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Mar172014

Bunions | Bupa UK




Bunions | Bupa UK

Treatment of bunions
Wearing the right shoes, using shoe inserts (orthoses) and padding, and taking painkillers can all help to ease your symptoms of a bunion. However, these treatments can't cure a bunion or stop it getting worse. If you have severe pain or discomfort from a bunion, you may be advised to have an operation to correct it.


Self-help

One of the most important things you can do is to wear the right footwear. You should try to wear flat, wide-fitting shoes with laces or an adjustable strap that fits you properly. You may also want to place a bunion pad over your bunion to give it some protection from the pressure of your shoes. You can usually buy these pads from a pharmacy, or get them from your podiatrist or chiropodist. He or she may also recommend a shoe insert, which can be moulded specifically to your foot. Shoe inserts aim to reduce the pain of your bunion by improving how you walk.


Medicines

You can take over-the-counter painkillers, such as paracetamol or ibuprofen, to help relieve the pain and inflammation of your bunion. Always follow the instructions in the patient information leaflet that comes with your medicine. Medicines give temporary relief but they won't be able to cure your bunion or prevent it from getting worse.


If you have a bunion as a result of underlying arthritis, your GP may prescribe specific medicines to treat this.


Surgery

If other treatments don't help and your bunion is very painful, you may be referred to an orthopaedic or a podiatric surgeon for assessment. There are over 130 different operations that can be carried out to treat bunions. The simplest operations are called bunionectomies.


The majority of the operations aim to correct the alignment of your big toe. This will narrow your foot and straighten out your big toe joint as much as possible. An operation won't return your foot back to normal, but most people find that surgery reduces their symptoms and improves the shape of their foot. The operation your surgeon will advise you to have will depend on how severe your bunion is and whether or not you have arthritis.


For more information on bunion surgery, see Related topics.




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Mar152014

Ankle Fractures (Broken Ankle)-OrthoInfo - AAOS




Ankle Fractures (Broken Ankle)-OrthoInfo - AAOS
Copyright 2013 American Academy of Orthopaedic SurgeonsAnkle Fractures (Broken Ankle)
A broken ankle is also known as an ankle "fracture."This means that one or more of the bones that make up the ankle joint are broken.

A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for a few months.

Simply put, the more bones that are broken, the more unstable the ankle becomes. There may be ligaments damaged as well. The ligaments of the ankle hold the ankle bones and joint in position.

Broken ankles affect people of all ages. During the past 30 to 40 years, doctors have noted an increase in the number and severity of broken ankles, due in part to an active, older population of "baby boomers."
Anatomy
Three bones make up the ankle joint:
Tibia - shinboneFibula - smaller bone of the lower legTalus - a small bone that sits between the heel bone (calcaneus) and the tibia and fibula


Anatomy of the ankle
Reproduced and adapted with permission from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.
The tibia and fibula have specific parts that make up the ankle:
Medial malleolus - inside part of the tibiaPosterior malleolus - back part of the tibiaLateral malleolus - end of the fibula
Doctors classify ankle fractures according to the area of bone that is broken. For example, a fracture at the end of the fibula is called a lateral malleolus fracture, or if both the tibia and fibula are broken, it is called a bimalleolar fracture.

Two joints are involved in ankle fractures:
Ankle joint - where the tibia, fibula, and talus meetSyndesmosis joint - the joint between the tibia and fibula, which is held together by ligaments
Multiple ligaments help make the ankle joint stable.
Top of pageCauseTwisting or rotating your ankleRolling your ankleTripping or fallingImpact during a car accidentTop of pageSymptoms
Because a severe ankle sprain can feel the same as a broken ankle, every ankle injury should be evaluated by a physician.

Common symptoms for a broken ankle include:
Immediate and severe painSwellingBruisingTender to touchCannot put any weight on the injured footDeformity ("out of place"), particularly if the ankle joint is dislocated as wellTop of pageDoctor Examination
Medical History and Physical Examination
After discussing your medical history, symptoms, and how the injury occurred, your doctor will do a careful examination of your ankle, foot, and lower leg.

