Women's Shoes

Image Credit: Pixabay (free to use and share commercially)

Image Credit: Pixabay (free to use and share commercially)

“I believe that the greatest gift you can give your family and the world is a healthy you.”- Joyce Meyer

When it comes to shoe shopping, the key is to find the right one. With the myriad of shoes that are available on the market, it can be tempting to purchase shoes because of how they look, because that’s what’s trending, or simply because those models were readily available. The right shoe is critical to ensuring the health of your feet. Many current foot and ankle ailments take place over very long intervals of time. With appropriate care, prevention will be better than cure in the long run.

What is the right shoe?

The right shoe provides the feet with a mixture of cushion, support and comfort. The anatomy of the foot is such that it supports the body on a hinge joint. The appropriate alignment of the feet is critical to so much, inclusive of the health of the spine. The right fit of the shoe should be such that it fits snugly, and there is at least 1-1.5 cm of space at the end of shoe. A few key characteristics of shoes that should be factored in include:

a)    A stiff back for appropriate heel support

b)    Flexibility to facilitate the motion of your feet

c)    Appropriate arch support - The arch of the foot is part of its engineering design that facilitates its ability to support the body appropriately. Shoes will not all be perfectly designed, so with the appropriate inserts, shoes can be customized to facilitate that additional comfort.

d)    Heel height - Heel height is very important for the support of the feet and the body. The body was designed for an optimum height. The higher an individual is off the ground, the higher will be the center of gravity of that individual. Any object with a high center of gravity will have the tendency to fall, compared to an object with a lower center of gravity. Women are aware of the fact that with higher heels, they do feel the instability that comes with being elevated. It will be important for an individual to ensure that they match their heel height with their personal height.

 

A consultation during the shoe purchase will help to facilitate that there is a match. With heels, the injury risk is significantly higher. Aside from the fact that one can fall, the possibility of a high ankle sprain due to twisting of the ankle is highly probably. Before you wear heels, ensure that you are aware of the terrain. If you’ll be walking on flat surfaces, you’ll be fine. Road surfaces that are rough or grainy such as asphalt, are not conducive to heels. Neither are grassy terrains. For the latter, heel stoppers, will prevent high heels from sinking too deep into the grass, and causing a potential injury.

 

e) Check your running shoes. Even though, they are designed to be comfortable, periodically check your running shoes, and change them once they are at a point where they are worn. Designed to absorb the shocks that are attributed to running, a worn running shoe will lose its ability to absorb shock. Check your shoes and ensure that you have the appropriate support for your arch as well as your sole.

 

As shoe designs vary, the key is to ensure that the critical key criteria are met for the purchase. Take some time to have your feet assessed by your foot and ankle surgeon, to determine the current health of your feet. Your orthopaedic surgeon will be able to guide you with respect the best shoes for your feet. As much as you want to purchase those cute shoes, the key will be to determine if they’ll enhance the health of your feet and body. For a special occasion, it will be occasion to purchase those out of the box shoes, but for every day care, it will be critical for you to ensure that the right fitting shoe is purchased.

 

When shoe shopping, carry a trace of your feet, and also allow yourself to shop for shoes in the afternoon when your feet have gotten a chance to expand, and also had a chance adjust to the weight of your body. When you first wake up, your feet will have been relieved of your weight. Giving them a chance to warm up will enable the appropriate choice to be made.

 

When it comes to women’s shoes, the options available are significantly greater than men’s shoes. Choice can lead to confusion, so it is important before hand to know what choices to be taken, in order to make the right decisions and enhance your health.

 

Article References:

1)    https://www.health.harvard.edu/staying-healthy/10-tips-for-finding-the-right-shoes

2)    https://www.uhs.umich.edu/shoes

Ring External Fixatuer

Image Credits: National Library of Medicine (USA)

Image Credits: National Library of Medicine (USA)

Background

 

For various foot and ankle related injuries, minimally invasive procedures are ideal for treatment. For more severe conditions, orthopaedic surgeons utilise an external fixation device to facilitate the appropriate realignment of the bones. When it comes to conditions such as Charcot foot or fractures of the tibia and/or fibula, brace realignment will be necessary in order to facilitate a relatively flawless healing and restoration of the foot.

