Joellen Blecker

Feet Problems Sorted

What Can You Do About Fallen Arches?

Overview

Adult Acquired Flat Foot

It is important to note that pronation is not wrong or bad for you. In fact, our feet need to pronate and supinate to achieve proper gait. Pronation (rolling inwards) absorbs shock and supination (rolling outwards) propels our feet forward. It is our body?s natural shock-absorbing mechanism. The problem is over-pronation i.e. the pronation movement goes too deep and lasts for too long, which hinders the foot from recovering and supinating. With every step, excess pronation impedes your natural walking pattern, causing an imbalance in the body and consequent excessive wear and tear in joints, muscles and ligaments. Some common complaints associated with over-pronation include heel Pain (Plantar Fasciitis), Ball of foot pain, Achilles Tendonitis, Shin splints, Knee Pain, Lower Back Pain.

Causes

If you tend to pronate, roll your foot and ankle in when you walk or run you may cause your arch to fall. Pronating your foot and ankle interferes with the normal movement of your foot. You should land on your heel first and roll through the middle of your foot. Landing on the inside of your foot stresses foot and ankle bones, tendons and ligaments. This can lead to many problems including flat feet. Your podiatrist can examine the way you land on your foot and then design orthotics to help you move correctly. It is important to wear the right shoes for an activity, to provide necessary arch support. Making these corrections can relieve symptoms.

Symptoms

Flat feet don't usually cause problems, but they can put a strain on your muscles and ligaments (ligaments link two bones together at a joint). This may cause pain in your legs when you walk. If you have flat feet, you may experience pain in any of the following areas, the inside of your ankle, the arch of your foot, the outer side of your foot, the calf, the knee, hip or back. Some people with flat feet find that their weight is distributed unevenly, particularly if their foot rolls inwards too much (overpronates). If your foot overpronates, your shoes are likely to wear out quickly. Overpronation can also damage your ankle joint and Achilles tendon (the large tendon at the back of your ankle).

Diagnosis

Flat feet are easy to identify while standing or walking. When someone with flat feet stands, their inner foot or arch flattens and their foot may roll over to the inner side. This is known as overpronation. To see whether your foot overpronates, stand on tiptoes or push your big toe back as far as possible. If the arch of your foot doesn't appear, your foot is likely to overpronate when you walk or run. It can be difficult to tell whether a child has flat feet because their arches may not fully develop until they're 10 years of age.

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Non Surgical Treatment

In many cases of PTTD, treatment can begin with non-surgical approaches that may include orthotic devices or bracing. To give your arch the support it needs, your foot and ankle surgeon may provide you with an ankle brace or a custom orthotic device that fits into the shoe. Immobilization. Sometimes a short-leg cast or boot is worn to immobilize the foot and allow the tendon to heal, or you may need to completely avoid all weight-bearing for a while. Physical therapy. Ultrasound therapy and exercises may help rehabilitate the tendon and muscle following immobilization. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Shoe modifications. Your foot and ankle surgeon may advise changes to make with your shoes and may provide special inserts designed to improve arch support.

Surgical Treatment

Flat Feet

Feet that do not respond to the treatments above may need surgery. The surgery will help to create a supportive arch.

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.

Treatment For Leg Length Discrepancy After Hip Replacement

Overview

Differences between lengths of the two upper extremities (upper and/or lower arms) or between the lengths of the two lower extremities (upper and/or lower legs) are called limb length discrepancy (LLD). A limb length discrepancy may be due to a normal variation that we all have between the two sides of our bodies, or it may be due to other causes. Some differences are so common that they are normal and need no treatment. For example, one study reported that 32 percent of 600 military recruits had a 5mm to 15mm (approximately 1/5 to 3/5 inch) difference between the lengths of their two lower extremities; this is a normal variation. Greater differences may need treatment because a discrepancy can affect a patient?s well being and quality of life.Leg Length Discrepancy

Causes

A number of causes may lead to leg length discrepancy in children. Differences in leg length frequently follow fractures in the lower extremities in children due to over or under stimulation of the growth plates in the broken leg. Leg length discrepancy may also be caused by a congenital abnormality associated with a condition called hemihypertrophy. Or it may result from neuromuscular diseases such as polio and cerebral palsy. Many times, no cause can be identified. A small leg length discrepancy of a quarter of an inch or less is quite common in the general population and of no clinical significance. Larger leg length discrepancies become more significant. The long-term consequences of a short leg may include knee pain, back pain, and abnormal gait or limp.