Imaging Tests
If your doctor suspects an ankle fracture, he or she will order additional tests to provide more information about your injury.

X-rays. X-rays are the most common and widely available diagnostic imaging technique. X-rays can show if the bone is broken and whether there is displacement (the gap between broken bones). They can also show how many pieces of broken bone there are.X-rays may be taken of the leg, ankle, and foot to make sure nothing else is injured.


Stress test. Depending on the type of ankle fracture, the doctor may put pressure on the ankle and take a special x-ray, called a stress test.This x-ray is done to see if certain ankle fractures require surgery.


Computed tomography (CT) scan. This type of scan can create a cross-section image of the ankle and is sometimes done to further evaluate the ankle injury. It is especially useful when the fracture extends into the ankle joint.


Magnetic resonance imaging (MRI) scan. These tests provide high resolution images of both bones and soft tissues, like ligaments. For some ankle fractures, an MRI scan may be done to evaluate the ankle ligaments.
Top of pageTreatment: Lateral Malleolus Fracture
A lateral malleolus fracture is a fracture of the fibula.

There are different levels at which that the fibula can be fractured. The level of the fracture may direct the treatment.



Different levels of lateral malleolus fractures
Reproduced with permission from Michelson JD: Ankle Fractures Resulting From Rotational Injuries J Am Acad Ortho Surg 2003;11:403-412.
Nonsurgical Treatment
You may not require surgery if your ankle is stable, meaning the broken bone is not out of place or just barely out of place. A stress x-ray may be done to see if the ankle is stable. The type of treatment required may also be based on where the bone is broken.

Several different methods are used for protecting the fracture while it heals. ranging from a high-top tennis shoe to a short leg cast. Some physicians let patients put weight on their leg right away, while others have them wait for 6 weeks.

You will see your physician regularly to repeat your ankle x-rays to make sure the fragments of your fracture have not moved out of place during the healing process.

Surgical Treatment
If the fracture is out of place or your ankle is unstable, your fracture may be treated with surgery. During this type of procedure, the bone fragments are first repositioned (reduced) into their normal alignment. They are held together with special screws and metal plates attached to the outer surface of the bone. In some cases, a screw or rod inside the bone may be used to keep the bone fragments together while they heal.
Top of pageTreatment: Medial Malleolus Fracture
A medial malleolus fracture is a break in the tibia, at the inside of the lower leg. Fractures can occur at different levels of the medial malleolus.

Medial malleolar fractures often occur with a fracture of the fibula (lateral malleolus), a fracture of the back of the tibia (posterior malleolus), or with an injury to the ankle ligaments.

Nonsurgical Treatment
If the fracture is not out of place or is a very low fracture with very small pieces, it can be treated without surgery.

A stress x-ray may be done to see if the fracture and ankle are stable.

The fracture may be treated with a short leg cast or a removable brace. Usually, you need to avoid putting weight on your leg for approximately 6 weeks.

You will need to see your physician regularly for repeat x-rays to make sure the fracture does not change in position.

Surgical Treatment


(Left) X-ray of a medial malleolus fracture. (Right) Surgical repair of a medial malleolus fracture with a plate and screws.If the fracture is out of place or the ankle is unstable, surgery may be recommended.
In some cases, surgery may be considered even if the fracture is not out of place. This is done to reduce the risk of the fracture not healing (called a nonunion), and to allow you to start moving the ankle earlier.

A medial malleolus fracture can include impaction or indenting of the ankle joint. Impaction occurs when a force is so great it drives the end of one bone into another one. Repairing an impacted fracture may require bone grafting. This graft acts as a scaffolding for new bone to grow on, and may lower any later risk of developing arthritis.

Depending on the fracture, the bone fragments may be fixed using screws, a plate and screws, or different wiring techniques.
Top of pageTreatment: Posterior Malleolus Fracture
A posterior malleolus fracture is a fracture of the back of the tibia at the level of the ankle joint.

