Echo Stachowski

Feet Problems

The Best Way To Diagnose Fallen Arches

Overview

Acquired Flat Foot

If you have flat feet, you may also experience pain throughout the lower body and into the lower back. Orthotics can be prescribed to create a system of support for the body and surgery can also offer a more permanent solution. Contact us today to discuss which treatment option may be right for you.

Causes

Over-pronation is a common biomechanical problem that occurs when the arches collapse while walking or standing. This condition hampers our natural walking pattern, causing an imbalance, and leading to wear and tear in other parts of the body with every step we take. Whether you suffer from over-pronation like most of the population, or you have a true flat foot, in both cases your poor walking pattern may contribute to a range of different complaints. As we age, poor aligment of the feet causes very common conditions such as heel pain or knee pain. Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch, leading to over-pronation. Over-pronation is also very common with athletes, especially runners, who most of them nowadays use orthotics inside their shoes.

Symptoms

Fallen arches symptoms may include the following. Being unable to slip fingers underneath arches. Inwards rolling of foot and ankle when running. Knee problems due to lack of support from feet.

Diagnosis

Podiatrists are trained in expertly assessing flat feet and identifying different risk factors and the causes for it. Initial assessment will begin with a detailed history attempting to find out if any underlying illness has resulted in this. A detailed clinical examination normally follows. The patient may be asked to perform certain movements such as walking or standing on their toes to assess the function of the foot. Footwear will also be analysed to see if there has been excessive wear or if they are contributing to the pronation of the foot. To assess the structure of the foot further, the podiatrist may perform certain x-rays to get a detailed idea of the way the bones are arranged and how the muscle tissues may be affecting them. It also helps assess any potential birth defects in a bit more detail.

pes planus exercises

Non Surgical Treatment

If the flat foot is rigid and causing problems, you will be referred to a foot specialist. Talk with your doctor about the best treatment plan for you. Options include the following. Physical Therapy and Exercises. Physical therapy may relieve discomfort. You may be given a specific stretching and strength program. You may also have treatment to help manage the discomfort. Exercises can help with the strength of the surrounding muscles. It may relieve some of the pressure in the foot. Orthotics are shoe inserts that support the foot. These inserts may help to reduce pain and disability in some people. In mild cases, a well-fitting pair of shoes with arch support may be all that is needed. Flat feet caused by nerve or muscle disease may need special braces. Fallen arches are usually treated using stretching exercises, physical therapy and medication (to reduce inflammation). In extreme cases however, surgery is recommended.

Surgical Treatment

Acquired Flat Feet

A better approach is to strengthen the weakened ligaments with Prolotherapy, supplemented by an arch support if the condition has existed for several years. Chronic pain is most commonly due to tendon and ligament weakness, or cartilage deterioration. The safest and most effective natural medicine treatment for repairing tendon, ligament and cartilage damage is Prolotherapy. In simple terms, Prolotherapy stimulates the body to repair painful areas. It does so by inducing a mild inflammatory reaction in the weakened ligaments and cartilage. Since the body heals by inflammation, Prolotherapy stimulates healing. Prolotherapy offers the most curative results in treating chronic pain. It effectively eliminates pain because it attacks the source: the fibro-osseous junction, an area rich in sensory nerves. What?s more, the tissue strengthening and pain relief stimulated by Prolotherapy is permanent.

After Care

Patients may go home the day of surgery or they may require an overnight hospital stay. The leg will be placed in a splint or cast and should be kept elevated for the first two weeks. At that point, sutures are removed. A new cast or a removable boot is then placed. It is important that patients do not put any weight on the corrected foot for six to eight weeks following the operation. Patients may begin bearing weight at eight weeks and usually progress to full weightbearing by 10 to 12 weeks. For some patients, weightbearing requires additional time. After 12 weeks, patients commonly can transition to wearing a shoe. Inserts and ankle braces are often used. Physical therapy may be recommended. There are complications that relate to surgery in general. These include the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots. Complications following flatfoot surgery may include wound breakdown or nonunion (incomplete healing of the bones). These complications often can be prevented with proper wound care and rehabilitation. Occasionally, patients may notice some discomfort due to prominent hardware. Removal of hardware can be done at a later time if this is an issue. The overall complication rates for flatfoot surgery are low.
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Heel Ache

Overview

Heel Discomfort

Every mile you walk puts tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle. A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people ignore the early signs of heel pain and keep on doing the activities that caused it. When you continue to walk on a sore heel, it will only get worse and could become a chronic condition leading to more problems.

