The Best Way To Prevent Heel Spur

Heel Spur

Overview

A heel spur is a bony projection at the base of the heel bone, as defined by the website webmd.com. Heel spurs are often accompanied by plantar fasciitis, the inflammation of the soft tissues surrounding the spur, and that is what causes the pain in those who suffer from this condition. To cure or remove a heel spur you will need to see a podiatrist; however, there are some natural remedies and exercises that may help.

Causes

Athletes who participate in sports that involve a significant amount of jumping and running on hard surfaces are most likely to suffer from heel spurs. Some other risk factors include poor form while walking which can lead to undue stress on the heel and its nerves and ligaments. Shoes that are not properly fitted for the wearer?s feet. Poor arch support in footwear. Being overweight. Occupations that require a lot of standing or walking. Reduced flexibility and the thinning of the fat pad along the bottom of the heel, both of which are a typical depreciation that comes with aging.

Inferior Calcaneal Spur

Symptoms

You may or may not experience any symptoms with your heel spurs. It is normally the irritation and inflammation felt in the tissues around your heel spur that cause discomfort. Heel pain is one of the first things you may notice, especially when pushing off the ball of your foot (stretches the plantar fascia). The pain can get worse over time and tends to be stronger in the morning, subsiding throughout the day; although it does return with increased activity. A sharp, poking pain in your heel that feels like you’re stepping on a stone can often be felt while standing or walking. You will sometimes be able to feel a bump on the bottom of your heel, and occasionally bruising may appear.

Diagnosis

Your doctor, when diagnosing and treating this condition will need an x-ray and sometimes a gait analysis to ascertain the exact cause of this condition. If you have pain in the bottom of your foot and you do not have diabetes or a vascular problem, some of the over-the-counter anti-inflammatory products such as Advil or Ibuprofin are helpful in eradicating the pain. Pain creams, such as Neuro-eze, BioFreeze & Boswella Cream can help to relieve pain and help increase circulation.

Non Surgical Treatment

The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight, wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion to the heel, and reduce the amount of shock and shear forces experienced from everyday activities.

Surgical Treatment

Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery with typically smaller incisions on each side of your foot.

Prevention

The best way to prevent heel spurs is by wearing properly fitted footwear. Shoes should have a shock absorbing tread and soles and should be effective in supporting the heel and arch. Proper warm up and stretching before embarking on any physical activity that will put pressure or impact on the area is highly recommended. Also, just as it?s important for your general health, if you can lose some extra pounds, you will be more likely to avoid heel spurs. If you are starting to feel the onset of pain, it may not be heel spurs, but could be a tendonitis condition that could lead to heel spurs.

What Are The Signals Of Heel Spur

Heel Spur

Overview

Although a heel spur is often thought to be the source of heel pain, it rarely is. When a patient has plantar fasciitis, the plantar fascia pulls on the bottom of the heel bone. Over time this can cause a spur to form. Heels spurs are a very common x-ray finding, and because the heel spur is buried deep in soft tissue and not truly in a weight bearing area, there is often no history of pain. It is important to note that less than one percent of all heel pain is due to a spur. but frequently caused by the plantar fascia pulling on the heel. Once the plantar fasciitis is properly treated, the heel spur could be a distant memory.

Causes

There exists a membrane that covers most of the bone along the heel. When this membrane gets torn repeatedly due to straining of the muscles in the foot, the calcium deposits that lead to heel spurs are more likely to occur.

Heel Spur

Symptoms

Heel spurs result in a jabbing or aching sensation on or under the heel bone. The pain is often worst when you first arise in the morning and get to your feet. You may also experience pain when standing up after prolonged periods of sitting, such as work sessions at a desk or car rides. The discomfort may lessen after you spend several minutes walking, only to return later. Heel spurs can cause intermittent or chronic pain.

Diagnosis

A Heel Spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The plantar fascia is the thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.

Non Surgical Treatment

Get some rest. You need to stay off of your aching foot as much as possible for at least a week. Think about possible causes of the problem while you’re resting and figure out how you can make some changes. Some actions that can contribute to heel spurs include running too often or running on hard surfaces such as concrete, tight calf muscles, shoes with poor shock absorption. Ease back into your activities. In many cases, you’ll be in too much pain to go ahead with a strenuous exercise routine that puts pressure or impact on your heel. Listen to your body and switch to different activities such as swimming or riding a bike until your heel spurs improve.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

Prevention

There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.

