Rocker Shoes for Plantar Fasciitis
A study that was published in Clinical Biomechanics in Sept (2012) investigated the pain levels in people aged 40-65 who had plantar fasciitis. They used a visual analogue pain scale (VAS), the investigated the use of foot orthotics to toning shoes to foot orthotics and toning shoes to see what effect they had on pain in the plantar fasciitis. The best results were with the combined shoe and foot orthotics rather than each treatment on their own. This was only measured in one session and was not followed up over time and the VAS is not the best measure for ...
Body weight and the risk for injury
Intuitively it could be assumed that those runners with a higher body mass index (BMI) would be at a greater risk of injury. Obesity has a significant impact on the lower limb and biomechanics, so when it comes to running, those with a higher body weight would have a greater load on the structures and be at greater risk for injury. This is important as the role that exercise plays in treating the obesity epidemic. Despite this hypothetical risk for injury, a recently published prospective study found that there was no correlation between BMI and the risk for injury in ...
Kohlers Disease
Kohlers disease is a rare disorder that needs to be considered in the differential diagnosis of pain in the midfoot of children aged around 6-9 years. It is an osteochondrosis of the navicular bone causes by the load on the bone and a problem with the vascular supply to the bone. This leads to a flattened appearance of the bone on x-ray, compared to the contralateral side. The pain is located over the navicular bone and there is usually swelling, as well as a slight limp. Kohlers disease needs to be put in cast for 6-8 weeks followed by at ...
Cracked Skin in Diabetes
Cracked heels are a common problem in those who are overweight, have dry callused skin around the heel and wear open heel shoes. Not a lot of attention has been placed to this problem in those with diabetes. A recently published study has investigated superficial and deep fissures in the foot of those with diabetes and the factors that are associated with them. A total number of 578 patients with diabetes were assessed. Superficial fissures was present in 9.0%, and that of deep fissures was present in 3.8%. The presence of superficial fissures was only correlated with autonomic but the ...
Growing Pains
Growing pains in children are common but generally do not cause any significant problems or long term problems. Despite that they can be quite distressing for the child and the parent as they wake the child at night. The definition of a true growing pains in children is pain in the upper part of the calf muscles or behind the knee that occurs at night. If the pain occurs during the day or in a different location, then it is not true growing pain. These need to be further investigated as to the causes. The problem with the diagnosis of ...
Lasers for toenail onychomycosis
The use of lasers for toenail onychomycosis has led to some debate and discussion (Laser treatment for nail fungus; The PinPointe Laser) on its clinical usefulness, efficacy and the published evidence for its use. There is next to no published evidence for the use of lasers for this and no controlled clinical trials have yet compared it to a current therapy or even a placebo. This lack of data has not stopped it beginning to be used in clinical practice and many powerful claims made for its effectiveness in the absence of this evidence (see the You Tube videos). The most ...
Sinus Tarsi Syndrome
This is a painful condition involving the sinus tarsi between the talus and calcaneus. It can be injured as part of an inversion sprain by a strain of the ligaments that cross the sinus tarsi or it can be injured due to an excessively pronated foot compressing structures in the sinus tarsi. Patients with sinus tarsi syndrome generally present with some perception of instability and pain on weghtbearing. Inversion and eversion of the subtalar joint may be painful. Pain is usually felt over the sinus tarsi on palpation. Treatment of sinus tarsi syndrome is usually with the use of physical therapy ...
Severs Disease
Severs disease is probably the most common problem that affects the heel bone in children. It has been likened to a stress fracture of the cartilage in the growth plate at the rear of the calcaneus. It is most common during the ages 10-14 years when the bone is actively growing. The pain is usually present at the back and sides of the calcaneus. The typical approach to treatment is the reduction in activity levels and the use of shock absorbing insoles or pads under the calcaneus. Some of the recent research on Severs Disease has shown: - arch taping in those ...
Chilblains
Chilblains are really common in some parts of the world and are unheard of in other parts of the world. In some parts of the world chilblains are as common as the everyday cold and recognised daily. In other parts of the world they can easily get missed as they do not happen that often. The key pathophysiological mechanism underpinning chilblains is a the microcirculation not responding appropriately to warming after the foot has got cold. The exact reason of this poor response of the circulation is not known. Chilblains are not due to poor circulation or the cold, but are ...
Navicular Stress Fracture
Occasionally you can hear about a top level athlete in the news getting surgery for a tarsal navicular stress fracture. Unless you are at that elite level, it assumed that the avenue of surgical management may not be open. A recent systematic review published in the American Journal of Sports Medicine compared outcome between conservatively managed () and surgical management. They found no differences, and in fact, there was a non-statistically significant trend towards the conservative care being better. There conclusion was: Non-weight bearing conservative management should be considered the standard of care for tarsal navicular stress fractures. The authors could find ...