Symptoms

Many people walk around with LLD?s of up to 2 cm. and not even know it. However, discrepancies above 2 cm. becomes more noticeable, and a slight limp is present. But even up to 3 cm. a small lift compensates very well, and many patients are quite happy with this arrangement. Beyond 3 cm. however, the limp is quite pronounced, and medical care is often sought at that point. Walking with a short leg gait is not only unsightly, but increases energy expenditure during ambulation. It could also put more stress on the long leg, and causes functional scoliosis. Where the discrepancy is more severe, walking becomes grotesque or virtually impossible.

Diagnosis

The only way to decipher between anatomical and functional leg length inequalities (you can have both) is by a physical measurement and series of biomechanical tests. It is actually a simple process and gets to the true cause of some runner?s chronic foot, knee, hip and back pain. After the muscles are tested and the legs are measured it may be necessary to get a special X-ray that measures both of your thighs (Femurs) and legs (Tibias). The X-ray is read by a medical radiologist who provides a report of the actual difference down to the micrometer leaving zero room for error. Once the difference in leg length is known, the solution becomes clear.

Non Surgical Treatment

Structural leg length discrepancy can be treated with a heel lift in the shorter leg?s shoe, if the leg length is greater than 5 mm. The use and size of the heel lift is determined by a physical therapist based on how much lift is needed to restore proper lumbopelvic biomechanics. In certain cases, surgical intervention may be needed to either shorten or lengthen the limb. An important component to any surgical procedure to correct leg length discrepancies is physical therapy. Physical therapy helps to stretch muscles and maintain joint flexibility, which is essential in the healing process. For a functional leg length discrepancy no heel lift is required, but proper manual therapy techniques and specific therapeutic exercise is needed to treat and normalize pelvic and lower extremity compensations. The number of treatments needed to hold the pelvis in a symmetrical position is different for each patient based on their presentation and biomechanical dysfunctions in their lower back, pelvis, hip, knee, and foot/ankle. If you have pain in your lower back or lower extremity and possibly a length discrepancy; the two symptoms could be related. A good place to start would be a physical therapy evaluation to determine whether you have a leg length discrepancy and if it could be contributing to your lower back pain, hip pain, knee pain, or leg pain.

LLD Insoles

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Surgical Treatment

Surgical operations to equalize leg lengths include the following. Shortening the longer leg. This is usually done if growth is already complete, and the patient is tall enough that losing an inch is not a problem. Slowing or stopping the growth of the longer leg. Growth of the lower limbs take place mainly in the epiphyseal plates (growth plates) of the lower femur and upper tibia and fibula. Stapling the growth plates in a child for a few years theoretically will stop growth for the period, and when the staples were removed, growth was supposed to resume. This procedure was quite popular till it was found that the amount of growth retarded was not certain, and when the staples where removed, the bone failed to resume its growth. Hence epiphyseal stapling has now been abandoned for the more reliable Epiphyseodesis. By use of modern fluoroscopic equipment, the surgeon can visualize the growth plate, and by making small incisions and using multiple drillings, the growth plate of the lower femur and/or upper tibia and fibula can be ablated. Since growth is stopped permanently by this procedure, the timing of the operation is crucial. This is probably the most commonly done procedure for correcting leg length discrepancy. But there is one limitation. The maximum amount of discrepancy that can be corrected by Epiphyseodesis is 5 cm. Lengthening the short leg. Various procedures have been done over the years to effect this result. External fixation devices are usually needed to hold the bone that is being lengthened. In the past, the bone to be lengthened was cut, and using the external fixation device, the leg was stretched out gradually over weeks. A gap in the bone was thus created, and a second operation was needed to place a bone block in the gap for stability and induce healing as a graft. More recently, a new technique called callotasis is being use. The bone to be lengthened is not cut completely, only partially and called a corticotomy. The bone is then distracted over an external device (usually an Ilizarov or Orthofix apparatus) very slowly so that bone healing is proceeding as the lengthening is being done. This avoids the need for a second procedure to insert bone graft. The procedure involved in leg lengthening is complicated, and fraught with risks. Theoretically, there is no limit to how much lengthening one can obtain, although the more ambitious one is, the higher the complication rate.

Mortons Neuroma Remedy

Overview

interdigital neuromaThe nerves located on the bottom of the foot between the metatarsal heads (the bone of the toe closest to the foot) supply feeling, or sensation, to the toes. One of these nerves may become irritated by the ligament located above it, causing it to become thickened and painful. Generally this problem occurs most often between the third and fourth toes, but it can occur between the second and third toes as well. It is uncommon for a neuroma to be located between the first and second or fourth and fifth metatarsals. Rarely is there more than one neuroma in a foot.

