Tag Archives: High-heeled footwear

Bunions

Definition:
A bunion is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal joint).The big toe (hallux) may turn in toward the second toe (angulation), and the tissues surrounding the joint may be swollen and tender.

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The term is used to refer to the pathological bump on the side of the great toe joint. The bump is partly due to the swollen bursal sac and/or an osseous (bony) anomaly on the mesophalangeal joint (where the first metatarsal bone and hallux meet). The larger part of the bump is a normal part of the head of first metatarsal bone that has tilted sideways to stick out at its top.

Although they’re more common in older people, they can begin at any age, and even children can develop them. A similar bump, but on the outer edge of the foot at the base of the smallest toe, is known as a bunionette.

The term “hallux valgus” or “hallux abducto-valgus” are the most commonly used medical terms associated with a bunion anomaly, where “hallux” refers to the great toe, “valgus” refers to the abnormal angulation of the great toe commonly associated with bunion anomalies, and “abductus/-o” refers to the abnormal drifting or inward leaning of the great toe towards the second toe, which is also commonly associated with bunions. It is important to state that “hallux abducto refers to the motion the great toe moves away from the body’s midline. Deformities of the lower extremity are usually named in accordance to the body’s midline, or the line bisecting the body longitudinally into two halves.

Bunions most commonly affect women. Some studies report that bunions occur nearly 10 times more frequently in women then men.

Symptoms:
Bunions may or may not cause symptoms. A frequent symptom is pain in the involved area when walking or wearing shoes that is relieved by resting. A bunion causes enlargement of the base of the big toe and is usually associated with positioning of the big toe toward the smaller toes. This leads to intermittent or chronic pain at the base of the big toe.

Bunions that cause marked pain are often associated with swelling of the soft tissues, redness, and local tenderness.

The symptoms of bunions include irritated skin around the bunion, pain when walking, joint redness and pain, and possible shift of the big toe toward the other toes. Blisters may form more easily around the site of the bunion as well.

Having bunions can also make it harder to find shoes that fit properly; bunions may force a person to have to buy a larger size shoe to accommodate the width the bunion creates. When bunion deformity becomes severe enough, the foot can hurt in different places even without the constriction of shoes because it then becomes a mechanical function problem of the forefoot.

Risk Factors & Causes:
It is found  that tight-fitting shoes, especially high-heel and narrow-toed, might increase the risk for bunion formation.
Bunions are reported to be more prevalent in people who wear shoes than in barefoot people. There also seem to be inherited (genetic) factors that predispose to the development of bunions, especially when they occur in younger individuals.

Other risk factors for the development of bunions include congenital (present from birth) abnormal formation of the bones of the foot, nerve conditions that affect the foot, rheumatoid arthritis, and injury to the foot. Bunions are common in ballet dancers.

Bunions are mostly genetic and consist of certain tendons, ligaments, and supportive structures of the first metatarsal that are positioned differently. This bio-mechanical anomaly may be caused by a variety of conditions intrinsic to the structure of the foot – such as flat feet, excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although some experts are convinced that poor-fitting footwear is the main cause of bunion formation, other sources concede only that footwear exacerbates the problem caused by the original genetic structure.

Bunions are commonly associated with a deviated position of the big toe toward the second toe, and the deviation in the angle between the first and second metatarsal bones of the foot. The small sesamoid bones found beneath the first metatarsal (which help the flexor tendon bend the big toe downwards) may also become deviated over time as the first metatarsal bone drifts away from its normal position. Arthritis of the big toe joint, diminished and/or altered range of motion, and discomfort with pressure applied to the bump or with motion of the joint, may all accompany bunion development.

Diagnosis:
A doctor can usually diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot and, in some cases, arthritis.

The doctor considers a bunion when noting the symptoms described above. The anatomy of the foot is assessed during the examination. Radiographs (x-ray films) of the foot can be helpful to determine the integrity of the joints of the foot and to screen for underlying conditions, such as arthritis or gout. X-ray films are an excellent method of calculating the alignment of the toes.

Treatment:
Bunions may be treated conservatively with changes in shoe gear, different orthotics (accommodative padding and shielding), rest, ice, and medications. These sorts of treatments address symptoms more than they correct the actual deformity. Surgery, by an orthopedic surgeon or a podiatrist, may be necessary if discomfort is severe enough or when correction of the deformity is desired.

Orthotics are splints, regulators while conservative measures include various footwear like gelled toe spacers, bunion / toes separators, bunion regulators, bunion splints, and bunion cushions.

