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How To Help Hammertoe Pain

July 9th, 2015 parašė tiabrengettey

HammertoeOverview
The term, Hammertoe, is commonly used as a general classification for any condition where the toe muscle weakens, causing digital contracture, and resulting in deformity, a digital contracture like this can actually be a hammertoe, claw toe or mallet toe, depending on which joints in the toe are contracted. Clawtoes are bent at the middle and end joints, while hammertoes are bent at the middle joint only. When it?s mallet toe, the joint at the end of the toe buckles. The skin near the toenail tip develops a painful corn that can eventually result in an ulcer. Doctors further categorize all forms of hammertoe based on whether the affected toe is flexible, semi-rigid or rigid. The more rigid the toe, the more pain it will cause.


Causes
Hammer toe usually affects the second toe. However, it may also affect the other toes. The toe moves into a claw-like position. The most common cause of hammer toe is wearing short, narrow shoes that are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter. Hammer toe is more likely to occur in women who wear shoes that do not fit well or have high heels and children who keep wearing shoes they have outgrown. The condition may be present at birth (congenital) or develop over time. In rare cases, all of the toes are affected. This may be caused by a problem with the nerves or spinal cord.

Hammer Toe

Symptoms
People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.


Diagnosis
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.


Non Surgical Treatment
You can usually use over-the-counter cushions, pads, or medications to treat bunions and corns. However, if they are painful or if they have caused your toes to become deformed, your doctor may opt to surgically remove them. If you have blisters on your toes, do not pop them. Popping blisters can cause pain and infection. Use over-the-counter creams and cushions to relieve pain and keep blisters from rubbing against the inside of your shoes. Gently stretching your toes can also help relieve pain and reposition the affected toe.


Surgical Treatment
In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed. Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

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Contracted Big Toe

July 9th, 2015 parašė tiabrengettey

HammertoeOverview
Hammer Toe a bending and hardening of the joints of the second, third, fourth, or fifth toes. If you look down at your feet and you can?t see the tips of the toenails, you might suffer from hammertoe. Early signs of hammertoe are a bend in the joint of any toe except the big toe. The bend in the joint causes the top of the toe to appear to curl under as if it?s ?hammering? into the floor.


Causes
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Hammertoes may be aggravated by shoes that don?t fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

Hammertoe

Symptoms
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe’s toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you’re not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.


Diagnosis
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.


Non Surgical Treatment
Mild hammer toe in children can be treated by manipulating and splinting the affected toe. The following changes in footwear may help relieve symptoms. Wear the right size shoes or shoes with wide toe boxes for comfort, and to avoid making hammer toe worse. Avoid high heels as much as possible. Wear soft insoles to relieve pressure on the toe. Protect the joint that is sticking out with corn pads or felt pads. A foot doctor can make foot devices called hammer toe regulators or straighteners for you, or you can buy them at the store. Exercises may be helpful. You can try gentle stretching exercises if the toe is not already in a fixed position. PIcking up a towel with your toes can help stretch and straighten the small muscles in the foot.


Surgical Treatment
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.

Hammer Toe

Prevention
Be good to your feet, because they carry you. They are designed to last a lifetime, but that doesn?t mean they don?t need some love and care as well as some basic maintenance. Check your feet regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check your feet every day so problems can be caught early on. Good circulation is essential. When you’re sitting down, put your feet up. If you’ve been sitting for a while, stretch your legs and feet. Give yourself a foot massage, or ask someone you love for a foot massage. A warm foot bath is also a good idea.

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What Is Hallux Valgus?

June 7th, 2015 parašė tiabrengettey

Overview
Bunions Hard Skin
A bunion is a bony prominence on the side of the foot, at the base of the big toe joint. This enlargement of the joint, spurring, bump or lump can be aggravated by sports and tight shoes. There is progressive movement of the big toe outward, toward the other toes. As the ?bump? gets bigger, shoes can increase pressure on the base of the big toe causing more and more discomfort or pain. The term Hallux Valgus is the medical name for this condition.


