Toe Walking
A lot of kid like to walk on their toes. They do so to make themselves taller. Generally it is off no consequences and they get over it. However, toe walking can also be due to a more serious problem so each case of toe walking does need to be taken seriously.
Toe walking is common in conditions like autism and cerebral palsy, but a number of other developmental and behavior problems can underpin it. If the child can get the heel to the ground easily and all the usual developmental milestones are reached, then the chances are that the toe walking is not a problem.
The Promise of Toning Shoes
Toning shoes came on the market a number of years ago claiming to cure everything from bad posture to cellulite. A lot of the claims have been ‘toned’ down now due to the threats of legal action as there was not much or any evidence to support the claims being made. Toning shoes are called that as they are deliberately made unstable. hence altering the posture and making the muscles work harder.
While the logic and rationale behind toning shoes could make sense, the actual science is not that good leading to legal challenges against the companies making the claims. There is on doubt that these shoes do help some people, but they also can hurt other people. There is plenty of information and misinformation on the web on these shoes, as well as a lot of testimonials.
Severs Disease
The most cause of heel pain in children is a condition known as Severs disease. The most common cause of pain is squeezing the sides of the heel near the posterior aspect. The pain is located in the bone and not in the joints and not in the tendon. It is usually only painful on activity and not at rest unless it has got really bad. There is debate if it should be called Severs disease or calcaneal apophysitis.
The standard treatment is lots of stretching of the calf muscles and a heel raise. A gel heel raise is commonly used for this. It is also common to reduce activity levels to help. Later a complete abstinence from sport may be needed if they the initial treatment does not help.
Pose Running
There are a number of different running techniques that runners can use to allegedly be more efficient and reduce the risk for injury. Each of these different techniques have their passionate supporters with little evidence to support one over the other. One of the more high profile approaches is Pose Running, that uses a forefoot strike, shorter stride length and high cadence.
There is not a lot of support for Pose Running from biomechanists and a number of the underpinnings of it are not biomechanically sound. There is one study that suggests that Pose running is less efficient than other forms of running, but those that promote Pose running are very critical of this study.
Reflexology
Reflexology is the alternative medicine approach to health in which there is a belief that every organ system in the body can be mapped to a zone on the foot. It is believed that massaging the area or zone on the foot can affect the health of that organ system.
There is no evidence that reflexology actually works and all the good research has shown that it does not work. A good foot massage will probably help anyone feel better and this is probably why there are so many testimonials from people who have had reflexology when the claim it improved. Anyone who is stressed or has a chronic illness will probably feel better after a good foot rub!
Plantar Fasciitis
Plantar fasciitis is the life blood of so many podiatry clinics. It something we see day in and day out. It is the most common musculoskeletal problem seen in the foot and I suspect that for every case we see, there are several others out in the community not be being treated. If its painful under the heel and if it worse after resting (ie sleeping) for the first few steps then it is probably plantar fasciitis.
The most appropriate treatment for plantar fasciitis is stretching and lots of it. Foot orthotics also help a lot at reducing the load in the plantar fascia. There a lots of secret sauces, miracle cures that you can buy, but there is nothing secret or magical about them! But it all comes down to stretching and reducing the load in the plantar fascia. Run Junkie probably has the most sensible approach to plantar fasciitis that I have seen.
Pitted Keratolysis
Pitted keratolysis is a relatively simple problem to deal with, yet is so common in the community and many to not seek treatment or seem to attempt the wrong self-treatment. Pitted keratolysis is a bacterial infection that tends to occur in sweaty feet (more). It creates a ‘soggy’ appearing skin with many ‘pits’ or little holes.
The treatment is simple topical antibiotics and removing of the sweaty conditions that create the environment that the pitted keratolysis develops in. That is not hard and is just good simple basic foot hygiene.
Growing Pains in Children
This is a really common problem and not a lot is really known about it. The classic symptoms are pain behind the knee that only occurs at night. generally it will wake the child from sleep and be distressing foe the child and parent. There are a number of rare conditions like bone tumors and juvenile arthritis that need to be ruled out as causing the pain, which is why the symptoms have to be taken seriously. The condition is self limiting and reassurance is all that is needed.
There is a paucity of research on growing pains with lots of opinions and ‘old wives tales’ on how to manage it. Most of these do seem to help in a lot of cases.
Onychomycosis
Onychomycosis is the fancy name for a fungal infection of the toenails and is a relatively minor problem, but is extremely difficult to treat. Well actually, in reality it is actually easy to treat, but its hard to stop happening again which gives the impression that it is hard to treat. The fungal agents that cause the onychomycosis thrive inside shoes where it is dark and moist. No matter what treatment is used, the foot is placed right back into the hostile environment that caused it in the first place!
Regardless of the treatment that is used, that environment that is so conducive to onychomycosis needs to be dealt with or this is going to be a problem for many years.
Obesity and Podiatry
Obesity is becoming a very big problem for society today. It is also becoming a big problem in podiatry practice for a couple of reasons. One is the load that it places on the foot and the problems associated with that and the other is the association of diabetes with obesity. Diabetes is associated with a very wide range of foot problems that can lead to serious complications such as diabetes.
Podiatrists need to play an increased role in the public health education of their patients about the impacts of obesity. Not only will it can help with a decrease in foot problems, but will also help with a decrease in the overall health burden.