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.

Feedback of the Patient-

FeedBack

SUCCESS STORY OF RECURRENT CORN 1

SUCCESS STORY OF RECURRENT CORN

25 Years old young man working in restaurant as a manager came with complaints of three painful recurrent corns since 3 years. He needs to stand a lot as he was floor manager in five star hotel. He needs to stand at least 6-8 hours every day.

ASSESSMENT REVEALS:

• Excessive forefoot pressure.
• Medial Arch- Pronounced Bilaterally
• Transverse arch- Reduced Bilaterally
• Subtalar Joint- Supinates statically & dynamically
• Corns- Three corns at 1st, 3rd & 5th Metatarsal heads

FOOT SIZE

• Right- 8 Wide to Extra-wide
• Left- 7 Extrawide

DIAGNOSIS- Corns with Pes Cavus foot type

CLINICAL REASONING:

Following are the reasons for corns in this case,

• Week Transverse arch had increased fore foot pressure.
• Both the foot sizes are different (Left foot is smaller than right)

He was wearing US 9 size shoes which was medium width. Left foot was sliding more inside the shoes resulted in more friction & corns.

Bio-Orthotic

TREATMENT & ADVISE:

• Treatment started with targeting to offload the corn area.
• Prescribed ready to wear orthotic footwear with metatarsal; raise for home wear.
• Given Medium Density prefabricated custom orthotics (Bio-Advance insole) to use in his formal shoes.

Follow Up: After 15 Days

Corns are not hurting anymore when he wears corrections. Also recommended wide width formal shoes.

After three months corns healed completely.

After five months: even marks of the corn disappear.

Recovery of Corn without Surgery

TESTIMONIAL

"I came to V-Care Clinic about year back. In lot of pain & frustration ailing with three corns in my left sole. I had consulted with three doctors, endless trial & errors done. One of doctor even advised for surgery. One day magically I came across V-Care clinic on Google. After few hours of research on Podiatry. I decided very apprehensively to visit.

The first visit was what changed everything!!

The analysis & prescription of my problem by Dr. Sarika & Dr. Vilas was amazing. I am sure Sherlock Homes would be surprised. The warmth & the dedication is second to none. The meticulous explanation of the problem & its cure is commendable. I wish the V-Care team all the best & hope their quest of relieving people from pain goes on forever.

I cannot express my gratitude in words to Dr. Sarika & Dr. Vilas" 

Online Feedback

SUCCESS STORY OF FLAT FEET WITH POSTERIOR TIBIAL TENDON DYSFUNCTION

CASE STUDY: FLAT FEET WITH POSTERIOR TIBIALTENDON DYSFUNCTION (PTTD)

41 year old female complaints pain & swelling at inner side of left ankle since a year. Pain was gradually increased. Initially it use to hurt on prolong standing & walking eventually pain got worst. Now not even able walk few steps also.

On Examination:

• Swelling was present around left navicular area
• Grade III tenderness at the navicular area

Biomechanical Assessment:
Static-

• Clawing of toes left side
• Medial Arch- Flat Bilaterlly (Flat Feet)
• Transvrse arch reduced
• Subtalar joint- Overpronation bilatrally more on lfert side
   
• Navicular drop- Present bilaterally
• Navicular drift- Present bilaterally
• Calcaneum (Posterior view)- Eversion bilaterally more on left side
• Knee- Valgus

Gait Assessment:

• Gait Pattern- Poor heel to pattern
• Heel Strike- Medial heel strike
• Stance Phase- Overpronation at the sub-talar joint bilaterally
• Limp on left side

Treatment & Advice:
Advice-

Bio-Advance

• Complete rest for one week with cold pack 4 time a day over affected area for 20 min. each time.

Orthotic correction to improve lower limb biomechnical alignment-

• Advised to wear sport shoes (Even indoor) with firm heel counter (Stable Shoes) few days as concidering her pain & sevirity of flat feet.
• Prescribed Bio-Advanced medium density orthotic insole in her shoes & also to reduce stress on Tibialis posterior muscle tendon.

1st Follow up after two week

• Demarkeble changes seen. More than 50% of pain was reduced.
• Added correction in orthotics to further enhance arch support.
• Advised to continue with cold pack. 

2 nd Follow up after one month

Strive

• This time 90% pain reduced.
• Now slight discomfirt only after long stand or walk.
• Adviced Strive orthotic footwear for short distance (Near by) & continue the sports shoes for out door.
• Exercises for strengthening tibialis posterior muscle.

3rd Follow up after 2 months
No pain & Adviced to continue with orthotics

Feedback of Patient's husband

Feedback

Metatarsalgia

METATARSALGIA

 Metatarsalgia is described as excessive pain which occurs over the toes & forefoot.
Most commonly, the first metatarsal head is affected- the ball of the foot just behind the big toe. In the foot there are small toe nerves between the metatarsal bones. When the head of one metatarsal bone is pressed against another, the small nerve is caught between them & start to become inflamed, thus causing metatarsalgia.

