Bursitis Of The Foot Physiology

posted on 25 Aug 2015 12:29 by greatnugget8794
Overview

In the foot we have a unique situation in that between the shoes that we wear and the ground that we walk on various parts of the foot are constantly being ?micro? traumatized meaning that every time we take a step we do a small amount of damage to a particular part of the foot and eventually that part of the foot begins to hurt. The body?s response to this micro-trauma is to create a bursal sac to initially protect the area but if micro-traumatized enough the bursal sac itself becomes inflamed and we have a bursitis.

Causes

Overtraining in a runner (eg, excessive increases in miles or intensity). Tight or poorly fitting shoes that, because of a restrictive heel counter, exert excessive pressure on the posterior heel and ankle

Haglund deformity, causing impingement between the increased posterior superior calcaneal prominence and the Achilles tendon during dorsiflexion. More recent research suggests that a misaligned subtalar joint axis (measured in terms of joint inclination and deviation) in relation to the Achilles tendon can result in an asymmetrical force load on the tendon, disrupting normal biomechanics. This altered joint axis is associated with an increased risk for Achilles pathologies, including bursitis.

Symptoms

A person with bursitis can have one or more of the symptoms below. Pain, the pain increases with movement or pressure. Tenderness is felt even without movement. Swelling. Loss of movement. If the bursitis is caused by an infection it is called Septic Bursitis. The patient with septic bursitis may have the following additional symptoms. Fever. The affected area is red. The affected area feels hot when touched.

Diagnosis

Medical examination is not necessarily required in light cases where the tenderness is minimal. In all cases where smooth improvement is not experienced, medical attention should be sought as soon as possible to exclude a (partial) rupture of the Achilles tendon or rupture of the soleus muscle. This situation is best determined by use of ultrasound scanning, as a number of injuries requiring treatment can easily be overlooked during a clinical examination (Ultrasonic image). Ultrasound scanning enables an evaluation of the extent of the change in the tendon, inflammation of the tendon (tendinitis), development of cicatricial tissue (tendinosis), calcification, inflammation of the tissue surrounding the tendon (peritendinitis), inflammation of the bursa (bursitis), as well as (partial) rupture.

Non Surgical Treatment

Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.

Surgical Treatment

Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

Prevention

Maintain proper form when exercising, as well as good flexibility and strength around the ankle to help prevent this condition. Proper stretching of the Achilles tendon helps prevent injury.

Can Hammer Toes Trigger Leg Pain

posted on 02 Jul 2015 18:11 by greatnugget8794
Hammer ToeOverview

What are hammertoes, mallet toes and claw toes? Often the words are used interchangeably to mean an abnormally contracted toe like the drawing above. Technically speaking, a "Hammer toe" is the name for a toe that is contracted at the first toe joint. If it's contracted at the second toe joint it is called a "mallet toe". IIf a toe is contracted at both toe joints, it is called a "claw toe". Each of these conditions can be quite uncomfortable and are cosmetically unappealing.

Causes

Hammer toe is often caused by wearing shoes that do not fit properly. If shoes are too small either in length or width, then the toes are held in a shortened position for long periods and the muscles eventually shorten and pull the toes into the bent position. Alternatively it can be caused by overactivity in the extensor digitorum dongus muscle (right) and a weakness in the counteracting muscle under the foot, such as flexor digitorum longus. Sometimes it can be a congenital condition, meaning it is present from birth. It is also more common in those with arthritis in the foot or diabetes.

Hammer ToeSymptoms

People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.

Diagnosis

Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.

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 Hammer toe is relatively safe fast, you may deal with some stiffness afterwards.

Surgical Treatment

Any surgery must be carefully considered and approached in a serious manner, as any procedure is serious for the patient. But in most cases the procedure is relatively straight forward. The surgery can be done using local anesthetic and does not require hospitalization. The patient goes home in a special post-operative shoe or a regular sandal, and in most cases can walk immediately. That's not to say that the patient is walking or functioning normally immediately after the procedure. The patient must take some time off work to rest the foot and allow it to heal.

HammertoePrevention

These tips may help you buy the right shoes. Buy shoes at the end of the day. Your feet are smaller in the morning and swell throughout the day. Don't assume your shoe size hasn't changed. As you age, your shoe size may change, especially the width. Measure both feet and buy for the larger foot. Ask for just the right fit. A shoe repair store can stretch shoes in tight spots.

Is Hammer Toe Uncomfortable

posted on 28 Jun 2015 23:06 by greatnugget8794
HammertoeOverview

hammertoes is a painful deformity wherein a toe bends unnaturally. Hammertoe can develop on any of the toes, but generally affects the middle three Hammer toe and, most often, the second toe. When unusual stress is applied over a period of years, the joints and tendons of your foot can cease to function in a balanced manner and toes, in an effort to compensate, can begin to bend into the hammertoe shape. Hammertoes tend to run in families.

Causes

The cause of hammertoes varies, but causes include genetics, arthritis and injury to the toe. Treatment for hammertoes depends on the severity and can include anti-inflammatory medication, metatarsal pads, foot exercises and better-fitting shoes. If the pain caused by a hammertoe is so severe that wearing a shoe is uncomfortable, surgery may be necessary. Typically this surgery is an outpatient procedure that doesn?t require general anesthesia, though it is an option. Recovery from surgery usually takes a few weeks, and patients are given special shoes to wear.

Hammer ToeSymptoms

Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis

Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.

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

Surgical Options: Several surgical procedures are available to the podiatric physician. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain. Severe hammer toes, which are not fully reducible, may require more complex surgical procedures. Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatrist.