How Can I Tell If I'Ve Got Over-Pronation Of The Feet
Overview
Normal, healthy feet pronate! Normal pronation does not need to be ?corrected?. However, some people OVER-pronate. Those people need a shoe that supports their over-pronating foot to help guide the foot and avoid injury. So, what does pronation mean exactly? Well, ?pronate? is the word used to describe the natural motion of the foot after it strikes the ground. When a person with a normally pronating foot runs, the outside part of the heel strikes the ground. As the individual shifts the body weight forward, the foot rolls inward (pronates) and the entire foot comes into contact with the ground. This allows the foot to properly support the body and absorb the impact forces. Motion continues forward and the peron pushes off (called ?toe off?) evenly from the front of the foot. Someone who OVER-pronates strikes the ground with the heel in the same way, but the foot rolls too far inward (overpronation). This causes foot and ankle strain, as it does not allow the foot and ankle to properly support the body nor to properly absorb the impact forces. As motion continues forward, they will toe-off more from the ball of her foot. Runners who overpronate are susceptible to foot, ankle and knee problems if they don't wear a shoe that properly supports the motion of their feet.
Causes
There has been some speculation as to whether arch height has an effect on pronation. After conducting a study at the Rose-Hulman Institute of Technology, Maggie Boozer suggests that people with higher arches tend to pronate to a greater degree. However, the generally accepted view by professionals is that the most pronation is present in those with lower arch heights. To complicate matters, one study done by Hylton Menz at the University of Western Sydney-Macarthur suggests that the methods for measuring arch height and determining whether someone is ?flat-footed? or ?high-arched? are unreliable. He says, ?For this reason, studies investigating the relationship between static arch height motion of the rearfoot have consistently found that such a classification system is a poor predictor of dynamic rearfoot function.
Symptoms
Not all foot injuries affecting runners are necessarily down to a particular running gait; it is rarely that simple to diagnose how a foot problem developed . Simply being an overpronator does not mean that a foot injury has been caused by the running gait and it could be due to a number of factors. However mild to severe overpronators tend to be at a higher risk of developing musculoskeletal problems due to the increased stresses and strains which are placed on the body when the foot does not move in an optimum manner. The following injuries are frequently due to overpronation of the feet. Tarsal tunnel syndrome. Shin splints. Anterior compartment syndrome. Plantar fasciitis. Achilles tendonitis. Bunions. Sesamoiditis. Stress fractures. Back and hip pain. Ankle pain.
Diagnosis
When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Non Surgical Treatment
Fortunately, there are simple things you can do to cure and correct your overpronation issues. Certain exercises help. Pull your toes back using a rolled up towel. Roll your feet over a golf or tennis ball for a minute. And do calf raises by standing up and lifting up on your toes. These all help reposition the foot and strengthen the muscles and tendons necessary for proper support. Beyond that, simple adjustments to footwear will help immensely.
Surgical Treatment
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%, depending on manufacturer. 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%.
Normal, healthy feet pronate! Normal pronation does not need to be ?corrected?. However, some people OVER-pronate. Those people need a shoe that supports their over-pronating foot to help guide the foot and avoid injury. So, what does pronation mean exactly? Well, ?pronate? is the word used to describe the natural motion of the foot after it strikes the ground. When a person with a normally pronating foot runs, the outside part of the heel strikes the ground. As the individual shifts the body weight forward, the foot rolls inward (pronates) and the entire foot comes into contact with the ground. This allows the foot to properly support the body and absorb the impact forces. Motion continues forward and the peron pushes off (called ?toe off?) evenly from the front of the foot. Someone who OVER-pronates strikes the ground with the heel in the same way, but the foot rolls too far inward (overpronation). This causes foot and ankle strain, as it does not allow the foot and ankle to properly support the body nor to properly absorb the impact forces. As motion continues forward, they will toe-off more from the ball of her foot. Runners who overpronate are susceptible to foot, ankle and knee problems if they don't wear a shoe that properly supports the motion of their feet.
