1/10. Defective running shoes as a contributing factor in plantar fasciitis in a triathlete.STUDY DESIGN: Case study of a patient who developed plantar fasciitis after completing a triathlon. OBJECTIVES: To describe the factors contributing to the injury, describe the rehabilitation process, including the analysis of defective athletic shoe construction, and report the clinical outcome. BACKGROUND: Plantar fasciitis has been found to be a common overuse injury in runners. Studies that describe causative factors of this syndrome have not documented the possible influence of faulty athletic shoe construction on the symptoms of plantar fasciitis. methods AND MEASURES: The patient was a 40-year-old male triathlete who was followed up for an initial evaluation and at weekly intervals up to discharge 4 weeks after injury and at 1 month following discharge. Perceived heel pain, ankle strength, and range of motion were the primary outcome measures. Shoe construction was evaluated to assess the integrity of shoe manufacture and wear of materials by visual inspection of how shoe parts were glued together, if shoe parts were assembled with proper relationship to each other, if the shoe sole was level when resting on a level surface, and if the sole allowed unstable motion. RESULTS: The patient appeared to have a classic case of plantar fasciitis with a primary symptom of heel pain at the calcaneal origin of the plantar fascia. On initial evaluation, right heel pain was a 9 of 10, plantar flexion strength was a 3 /5, and ankle dorsiflexion motion was 10 degrees. One month after discharge, perceived heel pain was 0, plantar flexion strength was 5/5, and dorsiflexion motion was 15 degrees and equal to the uninvolved extremity. The right running shoe construction deficit was a heel counter that was glued into the shoe at an inward leaning angle, resulting in a greater medial tilt of the heel counter compared with the left shoe. The patient was taught how to examine the integrity of shoe manufacture and purchased a new pair of sound running shoes. CONCLUSIONS: A running shoe manufacturing defect was found that possibly contributed to the development of plantar fasciitis. Assessing athletic shoe construction may prevent lower extremity overuse injuries.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/10. Management of foot pain associated with accessory bones of the foot: two clinical case reports.STUDY DESIGN: Case study. OBJECTIVES: To discuss the differential diagnosis, the nonsurgical and postoperative management of common accessory bones of the foot. BACKGROUND: Accessory bones of the foot that are formed during abnormal ossification are commonly found in asymptomatic feet. Two of the most common accessory bones are the accessory navicular and the os peroneum. Their painful presence must be considered in the differential diagnosis of any acute or chronic foot pain. The optimal treatment for the conservative and postoperative management of painful os peroneum and accessory navicular bones remains undefined. methods AND MEASURES: Therapeutic management of the fractured os peroneum included bracing, taping, and foot orthotics to allow healing of involved tissues, and stretching. The focus of the postoperative management of the accessory navicular was joint mobilization and progressive strengthening. Dependent variables included level of pain with provocation and alleviation tests of joint and soft tissue; girth and sensory tests of the foot and ankle; goniometric measures of foot and ankle; strength of ankle and hip muscles; functional tests; and patient's self-reported pain status. RESULTS: The patient with the fractured os peroneum was treated in 13 visits for 10 weeks. At discharge from physical therapy, the patient had the following outcomes relative to the noninvolved side: 100% return of normal sensation tested by light touch and vibration; pain decreased from 6/10 to 1/10; 100% reduction of swelling with ankle girth to normal; 100% range of motion of ankle and subtalar joints. Strength in plantar flexion and eversion remained 20% impaired (80% return to normal) secondary to pain. Upon discharge, he still reported mild pain when walking but was able to return to previous leisure activities. The second patient with the accessory navicular was treated in 18 visits over 9 weeks. Relative to the uninvolved side, she was discharged with the following: 70% return of range of motion in the foot and ankle, 100% of strength in hip and ankle, and 100% return of balance. She could squat and jump without pain and she returned to full premorbid activity level. CONCLUSIONS: Rehabilitative management of both cases addressed specific impairments and was successful in improving the patients' activity limitation. Clinicians should be aware that these accessory bones are possible sources of disability, secondary to foot pain.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
3/10. A new consideration in athletic injuries. The classical ballet dancer.The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
