Bunions Triggers Warning Signs And Therapies


Overview
Bunions Hard Skin
Bunions, Corns, and Calluses are common foot ailments associated with improperly-fitted footwear. Please contact your family doctor or Podiatrist to ask them how Birkenstock footwear or arch supports can help treat your symptoms. Also, feel free to contact your local Birkenstock retailer about their healthy footwear recommendations. Birkenstock has many products that can help with Bunions, Corns, and Calluses. Bunions are a prominent bump on the inside of the foot around the big toe joint. Corns are an accumulation of dead skin cells usually found on the toes, forming thick hardened areas. They contain a cone-shaped core whose point can press on a nerve below causing pain. Calluses are also an accumulation of dead skin cells that harden and thicken over an area of the foot. They are the body?s defense mechanism against excessive pressure and friction. Calluses are normally found on the bottom of the foot, the heel, and/or the inside of the big toe.

Causes
The most common cause of bunions is wearing shoes that are too tight. The condition is not hereditary, but it does tend to run in families-often due to a faulty foot structure. Other causes of this condition might be neuromuscular problems, flat feet, pronated feet, or foot injuries.
SymptomsPatients complain of a cosmetically deformed foot, along with some skin changes which occur due to constant irritation. Pain and redness of the joint may also occur. Footwear can be difficult to fit due to the deformity and pain is often exacerbated with physical activity. Some patients may experience pain and difficulty with simple walking.

Diagnosis
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.

Non Surgical Treatment
Your podiatrist can recommend exercises, orthoses (special devices inserted into shoes), shoe alterations or night splints (which hold toes straight over night) which may slow the progression of bunions in children. According to experts, ?conservative? measures such as these may help relieve symptoms, though there is no evidence they can correct the underlying deformity. Orthoses are designed to prevent the problem getting worse by decreasing any biomechanical causes of bunions. In other words, if the biomechanical theory is correct (i.e. if your bunions are caused by the way you walk), orthoses may help you walk in a way that doesn?t exacerbate the problem. But it won?t change the already established shape of your foot. For that, you need surgery.
Bunions Callous

Surgical Treatment
Surgery for bunions usually isn't done unless you have already tried other treatment and it did not relieve your pain. Other treatment includes wearing shoes with lots of room for your toes and using pads and supports in your shoe for protection and comfort. Surgery may be right for you if your toe is too painful, if your bunion is very big, or if you can't easily do your daily activities. It's not clear how well bunion surgery works or which kind of surgery is best. How well the surgery works depends on how bad your bunion is, the type of surgery you have, and your surgeon's experience. Your expectations will play a big role in how you feel about the results of surgery. If you want surgery mainly to improve the way your foot looks, you may be disappointed.

Prevention
The simplest way to reduce your chance of developing foot bunion or bunionette problems is to wear good-fitting shoes. Avoid high heels as they push your feet forwards to the front of the shoe where they get squashed. Also avoid narrow fitting shoes, especially those that are pointed at the front with a narrow toe box as again, these place pressure through the toes pushing them inwards. Shoes should be comfortable and leave enough room for you to wiggle your toes. Remember, bunions rarely affect non-shoe wearing people. Exercising your feet can also help. By strengthening the foot muscles you can improve your foot position which can help reduce foot bunion problems. Simple exercises like picking up small objects with your toes can help.

Tag : Bunions

Over-Pronation Aches

Overview


Over-pronation refers to pronation occurring at the wrong time in the gait cycle. Just before the foot pushes off, it should become a rigid lever as the arch rises and the ankle straightens. If instead, the arch remains flattened and the ankle remains turned inward, muscles and tendons will be stressed and the foot will undergo excessive wear and tear. This can cause the foot bones to shift position, which results in additional stress of the bones and joints above the pronated foot. Over time, it is this stress that causes pain in the knees, ankles, feet and back.Over-Pronation


Causes


Excess stress on the inner surface of the foot can cause injury and pain in the foot and ankle. Repeated rotational forces through the shin, knee, thigh and pelvis also place additional strain on the muscles, tendons and ligaments of the lower leg.


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


When you overpronate your foot rolls inwards causing the lower leg to rotate inwards too. It's thought that this increases stress on the soft tissues of the lower leg causing pain and inflammation, or more commonly known as shin splints.Over Pronation


Non Surgical Treatment


The following exercises help retrain the foot and ankle complex to correct overpronation. Step Up and Over. This exercise is designed to integrate skills learned in the Duck Stand, Big Toe Pushdowns and Side Step with Opposite Reach exercises to mimic walking and even running. Using the gluteal muscles and big toe in tandem will prevent overpronation while moving back and forth over the BT in a more effective, balanced motion. Movement Directions. Stand with left foot on top of the BT dome. (Note: For added balance, the right foot can tap on the ground, if needed). Extend right foot backwards to the ground and drop hips into a lunge position. Make sure that the right arm rotates across the left leg (this will activate the gluteal muscles on the left side). Now, step through and over the BT into a front lunge with the right leg forward. While lunging forward, the torso and left arm now rotate over the right leg. Throughout the exercise, push big toe down into the BT. Perform 8 to 10 repetitions on both sides.