These can cause metatarsalgia or Contribute:

• Ill fitting footwears- Footwears that is tight around the toes or has high heels that can add pressure on the ball of the foot as it is forced into tight space.
• Overweight- Overweight people may suffer this pain as the excess weight can strain on the foot.
• Age- As a person ages several degenerative changes occur in the body, one such is reduced shock absorption. Metatarsalgia can subsequently develop as the foot has less protection from the strain of impact & load.
• High Impact Exercise- People who run or play high impact sport are at risk of metatarsalgia. When we running our feet absorb large amounts of force.
  

• Shapes of the foot & toes- Having a high arch in your foot or a second toe longer than the big toe can add to the pressure on the metatarsals.
• Stress fractures- These are small breaks in the toe bones or metatarsals. They can cause pain when weight is put on the foot- the individual compensates by changing the way they put weight on his/her foot.

Medical conditions that can cause Metatarsalgia:

• Bunion- this is a painful swollen bump that occurs at the base of the big toe.
• Rheumatoid Arthritis- swelled joints in the foot can cause metatarsalgia.
• Morton's Neuroma- is entrapment & irritation of the inter digital nerve which passes between 3rd & 4th metatarsal bones.
• Diabetes- the small nerves in the foot can become irritated, thus causing metatarsalgia. 

Common symptoms of metatarsalgia:

• A burning pain
• Sharp aching
• Pain in the ball of the foot.
• Pain increases when walk bare feet.
• Pain that worsens when standing or moving around but decreases at rest.

Treatment:

• Apply ice pack to the area approximately 15-20 minutes 2-3 times a day. Wrap ice in something to protect your skin from direct contact to ice.
• Avoid high impact sports & exercise that puts pressure on the feet. Try something lighter on the feet i.e. Cycling or swimming.
• Try to keep pressure off the feet, when resting try putting your feet up.
• Be sure to exercise your ankle & keep stretching the Achilles tendon.
• Use fitted insoles (Orthotics) as these will reallocate pressure or reduce pressure, improve foot function & guard the ball your foot.
• Change to better fitting flat headed shoes.

Success Story of Metatarsalgia Click here- http://vcarerehab.blogspot.com/2018/03/success-story-of-metatarsalgia.html

HEEL PAIN

If you are waking up with acute pain at your heel, then mostly you are suffering from plantar fasciitis. This is one of the most common foot problems. Many times pain is very severe & disabling.

What is plantar fasciitis?

Plantar Fasciitis (plantar fasciosis) is inflammation of the plantar fascia. The planar fascia is a strong bowstring like ligament that runs from the calcaneus (Heel Bone) to the tip of the foot. When the plantar fascia is stretched too far its soft tissue fibers become inflamed, usually where it attaches to the heel bone. Sometimes the problem may occur in the middle of the foot. The patient experiences pain under the foot, especially after long period of rest. If inflammation persists for longer duration it can lead to calcaneal spur.

Causes: Plantar Fasciitis is not usually caused by a single injury, such as a twist or fall, but rather the result of repetitive stress and pounding of the heel. Still following factors play important role in increasing severity of plantar fasciitis.

1. Arch Type: Flat feet, High arch or in between.
2. Footwear: Wearing too flat or too high heel footwear.
3. Lifestyle: Continuous standing, walking  or running.
4. Body weight: Overweight results in more stress on platar fascia.
5. Osteoporosis: Weak bones will aggravate pain.

Symptoms

• Pain at the heel when standing.
• Throbbing or piercing type of pain.
• Pain in the first few steps in the morning after a period of inactivity.
• Pain while walking barefoot, on toes or while climbing stairs.
• Tenderness along the inferior surface of the heel

Causes: Plantar Fasciitis is not usually caused by a single injury, such as a twist or fall, but rather the result of repetitive stress and pounding of the heel. Still following factors play important role in increasing severity of plantar fasciitis.

Treatment:

• Rest: Temporary rest is important to allow plantar fascia to heal
• Cold pack: Helps to reduce inflammation. Recommended 3-4 times a day, 20 minutes each time (Not recommended for diabetic patient)

• Taping
• Right orthotics: To support your plantar fascia & correct your faulty alignment
• Supportive shoes: Orthotics with proper supportive shoe gives long term relief
• Exercises: Generally higher arched feet require a strict stretching program and flat feet require a gradual strengthening program and more support.  One should not do stretching in acute pain.

What to avoid:

1. Barefeet walking on hard surfaces 
2. Wearing too flat or too high heeled footwear
3. Heel Cushions: Silicone or foam heel cushions commonly available from pharmacies do nothing to actually cure this condition and at best provide temporary comfort.

Success Story- Click this link 

https://youtu.be/YfOE5jx5HVM

For more details visit- www.vcarerehab.in