Wednesday 27 December 2023

BUNION


BUNION

Bunion is characteristically a hallux valgus deformity which affect the first metatarsophalangeal (MTP) joint. The 1st metatarsal bone deviates medially & the 1st phalange deviates laterally. Sometimes it is accompanied with inflammation of the 1st MTP joint. 
Bunion is most commonly seen in individuals with flat feet owing to their over pronatory walking pattern. Bunion deformity implicates that there is excessive pressure exerted on the forefoot region. if left uncorrected the deviation keep progressing & results in over lapping of the great toe & 2nd to deu to progressive weakening of the transverse arch.

Symptoms:
  • Redness and inflammation over the great toe either unilaterally or bilaterally.
  • Deviation of great toe away from the body.
  • Pain and discomfort over great toe while walking.
  • Hard skin or callus over great toe.
                                                            Treatment:

  • Orthotics to redistribute the pressure evenly & thereby reduce the pressure coming over toes.










  • Use of Bunion/ Hallufix night splint to prevent further deterioration & overlapping of toes.








Saturday 24 June 2023

Unlocking the Power of Podiatry: A Must-Have Training for Doctors & Physiotherapists

 




At some point, many of us have experienced chronic pain or discomfort in our feet and lower limbs. However, it’s often difficult to find the cause of this pain and determine the best course of action for relief. Fortunately, doctors & physiotherapists can now proactively alleviate lower limb problems through podiatry training.
 
Podiatry training provides a quick clinical diagnostic assessment that helps identify the root cause of foot and lower limb issues. This type of training is cost-effective and doesn’t require much investment, making it an attractive option for doctors & physiotherapists looking to expand their services.
 
With the right training, they can help their patients find relief from pain and discomfort while also learning a new approach to managing lower limb problems. This new approach can provide immediate feedback that helps patients understand the cause of their issues and how best to treat them. In addition, podiatry training can help doctors & physiotherapists become more efficient with their time, as they’ll be able to diagnose and treat issues in one appointment rather than having to refer patients to another specialist or wait for results from further tests.
 
By taking podiatry training courses, doctors & physiotherapists can also help boost their business’s revenue. The skills they gain can be used to offer new services that weren’t previously available, which can lead to an increase in patient visits and more money in the bank. Furthermore, the need to hire an orthotist is eliminated, which reduces overhead costs and allows practitioners to keep more of their income.
 
If you’re a physiotherapist looking for a way to take your practice to the next level, consider taking a podiatry training course. Not only will you be able to provide comprehensive solutions for your patients’ foot and lower limb issues, but you’ll also be able to increase your income potential with the added skill set. With podiatry training, you’ll be able to help your patients find relief from pain while giving your business a boost in revenue.

Welcome to the world of Podiatry training! It’s one of the most important skills you can have when it comes to taking care of your feet. Not only does it help to keep your feet healthy and strong, but it also provides you with a range of other benefits as well.

Here are 10 of the most important benefits of Podiatry training:

1. New Skill: Podiatry training is a great way to learn a new skill. Whether you are looking to become an expert in foot care or just want to be able to take care of your own feet, learning podiatry will give you the tools you need to do so.

2. Unique Specialty: Podiatry training provides a unique specialty that many people may not have heard of. As a result, it will give you an edge when it comes to foot care and can open up doors for you in the healthcare industry.

3. Fastest Diagnosis: Podiatry training enables you to quickly and accurately diagnose foot problems. This can help to ensure that your patients get the best treatment possible and can also help you to get your patients back on their feet faster.

4. Immediate Response: One of the biggest advantages of Podiatry training is the ability to provide immediate response in the case of any foot problems or injuries. This can help to save lives and reduce the amount of time it takes for a patient’s recovery.

5. Improve Patients Compliance: By having a better understanding of the foot, podiatrists can help their patients understand the importance of compliance with treatments and follow-up visits. This can help to improve overall patient satisfaction, as well as improve their health outcomes over time.

6. Chronic Problem Can Solve: Many chronic foot problems can be solved through Podiatry training. This includes issues such as plantar fasciitis, bunions, hammer toes, and more. Having an expert handle these cases can help ensure that your patients get the best possible results.

7. Root Cause Diagnosis: Podiatry training enables you to identify the root cause of foot issues quickly and accurately. This can help you determine what treatments will be most effective for your patients, making them more likely to adhere to them in the long term.

8. No Extra Space Required: With Podiatry training, there is no need for extra space or equipment. As long as you have a chair and table available, you can carry out consultations and treatments at your own convenience. 

