|
When recurring heel pain occurs in children, it is usually due to Sever’s Disease, while adult heel pain is usually due to heel spurs, plantar fasciitis, or retrocalcaneal bursitis (Haglund’s Deformity). Definitions:
|
|
Shin splints is a term used to describe several conditions due to inflammation of the muscle and tendon attachments to the lower leg bone (tibia). Medial Tibial Stress Syndrome is also used to describe shin splints. The term shin splints should not be used to describe specific tenderness on one area of the bone such as a possible stress fracture. Shin splints are characterized by pain and tenderness along the inner aspect of the lower 2/3 of the tibia. The posterior tibialis and soleus muscles attach to the tibia in this area. The function of these muscles is to support the arch of the foot and to help the calf muscles direct the foot. Shin splints are usually due to repetitive use of these muscles, resulting in an inflammation at their attachment sites on the bone.
This term usually applies to pain in the front of the leg, occurring anywhere between the ankle and the knee. However, it can also refer to pain in the inner side of the lower leg. Walking, running, or jumping usually initiates the pain in both of these areas. In extreme cases one can have pain in these areas while just standing still.
Sprained ankles may occur frequently and become a serious medical problem, destabilizing your every step and putting you in jeopardy of taking a disastrous fall. Ankle sprains can be divided into groups of mild, moderate, or severe. These are often graded as Grade 1, which is a mild sprain, Grade 2 that is more severe and may be associated with longer recovery and may involve a partial tear of ligaments or tendon. Grade 3 often refers to a complete tear of the ligaments and tendon and requires longer periods of care and in severe cases may require surgical treatment.
Tendonitis is an inflammation of a tendon caused by an injury. It is most often an overuse injury. Often people begin a new activity or exercise that causes the tendon to become irritated. Tendon problems are most common in the 40-60 year old age range. Tendons are not as elastic and forgiving as they might be in younger people. Occasionally, there is an anatomical cause for tendonitis. If the tendon does not have a smooth path to glide along, it will be more likely to become irritated and inflamed. In these unusual situations, surgical treatment may be necessary to realign the tendon.
Muscles end as tendons, and it is the tendons that allow muscles to attach to the bones or joints of the body. You can easily see tendons on the back of the hand, or top of the foot, by moving a finger or toe. The tendon moves back and forth as you move the finger or toe. Most of the tendons in the feet, especially those on the top, are very close to the skin and are not well protected. Thus, they can easily be injured.
Injuries that frequently cause tendonitis include:
Twisting injuries of the foot and ankle.
Dropping an object on the foot (it does not have to be a heavy object; all it has to do is hit the tendon directly).
Tight shoes.
Tying shoelaces too tightly.
High heel shoes (especially if you are not used to wearing them).
Overdoing any weight-bearing activity, such as running too far.
If there is a cut or break in the skin associated with a tendon injury, see a doctor immediately. Tendons have few blood vessels, and an open wound down to the tendon can cause a severe infection. Tendons usually have an area of poor blood supply that leads to tissue damage and poor healing response. This area of a tendon that is prone to injury is called a “watershed zone,” an area when the blood supply to the tendon is weakest. In these watershed zones, the body has a hard time delivering oxygen and nutrients necessary for tendon healing.
The normal arch functions as a shock absorber for our entire body. Each time we step down we place up to 5 times our body weight on the foot, depending on whether we are walking, running, jumping, or carrying heavy loads. If the arch is either too low or high, it cannot function as efficiently as a shock absorber; thus, the soft tissues and bones of the absorb the pressure of each step. These structures are not designed to absorb these forces, and after a few hours they become “tired or achy.”
|
Biomechanical problems in the feet, such as pronation, may prevent the ligaments, tendons, and muscles from binding the joints together properly. This allows the joints to slip, the arch to collapse, and the bones to move into abnormal positions. When these actions occur, the feet can no longer act as an efficient support for the body. The results are feelings of fatigue and “achiness” which spreads to the legs and back. Loss of the protective fatty pads in the heels or balls of the feet can also lead to tired and achy feet and legs. These fatty pads act as cushions that absorb the tremendous forces that are applied to our feet with each step that we take. If these pads become too thin, or disappear all together, the bones and joints in the feet absorb these stresses instead. When this occurs, our feet become tired, “achy,” and eventually painful. This fatigue eventually travels to the leg muscles, causing them to ache. |
|
Carrying heavy loads, whether they are heavy trays of dishes or heavy pieces of equipment, will also place increased and abnormal forces and weight on our legs and feet. These forces and weight will eventually cause the body’s natural shock absorbers (the arches of the feet) to collapse, and our fatty cushions to be destroyed. As this occurs, our feet and legs become “tired,” producing aches and pains in the feet and legs.
