It’s not what fashion-conscious women want to hear—another warning about high heels. But, pump-style shoes often cause significant pain by irritating a common bony deformity on the back of the heel called ‘pump bump.’ In many cases, it can lead to bursitis or Achilles tendonitis if left untreated.
Pump bump is common in young women who wear high heels almost every day, and their feet take a beating as a result. The rigid back of a pump-style shoe can create pressure that aggravates the heel bone when walking.
The bump or bony protrusion is a hereditary deformity that can cause Achilles tendonitis or bursitis due to constant irritation from pump-style shoes. Those with high arches or tight Achilles tendons are especially vulnerable to developing pump bump if they work in high heels.
The medical term for the disorder is Haglund’s deformity. In addition to the noticeable bump, symptoms include pain where the Achilles tendon attaches to the heel, swelling in the back of the heel and redness in the area.
In the majority of cases, pump bump is treated non-surgically by reducing inflammation, but this does not get rid of the bony protrusion. Pain relief is the primary treatment goal, so anti-inflammatory medications usually are prescribed. Icing the back of the heel reduces swelling, and stretching exercises can relieve tension in the Achilles. Long-term, however, it’s best to avoid wearing high heels, if possible.
When the dress code requires high heels, it is advised that women try heel lifts to decrease pressure on the heel or wear appropriate dress shoes that have soft backs or are backless.
Wednesday, August 18, 2010
Soccer Season: Prime Time for Foot & Ankle Injuries
When soccer season is in full swing parents and coaches are strongly urged to think twice before coaxing young, injury-prone soccer players to “play through” foot and ankle pain.
In skeletally immature kids, starting and stopping and moving side to side on cleats that are little more than moccasins with spikes, is a recipe for foot and ankle sprains and worse. Kids will play with lingering, nagging heel pain that, upon testing, can turn out to be a stress fracture that can be very serious. By playing with pain, they can’t give their team 100 percent and they make their injuries worse, which prolongs their time out of soccer.
Symptoms of stress fractures include pain with activity, redness, and swelling with possible bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and can require surgery.
The constant running associated with soccer can place excessive stress on developing bones. Pain from overuse often stems from inflammation around the growth plate of the heel bone. The growth plates to the heel are still open and bones are still growing and maturing until children are about 13 to 16 years old. Rest, ice, anti-inflammatory medications and, in some cases, immobilization of the foot normally relieve this type of heel pain. Custom inserts can be helpful in kids with recurrent heel pain of this type.
Other types of overuse injuries are Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes). Quick, out-of-nowhere ankle sprains are also common to soccer. If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture. Ankle injuries should always be evaluated by a foot and ankle specialist to assess the extent of the injury.
In skeletally immature kids, starting and stopping and moving side to side on cleats that are little more than moccasins with spikes, is a recipe for foot and ankle sprains and worse. Kids will play with lingering, nagging heel pain that, upon testing, can turn out to be a stress fracture that can be very serious. By playing with pain, they can’t give their team 100 percent and they make their injuries worse, which prolongs their time out of soccer.
Symptoms of stress fractures include pain with activity, redness, and swelling with possible bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and can require surgery.
The constant running associated with soccer can place excessive stress on developing bones. Pain from overuse often stems from inflammation around the growth plate of the heel bone. The growth plates to the heel are still open and bones are still growing and maturing until children are about 13 to 16 years old. Rest, ice, anti-inflammatory medications and, in some cases, immobilization of the foot normally relieve this type of heel pain. Custom inserts can be helpful in kids with recurrent heel pain of this type.
Other types of overuse injuries are Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes). Quick, out-of-nowhere ankle sprains are also common to soccer. If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture. Ankle injuries should always be evaluated by a foot and ankle specialist to assess the extent of the injury.
Tuesday, August 17, 2010
Skin Conditions of the Foot & Ankle are Best Diagnosed with a Biopsy
Many skin conditions such as psoriasis, eczema, contact dermatitis and even “ring worm” look very similar on physical examination. Raised skin lesions like warts, moles, skin tags, and certain cancers of the skin can appear quite similar as well. In both examples, these conditions are all treated quite differently.
