The symptoms of plantar fasciitis are very distinct. Sharp tearing pain on the bottom of the heel upon standing that is relieved by rest is the hallmark symptom of this condition. But what about stress fractures of the heel? Can they have the same symptoms? Join us for the discussion.
November 21, 2007
November 19, 2007
Help! I broke my toe. Isn’t there anything I can do?
Should broken toes be treated? In most cases, yes. An x-ray can verify apposition and alignment of the bone to insure good healing. And like any other injury, ice, compression and elevation are imperative for the first few days.
But what else can be done for a broken toe to speed up the healing and cut down on the pain? Join us in a discussion on broken toe remedies.
November 10, 2007
Flat feet in children – do they all need to be treated?
I saw an interesting case this week in the office. A nice mom and dad came into the office with their son, Nathan. Nathan was a 10 y/o male with functional flatfoot. Functional flatfoot is the term used to describe a foot that has a great arch until the patient stands. When weight is applied to the foot, the arch completely disappears. Nathan was asymptomatic and was able to run just as fast as most of the kids in his school class, but boy did he have a flat foot.
I examined Nathan and obtained x-rays. Nathan had normal bone structure with the exception of moderated radiographic change in weight bearing x-rays consistent with a flexible flatfoot. and again, Nathan described no sensation of fatigue or pain in the feet or legs.
Over time and as Nathan matures into an adult, we’re bound to see this flexible, functional flatfoot stiffen and become less flexible. In fact the term we use is called a rigid flat foot. Rigid flatfeet in adults are tougher to treat. Arch supports are ineffective and the surgical procedure we use become a bit more aggressive to correct pain in the adult flatfoot.
So what can I say to Nathan’s parents? The surgeon in me knows that a subtalar joint implant will help him immensely. The implant is often considered an internal cast to stabilize the foot and creates an arch without using an arch support. Or do we simply opt for a pediatric arch support? How often will it get used and will it be there for more that 50% of the time that Nathan’s on his feet? 25% ? Or maybe even less.
But the father in me (father of three) knows that I would be very reluctant to advocate the surgery. Although the surgery is minimally invasive and is ambulatory, it’s a tough choice.
What’s the right choice? I’m not sure there is one. But in most cases we’ll start with the arch supports and see how things fare over time.
Jeff Oster, DPM
Medical Director
Myfootshop.com
Diagnosing tarsal tunnel syndrome
Diagnosing tarsal tunnel syndrome is never easy. The symptoms are vague and often difficult to interpret. Most cases of tarsal tunnel syndrome fail to be found on EMG (electromyogram) or NCV (nerve conduction velocity) testing. So how can we arrive at a reasonable conclusion that surgery for TTS is indicated? It’s just one of those conditions where we need to fall back onto the old standards in medicine; the history and physical exam. Nope. No MRI or test is going to supplement a good clinical exam.
