Mortons Neuroma Treatments

Overview

Morton?s Neuroma is a pain condition that affects your feet and toes. If you are suffering from Morton?s Neuroma, a growth of tissue has developed over one of the nerves running from your feet into your toes. This growth can cause inflammation and pain whenever you use your foot. A type of benign tumor, Morton?s Neuroma typically develops in the space between the third and fourth toes, although it can also form between the second and third toes. When you walk, the bones and ligaments in the top of your foot press down on this growth, causing pressure and pain.

Causes

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box. People with certain foot deformities – bunions, hammertoes, flatfeet, or more flexible feet – are at higher risk for developing a neuroma. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

Symptoms

Symptoms include tingling in the space between the third and fourth toes, toe cramping, a sharp, shooting, or burning pain in the ball of the foot and sometimes toes, pain that increases when wearing shoes or pressing on the area, pain that gets worse over time. In rare cases, nerve pain occurs in the space between the second and third toes. This is not a common form of Morton neuroma, but treatment is similar.

Diagnosis

Diagnosis of Morton?s Neuroma typically involves a physical examination of the affected foot. Your health care provider will ask you about your symptoms and examine your feet and toes. He will manipulate your toes, pushing them from side to side and squeezing on the spaces in between. This physical exam will allow your health care provider to feel for any lumps that may be present under the soft tissue of your feet. Your health care provider may also listen for any clicking sounds that your bones may be making. Known as Muldor?s Sign, this clicking is common amongst sufferers of foot neuroma. Occasionally, an x-ray or MRI (magnetic resonance imaging) is performed to help rule out any breaks, sprains, or fractures in your foot.

Non Surgical Treatment

Symptoms of a Morton’s neuroma can completely resolve with simple treatments, such as resting the foot, better-fitting shoes, anti-inflammation medications, and ice packs. More rapid relief of symptoms can follow a local cortisone injection. Symptoms can progressively worsen with time. For those with persistent symptoms, the swollen nerve tissue is removed with a surgical operation.Morton neuroma

Surgical Treatment

Surgery for mortons neuroma consists of either a decompression, where more space is created for the nerve or a resection, where this part of the nerve is removed completely. This will result in some permanent minor numbness. Success rates for surgical procedures to treat mortons neuroma have a high success rate.

Overcome Leg Length Imbalances With Shoe Lifts

There are not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital indicates that you are born with it. One leg is structurally shorter compared to the other. Through developmental phases of aging, the brain picks up on the walking pattern and identifies some variation. The body typically adapts by dipping one shoulder over to the “short” side. A difference of under a quarter inch isn’t really irregular, does not need Shoe Lifts to compensate and typically won’t have a profound effect over a lifetime.

Shoe Lifts

Leg length inequality goes largely undiagnosed on a daily basis, yet this problem is very easily fixed, and can reduce quite a few cases of back problems.

Treatment for leg length inequality typically consists of Shoe Lifts. Most are affordable, in most cases costing below twenty dollars, in comparison to a custom orthotic of $200 or maybe 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.

Lumbar pain is the most common ailment affecting men and women today. Over 80 million people suffer from back pain at some point in their life. It’s a problem that costs employers millions each year on account of lost time and production. Fresh and superior treatment solutions are continually sought after in the hope of minimizing the economic influence this condition causes.

Leg Length Discrepancy Shoe Lifts

People from all corners of the earth experience foot ache as a result of leg length discrepancy. In most of these cases Shoe Lifts can be of worthwhile. The lifts are capable of easing any discomfort and pain in the feet. Shoe Lifts are recommended by countless expert orthopaedic doctors.

So as to support the human body in a well-balanced manner, the feet have a critical part to play. In spite of that, it is often the most neglected region of the human body. Some people have flat-feet meaning there is unequal force placed on the feet. This will cause other areas of the body like knees, ankles and backs to be affected too. Shoe Lifts make sure that appropriate posture and balance are restored.