9. No Need To Hire Technical Support: Podiatry training gives you all of the skills and knowledge that you need in order to provide quality foot care services without having to hire technical support staff or buy expensive equipment. 

10. Revenue Boost: Providing quality foot care services is an effective way to increase your revenue stream in any healthcare setting. By learning podiatry skills, you can make more money by offering specialized services that many other health professionals may not be able to provide. 

Podiatry training is an incredibly valuable skill that provides a range of benefits for both health professionals and their patients alike. If you are looking for a way to expand your career opportunities or just want to learn how to take better care of your own feet, investing in podiatry training could be just what you need!

We are into Podiatry Training courses for the last decade, and our course is certified by LBG Medical UK. For More details kindly contact bellow.

India needs podiatry because of the country's high prevalence of diabetes and neglect of foot care.



Friday 2 September 2022

Corn & Calluses



Corn & calluses are prevalent issues. Some people suffer for many years like 15 to 30 years also. Why do you think any medications or even surgery doesn't give a complete cure? It is essential to understand that corn & calluses are one of the symptoms & the root cause is always different.

Let's understand why the corn & calluses occur in the first place.

When we stand & walk our body weight passes through our soles to the ground. this creates certain pressure areas in our feet. These pressure areas are the variable person to person spends on his/ her arches & walking pattern. For example, a person with flat feet will have more pressure on the inner side of the feet which can lead to corn at the great toe, and a person with a high arch can get corn below the little finger. Apart from this footwear also plays a major role. for example using high heels will increase a lot of pressure on the forefoot.



WHAT IS THE REMEDY?

Once we get any patient with corns we not only assess their foot arches but also their posture & walking pattern. This is necessary for a complete understanding of excess pressures. Further prescribed corrective insoles/ orthotic footwear to offload pressures from the corn area. As the patient starts using this correction they get pain relief immediately & corn starts healing. In follow-up visits, we remove corn without any surgery. Sometimes small corn falls down by itself.

 RESULTS:

In most cases, the influence is evident in one month. As the patient will continue using corrective footwear minimize the risk of recurrence.

 
 
 
 










Thursday 15 April 2021

SUCCESS STORY OF FLAT FEET WITH RHEUMATOID ARTHRITIS

 



The degree of freedom for podiatry in rheumatoid arthritis is very restricted. As podiatry approach in R.A. is mainly to reduce foot-related pain, maintain/improve foot function and so mobility while protecting skin and other tissues from damage. Pain & swelling are the main causes of restrictions.

Finely tuned podiatry intervention can give dramatic results in long run. Check out the images.
60 years old Lady with RA & pain 😔mostly at the right foot.
Drastic relief in foot pain in a month with customization in STRIVE orthotic footwear. But the real treat is the visible correction in her foot deformities within two years. (P.S. RA deformities are progressive means worsen day by day)
Good changes can happen at any age....!
Happy to see the smile on her face.


For video click the link- https://youtu.be/pIly9BttlPI

Wednesday 13 January 2021

Plantar fasciitis (Heel Pain)


Plantar fasciitis (Heel Pain)


Is the inflammation of the plantar fascia caused due to repetitive stress applied to it.

It is usually common in active individual, obese, runners or athletes, people who spend most of their day on foot.
The pain is usually characterized by piercing or searing type of heel pain that appears in the first few steps in the morning or after a period of inactivity.
Patient may present with tenderness around the medial calcaneal tuberosity at the plantar aponeurosis.
Pain increases when walking barefoot on toes or while climbing stairs.

Patho-physiology

As the term implies plantar fasciitis is the inflammation of the plantar fascia however in all the samples reviewed there is no evidence of inflammation histologically.
However research shows that plantar fascia is a degenerative condition, hence it is better to be  called “fasciosis” than fasciitis.1

Biomechanics of the foot during gait

There are 6 phases of gait cycle : heel contact, weight acceptance, mid stance, push off , propulsion and toe off phase. Foot goes for supination during heel contact phase followed by pronation in weight acceptance phase, in order to maintain contact with the surface. From the mid stance to the toe off phase the foot goes for supination thus making the foot as a rigid lever which is necessary for the propulsion of the foot.

Plantar fascia plays a very important role in maintaining this arch during the gait cycle of the foot. Because if plantar fascia fails to work effectively the medial arch arch would disrupt and the force required to control supination and pronation would be altered. Hence plantar fascia plays a very important role in control of supination and pronation of the foot during gait cycle.

