into the growth plate, then removing them when the desired result is achieved. Epiphysiodesis. An operation to slow the rate of growth of the longer limb by creating a permanent bony ridge near the growth plate. Limb lengthening. A procedure (also called distraction osteogenesis or the Ilizarov procedure) that involves attaching an internal or external fixator to a limb and gradually pulling apart bone segments to grow new bone between them. There are several ways your doctor can predict the final LLD, and thus the timing of the surgery. The easiest way is the so-called Australian method, popularised by Dr. Malcolm Menelaus, an Australian orthopedic surgeon. According to this method, growth in girls is estimated to stop at age 14, and in boys at age 16 years. The femur grows at the rate of 10 mm. a year, and the upper tibia at the rate of 6 mm. a year. Using simple arithmetic, one can get a fairly good prediction of future growth. This of course, is an average, and the patient may be an average. To cut down the risk of this, the doctor usually measures leg length using special X-ray technique (called a Scanogram) on three occasions over at least one year duration to estimate growth per year. He may also do an X-ray of the left hand to estimate the bone age (which in some cases may differ from chronological age) by comparing it with an atlas of bone age. In most cases, however, the bone age and chronological age are quite close. Another method of predicting final LLD is by using Anderson and Green?s remaining growth charts. This is a very cumbersome method, but was till the 1970?s, the only method of predicting remaining growth. More recently, however, a much more convenient method of predicting LLD was discovered by Dr. Colin Moseley from Montreal. His technique of using straight line graphs to plot growth of leg lengths is now the most widely used method of predicting leg length discrepancy. Whatever method your doctor uses, over a period of one or two years, once he has a good idea of the final LLD, he can then formulate a plan to equalize leg lengths. Epiphyseodesis is usually done in the last 2 to 3 years of growth, giving a maximum correction of about 5 cm. Leg lengthening can be done at any age, and can give corrections of 5 to10 cm., or more.

July 02 2017

karolynflegel

Fallen Arches Explained

http://karolynflegel.soup.io Overview

Flat Foot

A quarter of Americans have flat feet. While most people with flat feet don't have serious problems as a result, for some, flat feet can cause disabling foot pain as well as knee pain, shin splints, Achilles tendinitis, and plantar fasciitis. A person with foot or leg pain should pay particular attention to whether one foot is flatter than the other.

Causes

Family history, experts say fallen arches can run in families. Weak arch, the arch of the foot may be there when no weight is placed on it, for example, when the person is sitting. But as soon as they stand up the foot flattens (falls) onto the ground. Injury, arthritis, tibialis posterior (ruptured tendon), pregnancy, nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida. Tarsal Coalition, the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. Most commonly diagnosed during childhood. Diabetes. Age and wear and tear, years of using your feet to walk, run, and jump eventually may take its toll. One of the eventual consequences could be fallen arches. The posterior tibial tendon may become weakened after long-term wear a tear. The postario tibial tendon is the main support structure of the arch of our feet. The tendon can become inflamed (tendinitis) after overuse - sometimes it can even become torn. Once the tendon is damaged, the arch shape of the foot may flatten.

Symptoms

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

heelsncleavage

Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Surgical procedures for flat feet vary depending on the root cause of the condition. Surgical correction to control pronation may include bone implants or Achilles tendon lengthening. Tendon transfer, which is a procedure to re-attach a tendon to another area of bone, may also be used to reduce pronation and improve foot function.

Prevention

Sit up straight in a chair with your feet flat on the ground. Scrunch up the toes of one foot as if you are trying to grab hold of the floor then use your toes to drag your foot a small distance forwards. Do this a couple of times on each foot, but don?t use your leg muscles to push your foot forward -- the movement should come solely from the muscles in your feet. Sit in a chair and place a cleaning cloth, towel or small ball on the floor at your feet. Use the toes of one foot to grasp the object and lift it off the floor. This action will require you to clench your toes and contract your arch. Once you have lifted the object a little way off the floor, try to throw it in the air and catch it by stretching your toes and arch out and upwards. Repeat the exercise several times on both feet. Sit on the floor with your legs straight out in front of you then bend your knees out to either side and place the soles of your feet together so your legs form a diamond. Hold on to your ankles and, keeping your heels together at all times, separate your feet so your toes point out to either side. Open and close your feet in this way several times, making sure your little toes stay in contact with the floor throughout the exercise. Starting in the same position, try separating your heels, keeping your toes together at all times.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.