Contracted Toe Surgery

HammertoeOverview
A hammertoe is a deformity in the foot, causing the second, third, or fourth toe to be permanently bent in the middle joint, causing the toe to resemble a hammer (hence, its name!) or a claw. They are most commonly found in women who wear narrow shoes, such as high heels, that cause the toes to bend unnaturally for extended periods of time. A Hammer toes may be difficult or painful to move, and the skin may become callused from rubbing against the inside of the shoe. In fact, there are two types of hammertoe: flexible and rigid. Flexible hammertoes can still move at the joint and are indicative of an earlier, milder form of the problem. Rigid hammertoes occur when the tendon no longer moves, and at this stage, surgery is usually necessary to fix the problem.

Causes
The incorrect position of the person’s toes inside of their shoes also causes the formation of calluses or corns on the surfaces of their toes which are constantly bent as they are wearing inappropriate shoes because the surfaces are consistently rubbing against the hard materials of the interior of the shoes causing regular friction.

Hammer ToeSymptoms
A hammertoe causes you discomfort when you walk. It can also cause you pain when trying to stretch or move the affected toe or those around it. Hammertoe symptoms may be mild or severe. Mild Symptoms, a toe that is bent downward, corns or calluses. Severe Symptoms, difficulty walking, the inability to flex your foot or wiggle your toes, claw-like toes. See your doctor or podiatrist right away if you develop any of these symptoms.

Diagnosis
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Non Surgical Treatment
Symptoms of hammer toe might be helped through corn pads or cushions to alleviate them. If the person’s hammer toes were caused by an underlying disease, the person should ask for their doctor’s advice prior to performing any exercises without consent. It is also important for a person with hammer toes to remember that they must not attempt to treat or remove corns by themselves. If open cuts result from attempts to remove them, an infection becomes a very real possibility. People who experience diabetes or conditions that lead to poor circulation in their feet need to be especially careful.

Surgical Treatment
If you are unable to flex your toe, surgery is the only option to restore movement. Surgery is used to reposition the toe, remove deformed or injured bone, and realign your tendons. Surgery is normally done on an outpatient basis, so you can return home on the day of your surgery.

HammertoePrevention
Preventing foot problems, including hammertoes, is often a matter of wearing the right shoes and taking care of your feet. Check your feet regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check feet daily so that problems can be caught early on.

Hammer Toes Causes Treatment

Hammer ToeOverview

The hammertoes condition is usually irreversible, but often its progression can be slowed or halted. You should visit a Podiatrist if the toe becomes painful and you have difficulty walking. A Podiatrist will be able to provide advice and treatment including padding the bony top-part of your hammertoe to relieve pain or to tape your toes as a way to change their position. Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.

Causes

Certain risk factors increase your likelihood of developing a hammertoe. These include a family history of hammertoes, wearing tight or pointy-toed shoes, wearing shoes that are too small, having calluses, bunions, or corns (thickened layers of skin caused by prolonged/repeated friction) Wearing shoes that are too small can force the joint of your toes into a dislocated position. This makes it impossible for your muscles to stretch out. Over time, the practice of wearing improperly fitting shoes increases your risk of developing hammertoes, blisters, bunions, and corns.

Hammer ToeSymptoms

The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet Hammer toes toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe’s toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you’re not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.

Diagnosis

The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.

Non Surgical Treatment

If you have hammer toe, avoiding tight shoes and high heels may provide relief. Initial (non-surgical) treatment for hammer toe involves wearing shoes with plenty of room in the toe area. Shoes should be at least one-half inch longer than the longest toe. Stretching and strengthening exercises for the toes (such as picking up items with the toes or stretching the toes by hand) are also recommended. Sometimes orthopedists recommend special pads, cushions, or slings to help relieve the pain of hammer toe.

Surgical Treatment

The deformity is corrected in a variety of ways. There are actually a large number of procedures. The simplest procedure would involve a Tenotomy, the cutting of the tendon causing the deformity or a Tendon Lengthening procedure. These procedures are infrequently done, though, as the structural deformity (the arthritis and joint adaptation) is not addressed with these surgeries. Other soft-tissue procedures involve rebalancing the tendons around the joint. There are several techniques to do this, but the most common is probably the Girdlestone-Taylor procedure, which involves rerouting the tendons on the bottom of the toe up and over the toe where it sticks up, so that the tendon helps pull the toe downwards into proper alignment.

