Onychomycosis
Onychomycosis is the fancy name for a fungal infection of the toenails and is a relatively minor problem, but is extremely difficult to treat. Well actually, in reality it is actually easy to treat, but its hard to stop happening again which gives the impression that it is hard to treat. The fungal agents that cause the onychomycosis thrive inside shoes where it is dark and moist. No matter what treatment is used, the foot is placed right back into the hostile environment that caused it in the first place!
Regardless of the treatment that is used, that environment that is so conducive to onychomycosis needs to be dealt with or this is going to be a problem for many years.
Obesity and Podiatry
Obesity is becoming a very big problem for society today. It is also becoming a big problem in podiatry practice for a couple of reasons. One is the load that it places on the foot and the problems associated with that and the other is the association of diabetes with obesity. Diabetes is associated with a very wide range of foot problems that can lead to serious complications such as diabetes.
Podiatrists need to play an increased role in the public health education of their patients about the impacts of obesity. Not only will it can help with a decrease in foot problems, but will also help with a decrease in the overall health burden.
Overpronation
“Overpronation” – I wish that term will go away. It is really meaningless but is widely used by runners and running shoe shops, especially when they have no idea what they are talking about. See this video and you see what I mean:
Runners fall for this stuff all the time. They come in the clinic and think they know more about it than I do. They need to read blogs this like this for some common sense. There is still a lot to be learnt about the role that this plays in injury risk and so many pronation myths.
Navicular Stress Fracture
I do hate seeing a navicular stress fracture as they usually occur in dedicated athlete who train hard and who put in long hours and are often competing at a high level. I hate seeing it as I have to tell them the news that they going to have to stop for about 6 weeks and then gradually start back to full training loads. No one wants to tell a high level athlete than and no high level athlete wants to be told that! Unfortunately, there is no way that they can heal in quicker than 6 weeks.
The key signs for a navicular stress fracture are pain over the navicular often located to a particular spot on the navicular (more)
Medial Tibial Stress Syndrome
Medial tibial stress syndrome is a common overuse injury in runners or other athletes that use a lot of running in their training. It is also the most common reason for leg pain when runners talk about “shin splints”. There are a number of different theories as to exactly what it is and a number of different theories as to what causes it.
The treatment usually involves modifying the training routine (eg issues like too much too soon); checking the running shoes; determining if any changes need to be made to the running form; correction of any biomechanical faults; address any issues with bending moments in the tibia; and gradual return to full activity.
The MBT Footwear
The MBT footwear (Masai Barefoot Technology) have been getting a lot of attention at the first and market leader in the so-called toning shoes category. The shoes are deliberately unstable to achieve a number of different effects. Firstly, as they are unstable the muscles have to work harder which is claimed to give the body and extra workout – ie the ‘tone up’. Secondly, they alter the alignment of the posture which can help some people with postural problems.
As to if these shoes actually achieve these effects or not is debatable. Yes, they do make the muscles work harder, but do not necessarily give that much of an extra tone up. Yes, they do alter the alignment of the posture which can help some people, but can equally hurt other people. There really is a lack of clear guidelines on this class of footwear. See these discussions and videos for more. There are plenty of opinions as to if they work or not.
Kohlers Disease
This is an uncommon problem of the tarsal navicular bone, but I have seen 3 in the last 2 weeks! They were all in 5-6 year old boys. They all caused the child to limp and all were really poor at telling me where it hurts, which is pretty typical for this age. Once the pain was located to the bone, it was clear what this probably was and the x-rays confirmed it. In each case the navicular on the affected side was ‘squashed’ compared to the other foot (see these x-rays). I put all 3 into walking braces to protect the foot. Will report back how they did.