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Calcaneal Apophysitis (Severs Disease)

Calcaneal Apophysitis (Severs Disease)

Calcaneal Apophysitis (Severs disease) (Named after JW Sever MD, 1912  –  Sever JW: Apophysitis of the Os Calcis. New York Medical Journal 1912; 95: Page 1025-1029.) By Dennis Rehbock. Sports podiatrist. 26 June 2018. Based on an article written by Dennis Rehbock for SA Pharmaceutical Journal.   X-rays of typical Calcaneal Apophysitis. Severs disease is an inflammation of the heel growth plate that is commonly seen in children. Severs disease is pain in the heel bone (calcaneus) caused by a disturbance of the growth area (growth plate) at the back of the heel where the strong Achilles tendon attaches to it.  This is known as Severs disease or Calcaneal apophysitis.  It is seen most common in boys between the ages of 9 to 12 years of age. These are one of several different ‘osteochondroses’ that can occur in other parts of the body, such as Osgood-Schlatters Disease at the knee joint.   The cause of Severs disease is not entirely clear.  It is most likely due to overuse or repeated minor trauma that happens in a lot of sporting activities such as football and running activities. This trauma affects the cartilage join between the two parts of the growing bone in the heel and results in inflammation and pain. Hard playing surfaces, like those hard football fields in South Africa in winter, increases the risk of this Severs disease. Children who are heavier are possibly at greater risk for developing Severs disease. Tight calf muscles and a pronated foot (flat foot) can also predispose the child to Severs disease. Care must be taken not to diagnose this condition from x-rays. The appearance of Severs disease on is impossible to differentiate from a normal developing heel bone on x-ray. The history of the injury is of great importance. Signs and symptoms. Pain is usually felt at the back and side of the heel bone (body of the heel) and sometimes under the heel as well. The pain is usually relieved when the child is not active and becomes painful with sport. Squeezing the sides of the heel bone is often painful. Running and jumping make the symptoms worse and rest or inactivity will relieve it. One or both heels can be affected. In more severe cases, the child may be limping or walking on their toes. This toe walking can cause Achilles tendon strain and pain in the forefoot. Self...

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Plantar warts (warts, verruca, Afrikaans – soolvrat)

Plantar warts  (warts, verruca, Afrikaans – soolvrat)

Going barefoot is one of the luxuries of a South African summer but it also carries an increase risk of contracting a virus…

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Technical Running Shoe Tips.

Technical Running Shoe Tips.

Always purchase your technical running shoes from a reputable specialist running shoe store. If necessary or if you are injured get the specialized running shoe advice from your sports podiatrist. A technical running shoe is chosen / prescribed on the basis of biomechanical function. For example – If you have neutral biomechanics / feet then a NEUTRAL running shoe is needed. If your feet are slightly overpronated then a MILD ANTIPRONATION / stability running shoe is necessary. If your feet are excessively overpronated then a STRONG ANTIPRONATION / motion control running shoe is necessary. At times there are exceptions to these rules, where the runner is in the incorrect running shoes and yet had no injuries. The tendency is then to leave them in the incorrect running shoes. Do not change model or brand if you do not have to. All running shoe brands have these different categories of running shoes. Some may have different terminology for the categories of neutral / mild antipronation / strong antipronation. This choice can be complicated so get good professional help.  ...

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To wash or not to wash, is the question.

To wash or not to wash, is the question.

A common question I get asked time and time again, is should running shoes be washed, and if so how?     My answer is simply YES they should be washed. They should be washed, but care must be taken to not damage them in the process, as you have invested in an expensive pair of the state of the art running shoes and you want to get the most value out of them. You also want them to look good and to not smell. This is how to wash and look after your running shoes. General: Undo your laces before you take your shoes off or before you put them on. Alternate shoes from run to run. This will prolong the life of the shoe, which are only designed for 800 to 1200km of wear. If your shoes are showing signs of excessive wear and tear it is time to replace them with a new pair. Stick to the same brand and model of running shoe if it has worked well for you. Cleaning: Wipe your shoes regularly with a damp cloth to remove dust and mud. Washing: Submerse your shoes in tepid water and gently scrub them with a soft brush using a mild soap. Shoe shampoo products are available for this or a dash of Handy Andy will also work. Rinse them well and then place them up side down in a cool place to dry. This may take up to 48 hours. This is a good reason is to have 2 or more pairs of shoes to alternate wearing and washing them. Also wash the innersole in this manner. DO NOT: Do not wash them in a washing machine (even on a cold cycle). The prolonged immersion in the water may damage the materials and glue used in the shoe. The rolling around in the machine will also damage the shoe. Do not use and strong detergents or cleaning chemicals such as bleach or ammonia in the washing process. Do not place then in the direct sun or a hot place to dry. This can cause the materials to shrink. Do not dry them in a tumble dryer or in the warming drawer of a stove.   This topic of running shoe washing has been hotly debated by runners in general, and it is clear that everyone has their own system of washing their running...

