What Is Bursitis Of Your Feet?
Overview
You might be suffering from Achilles bursitis if you have sharp pain at the back of your heel. You have lump on the back of your heel. You have loss of range of motion walking and the pressure for shoes causes you to limp and you have weakness in your leg. You have warmth, redness and swelling on the heel. If any of those statements are true for you or you're suffering from on-going pain in your heel then you might have an injury called "retrocalcaneal bursitis". Many people don't know that Achilles bursitis is a very real injury affecting the bursa sac in your ankle. It can happen to anyone who regularly puts stress with repetitive movements as part of your job, sports related activities, acute trama to the ankle/foot and/or aging weakness the tissue around the ankle and the bursa.
Causes
Age. Bursitis is more common during middle age due to repetitive activities that put wear and tear on the body over time. Certain activities or occupations. If your job or hobby involves repetitive motion or puts pressure on bursae, you have a higher likelihood of developing bursitis. Reaching overhead, leaning elbows on arm rests, crossing your legs, laying carpet, setting tile, gardening, biking, playing baseball and ice skating are some activities that, when repeated very often, can put you at increased risk of developing bursitis. Sports in which you may get hit in the knee or fall to the knees, such as football, can also increase the risk. Some medical or health conditions. Rheumatoid arthritis, osteoarthritis, gout, thyroid disease, diabetes, alcoholism and some immunosuppressive disorders can increase the risk of bursitis. The reasons can vary, from cartilage breakdown around joints (arthritis) to crystals in the bursa that cause inflammation (gout). Wearing high heels. Posterior Achilles tendon bursitis occurs when the bursa located between the skin and the Achilles tendon (the band of tissue that attaches the calf muscle to the heel bone) becomes inflamed. High heels are often to blame for this, the stiff heel can put direct pressure on the bursa between the skin and the Achilles tendon.
Symptoms
Pain and tenderness are common symptoms. If the affected joint is close to the skin, as with the shoulder, knee, elbow, or Achilles tendon, swelling and redness are seen and the area may feel warm to the touch. The bursae around the hip joint are deeper, and swelling is not obvious. Movement may be limited and is painful. In the shoulder, it may be difficult to raise the arm out from the side of the body. Putting on a jacket or combing the hair becomes a troublesome activity. In acute bursitis symptoms appear suddenly, with chronic bursitis, pain, tenderness, and limited movement reappear after exercise or strain.
Diagnosis
Your GP or therapist will be able to diagnose you by both listening to your history and examining you. No X-rays or further investigation should be needed to confirm diagnosis but may be requested to check for any underlying health conditions that may have triggered the bursitis.
Non Surgical Treatment
Rest, ice, and anti-inflammatory medication will help with pain and swelling. Physical therapy can help stretch the Achilles to relieve any impingement. Also, a switch to properly-fitting shoes will help to prevent the condition from worsening or recurring. You might also find relief with shoe inserts such as heel cups or padding. If you have tried these measures, yet symptoms remain severe and continue to progress, surgical intervention is a possibility. Calcaneal bursitis surgery consists of excision or removal of the inflamed tissues and resection of the boney prominence. Debridement of the affected area near the Achilles may also be performed, as well as repair of the Achilles if the condition has gone so far that the tendon ruptures.
Surgical Treatment
Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
Prevention
You may be able to prevent bursitis from happening or coming back. Continue your home treatment with rest, ice, pain relievers, and gentle exercises. When you are ready to try the activity that caused the pain, start slowly and do it for short periods or at a slower speed. Warm up before and stretch after the activity. Increase your activity slowly, and stop if it hurts. Use ice afterward to prevent pain and swelling. Change the way you do activities with repeated movements that may strain your muscles or joints. For example if using a certain tool has caused bursitis, start switching hands or change the grip size of your tool. If sitting for long periods has caused bursitis, get up and walk around every hour. If a certain sport is causing bursitis, consider taking lessons to learn proper techniques. Have an expert check your equipment to make sure it's well suited to your size, strength, and ability. If certain activities at work may be causing bursitis, talk to your human resources department about other ways of doing your job, equipment changes, or other job assignments. Protect your joints from pressure. Cushion knees or elbows on hard surfaces, and wear shoes that fit you well and have good support.