A thorough history and physical examination often gives the physician enough information to make a highly educated guess as to the diagnosis of these types of skin lesions. Misdiagnosing skin lesions can prolong the treatment process and even worsen the condition in some cases.
A skin biopsy is the collection of a small piece of skin that is sent to a pathologist for microscopic examination. When viewed under a microscope, the skin condition can be positively identified. Most biopsies can easily be taken in the office setting. A small numbing injection is given to the area of the lesion. Small lesions may be completely excised. A punch core may be taken from the center of large lesions. Raised lesions are generally shaved.
If you have an unknown skin condition on your foot or ankle, call CKPA your foot and ankle specialist for an evaluation and possible skin biopsy.
A thorough history and physical examination often gives the physician enough information to make a highly educated guess as to the diagnosis of these types of skin lesions. Misdiagnosing skin lesions can prolong the treatment process and even worsen the condition in some cases.
A skin biopsy is the collection of a small piece of skin that is sent to a pathologist for microscopic examination. When viewed under a microscope, the skin condition can be positively identified. Most biopsies can easily be taken in the office setting. A small numbing injection is given to the area of the lesion. Small lesions may be completely excised. A punch core may be taken from the center of large lesions. Raised lesions are generally shaved.
If you have an unknown skin condition on your foot or ankle, call CKPA your foot and ankle specialist for an evaluation and possible skin biopsy.
Monday, August 16, 2010
Popular Flip-Flop Sandals Linked to Rising Youth Heel Pain Rate
Many of us wear flip-flop sandals throughout the year; however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population.
We’re seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem. A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.
Wearing sandals with reasonably strong soles and arch support is recommended. Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.
It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Tight calf muscles and wearing inappropriate footwear are common contributing factors.
The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle specialist to rule out other causes is advised.
Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.
Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain. To find out what is happening with your child feet don’t wait to see your foot specialist at Central Kansas Podiatry Associates today.
We’re seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem. A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.
Wearing sandals with reasonably strong soles and arch support is recommended. Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.
It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Tight calf muscles and wearing inappropriate footwear are common contributing factors.
The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle specialist to rule out other causes is advised.
Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.
Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain. To find out what is happening with your child feet don’t wait to see your foot specialist at Central Kansas Podiatry Associates today.
Runners: Fit Feet Finish Faster
Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners.
The human foot is a biological masterpiece that amazingly endures the stresses of daily activity. For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly.
The most common complaint from runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition known as plantar fasciitis. In athletes, heel pain can result from faulty mechanics and overpronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft.
At the first sign of heel pain, runners are advised to do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required? Surgery normally isn’t considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.
Neuromas and tendonitis are other common foot problems that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective. Sometimes surgery is the answer if pain between the toes continues for more than six months.
Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition. There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy. Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon.
A common myth among athletes is that it’s not possible to walk or run if a bone in the foot is fractured. Surprised patients often say “It can’t be broken, I can walk on it." That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days. If a fracture or sprain is suspected, runners should remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation. Should pain and swelling continue after following this procedure for three or four days, you should see a foot and ankle specialist for an x-ray and proper diagnosis.
Other common foot ailments runners should watch for are:
Athlete’s Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.
Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it’s best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.
Foot Odor: There are more than 250,000 sweat glands in the foot and daily hygiene plus regular changing of shoes and socks are best for controlling sweat and odor. Runners should avoid wearing cotton socks and running without socks. Foot powders, aerosols antiperspirants and vinegar soaks also are helpful.
Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-aid. Corns and calluses are caused by repeated friction, and should be treated by aseptically trimming the dead skin and eliminating the underlying cause.
The human foot is a biological masterpiece that amazingly endures the stresses of daily activity. For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly.
The most common complaint from runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition known as plantar fasciitis. In athletes, heel pain can result from faulty mechanics and overpronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft.
At the first sign of heel pain, runners are advised to do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required? Surgery normally isn’t considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.
Neuromas and tendonitis are other common foot problems that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective. Sometimes surgery is the answer if pain between the toes continues for more than six months.
Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition. There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy. Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon.
