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COMFORT  SHOE  HAVEN PRESENTS Common Hindfoot  and Forefoot Ailments and Solutions ________________________ Certified  in  Conservative Footwear Management Jeff  Macko  &  Sophia  Macko

Common Forefoot Ailments

Claw, hammer, mallet toe Each deformity is a variation on a common theme Deformity of toe joint that leads to excess pressure and eventually pain

Common Treatments Budin splints:  single or double loop Hammer toe crests in a   variety of materials

Overlapping Toes Commonly caused by shoes that are too tight and not a deep enough toe box, which creates pressure on medial and lateral side

Corns Caused by layers of dead skin, which may form a cone shape and put pressure on nerve Most common cause is poor fitting footwear

Overlapping Toes/Corns  Treatments Variety of tools available to prevent overlapping Silicon Gel or foam

Toe Deformities:  Additional Treatments Hammer toe shield Gel Toe Cap

Toe Deformities:  Footwear Considerations Require – X- Depth  Footwear Plastazote or leather lining desirable to reduce pressure

Ingrown Toenail Occurs when nail grows into the skin or skin overgrows the nail Silicon gel Toe covers provide temporary relief

Bunions Most commonly occurs as Hallux Valgus of the first MTP joint *Less commonly presents itself on lateral side as “Tailor’s bunion”

Bunions:  Treatment options Hallux Valgus night splint   Hallux Valgus day splint               Bunion pad [Footwear is key – X- Depth is generally recommended]

The Mortons Morton’s Toe Second toe longer than first, causing extra pressure on second metatarsal joint

Morton’s Toe Solutions Several choices     of  orthotics depending on footwear

Morton’s Toe Solutions (cont’d) Metatarsal Bandage Metatarsal Cushion

Morton’s Neuroma Pinched nerve usually between third and fourth toe at metatarsal joint Solutions:  similar to Morton’s toe

Morton’s Toe:  Footwear Rocker Sole Design takes stress off metatarsal area

Metatarsalgia and Sesamoiditis General pain in the ball of the foot Callus a sign of excess pressure Sesamoids: two small bones located under first metatarsal joint

Metatarsalgia/Sesamoiditis:  Products Familiar solutions:  goal is to provide relief for specific problem with standard product Therapeutic, cost effective

Common Hindfoot Problems

Plantar Fasciitis Also referred to as “heel spurs” Bony prominence sometimes evident on medial plantar aspect of heel Pain associated with inflammation of plantar fascia

Plantar Fasciitis:Conservative Modalities Variety of Heel products relieve tension on Plantar Fascia

Additional Conservative Measures Orthotic Management Goes together with Appropriate Footwear

Achilles Tendonitis Achilles Tendon stretches along lower posterior of calf and attaches to heel Repetitive stress causes inflammation

Achilles Tendonitis: Solutions Heel Products relieve tension on Achilles Tendon

Achilles Tendonitis:   More Solutions Orthotic Solutions Footwear again: firm counter reduces torque Plantar Fasciitis Splint

Post-Tib Tendonitis Inflammation of tibialis posterior  which runs along back of leg and attaches to medial plantar aspect of foot Post-Tib manlfunction frequently leads to severe flat foot

Post-Tib Treatment  Posted Orthotic helps take pressure off post-tib tendon Foot/Ankle Bandage (FABS) Supportive Footwear

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