Causes
Essentially, bunions are caused by a disruption of the normal interworking of the bones, muscles, ligaments and tendons that comprise your feet, often from wearing shoes that squeeze the toes or place too much weight-bearing stress on them. However, it should be pointed out that other causes or factors in the development of bunions can include flat feet or low arches in the feet, some forms of arthritis, problems with foot mechanics, foot injuries and neuromuscular disorders such as cerebral palsy. Arthritis in the MTP joint, for example, can degrade the cartilage that protects it, and other problems may cause ligaments to become loose. Pronation, walking in a way that your foot rolls inwards, increases your risk for developing bunions.


Symptoms
Bunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because bunions are progressive, they don’t go away, and will usually get worse over time. But not all cases are alike, some bunions progress more rapidly than others. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.


Diagnosis
Your doctor will be able to diagnose a bunion by asking about your symptoms and examining your feet. You may also have blood tests to rule out any other medical conditions, such as rheumatoid arthritis or gout, although this is rare. Your doctor may refer you to a podiatrist or chiropodist (healthcare professionals who specialise in conditions that affect the feet).


Non Surgical Treatment
Treatment falls into two broad categories, conservative and surgical. From a conservative standpoint, efforts are directed at correcting faulty foot mechanics with custom molded insoles and relief of symptoms. These include Custom Orthosis to stabilize the abnormal motion of the hind and fore foot. Shoe gear modification: Using shoes with larger toe boxed and more supple materials. Changes in activities. Try to avoid those things which cause symptoms. Anti-inflammatory medication for periodic relief this includes cortisone injections into the joint as well as oral medication.
Bunions


Surgical Treatment
If nonsurgical treatment fails, you may want to consider surgery. Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results. Reasons that you may benefit from bunion surgery commonly include severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. Chronic big toe inflammation and swelling that doesn’t improve with rest or medications. Toe deformity-a drifting in of your big toe toward the small toes. Toe stiffness-inability to bend and straighten your toe. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Failure to substantially improve with other treatments such as a change in shoes and anti-inflammatory medication. As you explore bunion surgery, be aware that so-called “simple” or “minimal” surgical procedures are often inadequate “quick fixes” that can do more harm than good. And beware of unrealistic claims that surgery can give you a “perfect” foot. The goal of surgery is to relieve as much pain, and correct as much deformity as is realistically possible. It is not meant to be cosmetic.

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Pain In The Arch Cause And Effect

June 2nd, 2015 parašė tiabrengettey

Overview
The tibialis posterior runs down the medial (inside) and posterior (back) of the ankle. The tibialis posterior tendon functions to stop the ankle from rolling inwards and the medial arch collapsing. This tendon can either completely rupture or develop tears along the length of it (tendonitis/dysfunction). Symptoms of tibailis posterior dysfunction/tendonitis or rupture include severe pes planus (flat foot deformity), pain on the medial (inside) of the ankle. swelling on the medial side of the ankle. pain on the lateral (outside) of the ankle, inability or difficulty doing a single leg calf raise.
Pain In Arch


Causes
There are several reasons why arch pain develops. Sometimes it?s due to a condition known as plantar fasciitis, in which the plantar fascia (the band of tissue that runs along the bottom of your foot from your heel to your toes) becomes inflamed after excessive stress. Heel pain results from this inflammation. Sometimes the pain is due to extensive time spent on your feet. Many people feel pain on the arch of their feet after a long workday, while others overuse their feet exercising or playing sports. A foot deformity, such as hammertoe or clubfoot, can also cause this pain. Medical conditions such as diabetes or obesity can put additional stress on your feet, thereby causing arch pain. Your footwear is also important. Shoes should support all parts of your foot, especially the bottom. This is very important if you spend excessive time on your feet, if your obese, if your pregnant, or if you engage in sport-related activities. Injuries to any of the twenty-six bones, thirty-three joints and over 100 muscles, tendons and ligaments in the feet can also cause arch pain. Because the foot is such a complex structure, it?s important to see a podiatrist at the first sign of symptoms.