Prevention


Duck stance: Stand with your heels together and feet turned out. Tighten the buttock muscles, slightly tilt your pelvis forwards and try to rotate your legs outwards. You should feel your arches rising while you do this exercise.


Calf stretch:Stand facing a wall and place hands on it for support. Lean forwards until stretch is felt in the calves. Hold for 30 seconds. Bend at knees and hold for a further 30 seconds. Repeat 5 times.


Golf ball:While drawing your toes upwards towards your shins, roll a golf ball under the foot between 30 and 60 seconds. If you find a painful point, keep rolling the ball on that spot for 10 seconds.


Big toe push: Stand with your ankles in a neutral position (without rolling the foot inwards). Push down with your big toe but do not let the ankle roll inwards or the arch collapse. Hold for 5 seconds. Repeat 10 times. Build up to longer times and fewer repetitions.


Ankle strengthener: Place a ball between your foot and a wall. Sitting down and keeping your toes pointed upwards, press the outside of the foot against the ball, as though pushing it into the wall. Hold for 5 seconds and repeat 10 times.


Arch strengthener: Stand on one foot on the floor. The movements needed to remain balanced will strengthen the arch. When you are able to balance for 30 seconds, start doing this exercise using a wobble board.

Tag : Over-Pronation Of The Foot

Can I Deal With Calcaneal Apophysitis From Home?

Overview


Sever's disease or Calcaneal apophysitis is a condition that affects children between the ages of 10 and 13 years. It is characterized by pain in one or both heels with walking. During this phase of life, growth of the bone is taking place at a faster rate than the tendons. Hence there is a relative shortening of the heel-cord compared to the leg bones. As a result, the tension the heel-cord applies to the heel bone at its insertion is very great. Moreover, the heel cord is attached to a portion of the calcaneus (heel bone) that is still immature, consisting of a mixture of bone and growing cartilage, called the calcaneal apophysis, which is prone to injury. Compounding to this is the fact that all these changes are happening in a very active child, prone to overuse. The end result is therefore an overuse syndrome of injury and inflammation at the heel where the heel cord (Achilles Tendonitis) inserts into the heel bone (Calcaneal apophysitis).


Causes


There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include inappropriate footwear, calf tightness and/or weakness, joint stiffness (particularly the foot and ankle), poor lower limb biomechanics, inappropriate or excessive training, inadequate recovery periods from training or activity, inappropriate training surfaces, inadequate warm up, poor core stability, a lack of lower limb strength and stability, poor proprioception or balance, rapid growth and age.


Symptoms


This is a condition that affects the cartilage growth plate and the separate island of growing bone on the back of the heel bone. This growth plate is called the physeal plate. The island of growing bone is called the apophysis. It has the insertion attachment of the Achilles tendon, and the attachment of the plantar fascia. This island of bone is under traction from both of these soft tissue tendon and tendon-like attachments.


Diagnosis


A Podiatrist can easily evaluate your child?s foot, lower limbs and muscular flexibility, to identify if a problem exists. If a problem is identified, a simple treatment plan is put in place. Initial treatment may involve using temporary padding and strapping to control motion or to cushion the painful area and based on the success of this treatment, a long-term treatment plan will be put in place. This long-term treatment plan may or may not involve Foot Supports, Heel Raises, muscle stretching and or strengthening.


Non Surgical Treatment


Stretching programs. Strengthening exercises. Exercise and training modification. Orthotic therapy. In rare cases, where fragmentation of the apophysis exists and pain fails to subside with traditional treatments then immobilization of the foot and ankle with a short leg pneumatic walker(walking cast) is indicated.


Exercise


For children with Sever's disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3 times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for patient suffering from Sever's disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or standing.

Tag : Severs Disease,Calcaneal Apophysitis

Posterior Tibial Tendon Dysfunction Physical Therapy


Overview
Collapsed arches occur in five percent of adults 40 years and older, especially those who are overweight or maintain sedentary lifestyles. At the onset of the condition, adult acquired flatfoot can be controlled with anti-inflammatory medications, physical therapy, taping, bracing, and orthotics. While most cases of adult-onset flatfoot require surgery, congenital flatfoot is an entirely different condition that is best treated with orthotics in children. Ninety percent of children born with flat feet will be fine with conservative treatment.
Flat Foot

Causes
Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs.

