Wednesday, 28 January 2015 17:32

What Are Ankle/Foot Orthotics?

Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.

Friday, 16 January 2015 09:35

Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Thursday, 08 January 2015 23:44

Ingrown Toenail Care

An ingrown toenail is caused when a toenail grows sideways into the bed of the nail, causing pain and swelling. Sometimes this can become infected causing drainage and may become serious.

There are many risk factors that can predispose a person to this common condition. Cutting your nails too short, participating in sports, diabetes, being overweight, or having a fungal infection of the toe can all cause ingrown toe nails. Many people are genetically prone to ingrown nails and it can often be related to genetics. Often the problem can come from wearing ill-fitting shoes, or even from shoes that keep the feet slightly damp.

There are some things that you can do to prevent and treat these painful problems. Letting your toe nails grow a little longer will help prevent this condition. If you do develop an ingrown nail, soaking the toe in hot water will help prevent infection and lessen pain. You may want to add antibiotic soap or Epsom salts to the water. This will help to prevent infection.

Some experts also recommend placing small pieces of cotton under the affected part. This will help the toenail to grow up instead into in your nail bed. Resting with your feet up can reduce swelling and redness.

If your pain is so severe that it keeps you from everyday activities, it is time to see your podiatrist. Also, if you see a red streak running up your leg, or if your infection is spreading, see a podiatrist immediately. There are many quick treatments that can lessen your pain and have you walking with comfort.
One method of treating an ingrown toenail involves using a Band-Aid. Wrapping the affected toe with a Band-Aid will prevent infection and also keep the nail from growing out at painful angles.

If your podiatrist feels it is necessary, he or she may make a small incision and remove part of your toe nail. Medication will be placed in the nail bed to prevent re-growth of the problem nail parts. This will be done under local anesthesia and should lessen your discomfort in no time. You will be advised to stay off your foot for a day or so, but can then carry on normal activities.

Take care of your feet; you have many steps to take in your life. Walking in comfort should be a priority for a lifetime of healthy living.

Thursday, 01 January 2015 00:00

Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.


Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.

Monday, 22 December 2014 23:25

Proper Shoe Fitting

Proper shoe fitting is one of the most common concerns people have when it comes to the health of their feet. To some this may not seem like a major issue, but the reality is that improperly fitted shoes account for a tremendous amount of injuries to the foot. Because our feet, our posture, and our gait directly affect the bio-mechanics and the overall structure of our entire body, pains and discomforts felt elsewhere within the body can frequently be attributed to improperly fitted footwear. Here are a few factors to consider, which will help you select the proper footwear when shopping.

Do not purchase shoes with the expectation that they will stretch to accommodate the size of your feet. You are looking for shoes that fit correctly right away. If the shoes you purchase are too large and are slipping in the area of the heel while you walk, do not purchase them. Do not look favorably upon shoes that slip with the intention of wearing thicker socks to compensate for the slippage. Make certain that in the widest portion of the shoes, the ball of your foot, fits comfortably in the shoe.

It may be difficult to focus on these things with all the distractions of shopping, or tempting to ignore them because you badly want an uncomfortable shoe. However, if you cannot wear shoes because they hurt too much to use, your money and time will be wasted. When you get your new shoes home, put them on and walk around on a carpeted surface to see ensure your shoe's fit comfortably with normal activity.

With 33 joints, 26 bones, and over 100 ligaments, the potential for damage to the sensitive components within the foot are greater than many people realize. Finding a properly fitting shoe is the single most important factor you can do to help prevent injury and maintain optimal foot health. Adults tend to forget the fact that our feet continue to change as we grow older. So, even though they may no longer experience growth spurts associated with youth, their feet still change shape as they mature.

If you already have problems with your feet, wearing improperly fitted shoes can potentially exacerbate those problems. Fortunately, it does not require a tremendous amount of effort to find shoes that fit correctly. When shopping for shoes, keep in mind that improperly fitted shoes can not only cause a whole host of disorders and problems to occur within the feet themselves—they can affect the entire bio-mechanical structure of the body. Your posture and your stride are based on your feet, so your footwear can have a tremendous impact on the legs, back, and rest of your body. Finding the proper shoe fitting is essential to keep your feet and body healthly.

Monday, 08 December 2014 00:00

Every Day Foot Care

Our feet are of great importance in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if the feet are cared for and looked after each day, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly everyday. Remember to get between the toes, and keep the toenails trimmed and short. If the feet feel dry or one can see visual signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If creams or lotions sit in that area, they can cause development of fungi and bacteria. When moisturizer is used between the toes, it can also cause the skin to macerate.

Shoes are also an important aspect of foot care to consider. When one is picking out shoes, make sure that they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if the shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet, and that pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture and keep it off the feet. Without socks, the build up of sweat in a closed-toe she can cause fungi problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend much time on your feet, make sure that your shoes show no signs of wear and offer ample support for the arches and the overall foot. Additionally, try to engage in thorough foot cleaning and maintenance a part of your daily routine. If you keep these things in mind, your feet will stay healthy and safe.

Monday, 01 December 2014 00:00

Plantar Fasciitis

Recently, a groundbreaking study concluded that their treatment combining ultrasound with steroid injections was 95% effective in the treatment of plantar fasciitis.

Plantar fasciitis is a foot problem affecting the plantar fascia, a connective tissue in the heel. This condition is treatable, but in many cases can take up to a year to be effective.

Conventional treatments have included exercises, rest, arch supports, and night splints. If this proves to be inaffective, many patients undergo shockwave therapy. In shockwave therapy, sound waves are directed to the area where pain is experienced. This therapy can be affective, but is somewhat painful, and calls for several sessions. Even still, shockwave therapy does not always alleviate the pain caused by plantar fasciitis.

Luca M. Sconfienza, M.D., from the University of Genoa in Italy, conducted the study. The new treatment involves an ultrasound-guided technique with a steroid injection to the plantar fascia. It is a one time out patient procedure involving a small amount of anesthesia. Then an anesthetic needle punctures the affected area. This technique, known as dry needling, causes small amounts of bleeding that aid in healing the fesci.

It was discovered that 42 of the 44 patients involved in the study had their symptoms disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy” Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try noninvasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option," she added.

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