Category Archives: Foot Problems

Chinese Foot Binding

There is a historic technique from rural China which involved the binding of the feet of female children to prevent them from growing. It was a brutal process and was debilitating and disabling to the feet. It was carried out as a smaller sized foot was considered an attractive feature in the female and a higher dowry can be asked for by the family for the bride-to-be when the feet had been bound. There was a considerable market in these rural communities for the ornamental and finely crafted shoes that these girls would need to wear because of the smaller and deformed feet. More than 100 or so years ago cultural pressures began to mount to ban the practice and this generally was successful and it is not done any longer. The practice had to stop as it was so disabling and painful for the child. When they became an adult, the damage had been done and there is not much that could be done to manage the suffering and deformity. Having said that, you will still find many elderly woman still living that had their feet bound when they were little girls.

You will find theoretically parallels to this practice of chinese foot binding that may be seen nowadays. A number of experts try to link the practice these days of females who force their feet into the high heel shoes as being the same as the foot binding. In rural China the practice was all about the female doing something that pleases the male, no matter the outcomes in terms of pain and deformity. The practice today of wearing tight fitting high heel shoes by females has consequences in the terms of foot disability and foot pain. It is also apparently done in the context of the female doing something which is pleasing to the eye of the man. There is some disagreement if the connection between the two practices really do warrant the type of evaluation that they have been put through.

Plantar Fasciitis

Plantar fasciitis has become the prevalent complaint which affects the feet. As a result of how widespread it is, there are so many pretending to be experts about it online giving out harmful advice on what to do about it. The characteristic signs of plantar fasciitis are soreness in the heel that is worse when getting up from rest, in particular first thing each morning.

Plantar fasciitis is an issue with the plantar fascia (which is a strong ligament which supports the mid-foot of the foot) once the cumulative weight applied to the plantar fascia is higher than what the tissues can carry. Because of this there are only two main reasons for plantar fasciitis: the cumulative load is simply too high or the tissues are too weak. The stress is elevated by body weight, restricted leg muscles, activity amounts and biomechanical reasons. The tissues being too prone is caused by nutritional deficits and genetic factors.

The sensible solution to improve from plantar fasciitis is to lessen the strain and increase the capacity of the plantar fascia to take the load. You reduce the force by slimming down, using strapping in addition to foot supports, as well as stretching the calf muscles. You increase the capability of the plantar fascia to accept the load through ensuring the dietary status is satisfactory and perform gradual loading activities for the plantar fascia. You can’t do anything at all about the genetics. It is really that easy and there is no necessity for plantar fasciitis to become such a huge problem that it is.

The problem with the therapy of plantar fasciitis and all the tips being given on the web for this is that the natural history of plantar fasciitis is to get better by itself eventually. Just look into the placebo groups in the clinical studies on different treatments for plantar fasciitis; they do improve. Eventually could be a long time and it is sore, so they still need to be addressed rather than wait until it improves. This means that, it doesn’t matter what therapy is used, a particular percent will likely become better regardless as a result of that natural history. Which means that bad remedies persist as they all do manage to help some, when in reality they didn’t help any. Those who appear to be effectively treated with that treatment probably will propose that it is useful. This also implies that the treatments that ought to be used are those which have been shown to result in superior results than just the natural history. Because of this we won’t become misled into believing a therapy will work when in reality it might not work any better than the natural history. You should be cautious taking any recommendations on the internet for almost any medical problem.

The Accessory Navicular

The accessory navicular is an extra piece of bone on the inside of the foot just above the mid-foot ( arch ) in close proximity to its top point. The bone is enclosed within the tibialis posterior tendon that inserts to the navicular bone towards the top of the mid-foot. The additional bone is also referred to as os navicularum or os tibiale externum. It is congenital, so is present from birth. There are various types of accessory navicular and the Geist classification is frequently used. This categorization divides the accessory navicular into 3 variations:

Type 1 accessory navicular bone:
This is the typical ‘os tibiale externum’ making up 30% of the occurrences; it’s a 2-3mm sesamoid bone embedded inside the distal portion of the tendon with no connection to the navicular tuberosity and may be divided from the bone by up to 5mm

Type 2 accessory navicular bone:
This type makes up about 55% of the extra navicular bones; it’s triangular or heart-shaped and linked to the navicular bone via cartilage material. It may well eventually merge to the navicular to create one bone.

Type 3 accessory navicular bone:
Pronounced navicular tuberosity. This might have been a Type 2 that’s merged to the navicular

The common symptom associated with an accessory navicular is the enlargement on the inside side of the arch. Because of the extra bone there, this affects how well the mid-foot muscles do the job and can lead to a painful foot. Rigid type shoes, such a ice skates, may also be very uncomfortable to use because of the enlarged pronounced bone.

The treatment is usually geared towards the signs and symptoms. If the flatfoot is a concern, then ice, immobilisation and pain relief medication may be required initially. Following that, physical therapy and foot orthotic inserts to aid the foot are used. If the soreness is due to pressure from the type of footwear that must be worn, then doughnut type padding is used to get load off the sore region or the footwear may need to be modified.

If these non-surgical treatment options fail to minimize the symptoms of the accessory navicular or the issue is a continuing one, then surgical procedures might be an appropriate option. This involves taking out the accessory bone and restoring the insertion of the tibialis posterior tendon so its function is improved upon.