It is rare to find someone who walks with both feet in perfect alignment. Often we walk on the inside or outsides of our feet, or with our toes or heels rotated inward. These typical walking patterns can cause many problems not just with the feet but also for the whole body as the alignment of the feet sets the foundation for the whole body?s alignment. One of the most common effects of improper alignment is known as flatfoot, or fallen arches.
Flat feet are often a congenital problem which has no specific cause. They can however occur after an injury, especially conditions such as Tibialis Posterior Syndrome or more traumatic injuries such as fractures or mid-tarsal joint sprains. The other thing to look out for is Overpronation. Often this is confused with having flat feet (or a fallen arch) although it is not technically the same thing. If an individual does not have flat feet but does overpronate then the arch of their foot appears to be normal when standing. However, when they walk the arch collapses and the foot rolls in excessively. This is more difficult to spot than flat feet. It is estimated that between 60 and 80% of the population overpronate!
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.
There are a few simple ways to assess your foot type, and most include making an imprint of your footprint. The classic way is to stand on a hard floor surface with wet feet to make a wet foot print. Look at the narrowest part of your footprint, which should be between your heel and ball of your foot. If the print of your foot in this part is less than 10% of the width of the widest part then you are likely to have high arches. more than 10% but less than 25% then your foot profile is probably normal, more than 25% or even the widest part, then you have flat feet.
Non Surgical Treatment
Treatment of flat feet may be appropriate if there is associated foot or lower leg pain, or if the condition affects the knees or the lower back. Treatment may include using Orthoses such as an arch support, foot gymnastics or other exercises as recommended by a podiatrist/orthotist or physical therapist. In cases of severe flat feet, orthoses should be used through a gradual process to lessen discomfort. Over several weeks, slightly more material is added to the orthosis to raise the arch. These small changes allow the foot structure to adjust gradually, as well as giving the patient time to acclimatise to the sensation of wearing orthoses. Once prescribed, orthoses are generally worn for the rest of the patient's life. In some cases, surgery can provide lasting relief, and even create an arch where none existed before; it should be considered a last resort, as it is usually very time consuming and costly.
Surgery is typically offered as a last resort in people with significant pain that is resistant to other therapies. The treatment of a rigid flatfoot depends on its cause. Congenital vertical talus. Your doctor may suggest a trial of serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. However, this generally has a low success rate. Most people ultimately need surgery to correct the problem. Tarsal coalition. Treatment depends on your age, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot. Lateral subtalar dislocation. The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bone back into proper alignment without making an incision. Anesthesia is usually given before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.
Donning a first-rate pair of arch supports, therapeutic socks and proper footwear before heading out to enjoy hours of holiday fun is one option to consider. Your podiatrist can help you find just the right ones. Once you have them on, they?ll help ease the amount of pressure being put on your body and keep the blood flowing in the right direction. While you?re standing in line, consider doing a bit of exercise as well. We?re not talking about channeling your inner Jack LaLanne here. Otherwise, you might attract the attention of the mall security guards. Simple ankle rotations and walking in place may help to reduce edema and give your flat feet a bit of a break. If you happen to be in a shopping mall or center where foot massages are available, take advantage of them periodically. They are likely to make you feel better and it?s a great excuse to carve out a few quiet moments for yourself. If you can?t visit a professional, tuck a personal foot massager into your purse. That way, you can lightly massage your own feet during the car ride home. Lastly, there are certain foods and nutritional supplements available that may reduce edema caused by standing on flat feet for hours at a time. The list includes potassium rich foods like raisins, bananas, baby carrots, nuts and yogurt. So, you may want to pack a snack for those trips to the mall or hit the food court before you hit the stores.
Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.
Surgery is another option. In some cases the longer extremity can be shortened, but a major shortening may weaken the muscles of the extremity. In growing children, lower extremities can also be equalized by a surgical procedure that stops the growth at one or two sites of the longer extremity, while leaving the remaining growth undisturbed. Your physician can tell you how much equalization can be attained by surgically halting one or more growth centers. The procedure is performed under X-ray control through very small incisions in the knee area. This procedure will not cause an immediate correction in length. Instead, the LLD will gradually decrease as the opposite extremity continues to grow and "catch up." Timing of the procedure is critical; the goal is to attain equal length of the extremities at skeletal maturity, usually in the mid- to late teens. Disadvantages of this option include the possibility of slight over-correction or under-correction of the LLD and the patient?s adult height will be less than if the shorter extremity had been lengthened. Correction of significant LLDs by this method may make a patient?s body look slightly disproportionate because of the shorter legs.