July 01 2017

karolynflegel

Leg Length Discrepancy Measurement Methods

http://karolynflegel.soup.io Overview

Many people undergo surgery for various reasons - arthritis, knee replacement, hip replacement, even back surgery. However, the underlying cause of leg length inequality still remains. So after expensive and painful surgery, follow by time-consuming and painful rehab, the true culprit still remains. Resuming normal activities only continues to place undue stress on the already overloaded side. Sadly so, years down the road more surgeries are recommended for other joints that now endure the excessive forces.Leg Length Discrepancy

Causes

From an anatomical stand point, the LLD could have been from hereditary, broken bones, diseases and joint replacements. Functional LLD can be from over pronating, knee deformities, tight calves and hamstrings, weak IT band, curvature in the spine and many other such muscular/skeletal issues.

Symptoms

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

Diagnosis

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

Non Surgical Treatment

A properly made foot orthotic can go a long way in substituting additional millimeters or centimeter on the deficient side. Additional full length inserts are added to the shorter side bringing the runner closer to symmetrical. Heel lifts do not work in runners because when you run you may land on your heel but the rest of the time you are on your forefoot then your toes pushing off. The right custom-made, biomechanical orthotic can address the underlying cause of your pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and are designed with your specific body weight, leg length discrepancy, and activity in mind. The restoration of correct mechanical function takes the abnormal stress from the uneven side and allows the body to heal naturally.

Leg Length Discrepancy Insoles

can gym help in increasing height?

Surgical Treatment

Large leg length inequalities can be treated by staged lengthenings or by simultaneous ipsilateral femoral and tibial lengthenings. Additionally, lengthenings can be combined with appropriately timed epiphysiodesis in an effort to produce leg length equality. Staged lengthenings are often used for congenital deficiencies such as fibular hemimelia, in which 15 cm or more may be needed to produce leg length equality. We typically plan for the final lengthening to be completed by age 13 or 14 years, and allow at least 3 years between lengthenings. Lengthening of both the tibia and femur simultaneously requires aggressive therapy and treatment of soft tissue contractures. Curran et al[57] reported the need for surgical release of soft tissue contractures in 3 of 8 patients treated with simultaneous ipsilateral femoral and tibial lengthenings. Lengthening over an IM nail can be done in an effort to decrease the amount of time the fixator needs to be worn and to prevent angular malalignment. This technique requires that the patient be skeletally mature and it carries a higher risk of osteomyelitis (up to 15%). Additionally, if premature consolidation occurs, a repeat corticotomy is more difficult.

June 30 2017

karolynflegel

All You Will Need To Know About

http://karolynflegel.soup.io Overview

Heel Discomfort

Heel pain is a very common foot problem. The sufferer usually feels pain either under the heel (planter fasciitis) or just behind it (Achilles tendinitis), where the Achilles tendon connects to the heel bone. Even though heel pain can be severe and sometimes disabling, it is rarely a health threat. Heel pain is typically mild and usually disappears on its own; however, in some cases the pain may persist and become chronic (long-term). There are 26 bones in the human foot, of which the heel (calcaneus) is the largest. The human heel is designed to provide a rigid support for the weight of the body. When we are walking or running it absorbs the impact of the foot when it hits the ground, and springs us forward into our next stride. Experts say that the stress placed on a foot when walking may be 1.25 times our body weight, and 2.75 times when running. Consequently, the heel is vulnerable to damage, and ultimately pain.

