Foot Pain Concerns

You May Have Pes Planus?


Overview
Acquired Flat Feet
The condition known as ?fallen arches? is also referred to as flat feet or pes planus. It arises when the arch of the foot collapses to the point that the entire sole is flat to the ground. It is commonly seen in young children who have yet to develop the muscles in the sole of their feet. In most cases as a child develops and learns how to walk the finer intrinsic muscles that support the sole of the foot will develop normally and an arch forms. However in a small number of cases these muscles don?t form properly and thus neither does the arch. Fallen arches which are acquired in adulthood may be due to a number of factors.

Causes
There is a lack of normal arch development, probably due to inherent ligamentous laxity. Around 20% of adults have Pes planus. The majority have a flexible flat foot and no symptoms. However, if there is also heel cord contracture, there may be symptoms (see 'Contributing factors', below). Loss of support for the arch. Dysfunction of the tibialis posterior tendon, a common and important cause. Tear of the spring ligament (rare). Tibialis anterior rupture (rare). A neuropathic foot, e.g from diabetes, polio, or other neuropathies. Degenerative changes in foot and ankle joints. Inflammatory arthropathy, eg rheumatoid arthritis. Osteoarthritis. Fractures. Bony abnormalities, eg tarsal coalition.

Symptoms
A significant number of people with fallen arches (flat feet) experience no pain and have no problems. Some, however, may experience pain in their feet, especially when the connecting ligaments and muscles are strained. The leg joints may also be affected, resulting in pain. If the ankles turn inwards because of flat feet the most likely affected areas will be the feet, ankles and knees. Some people have flat feet because of a developmental fault during childhood, while others may find that the problem develops as they age, or after a pregnancy. There are some simple devices which may prevent the complications of flat feet.

Diagnosis
It is important for people with foot pain to know if they have flat feet. The following tests can help you determine your arch type. When you get out of a swimming pool, look at your footprint on the concrete. The front of the foot will be joined to the heel by a strip. If your foot is flat, then the strip is the same width as the front of the foot, creating a footprint that looks like a stretched out pancake. With a normal arch, the strip is about half the width of the front of the foot. If you have a high arch, only a thin strip connects the front of the foot with the heel. Put your shoes on a flat table and view them at eye level from behind. See if the sole is worn evenly. A flat foot will cause more wear on the inside of the sole, especially in the heel area. The shoe will easily rock side to side. A flat foot will also cause the upper part of the shoe to lean inward over the sole. Both shoes should wear about the same way. If you have pain in one foot, you should make sure you don't have a fallen arch on that side. There are two good tests you can perform at home to detect this problem. Place your fingertips on a wall that you are directly facing and stand on your tiptoes on one foot. If you can't do it, a fallen arch may be the culprit. Stand with your feet parallel. Have someone stand in back of you and look at your feet from behind. You can also do it yourself if you stand with your back to a mirror. Normally, only the pinky toe is visible from behind. If one foot is flatter than the other, the 4th and sometimes the 3rd toe on that foot can also be seen.

Non Surgical Treatment
The type of treatment will depend on the stage of PTTD present. There are four stages of posterior tibial tendon dysfunction. Stage I. The posterior tibial tendon is inflamed but has normal strength. There is little to no change in the arch of the foot. The patient can still perform a single-limb heel rise and has a flexible hindfoot. Orthotic treatment options include modified off the shelf inserts and custom molded orthotics. Stage 2. The tendon is partially torn or shows degenerative changes and as a result loses strength.There is considerable flattening of the arch without arthritic changes in the foot pain relief; aishaLevins.jimdo.com,. The patient cannot perform single-limb heel rise. Pain is now present on the lateral aspect of the ankle. Orthotic treatment is similar as that in stage I, with the addition of more rigid arch supports and wedging. Stage 3. Results when the posterior tibial tendon is torn and not functioning. As a result the arch is completely collapsed with arthritic changes in the foot. A solid ankle AFO is suggested in conjunction with a modified orthopedic shoe. Stage 4. Is identical to stage three except that the ankle joint also becomes arthritic. A rigid AFO and modified orthopedic shoe is required.

Surgical Treatment
Acquired Flat Feet
Fallen arches may occur with deformities of the foot bones. Tarsal coalition is a congenital condition in which the bones of the foot do not separate from one another during development in the womb. A child with tarsal coalition exhibits a rigid flat foot, which can be painful, notes the patient information website eOrthopod. Surgery may prove necessary to separate the bones. Other foot and ankle conditions that cause fallen arches may also require surgery if noninvasive treatments fail to alleviate pain and restore normal function.
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What Is A Bunion?


Overview
Bunions Callous/><br>A bunion, (medical term: hallux abductovalgus) is a condition resulting in boney prominence at the inside of the foot at the big toe joint. A bunion occurs when the big toe begins to deviate toward the second toe. The biggest misconception is that bunions occur from an overgrowth of bone. While that may be true in very few people, the bunion really represents a dislocation of the big toe joint as it bulges against the skin.<br><br><b>Causes</b><br>Shoes with narrow toes can trigger a bunion, but they?re not the underlying cause. Bunions run in families, because foot type (shape and structure) is hereditary, and some types are more prone to bunions than others. Low arches, flat feet, and loose joints and tendons all increase the risk. The shape of the metatarsal head (the top of the first metatarsal bone) also makes a difference: if it?s too round, the joint is less stable and more likely to deform when squeezed into shoes with narrow toes. <br><b>Symptoms</b>Symptoms include redness, swelling and pain which may be present along the inside margin of the foot. The patients feet may become too wide to fit into their normal size shoes and moderate to severe discomfort may occur when the patient is wearing tight shoes. A "hammer toe" may occur at the 2nd toe. This is when the toe contracts and presses on the shoe. Subsequently, this may cause a corn on top of the 2nd toe.<br><br><b>Diagnosis</b><br>Bunions are readily apparent - the prominence is visible at the base of the big toe or side of the foot pain due to diabetes - <a href="http://youngsalvation883.jimdo.com">youngsalvation883.jimdo.com</a> -. However, to fully evaluate the condition, the foot and ankle surgeon may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don?t go away, and will usually get worse over time. But not all cases are alike - some bunions progress more rapidly than others. Once your surgeon has evaluated your bunion, a treatment plan can be developed that is suited to your needs.<br><br><b>Non Surgical Treatment</b><br>Making sure that shoes donBunions Hard Skin

Surgical Treatment
In severe hallux valgus bunion cases, the first long bone (metatarsal) in the foot dramatically shifts away from the second metatarsal, resulting in looseness and a large deformity. In severe bunion corrections, a surgery known as the Lapidus procedure realigns the first metatarsal into its natural position. Using screws, the surgery holds the bone stable so it does not shift again and reduces the change of the bunion returning to basically none. Surgery may also involve removing the enlarged portion of the bunion region, cutting and realigning the bone, and correcting the position of the tendons and ligaments. By using a special plate with Lapidus procedures, University Foot and Ankle Institute patients are able to put weight on their foot after only 2-3 weeks, rather than the typical 6-8 weeks of no weight.

Prevention
If the diagnosis is made early on, such as in preadolescence, bunion development can be slowed and in some cases arrested with the proper supportive shoe gear and custom functional shoe inserts (orthotics). Avoidance of certain athletic activities with improper shoe fit and toe pressure can prevent the symptoms that occur with bunions.
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