You might be suffering from Achilles bursitis if you have sharp pain at the back of your heel. You have lump on the back of your heel. You have loss of range of motion walking and the pressure for shoes causes you to limp and you have weakness in your leg. You have warmth, redness and swelling on the heel. If any of those statements are true for you or you're suffering from on-going pain in your heel then you might have an injury called "retrocalcaneal bursitis". Many people don't know that Achilles bursitis is a very real injury affecting the bursa sac in your ankle. It can happen to anyone who regularly puts stress with repetitive movements as part of your job, sports related activities, acute trama to the ankle/foot and/or aging weakness the tissue around the ankle and the bursa.
Causes
Age. Bursitis is more common during middle age due to repetitive activities that put wear and tear on the body over time. Certain activities or occupations. If your job or hobby involves repetitive motion or puts pressure on bursae, you have a higher likelihood of developing bursitis. Reaching overhead, leaning elbows on arm rests, crossing your legs, laying carpet, setting tile, gardening, biking, playing baseball and ice skating are some activities that, when repeated very often, can put you at increased risk of developing bursitis. Sports in which you may get hit in the knee or fall to the knees, such as football, can also increase the risk. Some medical or health conditions. Rheumatoid arthritis, osteoarthritis, gout, thyroid disease, diabetes, alcoholism and some immunosuppressive disorders can increase the risk of bursitis. The reasons can vary, from cartilage breakdown around joints (arthritis) to crystals in the bursa that cause inflammation (gout). Wearing high heels. Posterior Achilles tendon bursitis occurs when the bursa located between the skin and the Achilles tendon (the band of tissue that attaches the calf muscle to the heel bone) becomes inflamed. High heels are often to blame for this, the stiff heel can put direct pressure on the bursa between the skin and the Achilles tendon.
Symptoms
Pain and tenderness are common symptoms. If the affected joint is close to the skin, as with the shoulder, knee, elbow, or Achilles tendon, swelling and redness are seen and the area may feel warm to the touch. The bursae around the hip joint are deeper, and swelling is not obvious. Movement may be limited and is painful. In the shoulder, it may be difficult to raise the arm out from the side of the body. Putting on a jacket or combing the hair becomes a troublesome activity. In acute bursitis symptoms appear suddenly, with chronic bursitis, pain, tenderness, and limited movement reappear after exercise or strain.
Diagnosis
Your GP or therapist will be able to diagnose you by both listening to your history and examining you. No X-rays or further investigation should be needed to confirm diagnosis but may be requested to check for any underlying health conditions that may have triggered the bursitis.
Non Surgical Treatment
Rest, ice, and anti-inflammatory medication will help with pain and swelling. Physical therapy can help stretch the Achilles to relieve any impingement. Also, a switch to properly-fitting shoes will help to prevent the condition from worsening or recurring. You might also find relief with shoe inserts such as heel cups or padding. If you have tried these measures, yet symptoms remain severe and continue to progress, surgical intervention is a possibility. Calcaneal bursitis surgery consists of excision or removal of the inflamed tissues and resection of the boney prominence. Debridement of the affected area near the Achilles may also be performed, as well as repair of the Achilles if the condition has gone so far that the tendon ruptures.
Surgical Treatment
Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
Prevention
You may be able to prevent bursitis from happening or coming back. Continue your home treatment with rest, ice, pain relievers, and gentle exercises. When you are ready to try the activity that caused the pain, start slowly and do it for short periods or at a slower speed. Warm up before and stretch after the activity. Increase your activity slowly, and stop if it hurts. Use ice afterward to prevent pain and swelling. Change the way you do activities with repeated movements that may strain your muscles or joints. For example if using a certain tool has caused bursitis, start switching hands or change the grip size of your tool. If sitting for long periods has caused bursitis, get up and walk around every hour. If a certain sport is causing bursitis, consider taking lessons to learn proper techniques. Have an expert check your equipment to make sure it's well suited to your size, strength, and ability. If certain activities at work may be causing bursitis, talk to your human resources department about other ways of doing your job, equipment changes, or other job assignments. Protect your joints from pressure. Cushion knees or elbows on hard surfaces, and wear shoes that fit you well and have good support.