Evidence based therapy for plantar fasciitis

  • Cryotherapy or NSAIDS – Not much effective in the treatment of plantar fascia, however it provides only temporary pain relief.
  •  Taping – No studies have proved the effectiveness of taping.
  •  Shoe inserts-  a study was done to compare the effectiveness of the custom made orthotics and prefabricated shoe inserts with stretching. It was found that prefabricated shoe inserts with stretching showed more effect than custom made orthotics.
  •  Stretching – A study shows plantar fascia stretch alone more effective than combined stretch of calf muscle and Achilles tendon.
  •  Night splints – limited evidence suggesting the effectiveness of night splints.
  •  Extra-corporeal shock-wave therapy – No evidence supporting the effectiveness of Extra-corporeal shock wave therapy for reducing night pain and resting pain in short term.
  • Corticosteroid injection – According to Cochraine review Steroid iontophersis injecton improved only short term outcomes.2
As mentioned earlier the arch of the foot is very important to maintain stability on the surface when walking or standing. Overpronation or underpronation can have direct influence on the effective working of plantar fascia.

Overpronated foot

Overpronation of the foot is caused due to muscle weakness, tightness in the heel cord and abnormal structure of the foot. Proximal muscles such as gluteus medius, gluteus minimus, tensor fascia latae or quadriceps can contribute to the pronation of the foot. These proximal muscles help in assisting lower extremity response during gait, hence weakness of these muscles will transmit greater shock to the supporting foot structures and decreased pronation control.
Heel cord assist in dorsiflexion of the foot during gait, hence tightness in the heel cord limits the ability to dorsiflex the ankle at heel strike phase of the gait thus making the foot to over pronate more at the midtarsal joints in order to make contact with the surface of the ground.
Structural deformities include excessive sub-talar or forefoot varus.
Treatments for overpronated foot include strengthening of the weak muscles, stretching of the calf muscles, and using appropriate shoes with sufficient toe box and firm ankle grip to control the movement of the ankle within the shoes. Insoles made of polyurethane and ethyl vinyl acetate also enhances shoe support.3

Underpronated foot (Supination)

Supinated foot which is caused due to factors such as increased muscle tightness, decreased mobility within the joints and decreased plantar fascia extensibility.
Highy arched or cavus foot will have limited joint mobility to distribute the force during weight acceptance phase. Hence when foot does not pronate during weight acceptance phase, it indirectly applies a lot of tension force to  the insertion of plantar fascia at the medial tubercle of calcaneum.
Treatment for supinated foot include Stretching of calf muscles, mobilization of joints and increase plantar fascia extensibility. Appropriate shoe wear with ethyl vinyl acetate midsole provides appropriate space for the rearfoot and forefoot to move , offers much shock absorption.
Silicone heel pad can further enhance shock absorption.3

By Dr. Liana Thomas (PT)

Reference –

  1. Plantar fasciitis  A degenerative process without Inflammation (Harvey Lemont et al.)
  2. Plantar fasciitis (Charles Cole, Craig Seto et al.)
  3. Plantar faciitis and the Windlass mechanism : A Biomechanical Link to clinical practice (Lori   A. Bolgia et al. )



Saturday 24 March 2018

SUCCESS STORY OF METATARSALGIA


Metatarsalgia is condition which results in pain & inflammation under forefoot. Following case study of Metatarsalgia show how altered Biomechanics can create various injuries.

30 years old female patient came with complaints of pain under left forefoot since four weeks. She
has started learning SALSA recently, pain aggravates after dancing.
She used wear high heel footwear for office.

Bio-Mechanical Assessment-
  • Medial Arch- Flat both sides
  • Subtalar Joint- Over pronated
  • Transverse Arch- Reduced
  • Calcaneus- Eversion
  • Knee- Valgus
  • Left Knee higher than right
  • Spine- Sway back posture, mild scoliosis at lumbar level with convexity right side.
  • 1st Ray- Hyper mobile
  • Foot Size- US 10 Medium
Strive Ibiza
Gait-
  • Heel Strike- Medial
  • Mid Stance- Over-pronation at subtalar Joint
Orthotic Correction-
  • Prescribed Strive orthotic footwear with metatarsal pad.
  • Advised to avoid high heel foot wear.
Physical Therapy intervention-
  • Exercise prescribed for scoliosis
Bio-Fashion
Follow up (after 3 weeks)
Pain is disappeared. comfortable with correction. 
Considering her demand of wearing high heels advised to wear platform heels instead of pencil heels but occasionally.
Given Bio Fashion insole in high heel footwear's. Advised to walk minimal in high heels.




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