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26 Mar 2014 

PLANTAR FAT PAD ATROPHY is aácommon cause of pain in the BALL OF THE FOOT, due to thinning of the protective fatty cushion located under the heads of the metatarsal bones (the main bones of the foot).

When we walk, we propel ourselves forward through our toes and ball of the foot and at this point our body weight is transferred onto the small metatarsal heads, which are usually well cushioned and protected by this area of fat.á As this pad absorbs the shock instantly, giving the correct amount of cushioning, pain is not normally felt. Reduction of this fat pad can lead to pain, discomfort, ulcers and callus formation.


Ageing ? The supporting adipose (fatty) tissue is reduced. Genetics can play a role in this.
Metatarsal Head displacement ? A displacement of the head of the metatarsal bone can put pressure on the fattyátissue underneath.
Rheumatoid Arthritis ? This can lead to displacement of the fat pad.
High Arches ? Leading to a shortening of the toes and displacement of the fat pad.
Diabetic Patients ? If there is neuropathy present with toe deformity, displacement of the fat pad can occur.
Neuroma Treatment ? After surgery, damage to the fat pad can arise, together with fat pad atrophy resulting from steriod injections.
General Surgery or Fracture ? Resulting in a change in the gait.
High Heels/Thin Soled Shoes Or barefoot walking may initiate or worsen the condition.


Pain, soreness and tenderness in the area.
Walking without shoes very uncomfortable.
Callus (hard skin) formation or ultimately ulcers
The metatarsal bones appear prominent.

Wear soft supportive insoles and good quality shoes which offer support and cushioning, avoiding thin soled footwear.
Avoid excessive pressure during every day activities.
Avoid high heels.
Avoid walking barefoot.
Keep your weight within the recommended guidelines to avoid unnecessary load.
Avoid sports/activities which put added pressure on the ball of the foot.

It is always advisable to seek the help of a professional Foot Health Practitioner, Podiatrist or Chiropodist to assess the course of action which best suits your needs.

For further help and advice call Suzanne on 07738 521042.

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20 Mar 2014 

Foot pain: MedlinePlus Medical Encyclopedia

Pain or discomfort can be felt anywhere in the foot. You may have painin the heel, toes, arch, instep, or bottom of foot (sole).

Foot pain may be due to:
AgingBeing on your feet for long periods of timeBeing overweightFoot deformity that you were born withInjuryShoes that fit poorly or do not have much cushioningToo much walking or other sports activity
The following can cause foot pain:
Arthritis and gout -- common in the big toe, which becomes red, swollen, and very tenderBroken bonesBunions: A bump at the base of the big toe from wearing narrow-toed shoes.Calluses and corns: Thickened skin from rubbing or pressure. Calluses are on the balls of the feet or heels. Corns appear on the top of your toes.Hammer toes: Toes that curl downward into a claw-like position.Fallen arches: Also called flat feet.Morton's neuroma, a thickening of nerve tissue between the toesPlantar fasciitisPlantar warts: Sores on the soles of your feet due to pressure? SprainsStress fracture
Home Care
The following steps may help relieve your foot pain:
" ? Apply ice to reduce pain and swelling." ? Raise your painful foot as much as possible." ? Reduce your activity until you feel better." ? Wear shoes that fit your feet and are right for the activity you are doing." ? Wear foot pads to prevent rubbing and irritation." ? Use an over-the-counter pain medicine, such as ibuprofen or acetaminophen. (Talk to your doctor first if you have a history of ulcer or liver problems.)
Other home care steps depend on what is causing your foot pain.

When to Contact a Medical Professional
Call your doctor or nurse? if:
You have sudden, severe foot painYour foot pain began following an injury, especially if your foot is bleeding or bruising, or you cannot put weight on itYou have redness or swelling of the joint, an open sore or ulcer on your foot, or a feverYou have pain in your foot and have diabetes or a disease that affects blood flowYour foot does not feel better after using at-home treatments for 1-2 weeks
What to Expect at Your Office Visit
Your doctor will perform a physical examination, paying particular attention to your feet, legs, and back, your posture, and how you walk.

Your doctor will ask questions about your symptoms and medical history, such as:
Do you have pain in one or both feet?What part of the foot hurts?Does the pain move from joint to joint, or does it always occur in the same place?Did the pain begin suddenly or slowly?How long have you had the pain?Is it worse at night or when you first wake up in the morning?Is it getting better?Does anything make your pain feel better or worse?Do you have any other symptoms?Do you have numbness in your toes?
X-rays may be done to help your doctor diagnose the cause of your foot pain.