A common myth among athletes is that it’s not possible to walk or run if a bone in the foot is fractured. Surprised patients often say “It can’t be broken, I can walk on it." That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days. If a fracture or sprain is suspected, runners should remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation. Should pain and swelling continue after following this procedure for three or four days, you should see a foot and ankle specialist for an x-ray and proper diagnosis.
Other common foot ailments runners should watch for are:
Athlete’s Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.
Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it’s best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.
Foot Odor: There are more than 250,000 sweat glands in the foot and daily hygiene plus regular changing of shoes and socks are best for controlling sweat and odor. Runners should avoid wearing cotton socks and running without socks. Foot powders, aerosols antiperspirants and vinegar soaks also are helpful.
Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-aid. Corns and calluses are caused by repeated friction, and should be treated by aseptically trimming the dead skin and eliminating the underlying cause.
Sunday, August 15, 2010
CHECK KIDS’ FEET BEFORE SCHOOL STARTS
Simple At-home Checks Help Spot Foot Problems
During the annual rite of preparing for the new school year, it is recommended that parents take five minutes at home to check for signs of possible foot disorders that could prevent active children from participating in sports and other activities.
The American College of Foot & Ankle Surgeons (ACFAS) suggests these additions to this year’s back-to-school checklist:
• Do the bottom of the child’s shoes show uneven wear patterns?
• Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?
• Do pre-schoolers walk on their toes?
• Does the child often trip or stumble?
• Does the child complain of tired legs, night pains and cramping?
If parents take time to perform these checks, they will identify symptoms of common foot ailments, such as ingrown nails, and more serious foot disorders like flat feet that can hamper a child’s performance in physical education classes and sports. If a child’s shoe is worn on the big toe side of the foot, it could be a sign of poor arch support or flat feet.
Parents can spot several potential foot problems by observing kids’ walking patterns. For example, if a parent determines that one leg is longer than the other, heel lifts may be required to restore proper balance.
Toe-walking in younger children can result from too much time spent in walkers as toddlers. Parents are urged take action to correct tightness in the Achilles tendon area that occurs from excessive toe-walking. ACFAS recommends stretching exercises that can be fun for small children and will help prevent lower back pain as they get older.
For those beginning college, heel pain and shin splints can plague freshmen not acclimated to walking long distances across campus to attend classes. Daily stretching and proper walking shoes are recommended, and for those with deformities such as hammertoes, surgery may be necessary to make walking more comfortable.
Parents also should heed complaints about tired legs, heel pain and leg or foot cramps at night. There’s no such thing as “growing pains,” so when kids complain about leg and foot pain they might have flat feet or another disorder that should be evaluated immediately. Children with flat feet are at risk for arthritis later in life if the problem is left untreated.
Parents who notice a potential foot problem should have the child evaluated by the foot specialist at Central Kansas Podiatry Associates.
During the annual rite of preparing for the new school year, it is recommended that parents take five minutes at home to check for signs of possible foot disorders that could prevent active children from participating in sports and other activities.
The American College of Foot & Ankle Surgeons (ACFAS) suggests these additions to this year’s back-to-school checklist:
• Do the bottom of the child’s shoes show uneven wear patterns?
• Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?
• Do pre-schoolers walk on their toes?
• Does the child often trip or stumble?
• Does the child complain of tired legs, night pains and cramping?
If parents take time to perform these checks, they will identify symptoms of common foot ailments, such as ingrown nails, and more serious foot disorders like flat feet that can hamper a child’s performance in physical education classes and sports. If a child’s shoe is worn on the big toe side of the foot, it could be a sign of poor arch support or flat feet.
Parents can spot several potential foot problems by observing kids’ walking patterns. For example, if a parent determines that one leg is longer than the other, heel lifts may be required to restore proper balance.
Toe-walking in younger children can result from too much time spent in walkers as toddlers. Parents are urged take action to correct tightness in the Achilles tendon area that occurs from excessive toe-walking. ACFAS recommends stretching exercises that can be fun for small children and will help prevent lower back pain as they get older.
For those beginning college, heel pain and shin splints can plague freshmen not acclimated to walking long distances across campus to attend classes. Daily stretching and proper walking shoes are recommended, and for those with deformities such as hammertoes, surgery may be necessary to make walking more comfortable.
