Bursitis Of The Foot Pain In Heel

Overview

Pain at the posterior heel or posterior ankle is most commonly caused by pathology at the posterior calcaneus, the Achilles (calcaneal) tendon, or the associated bursae. The following bursae are located just superior to the insertion of the Achilles tendon. Subtendinous calcaneal bursa. This bursa (also called the retrocalcaneal bursa), situated anterior (deep) to the Achilles tendon, is located between the Achilles tendon and the calcaneus. Subcutaneous calcaneal bursa. Also called the Achilles bursa, it is found posterior (superficial) to the Achilles tendon, lying between the skin and the posterior aspect of the distal Achilles tendon. Inflammation of one or both of these bursae can cause pain in the posterior heel and ankle regions.

Causes

Bursitis of the Achilles tendon is caused by the irritation and inflammation of the retrocalcaneal bursa, a small fluid-filled sac located in the back of the ankle that acts as a cushion and lubricant for the ankle joint. Possible causes of Achilles tendon bursitis include aging, Factors related to the aging process, including the onset of rheumatoid arthritis and gout, can deteriorate the bursa. Overuse of ankle. Excessive walking, uphill running, jumping, and other aggressive exercise regimens, especially without proper conditioning, can cause irritation to the bursa. Trauma. Sudden injury to the ankle joint, or trauma caused by rigid or improperly fitted shoes, can increase the chances of developing bursitis.

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

Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.

Non Surgical Treatment

The most important part of treating bursitis is resting your Achilles tendon while the bursa heals. Resting your ankle as much as possible may decrease swelling and keep the bursitis from getting worse. When the pain decreases, begin normal, slow movements. Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Put crushed ice in a plastic bag or use a bag of frozen corn or peas. Cover it with a towel. Put this on your heel for 15 to 20 minutes, three to four times each day. Do not sleep on the ice pack because you can get frostbite. After two or three days, you may try using heat to decrease pain and stiffness. Use a hot water bottle, heating pad, whirlpool or warm, moist compress. To make a compress, dip a clean washcloth in warm water. Wring out the extra water and put it on your heel for 15 to 20 minutes, three to four times each day. Your caregiver may tell you to switch between treating your heel with ice packs and heat treatments. Follow the caregiver's directions carefully when doing these treatments.

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.

Hammer Toe Operation Procedure

HammertoeOverview

hammertoe is the general term used to describe an abnormal contraction or "buckling" of the toe because of a partial or complete dislocation of one of the joints of the Hammer toe toe or the joint where the toe joins with the rest of the foot. As the toe becomes deformed, it rubs against the shoe and the irritation causes the body to build up more and thicker skin to help protect the area. The common name for the thicker skin is a corn.

Causes

Medical problems, such as stroke or diabetes that affect the nerves, may also lead to hammertoe. For example, diabetes can result in poor circulation, especially in the feet. As a result, the person may not feel that their toes are bent into unnatural positions. The likelihood of developing hammertoe increases with age and may be affected by gender (more common in women) and toe length; for example, when the second toe is longer than the big toe, hammertoe is more likely to occur. Hammertoe may also be present at birth. Genetics may factor in to developing hammertoe, particularly if the foot is flat or has a high arch, resulting in instability.

HammertoeSymptoms

A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.

Diagnosis

The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.

Non Surgical Treatment

Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area. Wear a shoe with a deep toe box. If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling. Avoid heels more than two inches tall. A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician?s office will be necessary to repair the toe to allow for normal foot function. Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly. See your podiatric physician if pain persists.

Surgical Treatment

Curative treatment of hammertoes varies depending upon the severity of the deformity. When the hammertoe is flexible, a simple tendon release in the toe works well. The recovery is rapid often requiring nothing more that a single stitch and a Band-Aid. Of course if several toes are done at the same time, the recovery make take a bit longer.