4/10. dermatitis artefacta. case reports.patients who seek care for foot problems may present to the podiatrist with concurrent problems, such as anxiety, depression, phobias, personality disorders, and psychoses. These may or may not have any direct relationship to the pathogenesis of the foot problem. The podiatrist may learn of the presence of an emotional problem directly from the patient or from a family member. In many cases, the patient may be unaware or deny the presence of an emotional problem, leaving the podiatric physician in the dark about the patient's mental health state or its implications for the management of the skin problem. In a review of the psychosomatic aspects of dermatology, Koblenzer offered a working classification of the psychodermatoses. This is helpful to the podiatrist in recognizing those dermatologic disease states in which the various aspects of the individual participate in the disease, signs and symptoms of the disease, and the potential psychological value of the disease for the patient. It is also helpful to the podiatrist for recognizing those dermatoses in which psychiatric consultation may be useful so that recognition, treatment, improvement, and perhaps cure may be effected quickly.- - - - - - - - - - ranking = 0.5keywords = motion (Clic here for more details about this article) |
5/10. ketoprofen gel as an adjunct to physical therapist management of a child with Sever disease.BACKGROUND AND PURPOSE: Sever disease is the most common cause of heel pain in athletic children. The purpose of this case report is to describe the addition of ketoprofen gel to the physical therapy intervention of a child with Sever disease. CASE DESCRIPTION: The patient was an 8-year-old girl diagnosed with Sever disease. Physical therapy intervention consisted of 6 visits over a 3-week period with traditional interventions (including rest, discontinuation of activities that aggravate the condition, hot and cold packs, heel lifts, calf stretching, and strengthening) and the addition of ketoprofen gel to reduce local inflammation and relieve pain. OUTCOMES: The patient demonstrated improvement in all outcome measures: pain rating, the lower extremity Functional Scale, strength, and range of motion. DISCUSSION: The child had relief of pain and returned to activities after 18 days of intervention, which was 30 days less than reports of intervention in the literature that did not include the use of ketoprofen gel.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
6/10. Keller arthroplasty with autogenous bone graft in the treatment of hallux limitus.This manuscript presents an alternative surgical procedure in the treatment of hallux limitus. A description of a modified Keller arthroplasty in which the removed base of the proximal phalanx is remodeled and replaced in the first metatarsophalangeal joint is presented. An in-depth review of the procedure has been performed in 220 cases over the last 4 years at the podiatry Hospital of Pittsburgh, and a study of 25 patients with over 15 months of follow-up is included. Early range of motion, preservation of articular surfaces, no implanted materials, and the option of multiple revisional procedures are the advantages of this procedure.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
7/10. Prenatal ultrasound diagnosis of isolated arthrogryposis of feet.prenatal diagnosis of isolated arthrogryposis of the feet at the ankle joint was made by ultrasound and confirmed at birth. The criteria for ruling out joint contracture are absence of fixed limb deformity, and free fetal motion.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
8/10. Remitting seronegative symmetrical synovitis with pitting edema. RS3PE syndrome.Eight elderly men and two elderly women presented with symmetrical polysynovitis of acute onset involving most of their appendicular joints and flexor digitorum tendons associated with pitting edema of the dorsum of both hands and both feet. Onset of seven of the ten cases could be pinpointed almost to the hour. Rheumatoid factors were absent from serum samples in all, and no radiologically evident erosions developed. Clinical and laboratory signs of inflammation and the edema disappeared gradually in each case. Treatment consisted of aspirin or other nonsteroidal anti-inflammatory drugs. hydroxychloroquine, 200 to 400 mg/day, was given in six and gold therapy in two cases. Painless limitation of motion of the wrists and/or fingers persisted in all, although the patients were both unaware of and unhampered by this abnormality. Six of eight cases where typing was possible were positive for HLA-B7, CW7, and DQW2 (relative risk for B7, 9.5). Three cases of this syndrome were found in a consecutive series of 52 men diagnosed as having definite "rheumatoid arthritis," and thus represent a distinctive condition with an excellent prognosis.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
9/10. Bone changes in sarcoidosis. association of tuberculosis and extensive phalangeal cystic lesions as an early manifestation of sarcoidosis.A young black man with pulmonary tuberculosis and a seven year course of insidious but eventually marked deformity of the hands and feet and some limitation of motion is presented herein. Radiologic findings from the digits were diagnostic of sarcoidosis, but the skin lesion which led to a definite diagnosis of sarcoidosis only appeared after seven years.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
10/10. anxiety, depression, and diseases of the lower extremities.There are many physical disorders that have little or no organic basis. Many of these conditions are caused by mental pathology. Certain emotional disorders can magnify the person's ability to perceive pain. anxiety and depression are often the culprits. It behooves the podiatrist to be aware that anxiety and depression can be a cause of foot and ankle pain or that they can exacerbate true physical symptoms. The podiatrist should be able to perform a rudimentary psychological evaluation in the outpatient clinical setting, and should be prepared to make a timely and proper referral to a mental health professional for additional testing and treatment.- - - - - - - - - - ranking = 0.25keywords = motion (Clic here for more details about this article) |
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