In most cases of posterior malleolus fracture, the lateral malleolus (fibula) is also broken. This is because it shares ligament attachments with the posterior malleolus. There can also be a fracture of the medial malleolus.

Depending on how large the broken piece is, the back of the ankle may be unstable.Some studies have shown that if the piece is bigger than 25% of the ankle joint, the ankle becomes unstable and should be treated with surgery.

It is important for a posterior malleolus fracture to be diagnosed and treated properly because of the risk for developing arthritis. The back of the tibia where the bone breaks is covered with cartilage. Cartilage is the smooth surface that lines a joint. If the broken piece of bone is larger than about 25% of your ankle, and is out of place more than a couple of millimeters, the cartilage surface will not heal properly and the surface of the joint will not be smooth. This uneven surface typically leads to increased and uneven pressure on the joint surface, which leads to cartilage damage and the development of arthritis.

Nonsurgical Treatment
If the fracture is not out place and the ankle is stable, it can be treated without surgery.

Treatment may be with a short leg cast or a removable brace. Patients are typically advised not to put any weight on the ankle for 6 weeks.

Surgical Treatment
If the fracture is out of place or if the ankle is unstable, surgery may be offered.

Different surgical options are available for treating posterior malleolar fractures. One option is to have screws placed from the front of the ankle to the back, or vice versa.Another option is to have a plate and screws placed along the back of the shin bone.
Top of pageTreatment: Bimalleolar Fractures or Bimalleolar Equivalent Fractures
"Bi" means two. "Bimalleolar" means that two of the three parts or malleoli of the ankle are broken. (Malleoli is plural for malleolus.)

In most cases of bimalleolar fracture, the lateral malleolus and the medial malleolus are broken and the ankle is not stable.

A "bimalleolar equivalent" fracture means that in addition to one of the malleoli being fractured, the ligaments on the inside (medial) side of the ankle are injured. Usually, this means that the fibula is broken along with injury to the medial ligaments, making the ankle unstable.

A stress test x-ray may be done to see whether the medial ligaments are injured.

Bimalleolar fractures or bimalleolar equivalent fractures are unstable fractures and can be associated with a dislocation.



(Left) X-ray of bimalleolar ankle fracture. (Right)Surgical repair bimalleolar ankle fracture
Nonsurgical Treatment
These injuries are considered unstable and surgery is usually recommended.

Nonsurgical treatment might be considered if you have significant health problems, where the risk of surgery may be too great, or if you usually do not walk.

Immediate treatment typically includes a splint to immobilize the ankle until the swelling goes down. A short leg cast is then applied. Casts may be changed frequently as the swelling subsides in the ankle.

You will need to see your physician regularly to repeat your x-rays to make sure your ankle remains stable.

In most cases, Weightbearing is not be allowed for 6 weeks. After 6 weeks, the ankle may be protected by a removable brace as it continues to heal.

Surgical Treatment
Surgical treatment is often recommended because these fractures make the ankle unstable.

Lateral and medial malleolus fractures are treated with the same surgical techniques as written above for each fracture listed.
Top of pageTreatment: Trimalleolar Fractures
"Tri" means three.Trimalleolar fractures means that all three malleoli of the ankle are broken.These are unstable injuries and they can be associated with a dislocation.



(Left) X-ray of trimalleolar ankle fracture. (Right) Surgical repair.
Nonsurgical Treatment
These injuries are considered unstable and surgery is usually recommended.

As with bimalleolar ankle fractures, nonsurgical treatment might be considered if you have significant health problems, where the risk of surgery may be too great, or if you usually do not walk.

Nonsurgical treatment is similar to bimalleolar fractures, as described above.

Surgical Treatment
Each fracture can be treated with the same surgical techniques as written above for each individual fracture.
Top of pageTreatment: Syndesmotic Injury
The syndesmosis joint is located between the tibia and fibula, and is held together by ligaments. A syndesmotic injury may be just to the ligament -- this is also known as high ankle sprain. Depending on how unstable the ankle is, these injuries can be treated without surgery.However, these sprains take longer to heal than the normal ankle sprain.

