Achilles Tendon Injuries
The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.
The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.
A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.
If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.
Plantar Fasciitis
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.
There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.
People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.
Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.
If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.
The Importance of Biomechanics in Podiatry
Biomechanics and its related study deal with the forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
Biomechanics and its related study deal with forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root founded Root Lab to make custom orthotics. He proposed that corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of foot orthotics to this day.
As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can take readings and also map out what treatment will do to the affected areas.
These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics are able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot. Speak with your podiatrist if you have any of these problems.
What is a Podiatrist?
A podiatrist is a Doctor of Podiatric Medicine who treats the foot, ankle, and related structures of the leg. If you are having any pain, injuries, or abnormalities in these areas, it is best that you seek help from a podiatrist.
Podiatrists complete four years of training in a podiatric medical school. Their training is like that of other physicians, and they may go on to complete a fellowship training after a residency training. Some podiatrists are board certified meaning they have advanced training, clinical experience, and have taken an exam to prove their skills. Certifying boards for podiatry are the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine. Podiatrists may work in private practices, hospitals, clinics, or they may even become professors at colleges of podiatric medicine.
While in college, those who want to be podiatrists often take biology, chemistry, and physics classes in preparation for podiatry school. In podiatry school, students study how the bones, nerves, and muscles work together to help you move around. Additionally, they study injuries and how to properly diagnose and treat them. Admittance into podiatric medical school requires the completion of 90 semester hours of undergraduate study with a good grade point average, and acceptable scores on the MCAT (Medical College Admission Test)
Podiatrists treat many different conditions such as: aching feet, ankle pain, bunions, corns, hammertoes, fungus, ingrown toenails, plantar fasciitis, sprains and more. Common forms of treatment for these conditions are physical therapy, drugs, or surgery. Podiatrists may also recommend corrective shoe inserts, custom-made shoes, plaster casts, and strappings to correct deformities.
Even if you are someone whose feet are in generally good condition, you should still visit a podiatrist to have your feet properly exfoliated and maintained, or to make sure you are looking after your feet properly.
Blisters
Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.
The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.
The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.
If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.
Treating Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.
Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.
If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.
Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.
If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.
The Causes, Types, and Treatments of Achilles Tendon Injuries
Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking.
Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.
Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.
The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.
Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.
An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.
Plantar Fibroma
A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas. Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.
Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
Three Grades of Ankle Sprains
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
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Arthritic Foot Care
During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in each of your feet will lose flexibility and elasticity. Your foot’s natural shock absorbers will wear down as well. Having arthritis added to this mix only makes matters worse. Your joints will become distorted and inflamed, which is why arthritic foot care needs to be something to think about every day.
When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buy well-fitting shoes with a lower heel and good support. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.
Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.
Exercise is another key aspect of arthritic foot care. Exercise not only strengthens and stretches your muscles and joints, but helps to prevent further injury and pain as well. Stretching the Achilles tendon, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.
Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well. You will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together. Then, pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet. Then, try to separate each individual toe, stretching them all.
A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately, there is no complete way to remove all of your arthritic pain. However, following some of this advice can go a long way in staying as pain-free as possible.
Rheumatoid Arthritis in the Feet
Rheumatoid Arthritis is a chronic progressive disease that attacks several joints throughout the body. It is an autoimmune disease in which the body’s immune system mistakenly attacks the joints. As a result, the tissue inside the joints, called synovium, starts to thicken and causes pain around the joints. The synovium is responsible for creating a fluid that lubricates the joints to help them move. Approximately 1.5 million people in the United States have Rheumatoid Arthritis. Women are almost three times as likely to have RA compared to men, and it’s disease usually begins between the ages of 30 and 60. People who have a genetic history of RA are more likely to develop the disease.
Symptoms of RA may include the following sensations in the joints: pain, tenderness, swelling, redness, warmth, stiffness, and loss of range. Swollen joints are a very common symptom for those with the disease. At times, it may be minimal, but it may also be very apparent. Another typical symptom is joint stiffness. Doctors will often use the direction of morning stiffness to measure the severity of a patient’s joint inflammation. Other RA symptoms include limping, anemia, fever, and fatigue.
To diagnose RA, your podiatrist will typically request x-rays to see how much damage there is in the joints. Blood tests may also be performed to show if there are any signs of anemia, or antibodies such as the rheumatoid factor. If you have previously been diagnosed with RA, you should know the disease may spread to your feet and ankles.
There are many non-surgical options that can be used to treat this ailment. Some of these options include physical therapy, foot massages, orthotics, bracing, supportive shoes, and steroid injections. Physical therapy is useful because it will help stretch and strengthen the joints in both the foot and ankle to improve joint function. Massages can help improve blood circulation which will be good for the feet. Choosing proper footwear will allow you to walk with comfortability if you are a sufferer from RA. Lastly, bracing will help stabilize the foot joints, limit deformities and decrease pain.
In severe cases, surgery may be a treatment option that should be considered. For those who cannot walk without experiencing pain and those whose deformities can not be managed with braces, surgery should be considered. Your podiatrist will recommend surgery if he or she believes it will improve your foot biomechanics.
Causes, Symptoms, and Treatment for a Broken Foot
One out of ten broken bones is reported to be in the feet. When an object crushes, bends, or stretches the bone beyond acceptable ranges, bones break. A break in the foot is either a fracture or a straight break.
The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked hard and with great force. Heel breaks almost always are a result of an improper landing from a tall height. Twists or sprains are the other two frequent occurrences. As with all usual breaks, they result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time from repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break. Stress fractures result from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.
Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high, as are a few other particular bones. As the severity of the broken foot increases, symptoms like blueness, numbness, misshaping of the foot, cuts, or deformities will become apparent. These symptoms indicate the need to see a medical professional with access to an x-ray facility.
Prior to seeing a specialist, precautions should be taken to reduce pain and swelling. Elevate and stabilize the foot, and refrain from moving it. Immobilization of the foot is the next priority, so creating a homemade splint is acceptable. Keep in mind that while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and relieve pain symptoms.
When dealing with a medical center, the patient should note that the treatment can vary. The treatment will depend on the severity of the fracture and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bones.
Solutions for Cracked Heels
Cracked heels can make life very frustrating and embarrassing when displaying the bare feet. Aside from being unpleasing to the eye, they can also tear stockings and socks and wear out shoes at a faster rate. When severe, cracked heels may cause pain or infection.
Cracked heels are a problem for those who are athletic, those who may walk a lot, and those who have especially dry skin. Those who use medication that dry the skin, those who swim often, wearing certain types of shoes, and those who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil may also have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.
Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter. Others are prescribed by a doctor, especially for those who have chronic dry feet and heels.
Some doctors recommend wearing socks at night for those with rough skin. This helps further healing, and helps creams stay on longer and better absorb into the skin.
One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to buff away dead skin before putting on moisturizer can also help. Cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.
Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it. Taking supplements of omega-3 fatty acids and zinc can also be very beneficial.
Nevertheless, not all products are guaranteed to help treat cracked feet. Seeing a professional is best if other treatments options were unsuccessful. A podiatrist should be able to give the best advice to help with this problem.
