Farnsworth Orthopedic Physical Therapy

Orthopedic Physical Therapy

feet

Plantar Plate Tear

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What is it?

Your plantar plate is a thick ligament that runs along the ball of your foot, connecting to the joints. A plantar plate tear is a common foot injury which is caused by repetitive overload. Your plantar plate is a ligament that is on the underside of the joints at the ball of your feet.

Persistent pain and swelling under the ball of the foot that extends towards your toes is often the first sign of a plantar plate tear. This pain may be reproduced by bending your toe upwards. Some swelling may be visible on the top of your foot. Sometimes there can be redness. Often a sensation of ‘walking on the bones of the foot’ will be described, and a ‘V’ sign between the toes may be present, where two toes have separated further from one another than what is normal due to a plantar plate tear. You may experience swelling, and tenderness underneath the joint.

Causes

The reasons for the overload can be due to the your individual anatomy, over pronation (rolling in), hyper-mobile joints and incorrect casual and/or running shoes.

Treatment

A special test called the modified Lachman’s test can be performed by your therapist to assess your situation. Ultrasound or MRI  can sometimes be important to determine the extent of a potential tear. This is especially true if you have a lot of pain or a claw toe deformity.

Treatment involves offloading the area using padding and stiff-soled shoes. A taping technique called ribbon taping can be used to reduce any claw toe deformity . Icing, non-steroidal anti-inflammatory drugs and active rest is also important to help settle the condition down.  An orthotic can be used once a positive result has been obtained using functional foot taping. A metatarsal pad is added onto the device as well to deflect pressure away from the affected area and to improve loading patterns.

Written by Travis Rohner PT

Raynaud’s Disease

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What is Raynaud’s Disease?

Raynaud’s disease causes the fingers or toes to grow cold, change color, lose sensation due to decreased blood flow. While anyone may experience Raynaud’s disease, women are more likely to experience it.  Most of the time, this is more of a nuisance than a severe medical condition. It was discovered by a man by the name of, you guessed it, Raynaud.

Causes

While we don’t know the specific causes of Raynaud’s Disease, it occurs because the small blood vessels of the fingers and/or toes go into spasm. Your fingers or toes grow numb, and the involved body part changes colors. A lack of blood flow due to lack of oxygen makes the finger change from white to blue, then finally red due to a “flushing” of that body part with richly oxygenated blood.   When the blood flow returns to the body part, there might be swelling, tingling and mild pain.   Cold temperatures and stress are some of the most common things that trigger the Raynaud’s response.

Not all of us can be Elsa.

If the lack of blood flow is caused by a more serious medical condition, this is known as Secondary Raynaud’s Phenomenon.  Some conditions that lead to this phenomenon are atherosclerosis, rheumatoid arthritis, frost bite, and smoking.  Luckily, this condition is usually not a medical emergency or in need of immediate medical attention.

What Can I Do?

There are certain things you can do on your own to help cut down on the symptoms of Raynaud’s Disease:

  • Keep your hands and feet warm. Use gloves or potholders when getting things out of the freezer or fridge.
  • Exercise (performing finger exercises, arm circles, ankle pumps, toe scrunches, stationary bike, or choose your favorite aerobic exercise)
  • Massaging your fingers or toes to promote blood flow
  • Soaking in warm water or using a moist heat pack or microwaveable hand mitt to hands/feet to increase your circulation.
  • Managing emotional and environmental stress (practice stress reducing techniques like deep breathing, meditation, yoga)
  • Quit Smoking

Get Treated

At our physical therapy office, we have treatments and exercises that we can use to increase blood flow to the affected area and decrease your symptoms.  We also have some techniques we can teach you in person that you can use at home.

Written by Tom Farnsworth PT

Haglund’s Deformity

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What is it?

Haglund’s Deformity is a bony enlargement of the back of the heel bone. Sometimes it’s called
“pump bump” because the deformity often occurs in women who wears pumps and runners.

So, Quasimodo likely had this.  If there was a deformity, he had it.