In many cases, a syndesmotic injury includes both a ligament sprain and one or more fractures. These are unstable injuries and they do very poorly without surgical treatment.

Your physician may do a stress test x-ray to see whether the syndesmosis is injured.



(Left) X-ray of syndesmotic injury with lateral malleolus fracture. Note the space between the tibia and fibula. (Right) Surgical repair.Top of pageOutcome
Because there is such a wide range of injuries, there is also a wide range of how people healafter their injury.

It takes at least 6 weeks for the broken bones to heal. It may take longer for the involved ligaments and tendons to heal.

As mentioned above, your doctor will most likely monitor the bone healing with repeated x-rays. This is typically done more often during the first 6 weeks if surgery is not chosen.

Although most people return to normal daily activities, except for sports, within 3 to 4 months, studies have shown that people can still be recovering up to 2 years after their ankle fractures. It may take several months for you to stop limping while you walk, and before you can return to sports at your previous competitive level.Most people return to driving within 9 to 12 weeks from the time they were injured.

Rehabilitation
Rehabilitation is very important regardless of how an ankle fracture is treated.

When your physician allows you to start moving your ankle, physical therapy and home exercise programs are very important.Doing your exercises regularly is key.

Eventually, you will also start doing strengthening exercises. It may take several months for the muscles around your ankle to get strong enough for you to walk without a limp and to return to your regular activities.

Again, exercises only make a difference if you actually do them.

Weightbearing
Your specific fracture determines when you can start putting weight on your ankle. Your physician will allow you to start putting weight on your ankle when he or she feels your injury is stable enough to do so.

It is very important to not put weight on your ankle until your physician says you can.If you put weight on the injured ankle too early, the fracture fragments may move or your surgery may fail and you may have to start over.

Supports
It is very common to have several different kinds of things to wear on the injured ankle, depending on the injury.

Initially, most ankle fractures are placed in a splint to protect your ankle and allow for the swelling to go down.After that, you may be put into a cast or removable brace.

Even after the fracture has healed, your physician may recommend wearing an ankle brace for several months while you are doing sporting activities.
Top of pageComplications
People who smoke, have diabetes, or are elderly are at a higher risk for complications after surgery, including problems with wound healing. This is because it may take longer for their bones to heal.

Nonsurgical Treatment
Without surgery, there is a risk that the fracture will move out of place before it heals.This is why it is important to follow up with your physician as scheduled.

If the fracture fragments do move out of place and the bones heal in that position, it is called a "malunion." Treatment for this is determined by how far out of place the bones are and how the stability of the ankle joint is affected.

If a malunion does occur or if your ankle becomes unstable after it heals, this can eventually lead to arthritis in your ankle.

Surgical Treatment
General surgical risks include:
InfectionBleedingPainBlood clots in your legDamage to blood vessels, tendons, or nerves
Risks from the surgical treatment of ankle fractures include
Difficulty with bone healingArthritisPain from the plates and screws that are used to fix fracture. Some patients choose to have them removed several months after their fracture healsTop of pageWhat to Discuss With Your Orthopaedic Surgeon:When will I be able to start putting weight on my leg?How long will I be off of work?Do I have any specific risks for not doing well?If I have to have surgery, what are the risks?Do I have weak bone?Top of pageLast reviewed: March 2013


Co-developed by the Orthopaedic Trauma Association

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.Copyright 2013 American Academy of Orthopaedic SurgeonsRelated LinksVideo: Fracture Healing

