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Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If the bone is removed, it is then replaced with prostheses, synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in each of your feet will lose flexibility and elasticity. Your foot’s natural shock absorbers will wear down as well. Having arthritis added to this mix only makes matters worse. Your joints will become distorted and inflamed, which is why arthritic foot care needs to be something to think about every day.
When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buy well-fitting shoes with a lower heel and good support. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.
Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.
Exercise is another key aspect of arthritic foot care. Exercise not only strengthens and stretches your muscles and joints, but helps to prevent further injury and pain as well. Stretching the Achilles tendon, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.
Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well. You will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together. Then, pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet. Then, try to separate each individual toe, stretching them all.
A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately, there is no complete way to remove all of your arthritic pain. However, following some of this advice can go a long way in staying as pain-free as possible.
Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.
Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.
Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.
Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.
If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.
If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.
Have you ever gotten up from a chair or out of bed in the morning, and upon taking that first step, feel like your heel has stepped on a tack? Many people experience a feeling of sharp pain which radiates into their arch from their heel and which does not allow them to put their heel on the floor. Sometimes they need to sit back down, stand only on their toes and use the wall for balance. If you can take a few steps, it seems to go away and lessen, allowing you to then resume your activity. Later, throughout your day and after a period of rest, it can happen again. If this sounds familiar you may be suffering from your first attack of heel pain.
Heel pain is a debilitating condition that affects day to day activities. Running and walking both causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.
Plantar Fasciitis
One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill-fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.
Achilles Tendonitis
Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.
Heel Spur
A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.
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