Surgery:
Procedures are designed and chosen to correct a variety of pathologies that may be associated with the bunion. For instance, procedures may address some combination of:

*removing the abnormal bony enlargement of the first metatarsal,
*realigning the first metatarsal bone relative to the adjacent metatarsal bone,
*straightening the great toe relative to the first metatarsal and adjacent toes,
*realigning the cartilagenous surfaces of the great toe joint,
*addressing arthritic changes associated with the great toe joint,
*repositioning the sesamoid bones beneath the first metatarsal bone,
*shortening, lengthening, raising, or lowering the first metatarsal bone, and
*correcting any abnormal bowing or misalignment within the great toe.

At present there are many different bunion surgeries for different effects. Ultimately, surgery should always have function of the foot in mind besides its look. Can the proposed surgery help resolve the pain and callus under the middle metatarsal heads? Can one return to sports? Can the foot enjoy fashionable or high heel shoes like normal feet without undue discomfort? Does the proposed surgery prevent recurrence with any specific built-in mechanism? These are very reasonable challenges for any truly functional bunion surgeries but may not be so for esthetic bunion surgeries.

The age, health, lifestyle, and activity level of the patient may also play a role in the choice of procedure.

Bunion surgery can be performed under local, spinal, or general anesthetic. The trend has moved strongly toward using the less invasive local anesthesia over the years. A patient can expect a 6- to 8-week recovery period during which crutches are usually required for aid in mobility. An orthopedic cast is much less common today as newer, more stable procedures and better forms of fixation (stabilizing the bone with screws and other hardware) are used.

Prognosis:
The prognosis depends on your age and activities, and the severity of the bunion. Teenagers may have more trouble treating a bunion than adults. Many adults do well by caring for the bunion when it first starts to develop, and wearing different shoes. Surgery reduces the pain in many, but not all, people with bunions.

Possible Complications:

*Chronic foot pain
*Foot deformity
*Stiff foot
*Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/bunions/page2.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001231.htm
http://en.wikipedia.org/wiki/Bunion
http://www.bbc.co.uk/health/physical_health/conditions/bunions.shtml

http://www.consumerreports.org/health/conditions-and-treatments/bunions/what-is-it.htm

http://www.cafai.com/bunions.html

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High Heels are Heath-Wreckers

Like the tall Lara Dutta or the shorter Rani Mukerji, you might want to flaunt stilettos to look glamorous and sleek. But experts feel this style statement can cause serious harm to the body if proper care is not taken.
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“Increased pressure puts the forefoot at risk of injuries such as stress fractures, bunions and hammer toes. Knee pain is also common when high heels are involved,” says Ashish Jain, M.S. (orthopaedics), consultant joint replacement specialist at Max Hospital.

“The heel height causes increased strain on the knee joint and associated tendons. The quadriceps muscle group in the front of the thigh works harder, increasing pressure on the kneecap by up to 26 percent.”

“This can ultimately increase the incidence of osteoarthritis of the knee and quadriceps tendonitis,” Jain added.

Jain also spoke of other hazards
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He revealed that when the heel is constantly elevated, the calf muscle and Achilles tendon can contract and shorten. Wearing high heels habitually can result in a woman not being able to tolerate a flat shoe. On occasions, this can even require surgery to lengthen the Achilles tendon.

Sometimes the tight fit of many heels will force the toes to conform to its shape. The pressure of the shoe itself can cause corns to form. Furthermore, the compression of the metatarsal bones can cause pressure on the nerves that run between them.

“The toenails are also at risk as the incidence of in-growing toenails and nail infections is higher in heel wearers. In-growing toenails can be very painful, unsightly and require surgery to correct,” Jain added.

Women feel high heels like gladiator sandals, tip toes and others add a touch of elegance and glamour to one’s overall style and the legs appear longer and slimmer. Thus, to look special in that chic footwear and not experience painful after effects, many are going in for dermal fillers.

“It has been observed that women are undergoing filler injections to plump up the underside of their feet, thus filling them out and providing padding inside the foot to relieve the pain that comes from wearing high heels,” said Satish Bhatia, dermatologist and skin surgeon, Lady Ratan Tata Medical and Research Centre.

“This trend is rising despite the fact that the effect does not usually last for more than six-seven months,” Bhatia added.

Given that certain industries like hospitality, aviation and fashion place a premium on height and appearance, wearing heels becomes a norm, thus making women opt for the expensive solution to ease pain arising out of use of high heels.

“The dermal filler injection is injected in the ball of the foot to ease the pain caused by wearing high heels. The injection costs between Rs.12,000 and Rs.15,000,” he added.

Rajesh Malhotra, professor of orthopaedics, AIIMS, threw light on a few other ways of curing the pain arising out of extended use of stilettos.

“The best way to avoid pain is that one stops wearing high heels at all because they are the cause of the problem. But if that is not possible then there are a few treatments,” he said.