HammertoePrevention

How can I prevent hammer toe? Avoid wearing shoes that are narrow or don?t fit well. Also, don?t wear heels higher than 2 inches. Instead, choose shoes with a wide toe box that give you ? inch between the end of your longest toe and the inside tip of the shoe. Check often to make sure your child?s shoes fit, especially when he or she is having a growth spurt.

Hammer Toe Issues

HammertoeOverview

Hammer toes is most common in women, and a big part of this is poor shoe choices, which are a big factor in the development of many foot problems. Tight toe boxes and high heels are the biggest culprits. Genetics certainly plays a role in some cases of hammertoes, as does trauma, infection, arthritis, and certain neurological and muscle disorders. Most cases of contracted toes are associated with various biomechanical abnormalities in how a patient walks. This causes the muscles and tendons to be used excessively or improperly, which deforms hammertoe the toes over time.

Causes

Hammer toe is often caused by wearing shoes that do not fit properly. If shoes are too small either in length or width, then the toes are held in a shortened position for long periods and the muscles eventually shorten and pull the toes into the bent position. Alternatively it can be caused by overactivity in the extensor digitorum dongus muscle (right) and a weakness in the counteracting muscle under the foot, such as flexor digitorum longus. Sometimes it can be a congenital condition, meaning it is present from birth. It is also more common in those with arthritis in the foot or diabetes.

HammertoeSymptoms

The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.

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

Conservative treatment starts with new shoes that have soft, roomy toe boxes. Shoes should be one-half inch longer than your longest toe. For many people, the second toe is longer than the big toe.) Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammer toe. Or, a shoe repair shop may be able to stretch the toe box so that it bulges out around the toe. Sandals may help, as long as they do not pinch or rub other areas of the foot.

Surgical Treatment

If a person's toes have become very inflexible and unresponsive to non-invasive means of treatment and if open sores have developed as a result of constant friction, they may receive orthopaedic surgery to correct the deformity. The operation is quick and is commonly performed as an out-patient procedure. The doctor administers a local anesthetic into the person's foot to numb the site of the operation. The person may remain conscious as the surgeon performs the procedure. A sedative might also be administered to help calm the person if they are too anxious.

Bunions Reasons Symptoms And Therapies

Overview
Bunions Callous The foot is made up of many small bones that sit perfectly together forming many joints. The big toe joint comprises of the first metatarsal and the proximal (close) phalanx of the toe. A bunion forms when base of the toe (first metatarsal) drifts away from the second metatarsal. The 1st metatarsal rotates and drops and so no longer sits in its correct alignment. The tip of the first toe then rotates and drifts inwards. Overtime, under the continuing stress of this altered position of the joint and the irritation that this causes, the joint can become inflamed.

Causes
By far the most common cause of bunions is the prolonged wearing of poorly fitting shoes, usually shoes with a narrow, pointed toe box that squeezes the toes into an unnatural position. Bunions also may be caused by arthritis or polio. Heredity often plays a role in bunion formation. But these causes account for only a small percentage of bunions. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.

Symptoms
Just because you have a bunion does not mean you have to have pain. There are some people with very severe bunions and no pain and people with mild bunions and a lot of pain. Symptoms for a bunion may include pain on the inside of your foot at the big toe joint. Swelling on the inside of your foot at the big toe joint. Redness on the inside of your foot at the big toe joint. Numbness or burning in the big toe (hallux). Decreased motion at the big toe joint. Painful bursa (fluid-filled sac) on the inside of your foot at the big toe joint. Pain while wearing shoes, especially shoes too narrow or with high heels. Joint pain during activities. Other conditions which may appear with bunions include corns in between the big toe and second toe. Callous formation on the side or bottom of the big toe or big toe joint. Callous under the second toe joint. Pain in the second toe joint.

Diagnosis
A doctor can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.

