The Foot in Ankylosing Spondylitis

Ankylosing spondylitis is a long-term inflammatory joint condition that usually affects the vertebrae, but could affect all joints in the body and several other organ systems. The name ‘ankylosing’ means a fusing of the joints and ‘spondylitis’ means the spine. The disease impacts on about 0.1-0.2% of the population and does affect males more often. It generally simply begins as an ache in the lower back which is really no different in signs and symptoms to almost every other common low back condition so is typically treated as such. Generally, this treatment will probably not work and other methods get used. Inevitably, when some other symptoms occur in additional joints there might be more investigation bringing about the proper diagnosis of ankylosing spondylitis. This process could take up to a decade before the diagnosis is made. The standard approach to treatment for this is to use drugs to deal with the inflammatory process inside the joint along with physiotherapy to help keep the spine mobile and flexible.

Ankylosing spondylitis affects the foot often. One way is that the joint inflammation process can affect the joints in the feet and cause symptoms there. Heel spurs or plantar fasciitis is quite common in those with this disease. This type of heel pain isn’t the typical one that you get because it is part of the disease process, consequently tends not to respond effectively to the conventional methods of dealing with heel pain. Like the joint inflammation that impacts the joints in the foot, the treatment is primarily directed at the drugs that reduce the inflammatory response. The other way that ankylosing spondylitis impacts feet are indirect. Because the major symptoms of the disease are in the spine, the lower as well as upper back become very limited in motion, so people that have ankylosing spondylitis tend to have difficulties bending over to reach their feet. Because of this they cannot even perform basic things like cut their own toe nails or self-care for their feet. They’re also going to have issues managing different conditions that impact the foot. They will often need to see a podiatrist frequently for foot care and maintenance of foot health and for the regular management of any foot conditions that might occur.

The Adidas Springblade Running Shoe

The Adidas Springblade running footwear is a very unique and unusual running shoe. It has only been in the market for approximately 12 months to varying evaluations. The main feature of the Springblade are, as the brand implies, individual blades that create a spring effect for both shock absorption as well as energy return to propel the runner forward when running. The running shoe was created over the 6 years and had been put through significant testing for the durability, comfort, as well as power in order that the various variations could match runners of all types. They don’t match all runners and were not actually made for running long distance which is what some of the critics of the shoes have attempted to use the shoe for. They’re probably more suited to runs on the track or trails, with reduced runs on the road.

There are several models of the Springblade available on the market. You have the Adidas Springblade Drive that is created to be there all-rounder running shoe form this range. It has got the ESM-mesh technology which is supposed to enhance the breathability as well as comfort while at the same time being very conforming to the shape of the foot. The Drive is recommended as being most suitable for runners wanting a more general cross-training shoe and just want one shoe that addresses all their requirements. Another shoe in the line-up is the Adidas Springblade Razor which is more firm compared to the Drive in order that it supports the foot better in place. It is suitable for runners using the track more for speedier runs as opposed to the road. The final shoe in the selection is just called the Springblade. It is viewed as the workhorse of the range. The shoe has a tech-fit upper structure that does trade-off some degrees of breathability for more flexibility as well as comfort. A different unique feature of this range is when you get the running shoe through the online site, you are able to customize it with a few personal reaches.

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.

Abebe Bikila and His Barefoot Marathons

Abebe Bikila was a marathon runner from Ethiopia, winning double Olympic gold medals: Rome in 1960 and at Tokyo in 1964. Abebe died in 1973 at the age of forty one because of troubles after having a motor vehicle accident. There’s a athletic field in Addis Ababa named after him. Google honored Abebe using one of their doodles on what could have been his 81st birthday celebration on 7 August 2013.

1960 Olympic Marathon at Rome:
Abebe had been a last minute substitute in the Ethiopian squad for the Olympics. Abebe had no shoes to compete in and Adidas, the official supporter simply had a few pairs remaining that didn’t fit him, therefore he ran the marathon barefoot (he previously had been running barefoot). Abebe won the gold medal in a time of 2hr 15min. Following the marathon, addressing an inquiry as to the reasons he competed without shoes, Bikila answered: “I wanted the whole world to know that my country, Ethiopia, has always won with determination and heroism.

1964 Olympic Marathon in Tokyo:
Forty days prior to the marathon Abebe was operated on for an acute appendicitis and at one stage it was thought that he might be unable to run. He went on to win this marathon in a world record time of 2hr 12min, being the 1st runner to win two Olympic marathons. Abebe had been wearing Puma shoes in the race (which Abebe Bikila also ran in to come 5th in the 1963 Boston Marathon).

He is a light to mild heel striker with a few midfoot strikes also. Despite that, he is not overstriding and could crack a world record. Bikila is frequently idolized by the barefoot running online community as a idol for running the marathon without running shoes (together with other elite athletes). Pundits of this love to point out that he did compete faster and break a world record when using footwear.

As part of his legacy, the minimalist running shoe producer, Vibram FiveFingers have the Bikila label of their range named after him. Early in 2015, the descendants of Abebe Bikila reported they were taking a law suit against Vibram for registering the ‘Bikila’ title without having authorization.