The traditional running shoe has been getting somewhat of a bad name in some sectors of the running community in recent years. Traditionally the purpose of a running shoe was to help performance and prevent injury. It was supposed to prevent injury by helping control motion and lessen the impact of the heel contacting the ground. The evidence is that this is not quite helping which has led to an emergence of barefoot running. While the actually number that run barefoot is small, a growing number are using the barefoot or minimalist running shoes, which are shoes that are supposed to mimic the action of running barefoot and not interfere with the natural function of the foot. While there is some debate if these shoes do actually mimic barefoot, they have grown to 8% of the running shoe market. There are plenty of claims about how many of those who run barefoot now get less injuries and there are plenty of advocates that this is the way for everyone to run. However, there are also plenty of claims that there are more injuries in those who run barefoot or in minimalist shoes. There is very little evidence to support one way of running over another, just a lot of claims and counterclaims. At the end of the day, barefoot or minimalist running will be suitable for some and not for others. It is going to be an individual choice.
Autism is a complex disorder that impacts on how the person with it interacts with the people and environment about them. There is a very wide variety of clinical symptoms associated with autism, it is probably better terms autistic spectrum disorder. Some of the symptoms include repetitive behaviors, poor language development, and poor social interactions. Despite lots of research and clinical trials on autism, not a lot of progress has necessarily been made and there are plenty of conspiracy theory’s regarding the causes. There is no cure for autism, just behavior modification approaches.
What has autism got to do with the feet and podiatry? Podiatrists treat children with foot problems. Some of those children will be on the autistic spectrum, so podiatrists do need to be familiar with autism ad how to interact with the child and have empathy with the parents. Secondly, those with autism tend to toe walk, so Podiatrists need to be aware of this when considering a differential diagnosis of a child that presents with walking on the toes. Thirdly, toe walking affects the weightbearing pattern on the foot, so symptoms and things like unusual callus patterns can often show up in those who toe walk over a long period of time.
There are many causes of pain in the low back and one of the least common is a condition called ankylosing spondylitis. This is a type of arthritis the primarily affects the spine, but does eventually affect most of the joints in the body. It can take many years to get a diagnosis as it often just starts as a mild ache in the low back. Most people to get some back pain from tome to time so diagnosing this condition is difficult. For podiatrists, the condition can affect the joints in the foot and they can become painful. Also occurring in ankylosing sponditis is an inflammation of the plantar fascia at the heel the causes pain on the bottom of the foot. This type of plantar fasciitis is resistant to treatment with the usual methods that are used to treat it. The only really effective treatment for this heel pain is the more powerful drugs that are used to treat the arthritis. The insertion of the Achilles tendon into the heel can also be affected as well.
A rupture of the Achilles tendon occurs in those who are at rick for it and simultaneously dorsiflex the foot and extend the knee. As the calf muscles and Achilles tendon cross both these joints, both these motions happening at the same time put a great load on the Achilles and if its is at risk, there is a high possibility that it might rupture.
When a rupture occurs, it is usually pretty obvious. There is usually an audible ‘snap’ and it is difficult to raise up on to the ball of the foot. It is also going to hurt! There will usually also be some swelling.
There is a lot of difference of opinion on to how the rupture should be treated. Some argue for a surgical repair and others argue for a more conservative casting. All the research on the difference in the outcomes between the two show they both tend to have equally successful outcomes.
