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Sever's Disease
Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.
Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.
Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.
Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.
If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.
Working on Your Feet
Foot care is important regardless of your profession, but those who work on their feet must pay special attention. Bunions, calluses, blisters, and plantar warts are just a few of the many conditions that can arise after standing all day. While painful at their worst, these conditions can easily be avoided with the right foot care. This includes both appropriate footwear and proper posture—important elements that affect the health of your feet.
Choosing appropriate footwear means choosing a shoe that has a negative heel. This means that the heel is slightly lower than the ball of your foot, which places less of a strain. If you have a profession that requires you to be on your feet all day, investing in a pair of high-quality shoes is pertinent. High-quality shoes can be purchased from a respected manufacturer that emphasizes foot care and foot health.
Despite the regularity of wearing shoes, the feet are naturally not designed to be enclosed. Regular “barefoot” time for your feet can be beneficial for foot health. Among other methods, allowing your feet to breathe can help alleviate the pain and pressure your feet may be experiencing from being on your feet all day.
Simple foot exercises and yoga positions can help improve both the health and function of your feet. Active foot exercises that create movement will stimulate your foot’s blood flow and circulation, and yoga positions that place your feet flat onto the floor will stretch out their muscles. Yoga is particularly beneficial for your Achilles tendon and calf muscles, which are areas that can become especially problematic if not taken care of. Foot exercises and yoga positions can be easily performed every day at virtually any location and any time; whether it is at the office, at the gym, or at home right before you go to bed. Simple stretching can increase your foot health by miles.
The foot pain you experience after lengthy hours working on your feet may seem inevitable and unavoidable; in reality, however, that is not the case. Wearing proper footwear and performing simple foot exercises and stretches can help ease foot pain and allow you to truly avoid frustrating foot problems.
Your feet can easily be kept healthy with some education and a little effort. Pain that begins at the feet can eventually affect the whole body. Begin taking care of your feet now!
Plantar Warts
Plantar warts are growths that typically appear on the heels or other weight-bearing areas of the feet. These warts are caused by the human papillomavirus (HPV). The virus enters the body through breaks in the skin, such as cuts, that are on the bottom of the feet. Plantar warts are more likely to affect children and teenagers, people with weakened immune systems, people who have a history with plantar warts, and people who walk barefoot in environments exposed to a wart-causing virus.
If you suspect you have plantar warts, you may have the following symptoms: pain or tenderness while walking, a lesion that interrupts the ridges in the skin of your foot, small fleshy lesions on the bottom of the foot, or a callus where a wart has grown inward over a well-defined spot on the skin.
HPV causes plantar warts to form and is very common. There are more than 100 kinds of the virus in existence. However, only a few of them cause warts on the feet. The other types of HPV are likely to cause warts on other parts of the body.
If you have plantar warts, your podiatrist may try different treatment methods depending on your specific case. Some treatments for plantar warts are peeling medicines (salicylic acid), freezing medicines (cryotherapy), or surgical procedures. Laser treatments and vaccines are also used to treat plantar warts.
Sports Related Foot and Ankle Injuries
Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.
Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.
Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.
Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.
It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.
Plantar Fasciitis
The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.
Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.
Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.
For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.
No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.
Ankle Foot Orthotics for Athletes
Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.
Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.
The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.
Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.
Vascular Testing in Podiatry
In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.
Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.
Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.
What is Morton's Neuroma?
Morton’s neuroma, (also referred to as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma or intermetatarsal neuroma) is a condition that is caused when the tissue around one of the nerves between your toes begins to thicken. This thickening can result in pain in the ball of the foot. Fortunately, the condition itself is not cancerous.
Morton’s neuroma affects women more often than men with a ratio of 4:1. It tends to target women between the age of 50 and 60, but it can occur in people of all ages. There are some risk factors that may put you at a slightly higher risk of developing the condition. People who often wear narrow or high-heeled shoes are often found to be linked to Morton’s neuroma. Additionally, activities such as running or jogging can put an enormous amount of pressure on the ligament and cause the nerve to thicken.
There usually aren’t any outward symptoms of this condition. A person who has Morton’s neuroma may feel as if they are standing on a pebble in their shoe. They may also feel a tingling or numbness in the toes as well as a burning pain in the ball of their foot that may radiate to their toes.
In order to properly diagnose you, the doctor will press on your foot to feel for a mass or tender spot. He may also do a series of tests such as x-rays, an ultrasound, or an MRI. X-rays are usually done to rule out any other causes for your foot pain such as a stress fracture. Ultrasounds are used to reveal soft tissue abnormalities that may exist, such as neuromas. Your podiatrist may want to use an MRI in order to visualize your soft tissues.
There are three main options for treatment of Morton’s neuroma: Injections, decompression surgery, and removal of the nerve. Injections of steroids into the painful area have been proven to help those with Morton’s neuroma. Decompression surgery has been shown to relieve pressure on the affected nerve by cutting nearby structures such as the ligaments in the foot. Another treatment option would be to surgically remove the growth to provide pain relief.
If you suspect that you have Morton’s neuroma you should make an appointment with your podiatrist right away. You shouldn’t ignore any foot pain that lasts longer than a few days, especially if the pain does not improve.
Treating Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.
Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.
If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.
Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.
If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.
Ankle Pain
The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.
The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.
If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.
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Flatfoot
Flatfoot is a foot disorder that is not as straightforward as many people believe. Various types of flatfoot exist, each with their own varying deformities and symptoms. The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot. Other signs of flatfoot include:
- “Toe drift,” or the pointing outward of the toes and the front part of the foot
- The tilting outward of the heel and the tilting inward of the ankle
- The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
- Hammertoes
- Bunions
One of the most common types of flatfoot is flexible flatfoot. This variation usually starts in childhood and progresses as one ages into adulthood. Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing. When not standing, the arch returns. Symptoms of flexible flatfoot include:
- Pain located in the heel, arch, ankle, or along the outside of the foot
- Overpronation, or an ankle that rolls in
- Shin splint, or pain along the shin bone
- General foot aches or fatigue
- Pain located in the lower back, hip, or knee
Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit. X-rays may be taken to define the severity and help determine the treatment option best for your condition. Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices. If nonsurgical methods prove ineffective, surgery may be considered. Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.
Heel Pain
Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.
Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.
Plantar Fasciitis
One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.
Achilles Tendonitis
Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.
Heel Spur
A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.
Plantar Fasciitis
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.
There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.
People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.
Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.
If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.
Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.