Hammer Toe

posted on 16 Aug 2015 12:40 by jasminegates88
Hammer ToeOverview

hammertoes, also called hammer toe, deformity of the second, third, or fourth toe in which the toe is bent downward at the middle joint (the proximal interphalangeal [PIP] joint), such that the overall shape of the toe resembles a hammer. Most cases of hammertoe involve the second toe, and often only Hammer toes one or two toes are affected. In rare cases when all the toes are involved, a thorough neurological assessment is necessary to evaluate for underlying nerve or spinal cord problems.

Causes

Those fashionable shoes. Women tend to cram their feet into too-narrow, ill-fitting shoes with little to no arch support. That?s why we see more hammertoes in women than men. Pointy, high-heeled shoes put severe pressure on the toes and their joints, and they typically have little to no arch support. Neuromuscular diseases can contribute to the development of hammertoe, too. People with diabetes can be at increased risk for complications from a hammertoe. In diabetics, if a toe has a corn or other ulceration, it indicates there is too much pressure on the toes. In those with poor blood flow or neuropathy, these lesions can get infected and lead to the loss of a toe or foot unless shoes are modified.

Hammer ToeSymptoms

The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened skin (calluses) may also appear on the bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.

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

A toe doctor can provide you with devices such as hammer toe regulators or straighteners. These are also available for purchase locally. Another good idea is to start the hammer toe rehabilitation process by gently trying to straighten the joint and moving and flexing the affected toe as much as possible without straining it. If hammer toe taping doesn?t work, you may require surgery. If the joints and tendons have stiffened to a point of non-movement, hammer toe corrective surgery may need to enter the toe and either cut or manually move some of the tendons and ligaments. Although the treatment is relatively safe fast, you may deal with some stiffness afterwards.

Surgical Treatment

In more advanced cases of hammer toe, or when the accompanying pain cannot be relieved by conservative treatment, surgery may be required. Different types of surgical procedures are performed to correct hammer toe, depending on the location and extent of the problem. Surgical treatment is generally effective for both flexible and fixed (rigid) forms of hammer toe. Recurrence following surgery may develop in persons with flexible hammer toe, particularly if they resume wearing poorly-fitted shoes after the deformity is corrected.

Bunionette Tailor'S Bunion Symptoms

posted on 06 Jun 2015 10:46 by jasminegates88
Overview
Bunions Even though bunions are a common foot condition, they are probably the one with the most misconceptions. Many people suffer unnecessarily with the pain and/or appearance of bunions for years before seeking treatment out of fear about ?surgery?. The good news is that most bunion pain can be resolved without surgery.

Causes
Bunions are most widely considered to be due to an imbalance in the forces that is exerted across the joint during walking. The resulting abnormal motion and pressure over the joint, over many years (combined with poor fitting footwear) leads to instability in the joint causing hallux valgus and bunions. Bunions are really only a symptom of faulty foot mechanics and are usually caused by a combination of the way we walk, the foot we inherit and inappropriate footwear use.

Symptoms
Symptoms include redness, swelling and pain which may be present along the inside margin of the foot. The patients feet may become too wide to fit into their normal size shoes and moderate to severe discomfort may occur when the patient is wearing tight shoes. A "hammer toe" may occur at the 2nd toe. This is when the toe contracts and presses on the shoe. Subsequently, this may cause a corn on top of the 2nd toe.

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
One of the best things you can do is to go for wider, deeper shoes. Trevor Prior says there should be a centimeter between the end of your longest toe and end of shoe. You should also choose shoes with an adjustable strap or lace. Podiatrists often recommend exercises to strengthen muscles and tendons around the big toe. Here?s one you can try yourself. Put your feet side by side, and try to move your big toes towards each other. Do this three or four times a day, while you?re in the bath or in bed. Bunion Pain

