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December Articles 2014

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age.

Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever's disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid sports activity which only worsens the problem. Over the counter pain medications targeted at relieving inflammation can be helpful for reducing the amount of heel pain. Combined with rest and pain medication, a child with Sever's disease should wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect just one heel of either foot as well as the heels of both feet. It is important to have a child experiencing heel pain get an examination by a foot doctor who can apply the squeeze test, which compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

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.

Treatment methods should usually continue for at least 2 weeks and as long as 2 months before the heel pain goes completely away and the child can resume normal physical and athletic activities again. A child can continue doing daily stretching exercises for the legs and feet to prevent the heel pain of Sever's disease from returning.

 

Plantar Fasciitis

Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be inaffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one time out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.

 

Foot Health: The 4 Differences between Walking and Running Shoes

Both running and walking are great exercises, but should a person wear the same shoes for running and for walking? The answer is no, because there is a difference between the way that a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed totally different. Before you begin any exercise program it is always recommended that you speak with your doctor.

Walking is a low impact exercise that is often recommended by doctors to their patients. Walking is the simplest exercise there is, but it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you walk along, you will notice that your heel hits the ground first and then your foot continues to roll forward until your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. The flexibility helps the walker to push off with each step taken.

Another thing about walking shoes is that your heel hits the ground first, therefore it absorbs most of the shock. This is why walking shoes need to have a beveled or angled heel. The angle of the heel helps to absorb some of the shock instead of putting all of the pressure on the ankles. This is especially important for speed walkers as their feet will hit the ground twice as often as the normal walker.

When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise that if not done with the proper equipment, could cause damage to their feet and legs. Running shoes are designed to be more light weight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. For this reason alone it is never recommended that a person wear walking shoe to run in. However, it's fine if you want to walk in running shoes. Walking shoes most often do not have the proper arch support that runners do.

One very important thing to remember is that a proper fit can make or break a runner or a walker. If a runner or walker’s shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. What ever your sport, running or walking, the right equipment can make all of the difference in the world.

 

Heel Pain

Heel pain is a stressful condition that effects day to day activities. Running and walking 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.

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 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.

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.

Treatments for heel pain are easy and effective as long as problems are addressed quickly. The most common solution is simply taking stress off the feet, particularly off of the heel. This will ease the pain and allow the tendons and ligaments to relax. In the case of both plantar fasciitis and Achilles tendonitis, icing will reduce swelling of any part of the foot and anti-inflammatory medication is highly recommended. Properly fitting your shoes and wearing heel pads or comfort insoles will also reduce the risk of developing heel pain. Stretching before and after exercises such as running will help the foot muscles prepare for stress and lower the chances of inflammatory pain. In extreme cases, relieving heel   pain might require surgery. Always make sure to discuss these symptoms and treatment options with your podiatrist to keep yourself active and pain free.

 

All About Broken Ankles

Broken ankles are a very serious injury which, if not properly treated, can lead to continuous pain and an inability to walk. An ankle is made up of at least three major bones--the tibia, fibula, and talus. The tibia and fibula are the two bones that connect to your knees. They sit directly upon the talus bone, protected by a fibrous membrane that allows slight movement in our ankle joint. When the ankle is broken, it is because the foot rolled under or twisted too far, causing one or more of these three bones to break.

An ankle sprain occurs when ligaments are ripped or torn but no bones were broken. A sprain can be very severe, causing severe bruising of the foot and an inability to hold weight. In the case of broken ankles, the bones broken in this region could be numerous. If a person cannot stand their own weight on their ankle then it is most likely a broken ankle. The best thing to do if you suspect you have a broken ankle is to get an x-ray to determine the severity of the break immediately. The longer you wait to be diagnosed, the longer the healing process will take.

The most common cause of a broken ankle is when the foot has rolled over on itself, usually while engaged in exercise, physical activity, or sports. Another common cause is from a jump of great height. It is most important to seek medical treatment if one suspects they have broken ankles. A doctor can determine if surgery is needed in order to heal correctly. Without medical assistance after such an injury, a person may suffer severe arthritis and pain later in life. In some cases, an operation may be the only option to ensure the ability to walk properly again.

Broken ankles will cause severe pain. It will help to elevate the feet above your head to reduce blood flow to the injured area, as well as applying ice to the ankles to help decrease swelling. If surgery is required, it usually means an ankle cast for at least three months and then rehabilitation. Rehabilitation can be painful, using atrophied muscles and building tendon strength.

It is important to determine if surgery is needed as a broken ankle can become more severe than you realize. If not professionally treated, the broken ankle bones will inhibit your ability to walk properly.