Hammer ToePrevention

wear sensible shoes. Here are some tips. Most people have one foot that’s bigger than the other. Fit your shoes to the bigger foot. Buy your shoes at the end of the day as your feet tend to swell a bit and you will get a better sense of fit. When you buy your shoes, wear the sock that you will be using when wearing that shoe – wear a sports sock when buyingtrainers, for example. As you get older, your feet get bigger. Get your feet measured every time you buy shoes. Don’t go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy so that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the sole or twisted side to side is generally too flimsy. There should be at least 1.5 cm between the tip of your longest toe and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent areas on your feet such as hammer toes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas tend not to stretch to accommodate various toe deformities. Your shoes shouldn’t ride up and down on your heel as you walk. The higher the heel, the less safe the shoe. Check children’s shoes regularly.

How To Identify Bunions

Overview
Bunions Hard Skin
Bunion pain can be debilitating and bunion surgery can be a scary decision most people would rather put off. I know. I’ve been there and I’ve learned that IF you know what to expect ahead of time and what questions to ask your doctor, you will lessen your fear, make better decisions, and increase your success with bunion surgery and bunion surgery recovery. No matter how good your podiatrist or bunion surgeon is, the truth is, no one knows exactly what’s right for you except you and that’s what can make your decision so scary. What if the surgery doesn’t really fix the problem, and like others you read about or hear about, you end up worse off than before? It’s not always clear what to do, but with the right information, questions, and support, it can be an easier decision for you.

Causes
Foot problems typically develop in early adulthood and get worse as the foot spreads with aging. For many people, bunions run in the family. They may be just one of several problems due to weak or poor foot structure. Bunions sometimes develop with arthritis. In people with leg length discrepancies, bunions usually form in the longer leg. Women are especially prone to developing bunions. Years of wearing tight, poorly fitting shoes especially high-heeled, pointed shoes can bring on bunions. Such shoes gradually push the foot bones into an unnatural shape.
SymptomsWith the positional change of the hallux, pain is a common occurrence. As the foot goes through the gait cycle the hallux plays an integral role as the body’s weight transmits through during propulsion. With this in mind, it easy to see how the change in the hallux joints (metatarsal phalangeal joint and the proximal interphalangeal) would cause joint narrowing and early degeneration of the articular cartilage. In addition, two small bones (ossicles) found underneath just behind the joint will start placing extra pressure on the metatarsal. Along with bony changes, there are many soft tissue changes as the hallux and metatarsal reposition, which causes added strain to other bony structures and can accelerate the problem.

Diagnosis
Generally, observation is adequate to diagnose a bunion, as the bump is obvious on the side of the foot or base of the big toe. However, your physician may order X-rays that will show the extent of the deformity of the foot.

Non Surgical Treatment
Treatment falls into two broad categories, conservative and surgical. From a conservative standpoint, efforts are directed at correcting faulty foot mechanics with custom molded insoles and relief of symptoms. These include Custom Orthosis to stabilize the abnormal motion of the hind and fore foot. Shoe gear modification: Using shoes with larger toe boxed and more supple materials. Changes in activities. Try to avoid those things which cause symptoms. Anti-inflammatory medication for periodic relief this includes cortisone injections into the joint as well as oral medication.
Bunions Hard Skin

Surgical Treatment
Surgery may be recommended for some bunions, but only when symptoms are severe enough to warrant such intervention. Surgery for a bunion, called a bunionectomy, is done in hospital usually under general anaesthesia. The surgeon can often realign the bone behind the big toe by cutting the ligaments at the joint. For a severe bunion, you may need to have the bone cut in a technique called an osteotomy. Wires or screws may be inserted to keep the bones in line, and excess bone may be shaved off or removed. Potential complications of surgery include recurrence of the bunion, inadequate correction, overcorrection (the toe now points inwards), continued pain, and limited movement of the big toe.

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.

