Podiatry New York City

Pain on Top of the Foot in Runners

admin — Mon, 23 Jan 2012 22:57:26 +0000

Barefoot and minimalist running is getting a lot of publicity recently. There appears to be a lot of barefoot runners who are no running injury free after a running injury. There are also a lot of injuries in barefoot runners as well. The most common of these injuries is a pain on top of the foot. While the differential for this is a number of things, probably the most common cause for pain on the top of the foot is a dorsal compression syndrome from the forefoot trying to dorsiflex on the rearfoot more when forefoot striking compared to rearfoot striking. This dorsal compression of the base of the metatarsal bones and the tarsal bones is probably the cause of pain on the top of the foot in runners. The treatment for this pain on top of the foot is to increase the plantarflexion of the forefoot on the rearfoot or reduce the dorsiflexion forces. In the short term, this means using strapping and going back to rearfoot striking. In the medium term, foot orthoses that allow the forefoot to plantarflex can help pain on top of the foot. In the long term, there can be a transition back to the forefoot striking as the tissues adapt, but this can depend on how high the forces are that caused the pain on the top of the foot was in the first place.

Whats Wrong With the Weil Osteotomy?

admin — Sun, 26 Jun 2011 19:55:45 +0000

Why is the Weil Osteotomy so controversial? Both Podiatry Today and Podiatry arena have run polls on the Weil Osteotomy and while most think that it is a useful procedure. Despite that, there is still a number of people that do are concerned about the Weil Osteotomy. There have been a number of outcome studies published on the Weil Osteotomy, so there is no real need to be concerned about any systematic issues with the Weil Osteotomy. Feel free to vote or comment on the Weil Osteotomy on Podiatry Arena.

Cracked Heels

admin — Tue, 03 May 2011 23:25:32 +0000

Cracked heels or heel fissures are a common problem seen in podiatric practice. The most common predisposing factors for cracked heels are being overweight, wearing open back shoes and having dry and thick sign around the periphery of the heel. On weight bearing, the fat pad under the heel expands out sideways, this puts pressure on the dry and hard skin to crack it. Wearing closed in shoes helps keep the fat pad under the heel and prevents the expansion. Being overweight, means that there is a greater expansion of the fat pad under the heel. The best way to prevent cracked heels is to ensure that the skin is supple, so that when it expands the cracks do not happen. This is best done by the regular removal of the dry hard skin by a podiatrist and the regular use of emollients and creams. Wearing closed in shoes will also help prevent it. Once a cracked heel develops, then it is important that the hard skin be removed and care taken to heal the fissure.

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Plantar Fasciitis

admin — Mon, 14 Mar 2011 06:31:12 +0000

Everyone’s an expert on plantar fasciitis on the web these days. There is no end of advice on how to treat plantar fasciitis. The websites you find the advice on range from the well written and well researched and evidence based to the nonsense like you see on some footwear websites and those with a product to sell. There is nothing secretive or magic about plantar fasciitis.

The key principle in plantar fasciitis is that it is due to too much load or stress in the plantar fascia. The best way to treat plantar fasciitis is to reduce that load. This is achieved by reducing activity levels (not always possible); reducing body weight (may have to be a very long term goal); strapping (a very effective short term measure); stretching the calf muscles (essential); and the use of foot orthotics (but not all foot orthotic design features actually work to reduce the load, so the right foot orthotic for plantar fasciitis is essential).

None of the other treatments for plantar fasciitis actually work at reducing the load in the plantar fascia. They are all aimed at helping the tissues heal. It does make sense in those with plantar fasciitis that the load is reduced first, and then one or some of all the other treatments can be applied.

Only in rare occasions should surgery be needed for plantar fasciitis. More often than not, if the conservative treatments are not working it is because the load in the damaged tissue has not been reduced adequately.

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The Cluffy Wedge

admin — Fri, 22 Oct 2010 22:57:20 +0000

The Cluffy Wedge is an interesting orthotic modification that has been used in various incarnations over the years. The aim of the Cluffy wedge is to hold the hallux in slightly dorsiflexed position. This has the effect of helping with things like functional hallux limitus and a delayed onset to the windlass mechanism. Various types of padding and orthotic modifications can be used to treat the same thing, but the Cluffy Wedge is a trademarked device to commercialise this effect. It was described as the Cluffy Wedge by Dr James Clough in a publication in JAPMA as a treatment for functional hallux limitus. It is also be made available at the retail level and there are a number of You Tube videos on the Cluffy wedge.