Medial Tibial Stress Syndrome and Bending Moments
The April 2010 edition of Podiatry Today has an update of the latest concepts in Medial Tibial Stress Syndrome. Two key concepts that came through in the article is exactly what is the pathological process in the condition - is it a soft tissue traction issue or a bone stress reaction due to tibial bending actions? If it is due to tibial bending moments,then this has implications for foot orthotics prescription for the mechanical management of medial tibial stress syndrome. There has been some discussion on this concept for medial tibial stress syndrome. {openx:164}
Risk for plantar fasciitis in factory workers
A recent study from the University of Michagan looked at the risk factors for plantar fasciitis in asembly plant workers. They found that plantar fasciitis was common in this group of workers and the factors that increased the risk for it were: forefoot pronation on physical examination high metatarsal pressure on the gait assessment increasing time spent standing on hard surfaces increased time spent walking medium tenure at the plant an increased number of times getting in and out of the vehicle (for the truck/forklift drivers) The key seems to be weight bearing on a hard surface, so it appears that one of the best strategies to ...
Barefoot Running
There has been a lot of publicity in the media in the last few days with a number of press releases related to the benefits of barefoot running as opposed to running in running shoes. A quick look around some barefoot running websites and some running forums show that these studies have been widely discussed and promoted. The first was this: The Effect of Running Shoes on Lower Extremity Joint Torques and the other was in Nature: Foot strike patterns and collision forces in habitually barefoot versus shod runners. What is somewhat alarming is the support that barefoot runners are giving ...
Lipid disorders and diabetic neuropathy
More and more research is linking cholesterol and lipid disorders to the development and management of diabetic neuropathy. Most recently a review in the Journal of the Pheripheral Nervous System (Hyperlipidemia: a new therapeutic target for diabetic neuropathy Andrea M. Vincent, Lucy M. Hinder, Rodica Pop-Busui, and Eva L. Feldman Journal of the Peripheral Nervous System; Volume 14 Issue 4, Pages 257 - 267 2009) discusses how the separate metabolic imbalances of hyperglycemia and hyperlipidemia, converge to lead to oxidative stress in the sensory neurons. They concluded that this provides opportunites for novel therapeutic strategies to treat diabetic neuropathy. A 2007 press release from ...
Is MRSA in infecting or contaminating organism?
In the latest issue of Current Diabetes Reports, Bowling, Jude and Boulton ask the question as if wound colonization by methicillin-resistant Staphylococcus aureus (MRSA) is the cause of infection or just a contaminating organism. A number of studies have found the bacterial content of diabetic foot ulcers to be polymicrobial, so this question as to which is the infecting organism remains unanswered. Bowling FL, Jude EB, Boulton AJ.; MRSA and diabetic foot wounds: contaminating or infecting organisms?. Curr Diab Rep. 2009 Dec;9(6):440-4. (link) {openx:164}
More than half of Scotland are obese
Data from 2008 was disclosed by Public Health Minister Shona Robison in answer to Tory questions in parliament show that two-thirds of men and more than half of women in Scotland are overweight. Conservative MSP Jackson Carlaw said the statistics disclosed the true scale of "Scotland's obesity epidemic" and are appalling. Figures for children aged between two and 15 showed that more than a third of boys and a quarter of girls weighed too much. See the full story from the BBC. {openx:164}
Guidelines for the treatment of Psoriasis
Several issues of the Journal of the American Academy of Dermatology has some definitive review and guidelines on teh treatment of psoriasis for those that can access the journal: Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: Overview and guidelines of care for treatment with an emphasis on the biologics Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for ...
New Rheumatoid Arthritis Criteria
The current criteria for the diagnosis of rheumatoid arthritis (RA) were developed in 1987. At its October meeting, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) released revised the guidelines. The revised criteria rate patients on a scale of 0-10 points, with points assigned in four separate domains of signs and symptoms: joint involvement, serology, duration of symptoms, and acute phase reactants. Those who tally 6 or more points are considered to have definite rheumatoid arthritis. The joint ACR/EULAR panel is still considering what score should distinguish patients with probable RA from those in whom RA is unlikely, but ...
Cuboid Syndrome
Cuboid syndrome is due to what is thought to be a subluxation of the cuboid bone. When the peroneus longus muscle muscle contracts, it tries to dorsally displace and evert the cuboid as the tendon passes under the bone. To prevent this from happening the cuboid needs to be very stable against the calcaneus. If it is not stable, then there is some amount of subluxation of the bone. This results in symptoms around the joints on the lateral side of the foot. Treatment usually starts with some form of cuboid manipulation. Foot othotics and or strapping may be needed to ...
Rocker Shoes for Plantar Fasciitis
Rocker Shoes for Plantar Fasciitis
Cracked Skin in Diabetes
More than half of Scotland are obese
Rocker Shoes for Plantar Fasciitis
A study that was published in Clinical Biomechanics in Sept (2012) investigated the pain levels in people aged 40-65 who had plantar fasciitis. They used a visual analogue pain scale (VAS), the investigated the use of foot orthotics to toning shoes to foot orthotics and toning shoes to see what effect...
Body weight and the risk for injury
Intuitively it could be assumed that those runners with a higher body mass index (BMI) would be at a greater risk of injury. Obesity has a significant impact on the lower limb and biomechanics, so when it comes to running, those with a higher body weight would have a greater load on the structures and...Kohlers Disease
Kohlers disease is a rare disorder that needs to be considered in the differential diagnosis of pain in the midfoot of children aged around 6-9 years. It is an osteochondrosis of the navicular bone causes by the load on the bone and a problem with the vascular supply to the bone. This leads to a flattened...Cracked Skin in Diabetes
Cracked heels are a common problem in those who are overweight, have dry callused skin around the heel and wear open heel shoes. Not a lot of attention has been placed to this problem in those with diabetes. A recently published study has investigated superficial and deep fissures in the foot of those...Does the Circulation Booster Work?
{openx:164}Growing Pains
Growing pains in children are common but generally do not cause any significant problems or long term problems. Despite that they can be quite distressing for the child and the parent as they wake the child at night. The definition of a true growing pains in children is pain in the upper part of the...Lasers for toenail onychomycosis
The use of lasers for toenail onychomycosis has led to some debate and discussion (Laser treatment for nail fungus; The PinPointe Laser) on its clinical usefulness, efficacy and the published evidence for its use. There is next to no published evidence for the use of lasers for this and no controlled...Sinus Tarsi Syndrome
This is a painful condition involving the sinus tarsi between the talus and calcaneus. It can be injured as part of an inversion sprain by a strain of the ligaments that cross the sinus tarsi or it can be injured due to an excessively pronated foot compressing structures in the sinus tarsi. Patients...Severs Disease
Severs disease is probably the most common problem that affects the heel bone in children. It has been likened to a stress fracture of the cartilage in the growth plate at the rear of the calcaneus. It is most common during the ages 10-14 years when the bone is actively growing. The pain is usually present...Chilblains
Chilblains are really common in some parts of the world and are unheard of in other parts of the world. In some parts of the world chilblains are as common as the everyday cold and recognised daily. In other parts of the world they can easily get missed as they do not happen that often. The key pathophysiological...Navicular Stress Fracture
Occasionally you can hear about a top level athlete in the news getting surgery for a tarsal navicular stress fracture. Unless you are at that elite level, it assumed that the avenue of surgical management may not be open. A recent systematic review published in the American Journal of Sports Medicine...Medial Tibial Stress Syndrome and Bending...
The April 2010 edition of Podiatry Today has an update of the latest concepts in Medial Tibial Stress Syndrome. Two key concepts that came through in the article is exactly what is the pathological process in the condition - is it a soft tissue traction issue or a bone stress reaction due to tibial bending...Risk for plantar fasciitis in factory workers
A recent study from the University of Michagan looked at the risk factors for plantar fasciitis in asembly plant workers. They found that plantar fasciitis was common in this group of workers and the factors that increased the risk for it were:
forefoot pronation on physical examination
high metatarsal...Barefoot Running
There has been a lot of publicity in the media in the last few days with a number of press releases related to the benefits of barefoot running as opposed to running in running shoes. A quick look around some barefoot running websites and some running forums show that these studies have been widely discussed...Lipid disorders and diabetic neuropathy
More and more research is linking cholesterol and lipid disorders to the development and management of diabetic neuropathy. Most recently a review in the Journal of the Pheripheral Nervous System (Hyperlipidemia: a new therapeutic target for diabetic neuropathy
Andrea M. Vincent, Lucy M. Hinder, Rodica...Is MRSA in infecting or contaminating organism?
In the latest issue of Current Diabetes Reports, Bowling, Jude and Boulton ask the question as if wound colonization by methicillin-resistant Staphylococcus aureus (MRSA) is the cause of infection or just a contaminating organism. A number of studies have found the bacterial content of diabetic foot...More than half of Scotland are obese
Data from 2008 was disclosed by Public Health Minister Shona Robison in answer to Tory questions in parliament show that two-thirds of men and more than half of women in Scotland are overweight. Conservative MSP Jackson Carlaw said the statistics disclosed the true scale of "Scotland's obesity epidemic"...Guidelines for the treatment of Psoriasis
Several issues of the Journal of the American Academy of Dermatology has some definitive review and guidelines on teh treatment of psoriasis for those that can access the journal:
Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines...New Rheumatoid Arthritis Criteria
The current criteria for the diagnosis of rheumatoid arthritis (RA) were developed in 1987. At its October meeting, the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) released revised the guidelines. The revised criteria rate patients on a scale of 0-10 points,...Cuboid Syndrome
Cuboid syndrome is due to what is thought to be a subluxation of the cuboid bone. When the peroneus longus muscle muscle contracts, it tries to dorsally displace and evert the cuboid as the tendon passes under the bone. To prevent this from happening the cuboid needs to be very stable against the calcaneus....