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Thursday, 07 February 2013 15:12

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age.

Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever's disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid sports activity which only worsens the problem. Over the counter pain medications targeted at relieving inflammation can be helpful for reducing the amount of heel pain. Combined with rest and pain medication, a child with Sever's disease should wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect just one heel of either foot as well as the heels of both feet. It is important to have a child experiencing heel pain get an examination by a foot doctor who can apply the squeeze test, which compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

Treatment methods should usually continue for at least 2 weeks and as long as 2 months before the heel pain goes completely away and the child can resume normal physical and athletic activities again. A child can continue doing daily stretching exercises for the legs and feet to prevent the heel pain of Sever's disease from returning.

Wednesday, 30 January 2013 21:37

Everything You Need to Know About Gout

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

Wednesday, 23 January 2013 21:36

Pregnancy and Foot Health

Many pregnant women complain about foot pain while they are expecting. Foot pain can primarily be caused by weight gain and hormonal changes taking place in the body. By understanding how pregnancy impacts the health of a woman's feet, a pregnant woman can take action to keep her feet as healthy and comfortable as possible.

Because a woman's weight changes during pregnancy, more pressure is brought to bear on both the legs and the feet. This weight shift can cause two major foot problems: over-pronation, also known as flat feet, as well as edema, which is swelling of the feet. Over-pronation occurs when the arch of the foot flattens, causing the foot to roll inwards when the individual is walking, and can aggravate the plantar fascia tissues located along the bottom of the feet. If these tissues become inflamed, a pregnant woman can experience pain in the heel of the foot as well as severe foot pain while walking or standing. Swelling of the feet, or edema, often occurs in the later stages of pregnancy. It is caused by slow circulation and water retention, and may turn the feet a light purple color.

To keep feet in good health and prevent over-pronation, pregnant women should avoid walking barefoot and be sure they are wearing shoes that offer good arch support. A device known as an orthotic can be added to regular footwear in order to provide additional support for the feet during pregnancy. Any expectant mother whose feet hurt should first check to see if the shoes she is wearing are old, worn out and not offering the proper support necessary for distributing the weight of her body during pregnancy.

To treat edema of the feet, a good start is to wear quality footwear which offers support and good circulation. Keep feet elevated whenever possible by using a foot stool while seated. Stay well hydrated by drinking plenty of water to prevent water retention in the feet. Any swelling that occurs in only one foot should be examined as soon as possible by a doctor.

Good foot health during pregnancy can help expectant mothers avoid foot pain that leads to other health problems. Massaging the feet and doing regular gentle exercise like walking aids foot health by contributing to good circulation. Supportive shoes are also a good investment that will support foot health during pregnancy.

Both running and walking are great exercises, but should a person wear the same shoes for running and for walking? The answer is no, because there is a difference between the way that a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed totally different. Before you begin any exercise program it is always recommended that you speak with your doctor.

Walking is a low impact exercise that is often recommended by doctors to their patients. Walking is the simplest exercise there is, but it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you walk along, you will notice that your heel hits the ground first and then your foot continues to roll forward until your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. The flexibility helps the walker to push off with each step taken.

Another thing about walking shoes is that your heel hits the ground first, therefore it absorbs most of the shock. This is why walking shoes need to have a beveled or angled heel. The angle of the heel helps to absorb some of the shock instead of putting all of the pressure on the ankles. This is especially important for speed walkers as their feet will hit the ground twice as often as the normal walker.

When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise that if not done with the proper equipment, could cause damage to their feet and legs. Running shoes are designed to be more light weight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. For this reason alone it is never recommended that a person wear walking shoe to run in. However, it's fine if you want to walk in running shoes. Walking shoes most often do not have the proper arch support that runners do.

One very important thing to remember is that a proper fit can make or break a runner or a walker. If a runner or walker’s shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. What ever your sport, running or walking, the right equipment can make all of the difference in the world.

About the Author: Dr. Howard Hyman from The Podiatry Center is a board certified podiatric surgeon who has over 30 years of experience. With help from his reliable and personable staff, Dr. Howard Hyman treats a wide range of podiatric needs from athlete's foot to broken ankles and everything in between. Visit http://www.thepodiatrycenter.net/ or call 973-313-5592

Wednesday, 16 January 2013 07:31

Orthoses

Orthoses are devices used to correct physical impairment caused by scoliosis, spina bifida, cerebral palsy, or foot deformities. Orthopedic devices control, guide, limit or immobilize body segments. They assist in movement; reduce weight bearing forces and aid in rehabilitation from fractures. They also correct the shape and function of the body.

