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Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
Biomechanics and its related study deal with the forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
Biomechanics and its related study deal with forces that act against the body and affect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.
Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet. These issues can also limit our bodies’ mobility that we often take for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area. This affects the way you move around on a daily basis.
The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root founded Root Lab to make custom orthotics. He proposed that corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of foot orthotics to this day.
As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can take readings and also map out what treatment will do to the affected areas.
These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics are able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot. Speak with your podiatrist if you have any of these problems.
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas. Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.
Both running and walking are great exercises, but should a person wear the same shoes for both activities? The answer is no, because there is a difference between the way a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed differently. Before you begin any exercise program it is always recommended that you speak with your doctor or podiatrist.
Walking is a low impact exercise that is often recommended by doctors to their patients. While walking is a simple activity, it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you move, you will notice that your heel hits the ground first before your foot continues to roll forward and your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. This flexibility helps the walker push off with each step taken.
Because the heel hits the ground first when you walk, walking shoes are designed to absorb most of the shock. Walking shoes should therefore have a beveled or angled heel. The angle of the heel helps absorb the shock and reduces pressure from the ankles. This is especially important for speed walkers, as their feet will hit the ground twice as often as the normal walker.
When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise. If not done with the proper equipment, running may cause damage to the feet and legs. Running shoes are designed to be more lightweight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. Walking shoes often do not have the proper arch support that running shoes do.
A proper fitting shoe can make or break a runner or a walker. If the shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. Whether you will be running or walking, the right equipment can make all of the difference in the world.
The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.
To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.
When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.
Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise. Referrals will then be made to specialists that handle the greater health problems.
Some podiatrists have their own independent, private practices or clinics where they have a small staff and administrative personnel. Many podiatrists work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals, or visit patients in nursing homes. Podiatrists typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.
Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that results from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.
Flatfoot is a foot disorder that is not as straightforward as many people believe. Various types of flatfoot exist, each with their own varying deformities and symptoms. The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot. Other signs of flatfoot include:
- “Toe drift,” or the pointing outward of the toes and the front part of the foot
- The tilting outward of the heel and the tilting inward of the ankle
- The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
- Hammertoes
- Bunions
One of the most common types of flatfoot is flexible flatfoot. This variation usually starts in childhood and progresses as one ages into adulthood. Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing. When not standing, the arch returns. Symptoms of flexible flatfoot include:
- Pain located in the heel, arch, ankle, or along the outside of the foot
- Overpronation, or an ankle that rolls in
- Shin splint, or pain along the shin bone
- General foot aches or fatigue
- Pain located in the lower back, hip, or knee
Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit. X-rays may be taken to define the severity and help determine the treatment option best for your condition. Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices. If nonsurgical methods prove ineffective, surgery may be considered. Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.
Overtraining and overusing the feet are the main causes of common running injuries. A number of these common injuries are caused by overrunning. Runner’s knee is a condition that is characterized by the back of the kneecap beginning to wear away and cause pain in the knee. This frequently occurs due to either a decrease in strength in the quadriceps muscles or ill-fitting shoes that are lacking in proper support for the inside of the forefoot. Strengthening exercises focusing on the quad muscle and sports orthotics are the usual treatments for those suffering from runner’s knee. Prevention of the condition lies in a focus on hip strengthening and quad-strengthening to keep the kneecap aligned. To help learn the best exercise to heal runner’s knee, one can also undergo physical therapy.
One common injury, called iliotibial band syndrome, is often caused by overtraining. This condition occurs when the iliotibial band gets irritated, creating pain and discomfort in the outside knee area. Plantar fasciitis, another common running injury, also occurs as a result of inflammation and irritation. Plantar fasciitis is an inflammation and irritation of the bone in the foot. A large amount of pain is often experienced due to plantar fasciitis. The condition can be caused by a high arch, improper footwear, tight muscles, or flat feet. It can best be avoided by stretching and wearing appropriate footwear that supports the foot.
Another common injury for runners is stress fractures. These injuries occur due to running style, overtraining, or a lack of calcium. Stress fractures most often occur in several locations in runners, including the inner bone of the leg, the thighbone, the bone at the base of the spine and the bones of the toes. Stress fractures are best prevented by wearing proper footwear and by running on flat and hard surfaces; this will absorb some of the shock created during running.
Aside from overtraining, other causes of common running injuries include ill-fitting footwear, a lack of flexibility and strength, and irregular biomechanics. The best way to avoid running injuries is to prevent them from even occurring. Both iliotibial band syndrome and stress fractures are preventable. The first step that should be taken to prevent running injuries is to only wear footwear that fits properly and that is appropriate for whatever activity you are doing. Running shoes are the only protective gear available to runners that can safeguard them from sustaining injuries. Choosing the right pair of shoes is therefore extremely important. While running shoes are an important factor, it is also important to consider other facets of your running routine such as training schedules, flexibility, and strengthening. These elements should be considered and altered according to your running needs to best maximize your run and minimize the possibility of injury. Careful stretching before and after a run should also be considered to help prevent running injuries. Stretching muscles enables greater flexibility and a lesser chance of sustaining injury.
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When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition. A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case. Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery. Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.
Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome. A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications. Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered. Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.
Care post-surgery will depend on the type of surgical procedure performed. Typically, all postoperative care involves rest, ice, compression, and elevation. To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes. He will also determine if and when you can bear weight. A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.