Causes Of Hammertoe Problems
Overview
A hammertoe is a misshapen second, third, or fourth toe. The toe bends up at the middle joint. The toe becomes a hammertoe because a muscle in the toe isn?t working properly or is too weak, increasing pressure on the tendons and the toe joints. Muscles normally work in twos to bend and straighten toes. If the toe stays bent too long, a hammertoe develops. Ill-fitting shoes, arthritis, heredity, even an injury, can cause the hammertoe to form. To add insult to injury, corns and calluses are common on top of hammertoes because the toe is rubbing against the shoe.
Causes
Many people develop hammertoe because they wear shoes that are too tight. Shoes with narrow toe boxes squeeze the toes together, forcing some to bend. This causes the toe muscles to contract. If the toes are forced into this cramped position too often, the muscles may hammertoe permanently tighten, preventing the toes from extending. Chronic hammertoe can also cause the long bones that connect the toes to the foot, called metatarsals, to move out of position. The misaligned metatarsal bones may pinch a nerve running between them, which can cause a type of nerve irritation called a neuroma.
Symptoms
The most common symptoms of hammertoes include. The toe is bent upward at the middle toe joint, so that the top of this joint rubs against the top of the shoe. The remainder of the toe is bent downward. Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe. This occurs because the contracted digit puts pressure on the metatarsal head creating callouse and pressure on the ball of the foot.
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
Symptomatic treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous often seen with the hammertoe. These medications must be used with caution. They are a mild acid that burns the callous off. These medications should never be used for corns or callouses between the toes. Persons with diabetes or bad circulation should never use these products.
Surgical Treatment
If these non-invasive treatments don?t work, or if the joint is rigid, a doctor?s only recourse may be to perform surgery. During the surgery, the doctor makes an incision and cuts the tendon to release it or moves the tendon away from or around the joint. Sometimes part of the joint needs to be removed or the joint needs to be fused. Each surgery is different in terms of what is needed to treat the hammertoe. Normally after any foot surgery, patients use a surgical shoe for four to six weeks, but often the recovery from hammertoe surgery is more rapid than that. An unfortunate reality is that hammertoe can actually return even after surgery if a patient continues to make choices that will aggravate the situation. Though doctors usually explain pretty clearly what needs to be done to avoid this.
Prevention
Few people realize that their feet grow over the years: actually, the heel stays the same, but the front of the foot becomes wider and longer. The result, most women wear shoes that fit at the heel but are much too narrow in the front. Buy shoes that fit the longer foot. For two out of three people, one foot is significantly bigger than the other. Have both feet measured whenever you buy shoes. Have your feet measured while you're standing, and buy shoes that fit the larger foot. Shop at the end of the day, when foot swelling is greatest. No shoe should feel tight. Don't go by numbers. You may think of yourself as a size 8B, but size varies from shoe to shoe. There is no standardization, so pick the shoes that fit best. Limit high-heel use. These shoes increase pressure on the front of the foot by at least 50 percent, so wear them only for special occasions. Flat shoes are more comfortable than high heels, but they, too, can be hard on your feet, especially if they are thin-soled. Change your shoes. If your shoes are too short or too narrow, get another pair. This is especially important for children going through periods of rapid growth. The toe area should be high enough so that it doesn't rub against the top of your toes-especially if hammer toes have started to develop.
Hammer Toe Cause & Treatment Solution
Overview
Hammer toe can occur when feet are crammed into shoes so tight that the front of the toes are pushed against the front of the shoes for prolonged periods of time. One or more toes then remain bent with the middle knuckle pointing up, even when shoes are taken off. If the condition is left untreated and tight footwear is continually worn, these bent toes can become so rigid that they can no longer straighten out on their own. While any shoes that are too tight can lead to this condition, high heels seem to be a big culprit since the elevated ankle causes more weight to push the toes forward. This may explain why the condition affects more women than men.
