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.
Laser Treatment for Fungal Nails
This has been getting a lot of publicity all over the media and especially, on YouTube. Lots or providers widely touting it and its benefits. Fungal nails or onychomycosis is notoriously difficult to treat, so any new treatment that comes along needs to be considered. The problem with any treatment for fungal nails is that it can take 6 or more months to know if it works and the re-infection rate is so high. This means that even if a treatment is fantastic, there is no guarantee that you will not get the fungal nail problem again! Because of this good evidence is needed on the laser treatment of fungal nails compared to the other standard treatments. The laser treatment is not cheap and we just do not know how effective it is compared to other methods.
There is plenty of debate and advice, but no good scientific evidence as to it effectiveness.
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.
The Foot Detox
I can’t believe that people are so gullible that they fall for this. A detox to remove toxins from the body via the foot. Its physiologically impossible. Its ludicrous.
The foot detox is a scam (see this) and does not work and will never work. See these videos for more.
Forensic Podiatry
Forensic podiatry is an interesting and fascinating discipline. It uses the expertise and skills that from podiatry in criminal investigations.
Some of these skills include footwear investigations, wear patterns in shoes and insoles and gait analysis. See these links here for more.
Cracked Heels
This is a problem that we see often and should not have to see as it can easily be managed by the individual if they are prepared to put in the effort to manage it. The cracks develop in the callus and dry skin around the heel. These fissure never heel and will tear on the good skin underneath which can become very painful. As long as the dry skin is kept moist and the thick skin is kept down, this is not going to be a problem.
Self care is the key to this condition. There is a good resource here on cracked heels. It really comes down to either putting the effort in to maintain it or coming and seeing a Podiatrists every few months. I give people the option. There is no miracle cure. Get the products you need and get going. Cracked heels is manageable.