Overview
A Hammer toes is a term used to describe a crooked, deviated, or contracted toe. Although the condition usually stems from muscle imbalance, it is often aggravated by poor-fitting shoes or socks that cramp the toes. Over a period of years, the tendons that move the toe up and down begin to pull the toe with unequal tension, and the toe then begins to buckle or become contracted, causing an abnormal "v"-shaped bending of the little toes. Patients with this condition often experience pain, swelling, redness and stiffness in the affected toes. Causes Essentially, hammertoes are caused by an abnormal interworking of the bones, muscles, ligaments and tendons that comprise your feet. When muscles fail to work in a balanced manner, the toe joints can bend to form the hammertoe shape. If they remain in this position for an extended period, the muscles and tendons supporting them tighten and remain in that position. A common factor in development of hammertoe is wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Most likely due to these factors, hammertoe occurs much more frequently in women than in men. Symptoms Patients with hammer toe(s) may develop pain on the top of the toe(s), tip of the toe, and/or on the ball of the foot. Excessive pressure from shoes may result in the formation of a hardened portion of skin (corn or callus) on the knuckle and/or ball of the foot. Some people may not recognize that they have a hammer toe, rather they identity the excess skin build-up of a corn.The toe(s) may become irritated, red, warm, and/or swollen. The pain may be dull and mild or severe and sharp. Pain is often made worse by shoes, especially shoes that crowd the toes. While some hammer toes may result in significant pain, others may not be painful at all. Painful toes can prevent you from wearing stylish shoes. Diagnosis Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes. Non Surgical Hammer toes Treatment People with a hammer toe benefit from wearing shoes in which the toe box is made of a flexible material and is wide enough and high enough to provide adequate room for the toes. High-heeled shoes should be avoided, because they tend to force the toes into a narrow, flat toe box. A doctor may recommend an insert (orthotic) for the shoe to help reduce friction and pressure on the hammer toe. Wearing properly fitted shoes may reduce pain and inflammation. It may also prevent ulcers from developing and help existing ulcers heal. However, the hammer toe does not disappear. Surgical Treatment If your hammer, claw, or mallet toe gets worse, or if nonsurgical treatment does not help your pain, you may think about surgery. The type of surgery you choose depends on how severe your condition is and whether the toe joint is fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be straightened without surgery. Surgery choices include Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone. Joint fusion (arthrodesis), in which the surgeon removes part of the joint, letting the toe bones grow together (fuse). Cutting supporting tissue or moving tendons in the toe joint. How well surgery works depends on what type of surgery you have, how experienced your surgeon is, and how badly your toes are affected. Overview
To better understand how the muscles and tissue structures in the feet, ankles, legs and hips are adversely affected by overpronation, imagine a person on the end of a bungee cord jumping off a bridge. If the bungee cord gets the right amount of tension on it as the person nears the ground, then he or she will be saved from smashing into the earth. However, if the bungee cord does not pull tight because it is twisted or has no elasticity, then the person will impact the ground with dire consequences. The muscles, tendons, ligaments, and fascia of the legs and feet are the body's bungee cords. If these bungee cords work together, they can protect the joints of the feet and ankles from excessive stress, and prevent muscle and tissue damage caused by overpronation. If they do not work properly, a person will be able to see evidence of this in the feet and ankles, particularly in the alignment of the joints. Causes Over-pronation occurs when the foot collapses too far inward stressing the plantar fascia (the area underneath the arch of the foot.) Normally, one pronates every time he or she walks, but excessive pronation is called over-pronation. When this occurs it can cause pain in the feet, knees, hips, low back and even the shoulder. Decreasing over-pronation, which is very prominent in runners, will help add endurance, speed and efficiency to your run and ultimately place less stress on your body. Symptoms Symptoms can manifest in many different ways. The associated conditions depend on the individual lifestyle of each patient. Here is a list of some of the conditions associated with Over Pronation. Hallux Abducto Valgus (bunions). Hallux Rigidus (stiff 1st toe). Arch Pain. Heel Pain (plantar fascitis). Metatarsalgia (ball of the foot pain). Ankle sprains. Shin Splints. Achilles Tendonitis. Osteochondrosis. Knee Pain. Corns & Calluses. Flat Feet. Hammer Toes. Diagnosis Look at the wear on your shoes and especially running trainers; if you overpronate it's likely the inside of your shoe will be worn down (or seem crushed if they're soft shoes) from the extra strain. Non Surgical Treatment Over-Pronation can be treated conservatively (non-surgical treatments) with over-the-counter orthotics. These orthotics should be designed with appropriate arch support and medial rearfoot posting to prevent the over-pronation. Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improper fitting footwear can lead to additional problems of the foot. Prevention Custom-made orthotics supports not only the arch as a whole, but also each individual bone and joint that forms the arch. It is not enough to use an over-the-counter arch support, as these generic devices will not provide the proper support to each specific structure of the arch and foot. Each pronated foot?s arch collapses differently and to different degrees. The only way to provide the support that you may need is with a custom-made device. This action of the custom-made orthotic will help to prevent heel spurs, plantar fasciitis, calluses, arch pain, and weakness of the entire foot. Overview
This is a condition that is quite often misdiagnosed as growing pains this generally affects boys more than it may affects girls, especially between the ages of 9 and 15. This is a common disease in children that play the following sports. Soccer. Football. Basketball. Hockey. However it is not limited just to these sports, nor is it simply a pre-season type condition related to fitness. Sever?s Disease is common and although it does not sound good there is no need to panic as it is not something you can catch or incurable. Children have a growth plate in the heel bone, which at puberty becomes solid and forms part of the heel, prior to puberty this can cause pain especially if the child?s foot rolls inwards or outwards too much, this can cause increased stress on this growth plate and therefore causes pain. Causes Sever's Disease typically affects boys and girls between 8-15 years of age. Risk factors include. Athletic activity that involves heel contact with hard surfaces, as in gymnastics, track, soccer, basketball, ice skating, ballet and aerobics. The wearing of ill-fitting shoes. Well-made shoes that fit properly are a must for every child. Prolonged periods of standing. If a child complains of heel pain after choir practice, doing dishes, standing in lines or other activities that put pressure on the heel bones, pay attention. Symptoms Athletes with Sever?s disease are typically aged 9 to 13 years and participate in running or jumping sports such as soccer, football, basketball, baseball, and gymnastics. The typical complaint is heel pain that develops slowly and occurs with activity. The pain is usually described like a bruise. There is rarely swelling or visible bruising. The pain is usually worse with running in cleats or shoes that have limited heel lift, cushion, and arch support. The pain usually goes away with rest and rarely occurs with low-impact sports such as bicycling, skating, or swimming. Diagnosis Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of clinical information was not reliable. Non Surgical Treatment First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 25 minutes three times a day. Your child should not go barefoot. If your child has severe heel pain, ibuprofen (Advil) will help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches five times each, two or three times a day. Each stretch should be held for 20 seconds. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, have your child stand facing a wall to stretch the calves and the heel cord. Place one foot a shoulder?s width in front of the other, both feet facing the wall. The front knee is bent and the back knee is straight during the calf stretch. Then have your child push against the wall and feel the stretch in his or her back leg. To stretch out the heel cord, have him or her stay in the same position and bend the back knee. Repeat three times. Practice this stretch twice daily.
Overview
Achilles tendon rupture are common. Most athletes describe a sudden acute event with an associated popping sensation and pain in the Achilles tendon. They often think that they have been kicked or struck in the calf. It is important to get prompt treatment and to be placed in an equinous cast (a cast with the foot in a pointed position). More definitive treatment options can be discussed after this has occurred. Causes The Achilles tendon can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Achilles tendon rupture is more common in those with preexisting tendinitis of the Achilles tendon. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics, including quinolones such as levofloxacin [Levaquin] and ciprofloxacin [Cipro]) can also increase th |
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