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Hammer Toes Pain

Hammer ToeOverview


Toe problems and toe deformities such as claw toe and Hammer toe happen when the tendons (guiders) that move the toes get too tight or out of balance. The affected toe can rub on other toes and on the inside of your shoe, causing pressure and pain. Inflammatory arthritis, (swelling, pain, stiffness in joints), which, such as rheumatoid arthritis can damage the toe joints and this may make them come out of position (dislocate).


Causes


A common cause of hammertoe and mallet toe is wearing improper footwear - shoes that are too tight in the toe box, or high-heel shoes. Wearing shoes of either type can push your toes forward, crowding one or more of them into a space that's not large enough to allow your toes to lie flat. Hammertoe and mallet toe deformities can also be inherited and may occur despite wearing appropriate footwear. The result is a toe that bends upward in the middle and then curls down in a hammer-like or claw-like shape. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses. The bottom of the affected toe can press down, creating the mallet-like appearance of mallet toe. At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff.


HammertoeSymptoms


Symptoms include sharp pain in the middle of the toe and difficulty straightening the toe. People with hammertoe may also develop blisters, which are fluid-filled pockets of skin, because the bent toe is likely to rub against the inside of a shoe. This increased friction may also lead to calluses, which are areas of thickened skin, and corns, which are hard lumps that may form on or between toes. Symptoms may be minor at first, but they can worsen over time.


Diagnosis


A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.


Non Surgical Treatment


If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.


Surgical Treatment


A variety of anaesthetic techniques are possible. Be sure an discuss this with your surgeon during your pre-op assessment. The type of surgery performed will depend on the problem with your toes and may involve releasing or lengthening tendons, putting joints back into place, straightening a toe and changing the shape of a bone.Your surgeon may fix the toes hammertoes in place with wires or tiny screws.
26 Jun 2015
Admin · 87 views · 0 comments

Diagnosing Severs Disease

Overview


Severs? disease usually presents with pain in either one or both of a sufferer?s heels. The area can be sore or tender, particularly first thing in the morning or after squeezing. Because the pain is focussed on the heel, an important part of the foot that makes contact with the ground through virtually all movement, sufferers often have to limp to alleviate their discomfort. The pain of Severs? disease is at its worst after any exertion that involves contact between a heel and the ground, particularly strenuous exercise like running or sport. The condition is caused by the wear and tear of structures in the heel, most significantly the heel bone and any attached tendons. Severs? disease is prevalent in young children who are extremely active, particularly as the heel and its attached tendons are still growing in the age group the condition most commonly affects (7-14).


Causes


There is no specific known cause of Sever?s disease. However, there are several common factors associated with the condition including. Tight calf muscles. Pronated foot type (rolled in towards the ankle). Children who are heavier. Puberty/growth spurts. External factors, e.g. hard surfaces or poor footwear. Increase in physical activity levels.


Symptoms


Sever condition causes pain at the back of the heel. The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance. Sever condition also causes tenderness and swelling in the area of the pain.


Diagnosis


A Podiatrist can easily evaluate your child?s feet, to identify if a problem exists. Through testing the muscular flexibility. If there is a problem, a treatment plan can be create to address the issue. At the initial treatment to control movement or to support the area we may use temporary padding and strapping and depending on how successful the treatment is, a long-term treatment plan will be arranged. This long-term treatment plan may or may not involve heel raises, foot supports, muscle strengthening and or stretching.


Non Surgical Treatment


Treatment depends on the severity of the condition, but may include relative rest and modified activity, a physiotherapist can help work out what, and how much, activity to undertake. Cold packs, apply ice or cold packs to the back of the heels for around 15 minutes after any physical activity, including walking. Shoe inserts, small heel inserts worn inside the shoes can take some of the traction pressure off the Achilles tendons. This will only be required in the short term. Medication, pain-relieving medication may help in extreme cases, but should always be combined with other treatment and following consultation with your doctor). Anti-inflammatory creams are also an effective management tool. Splinting or casting, in severe cases, it may be necessary to immobilise the lower leg using a splint or cast, but this is rare. Time, generally the pain will ease in one to two weeks, although there may be flare-ups from time to time. Correction of any biomechanical issues, a physiotherapist can identify and discuss any biomechanical issues that may cause or worsen the condition. Education on how to self-manage the symptoms and flare-ups of Sever?s disease is an essential part of the treatment.