Causes

The shape of your foot can contribute to the development of Haglund’s Deformity. So, if you have
high arches, a tight Achilles tendon, or a tendency to walk on the outside of your feet, you’re
more likely to develop Haglund’s Deformity than other people. But, wearing shoes with a firm,
rigid back may also contribute to the development of Haglund’s Deformity.

Symptoms

Next, the primary symptoms of Haglund’s Deformity are an enlarged bony prominence on the back
of the heel and heel pain. You might also develop blisters on your heels as a result of your shoes
rubbing against the bump.

 

Home Care

Heel pads placed in the backs of your shoes may relieve and redistribute some of the pressure.
Applying ice to the area after removing your shoes may ease some of the pain and discomfort.
Also, switching shoes can help too. If you have an otherwise normal foot, wearing open-heeled
shoes may provide relief. However open-heeled shoes may not be not a good idea if you have
tendinitis, bunions, foot pain, or a structural deformity of the foot.

Diagnosis and Treatment

A podiatrist will begin by carefully examining your feet and taking a thorough medical history. And
X-rays may be ordered to get a good look at the structure of your feet. Sometimes, an MRI or
ultrasound might be ordered as well.

Treatment will depend on the severity of the condition. And options include:

● Shoe modification. Your podiatrist can recommend over-the-counter heel pads, heel
lifts, or arch supports, or create custom orthotic supports to change the position of
your feet in your shoes to relieve pressure on the back of your foot.
● Medication. Topical anti-inflammatory medication, applied directly to the heel, may
provide pain relief. Oral anti-inflammatory medication (such as ibuprofen) can help as
well.
● Immobilization. If the area is extremely inflamed, use a custom made soft cast or walking boot to immobilize the area and allow it to heal.
● Physical Therapy
● Surgery. If none of the non-surgical methods provide adequate relief, your podiatrist
may recommend surgery to correct the deformity. Podiatrists are specially-trained foot
and ankle surgeons who can surgically re-shape the heel bone.

Prevention

(Step one, don’t wear these shoes)

Avoid shoes with rigid backs. And if you have a high arch or tight Achilles tendon, wearing
appropriate shoe inserts and/or adequately stretching the Achilles tendon can help prevent the
development of Haglund’s Deformity.However, if you do find yourself struggling with this issue, don’t hesitate to come see us at our office and we can get you taken care of.

Written by Travis Rohner PT

Bunions Are Not Like Onion Bagels

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What is a bunion anyway?

What comes to mind when you hear the word bunion? Bunions always make me think of onion bagels for some reason. Many people think that bunions are callous-like spots that form on the bottoms of your feet, but this is not the case. They’re actually a bony projection that develops on the joint at the base of your big toe. Bunions are a very common ailment. There are more than 3 million cases per year in the US alone. Bunions are more common in females, and can last several months or years.

(Those are not bunions)

Symptoms

Common symptoms may include an outward bulge or bump at the base of the big toe, and corns or calluses on your toes. Swelling and redness on the skin around the big toe joint, and pain near the swollen area are also common problems that occur where bunions are present. This problem may result in limited mobility in the big toe, and general foot pain.

Diagnosis

Bunions must be properly diagnosed by a physician. Typically, an x-ray of the foot is taken to identify the cause and severity of a bunion. In some cases, blood work may also be ordered to see if there is also arthritis present. The exact cause is unknown. However, several factors can contribute to this unpleasant ailment, including pressing of your big toe against your second toe. They can also be caused by wearing narrow or tight shoes, arthritis, and stress or injury to the foot.

Treatment

In severe cases, a surgery called a bunionectomy or osteotomy may be performed. Treatment other than surgery may include anti-inflammatory medications, a change in footwear, and adding padded footwear to your shoes.You can also ice the area which reduces pain, soreness, and inflammation. If you need surgery, it’s likely that you will benefit from having physical therapy after your operation to help heal and strengthen your foot. We’ll have you feeling like you’ve got brand new feet in no time.
Written by Tom Farnsworth PT

Sever’s Disease

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Sever’s Disease

Sever’s disease is a painful condition that can happen to children as they grow. It happens when the tendon that attaches to the back of the heel (your Achilles) pulls on the growth plate of the bone of the heel. The stress over and over again on the growth plate causes pain and inflammation.

