Kid’s Feet Can Keep Them on the Sideline Too
While physical activity is great for kids, overdoing it can cause lasting problems for their feet and ankles. Bones, ligaments and tendons in kids’ feet and ankles aren’t fully developed yet, and damage can occur when they are stressed from hours of playing sports. Parents and coaches need to be on the lookout for signs and symptoms of overuse injuries in youth athletes, and to have problems evaluated by a foot and ankle surgeon for an accurate diagnosis and appropriate treatment.
Common overuse injuries that can occur in children’s feet and ankles include:
- Inflammation of the heel’s growth plate, due to muscle strain and repetitive stess. In children, the heel bone is not yet fully developed until age 14 or older. Until then, new bone is forming at the growth plate, a weak area located at the back of the heel.
- Achilles tendonitis, occurs mainlyin adolescents when the Achilles tendon becomes stressed and inflamed from repeated running and pounding.
- Stress fractures, which are hairline breaks resulting from repeated stress on the bone, often occur in adolescents engaged in athletics, especially when the intensity of training suddenly changes.
- Tendo-Achilles bursitis, is an inflammation of the fluid-filled sac located between the Achilles tendon and the heel bone. It can result from injuries to the heel, repetitive stress, or wearing poorly-cushioned shoes.
Remember, pain is never normal in a child’s foot or ankle! Some kids will insist on continuing to play even when they’re in pain. Parents and coaches should never allow this to happen! Continuing to play with an injury can result in problems that may plague the child into adulthood. Any pain that lasts more than a few days, or that is severe enough to limit the child’s ability to walk, should be evaluated in our office as soon as possible.
Is It Time For Surgery For Your Heel?
Heel pain is one of the most common complaints by patients visiting a Podiatrist or Orthopedist. Often times, the patient has had the heel pain for several months, always thinking that the pain will improve with time. Unfortunately, the pain usually worsens progressively to the point where the patient can not handle it any further, and finally goes to either their primary doctor or a podiatrist.
Conservative treatments include icing of the heel, stretching, anti-inflammatories and inserts into shoes. If the pain fails to improve, further options include injection and physical therapy. Unfortunately, approximately 20% of patients fail to improve or have resolution of their symptoms. If you have had heel pain for more than 3 months with appropriate treatment, then you may be in the group for whom surgery becomes the next step.
This kind of surgery typically involves a small incision on the bottom of the foot which not only allows for removal of the heel spur causing the pain, but results in a relatively quick recovery and significant reduction in pain. A study published in The Journal of Foot and Ankle Surgery found that patients who had surgery with the special technique just described had a 96% resolution rate! That is substantially higher than all other procedures including extracorporeal shock-wave therapy and plantar fasciotomy.
A recent study has shown that only 70% related a “sharp decline” in pain using extracorporeal shock-wave therapy. Heel pain responds to non-surgical treatment, but when it does not, there are options. The Podiatrist you will see at AnkleNFootCenter.com will be highly skilled at performing successful and minimally invasive procedures. This allows for quick recovery and return to normal activity.
Broken Toe Myths
Myth #1: A doctor can’t do anything for a broken toe.
Although it isn’t true, unfortunately many people believe this myth and never get proper treatment for these injuries. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop.
For example: the bones may become deformed, thereby limiting the ability to move the foot or causing difficulty in fitting shoes.
If there is a fracture in a joint (the juncture where two bones meet), arthritis may develop. Arthritis may also be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected.
An untreated fracture can cause chronic pain and long-term dysfunction.
A fracture that does not heal can lead to the need for surgery
Myth #2: If you can walk on it, it isn’t broken.
Many people believe this myth, and will continue to walk after a bone in their foot is fractured…sometimes resulting in even greater damage. Symptoms of a fracture include:
- Pain at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours.
Misshapen appearance of the toe.
Bruising and selling the next day
In addition to fractures that are caused by trauma to the foot, some people (especially those who participate in athletics or who suffer from osteoporosis) may get a stress fracture in their foot. Although one can walk on a foot that has a stress fracture, these tiny, hairline breaks should not be ignored, because they will come back unless properly treated. You may have a stress fracture if you notice:
- Pain with or after normal activity
- Pain that goes away when resting and then returns when standing or during activity
- Pain at the site of the fracture when touched
Swelling, but no bruising
The bottom line is: fractures of the foot require proper treatment. Even if your fracture has been treated in an emergency room, follow-up with our office is advised to avoid improper healing and possible long-term consequences.
Morton’s Neuroma
is an enlarged nerve that usually occurs between the third and fourth toes. The most common symptom is pain in this area. It can be sharp or dull, and is worsened by wearing shoes and by walking. Pain usually is less severe when the foot is not bearing weight. Causes may be tight shoes, high heels, and flat feet.
To diagnose, the podiatrist may try to reproduce the symptoms of pain by trying to squeeze the enlarged nerve. An x-ray should be taken to ensure that there is not a fracture. X-rays also can be used to examine the joints and bone density, ruling out arthritis (particularly rheumatoid arthritis and osteoarthritis). An MRI may be used to ensure that the compression is not caused by a tumor in the foot and also determine the size of the neuroma.
