Chilblains
Chilblains area common problem in some countries and unheard of in others. They tend to commonly occur in colder climates.
Once they occur, it is important to keep the foot warm (link to advice) and prevent it from happening again. There is not a lot of research done on them despite how common they are (link to the research). They are more common in females, so that suggest hormonal issues, but the do occur in males. Lots of questions gets asked in forums and often the answers for a “cure” are just not there, so a lot more research is needed to get to the bottom of this small, but annoying problem.
Ankylosing Spondylitis and the Foot
Ankylosing spondylitis is a problem that mostly affects the spine with a form of arthritis. It can also affect other points and some other organs. The problem in the spine affects mobility and creates a progressive deformity that will need a lot of physical therapy to manage.
It affects the foot in three ways:
1. The arthritis like symptoms can affect the joints in the foot
2. Pain in the heel similar to plantar fasciitis is common
3. Due to the affect on the spine, the ability to reach the feet and do self-care is difficult.
Trench Foot
Trench foot was a cold injury that was really common in the trenches during war time. Th soldiers were subjected to cold and damp as well as unsanitary conditions. This no freezing injury affected a lot of soldiers and still is an issue in today’s armies.
It is just not a problem now for the army, but trench foot can occur in extreme sports in cold environments and in those with occupational risk such as cold store workers. It is more appropriately called a non-freezing cold injury. Frostbite is a freezing cold injury and the cold directly damages the tissues. In a non-freezing cold injury the tissue damage is more related to changes in the circulation.
Calcaneal Apophysitis
Calcaneal Apophysitis is the technical name for severs disease. This is an injury or inflammation to the back of the heel bone in growing kids. The classic symptom is pain on squeezing the sides of the heel bone. The pain is usually present with activity and can limit sports participation.
This video from PodChatLive is an in-depth look into calcaneal apophysitis.
The standard treatment for this condition is to use a heel raise to lesson the pull from the achilles tendon and cushion the impacts with the ground. A reduction is sports activity is often needed. If none of these treatments help, then calcaneal apophysitis should be placed in a walking cast.
Restless Legs Syndrome
Restless Legs Syndrome is a particularity unpleasant problem that can drive people crazy. When at rest, especially at bed at night, they have an uncontrollable urge to move the legs.
There is very little that can be done for the problem, except getting up and walking or taking drugs to help the sleep. Drugs can often deal with a lot of the symptoms, but it can take a while and some trial and error to get the exact drug or comobination in the right does right for the individual. There are a number of natural approaches that have been advocated, but very little evidence supports these approaches, though the testimonials do suggest that they help some people. Support groups, in person and online, are often helpful.
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.
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.
Navicular Stress Fracture
I do hate seeing a navicular stress fracture as they usually occur in dedicated athlete who train hard and who put in long hours and are often competing at a high level. I hate seeing it as I have to tell them the news that they going to have to stop for about 6 weeks and then gradually start back to full training loads. No one wants to tell a high level athlete than and no high level athlete wants to be told that! Unfortunately, there is no way that they can heal in quicker than 6 weeks.
The key signs for a navicular stress fracture are pain over the navicular often located to a particular spot on the navicular (more)