Best Cure For Bursitis Of The Foot

Overview

A properly functioning heel is essential to normal, smooth, and painless gait. The heel is the first area to strike the ground during normal gait, which means it takes the brunt of the stress incurred during walking and running activities. Of course, this also means that the heel is highly prone to injury. One such injury is called heel bursitis.

Causes

Overtraining in an athlete. Tight or poorly fitting shoes that produce excessive pressure at the posterior heel. Haglund deformity. Altered joint axis. Inflammation of the calcaneal bursae is most commonly caused by repetitive (cumulative) trauma or overuse, and the condition is aggravated by pressure, such as when athletes wear tight-fitting shoes. Retrocalcaneal bursitis may also be associated with conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies. In some cases, retrocalcaneal bursitis may be caused by bursal impingement between the Achilles tendon and an excessively prominent posterosuperior aspect of the calcaneus (Haglund deformity). In Haglund disease, impingement occurs during ankle dorsiflexion.

Symptoms

When the bursa becomes inflamed after an injury, symptoms usually develop suddenly. When the bursa develops without an injury, symptoms may develop gradually. With both posterior and anterior Achilles tendon bursitis, symptoms usually include swelling and warmth at the back of the heel. A minimally red, swollen, tender spot develops on the back of the heel. When the inflamed bursa enlarges, it appears as a red lump under the skin of the heel and causes pain at and above the heel. If posterior Achilles tendon bursitis becomes chronic, the swelling may become hard, fluid-filled, and red or flesh-colored.

Diagnosis

When a patient has pain in a joint, a careful physical examination is needed to determine what type of movement is affected and if there is any swelling present. Bursitis will not show up on x-rays, although sometimes there are also calcium deposits in the joint that can be seen. Inserting a thin needle into the affected bursa and removing (aspirating) some of the synovial fluid for examination can confirm the diagnosis. In most cases, the fluid will not be clear. It can be tested for the presence of microorganisms, which would indicate an infection, and crystals, which could indicate gout. In instances where the diagnosis is difficult, a local anesthetic (a drug that numbs the area) is injected into the painful spot. If the discomfort stops temporarily, then bursitis is probably the correct diagnosis.

Non Surgical Treatment

According to the National Institutes of Health, custom heel wedges can be purchased by people suffering from retrocalcaneal bursitis. These wedges reduce stress on the heel, which can reduce the pain and inflammation associated with an inflamed bursa. They can be purchased without a prescription, making it easy for anyone experiencing a flare-up of symptoms to get the added support of these wedges.

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.

Prevention

Continue to wear your orthotics for work and exercise to provide stability and restore foot function. Select suitable shoes for work and physical activity that provide stability for the heel. Regular stretching of the calf muscle can prevent heel bursitis. Do not suddenly increase activity amount without appropriate conditioning.

Contracted Toe Tendon Surgical Treatment

HammertoeOverview

A Hammer toe is commonly mistaken as any type of toe deformity. The terms claw toe, or mallet toe, although technically different than a hammer toe, are commonly referred as such. The toe may be flexible with movement at the joints, or it may be rigid, especially if it has been present for a long time. With a true hammertoe the deformity exists at the proximal interphalangeal joint only.

Causes

Hammertoes are more commonly seen in women than men, due to the shoe styles women frequently wear: shoes with tight toe boxes and high heels. Genetics plays a role in some cases of hammertoes, as does trauma, infection, arthritis, and certain neurological and muscle disorders. But most cases of contracted toes are associated with various biomechanical abnormalities of the feet, such as flat feet and feet with abnormally high arches. These biomechanical abnormalities cause the muscles and tendons to be used excessively or improperly, which deforms the toes over time.

Hammer ToeSymptoms

Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be treated conservatively and/or with surgery.

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

In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases podiatric surgery may be necessary to correct the deformity. The patient’s doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.