The causes of LLD are many, including a previous injury, bone infection, bone diseases (dysplasias), inflammation (arthritis) and neurologic conditions. Previously broken bones may cause LLD by healing in a shortened position, especially if the bone was broken in many pieces (comminuted) or if skin and muscle tissue around the bone were severely injured and exposed (open fracture). Broken bones in children sometimes grow faster for several years after healing, causing the injured bone to become longer. Also, a break in a child?s bone through a growth center (located near the ends of the bone) may cause slower growth, resulting in a shorter extremity. Bone infections that occur in children while they are growing may cause a significant LLD, especially during infancy. Bone diseases may cause LLD, as well; examples are neurofibromatosis, multiple hereditary exostoses and Ollier disease. Inflammation of joints during growth may cause unequal extremity length. One example is juvenile rheumatoid arthritis. Osteoarthritis, the joint degeneration that occurs in adults, very rarely causes a significant LLD.
Back pain along with pain in the foot, knee, leg and hip on one side of the body are the main complaints. There may also be limping or head bop down on the short side or uneven arm swinging. The knee bend, hip or shoulder may be down on one side, and there may be uneven wear to the soles of shoes (usually more on the longer side).
On standing examination one iliac crest may be higher/lower than the other. However a physiotherapist, osteopath or chiropractor will examine the LLD in prone or supine position and measure it, confirming the diagnosis of structural (or functional) LLD. The LLD should be measured using bony fixed points. X-Ray should be taken in a standing position. The osteopath, physiotherapist or chiropractor will look at femoral head & acetabulum, knee joints, ankle joints.
Non Surgical Treatment
Treatment depends on what limb has the deformity and the amount of deformity present. For example, there may be loss of function of the leg or arm. Cosmetic issues may also be a concern for the patient and their family. If there are problems with the arms, the goal is to improve the appearance and function of the arm. Treatment of leg problems try to correct the deformity that may cause arthritis as the child gets older. If the problem is leg length, where the legs are not "equal," the goal is equalization (making the legs the same length). Treatment may include the use of adaptive devices, prosthesis, orthotics or shoe lifts. If the problem is more severe and not treatable with these methods, then surgery may be necessary.
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Many people undergo surgery for various reasons - arthritis, knee replacement, hip replacement, even back surgery. However, the underlying cause of leg length inequality still remains. So after expensive and painful surgery, follow by time-consuming and painful rehab, the true culprit still remains. Resuming normal activities only continues to place undue stress on the already overloaded side. Sadly so, years down the road more surgeries are recommended for other joints that now endure the excessive forces.
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.
Morton's neuroma develops for several reasons. The primary reason is wearing narrow toe-box shoes, which compress the metatarsal heads. Certain anatomical factors also make nerve compression more likely with the narrow toe box shoes. In some people fibers, the medial and lateral plantar nerves converge close to the heads of the third and fourth metatarsals. This junction creates a larger nerve structure between the metatarsal heads making it more vulnerable to compression.
Symptoms of interdigital neuroma typically manifest as a sharp, burning or tingling sensation in the forefoot. The pain radiates toward the lesser toes and is aggravated by shoe wear. The pain is relieved when the shoe is removed and the forefoot is massaged. Sometimes the symptoms involve specific toes.
There is a special orthopedic test called the Morton's test that is often used to evaluate the likelihood of plantar nerve compression. For this test, the client is supine on the treatment table. The practitioner grasps the client's forefoot from both sides and applies moderate pressure, squeezing the metatarsal heads together. If this action reproduces the client's symptoms (primarily sharp, shooting pain into the toes, especially the third and fourth), Morton's neuroma may exist.
Non Surgical Treatment
Anti-inflammatory drugs may be recommended to dull the pain and lessen swelling. Neuropathic pain medications such as the antionvulsants and / or antidepressants may be tried as well. Many are able to recover from this issue at home by icing the area, resting the feet, and by avoiding wearing narrow or tight shoes. If these remedies do not work to alleviate symptoms, the doctor may give special devices to separate the toes and avoid the squeezing of the nerve. Steroid injections may reduce pain and swelling. Surgery may be required if these do not help.
Surgery may be considered in patients who have not responded adequately to non-surgical treatments. Your foot and ankle surgeon will determine the approach that is best for your condition. The length of the recovery period will vary, depending on the procedure performed. Regardless of whether you?ve undergone surgical or nonsurgical treatment, your surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities to reduce the repetitive pressure on the foot.
Leg length inequality goes mainly undiscovered on a daily basis, yet this condition is very easily solved, and can eradicate a number of incidents of upper back pain.
Therapy for leg length inequality usually involves Shoe Lifts. They are affordable, normally being less than twenty dollars, compared to a custom orthotic of $200 and up. 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.
Upper back pain is the most common condition impacting people today. Around 80 million men and women are afflicted by back pain at some stage in their life. It is a problem which costs companies millions of dollars every year as a result of time lost and productivity. Fresh and superior treatment methods are continually sought after in the hope of reducing the economic impact this issue causes.
Men and women from all corners of the earth suffer the pain of foot ache as a result of leg length discrepancy. In these situations Shoe Lifts can be of worthwhile. The lifts are capable of easing any discomfort and pain in the feet. Shoe Lifts are recommended by many specialist orthopaedic practitioners".
So as to support the body in a well balanced fashion, your feet have got a significant role to play. In spite of that, it's often the most overlooked region of the 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 impacted too. Shoe Lifts guarantee that ideal posture and balance are restored.
There are two types of Hammer toes, Flexible hammertoes. If the toe still can be moved at the joint, it's a flexible hammertoe. That's good, because this is an earlier, milder form of the problem. There may be several treatment options. Rigid hammertoes. If the tendons in the toe become rigid, they press the joint out of alignment. At this stage, the toe can't be moved. It usually means that surgery is needed.
Your shoes, your genetic predisposition, an underlying medical condition or all of these can make you susceptible to developing one of these deformities of the toes. The genes your parents gave you. When it comes to genetics, the foot type you?re born with predisposes you to developing this type of joint deformity over a lifetime. For many, a flat flexible foot leads to hammertoes as the foot tries to stabilize against a flattening arch. Those with high arches can also form hammertoes as the extensor tendons overpower the flexors.
For some people, a hammer toe is nothing more than an unsightly deformity that detracts from the appearance of the foot. However, discomfort may develop if a corn or callus develops on the end or top of the toe. If pressure and friction continue on the end or top of the toe, a painful ulcer may develop. Discomfort or pain can lead to difficulty walking.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and Hammer toe ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
If your hammertoe problem is diagnosed as flexible hammertoe, there are a number of nonsurgical treatments that may be able to straighten out your toe or toes and return them to their proper alignment. Padding and Taping. Your physician may pad the boney top-part of your hammertoe as a means of relieving pain, and may tape your toes as a way to change their position, correct the muscle imbalance and relieve the pressure that led to the hammertoe's development. Medication. Anti-inflammatory drugs such as aspirin and ibuprofen can help deal with inflammation, swelling and pain caused by your hammertoe. Cortisone injections may be prescribed for the same purpose. If your hammertoe is a consequence of arthritis, your physician may prescribe medications for that.
For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the damaged skin where the corn is located. Then a small section of bone is removed at the level of the rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a pin may be required to hold the toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly. Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.
Some people develop bunions from wearing shoes that do not fit correctly (especially high heels or narrow-toed shoes). For other people, bunions are caused by factors beyond their control. These can include a family history of a foot type that is susceptible to bunions, neuromuscular disorders, conditions affecting the joints (e.g., arthritis), severe injury to the foot, deformities at birth, problems that affect the way a person walks (e.g., rolling in at the ankles).
Bunions are an often painful condition that may become even more painful as extra bone and a fluid-filled sac grow at the base of your big toe. Some of the most frequently experienced signs and symptoms associated with bunions, besides pain, include redness in your affected area. Blistering over your bunion. Callus formation around your bunion. Bursitis. Nerve damage (numbness and/or sharp pains) in your involved area. Bunions may also cause pain within and below your first metatarsophalangeal, or MTP, joint. Your bunion may become further dislocated and unstable as it progresses and may overload your adjacent joints.
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.
Non Surgical Treatment
A bunion treatment must address the underlying cause of the deformity, not just the bump (bunion) itself but also the functions of the foot. The up and down motion of the longitudinal arches in the foot. The sideways motion of the transverse arch. Bunion aids effectively treat this underlying foot function while straightening the big toe because the mid-foot strap stabilizes the longitudinal arches and transverse arch. The toe strap gradually and gently pulls the big toe away from the second toe. The metatarsal pad helps align the transverse arch. The hinged splint enables the big toe to flex while walking and adapts to the contour of the foot, especially around the inflamed area of the joint.
Surgery isn't recommended unless a bunion causes you frequent pain or interferes with your daily activities. If conservative treatment doesn't provide relief from your symptoms, you may need surgery. There are many different types of surgical procedures for bunions, and no particular bunion procedure is best for every problem. If the bunion gets worse and more painful, surgery to realign the toe and remove the bony bump (bunionectomy) can be effective. Most surgical procedures include a bunionectomy, which involves. Removing the swollen tissue from around your big toe joint. Straightening your big toe by removing part of the bone. Realignment of the 1st metatarsal bone to straighten out the abnormal angle in your big toe joint. Permanently joining the bones the 1st metatarsophalangeal joint. It's possible you may be able to walk on your foot immediately after a bunion procedure. However, full recovery can take up to eight weeks or longer with some bunion procedures. To prevent a recurrence, you'll need to wear proper shoes and a foot orthotic after recovery. No surgical procedure is without risk and you may still have pain or you could develop a new bunion in your big toe joint after surgery.
To help prevent bunions be sure your shoes don't cramp or irritate your toes. Choose shoes with a wide toe box - there should be space between the tip of your longest toe and the end of the shoe. Your shoes should conform to the shape of your feet without squeezing or pressing any part of your foot. Avoid pointy-toed shoes.