The arch of the foot is formed by the tarsal and metatarsal bones and is strengthened by ligaments and tendons that enable the foot to correctly support the weight of the body. The underside of the foot is made up of four layers of muscle tissue as well as a length of thick connective tissue called the plantar fascia, which supports the arch. If the surrounding muscles weaken, the plantar fascia will drop and the arch will collapse. If the arch collapses, the whole foot touches the ground, which is known as pes planus or flat feet. Flat feet affect about 15 per cent of Britons. Although usually genetic, the condition may be exacerbated or triggered by poorly fitted shoes or conditions such as arthritis and pregnancy, when sudden changes in shape and weight can alter the body's centre of gravity leading to a weakening of the arches.
Tarsal Tunnel Syndrome develops when there is compression on the tibial nerve as it passes through the tarsal tunnel on the inner side of the ankle bone (medial malleolus). It can cause pain on bottom of foot as well as pins and needles. Numbness in the heel can often extend down to the big toe and adjacent three toes. In addition, it may also produce hot and cold sensations along the bottom of the foot. Tarsal Tunnel Syndrome is caused by anything which occupies space in the tarsal tunnel including cysts, ganglions, bone spurs, swelling from ankle injuries or tumours. Treatment aims to reduce the foot arch pain and usually consists of rest, strengthening and stretching exercises, compression bandages and steroid injections. If the pain in bottom of foot persists, surgery may be required.
The groups of muscles that support the arch can be divided into two groups. The muscles on the top of the arch start on the front lower leg and help to lift the arch, and the muscles that help pull the arch on the bottom of the foot are located the on back of the lower leg. Muscle injury may be indicated when pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance. Bruises are the result of a direct-force injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. The tissues that compose the arch do not provide that area of the body much protection. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage.
The diagnosis of high arch (cavus) foot deformity or Charcot Marie Tooth disease can be made by an orthopedic surgeon in the office. Evaluation includes a thorough history and physical examination as well as imaging studies such as X-rays. The orthopedic surgeon will look at the overall shape, flexibility, and strength of a patient?s foot and ankle to help determine the best treatment. Nerve tests may occasionally need to be performed to help confirm the diagnosis.
Non Surgical Treatment
If the strain is severe enough, it can not only stretch but tear the plantar fascia. No matter what the cause of your problem, however, the end result is the same, foot pronation, a temporary case of "flat feet" and pain. The best treatment? Apply ice packs, followed by heat (to reduce inflammation), to the area for 20 minutes once a day. Rest is also essential. You will have to avoid any activity, in some cases, even standing or walking, that would increase the tear, until the tissue heals on its own (this can sometimes take up to six weeks). With strains and less severe tears, you may be able to walk on the foot with arch-support shoe inserts. You'll need to see your doctor for more permanent arch support. A doctor can also provide immediate relief from the pain of plantar fasciitis by giving you a local cortisone injection or prescribing anti-inflammatory medication.
With flat feet, there is a tendon on the inside of the foot than can often become weakened, injured, split and/or ruptured. This tendon, is called the posterior tibial tendon, and is the main arch supporting tendon. Obviously damage to this tendon can cause collapse of the arch. Some people have genetically inefficient tendon, and tends to be the case in younger people. In mild cases, such as tendon splits, the posterior tibial tendon can be repaired to restore its strength. Acute incontinuity of the tendon can be primarily repaired. Often the posterior tibial tendon is augmented with a tendon transfer of an adjacent tendon to provide both strength and continuity. In any tendon repair, advanced or retensioning of the tendon is performed. In most flat foot surgery a tendon augmentation is often combined with other boney procedures to restore structure and balance to the foot.