Surgical Treatment
Depending on the severity of the deformity, this osteotomy can be done either at the end of the metatarsal (a distal osteotomy) or if the deformity is more severe, the osteotomy is performed at the base of the first metatarsal (a proximal osteotomy). One of the more common distal metatarsal osteotomies that is performed is called the chevron osteotomy. Typically a small screw is inserted into the bone to hold the metatarsal head in place and speed up bone healing. Following a chevron osteotomy, walking is permitted in a surgical shoe the next day after surgery and the shoe is worn for approximately three to four weeks before a more comfortable walking/running type shoe is worn.
Tags: bunions

What Is Calcaneal Apophysitis?

posted on 14 May 2015 07:46 by jasminegates88
Overview

Sever's disease is commonly found in young athletes during early puberty. It is a form of aphophysitis, an inflammatory condition of the growth plate that sits below the insertion of a tendon. In the case of Sever's, the Achilles tendon places tension on the growth plate of the calcaneus (or heel bone). Sever's disease is common in sports like soccer, volleyball, football, basketball and gymnastics, as jumping and running typically exacerbate the condition. Symptoms of Sever's are heel pain that may worsen with activity, and one may also notice a tiptoe gait as the athlete tries to take weight off the heel.

Causes

Sever?s disease is directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves a lot of heel movement. It can be associated with starting a new sport, or the start of a new season. Children who are going through adolescence are also at risk of getting it because the heel bone grows quicker than the leg. Too much weight bearing on the heel can also cause it, as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who over-pronate, and involves both heels in more than half of patients.

Symptoms

A few signs and symptoms point to Sever?s disease, which may affect one or both heels. These include pain at the heel or around the Achilles tendon, Heel pain during physical exercise, especially activities that require running or jumping, worsening of pain after exercise, a tender swelling or bulge on the heel that is sore to touch, calf muscle stiffness first thing in the morning, limping, a tendency to tiptoe.

Diagnosis

A doctor or other health professional such as a physiotherapist can diagnose Sever?s disease by asking the young person to describe their symptoms and by conducting a physical examination. In some instances, an x-ray may be necessary to rule out other causes of heel pain, such as heel fractures. Sever?s disease does not show on an x-ray because the damage is in the cartilage.

Non Surgical Treatment

The practitioner should inform the patient and the patient?s parents that this is not a dangerous disorder and that it will resolve spontaneously as the patient matures (16-18 years old). Treatment depends on the severity of the child?s symptoms. The condition is self-limiting, thus the patient?s activity level should be limited only by pain. Treatment is quite varied. Relative Rest/ Modified rest or cessation of sports. Cryotherapy. Stretching Triceps Surae and strengthen extensors. Nighttime dorsiflexion splints (often used for plantar fasciitis, relieve the symptoms and help to maintain flexibility). Plantar fascial stretching. Gentle mobilizations to the subtalar joint and forefoot area. Heel lifts, Orthoses (all types, heel cups, heel foam), padding for shock absorption or strapping of heel to decrease impact shock. Electrical stimulation in the form of Russian stimulation sine wave modulated at 2500 Hz with a 12 second on time and an 8 second off time with a 3 second ramp. Advise to wear supportive shoes. Ultrasound, nonsteroidal anti-inflammatory drugs. Casting (2-4 weeks) or Crutches (sever cases). Corticosteroid injections are not recommended. Ketoprofen Gel as an addition to treatment. Symptoms usually resolve in a few weeks to 2 months after therapy is initiated. In order to prevent calcaneal apophysitis when returning to sports (after successful treatment and full recovery), icing and stretching after activity are most indicated. Respectable opinion and poorly conducted retrospective case series make up the majority of evidence on this condition. The level of evidence for most of what we purport to know about Sever?s disease is at such a level that prospective, well-designed studies are a necessity to allow any confidence in describing this condition and its treatment.

Prevention

Sever?s disease may be prevented by maintaining good flexibility while your child is growing. The stretching exercises mentioned here can lower your child?s risk for injuries during the growth spurt. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces. If your child has already recovered from Sever?s disease, stretching and putting ice on the heel after activity will help keep your child from getting this condition again.