Flat foot (Pes planus) in adults What is flat foot?
Absence or loss of medial arch of the foot is defined as flat foot.
What are the types of flat foot in adults?
There are two types of flat foot in adults:
a) Physiological b) Pathological
What is the difference in the two types of flat foot?
a) Physiological flat foot: This is bilateral and symmetrical. The flat foot deformity is flexible. This is usually asymptomatic and does not require surgical treatment.
b) Pathological flat foot: This is usually unilateral or bilateral, asymmetrical. The deformity is rigid. The patients are symptomatic. The deformity is progressive. This group of patients should be diagnosed and treated soon as delay in management affects the treatment and prognosis.
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Cavus represents high arch. This is best appreciated from side. Varus deformity means that the hind feet rather than being in a neutral position, are medially inclined (heels facing each other). Varus is best appreciated from behind.
What are the causes of Cavo Varus deformity?
Although in quite a few cases there is no known cause (Idiopathic), this deformity can be associated with a neurological cause such as Charcot Marie tooth disease, Cerebral Palsy, Spinal problems or Polio. On the other hand, a varus deformity on its own can be due to significant ankle arthritis (usually post traumatic commonly resulting from an old severe lateral ligament or peroneal tendon injury).
What is the treatment?
In early stages orthotics can be tried for a flexible deformity. However, this being progressive deformity a surgical intervention is indicated in most cases. In early stages, tendon transfers and osteotomies can be considered. In cases of fixed deformity joint fusion surgery is required.
Take Home message: Consider a neurological cause when examining a cavo varus deformity. This usually requires specialist surgical intervention and therefore should be referred to Secondary
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Most patients with a grade II injury get better by about 6-12 weeks after injury. However, up to 40% of patients suffering from a Grade III sprain do not improve and suffer from pain and or instability.
What is the treatment of Acute Ankle Sprains?
Treatment of the acute sprain includes conventional measures (Rest, Ice or cold packs, compression, elevation, NSAIDs). If patients have persistent pain, swelling, and activity limitations or reach an unacceptable plateau after 12 weeks, an MRI is indicated.
What are the indications for surgery?
There are two indications for surgery:
a) Pain: This is seen in about 20-40% patients with grade 3 sprain. This is due to soft tissue impingement. Arthroscopic surgery is quite effective to deal with this.
b) Instability: This is seen in up to a third of patients with grade 3 sprains. An anatomic ligament reconstruction (Brostrom repair) has been reported as gold standard of surgical treatment with good functional outcome in 90% patients.
Take Home message: 95% of ankle sprains involve lateral aspect of ankle. Majority improve with non surgical measures. Physiotherapy is useful and should be considered for severe ankle sprain. If symptoms do not settle after 3 months MRI scan / referral to secondary care is
Sometimes the UCL will weaken and stretch (technically a sprain), making it incompetent. Other times a catastrophic stress will cause the structure to "pop" or blow out. The injury isn't tremendously painful, and it can be incredibly diffic...
Sussmilch-Leitch, S. P., Collins, N., Bialocerkowski, A. E., Warden, S. J., & Crossley, K. M. (2012). Physical therapies for achilles tendinopathy: systematic review and meta-analysis. Journal of Foot and Ankle Research , 1-16.
This article is about the results of a survey conducted by three PhD’s; Janet Simon, Matthew Donahue, and Carrie Docherty, and was published by the International Journal of Athletic Therapy and Training. The purpose of the survey was to determine Athletic Trainers current utilization of ankle support, and to determine ATs current attitudes towards the use of ankle taping and bracing. It gives some history and benefits of ankle bracing and taping, and how it has become a multimillion dollar industry, considering that 66-73% of all college athletes have reported an ankle sprain. Also, a third of people with ankle sprains will either re-sprain the ankle or report feelings of instability after the initial sprain. Ankle taping has become essential part of sports medicine,
Plantar fasciitis is caused from muscles and ligaments that alter the calcaneous (the big bone on hill of foot) (Daniels and Morrell 2012). The alteration of these muscles and ligaments will inflict pain and discomfort on the patient, and if not treated will cause failure of ligaments, bones, and muscles. The patient was tested with a simple squat technique that showed his heels were coming off the ground (Daniels and M...