View this videoView this video ()Related TopicsAnkle Fractures in ChildrenAnkle Fractures in Children (http://orthoinfo.aaos.org/topic.cfm?topic=A00632)Care of Casts and SplintsCare of Casts and Splints (http://orthoinfo.aaos.org/topic.cfm?topic=A00095)Fractures (Broken Bones)Fractures (Broken Bones) (http://orthoinfo.aaos.org/topic.cfm?topic=A00139)How to Use Crutches, Canes, and WalkersHow to Use Crutches, Canes, and Walkers (http://orthoinfo.aaos.org/topic.cfm?topic=A00181)Internal Fixation for FracturesInternal Fixation for Fractures (http://orthoinfo.aaos.org/topic.cfm?topic=A00196)NonunionsNonunions (http://orthoinfo.aaos.org/topic.cfm?topic=A00374)Pilon Fractures of the AnklePilon Fractures of the Ankle (http://orthoinfo.aaos.org/topic.cfm?topic=A00527)OrthoInfo
The American Academy of Orthopaedic Surgeons
6300 N. River Road
Rosemont, IL 60018
Phone: 847.823.7186
Email: orthoinfo@aaos.org

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Mar152014

Treatment of Ankle Pain, Bunions, Foot Pain, Arthritis | Seattle, Bellevue Podiatrist

Treatment of Ankle Pain, Bunions, Foot Pain, Arthritis | Seattle, Bellevue Podiatrist

Pain Management
Ankle Pain | Arch Pain | Arthritis | Ball of the Foot Pain | Bunions | Heel Pain | Metatarsalgia | Top of the Foot Pain
Ankle Pain
Recurring or persistent (chronic) pain on the outer (lateral) side of the ankle often develops after an injury such as a sprained ankle.Both conservative (nonoperative) and surgical treatment methods may be used to alleviate the pain, according to the American Orthopaedic Foot and Ankle Society. Conservative treatments include:
Anti-inflammatory medications such as aspirin or ibuprofen to reduce swellingPhysical therapy, including tilt-board exercises, directed at strengthening the muscles, restoring range of motion, and increasing your perception of joint positionAn ankle brace or other supportAn injection of a steroid medicationIn the case of a fracture, immobilization to allow the bone to heal
Almost half of all people who sprain their ankle once will experience additional ankle sprains and chronic pain, according to the American Orthopaedic Foot and Ankle Society. You can help prevent chronic pain from developing by following these simple steps:
Follow your doctor's instructions carefully and complete the prescribed physical rehabilitation program.Do not return to activity until cleared by your physicianWhen you do return to sports, use an ankle brace rather than taping the ankle. Bracing is more effective than taping in preventing ankle sprains.If you wear hi-top shoes, be sure to lace them properly and completely.Arch Pain
Plantar fasciitis is an inflammation of a thick, fibrous ligament in the arch of the foot called the plantar fascia. The plantar fascia attaches into the heel bone and fans out toward the ball of the foot, attaching into the base of the toes. If this ligament is stretched excessively it will become inflamed and begin to cause pain.

Cortisone injections, used in the treatment of heel pain, are not commonly used for the treatment of plantar fasciitis. The main emphasis of treatment is to reduce the forces that are causing the plantar fascia to stretch excessively. This includes calf muscle stretching, over the counter arch supports, and orthotics. Oral anti-inflammatory medications may be useful in controlling the pain.
Arthritis
Arthritis can be treated in many ways, including:
Physical therapy and exerciseOrthoses or specially prescribed shoesFoot soaks/paraffin baths Ice packsMassagesOver-the-counter anti-inflammatory medications such as Advil, Tylenol, and Aspirin are good medications that supply relief.Prescription non-steroidal anti-inflammatory medicationsVitamins B6, B12 and folic acid combined in the Rodex Forte capsules also help in the treatment of arthritis.Ball of the Foot Pain
Treatment of calluses on the balls of your feet consists of periodic trimming or shaving the callous, padding the shoes to remove the pressure, functional shoe orthotics, or surgery.

Pain in the ball of the foot not associated with calluses can be a result of inflammation of a tendon into the toe, inflammation of the joint, or due to a pinched nerve called a Neuroma. A neuroma will also often cause a burning pain into one or more toes.. Another cause of pain in the ball of the foot is arthritis. Treatments include orthoses (shoe inserts) and/or cortisone injections, but surgical removal of the growth is sometimes necessary.