Do I Suffer Overpronation Of The Foot

Overview

The way your foot rolls when it hits the ground is known as pronation, and if you’re a runner, it’s essential to know what type of pronator you are. There are three types, normal pronation, overpronation, and underpronation (supination). Figuring out your running pattern will help you buy the right running shoe. Not only will this make running more comfortable, but it can also help prevent future injury.Overpronation

Causes

Unless there is a severe, acute injury, overpronation develops as a gradual biomechanical distortion. Several factors contribute to developing overpronation, including tibialis posterior weakness, ligament weakness, excess weight, pes planus (flat foot), genu valgum (knock knees), subtalar eversion, or other biomechanical distortions in the foot or ankle. Tibialis posterior weakness is one of the primary factors leading to overpronation. Pronation primarily is controlled by the architecture of the foot and eccentric activation of the tibialis posterior. If the tibialis posterior is weak, the muscle cannot adequately slow the natural pronation cycle.

Symptoms

Over-pronation is a condition where the arch flattens out which makes the feet roll inward while walking. This condition is also known as flat feet. It imposes extreme additional stresses on the plantar fascia, a fibrous band of tissue which connects the heel to the forefoot. Over-pronation makes walking a painful experience because of the additional strain on the calves, heel and/or back. Treatment for over-pronation involves the use of specially-made orthotics which offers arch support and medial rear foot posting as corrective measures.

Diagnosis

At some point you may find the pain to much or become frustrated. So what are you options? Chances are your overpronation has led to some type of injury if there’s pain. Your best bet is to consult with someone who knows feet. Start with your pediatrist, chiropodist or chiropractor. They’ll be able to diagnose and treat the injury and give you more specific direction to better support your feet. One common intervention is a custom foot orthotic. Giving greater structural support than a typical shoe these shoe inserts can dramatically reduce overpronation.Over-Pronation

Non Surgical Treatment

Pronation and supination are bio-mechanical problems, and are best treated and prevented with orthotic inserts. But before you run out to buy orthotics it makes sense to get the right advice on footwear, and the best advice I can give you, is to go and see a qualified podiatrist for a complete foot-strike and running gait analysis. They will be able to tell you if there are any concerns regarding the way your running gait is functioning. After your running gait has been analysed, have your podiatrist, or competent sports footwear sales person recommend a number of shoes that suit your requirements. Good quality footwear will go a long way in helping to prevent pronation and supination. And, if needed, invest in a pair of orthotic inserts to further prevent excessive pronation or supination.

Surgical Treatment

HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.

Will Severs Disease Necessitate Surgical Treatments?

Overview

Sever’s disease is a disorder that commonly occurs in active children between the ages of 9 and 13 years of age. Even though it is misnamed as a disease, it is actually a self-limiting disorder that occurs around the growth plate in the back of the heel. The Achilles tendon attaches to the upper portion of the heel growth plate. On the bottom of the growth plate is an attachment of a ligament known as the plantar fascia. With increased activity, there is a pulling or tugging that occurs on this growth plate, and a portion of the growth plate is being pulled away from its attachment to the heel. X-rays are often taken to verify the position and location of this growth plate.

Causes

The foot is one of the first body parts to grow to full size. During the time of growth, bones grow faster than muscles and tendons. This results in the muscles and tendons becoming tight. The strongest tendon that attaches to the heel is the Achilles Tendon. It attaches to the back of the heel at the site of the growth plate, and during sports activities it pulls with great force on the growth plate. If this pull by the tight Achilles Tendon (calf muscle) continues for long periods of time, the growth plate may become inflamed and painful. If exertive activities continue, Sever’s Disease may result.

Symptoms

The most common symptoms of Sever?s involves pain or tenderness in one or both heels. This pain usually occurs at the back of the heel, but can also extend to the sides and bottom of the heel. A child with Sever?s may also have these common problems, Heel pain with limping, especially after running. Difficulty walking, Discomfort or stiffness in the feet upon awaking. Swelling and redness in the heel, Symptoms are usually worse during or after activity and get better with rest.