Causes

Pain in the foot can be due to a problem in any part of the foot. Bones, ligaments, tendons, muscles, fascia, toenail beds, nerves, blood vessels, or skin can be the source of foot pain. The cause of foot pain can be narrowed down by location and by considering some of the most common causes of foot pain. Plantar fasciitis is the most common cause of heel pain. The plantar fascia, a band of tough tissue connecting the heel bone to the toes, becomes irritated or inflamed. Heel pain, worst in the morning when getting out of bed, is the most common symptom. Arch pain may also be present.

Symptoms

Depending on the specific form of heel pain, symptoms may vary. Pain stemming from plantar fasciitis or heel spurs is particularly acute following periods of rest, whether it is after getting out of bed in the morning, or getting up after a long period of sitting. In many cases, pain subsides during activity as injured tissue adjusts to damage, but can return again with prolonged activity or when excessive pressure is applied to the affected area. Extended periods of activity and/or strain of the foot can increase pain and inflammation in the foot. In addition to pain, heel conditions can also generate swelling, bruising, and redness. The foot may also be hot to the touch, experience tingling, or numbness depending on the condition.

Diagnosis

Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot - this could be a sign of nerve damage in your feet and legs (peripheral neuropathy), your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection, you have stiffness and swelling in your heel - this could be a sign of arthritis. Possible further tests may include, blood tests, X-rays - where small doses of radiation are used to detect problems with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.

Non Surgical Treatment

Initial treatment should consist of an ice pack. Some runners prefer to use a wet towel that has been in the fridge. We recommend you use commercially available ice packs for focused pain released. An anti-inflammatory such as Ibuprofen will help to reduce the swelling. Please note this should be taken with meals and never before running. As with all soft tissue injuries, you may have to re-examine your training regime. A reduction or even a total break form running may be necessary. . Examine your running shoes, making sure the shoes do not bend excessively near the middle of the foot and at the ball of the foot. Sports shoes with built in insoles can be beneficial, however we recommend you replace existing insoles with specific sports orthotics/ insoles. Silicone heel cups, leather heel pads and contrasting cold and hot therapy can all help to speed up the healing process. The plantar fascia stretch will help to prevent the injury from occurring again. Please note that this stretch should not be done while the heel is inflamed and should only be attempted once you?re a feeling minimal or no pain from your heel.

Surgical Treatment

Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do not have to be remade.

ankle straps for heels

Prevention

Pain In The Heel

You can try to avoid the things that cause heel pain to start avoid becoming overweight, where your job allows, minimise the shock to your feet from constant pounding on hard surfaces, reduce the shocks on your heel by choosing footwear with some padding or shock-absorbing material in the heel, if you have high-arched feet or flat feet a moulded insole in your shoe may reduce the stresses on your feet, if you have an injury to your ankle or foot, make sure you exercise afterwards to get back as much movement as possible to reduce the stresses on your foot and your heel in particular, If you start to get heel pain, doing the above things may enable the natural healing process to get underway and the pain to improve.
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Leg Length Discrepancy Measurement Methods

Overview

Approximately 75% of us present with one leg longer than the other. It?s staggering, literally, that so many people walk about with an imbalance. Yet to have one leg longer than the other doesn?t seem to create pain for everyone but for those that it does it brings pain in a myriad of dysfunction from TMJ, headaches, low back pain, IBS, bladder problems, sexual dysfunction, sacroiliac joint pain, pubis dysfunction, groin strain, gluteal dysfunction as well as the formation of trigger points.Leg Length Discrepancy

Causes

There are many causes of leg length discrepancy. Some include, A broken leg bone may lead to a leg length discrepancy if it heals in a shortened position. This is more likely if the bone was broken in many pieces. It also is more likely if skin and muscle tissue around the bone were severely injured and exposed, as in an open fracture. Broken bones in children sometimes grow faster for several years after healing, causing the injured bone to become longer. A break in a child's bone through the growth center near the end of the bone may cause slower growth, resulting in a shorter leg. Bone infections that occur in children while they are growing may cause a significant leg length discrepancy. This is especially true if the infection happens in infancy. Inflammation of joints during growth may cause unequal leg length. One example is juvenile arthritis. Bone diseases may cause leg length discrepancy, as well. Examples are, Neurofibromatosis, Multiple hereditary exostoses, Ollier disease. Other causes include inflammation (arthritis) and neurologic conditions. Sometimes the cause of leg length discrepancy is unknown, particularly in cases involving underdevelopment of the inner or outer side of the leg, or partial overgrowth of one side of the body. These conditions are usually present at birth, but the leg length difference may be too small to be detected. As the child grows, the leg length discrepancy increases and becomes more noticeable. In underdevelopment, one of the two bones between the knee and the ankle is abnormally short. There also may be related foot or knee problems. Hemihypertrophy (one side too big) or hemiatrophy (one side too small) are rare leg length discrepancy conditions. In these conditions, the arm and leg on one side of the body are either longer or shorter than the arm and leg on the other side of the body. There may also be a difference between the two sides of the face. Sometimes no cause can be found. This is known as an "idiopathic" difference.