Symptoms
Symptoms of arch pain and arch strain are found in the underside of the foot, where the foot arch is. Arch pain and arch strain is actually inflammation of the tissue in the midfoot, formed by a band that stretches from the toes to the heel. The arch of the foot is needed for the proper transfer of weight from the heel to toe. When the band forming the arch of the foot or plantar fascia becomes inflamed, it becomes painful to perform simple tasks.


Diagnosis
The diagnosis of high arch (cavus) foot deformity or Charcot Marie Tooth disease can be made by an orthopedic surgeon in the office. Evaluation includes a thorough history and physical examination as well as imaging studies such as X-rays. The orthopedic surgeon will look at the overall shape, flexibility, and strength of a patient?s foot and ankle to help determine the best treatment. Nerve tests may occasionally need to be performed to help confirm the diagnosis.


Non Surgical Treatment
The right kind of self treatment can help you knock out Plantar Fasciitis, a common and annoying injury. Experiencing persistent pain and stiffness in the bottom of the heel or foot? The cause of this either sharp or dull discomfort could be plantar fasciitis, inflammation of the thick tissue, or fascia, that runs along the bottom of the foot. Common among distance runners with chronically tight hamstrings, back, calves and Achilles tendons, or those who run in shoes without proper arch support, the condition may also be caused by a muscular imbalance in the hips or pelvis. This imbalance can cause slight compensations in the stride that place more stress on one leg than the other, according to San Diego-based running coach Jon Clemens, who has a master?s degree in exercise physiology. While correcting the imbalance permanently requires a strength program that focuses on balance, calf- and pelvis-strengthening drills, said Clemens, treatment to temporarily relieve the inflammation can be performed easily at home.
Foot Arch Pain


Surgical Treatment
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage. Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage. The most common complications of release surgery include incomplete relief of pain and nerve damage. Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted.


Prevention
Because most cases of flatfeet are inherited, the condition is usually impossible to prevent. Even when children with flexible flatfeet are treated with arch supports and corrective shoes, there is little evidence that these devices prevent the condition from lasting into adulthood.


Stretching Exercises
Below are two simple plantar fasciitis stretching exercises to help improve the flexibility of the muscles and tendons around the foot and ankle. Plantar fasciitis stretch taken from The Stretching Handbook. Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. In the photo to the left, the athlete is stretching the arch of her left foot. Kneel on one foot with your hands on the ground. Place your body weight over your knee and slowly move your knee forward. Keep your toes on the ground and arch your foot. In the photo to the right, the athlete is stretching the arch of his right foot.

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Does Pain In The Arch Require Surgery ?

May 9th, 2015 parašė tiabrengettey

Overview
Arch pain (medically known as plantar pain) is a broad term many people use to describe pain in their muscles, tendons, ligaments, bones, or nerves. All these components are connected to the bottom of the foot; therefore, damage to any one of these can cause pain on the bottom of the foot. This pain may only last for short time, but can progressively worsen if untreated. Most people who suffer from this pain are between the ages of 30 and 80, but many younger athletes are also susceptible, particularly those who participate in high-impact sports.


Causes
Unlike a flexible flatfoot, a rigid flatfoot is often the result of a significant problem affecting the structure or alignment of the bones that make up the foot’s arch. Some common causes of rigid flatfeet include Congenital vertical talus, In this condition, there is no arch because the foot bones are not aligned properly. In some cases, there is a reverse curve (rocker-bottom foot, in which the shape is like the bottom rails of a rocking chair) in place of the normal arch. Congenital vertical talus is a rare condition present at birth. It often is associated with a genetic disorder, such as Down syndrome, or other congenital disorders. The cause is unknown in up to half of cases. Tarsal coalition (peroneal spastic flatfoot), In this inherited condition, two or more of the foot bones are fused together, interfering with the flexibility of the foot and eliminating the normal arch. A rare condition, it often affects several generations of the same family. Lateral subtalar dislocation. Sometimes called an acquired flatfoot, it occurs in someone who originally had a normal foot arch. In a lateral subtalar dislocation, there is a dislocation of the talus bone, located within the arch of the foot. The dislocated talus bone slips out of place, drops downward and sideways and collapses the arch. It usually occurs suddenly because of a high-impact injury related to a fall from a height, a motor vehicle accident or participation in sports, and it may be associated with fractures or other injuries.