 

The semi-permanent brace that is used in restoring severe foot injuries, is the Ring External Fixateur also known as the Ilizarov Apparatus. Much like orthodontics (braces for one’s teeth), the Ring External Fixateur

is a wire frame that applies appropriate vertical and lateral pressures to the healing system. The frame is designed to keep the fractured bones in the optimal position for fusion and restoration.

 

Orthopaedic surgery has a wide range of advanced technologies for healing fractured bones. Consult with your foot and ankle surgeon to determine the best treatment plan for your current condition.

Treatment Plans

 

Generally used to lengthen or to reshape the bones in the leg, the root causes for which the ring external fixateur is the solution do vary. First pioneered by the orthopaedic surgeon Gavriil Abramovich Ilizarov, based in the Soviet Union, the procedure has found widespread application in the field of foot and ankle surgery.

Consultation with your orthopaedic surgeon will usually identify the following conditions as appropriate for treatment with the ring external fixateur:

  1. Angular Deformity

  2. Leg-Length Differences

  3. Non-Unions

The main mechanism of attachment of the ring external fixateur is highlighted in the image below:

Image credit: A.D.A.M. Inc

Image credit: A.D.A.M. Inc

Image credit: Wikipedia.org

Image credit: Wikipedia.org

Mechanism of Action

 

The apparatus comprises of the external circular fixator, constructed of stainless steel or titanium, held in place by a series of pins to the bone and in turn the rings are aligned vertically and held together via series of rods. Together, they form a column that surrounds and supports the leg while it heals. The central rings and pins immobolise the fracture site.

 

The frame is also attached to the healthy bone above and below the injury site. This acts as a by-pass (of the fracture site) and allowing movement through the leg and partial weight bearing through the appartus.

 

Article References: 

  1. https://medlineplus.gov/ency/imagepages/18021.htm

  2. https://en.wikipedia.org/wiki/Ilizarov_apparatus

Ankle Reconstruction

Image Credit: Canvas Art Rocks (sourced via Google Images)

Image Credit: Canvas Art Rocks (sourced via Google Images)

In the design of the human body, majority of the body’s pressure is placed on the ankles and feet, in order to keep the frame upright and to facilitate motion. The ankle, as a hinge joint, is therefore susceptible to a myriad of injuries due to its small size in comparison to other bones and joints in the body.

Due to the strains and stresses exerted daily from simple walking to strenuous activity that are experienced by athletes; conditions such as sprains, strains and fractures can occur in the region of the ankle.

As a sensitive area that is frequently used, healing of certain conditions may take a longer time than anticipated. Through a consultation with your orthopaedic surgeon, minimally invasive procedures can be used to facilitate enhanced healing.

The nature of treatment

Ankle reconstruction is a common procedure utilised by orthopaedic surgeons in order to treat chronic ankle conditions.

Patients no longer need to suffer in silence where they would in the past by alleviating symptoms utilising ankle braces for example. They can approach surgeons who are specialist in the foot and ankle region and the duration of treatment and recovery can be significantly reduced by utilising a combination of surgical techniques such as Key Hole and Minimally Invasive Surgery.

Post-surgical radiograph of torn ligament case treated with minimally invasive surgical technique, day case.  Surgeon: Dr Gordon Slater

Post-surgical radiograph of torn ligament case treated with minimally invasive surgical technique, day case.

Surgeon: Dr Gordon Slater

Approaching your Doctor

If you have been involved in strenuous physical activity which has resulted in or you suspect that you may have an ankle injury, approach your GP for a referral for a Foot and Ankle Surgeon for a diagnosis, treatment options and recovery.