Treatment depends on the exact cause of the foot pain. Treatment may include:
A cast, if you broke a boneRemoval of plantar warts, corns, or calluses by a foot specialistOrthotics, or shoe insertsPhysical therapy to relieve tight or overused musclesFoot surgery
The following steps can prevent foot problems and foot pain:
" ? Wear comfortable, properly fitting shoes, with good arch support and cushioning." ? Wear shoes with plenty of room around the ball of your foot and toe " wide toe box" ? Avoid narrow-toed shoes and high heels." ? Wear sneakers as often as possible, especially when walking." ? Replace running shoes frequently." ? Warm up and cool down when exercising. Always stretch first. " ? Increase your amount of exercise slowly over time to avoid putting excessive strain on your feet." ? Lose weight if you need to." ? Learn exercises to strengthen your feet and avoid pain. This can help flat feet and other potential foot problems.
Alternative Names
Pain - foot

Koenig MD. Ligament injuries. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez""??s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section C.

Baer GS, Keene JS. Tendon injuries of the foot and ankle. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez""??s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section D.

Brodsky JW, Bruck N. Stress fractures of the foot and ankle. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez""??s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section E.

Klein SE. Conditions of the forefoot. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez""??s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section H.

Hirose CB, Clanton TO, Wood RM. Etiology of injury to the foot and ankle. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez""??s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:section J.

Price MD, Chiodo CP. Foot and ankle pain. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 43.

Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics.In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa:Saunders Elsevier; 2011:chap 30.

Update Date: 1/17/2013
Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
Browse the Encyclopedia

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18 Mar 2014 

Achilles Tendonitis: Treatment, Symptoms, and Causes | FootSmart

WHAT ARE THE CAUSES AND SYMPTOMS?Drawn diagram of foot with Achilles area highlighted to show symptoms of tendonitis
Named after a mythological Greek warrior whose only mortal vulnerability lay in his heel, the Achilles tendon connects the calf muscles to the heel bone. Like its namesake, this tendon is significant. As the strongest connective tissue in the body, it boosts us forward when we walk, run, or jump.

If overloaded, the Achilles tendon may become inflamed, leading to Achilles tendonitis. This condition causes swelling and a painful, burning sensation behind the ankle about two inches above the heel. The area may also turn red and feel warm to the touch. Without treatment, scar tissue may build up over time and cause palpable bumps along the tendon.

Experiencing these difficult symptoms daily can interfere not only with your healthful exercise routine, but also with everyday activities.

Experts at FootSmart and the Podiatry Institute have identified
several common causes of the irritation that can lead to Achilles tendonitis:Injury caused by repetitive overuse, like long-distance running, or trauma to the Achilles tendon, such as a tear. Not surprisingly, injuries such as these lead to the inflammation and pain typical of Achilles tendonitis.Tight calf muscles due to inadequate stretching. This tightness can irritate the Achilles tendon and cause inflammation.Other painful foot and lower leg conditions, like over-pronation and flat feet. Such conditions can become irritated by lack of proper footwear support and cause irritation in other parts of the foot and leg, such as the Achilles tendon.
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15 Mar 2014 

Claw Toes and Hammertoes - Patient Education - Orthogate

What can be done for the problem?

Nonsurgical Treatment
Treatment depends on how far along the process is. Early on, simplyswitching to shoes that fit properly may stop the deformity and returnthe toes to a more normal condition. If the condition is more advancedand the toes will not completely straighten out on their own, a contracture may exist. A contracture occurs when scar tissue tightens a joint and keeps it from moving through its normal range of motion.

Pressure points and calluses caused by a contracture can be treatedby switching to shoes that have more room in the toe or by placing padsover the calluses to relieve the pressure.

If all else fails, surgery may be suggested to correct the alignmentof the toe. The main type of procedure performed for these conditionsis referred to as an arthroplasty. Arthroplasty is the reconstruction or replacement of a joint.
DIP Joint Arthroplasty
For the hammertoe deformity, an arthroplasty of the DIP jointmay be suggested. This procedure is performed through a small incisionin the top of the toe over the DIP joint. Once the joint is entered, anarthroplasty is performed by removing one side of the joint. Thisreleases the tension on the ligaments and tendons around the joint andallows the toe to be realigned in the proper position. Once the toe isin the proper position, it is held with sutures (stitches) or a metalpin while it heals.
PIP Joint Arthroplasty
One of the most common procedures to correct the claw toe deformity is an arthroplasty of the PIP joint.In this procedure an incision is made over the joint. Once the surgeoncan see the joint, the end of the proximal phalanx is removed toshorten the toe and relax the contracture around the joint. The toe isthen either held with metal pins or sutures in the straight positionuntil it heals.

As the joint heals, scar tissue forms, connecting the two bonestogether and replacing the area where the joint once was. Surgeonsrefer to this as a false joint (or pseudo joint) because thescar tissue allows a bit of motion to occur between the two bones whilekeeping them from rubbing together and causing pain.
MTP Joint Release
If clawing is a problem, then the MTP joint may also have to bereleased to relieve the contracture of this joint and allow theproximal phalanx to come into the correct position. This procedure isperformed by making an incision on the top of the toe over the MTPjoint. The surgeon then releases the tight ligaments and tendons untilthe toe easily moves back into the proper alignment. The toe may beheld in the proper alignment with a metal pin until the soft tissuesheal. The pin may remain in place for three or four weeks.