Non Surgical Treatment
Treatment falls into two broad categories, conservative and surgical. From a conservative standpoint, efforts are directed at correcting faulty foot mechanics with custom molded insoles and relief of symptoms. These include Custom Orthosis to stabilize the abnormal motion of the hind and fore foot. Shoe gear modification: Using shoes with larger toe boxed and more supple materials. Changes in activities. Try to avoid those things which cause symptoms. Anti-inflammatory medication for periodic relief this includes cortisone injections into the joint as well as oral medication. Bunions Hard Skin

Surgical Treatment
Surgery for bunions usually isn't done unless you have already tried other treatment and it did not relieve your pain. Other treatment includes wearing shoes with lots of room for your toes and using pads and supports in your shoe for protection and comfort. Surgery may be right for you if your toe is too painful, if your bunion is very big, or if you can't easily do your daily activities. It's not clear how well bunion surgery works or which kind of surgery is best. How well the surgery works depends on how bad your bunion is, the type of surgery you have, and your surgeon's experience. Your expectations will play a big role in how you feel about the results of surgery. If you want surgery mainly to improve the way your foot looks, you may be disappointed.

Prevention
To minimize the chance of developing bunions, never force your feet into shoes that don?t fit. Choose a shoe that conforms to the shape of your foot. Opt for shoes with wider insteps, broad toes, and soft soles. Shoes that are short, tight, or sharply pointed should be avoided.

Which Are The Primary Reasons For Over-Pronation

Overview

Over Pronation (Flat Feet) refers to the biomechanical shock-absorbing motion of the ankle, foot and lower leg. It is the natural inward flexing motion of the lower leg and ankle. Standing, walking, and running cause the ankle joint to pronate which in turn helps the body to absorb shock and allows it to control balance. An ankle joint that is too flexible causes more pronation than desired. This common condition is called Over- Pronation (sometimes referred to as "Flat Feet"). This foot condition places an extreme degree of strain on various connective tissues of the ankle, foot, and knee. If this condition is not addressed foot pain and toe deformities such as bunions and hammer toes (just to name a couple) may develop. Hip and lower back pain may also be residual results from this condition.Over Pronation

Causes

There are many biomechanical issues that can contribute to excessive pronation, including weak foot intrinsic muscles, limited ankle dorsiflexion mobility and calf flexibility, weak ankle invertor muscles (e.g. posterior tibialis), weak forefoot evertor muscles (peroneus longus), poor hip strength and control, Anterior pelvic tilting, heel InversionIn a person who overpronates, the heel bone goes into an everted position meaning that it turns out away from the midline of the body. The opposite motion of eversion is inversion. Inversion is a motion that needs to be controlled to prevent the foot from excessively pronating.

Symptoms

Because overpronation affects the entire lower leg, many injuries and conditions may develop and eventually cause problems not only in the leg and foot, but also the knee, hips and lower back. Pain often begins in the arch of the foot or the ankle. Blisters may develop on the instep, or on the inside edge of the heels. As overpronation continues and problems develop, pain will be felt elsewhere, depending on the injury.

Diagnosis

The best way to discover whether you have a normal gait, or if you overpronate, is to visit a specialty run shop, an exercise physiologist, a podiatrist or a physical therapist who specializes in working with athletes. A professional can analyze your gait, by watching you either walk or run, preferably on a treadmill. Some facilities can videotape your gait, then analyze the movement of your feet in slow-motion. Another (and less costly) way is to look at the bottom of an older pair of run shoes. Check the wear pattern. A person with a normal gait will generally see wear evenly across the heel and front of the shoe. A person who overpronates will likely see more wear on the OUTside of the heel and more wear on the INside of the forefoot (at the ball). A person who supinates will see wear all along the outer edges of the shoe. You can also learn about your gait by looking at your arches. Look at the shape your wet feet leave on a piece of paper or a flat walking surface.Over-Pronation

