November Articles 2013

Biomechanics in Podiatry

Biomechanics and its related study deal with forces that act against the body and effect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot itself, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.

Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet and limit the mobility everyone takes for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area, all effecting the way you move around on a daily basis.

The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root claimed that changing or controlling the forces between the ankle and the foot, corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of thermoplastic foot orthotics to this day.

As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can not only take readings, but also map out what treatment will do to the affected areas.

These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics is able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot, so speaking with your podiatrist if you have any of these problems is highly recommended.



When Foot Surgery is necessary

When non-invasive procedures fail to help with issues pertaining to the foot, sometimes foot surgery may be necessary. Some cases that demand surgery can include foot deformities such as bunions and bone spurs, arthritic problems, and reconstruction as a result of injuries caused by accidents and congenital malformation. Regardless of age or race, foot surgery can help all individuals.

If foot surgery is necessary, the reason you will need the surgery will affect the type of surgery you need. For example, a bunionectomy may be performed to remove a growth such as a bunion. If you need to have bones realigned and fused together, you will likely undergo a surgical fusion. Surgical removal of painful nerves are used when it comes to problems dealing with nerve pain and the tissues surrounding it. Normally other, less drastic treatments are applied for most symptoms, but if those treatments are not effective, surgery is used.

Although foot surgery is considered a last resort by many physicians, there are benefits if it used to fix the problem. The first advantage is that the pain associated with the problem is normally alleviated, allowing you to resume the activities you could not do as a result of your foot problem. The second advantage is that once the surgery is complete, the problem with your foot is generally eliminated since it was addressed in a permanent fashion.

The history of podiatry shows that foot surgery techniques advance each year. For example, endoscopic surgery is one of the many advancements in the realm of foot surgery. As this technology evolves and improves, so will surgical techniques. Many procedures can now be completed with the use of a very small incision and smaller, more refined surgical instruments. Due to these better and more useful tools, surgeries are less invasive and recovery time has become a lot shorter. Shorter recovery periods allow you to be back on your feet in no time.



Plantar Fasciitis Treatment

A study conducted by Luca M. Sconfienza, M.D., of the University of Genoa in Italy focused on a relatively new treatment option combines steroid injections and ultrasound waves. This form of treatment was found to be 95% effective in plantar fasciitis patients in the study.

The plantar fascia is a connective tissue that stretches the bottom length of your foot from the heel. The condition of plantar fasciitis is an inflammation of this connective band, known for causing discomfort and pain while standing or walking. Although the condition can be treated, conservative methods may take up to a year before they become effective.

Conventional treatments include certain exercises, night splints, arch support, staying off your feet and overall rest. Previously the cure for plantar fasciitis was shockwave therapy, which directs sound waves to the area where pain is being experienced. Despite the treatment’s success it is considered painful and requires several sessions before any notable results occur. It is also fairly expensive and does not cure the pain for every plantar fasciitis patient.

Dr. Sconfienza examined the effects of a new technique that combined ultrasound-based methods similar to shockwave therapy, applying a steroid injection directly to the plantar fascia. This form of treatment is a one-time outpatient procedure that involves a small dose of local anesthesia. A needle punctures the affected area and causes a nominal amount of bleeding that assists the fascia in healing. This technique is known as dry-needling.

Dr. Sconfienza found that 42 of the 44 patients that were involved in the new procedure had their symptoms disappear completely within a three week timespan, including pain. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza said. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”

 

Flat Feet

Flat feet is a foot condition in which the arch of the foot either drops or is never developed. This generally makes the sole of the foot completely or almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arch never formed during growth. While it is common in babies and small children, it can become a problem if the arch never develops. For adults, the development of flat feet can be brought upon by injury, or may even be a result of pregnancy due to the increased elasticity; however, in adults the flat footedness is usually permanent.

Having flat feet can sometimes make it difficult to walk due to the stress it places on the ankles. The general alignment of your legs is thrown off because the ankles move more inward which can cause some major discomfort. This also has a big effect on the knees as many people that have flat feet often have arthritis in that area. However, in many cases, flat feet does not cause any pain and it should not be a cause for concern in that case.

The wet footprint test can be an indicator to diagnosing flat feet. In this test, the individual would place a flat foot on a surface in order to show a footprint. If there is no indentation or indication of an arch, that person may have flat feet. In all cases, it is best to consult a podiatrist if flat feet is suspected or noticed.

Once flat feet has been diagnosed, it can be treated by walking barefoot in beach-like terrain, or wearing insoles. There are two types of flat feet; one being rigid, where the feet appear to have no arch even when the person is not standing, and the other being flexible where the person appears to have an arch while not standing, but once standing the arch goes away. In the case of flexible flat feet, unless there is pain caused by the condition, there is no need for treatment. However, if it causes pain or in the case of rigid flat feet, exercises and orthotic insoles may be prescribed in order to help the arches develop.

In some cases when the condition is severe and all other methods have been exhausted surgery may be required but this is normally avoided due to a lengthy recovery time and high cost.


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