Causes

Morton's neuroma seems to occur in response to irritation, pressure or injury to one of the nerves that lead to your toes. Factors that appear to contribute to Morton's neuroma include. High heels. Wearing high-heeled shoes or shoes that are tight or ill fitting can place extra pressure on your toes and the ball of your foot. Certain sports. Participating in high-impact athletic activities such as jogging or running may subject your feet to repetitive trauma. Sports that feature tight shoes, such as snow skiing or rock climbing, can put pressure on your toes. Foot deformities. People who have bunions, hammertoes, high arches or flatfeet are at higher risk of developing Morton's neuroma.

Symptoms

Patients with neuroma may develop pain on the bottom of the forefoot, most commonly under the 3rd and 4th toes, though any toe may be affected. The pain may be dull and mild or severe and sharp. The toes may feel ?numb? as times, especially the area between the 3rd and 4th toes. A classic complaint is that patients feel as if they are ?walking on a stone or pebble? and/or ?feel as if the sock is rolled up in the shoe.? Pain is often worse when walking barefoot.

Diagnosis

A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose a Morton's neuroma. Investigations such as an X-ray, ultrasound, MRI, CT scan or bone scan may sometimes be used to assist with diagnosis, assess the severity of the injury and rule out other conditions.

Non Surgical Treatment

Treaments may include wearing wider shoes to reduce the squeezing force on the foot. Adding a specially made padding to shoes to offload the pressure on the ball of the foot (called a metatarsal dome) Addressing the foot and lower limb biomechanics. This involves looking at foot stability and if needed prescribing an orthotic device to correct your foot position. Anesthetic & Cortisone injections. This is done when the above treatments are insufficient. The trauma is sometimes so great that conservative treatment cannot control the inflammation or cause of the pain. A series of injections are performed to control the inflammation or to temporarily settle the nerve. An ultrasound and cortisone injection can be prescribed by your podiatrist.interdigital neuroma

Surgical Treatment

Surgical treatment has provided relief in some cases while poor results and surgical complications have resulted in other cases. It is believed that ligament weakness, as opposed to the pinching of nerves in the foot, may be to blame for recurrent pain in these situations. For reasons which are not fully understood, the incidence of Morton?s Neuroma is 8 to 10 times greater in women than in men.

Leg Length Discrepancy And Shoe Lifts

There are actually not one but two different types of leg length discrepancies, congenital and acquired. Congenital indicates you are born with it. One leg is structurally shorter in comparison to the other. Through developmental stages of aging, the brain senses the stride pattern and recognizes some variation. Your body usually adapts by tilting one shoulder to the "short" side. A difference of less than a quarter inch is not really excessive, require Shoe Lifts to compensate and commonly doesn't have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lifts

Leg length inequality goes mainly undiscovered on a daily basis, however this condition is simply solved, and can eradicate numerous cases of back discomfort.

Therapy for leg length inequality usually consists of Shoe Lifts. These are generally very inexpensive, frequently priced at under twenty dollars, compared to a custom orthotic of $200 or maybe more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Chronic back pain is the most prevalent ailment afflicting men and women today. Over 80 million men and women suffer from back pain at some stage in their life. It is a problem which costs businesses millions annually due to lost time and output. Fresh and more effective treatment solutions are continually sought after in the hope of reducing the economic impact this issue causes.

Shoe Lifts

Men and women from all corners of the earth suffer from foot ache as a result of leg length discrepancy. In a lot of these situations Shoe Lifts might be of very helpful. The lifts are capable of decreasing any discomfort and pain in the feet. Shoe Lifts are recommended by many skilled orthopaedic doctors.

So that you can support the human body in a well balanced manner, feet have got a critical job to play. Despite that, it's often the most neglected region in the body. Some people have flat-feet which means there is unequal force exerted on the feet. This will cause other parts of the body including knees, ankles and backs to be affected too. Shoe Lifts guarantee that suitable posture and balance are restored.

Shoe Lifts The Podiatrists Option For Leg Length Difference

There are not one but two different kinds of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter than the other. Through developmental stages of aging, the human brain picks up on the stride pattern and recognizes some variance. The human body typically adapts by dipping one shoulder over to the "short" side. A difference of under a quarter inch is not blatantly irregular, doesn't need Shoe Lifts to compensate and mostly doesn't have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lifts

Leg length inequality goes largely undiagnosed on a daily basis, yet this problem is simply remedied, and can eliminate a number of incidents of upper back pain.