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Severs Disease

admin — Fri, 08 Oct 2010 22:05:45 +0000

Severs disease is a common problem in children that is treated by Podiatrists. It is considered to be a strain of the small growth area at the back of the heel bone where the Achilles tendon attaches to the bone. There is a small thin area of cartilage that growth of this bone occurs at, so because of this, severs disease is only a problem of youngsters. This growth plate is put under a lot of strain, especially in active children from the pull of the Achilles tendon and from impact on hard grounds. The classic symptoms of Severs disease is pain when compressing the sides of the back of the heel and it is also painful on activity. As it gets worse, the pain continues after activity. The treatment of severs disease is to relieve the strain on the growth plate. This is done by having the child cut back on activity levels and using heel raises. Calf muscle stretching and foot orthotics can sometimes be helpful. Severs disease is always self limiting eventually as the growth plate merges with the surrounding bone around the mod-teens.

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Podiatry Site Search Engine Optimization

admin — Mon, 27 Sep 2010 10:16:54 +0000

Do you have a website for your podiatry clinic? Have you heard of Search Engine Optimization (SEO)?

Search engine optimization is the strategies and techniques that are used by webmasters to try and get their website to rank higher in the search engines. It makes a big difference to a website to be ranked in the top few of the search results compared to being on page two or even lower of the search results. The use of these search engine optimization strategies by Podiatrists is getting more common.

There are many strategies used by professionals in the industry. They mostly consist of the use of keywords on the page of the site to make it relevant to what the searcher is typing in the search box. The other key element of search engine optimization is link building. This is the building of links to a site. These are considered ‘votes’ by the search engines and they tend to rank higher those sites with more votes. Linkvana provides a good link building service.

There are many strategies that owners of podiatry websites can do to get them ranking higher without the use of professionals. You can see the pros in action on the SEO Forums.

Why do some people and not other get Chilblains?

admin — Sat, 28 Aug 2010 23:22:26 +0000

No one seems to know why some people get chilblains and other do not. Chilblains do seem to be more common in females; they do seem to be more common in area subjected to shoe pressure; but why one person gets a chilblain and another does not is still a mystery. What is also still a mystery about chilblains is that they can occur for a number of years and suddenly not appear for a few years. When looked at closely, no reason can be found to explain this behaviour of chilblains. What is known is that chilblains are not really caused by the cold (they are caused by a too rapid warming after the foot gets cold) and they are not caused by poor circulation, as younger people with good circulation get chilblains. Chilblains are something of enigma. They are very common in some climates and very rare in other climates.

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Functional Hallux Limitus

admin — Sat, 28 Aug 2010 21:42:50 +0000

Functional hallux limitus is a condtion of the first MPJ that is not without its controversy. Many think it’s the root of all evil and casues a lot of problems, yet many others think that it does not exist. Functional hallux limitus can be defined as a restriction in the range of dorsiflexion at the first MPJ during functioning, i.e. walking or running. During a non-weight bearing assessment functional hallux limitus does have a normal and adequate range of motion, but for some reason during weight bearing, the first metatarsophalangeal joint does not want to dorsiflex as it should. There is much debate as to if functional hallux limitus just secondary to rearfoot pronation and midfoot collapse or if functional hallux limitus is a primary problem and is the cause of the pronated foot and midfoot collapse. There is no good research evidence to guide which one of these approaches is probably the most appropriate. There have also been suggestions made that a functional hallux limitus is really just a dysfunction windlass mechanism mechanics. The treatment of functional hallux limitus (assuming it exists) is the use of things like the trademarked cluffy wedge and the patented kinetic wedge. Functional hallux limitus can also be helped by inverting the rearfoot with a typical foot orthotic.

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Posterior Tibial Tendon Dysfunction

admin — Sun, 11 Jul 2010 21:48:37 +0000

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