Why is my Achilles tendon burning?

Why is my Achilles tendon burning?

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نوشته شده در تاريخ سه شنبه 27 تير 1396 توسط Minnie McGowan
Overview
A high arch foot is known in medical terms as a ?subtle cavus foot?. People with high arch feet tend to be very stiff through the midfoot, with very little movement through the main midfoot joints (ex. the talo-navicular joint). The heel tends to be pointed inward in what is known as a varus position (Figure 1a). This foot position can be easily identified on examination by looking at the feet head on with the patient standing. If the inside edge of the heel is visible from the front (this is known as a peek-a-boo heel), then the individual likely has an inwardly pointed heel (varus heel).

Causes
An inherited disorder called Charcot-Marie-Tooth disease (CMT) is the most common cause of cavus foot. But there is a long list of disorders that may cause the problem. Children who have muscular dystrophy (MD) Cavus foot can affect only one foot, too. Cavus foot in one foot is more common in children with injuries to the nerves in their legs or spinal cord or to the muscles in their legs. Other conditions that make it more likely a child will develop cavus foot are poliomyelitis, cerebral palsy and spinal cord tumor.Cavoid Foot

Symptoms
Because so How much can you grow from stretching? extra weight is being placed on the ball and heel of the foot, you may notice calluses developing in these areas, as well as on the side of the foot opposite the arch (the outside edge of your foot). Walking will probably also make your foot rather sore, since pressure is being put in all the wrong areas. Wearing shoes will probably be uncomfortable, since most shoes aren?t designed to fit feet with very high arches. Plus, your ankles will probably be pretty unstable because you?re in essence balancing on your heel and the ball of your foot, not a secure arrangement. This may mean that you sprain your ankle rather often.

Diagnosis
The key in examining the foot is to determine to what extent deformities are fixed or flexible. This guides orthotic and surgical treatment. Gait is inspected; in HSMN the typical gait is high-stepping because of foot-drop, with the toe striking the ground before or with the heel. Foot shape is best assessed with the patient standing. The soles are inspected for calluses and the shoes for differential wear (indicating sites of excessive pressure). Tender areas, such as the metatarsal heads or base of the fifth metatarsal, are palpated. Passive movements should be assessed, looking for joint contractures. Testing active movements detects muscle weakness. The Coleman block test is one way to determine whether the hindfoot is flexible. With the patient standing, the heel and fifth ray are placed on a wooden block, permitting the forefoot to pronate. If the hindfoot also pronates, it is flexible; if not, it is in fixed varus.

Non Surgical Treatment
Treatment of high arches really depends a great deal on what?s causing them. If it?s not likely the condition will worsen with time, usually the case when the cause is NOT neurological, then more conservative treatments may be effective, enabling you to live without significant pain.

Surgical Treatment
Toe deformities can be effectively treated with the Jones and Hibbs procedures. These correct the cock-up deformities by fusion of the interphalangeal (IP) joints, combined with transfer of the EHL and EDL tendons to the metatarsal necks to assist with ankle dorsiflexion. The EHL and EDL transfers remove the deforming force on the MTP joint, and relax the plantar fascia.High Arch

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نوشته شده در تاريخ سه شنبه 27 تير 1396 توسط Minnie McGowan
Overview
Achilles Tendinitis
Achilles tendon rupture is an injury that affects the back of your lower leg. It most commonly occurs in people playing recreational sports. The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture). The tendon can rupture completely or just partially. If you have an Achilles tendon rupture, you might feel a pop or snap, followed by an immediate sharp pain in the back of your ankle and lower leg that usually affects your ability to walk properly. Surgery is often the best treatment option to repair an Achilles tendon rupture. For many people, however, nonsurgical treatment works just as well.

Causes
The cause of Achilles tendon ruptures besides obviously direct trauma, is multifactorial. In many instances the rupture occurs about 2-6 cm before its attachment to the calcaneous (heel bone). In this area there is a weaker blood supply making it more susceptible to injury and rupture. Rigid soled shoes can also be the causative factor in combination with the structure of your foot being susceptible to injury.