Symptoms
The primary symptom is pain or aching in the arch area. This can be accompanied by inflammation and tenderness. If the pain is caused by the plantar fascia, it is likely to be considerably more severe in the mornings due to the muscles being unused. If you notice that the twinges of pain you have are most commonly associated with or immediately after exercise, you might want to visit a good athletic shoe store to make sure you are wearing the right kind of shoe. Another cause of arch pain is plantar fasciitis. The plantar fascia is a tough tissue structure that holds the bottom part of the arch in place. The fascia often becomes inflamed and sore, usually as a result of repetitive motion (for example, very common in those who stand on their feet for work). The pain is often noticeable first thing in the morning and worse with activity.


Diagnosis
The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.


Non Surgical Treatment
Initial treatment of the tear will focus on symptom relief. This may involve the use of anti-inflammatory medications, strapping of the toe, off-loading padding, altered footwear and activity modification. Following this treatment will focus on the underlying causes of the problem, such as flat feet, bunions and hammer toes. Your podiatrist will perform a thorough biomechanical assessment to determine the best course of action to offload the forefoot and decrease the mechanical stress on the area. This injury usually occurs gradually and is best treated in the early stages. Often a customised soft full length orthotic and footwear modifications can prevent the problem from progressing. Occasionally surgery needs to be performed, either frank repair of the plantar plate or in chronic cases a resection osteotomy may be suggested.


Surgical Treatment
The main goal of surgery is to reduce pain and improve function. It may also reduce other injuries such as repeated ankle sprains and broken bones. Surgery may be considered if there is no relief with physical therapy, changes in shoewear and/or changes in activity. Some patients will also have tendon problems, ankle weakness and foot fractures. These patients may require other procedures to address related problems. If you have medical problems that make surgery unsafe, any infections or blood vessel disease, cavus foot surgery may not be appropriate. The surgical procedures involved with the correction of the cavus foot are varied. Theses may include correction of the bony deformity, ankle looseness and the muscle imbalances that cause the deformity. The goal is to provide a foot that evenly distributes weight along both inside and outside edges. A variety of incisions may be needed to perform the procedures related to the correction of the cavus foot.


Stretching Exercises
People with flexible feet who develop fallen arches may benefit from foot strengthening exercises, notes the Nicholas Institute of Sports Medicine and Athletic Trauma. Standing on a towel in bare feet and grasping the material with the toes is an easy foot-strengthening exercise that can be done at home. Standing on one leg while arching and releasing the foot may also prove useful. Doctors may prescribe gentle stretching exercises for the foot and ankle tendons.

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What Will Be The Indicators Of A Ruptured Achilles Tendon?

May 6th, 2015 parašė tiabrengettey

Overview

Rupture of the Achilles tendon is a common injury in healthy, young, active individuals. The rupture is typically spontaneous and most commonly observed in individuals in between 24-45 years of age. The majority have had no prior history of pain or previous injury to the heel. In the majority of cases, rupture of the Achilles tendon occurs just a few centimeters above the heel bone. Common causes of Achilles tendinitis or rupture include advanced age, poor conditioning, and overexertion during exercise. In most cases, the individual rapidly performs activity like running or standing on the toes, which generates intense force on the tendon, leading to rupture. Achilles tendon rupture is often described as an abrupt break with instantaneous pain that is felt in the foot or heel area. The pain may radiate along the back of the leg and is often intense. Generally, walking may be difficult and the foot may drag. Most individuals claim that they felt like they were kicked in that area or even shot at. These symptoms lead to a suspicion of rupture of the Achilles tendon. Sometimes the tendon does not fully rupture but only a partial tear develops. The partial tear can also present with pain, and if not recognized, can rapidly develop into a full-blown rupture. In the majority of cases, the Achilles tendon rupture occurs just above the heel, but it may occur anywhere along the length of the tendon.