Causes

Plantar Fasciitis is the most common form of heel pain. The tears and inflammation that develop along the plantar fascia ligament result in dull aching pain or a burning sensation along the bottom of the foot. Pain becomes particularly noticeable after periods of rest, such as during the first few steps after getting out of bed in the morning, or after getting up after a prolonged period of sitting. Another common form of heel pain is the development of a heel spur. A heel spur, as mentioned above, is the formation of a bony hook extending from the heel. Typically, these growths develop near the area where the plantar fascia connects to the heel bone. The repetitive pressure on the plantar fascia that results from stretching excessively away from the heel bone causes a response from our body that delivers calcium to the area. The heel pain that ensues develops from the nerves and sensitive tissue that become irritated when the bone fragment digs into the bottom of the heel. Pain may decrease after walking as the tissue in the heel gets used to the fragment and adjusts around it. However, pain will be particularly problematic following periods of rest. Strained muscle tissue may cause heel pain in several areas. A tight plantar fascia causes additional tension, particularly while exercising, placing runners and other athletes at risk if the ligament is not properly warmed up prior to exercise. Additionally, a tight Achilles tendon along the back of the foot can also add tension along the plantar fascia, resulting in possible damage, not to mention the damage and pain that can occur along the Achilles tendon itself (Achilles tendonitis). It is recommended that athletes properly stretch the foot as well as the calf in order to reduce tension on muscle and other tissue in the foot.

Symptoms

Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the centre of the heel or on the inside margin of the heel. Often the pain is worse on first rising in the morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.

Diagnosis

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

Non Surgical Treatment

Heel pain often goes away on its own with home care. For heel pain that isn't severe, try the following. Rest. If possible, avoid activities that put stress on your heels, such as running, standing for long periods or walking on hard surfaces. Ice. Place an ice pack or bag of frozen peas on your heel for 15 to 20 minutes three times a day. New shoes. Be sure your shoes fit properly and provide plenty of support. If you're an athlete, choose shoes appropriate for your sport and replace them regularly. Foot supports. Heel cups or wedges that you buy in the drugstore often provide relief. Custom-made orthotics usually aren't needed for heel problems. Over-the-counter pain medications. Aspirin or ibuprofen (Advil, Motrin IB, others) can reduce inflammation and pain.

Surgical Treatment

Extracorporeal shockwave therapy (EST) is a fairly new type of non-invasive treatment. Non-invasive means it does not involve making cuts into your body. EST involves using a device to deliver high-energy soundwaves into your heel. The soundwaves can sometimes cause pain, so a local anaesthetic may be used to numb your heel. It is claimed that EST works in two ways. It is thought to have a "numbing" effect on the nerves that transmit pain signals to your brain, help stimulate and speed up the healing process. However, these claims have not yet been definitively proven. The National Institute for Health and Care Excellence (NICE) has issued guidance about the use of EST for treating plantar fasciitis. NICE states there are no concerns over the safety of EST, but there are uncertainties about how effective the procedure is for treating heel pain. Some studies have reported that EST is more effective than surgery and other non-surgical treatments, while other studies found the procedure to be no better than a placebo (sham treatment).

deelsonheels

Prevention

Pain At The Heel

You should always wear footwear that is appropriate for your environment and day-to-day activities. Wearing high heels when you go out in the evening is unlikely to be harmful. However, wearing them all week at work may damage your feet, particularly if your job involves a lot of walking or standing. Ideally, you should wear shoes with laces and a low to moderate heel that supports and cushions your arches and heels. Avoid wearing shoes with no heels. Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on holiday. Their feet are not accustomed to the extra pressure, which causes heel pain. If you do a physical activity, such as running or another form of exercise that places additional strain on your feet, you should replace your sports shoes regularly. Most experts recommend that sports shoes should be replaced after you have done about 500 miles in them. It is also a good idea to always stretch after exercising, and to make strength and flexibility training a part of your regular exercise routine.

July 02 2017

karolynflegel

Fallen Arches Explained

http://karolynflegel.soup.io Overview

Flat Foot

A quarter of Americans have flat feet. While most people with flat feet don't have serious problems as a result, for some, flat feet can cause disabling foot pain as well as knee pain, shin splints, Achilles tendinitis, and plantar fasciitis. A person with foot or leg pain should pay particular attention to whether one foot is flatter than the other.