Causes
Ill-fitting shoes or a muscle imbalance are the most common causes of Hammer Toe. If there is an issue with a muscle in the second, third or fourth toes preventing them from straightening, Hammer Toe can result. If one of these toes is bent long enough in one position, the muscles tighten and cannot stretch out. Left untreated, surgery may be required. Women are especially prone to developing Hammer Toe because of their shoes. Hammer Toe results from shoes that don?t fit properly. Shoes that narrow toward the toe, pushing smaller toes into a bend position for extended periods of time. High heels that force the foot down into a narrow space, forcing the toes against the shoe, increasing the bend in the toe.
Symptoms
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
Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.
Non Surgical Treatment
Often padding and taping are the first steps in a treatment plan. Padding the hammer toe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammer toe deformity.
Surgical Treatment
Hammertoe surgery is performed when conservative measures have been exhausted and pain or deformity still persists. The surgery is performed on an outpatient basis. It typically required about one hour of time. An incision is placed over the inter-phalangeal joint. Once the bone is exposed, the end portion of the bone is removed. Your surgeon hammertoes may then use pins or other fixation devices to assist in straightening the toe. These devices may be removed at a later date if necessary. Recovery for hammertoe surgery is approximately 10 to 14 days. You are able to walk immediately following the surgery in a surgical shoe. Swelling may be present but is managed as needed. Physical therapy is used to help reduce swelling in the toe or toes after surgery. Most of these toe surgeries can be performed in the office or the outpatient surgery under local anesthesia.
The Cause Of Bunions?
Overview
A bunion is an abnormal bump, or bony enlargement that forms at the base of your big toe. In the early stages, the bunion may be small and the side of your foot may be slightly swollen. As it progresses, the bump gets larger and becomes increasingly painful. Your big toe may point towards your other toes, rather than straight. Shoes may be uncomfortable to wear and add to the irritation of the joint.
Causes
Bunions are a common problem that can cause foot pain and difficulty wearing shoes. Bunions occur in about 30% of the population of most Western countries. They are seen most commonly in women and become more common as people get older. Patients with bunions generally have one of two problems that can cause pain. As the big toe becomes more and more angled (pointing toward the other toes), the base of the toe becomes more and more prominent, forming the bunion. The bunion forms in part because of the new angle of the toe, and in part due to inflammation over the bunion surface. As the inflammation worsens, people can experience pain with shoe wear and walking. The big toe may eventually come to lie over, or more commonly under, the second toe. This may cause further irritation while wearing shoes and more pain. The second toe of patients who have bunions commonly forms a hammer toe.
Symptoms
Bunions may or may not cause symptoms. A frequent symptom is foot pain in the involved area when walking or wearing shoes; rest relieves this pain. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. Shoe pressure in this area can cause interment pain while the development of arthritis in more severe bunions can lead to chronic pain. Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness. It is important to note that, in postpubertal men and postmenopausal women, pain at the base of the big toe can be caused by gout and gouty arthritis that is similar to the pain caused by bunions.
Diagnosis
Although bunions are usually obvious from the pain and unusual shape of the toe, further investigation is often advisable. Your doctor will usually send you for X-rays to determine the extent of the deformity. Blood tests may be advised to see if some type of arthritis could be causing the pain. Based on this evaluation, your doctor can determine whether you need orthopaedic shoes, medication, surgery or other treatment.