After the injury has occurred, the injured should see the family doctor or possibly a specialist to see if something is torn. The doctor will do some range of motion testing. Theses test are the Lachman, Dynamic extension and the pivot jerk.
A major part of these regions were due to ligament sprains, targeted stretching exercises may be beneficial. The most injure players were those with the position of running back and linebackers. In the season of 2005-2006 there were recorder more than half a million injuries nationally of football high school players. This data was collected from over 100 high school football teams. The Columbus Children’s Hospital was the first one to compare injuries between college players and high school players. I can infer this when I read this from the text, “Four out of every 1,000 high school football exposure resulted in an injury, while eight out of every 1,000 collegiate football exposure resulted in an injury.”
Sometimes you can’t control your injury and need to get back to your sport as soon as possible. Stop exercising no matter what if you feel pain and see a doctor if the pain continues. Sometimes, it might turn out that you just have to strengthen a certain muscle group. “When you have JUST injured yourself then remember RICE…. It is sometimes extended to PRICER” (Lowry 1). PRICER is an acronym that teaches the steps to recover from an injury that may not be
Treatment for this condition depends on the type of ankle fracture. Stable fractures are treated with a cast or splint and then crutches to avoid putting weight on the injured ankle. This is followed by an ankle strengthening program. Unstable fractures require surgery to ensure the bones heal properly.
A. Walks on toes, can look very odd when moving in general and appears rigid or droopy in posture.
The soleus, gastrocnemius and tibialis anterior contract isometrically to keep the ankle stable at 90 degrees (Teachpe.com n.d.) (The previous reference was used to identify key joint types and muscles throughout my analysis). The knee joint is extended when in the standing position, to stabilize this joint the biceps femoris, semi-mebranosus, semi-tendonosus (hamstrings) and the rectus femoris, vastus lateralis, vastus transcriptis and vastus medialis (quadriceps) co-contract isometrically. The vertebral column of the body remains stable due to the isometric co-contraction of the erector spinae, rectus abdominus and the external and internal obliques.... ...
She immediately scheduled an appointment with an ankle specialist, who diagnosed me with hairline fractures throughout my ankle. At this moment, I thought that my career in sports was over as I would never come back from the months spent in a boot, unable to participate in any form of physical activity, and the months of therapy that followed, but I persevered and returned to playing condition before too long. Some people aren’t so fortunate. They sustain career ending injuries which often include soft tissue damage. The problem with injuries like these is not that they will never heal, as many of them will, but the time it takes for them to heal.
There are different studies of the MLA development as to where some research remain consistent as to other findings the foot arch is becoming higher. It’s also believed that while wearing shoes at an early age may be the influence of MLA development. The MLA
Congenital defects also may have genetic bases, as in families who have extra fingers or toes or in the disease osteogenesis imperfecta, in which children have such brittle bones that many are fractured. Disorders of growth and development include several kinds of dwarfism and gigantism. Bones or limbs may develop deformity as the result of known causes, such as the infection poliomyelitis, or unknown or variable causes, such as curvature of the spine (SCOLIOSIS) or CLUBFOOT. Infections Infections of bone, called osteomyelitis, are usually caused by pus-producing bacteria, especially Staphylococcus and Streptococcus.
If the spine is normal then the issue is part of the child growing or a different issue that is causing enough pain to warent a trip to the doctors. If the angle is off however then it will be diagnosed as Scoliosis, Lordosis or Kyphosis respectively.
Which is why people need acknowledge the problem and take precaution to find out what the symptoms are, how to prevent it and how to handle the injury. The ankle is frequently injured in dance because it accounts for 57% of dancers’