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MUSCULOSKELETAL FOOT PAIN
Plantar Fasciitis - Anterior Knee Pain - Neuromas - Gout - Arthritic Joints - Bunions - Achilles Tendonitis - Shin Splints
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Heel Pain from Plantar Fasciitis
Plantar Fasciitis is inflammation of the plantar fascia, that is a ligamentous band running across the sole of the each foot from the heel to the toes. The inflammation is caused by excessive stress at its attachment to the heel bone, or sometimes along its length in the arch. It feels like a deep bruise which is most painful when you first stand in the morning or after sitting.
It usually starts the day after some unusual activity, it may be a long walk, run or even having to stand in flat shoes for an unusually long time. Sometimes it is linked to sudden weight gain.
It should heal naturally but sometimes becomes chronic, that is doesn't heal because of underlying biomechanical problems such as overpronation and restricted ankle joint mobility often due to tight calf muscles.
These are painful swellings in the sheath encasing digital nerves as they pass between the metatarsal joints. They can occur when the nerves are pinched due to tight shoes or poor foot function. It most commonly occurs in the cleft between the 3rd and 4th toes. If treated early simple insoles can settle the inflammation. However if the neuroma is larger they still respond particularly well to corticosteriod injections.
Just to say another Juriansz miracle seems to be happening! I hope I am not celebrating too early but, for the past ten days, I have not had any pain from my Morton’s Neuroma, no having to suddenly take my shoe off to relieve agony etc.
Thank you, Eve
Ultrasound scans are a useful aid to diagnosis
Image: Ultrasound scans are a useful aid to diagnosis
Podiatric Biomechanical Assessment
Whether you're involved in professional sports or just on your feet a lot at work, the way your feet function can lead to excessive stress and strain on muscles and ligaments throughout your body.
Podiatrists are able by examining the feet to assess the cause of poor foot function and the treatment needed to improve it.
The Podiatric biomechanical assessment involves a thorough examination of the mobility, range of motion and alignment of the joints in the feet and legs, when resting, standing and walking.
Various diagnostic tools are used to aid the diagnosis such as the Quintic Digital Video Gait Analysis System, whereby the subject is videoed walking on a treadmill which can then be analysed through a specific computor program.
Image: Excessive pronation
What are we looking for
The Podiatrist tries to establish whether there is any imbalance in your feet causing them to overpronate (roll in) or over supinate (roll out) and if there is, what is causing it.
Arthritic Joints - Gout - Bunions
There are 26 bones in each foot so there are lots of joints each with the potential for injury and inflammation. The most commonly effected joint is at the base of the big toe, it can become painful and swollen. Old injuries from sport or tight shoes can damage cartilage causing excessive wear in the joint, leading to extra bone outgrowth which stiffens the joint. Many other joints can be affected. Corticosteroid injections, therapeutic ultrasound and insoles or orthotics can be effective treatments.
Achilles Tendonitis - Shin Splints
Achilles tendonitis presents as pain in the back of the heel or along the achilles tendon. Shin splints present as pain along the front of the lower leg at the muscle attachment to the shin. Anterior knee pain presents as pain under or around the knee cap. They are commonly caused by overpronation of the foot in people on their feet a lot either at work or in a sporting activity. Orthotics are probably needed to reduce overpronation reducing stress on the tendons, muscles and ligaments.
Treatment of Musculoskeletal Problems
Sometimes simple stretching exercises may be all that is required.
Pain can be relieved by anti-inflammatory medication, ice packs, massage, padding, simple insoles and therapeutic ultrasound. If necessary we can provide corticosteriod injection therapy which is usually fast acting and can provide long term relief.
Long term functional control of the feet can be improved with foot orthotics. They are hard insoles that are moulded to the shape of your feet when they are appropriately aligned with your leg. Posting may also be applied to improve the alignment further by tilting the heel or forefoot. By reducing over pronation or supination they reduce the stresses which are the underlying causes of many painful musculoskeltal problems.
They need to be rigid to control the mobility of the foot which is why they need to be moulded to make them comfortable to wear. Off the shelf orthotics are softer and more flexible sacrificing functional control.
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