Causes
There has been some speculation as to whether arch height has an effect on pronation. After conducting a study at the Rose-Hulman Institute of Technology, Maggie Boozer suggests that people with higher arches tend to pronate to a greater degree. However, the generally accepted view by professionals is that the most pronation is present in those with lower arch heights. To complicate matters, one study done by Hylton Menz at the University of Western Sydney-Macarthur suggests that the methods for measuring arch height and determining whether someone is ?flat-footed? or ?high-arched? are unreliable. He says, ?For this reason, studies investigating the relationship between static arch height motion of the rearfoot have consistently found that such a classification system is a poor predictor of dynamic rearfoot function.
Symptoms
Not all foot injuries affecting runners are necessarily down to a particular running gait; it is rarely that simple to diagnose how a foot problem developed . Simply being an overpronator does not mean that a foot injury has been caused by the running gait and it could be due to a number of factors. However mild to severe overpronators tend to be at a higher risk of developing musculoskeletal problems due to the increased stresses and strains which are placed on the body when the foot does not move in an optimum manner. The following injuries are frequently due to overpronation of the feet. Tarsal tunnel syndrome. Shin splints. Anterior compartment syndrome. Plantar fasciitis. Achilles tendonitis. Bunions. Sesamoiditis. Stress fractures. Back and hip pain. Ankle pain.
Diagnosis
When sitting, an over-pronating foot appears quite normal, i.e. showing a normal arch with room under the underside of the foot. The moment you get up and put weight on your feet the situation changes: the arches lower and the ankle slightly turns inwards. When you walk or run more weight is placed on the feet compared to standing and over-pronation will become more evident. When walking barefoot on tiles or timber floors over-pronation is more visible, compared to walking on carpet or grass.
Non Surgical Treatment
Fortunately, there are simple things you can do to cure and correct your overpronation issues. Certain exercises help. Pull your toes back using a rolled up towel. Roll your feet over a golf or tennis ball for a minute. And do calf raises by standing up and lifting up on your toes. These all help reposition the foot and strengthen the muscles and tendons necessary for proper support. Beyond that, simple adjustments to footwear will help immensely.
Surgical Treatment
Hyperpronation can only be properly corrected by internally stabilizing the ankle bone on the hindfoot bones. Several options are available. Extra-Osseous TaloTarsal Stabilization (EOTTS) There are two types of EOTTS procedures. Both are minimally invasive with no cutting or screwing into bone, and therefore have relatively short recovery times. Both are fully reversible should complications arise, such as intolerance to the correction or prolonged pain. However, the risks/benefits and potential candidates vary. Subtalar Arthroereisis. An implant is pushed into the foot to block the excessive motion of the ankle bone. Generally only used in pediatric patients and in combination with other procedures, such as tendon lengthening. Reported removal rates vary from 38% - 100%, depending on manufacturer. 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%.
What Is Tailor'S Bunion?
Overview
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
Inflammatory joint diseases. Those who suffer from rheumatoid and psoriatic arthritis are at risk for bunions, although many times, those who suffer from bunions will mistakenly attribute the soreness in their feet to arthritis. Genetic and neuromuscular factors. Individuals with Down?s Syndrome are believed to be more prone to developing bunions; therefore, the gait and feet of such patients should be examined carefully and regularly so that any problems can be caught and treated early. Similarly, individuals of any age who have been diagnosed with Ehlers-Danlos or Marfan?s Syndrome, have also been shown to have a higher than average occurrence of bunions. Limb inequality. Individuals who have legs of unequal length often suffer from bunions on the longer limb due to the irregular mechanics of their walking or running gait.
Symptoms
The most common symptoms associated with this condition are pain on the side of the foot just behind the great toe. A red painful bump is usually present. Pain is usually brought on with walking or sports. Shoes don't cause bunions but will typically aggravate them. Stiff leather shoes or shoes with a tapered toe box are the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other.
Diagnosis
X-rays are the best way to determine the amount of deformity of the MTP joint. Blood work may be required to rule out other diseases that may be associated with bunions such as rheumatoid arthritis. Other tests such as bone scans or MRI's are not usually required.
Non Surgical Treatment
A range of treatments is available for bunions, including painkillers, modifying footwear, orthotics, such as insoles, bunion pads and toe spacers. Surgery may be considered if a person's symptoms are severe and do not respond to non-surgical treatment. The type of surgery used will depend on the level of deformity, the severity of any other associated symptoms, the patient's age and any other associated medical conditions. Bunion surgery is usually effective, with up to 85% of cases resulting in improvement to symptoms. However, the deformity can sometimes return after bunion surgery. 
