Marlo Rockovich

A learning experience is one of those things that says, 'You know that thing you just did? Don't do that.

There are not one but two different types of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter in comparison to the other. As a result of developmental periods of aging, the human brain senses the step pattern and recognizes some variation. Your body usually adapts by tilting one shoulder to the "short" side. A difference of less than a quarter inch isn't blatantly abnormal, require Shoe Lifts to compensate and mostly doesn't have a serious effect over a lifetime.


Shoe Lifts


Leg length inequality goes typically undiagnosed on a daily basis, yet this issue is easily corrected, and can eradicate quite a few incidents of back discomfort.


Treatment for leg length inequality typically consists of Shoe Lifts. These are cost-effective, normally costing below twenty dollars, in comparison to a custom orthotic of $200 plus. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.


Chronic back pain is easily the most widespread ailment affecting men and women today. Over 80 million men and women are afflicted by back pain at some point in their life. It is a problem which costs employers millions yearly as a result of time lost and production. Fresh and improved treatment solutions are constantly sought after in the hope of minimizing the economical impact this issue causes.


Leg Length Discrepancy Shoe Lift


Men and women from all corners of the world suffer the pain of foot ache due to leg length discrepancy. In a lot of these situations Shoe Lifts might be of very useful. The lifts are capable of relieving any pain and discomfort in the feet. Shoe Lifts are recommended by numerous expert orthopaedic practitioners".


So as to support the body in a healthy and balanced fashion, feet have got a very important task to play. Irrespective of that, it is sometimes the most overlooked area of the body. Many people have flat-feet which means there may be unequal force placed on the feet. This causes other body parts such as knees, ankles and backs to be impacted too. Shoe Lifts ensure that proper posture and balance are restored.
Posterior Calcaneal Spur


Overview


A heel spur is an overgrowth of bone that resembles a hook on the bottom of the foot. It is a reaction to stress placed on the thick connective tissue on the bottom of the foot (plantar fascia) that helps maintain the arches of the foot. Over-stress can stem from improper support of the feet. A heel spur is often accompanied by a bursitis that is a major contributor to pain.


Causes


Heel spurs are bony outgrowths positioned where the plantar fascia tissue attaches to the heel bone (the calcaneus). Heel spurs seldom cause pain. It is the inflamed tissue surrounding the spur that causes the pain. The Latin meaning of Plantar Fasciitis is, ?Inflammation of Plantar Fascia.? The plantar fascia is a long, thick and very tough band of tissue beneath your foot that provides arch support. It also connects your toes to your heel bone. Each time you take a step, the arch slightly flattens to absorb impact. This band of tissue is normally quite strong and flexible but unfortunately, circumstances such as undue stress, being overweight, getting older or having irregularities in your foot dynamics can lead to unnatural stretching and micro-tearing of the plantar fascia. This causes pain and swelling at the location where the plantar fascia attaches to the heel bone. As the fascia continually pulls at the heel bone, the constant irritation eventually creates a bony growth on the heel. This is called a heel spur.


Calcaneal Spur


Symptoms


The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at approximately ankle height.


Diagnosis


Your doctor will review your medical history and examine your foot. X-rays are used to identify the location and size of the heel spur.


Non Surgical Treatment


Some heel spurs do require surgery, however surgery is a last resort. In most cases the patients underlying foot problem needs to be addressed, such as Over Pronation and Over Supination and Heel Pain Treatment Options need to be implemented if Plantar Fasciitis and Achilles Tendonitis are still an ongoing concern. Your best treatment is always prevention.


Surgical Treatment


Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.


Prevention


You can help prevent heel spur symptoms from returning by wearing the proper shoes. Customized orthotics and insoles can help relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.
Posterior Calcaneal Spur


Overview


A heel spur is a bony projection on the sole (plantar) region of the heel bone (also known as the calcaneous). This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. This associated plantar fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes.


Causes


Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.


Calcaneal Spur


Symptoms


You may or may not experience any symptoms with your heel spurs. It is normally the irritation and inflammation felt in the tissues around your heel spur that cause discomfort. Heel pain is one of the first things you may notice, especially when pushing off the ball of your foot (stretches the plantar fascia). The pain can get worse over time and tends to be stronger in the morning, subsiding throughout the day; although it does return with increased activity. A sharp, poking pain in your heel that feels like you're stepping on a stone can often be felt while standing or walking. You will sometimes be able to feel a bump on the bottom of your heel, and occasionally bruising may appear.


Diagnosis


Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.


Non Surgical Treatment


Heel spurs can be solved with simple solutions that do not involve surgery. Avoiding extended periods of activity such as running, sports and walking. Applying ice directly to the heel for 5 minutes at a time. This helps soothe and reduce inflammation. Lose weight to reduce stress on your heels. A series of simple exercises. Inexpensive orthotic shoe inserts. The best way to treat heel spurs is by treating the underlying cause of the problem. This involves correcting the dynamics of your foot motion with orthotic insoles.


Surgical Treatment


When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.
Overview


Retrocalcaneal and retroachilles bursitis are both common types of bursitis that can cause pain at the back of the foot, just above the heel. This pain, and often swelling, occurs when one or both bursae at the back of the heel become irritated and inflamed. Because they have similar symptoms, heel bursitis is sometimes confused with problems affecting the Achilles tendon, which is a long strip of fibrous tissue that connects the back of the heel to the calf muscle. Other times, Achilles tendon problems may bring about the bursitis. For example, tight calf muscles can contribute to chronic pulling where the Achilles tendon inserts into the back of the heel. This pulling can result in friction and irritation that eventually lead to bursitis.


Causes


Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.


Symptoms


A dull ache under the heel when not weight bearing. Sometimes severe pain when walking. Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again. Throbbing under the heel. Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself. Tingling under the heel as swelling affect the plantar nerves. Pains shooting into the foot or up the leg.


Diagnosis


If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.


Non Surgical Treatment


Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.


Surgical Treatment


Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
HammertoeOverview


If you sneak a peek at your feet and notice that your toes are crossed, bent, or just pointing at an odd angle, you probably suffer from a hammertoe. Toes that are scrunched up inside tight shoes or pressed against the toe box of the shoe can bend at the joints and stay that way - resulting in a hammertoe. A hammertoe is a contracture of the toe at one of the two joints in the toe. Due to the pull of the tendons, the joints become more rigid over time. The toe is bent up at the joint and does not straighten out.


Causes


Hammer toe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is Hammer toe bent and held in one position long enough, the muscles tighten and cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma.


HammertoeSymptoms


Symptoms may include pain in the affected toe or toes when you wear shoes, making it hard or painful to walk. A corn or callus on the top of the joint caused by rubbing against the shoe. Swelling and redness of the skin over the joint. Trouble finding comfortable shoes.


Diagnosis


Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.


Non Surgical Treatment


Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include splinting the toe to keep it straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.


Surgical Treatment


If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity. The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.