Posts for: May, 2012
Still Think High Heels are Worth It?
For Immediate Release
It’s not what fashion-conscious women want to hear – another warning about high heels. But, according to the American College of Foot and Ankle Surgeons, pump-style shoes often cause significant pain by irritating a common bony deformity on the back of the heel, called ‘pump bump’ In many cases, it can lead to bursitis or Achilles tendonitis, if left untreated.
“Pump bump is common in young women who wear high heels almost every day,” said Marybeth Crane, DPM, FACFAS, a Dallas-area foot and ankle surgeon whose practice near DFW International Airport is well populated with flight attendants. She said the employee dress code on most airlines requires flight attendants to work in high heels and their feet take a beating as a result.
“The rigid back of a pump-style shoe can create pressure that aggravates the heel bone when walking,” said Crane.
According to the ACFAS consumer website, FootHealthFacts.org, the bump or bony protrusion is a hereditary deformity that can cause Achilles tendonitis or bursitis due to constant irritation from pump-style shoes. Those with high arches or tight Achilles tendons are especially vulnerable to developing pump bump if they work in high heels.
The medical term for the disorder is Haglund’s deformity. In addition to the noticeable bump, symptoms include pain where the Achilles tendon attaches to the heel, swelling in the back of the heel and redness in the area. In the large majority of cases, pump bump is treated non-surgically by reducing inflammation, but this does not get rid of the bony protrusion. “Pain relief is the primary treatment goal, so anti-inflammatory medications usually are prescribed,” said Crane. She added that icing the back of the heel reduces swelling, and stretching exercises can relieve tension in the Achilles. Long-term, however, it’s best to avoid wearing high heels, if possible.
“When the office or airline dress code requires high heels, I advise women to try heel lifts to decrease pressure on the heel or wear appropriate dress shoes that have soft backs or are backless,” said Crane.
To learn more about Haglund’s deformity or locate a foot and ankle surgeon in your area, visit FootHealthFacts.org.
Heel Pain Continues to Plague Adults
Foot and Ankle Surgeons: Best Defense is Early Treatment
If you are suffering from heel pain, you’re not alone. According to foot and ankle surgeons attending the 68th Annual Scientific Conference of the American College of Foot and Ankle Surgeons, heel pain continues to be the most common reason patients seek care. Surgeons advise the best defense to keeping pain in control is early treatment.
Heel pain can have many different causes with the most common being plantar fasciitis, an inflammation of the band of tissue (plantar fascia) that extends from the heel to the toes.
Conference speaker and foot and ankle surgeon Michelle Butterworth, DPM, FACFAS explains that patients who most frequently suffer with heel pain are those who spend the majority of their day on their feet. “Continuous standing or walking on a daily basis or even starting a repetitive activity, such as a new exercise routine, without proper shoes can put a lot of stress and strain on the ligaments in the foot, resulting in inflammation and pain,” Dr. Butterworth says.
The good news is heel pain is treatable. “If treatment is sought early, all but a small percentage of patients suffering will experience relief with conservative therapies such as limiting activities, footwear modifications, anti-inflammatory medications, and stretching exercises,” Dr. Butterworth adds. “The key to success in eliminating the pain is early treatment; heel pain can turn chronic and debilitating if not cared for promptly by a foot and ankle surgeon.”
When conservative therapies do not provide relief after several months, surgery may be considered. “New surgical techniques available now allow surgeons to easily eliminate or reduce pain with faster recovery times for patients,” says Dr. Butterworth.
For more information on heel pain, visit ACFAS’ consumer health web site FootHealthFacts.org.
Sprained Ankles Can Be Complicated—and Misdiagnosed
March 2, 2012
SAN ANTONIO, TX. – March 3, 2012 – Ankle sprains may be one of the most common injuries, but they’re also commonly misdiagnosed. That’s because the two major types of sprained ankles—high ankle sprains and lateral ankle sprains—often look the same, even though they affect entirely different ligaments. Surgeons are taking a closer look at the treatment of ankle sprains at the Annual Scientific Conference of the American College of Foot and Ankle Surgeons.
The less common type—a high ankle sprain—is often mistaken for a lateral sprain. Misdiagnosis can delay getting the right treatment—and that can impair recovery.
“One problem is that the symptoms of high ankle sprains parallel those of the lateral ankle sprain, which occurs in the lower ankle area,” says Marque Allen, DPM, FACFAS, foot and ankle surgeon from San Antonio, Texas and a Fellow of the American College of Foot and Ankle Surgeons.
Pain, swelling, limited motion, and bruising in the entire ankle region can occur in both high ankle sprains and lateral ankle sprains. The difference lies in where the injury occurs and which ligaments are involved.
“High ankle sprains can get complicated, because this region has five ligaments connecting two bones in the leg, compared with three ligaments that can be affected in lateral ankle sprains,” says Dr. Allen.
The more ligaments that have been involved and the worse they are torn, the more severe the injury.
To select proper treatment, the physician must first “grade” the sprain’s severity based on the extent of ligament injury. Grading also enables the physician to predict how long it will be before the patient can return to normal activity.
Ankle sprains are common in sports, where getting back in the game is a top concern. A popular misconception is that professional players receive “magical medicine” that speeds recovery. “That’s a myth,” says Dr. Allen. “It doesn’t matter whether it’s a professional athlete or a weekend warrior, if their injuries are exactly the same; they’re going to heal in the same amount of time.”
So when a high school athlete hears it will take 6 to 8 weeks before he can return to the game and he wants to know why New England Patriots tight end Rob Grankowski played in the Superbowl only 14 days after his high ankle sprain, the answer is clear: Not all ankle sprains are created equal.
In diagnosing an ankle sprain, it’s important for physicians to understand how the injury occurred. Lateral sprains are caused by the foot turning inward, whereas high ankle sprains are the result of the foot being forced outward.
Nowhere is this difference in motion more evident than in the world of sports. “I probably see 20 to 30 high ankle sprains during the 4-month football season,” says Dr. Allen. “Then, as soon as the basketball seasons starts, they go away and I see a lot of lateral ankle sprains.”
Treatment for less serious ankle sprains involves immobilization of the foot and non-weight bearing for 2 to 4 weeks. More severe high ankle sprains require surgery and a longer time to recover.
Considering that ankle sprains vary so widely in severity, what’s a good rule of thumb for when to seek medical care? “I tell patients and trainers they should see a doctor any time there’s bruising or the inability to bear weight on that foot,” says Allen.
If these symptoms aren’t present, home treatment involving rest, ice, compression, and elevation should suffice.
The key message regarding an ankle sprain is to have it correctly diagnosed and treated to achieve the best possible recovery.
For more information on foot and ankle injuries and conditions, visit the ACFAS consumer website, FootHealthFacts.org.
The American College of Foot and Ankle Surgeons is a professional society of over 6,500 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer website, FootHealthFacts.org.