Surgical Treatment
As you explore bunion surgery, be aware that so-called "simple" or "minimal" surgical procedures are often inadequate "quick fixes" that can do more harm than good. And beware of unrealistic claims that surgery can give you a "perfect" foot. The goal of surgery is to relieve as much pain, and correct as much deformity as is realistically possible. It is not meant to be cosmetic. There are several techniques available, often as daycare (no in-patient stay), using ankle block local anaesthetic alone or combined with sedation or full general anaesthesia. Most of the recovery occurs over 6-8 weeks, but full recovery is often longer and can include persistent swelling and stiffness. The surgeon may take one or more of the following steps in order to bring the big toe back to the correct position: (a) shift the soft tissue (ligaments and tendons) around the joint and reset the metatarsal bone (osteotomy), remove the bony bump and other excess bone or (b) remove the joint and connect (fuse) the bones on the two side of the joint (fusion). These are just a few examples of the many different procedures available and your treating surgeon can help you decide the best option for you.
What Is Severs Disease?
Overview
The large heel bone (called the calcaneus) has a growth plate at the back of the heel. This growth plate is made of soft cartilage and it gradually narrows and starts to turn into solid bone around 8 to 13 years of age. This growth plate is prone to becoming inflamed and painful at this time. The strong Achilles tendon happens to join onto the back of the heel bone and pulls on this growth plate when running causing Sever?s disease.
Causes
During the growth spurt of early puberty, the heel bone (also called the calcaneus) sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, making the heel less flexible and putting pressure on the growth plate. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress (force or pressure) on the already tight Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease. Such stress commonly results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and gymnastics.
Symptoms
The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.
Diagnosis
X-rays are normal in Sever's disease, but your doctor will probably get X-rays to rule out other problems. Treatment consists of non-steroidal anti-inflammatory medications and use of a heel lift to relieve tension on the calcaneal apophysis. In more severe cases, phycical therapy consisting of modalities to relieve the pain, and stretching exercises may be helpful. In extreme cases, castings have been used.
Non Surgical Treatment
Treatment revolves around decreasing activity. Usual treatment has been putting children in a boot in slight equinus, or a cast with the foot in slight equinus, thereby decreasing the tension on the heel cord, which in turn pulls on the growth plate at the heel. As the pain resolves, children are allowed to go back to full activities. Complete resolution may be delayed until growth of the foot is complete (when the growth plate fuses to the rest of the bone of the heel). A soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and increases the shock absorption, so the growth plate is not knocked around as much). The use of an ice pack after activity for 20mins is often useful for calcaneal apophysitis, this should be repeated 2 to 3 times a day. As a pronated foot is common in children with this problem, a discussion regarding the use of long term foot orthotics may be important. If the symptoms are bad enough and are not responding to these measures, medication to help with inflammation may be needed. In some cases the lower limb may need to be put in a cast for 2-6 weeks to give it a good chance to heal.
Recovery
One of the most important things to know about Sever's disease is that, with proper care, the condition usually goes away within 2 weeks to 2 months and does not cause any problems later in life. The sooner Sever's disease is addressed, the quicker recovery is. Most kids can return to physical activity without any trouble once the pain and other symptoms go away.
The large heel bone (called the calcaneus) has a growth plate at the back of the heel. This growth plate is made of soft cartilage and it gradually narrows and starts to turn into solid bone around 8 to 13 years of age. This growth plate is prone to becoming inflamed and painful at this time. The strong Achilles tendon happens to join onto the back of the heel bone and pulls on this growth plate when running causing Sever?s disease.
Causes
During the growth spurt of early puberty, the heel bone (also called the calcaneus) sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, making the heel less flexible and putting pressure on the growth plate. The Achilles tendon (also called the heel cord) is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress (force or pressure) on the already tight Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease. Such stress commonly results from physical activities and sports that involve running and jumping, especially those that take place on hard surfaces, such as track, basketball, soccer, and gymnastics.
Symptoms
The pain is at the heel or around the Achilles tendon. This is felt commonly during exercise, particularly activities involving running or jumping. The back of the heel may also be tender to touch and there may be localised swelling. There may be stiffness in the calf muscles first thing in the morning and you may notice limping or a tendency to tiptoe.