Non Surgical Treatment

The following exercises help retrain the foot and ankle complex to correct overpronation. Exercises may be performed while wearing shoes, or for an even greater challenge, in bare feet. Duck Stand. This exercise is designed to prepare for the more dynamic BT exercises ahead by waking up the gluteal muscles and teaching clients how the gluteal muscles control the degree of foot pronation. For example, when the glutes contract concentrically, they rotate the leg outward. As the leg rotates outward, the arch of the foot raises (i.e., supinates). Stand beside the BT with both heels together and feet turned outward. (Note: As you progress, perform this exercise while standing on the BT.) Try to rotate legs outward by tightening buttock muscles while tilting pelvis under. As legs rotate outward, arches of the feet raise up out of pronation. Hold position for 30 seconds. Big Toe Pushdowns. This exercise is designed to strengthen the muscle of the big toe that holds up the arch of the foot (i.e., flexor hallucis longus muscle). This stops the foot from overpronating. Stand on top of the BT dome with feet facing forward. Use gluteal muscles to raise the arches of the feet (see previous exercise - "Duck Stand"). Keep arches raised while pushing down big toe into the BT. While pushing down, tension build in the arch on the underside of their foot should be felt. Hold position for 15 seconds.

Surgical Treatment

Calcaneal "Slide" (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.

Addressing Severs Disease

Overview

If your child is experiencing activity related pain just below the kneecap, at the top of the shinbone, or in their heel or hip then the chances are they are suffering from Osgood Schlatter, Severs disease or Ischial Apophysitis respectively. Today, thousands of children are diagnosed with one of these conditions every year. Many others are never diagnosed and the discomfort is often dismissed as 'growing pains'

Causes

Sever?s Disease is thought to be caused by several reasons. Growth spurts. The muscles and tendons become tight due to rapid bone growth. Overuse. Sever?s Disease can also occur in children who are athletically active and overwork his or her muscles. Some physicians are beginning to caution parents about checking their children?s shoes to make sure they fit well and do not pinch or put undue pressure on the child?s feet. Pronation can also bring on Sever?s Disease.

Symptoms

Sharp pain will be present in the affected heel (or both heels), especially while running or walking. Pain can be heightened following activity. The area will be tender to the touch and usually becomes inflamed or reddened. It may also be painful to press on the heel with a finger from the back or to squeeze the sides together; the latter is particularly common. You might notice stiffness in some of the surrounding muscles, making regular movements more difficult to achieve. This and the pain can manifest physically in abnormal practices like tiptoeing or limping. In some cases a lump can be detected on the back of the heel, though it may be so small as to defy detection.

Diagnosis

Sever condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.

Non Surgical Treatment

First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 25 minutes three times a day. Your child should not go barefoot. If your child has severe heel pain, ibuprofen (Advil) will help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg. The child should do these stretches five times each, two or three times a day. Each stretch should be held for 20 seconds. Your child also needs to do exercises to strengthen the muscles on the front of the shin. To do this, have your child stand facing a wall to stretch the calves and the heel cord. Place one foot a shoulder?s width in front of the other, both feet facing the wall. The front knee is bent and the back knee is straight during the calf stretch. Then have your child push against the wall and feel the stretch in his or her back leg. To stretch out the heel cord, have him or her stay in the same position and bend the back knee. Repeat three times. Practice this stretch twice daily.

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.

What Causes Pain In Arch Of Foot After Running?

Overview

Arch pain(medically known as plantar pain)is a broad term many people use to describe pain in their muscles, tendons, ligaments, bones, or nerves. All these components are connected to the bottom of the foot; therefore, damage to any one of these can cause pain on the bottom of the foot. This pain may only last for short time, but can progressively worsen if untreated. Most people who suffer from this pain are between the ages of 30 and 80, but many younger athletes are also susceptible, particularly those who participate in high-impact sports.

Foot Arch Pain

Causes

Poor quality footwear. Excess weight. Commonly occurs in people over 50. Overuse or strain by athletes, especially runners. Plantar fasciitis can be caused by overuse of the plantar fascia due to walking or running in poorly supported footwear. It?s not surprising to note that healthy, active adults are the most common victims of plantar fasciitis: runners, joggers, basketball players, tennis and racquetball players? basically any sport that requires quick or repetitive movements combined with impact on the heel and arch of the foot can lead to plantar fasciitis. Seniors are also at risk due to the ligament and bone issues common to those of older years. Another leading cause of plantar fasciitis is being overweight or obese. In this case, while a sports-related injury may not be to blame, just the daily stress of walking with too much excess weight straining the plantar fascia ligaments can lead to inflammation and painful heel pain. Anyone whose job requires long periods of standing or walking is prone to develop plantar fasciitis as well. For those who develop arch strain or arch pain as a result of structural problems like flat feet, they require arch support that will accommodate their individual needs.