Arthritis will usually affect multiple joints in the ball of the foot. Common types of arthritis are rheumatoid arthritis, osteoarthritis and degenerative arthritis. Degenerative arthritis most commonly affects the big toe joint. Arthritis can be treated in many ways, including:
Physical therapy and exerciseMedicationOrthoses or specially prescribed shoes
The big toe joint is often stiff causing jamming (Hallux Limitus). Over time the jamming of the joint will cause an enlargement on the top of the joint. Anti-inflammatory medications, cortisone injections and/or functional orthotics are some of the common treatments for stiff big toe.

Surgery may be prescribed if spurring around the joint becomes severe.

The most common cause of pain in the ball of the foot, in the area of the big toe joint, is sesamoiditis. Sesamoiditis is an inflammation of two small bones under the big toe joint. On occasion, a stress fracture can occur in one of these bones. Severe pain with sudden onset about the big toe joint may be gout. Sesamoiditis can be relieved with proper shoe selection and orthoses.
Bunions
Most bunions can be treated without surgery by wearing protective pads to cushion the painful area, and of course, avoiding ill-fitting shoes in the first place.

Bunion surgery, or bunionectomy, realigns the bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. Many bunion surgeries are performed on a same-day basis (no hospital stay) using an ankle-block anesthesia. A long recovery is common and may include persistent swelling and stiffness.
Heel Pain
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. A podiatric physician can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.

Also called "heel spur syndrome," the condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy.
Metatarsalgia
Foot pain in the "ball of your foot," the area between your arch and the toes, is generally called metatarsalgia. The pain usually centers on one or more of the five bones (metatarsals) in this mid-portion of the foot, according to the American Orthopaedic Foot and Ankle Society.

Also known as "dropped metatarsal heads," metatarsalgia can cause abnormal weight distribution due to over pronation.

A simple change shoes may solve the problem. In more severe cases, podiatrists may prescribe full-length custom-molded foot orthoses.
Top of the Foot Pain
There are several causes of pain on the top of the foot. The type of pain and its location help the doctor in determining the cause of the pain and helps to direct them in the best treatment.

Managing pain on the top of the foot can be aided by:
A limitation of activityBelow the knee walking castsFunctional orthoticsOral anti-inflammatory medications
Back to top



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Mar112014

Plantar Fasciitis & Back Pain


So what causes the Plantar Fascia to become inflamed? There are a number of various reasons for this to occur. For example, you are more likely to develop Plantar Fasciitis, if you are over 50 years old, if you're overweight, or pregnant, or if you have a job that requires a lot of walking or standing on hard surfaces. You're also at risk if you do a lot of walking or running for exercise (overuse injury). And if you have tight calf muscles (which a lot of people have) you're also more likely to develop Plantar Fasciitis.

Plantar fasciitis Classification and external resources. Plantar fasciitis PF is a painful inflammatory process of the plantar fascia, the connective tissue on the sole bottom surface of the foot. It is often caused by overuse of the plantar fascia or arch tendon of the foot. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcareous heel bone and extending along the sole of the foot towards the toes. A symptom commonly recognized among sufferers of plantar fasciitis is an increased probability of knee pains, especially among runners.

Morning plantar fasciitis is commonly the most painful type of heel pain associated with this condition. This is because pain from plantar fasciitis is often felt more in the morning. After long periods of rest, such as after waking up in the morning, an inflamed area of the plantar fascia ligament becomes stressed when pressure is put on it. The first steps taken in the morning are usually extremely painful. Terrible morning plantar fasciitis pain results from the plantar fascia ligament being over stretched and becoming inflamed within a few steps.

Splints are particularly effective at preventing morning foot pain, and are strapped to the foot at bedtime and keep the tissue in its stretched state. Without the contraction the foot is prepared for the first few steps, and the devices can eradicate morning foot pain. Heel seats on the other hand are devices which are placed under the heel and fit easily into most shoes. By elevating the heel the plantar fascia is not required to stretch and flex as much when walking which eases the pain and prevents further damage. They are also particularly effective at easing the pain from heel spurs by cushioning the heel.

