There are not one but two different kinds of leg length discrepancies, congenital and acquired. Congenital implies that you are born with it. One leg is anatomically shorter compared to the other. As a result of developmental stages of aging, the human brain picks up on the step pattern and recognizes some variance. The entire body usually adapts by dipping one shoulder to the "short" side. A difference of less than a quarter inch is not blatantly irregular, does not need Shoe Lifts to compensate and typically won't have a serious effect over a lifetime.

Leg Length Discrepancy <a href="http://kileyboggus.weebly.com/blog/leg-length-discrepancy-surgical-treatment">Shoe Lifts</a>

Leg length inequality goes largely undiagnosed on a daily basis, however this problem is simply corrected, and can eliminate numerous cases of back problems.

Therapy for leg length inequality commonly involves Shoe Lifts. Most are economical, ordinarily priced at under twenty dollars, in comparison to a custom orthotic of $200 plus. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Low back pain is easily the most widespread condition affecting people today. Around 80 million people experience back pain at some point in their life. It's a problem which costs businesses millions year after year as a result of lost time and productivity. Fresh and superior treatment methods are constantly sought after in the hope of reducing the economical influence this issue causes.

Shoe Lift

People from all corners of the earth suffer the pain of foot ache due to leg length discrepancy. In a lot of these cases Shoe Lifts might be of immense help. The lifts are capable of eliminating any discomfort and pain in the feet. Shoe Lifts are recommended by countless expert orthopaedic practitioners".

So that you can support the body in a well balanced fashion, feet have got a crucial part to play. In spite of that, it can be the most overlooked area in the human body. Many people have flat-feet which means there may be unequal force exerted on the feet. This will cause other areas of the body like knees, ankles and backs to be impacted too. Shoe Lifts ensure that the right posture and balance are restored.
Calcaneal Spur

Overview

Heel spurs usually form under the base of the foot or the back of the heel bone. Spurs that develop underneath the foot may visibly protrude through the skin. In addition, plantar fasciitis as well as heel spurs may eventually lead to chronic pain that persists for three or more months, especially if the sides and base of the heel bone have been affected. A large heel spur can affect movement and prevent an individual from walking or even standing properly. If a heel spur begins to protrude excessively, then surgery usually becomes necessary.

Causes

When a patient has plantar fasciitis, the plantar fascia becomes inflamed and degenerative (worn out)--these abnormalities can make normal activities quite painful. Symptoms typically worsen early in the morning after sleep. At that time, the plantar fascia is tight so even simple movements stretch the contracted plantar fascia. As you begin to loosen the plantar fascia, the pain usually subsides, but often returns with prolonged standing or walking.

Posterior Calcaneal Spur

Symptoms

Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.

Diagnosis

Heel spurs and plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your heel spur or plantar fasciitis they will investigate WHY you are likely to be predisposed to heel spurs and develop a treatment plan to decrease your chance of future bouts. X-rays will show calcification or bone within the plantar fascia or at its insertion into the calcaneus. This is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.

Non Surgical Treatment

Only in rare cases do the symptoms of heel spurs fail to be resolved through conservative treatment. Conservative treatment, although not 100% effective, is successful in most cases and should be given ample time to work. In many cases, conservative methods should be utilized as long as a year depending on the rate at which your body responds to the treatment. When treatment is unsuccessful, surgery may be considered. A common surgical procedure for this condition is plantar fascia release surgery. In this procedure, the tension of the plantar fascia ligament is released, lessening tension in the heel and helping to prevent damage.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.
Inferior Calcaneal Spur

Overview

Heel spurs are abnormal bony growths that develop at the back of or under the heel. Inflammation around a spur, more so than the spur itself, can cause significant pain. Fortunately, symptoms can be eased with non-surgical treatments for the vast majority of people.

Causes

Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.

Calcaneal Spur

Symptoms

Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.

Diagnosis

Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).

Non Surgical Treatment

There are various ways to treat heel spurs. The first is to rest and apply ice to the afflicted area. Shoe inserts and night splints can also treat plantar fasciitis, and in turn, heels spurs. Unless you have stomach sensitivities, you may want to consider taking over-the-counter anti-inflammatory medication such as naprosyn to lower the swelling. A physical therapist can recommend gentle exercises and stretches to relax the tissue around the heel bone to relieve the tension. Even with these treatments, a stubborn heel spur may not go away. A physical therapist may decide to inject cortisone into the area to decrease inflammation, but that can cause other problems such as plantar fascial rupture and fat pad atrophy. Extracorporeal shock wave therapy is also an option, which uses energy pulses to apply microtrauma around the heel spur. Surgery is also an option but is not suggested unless the heel spur lasts more than a year. To prevent heel spurs from returning, shoe inserts can relieve the pressure on the plantar fascia. Also continue the recommended stretches and exercises.