Surgical Treatment

If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the toe. The procedures used vary greatly, depending upon the reasons for the hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint capsule repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the toe to straighten. The temporary use of pins or K-wires may be necessary to keep the toe straight during the Hammer toe healing period. Joint implants are sometimes used to allow for a better range of motion in the toe following surgery. Digital arthrodesis involves the removal of bone from the bent joint and fusing the toe in a straight position. If the corn is due to a bone spur, the most common procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.

Bunion Splint Effectiveness

Overview
Bunions Hard Skin
A bunion is an enlargement of bone at the great toe joint. Tight shoes don’t cause bunions, but they can aggravate them. Bunions are often inherited and become worse over time if left untreated they can cause pain, swelling, skin irritation and other foot problems. Bunion deformities are often part of a more generalized problem related to improper foot motion. There are presently over 25 types of bunion procedures performed today. The choice of procedure is based on many factors.

Causes
Bunions can be caused by improper footwear. Genetics. Foot injuries. Congenital deformities. Medical conditions such as arthritis. Stress on feet. Bunions are mainly caused by genetics. The bunion itself is not inherited, but the person?s hereditary foot type and gait pattern makes them more prone to developing bunions.You can also begin to develop bunionsby wearing shoes that are too tight or too small. When you wear shoes of this nature, your toes are squeezed together. Bunions are not caused by crowding of the toes, but wearing tight shoes can worsen the condition and cause symptoms to appear sooner. Some people are born with birth defects that put them at higher risk for developing bunions.
SymptomsWith the positional change of the hallux, pain is a common occurrence. As the foot goes through the gait cycle the hallux plays an integral role as the body’s weight transmits through during propulsion. With this in mind, it easy to see how the change in the hallux joints (metatarsal phalangeal joint and the proximal interphalangeal) would cause joint narrowing and early degeneration of the articular cartilage. In addition, two small bones (ossicles) found underneath just behind the joint will start placing extra pressure on the metatarsal. Along with bony changes, there are many soft tissue changes as the hallux and metatarsal reposition, which causes added strain to other bony structures and can accelerate the problem.

Diagnosis
Most patients are diagnosed to have bunions from clinical history and examination. However, in some cases, X-rays will be performed to determine the extent of damage to the joint. Furthermore, it will enable the treating doctor to decide on the best course of management of the patient.

Non Surgical Treatment
Your podiatrist can recommend exercises, orthoses (special devices inserted into shoes), shoe alterations or night splints (which hold toes straight over night) which may slow the progression of bunions in children. According to experts, ?conservative? measures such as these may help relieve symptoms, though there is no evidence they can correct the underlying deformity. Orthoses are designed to prevent the problem getting worse by decreasing any biomechanical causes of bunions. In other words, if the biomechanical theory is correct (i.e. if your bunions are caused by the way you walk), orthoses may help you walk in a way that doesn?t exacerbate the problem. But it won?t change the already established shape of your foot. For that, you need surgery.
Bunions Hard Skin

Surgical Treatment
The most significant portion of the bunion surgery is re-aligning the bones. This is performed though bone cuts or a fusion involving the first metatarsal. The severity of the bunion determines where the bone will be cut or fused. Mild or moderate bunions can be corrected close to the big toe joint. Moderate or large bunions often require that the bone work be performed further away from the big toe joint to swing the bone in the proper position.

How Can I Tell If I’Ve Got Over-Pronation

Overview

You know when we walk in the sand on the beach? Well, that?s how nature meant us to walk! You will notice how the sand forms a complete support under the foot. Unfortunately, instead of soft natural surfaces, we walk mainly on hard surfaces like pavements and floors. These hard surfaces cause the foot to roll inwards and the arches to flatten to gain ground contact. This condition is called ?over-pronation? and it affects an estimated 70% of the population. Over-pronation can lead to various foot problems such as heel pain and ball of foot pain. Because our feet are the foundation of our body, poorly aligned feet may also cause problems in other parts of the body, resulting in shin pain, aching legs, knee pain, even lower back pain.Over Pronation

Causes

Generally fallen arches are a condition inherited from one or both parents. In addition, age, obesity, and pregnancy cause our arches to collapse. Being in a job that requires long hours of standing and/or walking (e.g. teaching, retail, hospitality, building etc) contributes to this condition, especially when standing on hard surfaces like concrete floors. Last, but not least unsupportive footwear makes our feet roll in more than they should.