Exercise


Stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.
21 May 2015
Admin · 81 views · 0 comments

Chronic Achilles Tendon Rupture Repair Protocol

Overview
Achilles Tendinitis The Achilles tendon is found in the back of the leg above the heel, and is the largest tendon in the body. It connects the calf muscles to the heel bone and is used when walking, running and jumping. A rupture of the tendon is a tearing and separation of the tendon fibers. When a rupture of the tendon occurs, the tendon can no longer perform its normal function. A common issue related to a tear is the inability to point your toe.

Causes
The most common cause of a ruptured Achilles' tendon is when too much stress is placed through the tendon, particularly when pushing off with the foot. This may happen when playing sports such as football, basketball or tennis where the foot is dorsiflexed or pushed into an upward position during a fall. If the Achilles' tendon is weak, it is prone to rupture. Various factors can cause weakness, including corticosteroid medication and injections, certain diseases caused by hormone imbalance and tendonitis. Old age can also increase the risk of Achilles' tendon rupture.

Symptoms
The most common symptom of Achilles tendonitis is a sudden surge of pain in the heel and back of the ankle at the point of injury which is often described as a snapping sensation in the heel. After the injury has occurred, patients then struggle or find it near impossible to bear any weight on the affected leg. Pain can often be most prominent first thing in the morning after the injury has been rested. Swelling and tenderness is also likely to appear in the area.

Diagnosis
When Achilles tendon injury is suspected, the entire lower lag is examined for swelling, bruising, and tenderness. If there is a full rupture, a gap in the tendon may be noted. Patients will not be able to stand on the toes if there is a complete Achilles tendon rupture. Several tests can be performed to look for Achilles tendon rupture. One of the most widely used tests is called the Thompson test. The patient is asked to lie down on the stomach and the examiner squeezes the calf area. In normal people, this leads to flexion of the foot. With Achilles tendon injury, this movement is not seen.

Non Surgical Treatment
Not every torn Achilles tendon needs an operation. Recent studies have shown that even a conservative treatment, i.e. immobilizingt the leg can lead to satisfactory healing successes. This requires, however, that the patient is fitted with a cast (immobilization splint) and/or a special boot for a period of approximately 6 - 8 weeks. After that, the boot must be worn during the day for about two more weeks. An intensive physiotherapy will start after about six weeks to train the calf muscles so that the initial coordination can be restored. Running training on flat ground can be started again after another 10 - 12 weeks. Studies show that the danger of a recurring torn tendon is higher after a conservative treatment opposed to an operative treatment. Depending on the type of treatment, about 10 - 15 percent of those affected can expect at some point to again suffer from a tear of the Achilles tendon. Moreover, in the non-operated cases, we see more often a significant permanent weakness of the footprint, particularly restricting the ability to participate in sports. Achilles Tendonitis

Surgical Treatment
This injury is often treated surgically. Surgical care adds the risks of surgery, there are for you to view. After the surgery, the cast and aftercare is typically as follows. A below-knee cast (from just below the knee to the tips of the toes) is applied. The initial cast may be applied with your foot positioned in a downward direction to allow the ends of the tendon to lie closer together for initial healing. You may be brought back in 2-3 week intervals until the foot can be positioned at 90 degrees to the leg in the cast. The first 6 weeks in the cast are typically non-weight bearing with crutches or other suitable device to assist with the non-weight bearing requirement. After 6 weeks in the non-removable cast, a removable walking cast is started. The removable walking cast can be removed for therapy, sleeping and bathing. The period in the removable walking cast may need to last for an additional 2-6 weeks. Your doctor will review a home physical therapy program with you (more on this program later) that will typically start not long after your non-removable cast is removed. Your doctor may also refer you for formal physical therapy appointments. Typically, weight bearing exercise activities are kept restricted for at least 4 months or more. Swimming or stationary cycling activities may be allowed sooner. Complete healing may take 12 months or more.

Prevention
Achilles tendon rupture can be prevented by avoiding chronic injury to the Achilles tendon (i.e. tendonitis), as well as being careful to warm up and stretch properly before physical activity. Additionally, be sure to use properly fitting equipment (e.g. running shoes) and correct training techniques to avoid this problem!
04 May 2015
Admin · 72 views · 0 comments

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