Diagnosis

A doctor can usually tell that a child has Sever’s disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child’s activity level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever’s disease, some doctors order them to rule out other problems, such as fractures. Sever’s disease cannot be seen on an X-ray.

Non Surgical Treatment

The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment for Sever’s disease is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain. As directed by the doctor, a child should cut down on or avoid all activities that cause pain until all symptoms are gone, especially running barefoot or on hard surfaces because hard impact on the feet can worsen pain and inflammation. The child might be able to do things that do not put pressure on the heel, such as swimming and biking, but check with a doctor first. The doctor might also recommend that a child with Sever’s disease perform foot and leg exercises to stretch and strengthen the leg muscles and tendons, elevate and apply ice (wrapped in a towel, not applied directly to the skin) to the injured heel for 20 minutes two or three times per day, even on days when the pain is not that bad, to help reduce swelling, use an elastic wrap or compression stocking that is designed to help decrease pain and swelling, take an over-the-counter medicine to reduce pain and swelling, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Children should not be given aspirin for pain due to the risk of a very serious illness called Reye syndrome. In very severe cases, the doctor might recommend that the child wear a cast for anywhere from 2 to 12 weeks to immobilize the foot so that it can heal.

Exercise

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.

What Are The Leading Causes Of Posterior Tibial Tendon Dysfunction (PTTD) ?

Overview
Adult Acquired Flatfoot occurs when the arch of your foot collapses after your skeleton has stopped growing, usually resulting in the foot ?falling? inward with the toes pointing out. This allows your entire sole to touch the ground when you stand, instead of just the outside area. Arches fall for many reasons, including arthritis, injury to the supporting tendons or bones, nerve problems, diabetic collapse, pregnancy, aging, and obesity. A fallen arch doesn?t have to be painful-though as it develops and worsens, it can lead to strain and weakness in the feet that could allow for more uncomfortable foot problems later. Diabetics can develop serious complications from their fallen arches, and need to have their condition evaluated and treated.
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 types of symptoms that may indicate Adult-Acquired Flat Foot Deformity include foot pain that worsens over time, loss of the arch, abnormal shoe wear (excessive wearing on the inner side of shoe from walking on the inner side of the foot) and an awkward appearance of the foot and ankle (when viewed from behind, heel and toes appear to go out to the side). It is important that we help individuals recognize the early symptoms of this condition, as there are many treatment options, depending upon the severity, the age of the patient, and the desired activity levels.

Diagnosis
The history and physical examination are probably the most important tools the physician uses to diagnose this problem. The wear pattern on your shoes can offer some helpful clues. Muscle testing helps identify any areas of weakness or muscle impairment. This should be done in both the weight bearing and nonweight bearing positions. A very effective test is the single heel raise. You will be asked to stand on one foot and rise up on your toes. You should be able to lift your heel off the ground easily while keeping the calcaneus (heel bone) in the middle with slight inversion (turned inward). X-rays are often used to study the position, shape, and alignment of the bones in the feet and ankles. Magnetic resonance (MR) imaging is the imaging modality of choice for evaluating the posterior tibial tendon and spring ligament complex.

Non surgical Treatment
What are the treatment options? In early stages an orthotic that caters for a medially deviated subtalar joint ac-cess. Examples of these are the RX skive, Medafeet MOSI device. Customised de-vices with a Kirby skive or MOSI adaptation will provide greater control than a prefabricated device. If the condition develops further a UCBL orthotic or an AFO (ankle foot orthotic) could be necessary for greater control. Various different forms of surgery are available depending upon the root cause of the issue and severity.
Acquired Flat Foot

Surgical Treatment
For patients with a more severe deformity, or significant symptoms that do not respond to conservative treatment, surgery may be necessary. There are several procedures available depending on the nature of your condition. Ligament and muscle lengthening, removal of inflamed tendon lining, transferring of a nearby tendon to re-establish an arch, and bone realignment and fusion are examples of surgical options to help with a painful flatfoot condition. Surgery can be avoided when symptoms are addressed early. If you are feeling ankle pain or notice any warmth, redness or swelling in your foot, contact us immediately. We can create a tailored treatment plan to resolve your symptoms and prevent future problems.