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12 Mar 2014 

You doctor or podiatrist can help you discover the cause of your condition. After the cause has been determined, your doctor will advise you on the best plantar fasciitis pain therapy. Most of the time, plantar fasciitis pain therapy is easily conducted at home with exercise, rest and relaxation. Sometimes staying off your feet for a given amount of time is the best form of plantar fasciitis pain therapy. Other times, a doctor may tell you to apply tape across the plantar fascia located just in front of the heel where the arch begins to allow the inflammation to subside and the foot to heal correctly.

The mechanical structure of your feet and the manner in which the different segments of your feet are linked together and joined with your legs has a major impact on their function and on the development of mechanically caused problems. Merely having "flat feet" won't take the spring out of your step, but having badly functioning feet with poor bone alignment will adversely affect the muscles, ligaments, and tendons and can create a variety of aches and pains. Excess pronation can cause the arch of your foot to stretch excessively with each step. This "hypermobility" may cause other bones to shift and cause other mechanically induced problems.

How a shoe fits is crucial. Wearing small shoes may aggravate the symptoms of plantar fasciitis When choosing shoes or trying on shoes that have been purchaed and delivered online, patients should ensure they do so in the afternoon or evening. This is because as the day progresses, feet swell and become slightly bigger than they are first thing in the morning. Furthermore, one foot is often slightly larger than the other. If this is the case, patients should check for proper fitting on the larger foot. It is better for shoes to be slightly too large (on the smaller foot) than vice versa.

Heel pain is common complaint in runners. Actually, heel pain is common in all people. 40% of all visits to podiatrists in the U.S. are because of heel pain. Of all of the different causes of heel pain, the vast majority is due to a condition known as plantar fasciitis. This is an inflammation in the band of tissue (the plantar fascia) that runs from the heel to the toes. This condition is most often caused by a tight achilles tendon or poor foot structure such as overly flat feet or high arches.

Pain from plantar fasciitis can cause sharp pain on the bottom of the foot and can affect quality of life in many people. The American Academy of Podiatric Sports Medicine states that heel pain is the most common complaint to podiatric practitioners throughout the country. According to the National Library of Medicine, treatments for heel pain include rest, medicines, exercises and taping. They also mention that surgery is rarely needed in cases of heel pain caused by conditions like plantar fasciitis. Some exercises can be performed at home without a lot of equipment and can help with the symptoms associated with plantar fasciitis. Anatomyplantar fasciitis

To make a custom splint, a therapist, podiatrist or physician molds a hard plastic splint to each patient's leg and foot. The splint covers the posterior part of the leg and the sole of the foot. It is fastened around the leg and foot by Velcro straps. The splints can be made to control abnormal foot motion since they are fit closely to the leg with minimal or no padding. Because each splint is unique, they can cost more than a commercial off-the-shelf splint. The splints are not designed for walking.

Of all the hours I spent reading and researching a plantar fasciitis cure or remedy, my lightbulb moment came by surprise. In the As Seen on TV section of a store I saw Yoga Toes. Yoga Toes is a small bubbled ladder that goes between your toes to stretch out the ligaments and tendons in your foot side to side. But it was $30. So I wondered if I could think of something else that would stretch out my feet in the same way but cheaper. Then I thought of the foam pedicure toe separators. They were only $1 a pair.

Stand barefoot, with your feet hip-width apart and with your left foot in a slightly forward position - two to three inches ahead of your right foot. The bottoms of the toes of your left foot should be in contact with a wall in front of you (the wall should be creating a forced dorsiflexion of the toes, so that the sole of the left foot is on the ground but the toes are on the wall), and your left knee should be bent slightly. Keep your weight evenly distributed between your right and left foot to start the exercise (see note below).

The Achilles tendon is a group of tissues that connect the heel bone to your calf muscles. When these are inflamed, you have Achilles tendonitis. The plantar fascia is also a group of tissues; but, this links the toes to your heel. Home remedies work well for both the conditions. The treatment of plantar fasciitis and Achilles tendonitis are almost the same. When ice packs and stretching exercises don't work for plantar fasciitis, it may be advisable for you to visit a podiatrist. A new therapy called ESWT or 'Extracorporeal Shock Wave Therapy' is recommended. The therapy may take about 4 months for complete cure.

I then begin to send healing energy to the affected area of pain, in this case the heel of your foot. I send the energy for about 20 minutes and then ask you for your pain level again. Most of my client notice a pain reduction anywhere from 20-30% in the first twenty minutes. We repeat this process another two times in the course of the hour healing session until the pain level is zero or greatly reduced to a much more comfortable level. Some people may need two or three sessions to experience complete relief.plantar fasciitis relief
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