Symptoms

Due to the laxity of the soft tissue structures of the foot, and the fact that the joints are not held together properly, the bones of the feet shift. When this occurs, the muscles that attach to these bones must also shift, or twist, in order to attach to these bones. The strongest and most important muscles that attach to our foot bones come from our lower leg. So, as these muscles course down the leg and across the ankle, they must twist to maintain their proper attachments in the foot. This twisting of these muscles will cause shin splints, Achilles Tendonitis, generalized tendonitis, fatigue, muscle aches and pains, cramps, ankle sprains, and loss of muscular efficiency (reducing walking and running speed and endurance). The problems we see in the feet, which are due to over-pronation include bunions, heel spurs, plantar fasciitis, fallen and painful arches, hammertoes, metatarsalgia (ball of foot pain), and calluses.

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.Over-Pronation

Non Surgical Treatment

Flat feet and fallen arches can be treated effectively by wearing an orthotic insert in your shoes. Orthotics can be custom-made and prescribed by your foot specialist (podiatrist), or you can use a so called pre-made foot orthotic. Most people do not require expensive custom-made orthotics to combat excess pronation, unless they have a specific medical foot condition. Footlogics orthotic insoles were developed to correct excess pronation, thereby providing sustainable, long-lasting pain relief to many aches and pains in a natural way. Footlogics Comfort, Casual and Sports are products which promote excellent biomechanical control of the foot.

Surgical Treatment

HyProCure implant. A stent is placed into a naturally occurring space between the ankle bone and the heel bone/midfoot bone. The stent realigns the surfaces of the bones, allowing normal joint function. Generally tolerated in both pediatric and adult patients, with or without adjunct soft tissue procedures. Reported removal rates, published in scientific journals vary from 1%-6%.

Severs Disease Physical Therapy

Overview

Sever’s disease is a painful irritation in the heel bone of the foot. It is the most common cause of heel pain in children and teens. Sever?s disease is also called calcaneal apophysitis.

Causes

A big tendon called the Achilles tendon joins the calf muscle at the back of the leg to the heel. Sever?s disease is thought to occur because of a mismatch in growth of the calf bones to the calf muscle and Achilles tendon. If the bones grow faster than the muscles, the Achilles tendon that attaches the muscle to the heel gets tight. At the same time, until the cartilage of the calcaneum is ossified (turned into bone), it is a potential weak spot. The tight calf muscle and Achilles tendon cause a traction injury on this weak spot, resulting in inflammation and pain. Sever?s disease most commonly affects boys aged ten to 12 years and girls aged nine to 11 years, when growth spurts are beginning. Sever?s disease heals itself with time, so it is known as ?self-limiting?. There is no evidence to suggest that Sever?s disease causes any long-term problems or complications.

Symptoms

Sever?s is recognized by pain in the back and lower regions of the heel. It usually starts during or immediately following the child’s growth spurt, and/or in very active individuals. The child will usually have pain during or following participation in sport, and will often be seen limping off the field or court. Symptoms of Sever’s include painful heel, no swelling or warmth, night pain is absent, pain is worse with increased activity, pain which is usually relieved by rest. Children often hobble or limp from the sports field.

Diagnosis

This can include physical examination and x-ray evaluation. X-rays may show some increased density or sclerosis of the apophysis (island of bone on the back of the heel). This problem may be on one side or bilateral.

Non Surgical Treatment

A doctor, sports therapist or physiotherapist can apply a plaster cast or boot if the child is in severe pain. This may be worn for a few days or even weeks and should give relief of pain for a while. Carry out a full biomechanical assessment. This may help to determine if any foot biomechanics issues are contributing to the condition. Orthotics or insoles can be prescribed to help correct over pronation or other biomechanics issues. Prescribe anti-inflammatory medication such as ibuprofen to reduce pain and inflammation. This will not be prescribed if asthma the child has asthma. In persistent cases X-rays may be taken but this is not usual. A doctor, sports therapist or physiotherapist will NOT give a steroid injection or operate as these are not suitable treatment options. The condition will usually settle within 6 months, although it can persist for longer.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.