Initial treatment consists of padding and taping to disperse weight away from the neuroma. If the patient has flat feet, an arch support is incorporated. The patient is instructed to wear shoes with wide toe boxes and avoid shoes with high heels. An injection of local anesthetic to relieve pain and a corticosteroid to reduce inflammation may be administered. The patient is advised to return in a week or two to monitor progress. If the pain has been relieved, the neuroma is probably small and caused by the structure of the patient’s foot and the type of shoes the patient wears.
It can be relieved by a custom-fitted orthotic that helps maintain the foot in a better position. Serial (repeated) neurolysis injections have recently been reported to be quite effective if other conservative measures fail. This involves 3-7 injections of local anesthetic with 4% concentration of alcohol. This mixture effectively destroys the neural tissue, relieving the pain without having to surgically remove the enlarged nerve segment. If resolution is not accomplished via these methods, then surgical intervention to remove the inflamed nerve and possible release of the intermetatarsal ligament would be necessary.
Picture This: New Imaging Technology for the Feet
A good exam at your podiatrist’s office can be the simplest and most cost- effective way to get past any number of injuries that keep you from running your best. ( I know, one visit to my podiatrist netted me a “prescription” for nothing more than the right kind of running shoe, and I’ve been running pain-free ever since.)
Traditional exams require doctors to analyze your stance, your foot shape, muscle strength, flexibility, and gait through visual observation and physical tests. Not surprisingly, computer technology has given podiatrists another tool to help them make accurate diagnoses.
Digital foot imaging is a new system that helps podiatrists get a look at the way your foot works.
Dr. George Tsatsos stopped by our offices to tell us about the system, and to show us how it works. The system is pretty simple: It includes a sensor pad and a laptop with appropriate software.
“Basically, there are microchips in the pad,” Tsatsos says. “When a patient stands or walk on it, they measure the amount of pressure. The computer translates it into a graphic image.”
One advantage of the system is that it can help remove some of the subjectivity involved with the visual observation of the foot. Another advantage is that the pad can record the pressures exerted by the foot when a patient walks over the pad, giving a snapshot of the feet’s walking dynamics.
Another advantage is that data can be recorded and sent directly to special labs. They use this precise information to build custom orthotics that, according to Tsatsos, are more likely to fit the patient than orthotics made through molding techniques. “Return rates for bio-foam and plaster molding are around 15 percent,” Tsatsos says, “But with the new technology, it’s less than one percent. We haven’t had any return yet, and we’ve done 15-20 sets with the new technology.”
The final advantage of the system is that the images are easy to understand, and that gives us patients more information, so we can make better health-care decisions.
Foot Pain Keeping You From Losing Weight?
With the beautiful summer weather, many of us are heading outdoors to get some exercise. And walking is one of the best, as well as one of the most economical, methods of exercise. In fact, the U.S. Centers for Disease Control tells us that people of all ages benefit from participating in regular, moderate-intensity physical activity, such as 30 minutes of brisk walking five or more times a week.
The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older—over 60 million people—are obese. And when we think about losing those extra pounds, a program of exercise walking usually pops into our minds, right?
Of course, exercise walking is difficult, if not impossible, when our feet hurt. And very often, being over weight has contributed to foot problems such as heel pain (plantar fascitis) and flat feet. So what’s an overweight person to do?
If your feet are keeping you from exercising, make an appointment with our office for an evaluation. Very often there are some simple approaches we can recommend that will ease the pain and make it possible for you to get started on your fitness walking program in very short order. In other cases we may recommend a surgical procedure to ease the pain of deformities such as bunions or hammertoes, and we’ll be able to suggest alternative types of exercise you can do until your feet are ready to take you out on the walking paths again.
Don’t let painful feet keep you from losing weight! Eliminating that pain is the first step in regaining physical fitness and having a more active and fulfilling lifestyle.
Video Gait Analysis
Are you having pain during your run? It could be a product of your running style, or gait. There is new technology out that can provide real time analysis of your running and help you on the road to a pain-free run, as recently mentioned in the September issue of Windy City Sports Magazine.
Using digital video cameras, computers and sophisticated motion analysis software, motion systems are on the cutting edge of performance enhancement for applications ranging from golf swing training and baseball hitting to physical therapy and human gait analysis. Sports MotionÔ is a leader in video motion analysis and its software is used by a myriad of sports teams, such as the Chicago White Sox, as well as by many sports medicine and physical therapy clinics, including the Mayo Clinic and Ankle N Foot.
In terms of analyzing gait, Sports MotionÔ software offers the ability to: Spot slight movement variations in your running form that always produce problems during your run. Improve training techniques since now they can be made body-specific to a “hidden” running problem. Compare old and new video tape of your improvements and/or problems. Reduce and prevent injuries On an initial visit at a clinic, the doctor will gather a health history as well as your running history (e.g., what surfaces you run on, how many miles a week, whether or not you wear orthotics, etc). Then you are videotaped while running on the treadmill and at the same time, the data is transferred to the computer, where the doctor will analyze your gait to pinpoint any problems you may be experiencing, such as abnormal motion or other biomechanical pathologies.
Remember, if you are planning to have motion analysis performed, research what type of technology the office has. A patient at the Ankle N Foot Center related one physical therapist who took videotape, then took it home to analyze it. In this case, the therapist was not able to provide real-time advice and the patient was unable to see with their own eyes the analysis while it happened to make immediate adjustments and get same-day advice. Bottom line: Quick & Concise Diagnosis leads to Quick & Concise Treatment.