Symptoms

Children whose limbs vary in length often experience difficulty using their arms or legs. They might have difficulty walking or using both arms to engage in everyday activities.

Diagnosis

The evaluation of leg length discrepancy typically involves sequential x-rays to measure the exact discrepancy, while following its progression. In addition, an x-ray of the wrist allows us to more carefully age your child. Skeletal age and chronological age do not necessarily equal each other and frequently a child's bone age will be significantly different than his or her stated age. Your child's physician can establish a treatment plan once all the facts are known: the bone age, the exact amount of discrepancy, and the cause, if it can be identified.

Non Surgical Treatment

Heel lifts and sole lifts are simple ways Pedorthists can compensate for leg length deficiencies. These small modifications can make a tremendous difference to a person?s comfort, balance and mobility. Although people do not always know if they have LLD if you have any of the symptoms I have mentioned you should consult a Pedorthist as treating your condition early will reduce the development of serious problems later on.

Leg Length Discrepancy Insoles

how to increase height after 18

Surgical Treatment

Surgeries for LLD are designed to do one of three general things ? shorten the long leg, stop or slow the growth of the longer or more rapidly growing leg, or lengthen the short leg. Stopping the growth of the longer leg is the most commonly utilized of the three approaches and involves an operation known as an epiphysiodesis , in which the growth plate of either the lower femur or upper tibia is visualized in the operating room using fluoroscopy (a type of real-time radiographic imaging) and ablated , which involves drilling into the region several times, such that the tissue is no longer capable of bone growth. Because the epiphyseal growth capabilities cannot be restored following the surgery, proper timing is crucial. Usually the operation is planned for the last 2 to 3 years of growth and has excellent results, with children leaving the hospital within a few days with good mobility. However, it is only appropriate for LLD of under 5cm.

Mortons Neuroma Treatment

Overview

MortonMorton's neuroma is the common name given to the nerve irritation that is found in the ball of the foot that may or may not be accompanied by an inter-metatarsal bursae (a bursa-neuromal complex). It is often associated with inflammation or degeneration and often occurs with constant pressure or irritation of the nerve from the surrounding bony structures or local bursas (fluid filled sacs). Morton's Neuroma can cause symptoms such as a sharp pain, burning even a lack of feeling in the ball of the foot and associated toes.

Causes

A Morton's neuroma commonly occurs due to repetitive weight bearing activity (such as walking or running) particularly when combined with tight fitting shoes or excessive pronation of the feet (i.e. "flat-feet"). The condition is also more common in patients with an unstable forefoot allowing excessive movement between the metatarsal bones. A Morton's neuroma can also occur due to certain foot deformities, trauma to the foot, or the presence of a ganglion or inflamed bursa in the region which may place compressive forces on the nerve.

Symptoms

Normally, there are no outward signs, such as a lump, because this is not really a tumor. Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.

Diagnosis

Morton?s neuroma can be identified during a physical exam, after pressing on the bottom of the foot. This maneuver usually reproduces the patient?s pain. MRI and ultrasound are imaging studiesthat can demonstrate the presence of the neuroma. An x-ray may also be ordered to make sure no other issues exist in the foot. A local anesthetic injection along the neuroma may temporarily abolish the pain, and help confirm the diagnosis.

Non Surgical Treatment

Common treatments involve wearing different shoes or using arch supports. Resting the foot, massaging the toes and using an ice pack may work for some people. A GP or a podiatrist (foot specialist) may also recommend anti-inflammatory painkillers or a course of steroid injections. Numbing injections, in which alcohol and a local anaesthetic are injected into the affected area of the foot, may also be effective. In extreme cases, when the condition does not respond to treatment, day case surgery may be needed.Morton neuroma

Surgical Treatment

Interdigital neurectomy (removal of the diseased nerve) in right hands, should give satisfactory results almost all the time. Some of the reasons behind failure is when not enough nerve is dissected, mistakes in initial diagnosis, or bad handling of adjacent nerves, tendons and joint capsules during the operation. It is very common and acceptable to have some numbness in the area where the nerve used to be. This never causes any discomfort and often gets better in few years. It is crucial to address the biomechanical pathologies underlying the impingement of the nerve during and after the surgery.