“The entire body pressure is on the ball of the foot; so among many treatments one is that we put the metatarsal bar on the sole of the footwear so that the entire body weight is not on the ball of the foot, which results in less pain,” Malhotra told.

If it is very essential to wear heels, the maximum height advised by doctors is not more than an inch.

“The height of the heel also changes the amount of weight on the forefoot. A one-inch heel will increase the pressure by 22 percent, a two-inch heel by 57 percent and a three-inch heel by 76 percent. So anything not more than an inch is fine,” said Jain.

Source:
The Times Of India. June 12. 2010

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Running Shoes May Damage Your Knees & Hips

Finally got that new pair of running shoes? Well, before you get down to taking them on the jogging track, here’s a piece of information—running shoes are likely to damage knees, hips and ankles.

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In a study, researchers compared the effects on knee, hip and ankle joint motions of running barefoot versus running in modern running shoes.

They concluded that running shoes exerted more stress on these joints compared to running barefoot or walking in high-heeled shoes.

Sixty-eight healthy young adult runners (37 women), who run in typical, currently available running shoes, were selected from the general population. None had any history of musculoskeletal injury and each ran at least 15 miles per week.

All runners were provided with a running shoe, selected for its neutral classification and design characteristics typical of most running footwear. They observed each subject running barefoot and with shoes using a treadmill and a motion analysis system.

The researchers observed increased joint torques at the hip, knee and ankle with running shoes compared with running barefoot.

Disproportionately large increases were observed in the hip internal rotation torque and in the knee flexion and knee versus torques.

An average 54 pct increase in the hip internal rotation torque, a 36 pct increase in knee flexion torque, and a 38 pct increase in knee varus torque were measured when running in running shoes compared with barefoot.

The findings confirmed that while the typical construction of modern-day running shoes provides good support and protection of the foot itself, one negative effect is the increased stress on each of the 3 lower extremity joints.

These increases are likely caused in large part by an elevated heel and increased material under the medial arch, both characteristic of today’s running shoes.

“Remarkably, the effect of running shoes on knee joint torques during running (36pc-38pc increase) that the authors observed here is even greater than the effect that was reported earlier of high-heeled shoes during walking (20pc-26pc increase). Considering that lower extremity joint loading is of a significantly greater magnitude during running than is experienced during walking, the current findings indeed represent substantial biomechanical changes,” said lead author D. Casey Kerrigan, JKM Technologies LLC, Charlottesville, VA, and co-investigators.

Kerrigan concluded: “Reducing joint torques with footwear completely to that of barefoot running, while providing meaningful footwear functions, especially compliance, should be the goal of new footwear designs.”

Source :
The study has been published in the latest issue of PM&R: The journal of injury, function and rehabilitation .

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Foot Pain

Whether it’s you or a loved one dealing with foot pain, you’ll   want to get a sense of the condition and what treatment options are available. Let us try to help you understand its different aspects and your treatment options.

Introduction:The foot is a complex structure of 26 bones and 33 joints, (it is made up of tarsal bones, metatarsal bones and phalanges ) layered with an intertwining web of over 120 muscles, ligaments, and nerves. It serves the following functions:

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1.Supports weight

2.Acts as a shock absorber

3.Serves as a lever to propel the leg forward

4.Helps to maintain balance by adjusting the body to uneven surfaces

Since the feet are very small compared with the rest of the body, the impact of each step exerts tremendous force upon them. This force is about 50% greater than the person’s body weight. During a typical day, people spend about 4 hours on their feet and take 8,000 – 10,000 steps. This means that the feet support a combined force equivalent to several hundred tons every day.

Causes of foot pain:

Many things can cause foot pain. Wearing shoes that don’t fit right is one of the most common reasons people (especially women) get foot problems such as calluses and bunions. With age, feet often grow wider. Also, being overweight can increase your chances of having foot problems or injuries. Go shopping for shoes in the afternoon when your feet are at their largest due to swelling. Heels on shoes shouldn’t be higher than 1 inch.

Let us jot down some important causes:

Nearly all causes of foot pain can be categorized under one or more of the following conditions:

*Shoes. The causes of most foot pain are poorly fitting shoes. High-heeled shoes concentrate pressure on the toes and are major culprits for aggravating, if not causing, problems with the toes. Of interest, however, was a British study, in which 83% of older women experienced some foot pain. In the study, 92% of them had worn 2-inch heels at some point in their lives. Foot problems, however, were significant even in women who regularly wore lower heels.

*Temporary Changes in Foot Size and Shape.
Temperature, and therefore weather, affects the feet: they contract with cold and expand with heat. Feet can change in shape and increase in size by as much as 5% depending on whether a person is walking, sitting, or standing.

*Poor Posture. Improper walking due to poor posture can cause foot pain.