Causes

Family history, experts say fallen arches can run in families. Weak arch, the arch of the foot may be there when no weight is placed on it, for example, when the person is sitting. But as soon as they stand up the foot flattens (falls) onto the ground. Injury, arthritis, tibialis posterior (ruptured tendon), pregnancy, nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida. Tarsal Coalition, the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. Most commonly diagnosed during childhood. Diabetes. Age and wear and tear, years of using your feet to walk, run, and jump eventually may take its toll. One of the eventual consequences could be fallen arches. The posterior tibial tendon may become weakened after long-term wear a tear. The postario tibial tendon is the main support structure of the arch of our feet. The tendon can become inflamed (tendinitis) after overuse - sometimes it can even become torn. Once the tendon is damaged, the arch shape of the foot may flatten.

Symptoms

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

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Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Surgical procedures for flat feet vary depending on the root cause of the condition. Surgical correction to control pronation may include bone implants or Achilles tendon lengthening. Tendon transfer, which is a procedure to re-attach a tendon to another area of bone, may also be used to reduce pronation and improve foot function.

Prevention

Sit up straight in a chair with your feet flat on the ground. Scrunch up the toes of one foot as if you are trying to grab hold of the floor then use your toes to drag your foot a small distance forwards. Do this a couple of times on each foot, but don?t use your leg muscles to push your foot forward -- the movement should come solely from the muscles in your feet. Sit in a chair and place a cleaning cloth, towel or small ball on the floor at your feet. Use the toes of one foot to grasp the object and lift it off the floor. This action will require you to clench your toes and contract your arch. Once you have lifted the object a little way off the floor, try to throw it in the air and catch it by stretching your toes and arch out and upwards. Repeat the exercise several times on both feet. Sit on the floor with your legs straight out in front of you then bend your knees out to either side and place the soles of your feet together so your legs form a diamond. Hold on to your ankles and, keeping your heels together at all times, separate your feet so your toes point out to either side. Open and close your feet in this way several times, making sure your little toes stay in contact with the floor throughout the exercise. Starting in the same position, try separating your heels, keeping your toes together at all times.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.

July 01 2017

karolynflegel

Leg Length Discrepancy Measurement Methods

http://karolynflegel.soup.io Overview

Many people undergo surgery for various reasons - arthritis, knee replacement, hip replacement, even back surgery. However, the underlying cause of leg length inequality still remains. So after expensive and painful surgery, follow by time-consuming and painful rehab, the true culprit still remains. Resuming normal activities only continues to place undue stress on the already overloaded side. Sadly so, years down the road more surgeries are recommended for other joints that now endure the excessive forces.Leg Length Discrepancy

Causes

From an anatomical stand point, the LLD could have been from hereditary, broken bones, diseases and joint replacements. Functional LLD can be from over pronating, knee deformities, tight calves and hamstrings, weak IT band, curvature in the spine and many other such muscular/skeletal issues.

Symptoms

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

Diagnosis

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

Non Surgical Treatment

A properly made foot orthotic can go a long way in substituting additional millimeters or centimeter on the deficient side. Additional full length inserts are added to the shorter side bringing the runner closer to symmetrical. Heel lifts do not work in runners because when you run you may land on your heel but the rest of the time you are on your forefoot then your toes pushing off. The right custom-made, biomechanical orthotic can address the underlying cause of your pain. Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized. San Diego Running Institute orthotics are custom molded to your foot and are designed with your specific body weight, leg length discrepancy, and activity in mind. The restoration of correct mechanical function takes the abnormal stress from the uneven side and allows the body to heal naturally.

Leg Length Discrepancy Insoles

can gym help in increasing height?

Surgical Treatment

Large leg length inequalities can be treated by staged lengthenings or by simultaneous ipsilateral femoral and tibial lengthenings. Additionally, lengthenings can be combined with appropriately timed epiphysiodesis in an effort to produce leg length equality. Staged lengthenings are often used for congenital deficiencies such as fibular hemimelia, in which 15 cm or more may be needed to produce leg length equality. We typically plan for the final lengthening to be completed by age 13 or 14 years, and allow at least 3 years between lengthenings. Lengthening of both the tibia and femur simultaneously requires aggressive therapy and treatment of soft tissue contractures. Curran et al[57] reported the need for surgical release of soft tissue contractures in 3 of 8 patients treated with simultaneous ipsilateral femoral and tibial lengthenings. Lengthening over an IM nail can be done in an effort to decrease the amount of time the fixator needs to be worn and to prevent angular malalignment. This technique requires that the patient be skeletally mature and it carries a higher risk of osteomyelitis (up to 15%). Additionally, if premature consolidation occurs, a repeat corticotomy is more difficult.

