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April 16 2015


Posterior Tibial Tendon Pain Symptoms

Adult acquired flatfoot deformity (AAFD or AAF) is a progressive, symptomatic deformity resulting from gradual stretch of the posterior tibial tendon as well as other ligaments supporting the arch of the foot. AAFD develops after skeletal maturity, May also be referred to as posterior tibial tendon dysfunction (PTTD), although due to the complexity of the disorder AAFD is more appropriate. Significant ligamentous rupture occurs as the deformity progresses. Involved ligaments include the spring ligament, the superficial deltoid ligament, the plantar fascia, and the long and short plantar ligaments. Unilateral AAFD is more common than bilateral AAFD. Adult acquired flat foot

Flat footedness, most people who develop the condition already have flat feet. With overuse or continuous loading, a change occurs where the arch begins to flatten more than before, with pain and swelling developing on the inside of the ankle. Inadequate support from footwear may occasionally be a contributing factor. Trauma or injury, occasionally this condition may be due to fracture, sprain or direct blow to the tendon. Age, the risk of developing Posterior Tibial Tendon Dysfunction increases with age and research has suggested that middle aged women are more commonly affected. Other possible contributing factors - being overweight and inflammatory arthritis.

Pain and swelling behind the inside of your ankle and along your instep. You may be tender behind the inner ankle where the posterior tibial tendon courses and occasionally get burning, shooting, tingling or stabbing pain as a result of inflammation of the nerve inside the tarsal tunnel. Difficulty walking, the inability to walk long distances and a generalised ache while walking even short distances. This may probably become more pronounced at the end of each day. Change in foot shape, sometimes your tendon stretches out, this is due to weakening of the tendon and ligaments. When this occurs, the arch in your foot flattens and a flatfoot deformity occurs, presenting a change in foot shape. Inability to tip-toe, a way of diagnosing Posterior Tibial Tendon Dysfunction is difficulty or inability to ?heel rise? (stand on your toes on one foot). Your tibialis posterior tendon enables you to perform this manoeuvre effectively. You may also experience pain upon attempting to perform a heel rise.

In the early stages of dysfunction of the posterior tibial tendon, most of the discomfort is located medially along the course of the tendon and the patient reports fatigue and aching on the plantar-medial aspect of the foot and ankle. Swelling is common if the dysfunction is associated with tenosynovitis. As dysfunction of the tendon progresses, maximum pain occurs laterally in the sinus tarsi because of impingement of the fibula against the calcaneus. With increasing deformity, patients report that the shape of the foot changes and that it becomes increasingly difficult to wear shoes. Many patients no longer report pain in the medial part of the foot and ankle after a complete rupture of the posterior tibial tendon has occurred; instead, the pain is located laterally. If a fixed deformity has not occurred, the patient may report that standing or walking with the hindfoot slightly inverted alleviates the lateral impingement and relieves the pain in the lateral part of the foot.

Non surgical Treatment
Nonoperative therapy for adult-acquired flatfoot is a reasonable treatment option that is likely to be beneficial for most patients. In this article, we describe the results of a retrospective cohort study that focused on nonoperative measures, including bracing, physical therapy, and anti-inflammatory medications, used to treat adult-acquired flatfoot in 64 consecutive patients. The results revealed the incidence of successful nonsurgical treatment to be 87.5% (56 of 64 patients), over the 27-month observation period. Overall, 78.12% of the patients with adult-acquired flatfoot were obese (body mass index [BMI] = 30), and 62.5% of the patients who failed nonsurgical therapy were obese; however, logistic regression failed to show that BMI was statistically significantly associated with the outcome of treatment. The use of any form of bracing was statistically significantly associated with successful nonsurgical treatment (fully adjusted OR = 19.8621, 95% CI 1.8774 to 210.134), whereas the presence of a split-tear of the tibialis posterior on magnetic resonance image scans was statistically significantly associated with failed nonsurgical treatment (fully adjusted OR = 0.016, 95% CI 0.0011 to 0.2347). The results of this investigation indicate that a systematic nonsurgical treatment approach to the treatment of the adult-acquired flatfoot deformity can be successful in most cases. Acquired flat feet

Surgical Treatment
If cast immobilization fails, surgery is the next alternative. Treatment goals include eliminating pain, halting deformity progression and improving mobility. Subtalar Arthroereisis, 15 minute outpatient procedure, may correct flexible flatfoot deformity (hyperpronation). The procedure involves placing an implant under the ankle joint (sinus tarsi) to prevent abnormal motion. Very little recovery time is required and it is completely reversible if necessary. Ask your Dallas foot doctor for more information about this exciting treatment possibility.

June 10 2014


How To Care For Diabetic Wounds

Having the right footwear may help diabetics to keep their feet healthy and free from cuts or blisters. Of course, everyone will get blisters and minor foot injuries from time to time, but having wide, comfortable shoes can help to prevent them significantly. It is recommended that diabetics have their shoes fitted for their feet. Once diabetics are comfortable with a particular brand or style, they can look online for special rates and lower prices on their diabetic shoes. Also, keep in mind that there are all kinds of diabetic shoes, including athletic shoes, casual shoes, and dress shoes that are all designed to be comfortable for diabetics. Antifungal foot cream – A separate cream might be needed to fend off fungi and bacteria from forming deformities on the foot Also, this can relieve symptoms like itching and burning sensation while adding in moisture into the skin to fortify its protection against microorganisms. Pumice stone – This stone may come in handy for people who are suffering from excessive formations of calluses. This stone can gently remove layers of hardened skin. For better results, use pumice stone in combination with moisturizing soap or cream to help hydrate the tissues of hardened areas. Foot worship can also be associated with foot fetish. Here items of the feet like socks, shoes, toenail rings and others become objects of scared interest. These items cause the individual to venerate and worship the objects. The objects in this case will take the place of an actual person’s presence and the foot worship can take place at anytime that it is desired. There are many manufacturers that claimed that their detoxification patches work. The most important thing when buying them is to look at the constituents of the ingredients. Using ingredients blended from herbs and plants have been a popular method to cure illnesses practiced by oriental physician.diabetic foot pain But even with good blood sugar control meticulous preventive care is important. This really is a situation where an ounce of prevention is worth way more than a pound of cure as the saying goes. It is a sad fact is that diabetes and the foot problems it causes is the leading cause of leg amputations. That's why diabetic foot care is so important. Diabetes affects more than 25 million nationwide. High blood glucose can damage many parts of the body, such as the heart, blood vessels, eyes and kidneys. It can also lead to feet and skin problems. Of equal importance is exercise. Humans were not meant to be sedentary-couch potatoes, which unfortunately, is how many Americans spend their day. Exercise should be undertaken at the highest level of your ability. If you are not sure of your ability, you should talk about it with your doctor. Diabetic people MUST get in the habit of regularly inspecting their feet. This is because Peripheral Neuropathy (one of the complications of diabetes) deadens the sensation on the bottom of the foot. This insensitivity can cause a diabetic person to injure their feet and not even realize it. The nerve damage and poor circulation in the legs of diabetic patients sometimes leads to amputation of the feet or legs. When diabetes patietns develops sores on their feet, they may not notice immediately if they also have nerve damage that numbs the affected area. Combined with the inability of the body to fight infection and heal the wound, a small sore may gradually grow into a large ulcer. If the ulcer grows to cover a large area of a foot or leg, doctors may have no choice but to amputate, explains the Merck Manuals Online Medical Library.diabetic foot problems
Tags: Diabetic Foot
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