Orthoses include ankle foot orthosis, thoracolumbosacral orthosis, knee orthosis and wrist hand orthosis. When orthoses were first made, plaster of Paris molds were made of the patient and then materials like plastic, elastic, metal or a combination of those materials. Now braces for participants in contact sports are made from neoprene to allow movement but reduce the range of movement.

The Boston Brace is used to assist scoliosis sufferers. It is also called a low-profile or underarm brace. It fits under the breast to above the pelvic area in the front and below the shoulder blades to the tail bone in the back. By applying three point of pressure to the curve, the lumbar area is forced to flex, the abdomen is pushed in and the posterior is flattened.

The Charleston Bending Brace is only worn at night. A mold is made of the patient’s body bent towards the outward bulge of the curve. The design of the brace is built to correct the curve of the scoliosis. Repeatedly wearing this brace for eight hours should eventually correct the problem somewhat if not completely. The brace is good for patients with a curve of 20 to 36 degrees.

The Milwaukee Brace is used for mid-back curves. This brace consists of a plastic pelvic girdle and a neck ring. The pieces are connected in the front and back by metal bars. Pressure pads are place along the patient’s curve pattern along the metal bars. This brace is rarely used but patients with a curve very high in the spine can benefit from wearing it.

A knee orthosis is a brace worn to give the knee strength. Osteoarthritis can cause significant pain in the knee resulting in immobility. Knee braces allow a person to remain active. Often therapy and drugs are used in conjunction with a knee brace.

Orthoses have changed over the decades. The materials used for the actual orthotic devices have evolved to include hydraulics as it appears in some knee braces that the patient adjusts to compensate for stability. When this is adjusted, it helps the knee by giving the sense of space between the bones which stops the pain that radiates when the bones rub together. Orthoses products stop pain and give patients the ability to move pain free.

Monday, 07 January 2013 01:33

Bunions

The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

Saturday, 05 January 2013 21:35

How to Prevent Running Injuries

Overtraining and overusing the feet are the main causes of common running injuries. A number of these common injuries are caused by overrunning. Runner’s knee is a condition that is characterized by the back of the kneecap beginning to wear away and cause pain in the knee. This frequently occurs due to either a decrease in strength in the quadriceps muscles or ill-fitting shoes that are lacking in proper support for the inside of the forefoot. Strengthening exercises focusing on the quad muscle and sports orthotics are the usual treatments for those suffering from runner’s knee. Prevention of the condition lies in a focus on hip strengthening and quad-strengthening to keep the kneecap aligned. To help learn the best exercise to heal runner’s knee, one can also undergo physical therapy.

One common injury, called iliotibial band syndrome, is often caused by overtraining. This condition occurs when the iliotibial band gets irritated, creating pain and discomfort in the outside knee area. Plantar fasciitis, another common running injury, also occurs as a result of inflammation and irritation. Plantar fasciitis is an inflammation and irritation of the bone in the foot. A large amount of pain is often experienced due to plantar fasciitis. The condition can be caused by a high arch, improper footwear, tight muscles, or flat feet. It can best be avoided by stretching and wearing appropriate footwear that supports the foot.

Another common injury for runners is stress fractures. These injuries occur due to running style, overtraining, or a lack of calcium. Stress fractures most often occur in several locations in runners, including the inner bone of the leg, the thighbone, the bone at the base of the spine and the bones of the toes. Stress fractures are best prevented by wearing proper footwear and by running on flat and hard surfaces; this will absorb some of the shock created during running.

Aside from overtraining, other causes of common running injuries include ill-fitting footwear, a lack of flexibility and strength, and irregular biomechanics. The best way to avoid running injuries is to prevent them from even occurring. Both iliotibial band syndrome and stress fractures are preventable. The first step that should be taken to prevent running injuries is to only wear footwear that fits properly and that is appropriate for whatever activity you are doing. Running shoes are the only protective gear available to runners that can safeguard them from sustaining injuries. Choosing the right pair of shoes is therefore extremely important. While running shoes are an important factor, it is also important to consider other facets of your running routine such as training schedules, flexibility, and strengthening. These elements should be considered and altered according to your running needs to best maximize your run and minimize the possibility of injury. Careful stretching before and after a run should also be considered to help prevent running injuries. Stretching muscles enables greater flexibility and a lesser chance of sustaining injury.

Thursday, 27 December 2012 17:07

Morton's Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones. Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area. If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

Thursday, 13 December 2012 21:34

How to Care for Diabetic Foot

Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.

A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Wednesday, 05 December 2012 03:00

Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

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