Surgery carries the risk of nerve injury, infection, rupture of the plantar fascia, and failure of the pain to improve. 13 Surgical procedures, such as plantar fascia release, are a last resort, and often lead to further complications such as a lowering of the arch and pain in the supero-lateral side of the foot due to compression of the cuboid bone 14 An ultrasound guided needle fasciotomy can be used as a minimally invasive surgical intervention for plantar fasciitis. A needle is inserted into the plantar fascia and moved back and forwards to disrupt the fibrous tissue. 15plantar fasciitis brace

The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes It has been reported that plantar fasciitis occurs in two million Americans a year and in 10% of the U.S. population over a lifetime. Another symptom is that the sufferer has difficulty bending the foot so that the toes are brought toward the shin (decreased dorsiflexion of the ankle ). A symptom commonly recognized among sufferers of plantar fasciitis is an increased probability of knee pains, especially among runners Diagnosis edit.

Heelpain is commonly felt on the bottom of the foot, where the plantarfascia attaches to the heel bone. Due to the fact that the fasciaconstricts when you sleep, you will typically feel the most pain in themornings. When you get up, the sudden stretch and load of your bodyweight pulls on the attachment to the heel bone. Mild to severesymptoms of foot pain in athletes may occur. The pattern of pain can bevery unpredictable over months at a time. Frequently, the paindisappears for several weeks, only to re-emerge full-blown after asingle workout or change in activity.

The pain associated with plantar fasciitis is typically gradual in onset and is usually located over the inner or medial aspect of the heel. Occasionally, the pain will be sudden in onset, occurring after missing a step or after jumping from a height. The pain is commonly most severe upon arising from bed in the morning, or after periods of inactivity during the day. Thus, it causes what is known as "first-step pain." The degree of discomfort can sometimes lessen with activity during the course of the day or after "warming-up", but can become worse if prolonged or vigorous activity is undertaken.

Shoe modifications are also important. Wearing the proper shoe and in some cases in combination with a custom orthotics helps to cushion and support the foot and keep the plantar fascia supported to stop excessive strain on the foot. Custom orthotic devices are custom molded to your foot and prevent any biomechanical defects with your foot to help aid in recovery and prevent future recurrences. Night splints are also used at night to keep the plantar fascia stretched to reduce morning pain associated with this condition. Injection therapy can be combined with the above modalities.

There are many treatment options for plantar fasciitis One of the most common treatment is through using the RICE system. This includes rest, ice, compression, elevation. This is used by many athletes and physical therapist to treat a wide variety of symptoms. Plantar fasciitis is no different, in that these techniques can dramatically improve symptoms of plantar fasciitis and reduce a lot of the pain associated with the condition. There other treatment options if this proves to be not enough, such as orthopedic inserts, night splints, and a wide range of products including massage products and rollers. plantar fasciitis relief

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Mar112014

Plantar Fasciitis Stretches


Plantar fasciitis means inflammation of your plantar fascia Your plantar fascia is a physically powerful band of tissue like a muscle that stretches from your heel to your focus foot bones. It supports the arch of your foot and too acts as a shock absorber in your foot. Plantar fasciitis is common. About 1 in 10 people will find plantar fasciitis at some time in their life. It is the majority common in people between the ages of 40 to 60 years. However, it can happen at any age. It is twice as frequent in women as men. It is too common in athletes.

As mentioned above, improper shoes cause plantar fasciitis. Also, for its treatment, good shoes are suggested. There are shoes which do not have a cushioning at the center of the foot. In walking shoes for plantar fasciitis, there is an arch at the middle of the sole. This arch and well supported mechanism in these shoes can help in rendering great relief while walking. Otherwise, excessive pressure on the feet can cause increase in pain and inflammation. These shoes have built-in features which provide relief from the pain. There are motion-controlled shoes for those who have developed plantar fasciitis due to flat foot or wrong shoes.