Symptoms
The first stage represents inflammation and symptoms originating from an irritated posterior tibial tendon, which is still functional. Stage two is characterized by a change in the alignment of the foot noted on observation while standing (see above photos). The deformity is supple meaning the foot is freely movable and a ?normal? position can be restored by the examiner. Stage two is also associated with the inability to perform a single-leg heel rise. The third stage is dysfunction of the posterior tibial tendon is a flatfoot deformity that becomes stiff because of arthritis. Prolonged deformity causes irritation to the involved joints resulting in arthritis. The fourth phase is a flatfoot deformity either supple (stage two) or stiff (stage 3) with involvement of the ankle joint. This occurs when the deltoid ligament, the major supporting structure on the inside of the ankle, fails to provide support. The ankle becomes unstable and will demonstrate a tilted appearance on X-ray. Failure of the deltoid ligament results from an inward displacement of the weight bearing forces. When prolonged, this change can lead to ankle arthritis. The vast majority of patients with acquired adult flatfoot deformity are stage 2 by the time they seek treatment from a physician.

Diagnosis
Although you can do the "wet test" at home, a thorough examination by a doctor will be needed to identify why the flatfoot developed. Possible causes include a congenital abnormality, a bone fracture or dislocation, a torn or stretched tendon, arthritis or neurologic weakness. For example, an inability to rise up on your toes while standing on the affected foot may indicate damage to the posterior tibial tendon (PTT), which supports the heel and forms the arch. If "too many toes" show on the outside of your foot when the doctor views you from the rear, your shinbone (tibia) may be sliding off the anklebone (talus), another indicator of damage to the PTT. Be sure to wear your regular shoes to the examination. An irregular wear pattern on the bottom of the shoe is another indicator of acquired adult flatfoot. Your physician may request X-rays to see how the bones of your feet are aligned. Muscle and tendon strength are tested by asking you to move the foot while the doctor holds it.

Non surgical Treatment
The adult acquired flatfoot is best treated early. There is no recommended home treatment other than the general avoidance of prolonged weightbearing in non-supportive footwear until the patient can be seen in the office of the foot and ankle specialist. In Stage I, the inflammation and tendon injury will respond to rest, protected ambulation in a cast, as well as anti-inflammatory therapy. Follow-up treatment with custom-molded foot orthoses and properly designed athletic or orthopedic footwear are critical to maintain stability of the foot and ankle after initial symptoms have been calmed. Once the tendon has been stretched, the foot will become deformed and visibly rolled into a pronated position at the ankle. Non-surgical treatment has a significantly lower chance of success. Total immobilization in a cast or Camwalker may calm down symptoms and arrest progression of the deformity in a smaller percentage of patients. Usually, long-term use of a brace known as an ankle foot orthosis is required to stop progression of the deformity without surgery. A new ankle foot orthosis known as the Richie Brace, offered by PAL Health Systems, has proven to show significant success in treating Stage II posterior tibial dysfunction and the adult acquired flatfoot. This is a sport-style brace connected to a custom corrected foot orthotic device that fits well into most forms of lace-up footwear, including athletic shoes. The brace is light weight and far more cosmetically appealing than the traditional ankle foot orthosis previously prescribed.
Adult Acquired Flat Feet

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.

Tag : Adult Aquired Flat Foot

Foot Arch Pain And Running

Overview


One of the most common causes of arch pain is plantar fasciitis, a condition that involves inflammation of the fibrous band of tissue that connects the heel to the toes (the plantar fascia). Pain from plantar fasciitis can be felt in the arch or the heel, and is most often felt toward the end of the day and after long periods of being stationary (e.g. getting up after sitting for a long time). Commonly, plantar fasciitis is the result of excessive foot pronation (rolling in of the foot) or excessive foot supination (e.g. high arches), both of which can increase tension on the plantar fascia. In these cases, orthotics and well-fitting footwear can address the cause of the problem by improving the position of the feet and relieving tension on the plantar fascia.


Arch Pain


Causes


Poor quality footwear. Excess weight. Commonly occurs in people over 50. Overuse or strain by athletes, especially runners. Plantar fasciitis can be caused by overuse of the plantar fascia due to walking or running in poorly supported footwear. It?s not surprising to note that healthy, active adults are the most common victims of plantar fasciitis: runners, joggers, basketball players, tennis and racquetball players? basically any sport that requires quick or repetitive movements combined with impact on the heel and arch of the foot can lead to plantar fasciitis. Seniors are also at risk due to the ligament and bone issues common to those of older years. Another leading cause of plantar fasciitis is being overweight or obese. In this case, while a sports-related injury may not be to blame, just the daily stress of walking with too much excess weight straining the plantar fascia ligaments can lead to inflammation and painful heel pain. Anyone whose job requires long periods of standing or walking is prone to develop plantar fasciitis as well. For those who develop arch strain or arch pain as a result of structural problems like flat feet, they require arch support that will accommodate their individual needs.