Jones Fractures

Image Credit: Canvas Art Rocks (sourced via Google Images)

Image Credit: Canvas Art Rocks (sourced via Google Images)

Of all the fractures that occur in the foot, the Jones fracture is one of the more common metatarsal fractures. The fifth metatarsal bone is the on the exterior periphery of the foot and is connected to the smallest toe. When there is a fracture between the base and the shaft of the fifth metatarsal bone, the condition is described as the Jones fracture. Named after its discoverer Sir Robert Jones. The Jones fracture is easily treatable by procedures such as minimally invasive surgery.

Occurring in the metaphyseal-diaphyseal junction, the types of people most susceptible to a Jones fracture include athletes who are constantly applying pressure to their feet. Statistical surveys have identified that basketball players are the athletes that are most susceptible to this condition. If you’re athletic, carefully consider your body position as you’re in motion. Should you succumb to such an injury, orthopaedic surgeons are an excellent source of treatment.

Jones Fracture Symptoms:

Painful walking experiences

Swollen feet, particularly at in the region at the base of the small toe

Position of fracture – highlighted

Position of fracture – highlighted

Jones Fracture – treated with Minimally Invasive Surgery and Synthetic bone  Surgeon: Dr Gordon Slater

Jones Fracture – treated with Minimally Invasive Surgery and Synthetic bone

Surgeon: Dr Gordon Slater

Approaching your Doctor

If you have been involved in strenuous physical activity and suspect that you may have a Jones fracture, approach your doctor for a diagnosis and referral to a Specialist. Treatment options for Jones fractures include:

Plaster

Walking orthotic

Minimally Invasive Surgery

Keyhole Surgery

Ankle Reconstruction – Early Rehabilitation

Image Credit: Murdoch Orthopaedic Clinic

Image Credit: Murdoch Orthopaedic Clinic

The ankle, as a joint, is a very complex mechanism. There are three joints within the ankle itself, held together by tissues and muscles which facilitate the stability of the joint. Through a series of stresses and strains or pushes and/or pulls, the joint facilitates movement of the body. As one of the weakest points in the body, the ankle is susceptible to a multitude of injuries, making ankle injuries one of the most common that are experienced.

For this reason, therapies such as ankle reconstruction involving minimally invasive surgical procedures are commonly used to rapidly restore the functionality of the joint once there is a persistent injury. Since mobility is critical to the well-being and livelihood of patients, particularly athletic patients, rapid recovery is a critical parameter that is involved in patient care. Orthopaedic surgeons, have successfully managed to optimise the turn-around time between surgery and recovery.

Surgical methods, such as the Rapid Broström Rehabilitation Protocol, have been developed in order to facilitate an accelerated recovery. The surgical details are such that the process involves no plasters at the end of the procedure and patients are less dependent on a post-operative boot. Compared to other procedures aiming to treat ankle injuries, the time to ankle function (full functionality) has been halved.

 

When to approach your Doctor

The most common reported sporting injuries are lateral ligament sprains. With foot pain, it is usually easy to ignore a condition, when one suspects that they have a sprain or strain. Usually patients utilise patches such as foot braces or bands, in the hope that the foot will heal itself with reduced mobility. While home remedies can be effective, it is important to visit a local foot and ankle surgeon, if the condition is bordering on chronic.

As the prevalence of ankle instability related illnesses persist, treatment of the condition will facilitate better health overall and improvement in the alignment of the spine, as better weight distribution will be facilitated in the body.

Charcot Foot

Sports related injuries are not the only contributors to ankle injuries.  From within the body, a deformity known as Charcot foot could develop due to the weakening of the bones. Induced by a condition known as neuropathy or nerve damage, the bones in the feet eventually become weakened due to fractures.  The joint ultimately disintegrates, and with persistent pressure placed on the foot due to activities such as walking, the foot eventually adapts a new shape as indicated in the image below. The rounded appearance known as a “rocker-bottom” is indicative of the Charcot foot.