Symptoms

Flat feet can exhibit a variety of symptoms, from mild to severe. The extent of the flat foto does not always correlate with the extent of symptoms. Patients may complain of arch pain and heel pain. Commonly there is pain on the outside of the foot, where the foot meets the ankle as the collapse foot abuts against the ankle. Muscle cramps within the foot, and onto the leg (shin splints) may occur. In general, patients have pain with activity, such as walking or running. The pain may be deep and focal to a generalized widespread achy feeling. Irritation from shoe gear can cause redness and swelling. Common reasons patients seek treatment are pain, interference with walking or activities, difficulty fitting shoes, swelling, and notice a change in appearance of the foot and/or unsightly appearance.

Diagnosis

The medical practitioner will examine how the muscles of your foot function. These tests may involve holding or moving your foot and ankle against resistance; you may also asked to stand, walk, or even run. Pain caused by movements may indicate the cause of the pain. The nerves in the foot will be tested to make sure no injury has occurred there. An x-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are changes in the makeup of the bone.

Non Surgical Treatment

An orthotic arch support, specially molded to fit your foot, may be part of your treatment. These supports can be particularly helpful if you have flat feet or high arches. You can tell if that is what is needed when short-term taping decreases your heel pain.

Arch Pain

Surgical Treatment

Cavus foot is caused in part by an over-pull of one of the lateral ankle muscles. A release of this tendon can be performed on the outside of the ankle. Additionally, a transfer of this tendon can be performed to help in correcting deformity of the ankle joint. Often patients will have a tightness of their gastrocnemius muscle, one of the main muscles in the calf. This can increase the deformity or prevent a correction from working. It is addressed with a lengthening of a part of the calf muscle or Achilles tendon. This is often performed through one or more small cuts in the back of the leg or ankle. Finally, the plantar fascia may be tight. The plantar fascia is a cord-like structure that runs from the heel to the front part of the foot. Partial or complete plantar fascia release may be done.

Prevention

It is possible to prevent arch pain by wearing well-fitting shoes while performing any physical activity. Many times doctors will suggest a therapeutic shoe with a higher heel to relieve the pressure on the achilles tendon and also the arch muscle (plantar fasciitis). People with arch pain suffer from regular flare-ups of pain. However there is no risk to others as this is not a contagious condition.

Stretching Exercises

Massage therapy is a great way to loosen muscles and help improve mobility in in your feet. As many people with foot pain have discovered, tight muscles in your legs or back can lead to tense foot muscles. All those muscles are connected, so tension in your back can cause tension in your legs which can pull the tendons in your feet and cause stiffness and pain. Getting acupuncture or a professional full body massage are probably the best ways to deal with this, but there are also some simple tricks you can do at home to help keep muscles limber. These are great for loosening up and improving circulation, both before and after exercise. Place a tennis ball under the arch of your bare foot and roll it around, stretching the muscles in your foot and promoting blood flow. You can also roll the ball under your calves and upper legs to work out stiffness and knots. If you feel the tennis ball is too easy, try a lacrosse ball for deeper massaging. This is also demonstrated in the exercise video above. Use a foam roller, those big overpriced rolls of foam that are now available in every department and sporting goods store are fantastic for self-massage (why a roll of foam costs $30 is beyond us, but they do work wonders-our advice is to not waste money on the more expensive fancy grooved ones because even the simplest rollers work great). The exercises you can do with foam rollers seem to be endless, and there are literally hundreds of free videos online showing how to use them to massage every part of your body. Here's one we picked out that specifically targets foot and leg muscles related to arches and plantar fasciitis.