Symptoms


Typically, the sufferer of plantar fasciitis experiences pain upon rising after sleep, particularly the first step out of bed. Such pain is tightly localized at the bony landmark on the anterior medial tubercle of the calcaneus. In some cases, pain may prevent the athlete from walking in a normal heel-toe gait, causing an irregular walk as means of compensation. Less common areas of pain include the forefoot, Achilles tendon, or subtalar joint. After a brief period of walking, the pain usually subsides, but returns again either with vigorous activity or prolonged standing or walking. On the field, an altered gait or abnormal stride pattern, along with pain during running or jumping activities are tell-tale signs of plantar fasciitis and should be given prompt attention. Further indications of the injury include poor dorsiflexion (lifting the forefoot off the ground) due to a shortened gastroc complex, (muscles of the calf). Crouching in a full squat position with the sole of the foot flat on the ground can be used as a test, as pain will preclude it for the athlete suffering from plantar fasciitis, causing an elevation of the heel due to tension in the gastroc complex.


Diagnosis


The adult acquired flatfoot, secondary to posterior tibial tendon dysfunction, is diagnosed in a number of ways with no single test proven to be totally reliable. The most accurate diagnosis is made by a skilled clinician utilizing observation and hands on evaluation of the foot and ankle. Observation of the foot in a walking examination is most reliable. The affected foot appears more pronated and deformed compared to the unaffected foot. Muscle testing will show a strength deficit. An easy test to perform in the office is the single foot raise.


Non Surgical Treatment


Flat feet in a child do not need treatment if they are not causing pain or walking problems. Your child's feet will grow and develop the same, whether special shoes, shoe inserts, heel cups, or wedges are used. Your child may walk barefoot, run or jump, or do any other activity without making the flat feet worse. In older children and adults, flexible flat feet that do not cause pain or walking problems do not need further treatment. If you have pain due to flexible flat feet, the following may help. An arch-support (orthotic) that you put in your shoe. You can buy this at the store or have it custom-made. Special shoes. Rigid or painful flat feet need to be checked by a health care provider. The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. Surgery may be needed if pain does not improve. In more severe cases, surgery may be needed to clean or repair the tendon, fuse joints in the foot into a corrected position. Flat feet in older adults can be treated with pain relievers, orthotics, and sometimes surgery.


Pain In Arch


Surgical Treatment


The main goal of surgery is to reduce pain and improve function. It may also reduce other injuries such as repeated ankle sprains and broken bones. Surgery may be considered if there is no relief with physical therapy, changes in shoewear and/or changes in activity. Some patients will also have tendon problems, ankle weakness and foot fractures. These patients may require other procedures to address related problems. If you have medical problems that make surgery unsafe, any infections or blood vessel disease, cavus foot surgery may not be appropriate. The surgical procedures involved with the correction of the cavus foot are varied. Theses may include correction of the bony deformity, ankle looseness and the muscle imbalances that cause the deformity. The goal is to provide a foot that evenly distributes weight along both inside and outside edges. A variety of incisions may be needed to perform the procedures related to the correction of the cavus foot.


Prevention


There are several things you can do to prevent pain on the bottom of the foot. Here are some tips to help you avoid this condition. Do simple stretches each day (See Plantar Fasciitis Exercises for a list of all exercises). Wear good shoes that fit properly and are appropriate for the activity you are participating in. Lose excess weight if possible. Build your stamina slowly, especially with new exercises. Rest and elevate your feet, whenever possible, keeping them at least twelve inches above your heart. Always follow your doctor?s instructions for treatment. Each day do a different activity. For example: one day ride your bike, and swim the next day.


Stretching Exercises


Strengthening exercises. Below are two simple strength exercises to help condition the muscles, tendons and joints around the foot and ankle. Plantar Rolling. Place a small tin can or tennis ball under the arch of the affected foot. Slowly move the foot back and forth allowing the tin can or tennis ball to roll around under the arch. This activity will help to stretch, strengthen and massage the affected area. Toe Walking. Stand upright in bare feet and rise up onto the toes and front of the foot. Balance in this position and walk forward in slow, small steps. Maintain an upright, balanced posture, staying as high as possible with each step. Complete three sets of the exercise, with a short break in between sets, for a total of 20 meters.

Tag : Arch Pain, Plantar Fasciitis, Pediatric Flatfoot, Flexible Flatfoot