Do You Really Understand Heel Pain And Discomfort?

Overview

Foot Pain

Your foot is made up of 26 bones, 33 joints, and more than 100 tendons. The heel is the largest bone in your foot. If you overuse or injure your heel, you may experience Heel Pain. This can range from mild to disabling. In many cases, if you have heel pain, you will need a doctor to diagnose the cause.

Causes

A flattening or overstretching of your plantar fascia can cause microscopic tears, inflammation, and a burning sensation. While developing slowly, there may be a sudden severe event sometimes occurring in only one foot at a time. Plantar Faciitis can affect people of all ages and backgrounds. Some contributing factors include age, weight-bearing activities, sudden increase in physical activity, improper shoes, excess weight or a recent weight gain (as little as 5 pounds), and poor biomechanics (flat feet, high arches or unnatural gait).

Symptoms

The most common complaint is pain and stiffness in the bottom of the heel. Heel pain may be sharp or dull, and it may develop slowly over time or suddenly after intense activity. The pain is typically worse in the morning, when taking your first steps of the day. After standing or sitting for a while. When climbing stairs.

Diagnosis

Your doctor will perform a physical exam and ask questions about your medical history and symptoms, such as have you had this type of heel pain before? When did your pain begin? Do you have pain upon your first steps in the morning or after your first steps after rest? Is the pain dull and aching or sharp and stabbing? Is it worse after exercise? Is it worse when standing? Did you fall or twist your ankle recently? Are you a runner? If so, how far and how often do you run? Do you walk or stand for long periods of time? What kind of shoes do you wear? Do you have any other symptoms? Your doctor may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your doctor may recommend a night splint to help stretch your foot. Surgery may be recommended in some cases.

Non Surgical Treatment

Morning Wall Stretch. Stand barefoot in front of wall, as shown. Press into wall with both hands and lean forward, feeling stretch along back of left leg and heel. Hold for 30 seconds; switch sides and repeat. Freeze and Roll. Freeze a small water bottle. Cover it with a towel and place arch of your foot on top of it. Slowly roll bottle beneath arch of foot for about 5 minutes at a time. Switch sides and repeat. Rub It Out. Use both thumbs to apply deep pressure along arch of the feet, heel, and calf muscles, moving slowly and evenly. Continue for 1 minute. Switch sides and repeat. If you foot pain isn’t improving or worsens after 2 weeks, a podiatrist or othopedist can prescribe additional therapies to alleviate discomfort and prevent recurrence.

Surgical Treatment

If treatment hasn’t worked and you still have painful symptoms after a year, your GP may refer you to either an orthopaedic surgeon, a surgeon who specialises in surgery that involves bones, muscles and joints or a podiatric surgeon, a podiatrist who specialises in foot surgery. Surgery is sometimes recommended for professional athletes and other sportspeople whose heel pain is adversely affecting their career. Plantar release surgery is the most widely used type of surgery for heel pain. The surgeon will cut the fascia to release it from your heel bone and reduce the tension in your plantar fascia. This should reduce any inflammation and relieve your painful symptoms. Surgery can be performed either as open surgery, where the section of the plantar fascia is released by making a cut into your heel or endoscopic or minimal incision surgery – where a smaller incision is made and special instruments are inserted through the incision to gain access to the plantar fascia. Endoscopic or minimal incision surgery has a quicker recovery time, so you will be able to walk normally much sooner (almost immediately), compared with two to three weeks for open surgery. A disadvantage of endoscopic surgery is that it requires both a specially trained surgical team and specialised equipment, so you may have to wait longer for treatment than if you were to choose open surgery. Endoscopic surgery also carries a higher risk of damaging nearby nerves, which could result in symptoms such as numbness, tingling or some loss of movement in your foot. As with all surgery, plantar release carries the risk of causing complications such as infection, nerve damage and a worsening of your symptoms after surgery (although this is rare). You should discuss the advantages and disadvantages of both techniques with your surgical team.