When it comes to maintaining foot health, wearing properly-fitting shoes is important. While wearing the appropriate pair of shoes may seem like a trivial concern, the reality is that improperly fitted shoes cause an astounding amount of injuries to the feet. The overall structure and the biomechanics of our bodies are directly affected by our posture, gait, and feet. Because of this, pain and discomfort felt throughout the body are often related to a problem in the feet. And, most foot problems usually stem from improper footwear.
Shoes should not be purchased with the expectation that they will easily stretch and contort to the size and shape of your feet. When shopping for footwear, look for shoes that fit correctly and comfortably as soon as you put them on. Do not purchase shoes that are too large or that slip in the heel area when you walk. Do not choose shoes that are loose with the intention of wearing thicker socks to compensate for the space. The widest portion of the shoe, the ball of the foot, must be made sure to fit comfortably in the shoe.
Keeping all of these suggestions in mind may be difficult when shopping and when trying to select from a wide array of different shoes. Nonetheless, your time and money will be wasted if you purchase a pair of shoes that are too uncomfortable for you to actually wear them. After finally selecting and purchasing a pair of shoes, try them on at home. To truly ensure whether or not your shoes fit comfortably with normal activity, walk around on a carpeted surface to determine how they feel on your feet.
The possibility of damaging your feet’s 33 joints, 26 bones, and 100+ ligaments is much higher than many people suspect. Finding an appropriate and properly-fitted pair of shoes is perhaps the single most important action you can take to maintain excellent foot health and help prevent injury. The fact that our feet continue to change with age is one that many people often forget. Even if our feet no longer change in size when we mature, our feet will still change in shape.
If you already have pre-existing foot problems, there is a greater possibility that wearing improperly-fitted shoes will worsen those problems. The good news, however, is that appropriate footwear is not difficult to find. While shopping for shoes, remember that improper footwear can detrimentally affect the feet, the entire body and its biomechanical structure as well. The shoes you wear can greatly impact your legs, back, and entire body, as your posture and gait are related to your feet. Finding and selecting the best properly-fitted shoes is necessary in achieving optimal health.
Podiatry is a branch of medicine that deals with the study, diagnosis, and treatment of foot and ankle conditions. There are various subdivisions in podiatry; biomechanics is one of them. Biomechanics is the way in which the bones, muscles, and joints of the feet and lower limb interact with each other.
Our feet play crucial roles in the way we move, and it is rare to have feet that are completely symmetrical. Common biomechanical issues include high or low arches or uneven leg heights. Excessive pronation often leads to fallen arches, or flat feet, and is a common cause of running injuries. People whose feet are over-pronated tend to have flexible and unstable feet. Pain is usually experienced during walking and running.
At times, people may be able to adapt to these abnormalities without any difficulties, but in other cases, these issues can cause a great deal of pain. This pain occurs because the joints, muscles, ligaments, and tendons are put under an excess amount of stress during movement. Common symptoms of biomechanical problems stemming from the feet include hip pain, knee pain, leg cramps, ankle pain, lower back pain, weak ankles, tripping, heel pain, Achilles pain, and shin splints.
Many biomechanical issues can be treated with orthotics. Orthotics are shoe insoles that are used to help control the way the foot operates. They can provide relief from foot pain, heel pain, and knee pain. Depending on your specific case, you may need to purchase over-the-counter orthotics or custom orthotics to fit your feet. Your podiatrist will be able to prescribe the perfect orthotic for your feet to help you walk around with ease.
Gait is defined as the way we move our bodies from one point to another. This is usually done by either walking or running. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities. Gait analyses are a great way to take a detailed look at how you walk and how your foot moves while you walk. An examination of the feet will help your podiatrist understand why you are suffering pain in other parts of your body.
Gaining weight can happen suddenly and at any time. Usually you won’t notice the extra weight until your feet start hurting at the end of the day. This happens as your feet begin adjusting to carrying more weight. Foot swelling and pain are two of the biggest side effects of having gained weight.
Many foot-related problems can occur even after just putting on a few pounds. This includes the body ‘compensating’ by changing the way it moves. You may find yourself putting extra weight on the wrong parts of your feet and even leaning forward a bit. Your feet were designed to carry a healthy, normal body weight. Extra weight places undue stress on them.
Being overweight often causes the development of Type-2 diabetes, causing leg and foot pain. Older people who do not attempt to control their condition can even lose sensation and feeling in their legs and feet. This can lead to the development of small sores that can lead to serious infection.
Extra stress placed on the joints, tendons and muscles in the feet as a result of extra body weight may also cause heel spurs, or plantar fasciitis. Plantar fasciitis is an inflammation of the foot tissue, causing stiffness and pain when walking and climbing stairs. This can usually be relieved by foot stretches and custom made orthotic shoe-inserts.
Problems in the feet triggered by obesity can be treated by paying special attention to footwear. Proper support shoes that allow for good circulation, especially in the arch and ankle, are vital. A podiatrist can help you find what sort of shoe is most suitable for your feet. They can also measure you for special orthotics if necessary.
It could also be high time to start losing weight in order to treat and prevent diabetes as well as other life threatening diseases. Some methods include yoga and water aerobics, which benefit your entire body without placing stress on your feet. Don’t risk losing your feet by losing interest in them. Take care of your feet and your body, as they deserve the very best.