Treatable conditions

There are a great many conditions that have their origins in poor posture and body movement. Very often these will be given a non-specific and quite general diagnosis, such as heel pain, calf pain or painful toe joints. Others may mimic similar symptoms with other causes (i.e. swollen feet can be caused by some heart conditions) and medical advice should be sought from a doctor, but often there is a simple remedy. What has to be remembered at all times is that we are all unique and how a condition manifests itself will constantly vary however there are often common characteristics. At the initial assessment, the overall approach will be explained and treatment plan will be mutually agreed upon. The main thrust is to develop and individual’s ability to sense the way their body is moving. To achieve this  the feet have to be stable under the body and the head and body have to be in the correct alignment over the centre of mass. To stabilize the feet a soft modifiable orthotics (specialised insoles) are created. These orthotics constantly change to reflect the changes in the body that the patient achieved between appointments. As the body realigns and falls back into normal limits of function so the presenting condition resolves and pain and aches disappear.

What has to be remembered at all times is that we are all unique and how a condition manifests itself will constantly vary however there are often common characteristics.

At the initial assessment, the overall approach will be explained and treatment plan will be mutually agreed upon. The main thrust is to develop and individual’s ability to sense the way their body is moving. To achieve this, the feet have to be stable under the body and the head and body have to be in the correct alignment over the centre of mass. To stabilize the feet a soft modifiable orthotics (specialised insoles) are created. These orthotics constantly change to reflect the changes in the body that the patient achieved between appointments. As the body realigns the presenting condition generally resolves and in the process pain and aches disappear.

Bunion

A Bunion (Hallux valgus) is considered to be a medial deviation of the first metatarsal shaft and lateral deviation and/or rotation of the big toe (hallux) with or without medial soft tissue enlargement of the first metatarsal head. This condition can also lead to pain in the joint with movement and/or difficulty with footwear. This condition can arise for a variety of reasons from, ill fitting footwear to a musculoskeletal imbalance or as a consequence of systemic disorder. Usually pain is the main reason for seeking help though occasionally it’s an inability to find comfortable footwear

Bursitis

Acute or chronic bursitis is an inflammation of  a bursa. A bursa is a saclike cavity filled with synovial fluid and located at tissue sites where friction occurs, such as where tendons or muscles pass over bony prominences so allowing for normal movement and reducing friction between moving parts of the body. Generally it is difficult to determine the actual cause. The most common sites are the back of the heel, around the knee, and in the hip as well elbow and shoulder.

Hallux rigidus

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the big toe, and with time it gets increasingly harder to bend the toe. "Hallux" refers to the big toe, while "rigidus" indicates that the toe is rigid and cannot move. In acute phases it may become increasingly more painful. When the joint is virtually rigid pain usually goes away however an adjacent joint frequently then starts to cause pain and discomfort. The causes of this condition are multifactorial; varying direct trauma e.g. stubbed toe or ill fitting footwear to a body that is musculo-skeletally out of balance.

Dyspraxia

Dyspraxia is an impaired ability to perform deliberate actions. Often there is poor co-ordination and a lack of dexterity skills. The question is: has it arisen because of a defect or problem in the brain or is it as a consequence of how the brain perceives external stimuli. An example of the latter would be a musculo-skeletal imbalance giving rise to an excessive pelvic tilt causing the head to move a lot when moving. If the cause is the perception of external events then there is a straight forward way of working with movement so that the head stays stiller therefore what is taken in by the eyes does not appear to move so excessively hence the brain’s response can be more accurate. 

Plantar Fasciitis

Plantar Fasciitis is the term which is applied when pain is experienced in the middle of a foot. There are a variety of causes, all of which invariably involves over loading the forefoot in someway. The end result is damage at the surface of a bone which invokes an inflammatory reaction and hence pain due to primarily swelling in the area which has been affected. 

Ingrown toenail

An ingrown toenail is one where the edge or corner of your nail grows down and cuts into the adjacent skin of your toe, leading to your toe becoming red, swollen and tender (inflamed). Your big toe is most likely to be affected, either on one or sometimes both sides. Your toenail curves and cuts into your skin causing your toe to be tender, especially when you walk on it. If left untreated, the inflammation can spread to the rest of your toe and the area becomes infected and may ooze pus.

Shin splints

Shin splints are when you experience pain along the shin bone (the bone at the front of the lower leg between the knee and the ankle), caused by inflammation and tiny fractures (microfractures) in the surface of the bone. Shin splints are common in any sport involving running and are usually caused by too much training too soon, although they can be caused by running on a hard surface or by running in shoes that do not have enough support for the foot and ankle.

Morton's neuroma

Morton's neuroma is a condition that affects one of the common plantar digital nerves that run between the metatarsal bones in the foot. It most commonly affects the nerve between the third and fourth metatarsal bones, causing pain and numbness in the third and forth toes. It can also affect the nerve between the second and third metatarsal bones, causing symptoms in the second and third toes. Morton's neuroma rarely affects the nerve between the first and second, or between the fourth and fifth, metatarsal bones. It tends to affect only one foot. It is rare to get two neuromas at the same time in the same foot.

Aching feet

Aching feet usually arise due to intrinsic muscles (Muscles with origin and insertion in the feet) or extrinsic muscles having to work harder than normal to stabilize the feet. In essence the muscles in question are suffering from fatigue. Orthotics work to gradually stabilize how the feet are working so that the function returns to normal

Swollen feet

There are numerous causes of swelling in the feet.  Circulation is impaired. This could be from a narrowing in an artery in the leg  or  possibly  an indication of a heart problem to wearing socks in which the elastic is too tight above the ankle. It is important that your GP arranges for all the usual tests to be done. After that the focus is to make changes so that the muscles in the legs and thighs have to contract more intensely so widening the pressure differential between the arterial supply into the feet and the venous return out.

Cold feet         

There are a variety of causes which induce cold feet. These range from inappropriate clothing to peripheral vascular diseases like Raynaud’s disease. The approach is multi-factorial; from the insulating properties of the orthotics through to changes in an individual’s way of dressing.

Collapsing Ankles

The most common causes of collapsed ankles are either a hypermobile inside arch of the foot or misalignment of the muscle contractions of the leg. It is resolved by realigning the leg and gradually stabilizing all the joints in the leg and foot.

Feet changing shape

Some people are born with odd shaped feet however the majority go through an imperceptible change as consequence of bad habits and or inappropriate footwear either way structures in the feet are over loaded and usually the forefoot spreads and or toes twist and buckle. The solution is to create an orthotic which gradually realigns the joints in the feet and for that to work there has to be a marked improvement in overall  posture.

Heel Pain

Generally, heel pain arises when the back of the foot has to absorb a force or load greater than the soft tissue structures can cope with, resulting in damage to the surface of the bone or strains/sprains to adjacent structures. This can invoke an inflammatory reaction with the concomitant swelling and hence pain. The solution is working out what has been damaged and then taking the measures to allow/promote faster healing. At the same time controlling how the forefoot works on the rearfoot to stabilise the mid-tarsal joint so that the foot does not twist or collapse at the ankle.