Prevention

Feet Pain

The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. The primary treatment is rest. Cold packs application to the area for 20 minutes several times a day or after activities give some relief. Over-the-counter pain medications can help manage the pain, consult your healthcare professional. Shoes should be well cushioned, especially in the midsole area, and should have the appropriate arch support. Some will benefit from an orthotic shoe insert, such as a rubber heel pad for cushioning. Orthotics should be used in both shoes, even if only one foot hurts. Going barefoot or wearing slipper puts stress on your feet. Put on supportive shoes as soon as you get out of bed. Calf stretches and stretches using a towel (place the towel under the ball of your feet and pull gently the towel toward you and hold a few seconds) several times a day, especially when first getting up in the morning. Stretching the Achilles tendon at the back of the heel is especially important before sports, but it is helpful for nonathletes as well. Increasing your exercise levels gradually. Staying at a healthy weight. Surgery is very rarely required.

Achilles Tendinitis Treatments And Causes

Overview

Achilles TendinitisAchilles tendonitis is a condition wherein the Achilles tendon, at or near its insertion to back of the heel, becomes inflamed and causes pain. The Achilles tendon is one of the longest and strongest tendons in the body. It is avascular (not supplied with blood vessels) so it can be slow to heal. The Achilles tendon is formed in the lower third of the leg. Two muscles join to form the Achilles tendon, the Gastrocnemius and the Soleus which are commonly referred to as the calf muscle. The Achilles tendon works as an anti-pronator which means it helps to prevent the foot from rolling inward.

Causes

Achilles tendonitis is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that requires the same repetitive action. Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon. A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time. Common causes of Achilles tendonitis include, over-training or unaccustomed use,?too much too soon?. Sudden change in training surface e.g. grass to bitumen. Flat (over-pronated) feet, High foot arch with tight Achilles tendon. tight hamstring (back of thigh) and calf muscles, toe walking (or constantly wearing high heels). Poorly supportive footwear, hill running. Poor eccentric strength.

Symptoms

People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.

Diagnosis

To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history, including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.

Nonsurgical Treatment

Most cases of Achilles tendonitis can be treated at home. Here’s what to do. Stop doing the activity that led to the injury. Avoid putting stress on your legs and feet, and give your tendon plenty of time to fully recover. Use the RICE formula. Don’t exercise for a few days, or try an exercise that doesn’t stress your feet, such as swimming. If necessary, your doctor may recommend that you use crutches or wear a walking boot to keep weight off your foot. Apply an ice pack wrapped in a towel or a cold compress to your tendon for 15 minutes or more after you exercise or if you feel pain in the tendon. Use tape or an athletic wrap to keep swelling down and help support and immobilize the tendon. Lie down and raise your foot above the level of your heart, and if possible, try to sleep with your foot elevated. This will help keep the swelling to a minimum. Take anti-inflammatory medications. Pain relievers like ibuprofen can help ease pain and reduce swelling in the affected area. Stretch and exercise your ankles and calf muscles while you recover. Keeping your muscles, tendons, and ligaments strong and flexible will aid in your recovery and help you keep from reinjuring your Achilles tendon. A doctor or a physical therapist can help you come up with a good exercise program. Try a pair of prescription orthotic inserts for your shoes if your doctor thinks it will help. Sometimes orthotics can be helpful. Talk to your doctor or someone trained in fitting orthotics to find out if they might work for you. Achilles tendon surgery is rarely needed. It’s usually only done if the tendon breaks, and then only as a last resort after other methods of therapy have been tried. Most cases of Achilles tendonitis will get better on their own with rest and minor treatment.

Achilles Tendonitis

Surgical Treatment

Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas of your tendon and repairing them.

Prevention

Do strengthening and stretching exercises to keep calf muscles strong and flexible. Keep your hamstring muscles flexible by stretching. Warm up and stretch adequately before participating in any sports. Always increase the intensity and duration of training gradually. Do not continue an exercise if you experience pain over the tendon. Wear properly fitted running and other sports shoes, including properly fitted arch supports if your feet roll inwards excessively (over-pronate).