Parents also should heed complaints about tired legs, heel pain and leg or foot cramps at night. There’s no such thing as “growing pains,” so when kids complain about leg and foot pain they might have flat feet or another disorder that should be evaluated immediately. Children with flat feet are at risk for arthritis later in life if the problem is left untreated.
Parents who notice a potential foot problem should have the child evaluated by the foot specialist at Central Kansas Podiatry Associates.
Saturday, August 14, 2010
Pain to the Bottom of the Heel Can Have Many Causes
Pain on the bottom of the heel is most often caused by plantar fasciitis. Heel pain may also be due to other causes, such as a stress fracture, arthritis, nerve irritation, or, a bone tumor or cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed.
A stress fracture to the heel bone will cause pain when walking, but the heel area may also be red, hot, swollen, and bruised.
Arthritic conditions such as rheumatoid arthritis and psoriatic arthritis not only affect the joints, but can also cause inflammation of the tendons and ligaments in the foot leading to heel pain.
There are 2 types of nerve entrapments that can cause heel pain. Tarsal Tunnel Syndrome is similar to Carpal Tunnel Syndrome. A large nerve to the inside of the foot can be compressed by large veins, a soft tissue mass, or even because of the structural changes to the foot from severe flatfoot deformity. Patients with Tarsal Tunnel Syndrome have pain to the bottom of the heel, but may also experience shooting pains along the entire bottom of the foot and numbness and tingling of the toes.
Baxter’s nerve entrapment is another cause of heel pain. Baxter’s nerve is a small nerve branch on the bottom of the foot that becomes entrapped by a muscle on the bottom of the foot. This type of heel pain is typically worsened with long activity and often radiates to the outside of the bottom of the heel.
Certain types of heel bone cysts or tumors can also cause heel pain. Bone cysts can be filled with water or blood. Fatty tumors called lipomas are common in the heel bone. Rarely, the heel bone can have a metastatic tumor.
Plantar fasciitis is an inflammation of the band of tissue that extends from the heel to the toes. Plantar fasciitis generally results in pain to the heel after any period of rest and with long activity.
A thorough history and physical exam is necessary to properly diagnose heel pain. X-rays, diagnostic ultrasound, MRI, CT scans, or nerve studies may be necessary as well.
If you have pain to the bottom of your heel, call Central Kansas Podiatry Associates for further evaluation.
A stress fracture to the heel bone will cause pain when walking, but the heel area may also be red, hot, swollen, and bruised.
Arthritic conditions such as rheumatoid arthritis and psoriatic arthritis not only affect the joints, but can also cause inflammation of the tendons and ligaments in the foot leading to heel pain.
There are 2 types of nerve entrapments that can cause heel pain. Tarsal Tunnel Syndrome is similar to Carpal Tunnel Syndrome. A large nerve to the inside of the foot can be compressed by large veins, a soft tissue mass, or even because of the structural changes to the foot from severe flatfoot deformity. Patients with Tarsal Tunnel Syndrome have pain to the bottom of the heel, but may also experience shooting pains along the entire bottom of the foot and numbness and tingling of the toes.
Baxter’s nerve entrapment is another cause of heel pain. Baxter’s nerve is a small nerve branch on the bottom of the foot that becomes entrapped by a muscle on the bottom of the foot. This type of heel pain is typically worsened with long activity and often radiates to the outside of the bottom of the heel.
Certain types of heel bone cysts or tumors can also cause heel pain. Bone cysts can be filled with water or blood. Fatty tumors called lipomas are common in the heel bone. Rarely, the heel bone can have a metastatic tumor.
Plantar fasciitis is an inflammation of the band of tissue that extends from the heel to the toes. Plantar fasciitis generally results in pain to the heel after any period of rest and with long activity.
A thorough history and physical exam is necessary to properly diagnose heel pain. X-rays, diagnostic ultrasound, MRI, CT scans, or nerve studies may be necessary as well.
If you have pain to the bottom of your heel, call Central Kansas Podiatry Associates for further evaluation.
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