Symptoms
Tendon strain or tendon inflammation (tendonitis) can occur from tendon injury or overuse and can lead to a rupture. Call your doctor if you have signs of minor tendon problems. Minor tenderness and possible swelling increases with activity. There is usually no specific event causing sudden pain and no obvious gap in the tendon. You can still walk or stand on your toes. Acute calf pain and swelling can indicate a tear or partial tear of the Achilles tendon where it meets the calf muscle. You may still be able to use that foot to walk, but you will need to see a specialist such as an orthopedic surgeon. Surgery is not usually done for partial tears. Sometimes special heel pads or orthotics in your shoes may help. Follow up with your doctor to check for tendonitis or strain before resuming activity, because both Can stretching help you grow taller? increase the risk of tendon rupture. Any acute injury causing pain, swelling, and difficulty with weight-bearing activities such as standing and walking may indicate you have a tear in your Achilles tendon. Seek prompt medical attention from your doctor or emergency department. Do not delay! Early treatment results in better outcome. If you have any question or uncertainty, get it checked.

Diagnosis
During the clinical examination, the patient will have significantly reduced ankle plantar flexion strength on the involved side. When the tendon is palpated with one finger on either side, the tendon can be followed from the calcaneus to where it "disappears" in the area of the rupture and to where it then returns 2 to 3 cm proximal to the rupture. If the injury is recent, the patient indicates that her pain is localized at the site of the rupture. The defect eventually fills with blood and edema and the skin over the area becomes ecchymotic.

Non Surgical Treatment
A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. Use support devices as directed. You may need crutches or a cane for support when you walk. These devices help decrease stress and pressure on your tendon. Your caregiver will tell you how much weight you can put on your leg. Ask for more information about how to use crutches or a cane correctly. Start activity as directed. Your caregiver will tell you when it is okay to walk and play sports. You may not be able to play sports for 6 months or longer. Ask when you can go back to work or school. Do not drive until your caregiver says it is okay.
Achilles Tendon

Surgical Treatment
Surgery is recommended to those who are young to middle-aged and active. The ruptured tendon is sewn together during surgery. This is an outpatient procedure. Afterward the leg is put into a splint cast or walking boot. Physical therapy will be recommended. In about 4 to 6 months, healing is nearly complete. However, it can take up to a year to return to sports fully.

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نوشته شده در تاريخ دوشنبه 26 تير 1396 توسط Minnie McGowan
Overview
The calcaneal apophysis is a growth center where the Achilles tendon and the plantar fascia attach to the heel. It first appears in children aged 7 to 8 years. By ages 12 to 14 years the growth center matures and fuses to the heel bone. Injuries can occur from excessive tension on the Achilles tendon and the plantar fascia, or from direct impact on the heel. Excessive stress on this growth center can cause irritation of the heel, also called Sever?s disease.

Causes
The heel bone sometimes grows faster than the leg muscles (including the calf muscles) and tendons (including the Achilles tendon) during the early puberty growth spurt. The different growth rate in these structures can cause lower leg muscles and tendons to become overstretched and tight, which makes the heel less flexible and puts excessive pressure on the heel growth plate. The Achilles tendon, the strongest tendon in the body, attaches to the heel growth plate, and repetitive stress on this structure, especially if it?s already tight, can damage the growth plate, leading to tenderness, swelling, and pain. Activities that involve running or jumping, such as soccer, gymnastics, track, and basketball, can place significant stress on a tight Achilles tendon and contribute to the onset of Sever?s disease. Ill-fitting shoes can also contribute to this health problem by failing to provide the right kind of support or by rubbing against the back of heel. The following factors may increase the likelihood of Sever?s disease in kids or young teens. Wearing footwear that is too narrow in the toe box. Leg length inequality. Obesity or carrying excess bodyweight. Excessive foot and ankle pronation.

Symptoms
Pain in the bottom surface and at the back of the heel. Extreme pain when the child places their heel on the ground. The pain is aggravated when running or jumping on hard surfaces. The pain is reduced when the child walks or runs on their toes.

Diagnosis
Sever's disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order X-rays or an MRI to determine if there are other injuries that may be causing the heel pain.

Non Surgical Treatment
Most patients with Sever?s Disease can be treated with a self-guided home exercise program. Your healthcare provider will discuss with you if a prescription for formal physical therapy What is a heel lift? indicated instead of a self-directed home or school exercise program. Rest (protection of the heel). Ice (Ice 20 minutes at a time, 2-3 times a day). Gel heel pads / inserts. Anti-inflammatory medication. Well cushioned pair of shoes. Brace (Cheetah) *Generally given for those who cannot wear shoes during their sport. Low impact aerobic training such as walking, riding a bike, elliptical or swimming. Home exercise program focusing on increasing the flexibility of the heel cord and calf muscle.

Surgical Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

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