Characot Normal.jpg
Characot.jpg

Image Credits: https://www.foothealthfacts.org/conditions/charcot-foot

Induced by the reduced sensations in the foot, many patients lose their ability to feel. Typical sensory capability such as the ability to experience pain, temperature and pressure on the feet; are lost during the onset of neuropathy. Diabetics,  in particular, are susceptible to this condition.  As a result, careful monitoring of the extremities is important during treatment and care. With the onset of additional cardiovascular related illnesses on the rise, Charcot foot is one side effect of the associated physical changes.  The reduced sensations can lead to negligence of what is taking place in the feet, and over time, deterioration to the final shape is achieved.

Diagnosis of Charcot Foot

Consultation with an Orthopaedic surgeon, early in the treatment of conditions such as diabetes, peripheral artery disease or any condition which later leads to the development of neuropathy will be key. Periodic pressure tests to ensure that the patients can feel the critical sensations in their feet will be needed in order to ensure that the condition doesn’t persist. Additionally, periodic analysis of the internals of the foot, such as periodic X-rays, will be critical to the early detection and treatment of Charcot foot.

Prevention is better than cure, and with the onset of minimally invasive surgeries to reinforce the ankle joints, immobilisation, custom shoes and braces, Charcot foot can be kept under control.

Are tight socks as damaging as tight shoes?

I read this and I believe it will be  of help to us. When you take off a pair of socks and notice sock band left on your leg or ankle, you should be careful. This is an obvious sign that your socks are too tight.

While you want your socks to fit well and not slip or bunch down inside the shoes, you have to be careful not to make it too tight.

There are some negative effects to this.


Lack of blood circulation

It can lead to circulatory issues, or pain in the legs and ankles. There is a lack of blood circulation, which can make varicose veins worse or more likely to occur. This brings a heavy feeling in the legs or feet and swelling of the ankles and legs.


Edma

It can cause edema, which is a swelling of the limbs due to fluid accumulation. Peripheral edema, characterized by swelling of the legs and feet, is the most common form of edema. With edema, the fluid gathers under the skin in spaces found in the tissues. Oftentimes, this can affect only the feet; at other times, it can move up the ankle and the calf right up to the thigh.

This can cause numbness in the foot and should never be taken lightly, particularly when it is not associated with sitting or standing in one position for too long.

According to Medline Plus, there are several medical causes for this type of numbness. One of the causes is wearing too tight socks.

Athlete’s foot

Wearing extremely tight-fitting shoes and socks is the most prominent reason of causing athlete’s foot. The fungi causing athlete’s foot are relatively harmless until and unless they have favourable conditions. They thrive only in moist and warm environment. When you have socks on for a longer time, your feet create these favourable conditions automatically and it results in fungal growth. As the fungus grows, the skin produces more cells pushing the older cells further. This gives the feet a scaly appearance. Similarly, wearing wet shoes, plastic shoes or even wet socks can result in fungal infection between the toes.

In a recent study in the British Journal of Dermatology as contained in healthninjas.com, as well as a study done at Washington University, researchers have discovered that many children have been scarred by wearing tight socks even just once. These “sock-band” lines are initially red markings that happen when the elastic band is too tight around the child’s ankle or leg. While the redness will go away in a few hours, the raised welt that is left can be permanent, even after just a few hours of wearing socks that are too tight.

The study conducted by Washington University also found a small association with the continual usage of tight socks and the banding being associated with some limb defects, but they do note that this potential link needs further study. Because this has only recently been noticed by parents, doctors and researchers; no one yet knows if the welts will last the entire life of the child, or if there are any other negative effects, other than just cosmetic ones.

When children wear the wrong socks

Oftentimes, parents do not know the actual size of their child’s feet, thinking their feet are smaller than they really are. You need to consider the height and width of the foot as well, especially if you have a larger size baby! A professional can measure your child’s feet and even if they are too young to wear shoes, you will at least know what size sock to purchase.

