Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body causing an interference with the biological structure and focuses on the movement of the ankle, the foot and the forces that interact with them.
At some time in our lives we will all experience foot problems, regardless of our lifestyle or age, and we all take our mobility for granted until we are in pain. Twists or turns can cause problems and apply stress to the feet, and that pain will spread from the foot structure to the surrounding tissues. The pain will concentrate in the foot and ankle, but may eventually spread up into the knees, hips and back.
The history of biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded. Afterwards, during the first century AD, corns on feet were recorded as specifically growing on feet and toes. In 1974 biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections of conditions could be implemented to gain strength and coordination to the area. His basic principles of thermoplastic foot orthotics are still in use throughout the industry today.
Modern technology improvements are based on past theories and therapeutic processes providing a better understanding of podiatry concepts for biomechanics. Computers provide accurate determinations about the forces, movements and patterns of the foot and lower legs with the most important information captured. Today’s knowledge of detailed measurement of external and internal forces in the foot is critical to the individual’s treatment. Like most health industries, precise determinations assist the practitioner in diagnosing and prescribing the best treatment for health improving results.
Advances in materials and more awareness of biomechanics have developed enhanced corrective methods, offering further options for foot-related injuries. Shoe orthotics options have expanded to treat walking inability, helping to realign the posture deviations caused by hip or back health occurrences. Attention to posture and foot mechanics uses individual insoles to position the foot, aligning the ankle and leg. The corrected positioning comforts the pressure and helps to ease the pain. Understanding foot biomechanics can help improve and eliminate pain, stopping further stress to the foot. However, these results can only happen if one seeks a podiatrist who specializes in biomechanics.
Although most people try to avoid foot trauma such as banging, stubbing, or dropping heavy objects on their feet, the unfortunate fact is that it is a common occurrence. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break (fracture). Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.
Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, when the injured person experiences fever or chills throughout their body, and when there is an open, bleeding wound present on the toe.
Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe with the affected foot elevated on pillows. Swelling can be alleviated by placing an ice pack on the broken toe for 15 minutes every two hours during the first two days after the fracture. The broken toe should be immobilized by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape.
Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.
The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time.
Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.
Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.
A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.
In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.
If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.
Some tips on feet may include purchasing shoes at mid-day as your feet are smaller in the morning and swell as the day progresses. Ensure that she shoes you buy are both the same size and have the store stretch shoes at painful points to provide for optimum comfort.
A broken foot is when one of the bones located in the foot fractures, or breaks. About 10% of broken bones occur in the foot.
Bones typically break when an object crushes, bends, or stretches the bone. In the foot, the location of the broken bone is usually indicative of how the break occurred. Toes usually break when something hard and solid is kicked with great force. Broken Heels are usually a result of falling from a great height and landing on the feet. Other broken bones in the feet can occur because of a twisted or sprained ankle. Most of the time, a broken foot results from a sudden accident or injury. Sometimes small cracks can form over time in the bones of the feet from repeated stress. These cracks are called stress fractures and usually only occur in athletes that put a lot of pressure on their feet, like runners, dancers, and gymnasts.
Symptoms of a broken foot typically include pain, swelling, bruising, and redness. Occasionally the pain of a broken foot may be so severe that walking is not an option. However, this depends on the location of the broken bone within the foot. Broken toes are usually less painful than broken heels or other bones within the foot. A foot that is blue, numb, cold, misshapen, cut or deformed can occur in more serious cases of broken feet. Those who are experiencing any of these symptoms, or suspect that they have a broken foot, should seek medical attention in a center where x-rays can be performed.
Prior to seeking the attention of a doctor, several steps can be taken at home in order to reduce pain and swelling. Stabilization and elevation of the broken foot should be the number one priority. It is important not to move the foot, so any type of homemade splint will work well. However, any splint that causes the foot to become more painful, or cut off blood circulation should be removed. Ice can also decrease swelling and alleviate some of the pain that a broken foot can cause.
In a medical center, treatment for a broken bone will differ depending on which bone in the foot is fractured and depending on what caused the break. Some broken feet will require the patient to use crutches, while others will require splits or casts. More severe cases may require surgery on the foot to repair the broken bone or bones.
Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.
Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.
Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.
In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.
There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.