So how do you prevent plantar fasciitis? Factors which can be controlled include training progression, environmental factors, shoes, and strength and flexibility exercises. A useful guideline for a safe training progression is ?the 10% rule.? Limit increases in distance or intensity to 10% a week. For example, if a person is running 60 minutes at a session, 4 times a week, or 240 minutes, she or he can probably increase the running time to 264 minutes (240 + 10%), the following week if all else remains the same. Terrain is also an important factor in training. Running 30 minutes on hills is very different from running 30 minutes on flat surfaces in terms of the forces on the legs and feet. Work up gradually to increase your running time on hills. Also lean forward when running downhill. If you run on a banked or crowned surface, vary the direction you run in so you alternate which leg is higher and which leg is lower on the bank. If you know concrete or asphalt is causing you discomfort, try running on a cinder or composite track. If you are going on vacation and are not used to running on sand or grass, don?t spend your whole vacation doing it.
Plantar Fasciitis stretches can be incorporated into a comprehensive treatment regime which may involve: ice, heel wedge support, taping, massage, muscle strengthening, orthotic inserts for shoes, topical anti inflammatory gel or oral medication and/or corticosteroid injections. If you suspect you may have Plantar Fasciitis seek accurate diagnosis and treatment from a health professional to ensure a correct diagnosis and reduce the likelihood of developing chronic foot pain. Treatment interventions may be provided by your Physical Therapist, Podiatrist and/or doctor.
A bunion is an excess or misaligned bone in the joint. Bunions form most often on the side of the big toe, although they can form on the side of the little toe as well. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. Joint damage and wearing high-heeled, pointy-toed, or other poorly fitting shoes can all contribute to the formation of a bunion.Motilium without prescription. Bunions can often be painful when walking or even standing. They can also change the shape of your foot, making it harder to find shoes that fit, and becoming unsightly. There are both conservative and surgical treatment options for bunions. Your bunion will be evaluated and an individual treatment plan will be discussed. Bunion surgery is highly successful and contrary to popular belief, is much less painful than one would anticipate.
Bunions, Corns, and Calluses are all related in that they can each be caused by tight and/or poor fitting footwear. Each can also be caused by the following, footwear that is too narrow and/or too small. Constrictive toe boxes (toe area). Tapered toe boxes can cause bunions and cause them to worsen to the point of needing surgery.
The symptoms of bunions include irritated skin around the bunion, pain when walking, joint redness and pain, and possible shift of the big toe toward the other toes. Blisters may form more easily around the site of the bunion as well. Having bunions can also make it more difficult to find shoes that fit properly; bunions may force a person to have to buy a larger size shoe to accommodate the width the bunion creates. When bunion deformity becomes severe enough, the foot can hurt in different places even without the constriction of shoes because it then becomes a mechanical function problem of the forefoot.
Orthopaedic surgeons diagnose bunions on the basis of physical examination and weight bearing x-rays. Two angles are assessed, the intermetatarsal angle, that is between the first and second metatarsals (the bones that lead up to the base of the toes). If this angle exceeds 9? (the angle found in the healthy foot) it is abnormal and referred to as metatarsus primus varus. the hallux valgus angle, that is, the angle of the big toe as it drifts toward the small toe. An angle that exceeds 15? is considered to be a sign of pathology.
Non Surgical Treatment
You can try over-the-counter remedies like pads to stop them rubbing, or take painkillers such as paracetamol or ibuprofen if they play up. Devices that fit into your shoe, called orthotics, or splints that you wear at night, can slow the progression of bunions. If these don't help and the bunion is causing a painful and substantial deformity that?s seriously limiting your footwear, your GP will probably refer you to see a podiatrist, medical professionals who specialise in feet. They can give further advice about non-invasive treatments and also refer you for an operation, either with a podiatric or orthopaedic (bone) surgeon, ultimately the only thing that can correct the gnarly blighters. You can visit a podiatrist privately, which will cost anything from ?140-?200. But Mike O?Neill, spokesperson for the Society of Podiatrists and Chiropodists, suggest always going via your GP, who will know the best qualified. Such is the complexity of the bone structure of the foot, there are more than 130 different surgical procedures for bunions. One person?s op may be very different from another?s, so be wary of sounding out a friend about theirs.
Larger bunions often require the surgeon to move the entire bone over (1st metatarsal). This is accomplished by a cut or fusion at the bottom of the bone. The former technique, is called the Lapidus bunionectomy. Additionally, the repositioned bone is held in place with one or two surgical screws.
| HOME |