It happens most often to physically active children between the ages of 8 and 14. This pain is often made worse by lots of physical activity or when the Achilles tendons are tight. Pain can also be worse during a growth spurt, when the bones grow faster than the tendons. This increases how much the tendon pulls on the heel.  While it is painful, Sever’s disease is not a serious condition. It doesn’t cause long term damage or arthritis and often resolves once the growth plates close.

How do I know if my child has it?

The following are some signs that your child may have Sever’s disease:

  • Heel pain in one or both heels, which often comes and goes
  • Pain that gets worse when doing activities activities, especially with new or strenuous activities
  • Pain may cause limping or walking on toes to avoid putting pressure on the heels
  • Pain that is worsened by running or jumping
  • Pain with pressing on the back of the heel
  • Pain is worse upon waking

What helps Treat it?

Ice: Ice their heel for 15 to 20 minutes when the have pain or after activities. Remember not to put the ice directly on skin. Use a towel or other cloth between the ice and their skin.

Rest: Rest from physical activities, especially running and jumping, while having pain. Take rest breaks between activities.

Shoes: Always have your child wear a well-cushioned pair of supportive shoes. Don’t allow them to walk around in bare feet. In some cases, special gel inserts for the shoe called heel cups may help.

Pain Relief: Anti-inflammatory medicines, such as ibuprofen can be used as needed for pain and swelling. Be sure to read the directions on the bottle in order to give the correct dosage for your child’s height and weight.

Stretching: Stretching their calf muscles can help loosen tight Achilles tendons and help decrease the pull of the tendons on the growth plates.

Road to Recovery

In most cases, Sever’s disease goes away on its own. The important thing is to make sure your child gets rest, treatment, and time to heal. Symptoms might get worse if your child tries to play through the pain.  Your child can gradually increase the amount of activities they do when they don’t have symptoms. Remember, this is a disease that can come and go.  Sever’s disease usually goes away completely when their growth plates close.

Written by Travis Rohner PT

That’s a Stretch

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Stretch Yourself

When life gets crazy, it’s easy to forget to take care of ourselves.  Setting aside a few moments to do something to better your health and the way you feel can make a big impact on your day.  One quick and simple thing you can do for your health is stretch. There are many effective stretches that target certain muscle groups and issues.  Below you’ll find a couple common stretches that you can do daily that target muscles that often get overworked and strained in our day to day lives.

Neck

First on the stretch list is the neck.  Let’s face it, you probably do things throughout your day that are not very kind to your neck. Whether it’s hunching over your phone, cleaning up after the kids, or straining over your work computer, your neck puts up with a lot.   Give your neck a stretch by tilting one ear towards your shoulder while standing upright.  Once you’ve stretched you neck as far as feels comfortable, open your hand on the side you’re tilting away from, turning your palm outward.  This allows your neck to stretch a little bit further.

Calf

Next, is a calf.  For those of us who spend a lot of time on our feet this stretch can be a lifesaver.  Sore feet are caused in part by tight calf muscles.  And for those who may suffer from plantar fasciitis this stretch can be especially helpful.  You’re going to need one extra item: a towel.  Place your heel on a soft but stable surface like a rug or yoga mat. Roll up a towel and place the ball of your foot on it. Step forward with the other foot. Do this with your knee straight instead of bent.  Hold it for a good half a minute and then switch to your other foot.

Give yourself a few minutes to stretch.  You’ll feel better.

Written by Tom Farnsworth PT

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Areas Served:

Mesa, Gilbert, Chandler, Phoenix, Queen Creek, Apache Junction, Tempe, Globe, Gold Canyon

Postal Address

Gilbert Office
730 N. Greenfield Rd.
Gilbert, AZ 85234
Phone: (480) 633-0666

Mesa Office
342 N Val Vista Dr. Suite 106
Mesa, AZ 85213
Phone: (480) 325-3310