*Medical Conditions. Any medical condition that causes imbalance or poor circulation can contribute to foot pain.

*Inherited Conditions. Inherited abnormalities in the back, legs, or feet can cause pain. For example, one leg may be shorter than the other, causing an imbalance.

*High-Impact Exercising. High-impact exercising, such as jogging or strenuous aerobics, can injure the feet. Common injuries include corns, calluses, blisters, muscle cramps, acute knee and ankle injuries, plantar fasciitis, and metatarsalgia.

*Industrial Cumulative Stress. Because of the effects of work-related repetitive stress on the hand, there has been considerable interest in the effect of work-stress on foot pain. According to one 2000 analysis, there is very little evidence for any significant impact of work on various foot disorders, including hallux valgus, neuroma, tarsal tunnel syndrome, toe deformity, heel pain, adult acquired flatfoot, or foot and ankle osteoarthritis. In general, the foot is designed for repetitive stress, and few jobs pose the same stress on the feet as many do on the hands. Nevertheless, certain professions, such as police work, are associated with significant foot pain. More research is needed.

Some Medical Conditions Causing Foot Pain:
Arthritic Conditions. Arthritic conditions, particularly osteoarthritis and gout, can cause foot pain. Although rheumatoid arthritis almost always develops in the hand, the ball of the foot can also be affected.

Diabetes.
Diabetes is an important cause of serious foot disorders. (See table: “Diabetes and Foot Problems.”)

Diseases That Affect Muscle and Motor Control.
Diseases that affect muscle and motor control, such as Parkinson’s disease, can cause foot problems.

High Blood Pressure. High blood pressure can cause fluid buildup and swollen feet. The effects of high blood pressure on the nervous and circulatory systems can cause pain, loss of sensation, and tingling in the feet, and can increase the susceptibility for infection and foot ulcers.

Risk Factors:

Nearly everyone who wears shoes has foot problems at some point in their lives. Some people are at particular risk for certain types of pain.

Age
The Elderly. Elderly people are at very high risk for foot problems. In one study, 87% of older people reported at least one foot problem. Feet widen and flatten, and the fat padding on the sole of the foot wears down as people age. Older people’s skin is also dryer. Foot pain, in fact, can be the first sign of trouble in many illnesses related to aging, such as arthritis, diabetes, and circulatory disease. Foot problems can also impair balance and function in this age group.

Prevention  : The American Podiatric Medical Association offers the following tips for preventing foot pain:

*Don’t ignore foot pain — it’s not normal. If the pain persists, see a doctor who specializes in podiatry.

*Inspect feet regularly. Pay attention to changes in color and temperature of the feet. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet could indicate athlete’s foot. Any growth on the foot is not considered normal.

*Wash feet regularly, especially between the toes, and be sure to dry them completely.

*Trim toenails straight across, but not too short. (Cutting nails in corners or on the sides increases the risk for ingrown toenails.)

*Make sure shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.

*Select and wear the right shoe for specific activities (i.e., running shoes for running).

*Alternate shoes. Don’t wear the same pair of shoes every day.

*Avoid walking barefoot, which increases the risk for injury and infection. At the beach or when wearing sandals always use sunblock on the feet, as you would on the rest of your body.

*Be cautious when using home remedies for foot ailments. Self-treatment can often turn a minor problem into a major one.

*It is critical that people with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they are more prone to infection.

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Shoes:

In general, the best shoes are well cushioned and have a leather upper, stiff heel counter, and flexible area at the ball of the foot. The heel area should be strong and supportive, but not too stiff, and the front of the shoe should be flexible. New shoes should feel comfortable right away, without a breaking in period.

Getting the Correct Fit
Well-fitted shoes with a firm sole and soft upper are the best way to prevent nearly all problems with the feet. They should be purchased in the afternoon or after a long walk, when the feet have swelled. There should be a 1/2 inch of space between the longest toe and the tip of the shoe (remember, the longest toe is not always the big toe), and the toes should be able to wiggle upward. A person should stand when being measured, and both feet should be sized, with shoes bought for the larger-sized foot. It is important to wear the same socks as you would regularly wear with the new shoes. Women who are accustomed to wearing pointed-toe shoes may prefer the feel of tight-fitting shoes, but with wear their tastes will adjust to shoes that are less confining and properly fitted.

Click to see the following links:
Insoles and Orthotics
Foot Injury Treatment
Toe Pain
Forefoot Pain
Heel Pain
Arch Pain
Ankle Pain

Joint Pains Treatment – Home and Ayurvedic Remedies

Natural healing of Foot Pain

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources :
http://www.healthcentral.com/chronic-pain/foot-pain-000061.html?ic=506019
http://www.nlm.nih.gov/medlineplus/ency/article/002094.htm