Non Surgical Treatment
Wide toe box, bunion pads, orthotics, or a combination. Mild discomfort may lessen by wearing a shoe with a wide toe box or with stretchable material. If not, bunion pads purchased in most pharmacies can shield the painful area. Orthotics can also be prescribed to redistribute and relieve pressure from the affected articulation. If conservative therapy fails, surgery aimed at correcting abnormal bony alignments and restoring joint mobility should be considered. If the patient is unwilling to wear large, wider shoes to accommodate the bunion because they are unattractive, surgery can be considered; however, patients should be told that orthotic devices should be worn after surgery to reduce the risk of recurrence. For bursitis, bursal aspiration and injection of a corticosteroid are indicated. For osteoarthritic synovitis, oral NSAIDs or an intra-articular injection of a corticosteroid/anesthetic solution reduces symptoms. For hallux limitus or hallux rigidus, treatment aims to preserve joint mobility by using passive stretching exercises, which occasionally require injection of a local anesthetic to relieve muscle spasm. Sometimes surgical release of contractures is necessary. 
Surgical Treatment
Bunion surgery is occasionally required when the bunion deformity is too advanced for conservative treatment to work. Your surgeon will usually cut an angular section from the bone to correct the alignment. In some cases, multiple toes may need to be straighten.
What Is Over-Pronation Of The Feet
Overview
Overpronation is the exaggerated inward rolling of the foot and ankle, which can lead to a collapsed arch and flat feet. Many people overpronate and do not even realize it; one way to tell is to simply look at the foot and see how it is placed on the ground when standing in a neutral position. Another way is to wet the bottom of the foot and step on a piece of paper. If the entire imprint of the foot is shown, it means you overpronate.
Causes
Flat feet don't automatically mean you have a problem. The problem can be divided into a flexible flat foot or rigid flat foot. The rigid flat foot is one that does not change shape when the foot becomes weight bearing. i.e. it does not go through the excessive motion of pronation. Generally speaking this foot does not provide too many problems. The flexible flat foot is the type that when it becomes weight bearing the foot and ankle tends to roll in (pronates) too far. This type of person will often say I have great arches but when I stand up much of this arch disappears as the foot excessively pronates When the foot is excessively pronating and causing problems like sore ankles, feet or knees when standing or exercising then arch support is extremely important to restore the foot structure.
Symptoms
Overpronation causes alterations in proper muscle recruitment patterns leading to tightness in the outside of the ankle (lateral gastrocnemius, soleus, and peroneals). This tightness can lead to weakness in the opposing muscles such as the medial gastrocnemius, anterior tibialis, and posterior tibialis. If these muscles are weak, they will not be able to keep the knee in proper alignment, causing the valgus position. All this tightness and weakness can cause pain within the ankle, calf, and knee region. And it can send imbalance and pain all the way up to the upper back, if deep core strength is lacking and can't hold the pelvis in neutral.
Diagnosis
When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Non Surgical Treatment
Mild cases of Overpronation may be controlled or corrected with a supportive shoe that offers medial support to the foot along with a strong heel counter to control excessive motion at the heel starting with heel strike. In mild cases with no abnormal mechanical pressures, an over the counter orthotic with heel cup and longitudinal or medial arch support to keep the foot from progressing past neutral may help to realign the foot. A Custom foot orthotic with heel cup and longitudinal arch support to help correct position of the foot as it moves through motion. Heel wedges may also assist in correcting motion.
Prevention
Custom-made orthotics supports not only the arch as a whole, but also each individual bone and joint that forms the arch. It is not enough to use an over-the-counter arch support, as these generic devices will not provide the proper support to each specific structure of the arch and foot. Each pronated foot?s arch collapses differently and to different degrees. The only way to provide the support that you may need is with a custom-made device. This action of the custom-made orthotic will help to prevent heel spurs, plantar fasciitis, calluses, arch pain, and weakness of the entire foot.
Overpronation is the exaggerated inward rolling of the foot and ankle, which can lead to a collapsed arch and flat feet. Many people overpronate and do not even realize it; one way to tell is to simply look at the foot and see how it is placed on the ground when standing in a neutral position. Another way is to wet the bottom of the foot and step on a piece of paper. If the entire imprint of the foot is shown, it means you overpronate.
Causes
Flat feet don't automatically mean you have a problem. The problem can be divided into a flexible flat foot or rigid flat foot. The rigid flat foot is one that does not change shape when the foot becomes weight bearing. i.e. it does not go through the excessive motion of pronation. Generally speaking this foot does not provide too many problems. The flexible flat foot is the type that when it becomes weight bearing the foot and ankle tends to roll in (pronates) too far. This type of person will often say I have great arches but when I stand up much of this arch disappears as the foot excessively pronates When the foot is excessively pronating and causing problems like sore ankles, feet or knees when standing or exercising then arch support is extremely important to restore the foot structure.
Symptoms
Overpronation causes alterations in proper muscle recruitment patterns leading to tightness in the outside of the ankle (lateral gastrocnemius, soleus, and peroneals). This tightness can lead to weakness in the opposing muscles such as the medial gastrocnemius, anterior tibialis, and posterior tibialis. If these muscles are weak, they will not be able to keep the knee in proper alignment, causing the valgus position. All this tightness and weakness can cause pain within the ankle, calf, and knee region. And it can send imbalance and pain all the way up to the upper back, if deep core strength is lacking and can't hold the pelvis in neutral.
Diagnosis
When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Non Surgical Treatment
Mild cases of Overpronation may be controlled or corrected with a supportive shoe that offers medial support to the foot along with a strong heel counter to control excessive motion at the heel starting with heel strike. In mild cases with no abnormal mechanical pressures, an over the counter orthotic with heel cup and longitudinal or medial arch support to keep the foot from progressing past neutral may help to realign the foot. A Custom foot orthotic with heel cup and longitudinal arch support to help correct position of the foot as it moves through motion. Heel wedges may also assist in correcting motion.
Prevention
Custom-made orthotics supports not only the arch as a whole, but also each individual bone and joint that forms the arch. It is not enough to use an over-the-counter arch support, as these generic devices will not provide the proper support to each specific structure of the arch and foot. Each pronated foot?s arch collapses differently and to different degrees. The only way to provide the support that you may need is with a custom-made device. This action of the custom-made orthotic will help to prevent heel spurs, plantar fasciitis, calluses, arch pain, and weakness of the entire foot.
Physiotherapy For Calcaneal Apophysitis
Overview
Sever's disease occurs in children when the growth plate (which is the growing part of the heel) is injured. The foot is one of the first body parts to grow to full size. This usually occurs in early puberty. During this time, bones often grow faster than muscles and tendons. As a result, muscles and tendons become tight. The heel area is less flexible. During weight-bearing activity (activity performed while standing), the tight heel tendons may put too much pressure at the back of the heel (where the Achilles tendon attaches). This can injure the heel and cause Sever's disease.
Causes
The usual cause is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with starting a new sport, or the start of a new season, or too much weight bearing on the heel. Also, excessive traction could cause this, since the bones and tendons are still developing. Many children who over pronate their feet exhibit symptoms and in most patients, it usually involves both heels.
Symptoms
Sharp pain will be present in the affected heel (or both heels), especially while running or walking. Pain can be heightened following activity. The area will be tender to the touch and usually becomes inflamed or reddened. It may also be painful to press on the heel with a finger from the back or to squeeze the sides together; the latter is particularly common. You might notice stiffness in some of the surrounding muscles, making regular movements more difficult to achieve. This and the pain can manifest physically in abnormal practices like tiptoeing or limping. In some cases a lump can be detected on the back of the heel, though it may be so small as to defy detection.
Diagnosis
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there are other injuries that may be causing the heel pain.
Non Surgical Treatment
Stretching programs. Strengthening exercises. Exercise and training modification. Orthotic therapy. In rare cases, where fragmentation of the apophysis exists and pain fails to subside with traditional treatments then immobilization of the foot and ankle with a short leg pneumatic walker(walking cast) is indicated.
Sever's disease occurs in children when the growth plate (which is the growing part of the heel) is injured. The foot is one of the first body parts to grow to full size. This usually occurs in early puberty. During this time, bones often grow faster than muscles and tendons. As a result, muscles and tendons become tight. The heel area is less flexible. During weight-bearing activity (activity performed while standing), the tight heel tendons may put too much pressure at the back of the heel (where the Achilles tendon attaches). This can injure the heel and cause Sever's disease.
