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Where is the achilles heel located?

Exercises For Accessory Navicular Syndrome

سه شنبه 27 تير 1396
8:20
Marlys Webster
Overview
The human body is rarely the same from person to person. Some things stay the same, like the function of the internal organs. Even when structures are similar, however, little variations, like extra bone tissue, can make a significant difference in the body. Having small, extra bones is not as uncommon as you might think. Sometimes, though, these additional tissues can cause painful problems, as with accessory navicular syndrome.

Accessory Navicular Syndrome

Causes
The syndrome may result from any of the following, previous trauma such as a foot or ankle sprain. Chronic irritation from shoes or other footwear causing friction against the bone. Strain from overuse or excessive activity.

Symptoms
The majority of people with an accessory navicular experience no symptoms, since, for the most part, the little extra bone simply isn?t large enough to cause problems. Unfortunately, some people lose on ?accessory navicular roulette,? and the bone begins to mess things up with the foot. These problems usually show up sometime in adolescence, when bones and cartilage in the body are settling into their final shapes (although occasionally people make it all the way through childhood, only to start experiencing discomfort and pain in adulthood).

Diagnosis
An initial assessment is an orthopaedic office begins with a thorough history and complete physical exam, including an assessment of the posterior tibial tendon and areas of tenderness. Associated misalignments of the ankle and foot should be noted. Finally, weight-bearing x-rays of the foot will help in making the diagnosis. Sometimes, an MRI may be needed to see if the posterior tibial tendon is involved with the symptoms or getting more clarity on the anatomy of the accessory navicular.

Non Surgical Treatment
Patients with a painful accessory navicular may benefit with four to six physical therapy treatments. Your therapist may design a series of stretching exercises to try and ease tension on the posterior tibial tendon. A shoe insert, or orthotic, may be used to support the arch and protect the sore area. This approach may allow you to resume normal walking immediately, but you should probably cut back on more vigorous activities for several weeks to allow the inflammation and pain to subside. Treatments directed to the painful area Do compression socks help with Achilles tendonitis? control pain and swelling. Examples include ultrasound, moist heat, and soft-tissue massage. Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area.

Accessory Navicular

Surgical Treatment
Depending upon the severity the non operative or conservative treatment should be maintained for at least 4- 6 months before any surgical intervention. There are 2 surgeries that can be performed depending upon the condition and symptoms. First is simple surgical excision. In this generally the accessory navicular along with its prominence is removed. In this procedure, skin incision is made dorsally to the prominence of accessory navicular. Bone is removed to the point where the medial foot has no bony prominence over the navicular, between the head of the talus and first cuneiform. Symptoms are relieved in 90% of cases. Second is Kindler procedure. In this the ossicle and navicular prominence is excised as in simple excision but along with the posterior tibial tendon advancement. Posterior tibial tendon is split and advanced along the medial side of foot to provide support to longitudinal arch. After surgery 4 week short leg cast, well moulded into the arch with the foot plantigrade is applied. Partial weight bearing till the 8th week and later full weight bearing is allowed. When the cast is being removed can start building up the ROM to counter atrophy and other physical therapy treatment which include stretching and strengthening exercises. [ بازدید : 2 ]

Managing Fallen Arches

سه شنبه 27 تير 1396
3:12
Marlys Webster
Overview
Acquired Flat Foot
Also known as fallen arches, the condition of flat feet is characterized by a lack of appropriate arch in the inner foot. It can be a genetic condition or the result of improper body mechanics. Often the whole of the foot will contact the ground. Because a healthy foot is structurally able to support the weight of the body thanks to the bone structure that comprises the arch, a flat foot often is unable to properly support this weight and will cause extreme pressure in the joints above, such as the ankles, knees and hips.

Causes
Over-pronation is a common biomechanical problem that occurs when the arches collapse while walking or standing. This condition hampers our natural walking pattern, causing an imbalance, and leading to wear and tear in other parts of the body with every step we take. Whether you suffer from over-pronation like most of the population, or you have a true flat foot, in both cases your poor walking pattern may contribute to a range of different complaints. As we age, poor aligment of the feet causes very common conditions such as heel pain or knee pain. Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch, leading to over-pronation. Over-pronation is also very common with athletes, especially runners, who most of them nowadays use orthotics inside their shoes.

Symptoms
Many people have flat feet and notice no problems and require no treatment. But others may experience the following symptoms, Feet tire easily, painful or achy feet, especially in the areas of the arches and heels, the inside bottom of your feet become swollen, foot movement, such as standing on your toes, What is the tendon at the back of your ankle? difficult, back and leg pain, If you notice any of these symptoms, it's time for a trip to the doctor.

Diagnosis
There are a few simple ways to assess your foot type, and most include making an imprint of your footprint. The classic way is to stand on a hard floor surface with wet feet to make a wet foot print. Look at the narrowest part of your footprint, which should be between your heel and ball of your foot. If the print of your foot in this part is less than 10% of the width of the widest part then you are likely to have high arches. more than 10% but less than 25% then your foot profile is probably normal, more than 25% or even the widest part, then you have flat feet.

Non Surgical Treatment
Physiotherapists will carry out a detailed biomechanical assessment of your feet and lower limb. Once the causes have been identified a number of treatment methods may be used to help relieve pain and restore function in the feet including the use of custom made orthotics to support the foot and offload the areas which are painful, strengthening exercises for weakened muscles and tendons in the arch, and massage and mobilisation techniques to help mobilise stiff tissue and joints in the foot.

Surgical Treatment
Adult Acquired Flat Feet
This is rare and usually only offered if patients have significant abnormalities in their bones or muscles. Treatments include joint fusion, reshaping the bones in the foot, and occasionally moving around tendons in the foot to help balance out the stresses (called tendon transfer). Flat feet and fallen arches are common conditions that are in most cases asymptomatic. However, in patients who do have symptoms, treatments are available that can help reduce pain and promote efficient movement. Orthotic devices are well recognised as an excellent treatment and podiatrists can offer these different treatment modalities as individualised treatments for patients.

Prevention
Orthotic inserts, either prescribed or bought over the counter, can help keep the arches fixed into position, but always wear them as although they support, they don?t strengthen, which is why some experts reccomend avoiding them. Gait analysis at a run specialist can help to diagnose overpronation and flat feet. Most brands produce shoes that will give support and help to limit the negative effects of a poor gait on the rest of the body. Barefoot exercises, such as standing on a towel and making fists with the toes, can help to strengthen the arches. Start easy and build up the reps to avoid cramping. Short barefoot running sessions can help take pressure off the arches by using the natural elasticity of the foot?s tendons to take impact and build strength to help prevent flat feet. These should be done on grass for only a few minutes at a time. [ بازدید : 4 ]
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