Updates of whats up in Podiatry

Treating Hallux Rigidus with Rigid Carbon Plates

Soreness in the big toe joint that hurts when walking is generally frequently as a result of osteoarthritis and is frequently given the term more commonly called hallux rigidus when the joint is really rigid or hallux limitus if it is not too inflexible. Hallux rigidus is painful whenever walking, so if its really painful while resting, then it may well more often than not be gout symptoms than a hallux rigidus. Considering the hallux rigidus, while we are walking and the back heel commences to lift up off the floor, the big toe joint must move for this motion to happen. In the event that movement is limited or there’s a painful osteoarthritis in the big toe joint, then this is not going to be as easy to walk. It is logical when that hallux joint is painful when walking, then a plausible solution to help the pain on motion should be to restrict just how much the joint flexes.

There are many methods to try this. One simple method in which Podiatrists use is with felt padding that could be put on the foot beneath the big toe and ball of the foot or strapping can be utilized to strap the big toe joint. These two are usually really good short term measures, but just impracticable for the long run. Should you prefer a foot support for some other reasons, there’s an expansion that a Podiatrist could add on the front edge of the foot orthotic which is known as a Morton’s extension which they can use to restrict up the big toe joint by reducing bending or flexion of the feet. One other way is by using a carbon fibre insert plate that typically are less than 2mm thick so they can fit easily into the footwear and therefore are very inflexible. These kinds of carbon fibre plates are often used to treat hallux rigidus and other issues for example turf toe which need to limit the movement in the joint. The research evidence is these rigid insoles are rather good at reducing the pain in the hallux joint in these kinds of problems. An alternate way to manage the discomfort from the osteoarthritis and hallux rigidus could be to simply use shoes which are more inflexible across the ball of the foot. The more flexible the sole of the footwear is, the more that the big toe or hallux joint will flex and the much more likely it is to be painful when walking. There are a few types of footwear, especially the Hoka running footwear, that have a rocker and additional cushioning included in them which are especially helpful at this. The effect of the rocker in these shoes is that the great toe or hallux doesn’t have to flex just as much as the foot moves forward on the rocker. A pedorthist or footwear tech may add a rocker to many different types of shoes to obtain the same thing.

When you have hallux rigidus or arthritis in the big toe joint, then there are alternatives for the short term to take care of the discomfort and possibilities in the longer term to manage the movement of the big toe joint that it is not as painful.

April 14, 2023 Posted by | Arthritis, Foot Problems | Comments Off on Treating Hallux Rigidus with Rigid Carbon Plates

Calcaneal Apophysitis

Calcaneal Apophysitis is the technical name for severs disease. This is an injury or inflammation to the back of the heel bone in growing kids. The classic symptom is pain on squeezing the sides of the heel bone. The pain is usually present with activity and can limit sports participation.

This video from PodChatLive is an in-depth look into calcaneal apophysitis.

The standard treatment for this condition is to use a heel raise to lesson the pull from the achilles tendon and cushion the impacts with the ground. A reduction is sports activity is often needed. If none of these treatments help, then calcaneal apophysitis should be placed in a walking cast.

December 12, 2012 Posted by | Foot Problems | , | Comments Off on Calcaneal Apophysitis

Toe Walking

A lot of kid like to walk on their toes. They do so to make themselves taller. Generally it is off no consequences and they get over it. However, toe walking can also be due to a more serious problem so each case of toe walking does need to be taken seriously.

Toe walking is common in conditions like autism and cerebral palsy, but a number of other developmental and behavior problems can underpin it. If the child can get the heel to the ground easily and all the usual developmental milestones are reached, then the chances are that the toe walking is not a problem.

November 18, 2012 Posted by | Foot Problems | , | Comments Off on Toe Walking

Severs Disease

The most cause of heel pain in children is a condition known as Severs disease. The most common cause of pain is squeezing the sides of the heel near the posterior aspect. The pain is located in the bone and not in the joints and not in the tendon. It is usually only painful on activity and not at rest unless it has got really bad. There is debate if it should be called Severs disease or calcaneal apophysitis.

The standard treatment is lots of stretching of the calf muscles and a heel raise. A gel heel raise is commonly used for this. It is also common to reduce activity levels to help. Later a complete abstinence from sport may be needed if they the initial treatment does not help.

November 4, 2012 Posted by | Foot Problems | , | Comments Off on Severs Disease

Plantar Fasciitis

Plantar fasciitis is the life blood of so many podiatry clinics. It something we see day in and day out. It is the most common musculoskeletal problem seen in the foot and I suspect that for every case we see, there are several others out in the community not be being treated. If its painful under the heel and if it worse after resting (ie sleeping) for the first few steps then it is probably plantar fasciitis.

The most appropriate treatment for plantar fasciitis is stretching and lots of it. Foot orthotics also help a lot at reducing the load in the plantar fascia. There a lots of secret sauces, miracle cures that you can buy, but there is nothing secret or magical about them! But it all comes down to stretching and reducing the load in the plantar fascia. Run Junkie probably has the most sensible approach to plantar fasciitis that I have seen.

October 19, 2012 Posted by | Foot Problems | | Comments Off on Plantar Fasciitis

Growing Pains in Children

This is a really common problem and not a lot is really known about it. The classic symptoms are pain behind the knee that only occurs at night. generally it will wake the child from sleep and be distressing foe the child and parent. There are a number of rare conditions like bone tumors and juvenile arthritis that need to be ruled out as causing the pain, which is why the symptoms have to be taken seriously. The condition is self limiting and reassurance is all that is needed.

There is a paucity of research on growing pains with lots of opinions and ‘old wives tales’ on how to manage it. Most of these do seem to help in a lot of cases.

October 13, 2012 Posted by | Foot Problems | , | Comments Off on Growing Pains in Children

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.

September 25, 2012 Posted by | Foot Problems | Comments Off on Obesity and Podiatry

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.

September 1, 2012 Posted by | Foot Problems | | Comments Off on Kohlers Disease

Hallux Rigidus

Hallux rigidus is a problem of no or very limited motion at the big toe joint in the foot. It is almost always associated with osteoarthrtis of the joint and is usually painful. It also alters the gait and can result in compensations and symptoms in a number of other locations due to the way it alters the gait. The big toe joint is an important pivot for walking, so to loose that pivot due to hallux rigidus is significant. The only way to restore the pivot is with a rocker on the outside of the shoe or a surgical replacement of the joint. There are a number of things that can be done to help the symptoms and self exercises to mobilize the joint is always useful:

There is more on hallux rigidus at Podiatry Arena and you can ask a question about it at the Foot Health Forum.

August 31, 2012 Posted by | Foot Problems | Comments Off on Hallux Rigidus

Foot Pain

If you have foot pain, then the internet is a treasure trove of information as well as misinformation! A recent study on the quality of foot care information on the web did raise some concerns with it:

The overall quality of Internet information for common foot and ankle diagnoses is variable, raising concerns about what information is currently available to patients.

There is no substitution for good quality advice from a licensed health professional versus an anonymous blogger!

Some source of infromation are better than other. I have found two sites that professionals answer questions on foot problems to be particularly helpful: Foot Health Forum and Podiatry Experts. Like any online advice, take the information with caution.

August 7, 2012 Posted by | Foot Problems | | Comments Off on Foot Pain