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Arch and heel pain

Arch and heel pain

Plantar fasciitis is one of the most common running injuries seen in podiatric practice, and anyone who is on his or her feet a lot may also get this injury, such as nurses, teachers, hairdressers and shopkeepers.What happens is, for various reasons, the ligament under the foot (in the arch) called the plantar fascia gets strained or traumatised and becomes inflamed. This hurts under the heel or in the arch area of the foot. The repetitive nature of long distance running, long standing, and excessive foot pronation (rolling in) may be major causes of this injury. There are also other causes that need identifying and managing. Long term a heel spur, which is a bony outgrowth under the heel, may develop in response to the excessive pull on the plantar fascia. This bony growth is of no major clinical significance in terms of treatment.   Your self-treatment is very important. Rest for a while to let the inflammation reduce. This is something runner’s do not like doing but it is important to help the injury get better by reducing the stress on the feet. While resting do some cross training to keep the fitness levels up and to keep you from getting depressed. Ice the area for 10 mins a few times a day. Rub some gel such as arnica into the area after you shower or bath. Get some physiotherapy done to the area. The usual anti-inflammatory tabs may make the pain feel better but doesn’t really cure the injury. Make sure your running shoes are in good shape and not old and collapsed. Also make sure that they are the correct biomechanical type for you. I find adding some arch support or an orthotic into the shoe will help reduce the tensile stress on the fascial band, which helps healing. This would also control the excessive pronation that could be a cause of the tension. Sleeping with a night splint that keeps your foot in a stretched position may also help. A similar and related injury, called bruised heel syndrome, can also occur and feel like plantar fasciitis. The treatment of bruised heel syndrome is essentially the same as for plantar fasciitis. This information and / advice is the opinion of the author in his capacity as a qualified and registered podiatrist. The information and advice is meant as a guide only and is intended to be...

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Foot Fungus

Foot Fungus

Athlete’s foot. (Dermatomycosis, Tinea Pedis) Athlete’s foot is a fungal infection of the skin on the feet and especially in-between the toes. Not only athletes or sportsmen get it, but they are more prone to it because of their sweaty feet while exercising. A fungus is microscopic organisms similar to bacteria and viruses that invade our bodies. This is why feet and in between the toes are commonly infected with it. Also if you scratch the area you may spread the infection to other areas of your body or to other people around you. It is very contagious especially when walking barefoot in wet environments like at the gym or in communal change rooms and showers. An incorrect fact about fungus is that you only get it in summer. Well no you don’t, as you can get it in winter too as your feet are nice and warm and sweaty in your shoes even though the external temperature may be cold. Prevention. Prevention is better than cure with fungal infections. Do not walk barefoot in these wet areas of the gym or communal showers. Wash and dry your feet carefully and make sure that in between your toes are kept dry. Use a prophylactic foot powder in your shoes, socks and in between your toes daily, as part of your cleanliness routine. Use clean socks daily. Socks with a higher wool or cotton content will help contain the sweat better.  (See sock guide) Go barefoot and aerate your feet when you get the chance. Wash your running shoes regularly, but take care with the washing of your shoes as not to damage them. Treatment. If you do have a fungus, use an antifungal cream or ointment twice a day after washing your feet. Lamisil cream is one the best although there are many others available. Also use a medicated foot powder in your shoes and socks. The antifungal cream will take the itch away and that will stop the need to scratch, which reduces cross infection. Any associated smell will also go away with time and treatment. This information and / advice is the opinion of the author in his capacity as a qualified and registered podiatrist. The information and advice is meant as a guide only and is intended to be easily understandable to the lay person. Anyone seeking health and/or medical advice is strongly advised to consult...

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