Surgical Treatment

In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.
Overview

Retrocalcaneal Bursitis. This bursa is located at the back of the heel. Bursitis in this area is often associated with conditions such as ankylosing spondylitis or rheumatoid arthritis. It can occur in healthy individuals who wear improperly fitted shoes. Symptoms include painful swelling that develops at the back of the heel. Calcaneal Bursitis. This bursa is located at the sole or bottom of the heel. Inflammation usually produces pain in the heel when standing. Causes include heel spurs, excess weight, injury, and wearing improperly fitted shoes.

Causes

Bursitis is caused by overuse or excessive pressure on the joint, injury, infection, or an underlying condition, such as osteoarthritis, rheumatoid arthritis, gout, pseudogout, or ankylosing spondylitis. When bursitis is caused by an underlying condition, the condition must be treated along with the bursitis. When bursitis is caused by infection, called septic bursitis, medical treatment and antibiotics are necessary.

Symptoms

Symptoms of bursitis usually occur after rest and relaxation. Upon activity there is usually more intense pain in the area of the bursa. The common areas to have a bursitis in the foot are in the bottom of the heel, behind the heel near the attachment of the Achilles Tendon as well as along the side of a bunion. A bursa may also form in multiple areas especially along the metatarsal heads, or "ball" of your foot. You may actually feel the sac like fluid when rubbing the area of pain.

Diagnosis

After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.

Non Surgical Treatment

During the initial acute phase of the condition, patients should apply ice to the back of the heel for 15 to 20 minutes and follow the R.I.C.E.R regime. Avoid activities that cause pain. Gradual progressive stretching of the calf muscle and Achilles tendon is also advocated. Changing the footwear. Wearing an open-backed shoe may help relieve pressure on the affected region. For those whose symptoms were caused by a sudden change from wearing high-heeled shoes to flat shoes, the temporary use of footwear with a heel height in between may be helpful. Inserting a heel cup in the shoe may help to raise the inflamed region slightly above the shoe?s restricting heel counter and relieve the pain. It is advisable to also insert the heel cup into the other shoe to avoid any leg-leg discrepancies that can lead to other problems. Training frequency and intensity should be gradually progressed with adequate rest between trainings.

Prevention

Protect that part of the body that may be most vulnerable, If you have to kneel a lot, get some knee pads. Elbow braces can protect tennis and golf players. If you are an athlete or avid walker, invest in some good walking or running shoes. When doing repetitive tasks have breaks. Apart from taking regular breaks, try varying your movements so that you are using different parts of your body. Warm up before exercise. Before any type of vigorous exercise you should warm up for at least 5 to 10 minutes. The warm up could include walking at a good speed, slow jogging, or a cycling machine. Strong muscles add extra protection to the area. If you strengthen the muscles in the area where you had bursitis (after you are better), especially the area around the joint, you will have extra protection from injury. Make sure you do this well after your bursitis has gone completely.
Hammer ToeOverview

There are two main types of Hammer toe. Hammertoes can be flexible, which means that you can still move the toe a bit - these are easier to treat with stretching, wider shoes and in some cases, toe splints. Rigid hammertoes occur when the foot condition has persisted for so long without treatment that the tendons become too rigid to be stretched back to normal. Rigid hammertoes are more common in people with arthritis. This foot condition usually needs to be treated with surgery.

Causes

Essentially, hammertoes are caused by an abnormal interworking of the bones, muscles, ligaments and tendons that comprise your feet. When muscles fail to work in a balanced manner, the toe joints can bend to form the hammertoe shape. If they remain in this position for an extended period, the muscles and tendons supporting them tighten and remain in that position. A common factor in development of hammertoe is wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Most likely due to these factors, hammertoe occurs much more frequently in women than in men.

HammertoeSymptoms

Here is a look at some of the symptoms hammertoe can cause. They include hammer-like or claw-like appearance of the toe. Pain when walking or moving the foot. Difficulty moving the toe. Corns may form on top of the toe. Callus may form on the sole of Hammer toes the foot. During the initial stages, you may be able to manually straighten your toe. This is called a flexible hammertoe. But as time passes, the toe will not move as easily and will continue to look like a hammer. Pressure and irritation over the joint can cause a blister to develop and become a corn over time. These corns have the potential to become infected and cause additional symptoms such as redness, bleeding, and difficulty wearing shoes and socks. Corns are the main cause of pain when hammertoes are developing.

Diagnosis

Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Non Surgical Treatment

Symptomatic treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous often seen with the hammertoe. These medications must be used with caution. They are a mild acid that burns the callous off. These medications should never be used for corns or callouses between the toes. Persons with diabetes or bad circulation should never use these products.