Diagnosis
X-rays are normal in Sever's disease, but your doctor will probably get X-rays to rule out other problems. Treatment consists of non-steroidal anti-inflammatory medications and use of a heel lift to relieve tension on the calcaneal apophysis. In more severe cases, phycical therapy consisting of modalities to relieve the pain, and stretching exercises may be helpful. In extreme cases, castings have been used.
Non Surgical Treatment
Treatment revolves around decreasing activity. Usual treatment has been putting children in a boot in slight equinus, or a cast with the foot in slight equinus, thereby decreasing the tension on the heel cord, which in turn pulls on the growth plate at the heel. As the pain resolves, children are allowed to go back to full activities. Complete resolution may be delayed until growth of the foot is complete (when the growth plate fuses to the rest of the bone of the heel). A soft cushioning heel raise is really important (this reduces the pull from the calf muscles on the growth plate and increases the shock absorption, so the growth plate is not knocked around as much). The use of an ice pack after activity for 20mins is often useful for calcaneal apophysitis, this should be repeated 2 to 3 times a day. As a pronated foot is common in children with this problem, a discussion regarding the use of long term foot orthotics may be important. If the symptoms are bad enough and are not responding to these measures, medication to help with inflammation may be needed. In some cases the lower limb may need to be put in a cast for 2-6 weeks to give it a good chance to heal.
Recovery
One of the most important things to know about Sever's disease is that, with proper care, the condition usually goes away within 2 weeks to 2 months and does not cause any problems later in life. The sooner Sever's disease is addressed, the quicker recovery is. Most kids can return to physical activity without any trouble once the pain and other symptoms go away.
Achilles Tendon Rupture How Do I Know I Have One?
Overview
Achilles tendon rupture is when the achilles tendon breaks. The achilles is the most commonly injured tendon. Rupture can occur while performing actions requiring explosive acceleration, such as pushing off or jumping. The male to female ratio for Achilles tendon rupture varies between 7:1 and 4:1 across various studies.
Causes
Often the individual will feel or hear a pop or a snap when the injury occurs. There is immediate swelling and severe pain in the back of the heel, below the calf where it ruptures. Pain is usually severe enough that it is difficult or impossible to walk or take a step. The individual will not be able to push off or go on their toes.
Symptoms
Often the person feels a whip-like blow that is followed by weakness in the affected leg - usually he or she is not able to walk afterwards. At place where the tendon ruptured, a significant dent is palpable. Often the experienced physician can diagnose a ruptured Achilles tendon by way of clinical examination and special function tests. Imaging techniques, such as ultrasound and magnetic resonance imaging (MRI) allow for a more precise diagnosis.
Diagnosis
Your caregiver will ask what you were doing at the time of your injury. You may need any of the following. A calf-squeeze test is used to check for movement. You will lie on your stomach on a table or bed with your feet hanging over the edge. Your caregiver will squeeze the lower part of each calf. If your foot or ankle do not move, the tendon is torn. An x-ray will show swelling or any broken bones. An ultrasound uses sound waves to show pictures of your tendon on a monitor. An ultrasound may show a tear in the tendon. An MRI takes pictures of your tendon to show damage. You may be given dye to help the tendon show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
Non Surgical Treatment
Achilles tendon rupture is treated using non surgical method or surgical method. Non surgical treatment involves wearing a cast or special brace which is changed after some period of time to bring the tendon back to its normal length. Along with cast or brace, physical therapy may be recommended to improve the strength and flexibility of leg muscles and Achilles tendon. 
Surgical Treatment
Most published reports on surgical treatment fall into 3 different surgical approach categories that include the following: direct open, minimally invasive, and percutaneous. In multiple studies surgical treatment has demonstrated a lower rate of re-rupture compared to nonoperative treatment, but surgical treatment is associated with a higher rate of wound healing problems, infection, postoperative pain, adhesions, and nerve damage. Most commonly the direct open approach involves a 10- to 18-cm posteromedial incision. The minimally invasive approach has a 3- to 10-cm incision, and the percutaneous approach involves repairing the tendon through multiple small incisions. As with nonsurgical treatment there exists wide variation in the reported literature regarding postoperative treatment protocols. Multiple comparative studies have been published comparing different surgical approaches, repair methods, or postoperative treatment protocols.