Prevention

Wearing shoes that fit properly and that have plenty of room in the toe area may help prevent Morton's neuroma.
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For Leg Length Imbalances Chiropodists Prefer Shoe Lifts

There are two unique variations of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter than the other. As a result of developmental stages of aging, the human brain picks up on the step pattern and recognizes some variation. The body usually adapts by tilting one shoulder to the "short" side. A difference of less than a quarter inch is not grossly abnormal, doesn't need Shoe Lifts to compensate and typically does not have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes typically undiscovered on a daily basis, however this issue is easily remedied, and can reduce quite a few cases of chronic back pain.

Treatment for leg length inequality typically consists of Shoe Lifts. Most are low cost, frequently priced at less than twenty dollars, in comparison to a custom orthotic of $200 or even more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Chronic back pain is easily the most widespread condition impacting people today. Over 80 million men and women experience back pain at some stage in their life. It is a problem that costs businesses huge amounts of money annually on account of lost time and productivity. Innovative and better treatment solutions are always sought after in the hope of lowering economic impact this condition causes.

Leg Length Discrepancy Shoe Lifts

Men and women from all corners of the earth suffer from foot ache as a result of leg length discrepancy. In a lot of these cases Shoe Lifts might be of beneficial. The lifts are capable of reducing any pain and discomfort in the feet. Shoe Lifts are recommended by many experienced orthopaedic practitioners".

In order to support the human body in a nicely balanced fashion, your feet have got a significant task to play. Inspite of that, it is often the most neglected region of the human body. Many people have flat-feet meaning there is unequal force placed on the feet. This causes other parts of the body such as knees, ankles and backs to be affected too. Shoe Lifts ensure that proper posture and balance are restored.

Contracted Toe Tendon Damage

HammertoeOverview

hammertoes (hammertoe) is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, into an upward position, causing it to resemble a hammer (sometimes decribed as ?curled toes?). Left untreated, hammer toes can become inflexible and require surgery. Toes which hammertoes take on a curled appearance are hammer toes. Mallet toe is a similar condition, but affects the upper joint of a toe.

Causes

Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when there is no confining shoe.

Hammer ToeSymptoms

Hammer, claw, and mallet toes can cause discomfort and pain and may make it hard to walk. Shoes may rub on your toes, causing pain, blisters, calluses or corns, or sores. Sores can become infected and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease. If you have one of these health problems and sores develop, contact your doctor.

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

In the earlier stages of hammer toe, when the toes can still be manually straightened, then conservative treatment is appropriate. This means wearing shoes which are a half size bigger than normal and which are not narrow around the toes. Exercises to stretch the toes out and strengthen the muscles under the foot which balances the tightness of the top tendons are important. Padding or corn plasters can be used to ease the discomfort of any associated corns and calluses.

Surgical Treatment

If pinning the toe is not required during the procedure, then the surgery could be preformed in the doctor's office under a local anesthesia. Some patients prefer the comfort of sedation during the surgery and if this is the case or if a pin must be placed, then the surgery could be preformed in an outpatient surgery center.
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Hammertoes Treatment

Hammer ToeOverview
If the joint on one of your toes, usually the toe next to the big toe or the smallest toe, points upward rather than lying flat, you might have a Hammertoes. The condition is actually a deformity that happens when one of the toe muscles becomes weak and puts pressure on the toe?s tendons and joints. This pressure forces the toe to become misshapen and stick up at the joint. Also, there?s frequently a corn or callus on top of the deformed toe. This outgrowth can cause pain when it rubs against the shoe.

Causes
The incorrect position of the person's toes inside of their shoes also causes the formation of calluses or corns on the surfaces of their toes which are constantly bent as they are wearing inappropriate shoes because the surfaces are consistently rubbing against the hard materials of the interior of the shoes causing regular friction. Hammer Toe

Symptoms
People with a hammer toe will often find that a corn or callus will develop on the top of the toe, where it rubs against the top of the footwear. This can be painful when pressure is applied or when anything rubs on it. The affected joint may also be painful and appear swollen.

Diagnosis
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment
Often padding and taping are the first steps in a treatment plan. Padding the hammer toe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammer toe deformity.

Surgical Treatment
As previously mentioned it?s best to catch this problem early; hammer toe taping is relatively harmless and simple. Long term complications can cause foot deformities and even difficulty walking. It?s always best to stiff shoes and high heel, especially if you?re working on hammer toe recovery. Pick comfortable shoes with plenty of toe space. Prevention is the best cure here as this injury is nearly always self inflicted. Hammertoe

Prevention
Daily modifications and correct shoe choices can prevent and slow the progression of hammertoe deformities. The main cause in hammertoe deformities is muscle/tendon dysfunction. Wearing of ill-fitting, tight, high heeled shoes contributes to the progression to hammertoe deformities. Also, bunion conditions can enhance the formation of hammertoes. A key to prevention of hammertoes is the wearing of correct footwear, specifically shoes with appropriate support and a deep, wide toe box.

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