Similarly, when we gain extra weight, our feet and legs do not become larger and stronger. Carrying extra weight will tire the feet and legs out quickly, causing “achy” and tired feelings. This may eventually lead to pain.
Standing in confined areas for long periods of time, or occupations that require redundant activity using legs and feet will cause fatigue.
Venous insufficiency can also cause a heavy feeling in the legs and fatigue. Even people without venous insufficiency can benefit and avoid tired, achy feet with the use of support socks and stockings. The gentle compression helps in eliminating the “tired feeling”.
An effective method of relieving foot and leg fatigue and “achiness” is to use specially designed custom-made orthotics. Custom-made orthotics are made from molds of your feet, designed for your foot’s structure and problems, your life-style, and your shoes. Our custom-made orthotics will help to:
Re-establish the normal position of the joints in your feet, thus allowing your feet to function efficiently again, helping to alleviate fatigue and “achiness.”
Support the arch of the foot, allowing it to be the efficient shock absorber it was designed to be, when it is at its optimum height.
Using modern materials that mimic the body’s protective fatty pads, we once again maximize the shock absorption at the heels and balls of the feet. This will reduce the stresses and forces on the bones, joints, and muscles of the feet. The feet will feel younger, and foot and leg fatigue and pain will subside.
A wart, or verruca, is a small bump on the skin caused by a virus that infects the top layer of skin cells. Warts are believed to be transmitted through direct or indirect contact (via a gym or shower floor) with a person carrying the virus. This virus, called human papilloma virus (HPV), is easier to “catch” if there is a cut or an abrasion on the skin. |
|
Plantar warts are non-cancerous skin growths that occur on the bottom of the feet. They frequently are studded with pinpoint dark spots, which are tiny, clotted blood vessels. When they occur on portions of the feet that bear weight, they are flattened by the weight placed on them, and can be quite painful. They can be confused with corns; however, corns lack surface pinpoint dark spots. Another diagnostic evaluation can be done manually; plantar warts or veruca are very painful upon lateral compression and less so on direct digital pressure. A deep seeded corn, keratosis, callous will be more painful on direct pressure.
During any repetitive weight-bearing activity, such as dancing, pressure is continuously applied to specific areas of the foot, rather than being equally distributed across the entire foot. All dance steps — whether you are ballroom dancing, swing or square dancing — cause tremendous forces to be applied to the balls of the feet, toes, arches, and ankles, and these structures are not constructed to bear these forces. Compounding these problems are inherent biomechanical abnormalities a dancer’s feet might have, such as pronation (a rolling out of the foot, so that you walk more on the inside border of the foot), supination (the opposite of pronation), a short leg, heel spurs, flat arches, very high arches, etc.
Custom-made sports orthotics are medical devices that allow the feet and ankles to function without pain, and to protect them from the repetitive stress of sports activities; or from just normal walking. They are designed and made from molds of your feet, constructed with comfortable "space age" materials, under the supervision of a Board Certified podiatrist who has 30 years of experience treating athletes.
|
WITHOUT ORTHOTICS |
WITH ORTHOTICS |
During midstance, the ankle and heel are misaligned, and your foot has no arch. |
At heel contact, orthoses limit the swing of your heel so your heel strikes the ground correctly. During midstance, your orthoses support your foot so it can regain its arch, allowing the ankle and heel to align. |
Foot drop describes the inability to raise the front part of the foot due to weakness or paralysis of the muscles that lift the foot. As a result, individuals with foot drop scuff their toes along the ground or bend their knees to lift their foot higher than usual to avoid the scuffing, which causes what is called a “steppage” gait. Foot drop can be unilateral (affecting one foot) or bilateral (affecting both feet). Foot drop is a symptom of an underlying problem and is either temporary or permanent, depending on the cause. Causes include: neurodegenerative disorders of the brain that cause muscular problems, such as multiple sclerosis, stroke, and cerebral palsy; motor neuron disorders such as polio, some forms of spinal muscular atrophy and amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s disease); injury to the nerve roots, such as in spinal stenosis; peripheral nerve disorders such as Charcot-Marie-Tooth disease or acquired peripheral neuropathy; local compression or damage to the peroneal nerve as it passes across the fibular bone below the knee; and muscle disorders, such as muscular dystrophy or myositis.