Causes
The usual cause is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with starting a new sport, or the start of a new season, or too much weight bearing on the heel. Also, excessive traction could cause this, since the bones and tendons are still developing. Many children who over pronate their feet exhibit symptoms and in most patients, it usually involves both heels.
Symptoms
Sharp pain will be present in the affected heel (or both heels), especially while running or walking. Pain can be heightened following activity. The area will be tender to the touch and usually becomes inflamed or reddened. It may also be painful to press on the heel with a finger from the back or to squeeze the sides together; the latter is particularly common. You might notice stiffness in some of the surrounding muscles, making regular movements more difficult to achieve. This and the pain can manifest physically in abnormal practices like tiptoeing or limping. In some cases a lump can be detected on the back of the heel, though it may be so small as to defy detection.
Diagnosis
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there are other injuries that may be causing the heel pain.
Non Surgical Treatment
Stretching programs. Strengthening exercises. Exercise and training modification. Orthotic therapy. In rare cases, where fragmentation of the apophysis exists and pain fails to subside with traditional treatments then immobilization of the foot and ankle with a short leg pneumatic walker(walking cast) is indicated.
Which Are The Principal Causes Of Posterior Tibial Tendon Dysfunction (PTTD) ?
Overview
Adult acquired flatfoot deformity (AAFD) is a painful condition resulting from the collapse of the longitudinal (lengthwise) arch of the foot. As the name suggests, this condition is not present at birth or during childhood. It occurs after the skeleton is fully matured. In the past it was referred to a posterior tibial tendon dysfunction (or insufficiency). But the name was changed because the condition really describes a wide range of flatfoot deformities. AAFD is most often seen in women between the ages of 40 and 60. This guide will help you understand how the problem develops, how doctors diagnose the condition, what treatment options are available. 
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
Often, this condition is only present in one foot, but it can affect both. Adult acquired flatfoot symptoms vary, but can swelling of the foot's inner side and aching heel and arch pain. Some patients experience no pain, but others may experience severe pain. Symptoms may increase during long periods of standing, resulting in fatigue. Symptoms may change over time as the condition worsens. The pain may move to the foot's outer side, and some patients may develop arthritis in the ankle and foot.
Diagnosis
Examination by your foot and ankle specialist can confirm the diagnosis for most patients. An ultrasound exam performed in the office setting can evaluate the status of the posterior tibial tendon, the tendon which is primarily responsible for supporting the arch structure of the foot.
Non surgical Treatment
Initial treatment consists of supporting the medial longitudinal arch (running the length of the foot) to relieve strain on the medial soft tissues. The most effective way to relieve pain on the tendon is to use a boot or brace, and once tenderness and pain has resolved, an orthotic device. A boot, brace, or orthotic has not been shown to correct or even prevent the progression of deformity. Orthotics can alleviate symptoms and may slow the progression of deformity, particularly if mild. The deformity may progress despite orthotics. 
Surgical Treatment
If conservative treatments don?t work, your doctor may recommend surgery. Several procedures can be used to treat posterior tibial tendon dysfunction; often more than one procedure is performed at the same time. Your doctor will recommend a specific course of treatment based on your individual case. Surgical options include. Tenosynovectomy. In this procedure, the surgeon will clean away (debride) and remove (excise) any inflamed tissue surrounding the tendon. Osteotomy. This procedure changes the alignment of the heel bone (calcaneus). The surgeon may sometimes have to remove a portion of the bone. Tendon transfer: This procedure uses some fibers from another tendon (the flexor digitorum longus, which helps bend the toes) to repair the damaged posterior tibial tendon. Lateral column lengthening, In this procedure, the surgeon places a small wedge-shaped piece of bone into the outside of the calcaneus. This helps realign the bones and recreates the arch. Arthrodesis. This procedure welds (fuses) one or more bones together, eliminating movement in the joint. This stabilizes the hindfoot and prevents the condition from progressing further.
