Items filtered by date: January 2018
Posterior Tibial Tendon Dysfunction (PTTD): Painful Flat Foot
Posterior Tibial tendon dysfunction (PTTD) is a painful and progressive condition where there is an inflammation or rupture in a major tendon called the posterior tibial tendon. This tendon functions to support the arch of the foot and overtime, PTTD causes the foot to flatten. Most often PTTD occurs from overusing the tendon through physical activities such as running, walking, hiking or climbing stairs. Patients may experience symptoms of swelling, flatting of the foot, and medial arch pain especially near the insertion site of the posterior tibial tendon. The heels maybe also turn outward along with the ankles rolling inward.
The following are treatment options that may be considered by your doctor or podiatrist for PTTD:
- Orthotics or functional bracing to provide your foot with arch support
- Ice, rest, and immobilization with a below the knee cast/ CAM boot to allow the tendon to heal
- Shoe modifications to improve the arch support
- Medications such as NSAIDs to reduce the pain and inflammation
- Physical therapy
If PTTD is not treated early enough, the condition may continue to worsen and therefore it is important to see your podiatrist to correctly diagnosis and treat PTTD as soon as possible. Your foot doctor may have you perform a single or double heel rise to examine the extent of the PTTD. To also determine if the PTTD is a flexible or rigid deformity, your podiatrist may lift up your big toe while you are weight bearing to test if the medial arch can be recreated. This is called a “Hubscher maneuver.” If after failing conservative treatments as listed above and the PTTD continues to progress further, surgical treatments may be needed to best address PTTD. Your doctor or podiatrist, who is a foot and ankle surgeon, may advise various options such as tendon transfer, osteotomy of bone cuts to mold a arched foot, and/or joint fusion. So if you are suffering from painful flat feet, call your podiatrist today to diagnosis and treat PTTD in order to prevent a permanent PTTD deformity.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office
Morton’s Neuroma
Morton’s neuroma is a painful benign fibrotic enlargement and swelling of the 3rd common digital nerve in the foot often as a result of nerve compression or micro-trauma. This entrapment syndrome is more common in females possibly due to certain shoe gear with high heels and a small toe box. When walking, especially in these types of constrictive shoe gear, the common digital nerve becomes compressed between the adjacent metatarsal bones and against the deep transverse metatarsal ligament.
The following are common symptoms of Morton’s neuroma that patients may experience:
- Burning pain, numbness, and/or electrical cramping sensation that occasional radiates to the toes
- Sharp pain that worsen when weight bearing, barefoot walking, and/or in narrow shoe gear
- Splaying of adjacent toes to the affected interspace upon weight bearing
- The feeling of walking on a wrinkled up sock or a pebble
- Pain with palpation of the affected interspace
- Relief with shoe removal
The treatment for Morton’s neuroma may begin conservatively with simply some shoe gear modifications such as avoiding high-heeled shoes, constrictive narrow shoes, and choosing shoes with a wider toe box. Applying metatarsal padding may also help to relieve pressure proximal to the neuroma by helping spread the metatarsal heads out. A similar concept is to get custom orthotics with the metatarsal pad to help alleviate the pressure on the metatarsal heads. Other conservative treatments your podiatrist may recommend are NSAIDs, physical therapy, and activity modifications. Injections into the affected interspace with corticosteroids or sclerosing alcohol may also help alleviate the pain and shrink the neuroma down. If after a series of injections are not providing pain relief, your physician may surgically decompress the nerve or perform a neurectomy of excising out the neuroma.
Start your New Year off on the right foot and call your podiatrist today if you are experiencing symptoms of Morton’s neuroma as this is a common painful forefoot condition that can be treated.
Please visit our website for more information or call 614-885-3338 (FEET) to schedule an appointment with us at our Columbus or Gahanna office