The treatment of plantar fasciitis may include non-steroidal anti inflammatory such as Ibuprophen, or Naproxen, rest, ice and heat modalities, or orthotic devices for shoes to provide arch support. Your doctor may inject your foot with corticosteroids or prescribe a corticosteroid cream which may provide relief. If you're overweight diet to normalize your weight may be suggested. Exercises to stretch the plantar fascia and strengthen the lower leg muscles may be suggested. Night splints which hold your foot at a 90 degree angle may be suggested to keep the plantar facia lengthened at night allow for greater stretching and decrease morning pain.

Inappropriate footwear is the No. 1 cause of plantar fasciosis. Footwear that possesses toe spring and a tapered toe box holds your big toe in an adducted and extended position. In this position, your abductor hallucis muscle—the muscle responsible for moving your big toe away from your foot’s midline—pulls on a foot structure called the flexor retinaculum and may restrict blood flow through your posterior tibial artery, the vessel that carries blood to the bottom of your foot. Tissues in the sole of your feet begin to degenerate as blood supply to this area is decreased.

Splints for plantar fasciitis should be worn overnight. They hold the foot in dorsiflexion position. This prevents the tightening of the plantar fascia tissues. The gentle stretching of the splint helps the tissue come back to its natural length over time. The stretching of the plantar fascia helps reduce the stress on the heel. It may cure a person within 2-3 days. It may also take longer depending on the injury. They are padded that provides comfort to the wearer. The adjustable night splint is helpful in gently reducing and increasing the stretch on the foot. This helps make the foot used to the night splint for plantar fasciitis.plantar fasciitis sock

When you go in to see your podiatrist about the pain in the bottom of your heel, be sure to come prepared to answer questions (and ask questions of your own, of course). Your doctor will probably want to know a history of your symptoms and will perform a physical exam of your foot to check for swelling and redness. He or she may also check for tenderness on the foot to find out where the pain is coming from. You may need to get X-rays to check for other possible sources of your pain (such as stress fractures).

Of all the hours I spent reading and researching a plantar fasciitis cure or remedy, my lightbulb moment came by surprise. In the As Seen on TV section of a store I saw Yoga Toes. Yoga Toes is a small bubbled ladder that goes between your toes to stretch out the ligaments and tendons in your foot side to side. But it was $30. So I wondered if I could think of something else that would stretch out my feet in the same way but cheaper. Then I thought of the foam pedicure toe separators. They were only $1 a pair.

Strengthening programs should focus on intrinsic muscles of the foot. Exercises used include towel curls and toe taps. Exercises such as picking up marbles and coins with the toes are also useful. To do a towel curl, the patient sits with the foot flat on the end of a towel placed on a smooth surface. Keeping the heel on the floor, the towel is pulled toward the body by curling the towel with the toes. Next, the process is reversed, and the outside four toes are repetitively tapped to the floor while keeping the big toe in the air.

Why is this exercise valuable? The muscles of the feet require good strength to control the forces associated with landing on the ground during the running stride. This toe-walking exercise helps to develop the eccentric (support) strength and mobility in the muscles of the foot and calf, as well as the plantar fascia and Achilles tendon (eccentric strength means hardiness as these structures are being stretched out). The exercise also works the foot and ankle through a broad range of motion, especially for the foot which is bearing weight on the ball and toes while the ankle is extended (is in plantar flexion).

Plantar fasciitis accounts for around eight percent of all running injuries,1 and is common among runners of all ability levels, and is even a problem for sedentary people, where obesity and working long hours while standing are probably the driving causes. Runners, of course, face additional issues due to the forces associated with running, but you shouldn’t overlook your footwear or habits in the rest of your life if you come down with a case of plantar fasciitis. Women’s footwear is especially bad with respect to strain on the arch, but unsupportive hard-soled men’s shoes are problematic too. Causes and what irritates plantar fasciitisplantar fasciitis relief

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