Plantar Fasciitis; symptoms and treatment

shutterstock_189254687a.jpg

Having a faulty foot structure (for example, flat or high arched feet) or prolonged wearing of non-supportive footwear on hard surfaces, can cause plantar fascia: a thick and strong structure on the bottom of your foot that becomes tight, pulling at the point where it attaches to your heel. This can make the fascia and heel inflamed and sore and create a condition known as plantar fasciitis.


People with plantar fasciitis often report that the pain is worse when they first get out of bed, or when they walk after they’ve been sitting still for some time. The pain is usually felt in the sole of the foot and the bottom of the heel. It usually eases after a few minutes of walking. Long term remedies include wearing supportive shoes, stretching and using orthotics.

Achilles tendinitis is another common cause of heel pain. It is the inflammation of the Achilles tendon, which runs from the heel to the calf. It often causes pain behind your heel (and may also cause swelling, warmth and tenderness in this region) It may also hurt when you rise to stand on your toes. Common causes are tight calf muscles and overuse. Gently stretching the calf might help, though if pain persists, you may need to consult a physiotherapist and undertake special exercises.
Other causes of heel pain include arthritis, heel bursitis, tarsal tunnel syndrome or osteomyelitis.

Heel pain diagnosis
A doctor or a physiotherapist is able to diagnose the cause of heel pain by talking to you about your symptoms and and examining your foot.

Heel pain treatment
Your doctor or physiotherapist may recommend rest and home treatments such as stretching your calf muscles if you have plantar fasciitis or Achilles tendinitis.
Other treatments may include:
1.     applying ice
2.     anti-inflammatory medicines or painkillers
3.     night splints or strapping
4.     supportive footwear or orthotics
5.     weight loss to reduce the stress on your feet.
If you are exercising and feel a sudden pain in the back of the leg, you may have ruptured your Achilles tendon. If this happens, you should seek medical help immediately.

Prevention
Reducing stress on the feet helps to prevent heel injury and pain. Stretching and a warming-up before exercise can help. If you feel pain in your tendon, you should stop the exercise. Always wear correctly fitted, supportive footwear suitable for your activity.

Do high heels cause bunions?

High heels may contribute to the development of bunions, however there’s uncertainty about the initial cause of bunions. Wearing poorly-fitting shoes tends to make foot problems worse, but it doesn’t necessarily cause foot problems.

High heeled shoes typically have a narrow toe box that puts pressure on the toe and pushes the toe over to the side. Flat shoes can be problematic too, as they’re narrow and do not provide arch support.

For some people, bunions are caused by the way they walk – rather than the shoes they wear. Our walk, or our gait, is influenced by many factors, some of which are inherited. For example, people who have flat feet are more likely to develop bunions as are those with very flexible or hyper-mobile joints. These conditions pre-dispose the foot to developing a bunion and associated conditions such as arthritis.

Women are also more likely to develop bunions, as does getting older.
A bunion (also known as hallux valgus) is a misalignment of the knuckle of the big toe. It can also form at the base of your little toe – sometimes referred to a tailor's bunion or a bunionette. This misalignment causes the big toe to turn toward the smaller toes. The pressure on the second toe commences and this aggravates the pressure from the shoe (bursitis). It often creates a bump at the base of the big toe.

Bunions are not always painful, though this deformity will generally increase over time. If you’re predisposed developing bunions, high heels may speed up development

If bunion pain interferes with your daily activities and shoe modifications don't help, it's time to discuss surgical options.

A Classification System for Foot Surgery

Classification systems have been used extensively in orthopaedics for research and descriptive purposes, to classify disease and injury and to predict pathology and treatment outcomes.

A good classification system should be easily reproducible so that inter-observer reliability is high. With the advent of minimally invasive techniques, accurate pre-planning for foot surgery has become even more important. In particular, obtaining consent has become an increasing burden for surgeons.

Documenting each bone to be operated on is a time-consuming process and there simply isn’t enough space on a standard hospital consent form to include this information.

I’m proposing the following classification system to simplify this process and increase the accuracy of surgery planning.

 
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