Therapy for leg length inequality commonly consists of Shoe Lifts. Most are low-priced, normally priced at below twenty dollars, in comparison to a custom orthotic of $200 or even more. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Back pain is the most widespread health problem impacting people today. Over 80 million people have problems with back pain at some stage in their life. It is a problem which costs employers millions yearly as a result of lost time and production. New and more effective treatment methods are continually sought after in the hope of reducing the economic influence this condition causes.

Leg Length Discrepancy Shoe Lifts

People from all corners of the world suffer the pain of foot ache due to leg length discrepancy. In these types of situations Shoe Lifts can be of immense help. The lifts are capable of easing any pain in the feet. Shoe Lifts are recommended by many qualified orthopaedic orthopedists.

To be able to support the body in a balanced fashion, the feet have got a critical task to play. Inspite of that, it's often the most neglected region in the body. Some people have flat-feet which means there is unequal force exerted on the feet. This will cause other areas of the body like knees, ankles and backs to be affected too. Shoe Lifts ensure that appropriate posture and balance are restored.

Shoe Lifts The Specialists Solution For Leg Length Discrepancy

There are actually not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter than the other. As a result of developmental stages of aging, the human brain picks up on the gait pattern and recognizes some difference. The entire body typically adapts by dipping one shoulder over to the "short" side. A difference of under a quarter inch isn't very abnormal, does not need Shoe Lifts to compensate and in most cases doesn't have a serious effect over a lifetime.

Shoe Lift

Leg length inequality goes typically undiscovered on a daily basis, yet this issue is easily corrected, and can reduce numerous cases of lower back pain.

Treatment for leg length inequality commonly involves Shoe Lifts. These are generally very reasonably priced, often priced at below twenty dollars, in comparison to a custom orthotic of $200 or more. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Low back pain is the most common health problem impacting men and women today. Over 80 million people are afflicted by back pain at some stage in their life. It's a problem that costs companies millions of dollars every year on account of lost time and output. New and better treatment methods are continually sought after in the hope of lowering economical impact this condition causes.

Shoe Lift

People from all corners of the earth experience foot ache as a result of leg length discrepancy. In a lot of these cases Shoe Lifts might be of very helpful. The lifts are capable of alleviating any discomfort and pain in the feet. Shoe Lifts are recommended by numerous professional orthopaedic doctors.

So that they can support the body in a nicely balanced manner, your feet have got a critical task to play. Irrespective of that, it is sometimes the most overlooked region of the body. Many people have flat-feet which means there is unequal force placed on the feet. This causes other parts of the body such as knees, ankles and backs to be affected too. Shoe Lifts ensure that proper posture and balance are restored.

Shoe Lifts The Answer To Leg Length Imbalances

There are not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter compared to the other. As a result of developmental periods of aging, the brain senses the stride pattern and recognizes some difference. The body usually adapts by dipping one shoulder over to the "short" side. A difference of less than a quarter inch isn't grossly excessive, does not need Shoe Lifts to compensate and ordinarily won't have a profound effect over a lifetime.

Leg Length Discrepancy Shoe Lift

Leg length inequality goes largely undiscovered on a daily basis, however this issue is simply remedied, and can reduce quite a few incidents of low back pain.

Therapy for leg length inequality commonly consists of Shoe Lifts. These are typically affordable, typically costing less than twenty dollars, in comparison to a custom orthotic of $200 or more. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Mid back pain is the most prevalent health problem impacting men and women today. Around 80 million men and women are afflicted by back pain at some stage in their life. It is a problem that costs businesses huge amounts of money year after year due to time lost and production. Innovative and more effective treatment solutions are constantly sought after in the hope of reducing the economical influence this issue causes.

Leg Length Discrepancy Shoe Lift

Men and women from all corners of the earth suffer the pain of foot ache as a result of leg length discrepancy. In these cases Shoe Lifts might be of worthwhile. The lifts are capable of easing any discomfort and pain in the feet. Shoe Lifts are recommended by numerous certified orthopaedic doctors.

To be able to support the human body in a balanced manner, feet have got a significant function to play. Irrespective of that, it is sometimes the most overlooked zone in the human body. Some people have flat-feet which means there is unequal force exerted on the feet. This causes other areas of the body including knees, ankles and backs to be affected too. Shoe Lifts guarantee that appropriate posture and balance are restored.