July 02 2017

karolynflegel

Fallen Arches Explained

http://karolynflegel.soup.io Overview

Flat Foot

A quarter of Americans have flat feet. While most people with flat feet don't have serious problems as a result, for some, flat feet can cause disabling foot pain as well as knee pain, shin splints, Achilles tendinitis, and plantar fasciitis. A person with foot or leg pain should pay particular attention to whether one foot is flatter than the other.

Causes

Family history, experts say fallen arches can run in families. Weak arch, the arch of the foot may be there when no weight is placed on it, for example, when the person is sitting. But as soon as they stand up the foot flattens (falls) onto the ground. Injury, arthritis, tibialis posterior (ruptured tendon), pregnancy, nervous system or muscle diseases, such as cerebral palsy, muscular dystrophy, or spina bifida. Tarsal Coalition, the bones of the foot fuse together in an unusual way, resulting in stiff and flat feet. Most commonly diagnosed during childhood. Diabetes. Age and wear and tear, years of using your feet to walk, run, and jump eventually may take its toll. One of the eventual consequences could be fallen arches. The posterior tibial tendon may become weakened after long-term wear a tear. The postario tibial tendon is the main support structure of the arch of our feet. The tendon can become inflamed (tendinitis) after overuse - sometimes it can even become torn. Once the tendon is damaged, the arch shape of the foot may flatten.

Symptoms

A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical and foot exam will be done. Flat feet can be diagnosed by appearance. To determine if the foot is rigid, you may be asked to do some simple tasks.

heelsncleavage

Non Surgical Treatment

Custom orthotics are specially designed insoles, which are made for your by prescription. This is done by taking a plaster cast of the foot in its neutral position and is then sent to a laboratory, with your prescription to be made to your exact specifications. The insole then correctly aligns your foot and as a result your body. This will relieve abnormal strain of tissues and structures which can cause pain. For less severe mal-alignments or for sports use a wide variety of temporary insoles.

Surgical Treatment

Flat Feet

Surgical procedures for flat feet vary depending on the root cause of the condition. Surgical correction to control pronation may include bone implants or Achilles tendon lengthening. Tendon transfer, which is a procedure to re-attach a tendon to another area of bone, may also be used to reduce pronation and improve foot function.

Prevention

Sit up straight in a chair with your feet flat on the ground. Scrunch up the toes of one foot as if you are trying to grab hold of the floor then use your toes to drag your foot a small distance forwards. Do this a couple of times on each foot, but don?t use your leg muscles to push your foot forward -- the movement should come solely from the muscles in your feet. Sit in a chair and place a cleaning cloth, towel or small ball on the floor at your feet. Use the toes of one foot to grasp the object and lift it off the floor. This action will require you to clench your toes and contract your arch. Once you have lifted the object a little way off the floor, try to throw it in the air and catch it by stretching your toes and arch out and upwards. Repeat the exercise several times on both feet. Sit on the floor with your legs straight out in front of you then bend your knees out to either side and place the soles of your feet together so your legs form a diamond. Hold on to your ankles and, keeping your heels together at all times, separate your feet so your toes point out to either side. Open and close your feet in this way several times, making sure your little toes stay in contact with the floor throughout the exercise. Starting in the same position, try separating your heels, keeping your toes together at all times.

After Care

Time off work depends on the type of work as well as the surgical procedures performed. . A patient will be required to be non-weight bearing in a cast or splint and use crutches for four to twelve weeks. Usually a patient can return to work in one to two weeks if they are able to work while seated. If a person's job requires standing and walking, return to work may take several weeks. Complete recovery may take six months to a full year. Complications can occur as with all surgeries, but are minimized by strictly following your surgeon's post-operative instructions. The main complications include infection, bone that is slow to heal or does not heal, progression or reoccurrence of deformity, a stiff foot, and the need for further surgery. Many of the above complications can be avoided by only putting weight on the operative foot when allowed by your surgeon.
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