December Articles 2014

Achilles Tendon Injuries

As the strongest tendon in the human body, the Achilles tendon connects heel of the foot to the calf and lower leg muscles. The Achilles tendon serves to facilitate movement that involves the legs such as walking and running. Due to the prime importance of this tendon, if there are any injuries incurred they should be addressed immediately with a physician.

The Achilles tendon is at risk for Achilles tendinitis, which is an injury often diagnosed via MRI. Achilles tendinitis contains the following symptoms: an increased flow of blood to the tendon, thickening of the tendon, inflammation, pain ranging from dull to severe and slower movement time.

An Achilles tendon rupture is caused by the tendon ripping or completely snapping, with the symptoms becoming more immediate and painful. If a rupture or tear is incurred, there are both operative and non-operative methods available. Depending on the severity of the injury, treatment and recovery time for Achilles tendon ruptures may take up to a year.

While no injury is completely unavoidable, there are preventative measures that can be taken to minimize the chances. Stretching out the tendon before and after exercise is a great way to stimulate the tissue. Exercises such as calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are excellent ways to help strengthen the lower legs and Achilles tendon.

People who overexert themselves during physical activity, especially athletes, are at a bigger risk for these injuries. When exercising, try to be on a cushioned surface such as a mat, as this can relieve heel pressure. Wearing occasion appropriate footwear can also decrease tendon injuries. As with the entire body, a healthy diet also increases tendon health while decreasing the risks associated with obesity.

Be sure to visit a podiatrist if you believe you have an injury in the Achilles region. Not addressing these injuries can result in further damage and severe complications that could render you immobile.

 

When Foot Surgery is Necessary

Foot surgery may be necessary for a variety of reasons, but it is normally reserved for cases in which less invasive procedures have failed to help with the problem. Cases in which surgery may be deemed necessary include, but are not limited to, surgically removing deformities of the foot (such as bone spurs and bunions), problems with arthritis that have caused severe bone issues within the foot, and reconstruction to attend to injuries caused by accidents and congenital malformation (such as club foot and flat feet). Foot surgery may be necessary for individuals of all ages and races.

If you find yourself in need of foot surgery, the reason why the surgery has been found to be necessary will dictate exactly what kind of surgery you need. If you have to have a growth, such as a bunion, removed, then you may undergo a bunionectomy. If your bones need to be realigned and fused together, then you may undergo a surgical fusion of the foot. If it is nerve pain and problems that you are enduring, then you may need to undergo surgery in which the tissue that surrounds the painful nerve is surgically removed. Normally other, less serious treatments are first applied when a problem is discovered, but if those treatments are found to be ineffective, surgical techniques are considered and used.

Even though surgery of the foot is usually reserved as a last resort by most physicians, there are some benefits if you and your doctor choose to use surgery to fix the problem. The first is that the pain associated with the issue is normally relieved, which means that you can finally resume the activities your foot problem was preventing you from participating in. The second benefit is that, once you have the surgery completed, the problem is generally eliminated since it has finally been addressed.

History of podiatry has shown that foot surgery techniques continue to advance every year. Endoscopic surgery is just one of the many advancements that have been made in the field of foot surgery. As technology improves, foot surgical techniques will also continue to improve. Many procedures can now be completed using a very small incision and smaller, more refined instruments. Because of these better tools, surgeries are becoming less invasive, and recovery time has become a great deal shorter. Shorter recovery periods mean that you will be back on your feet in no time.

 

Morton's Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.  Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.

If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

 

Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain conditions and should therefore be well informed about problems that may arise and what they can do to properly avoid or treat them.    

Some of the most common problems are foot ulcers, ingrown toenails, fallen arches, and fungal infection. A foot ulcer is an open sore on the foot and  can be a result of decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal infection is a condition that results in deformed and discolored toenails.

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a doctor for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier and between your bones and the ground as well as giving the skin on the foot a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. They also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.

 

Barefoot Running

A new trend in running and jogging has popped up recently, called barefoot running. Barefoot running is a popular and growing trend that is just what it sounds – running without shoes. Before deciding to do any running without shoes, it's best to understand how this kind of running affects the feet.

Running without shoes changes the motion of running. Most running is done by landing on the heel of the feet. Running barefoot requires a different way of running; in a barefoot stride landing is done on the front part of the feet. Because of this, the impact shifts from the heels to the front feet. Runners also shorten their strides to create a softer landing.

Running barefoot does have its advantages. When running and landing on the front feet, the impact on the feet and ankle is reduced, which may reduce the incidence of stress injuries. It strengthens muscles in the feet, and also strengthens muscles in the ankles and lower legs that aren't usually worked. Overall balance of the body is improved and there is greater sensory input from the feet to the rest of the body, making overall position and motion less stressful on the body. It has been found that in countries in which some of the population regularly wear shoes and some do not, numbers of foot and ankle injuries are much higher in those who wear shoes.

People hearing about barefoot running for the first time are skeptical about it, and there are good reasons for skepticism. Running barefoot certainly has its drawbacks, the obvious being no protection of the feet when running. This makes it likely that when runners land on sharp or rough objects,  scrapes, bruises, and cuts on feet will result. Blisters will form when beginning this kind of running especially, you may have plantar fascia problems. Landing on the front feet constantly also increases the risk of getting Achilles tendonitis.

So what can runners do to make barefoot running safe? It’s best to make a slow transition from running shoes to barefoot running. The body is used to wearing shoes so to slowly transition to bare feet, start by walking barefoot for a distance and then increase walking distance. Once the feet begin to adjust, try walking and then jogging and gradually increase the distance. If you have foot problems talk to the doctor first before attempting barefoot running. When starting out, it may also be helpful to begin by running on pavement or other consistent surfaces to avoid sharp or rough objects. Minimalist running shoes may also be an option, as they allow for many of the benefits of barefoot running while also protecting the feet from cuts and scrapes.