Causes
Inflammation/strain of the tendon is usually caused by overuse, for example, frequent jumping in volleyball, netball or basketball. It is often also caused by a sudden increase in certain types of training, such as hill sprinting or track running, particularly when running in spikes. Tendinopathy can also be associated with ageing. Our ability to regenerate damaged tissue decreases as we age and the quality of the tendon deteriorates. However, the better news is that sensible training can actually strengthen all our soft tissue (tendons, ligaments and muscle). Tightness in the calf muscles will demand greater flexibility of the tendon, which inevitably results in overuse and injury. Biomechanically, the tightness can reduce the range of dorsiflexion (toe up position) in the ankle, which increases the amount and duration of pronation. This problem is known as overpronation.* This reduces the ability of the foot to become a rigid lever at push off and places more lateral and linear forces through the tendon. This imbalance can translate into altered rotation of the tibia (shin bone) at the knee joint and, in turn, produce compensatory rotation at the hip joint with subsequent injuries to the shin, knee and hip. Pronation is part of the natural movement of the subtalar joint in the foot. It allows ?eversion? (turning the sole outwards), dorsiflexion and abduction (pointing the toes out to the side). Pronation is a normal part of the gait cycle, when walking and running, and it helps to provide shock absorption in the foot. When pronation is excessive, the foot has a tendency to roll inward more than normally acceptable. One sign of overpronation is greater wear on the inside of your running shoes than on the midsole. Lack of stability around the ankle joint can also be a contributory factor, as recurrent ankle sprains appear to be associated with a high incidence of Achilles tendonopathy. Wearing shoes that don?t fit or support the foot properly can be a major contributing cause of Achilles tendon injury.


Symptoms
Many people say that a ruptured Achilles feels like ?being shot in the heel?, if you can imagine how enjoyable that feels. You may hear a snap sound or feel a sudden sharp pain when the tendon tears. After a few moments, the pain settles and the back of the lower leg aches. You can walk and bear weight, but you may find it difficult to point the foot downward or push off the ground on the affected side. You will be unable to stand on tiptoe. Bruising and swelling are likely, and persistent pain will be present. Similar symptoms may be caused by an inflamed Achilles tendon (Achilles tendonitis), a torn calf muscle, arthritis of the ankle, or deep vein thrombosis in the calf, so an MRI or ultrasound scan will likely be used to diagnose your condition.


Diagnosis
Your doctor will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your doctor may ask you to do a series of movements or exercises to see how well you can move your lower leg. He or she may also examine your leg, heel and ankle and may squeeze your calf muscle to check the movement of your foot. You may need to have further tests to confirm if your tendon is torn, which may include the following. An ultrasound scan. This uses sound waves to produce an image of the inside of your leg. An MRI scan. This uses magnets and radio waves to produce images of the inside of your leg.


Non Surgical Treatment
The best treatment for a ruptured Achilles tendon often depends on your age, activity level and the severity of your injury. In general, younger and more active people often choose surgery to repair a completely ruptured Achilles tendon while older people are more likely to opt for nonsurgical treatment. Recent studies, however, have shown fairly equal effectiveness of both operative and nonoperative management. Nonsurgical treatment. This approach typically involves wearing a cast or walking boot with wedges to elevate your heel; this allows the ends of your torn tendon to heal. This method can be effective, and it avoids the risks, such as infection, associated with surgery. However, the likelihood of re-rupture may be higher with a nonsurgical approach, and recovery can take longer. If re-rupture occurs, surgical repair may be more difficult.


Surgical Treatment
In general, Achilles tendon repair surgery has a much higher success rate and lower incidences of re-rupture than non-surgical methods of treatment. It is preferred by the nation?s leading athletes as the best course of action, allowing them to return to previous activity and performance levels at a much faster rate, with a lower chance or re-injury and less potential muscle loss.

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Best Surgery For Flat Feet In Adults

April 28th, 2015 parašė tiabrengettey

Overview
Acquired adult flatfoot deformity (AAFD) is a progressive flattening of the arch of the foot that occurs as the posterior tibial tendon becomes insufficient. It has many other names such posterior tibial tendon dysfunction, posterior tibial tendon insufficiency and dorsolateral peritalar subluxation. This problem may progress from early stages with pain along the posterior tibial tendon to advanced deformity and arthritis throughout the hindfoot and ankle.


Causes
As the name suggests, adult-acquired flatfoot occurs once musculoskeletal maturity is reached, and it can present for a number of reasons, though one stands out among the others. While fractures, dislocations, tendon lacerations, and other such traumatic events do contribute to adult-acquired flatfoot as a significant lower extremity disorder, as mentioned above, damage to the posterior tibial tendon is most often at the heart of adult-acquired flatfoot. One study further elaborates on the matter by concluding that ?60% of patients [presenting with posterior tibial tendon damage and adult-acquired flatfoot] were obese or had diabetes mellitus, hypertension, previous surgery or trauma to the medial foot, or treatment with steroids?.


Symptoms
Initially, flatfoot deformity may not present with any symptoms. However, overtime as the tendon continues to function in an abnormal position, people with fallen arches will begin to have throbbing or sharp pain along the inside of the arch. Once the tendon and soft tissue around it elongates, there is no strengthening exercises or mechanism to shorten the tendon back to a normal position. Flatfoot can also occur in one or both feet. If the arch starts to slowly collapse in one foot and not the other, posterior tibial dysfunction (PTTD) is the most likely cause. People with flatfoot may only have pain with certain activities such as running or exercise in the early phase of PTTD. Pain may start from the arch and continue towards the inside part of the foot and ankle where the tendon courses from the leg. Redness, swelling and increased warmth may also occur. Later signs of PTTD include pain on the outside of the foot from the arch collapsing and impinging other joints. Arthritic symptoms such as painful, swollen joints in the foot and ankle may occur later as well due to the increased stress on the joints from working in an abnormal position for a long period of time.


Diagnosis
In the early stages of dysfunction of the posterior tibial tendon, most of the discomfort is located medially along the course of the tendon and the patient reports fatigue and aching on the plantar-medial aspect of the foot and ankle. Swelling is common if the dysfunction is associated with tenosynovitis. As dysfunction of the tendon progresses, maximum pain occurs laterally in the sinus tarsi because of impingement of the fibula against the calcaneus. With increasing deformity, patients report that the shape of the foot changes and that it becomes increasingly difficult to wear shoes. Many patients no longer report pain in the medial part of the foot and ankle after a complete rupture of the posterior tibial tendon has occurred; instead, the pain is located laterally. If a fixed deformity has not occurred, the patient may report that standing or walking with the hindfoot slightly inverted alleviates the lateral impingement and relieves the pain in the lateral part of the foot.


Non surgical Treatment
Non-surgical treatment includes rest and reducing your activity until the pain improves. Orthotics or bracing help support the tendon to reduce its pull along the arch, thus reducing pain. In moderate to severe cases, a below knee cast or walking boot may be needed to allow the tendon to rest completely and heal. Physical therapy is an integral part of the non-surgical treatment regimen to reduce inflammation and pain. Anti-inflammatory medication is often used as well. Many times evaluation of your current shoes is necessary to ensure you are wearing appropriate shoe gear to prevent re-injury.


Surgical Treatment
In cases of PTTD that have progressed substantially or have failed to improve with non-surgical treatment, surgery may be required. For some advanced cases, surgery may be the only option. Your foot and ankle surgeon will determine the best approach for you.

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April 28th, 2015 parašė tiabrengettey

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