Surgical Treatment

A variety of anaesthetic techniques are possible. Be sure an discuss this with your surgeon during your pre-op assessment. The type of surgery performed will depend on the problem with your toes and may involve releasing or lengthening tendons, putting joints back into place, straightening a toe and changing the shape of a bone.Your surgeon may fix the toes in place with wires or tiny screws.

Overview
Bunions
Bunions are probably the most common deformity seen in the adult foot. The term ?bunion? is actually Latin for turnip. The scientific phrase used to describe a bunion is hallux valgus. Hallux is Latin for great toe, while valgus means deviation towards the outer side of the body. Bunions come in all shapes and sizes. This causes significant variation in symptoms and also in the extent of the surgery required to correct a bunion. Most patients who have symptomatic bunions complain of pain on the medial, or inner aspect of the big toe. However, bunions may also cause pain underneath the big toe, or even under the second toe.

Causes
Bunions can be caused by improper footwear. Genetics. Foot injuries. Congenital deformities. Medical conditions such as arthritis. Stress on feet. Bunions are mainly caused by genetics. The bunion itself is not inherited, but the person?s hereditary foot type and gait pattern makes them more prone to developing bunions.You can also begin to develop bunionsby wearing shoes that are too tight or too small. When you wear shoes of this nature, your toes are squeezed together. Bunions are not caused by crowding of the toes, but wearing tight shoes can worsen the condition and cause symptoms to appear sooner. Some people are born with birth defects that put them at higher risk for developing bunions.
SymptomsNo matter what stage your bunion is in, you can be in pain. Though bunions take years to develop, you can experience pain at any stage. Some people don?t have bunion pain at all. Pain from a bunion can be severe enough to keep you from walking comfortably in normal shoes. The skin and deeper tissue around the bunion also may become swollen or inflamed.

Diagnosis
A thorough medical history and physical exam by a physician is necessary for the proper diagnosis of bunions and other foot conditions. X-rays can help confirm the diagnosis by showing the bone displacement, joint swelling, and, in some cases, the overgrowth of bone that characterizes bunions. Doctors also will consider the possibility that the joint pain is caused by or complicated by Arthritis, which causes destruction of the cartilage of the joint. Gout, which causes the accumulation of uric acid crystals in the joint. Tiny fractures of a bone in the foot or stress fractures. Infection. Your doctor may order additional tests to rule out these possibilities.

Non Surgical Treatment
Sometimes observation of the bunion is all that's needed. A periodic office evaluation and x-ray examination can determine if your bunion deformity is advancing, thereby reducing your chance of irreversible damage to the joint. In many other cases however some type of treatment is needed. Early treatments are aimed at limiting the progression of the deformity and easing the pain of bunion or an associated joint. Conservative treatments such as orthotics can achieve this but they won't reverse the deformity itself. These options include changes in shoewear. Padding. Pads placed over the area of the bunion can help minimise pain, but will not stop the progression of the bunion. Activity modifications. Avoid activity that causes bunion pain, this could include standing for long periods of time. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve pain. Icing. Applying an ice pack several times a day helps reduce inflammation and pain. Orthotic devices. Orthotics are the mainstay of non-surgical treatment for bunions.
Bunions Hard Skin

Surgical Treatment
As mentioned above, with mild cases, the bone is cut close to the big toe joint and shifted over into a correct position. The cut bone is held in placed with one or two surgical screws. With this procedure, just the top of the bone is moved over and the bottom of the bone remains in the same place. This technique is called the Austin bunionectomy and refers to type of bone cut that will be made by the Surgeon. There is, however, a limit on how far one can move the bone over with this technique. Its is generally thought that the cut bone should only be moved over a distance equal to half the width of the bone. In somes the bone may be moved over further.

Prevention
The best way to reduce your chances of developing a bunion is to wear shoes that fit properly. Any shoe that is too tight or too high will force your toes together and may cause the condition to develop. Shoes need to be wide enough, so they aren't rubbing against the joint, and preferably made of leather. Avoid shoes with a lot elaborate stitching at the front, as this can also cause irritation. Heels should be no more than three to four inches and you should only wear them occasionally. Court shoes should seldomly be worn, as they do not give the foot any support. Be honest with yourself, you know if your shoes aren't fitting you comfortably. Do something about it, or you will suffer for your vanity.
Overview

During initial contact or heel strike, the ankle rolls inward, causing excessive pronation or flattening of the foot. This action forces the big toe (instead of the ball of foot and all toes) to do all the work to push off the ground. When the ankle overpronates, this causes the tibia (shin bone) to rotate and the femur (thigh bone) to adduct (move toward the mid-line of the body), causing internal rotation or knee valgus (knock-kneed).Pronation

Causes

Over-pronation has different causes. Obesity, pregnancy, age or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Over-pronation is also very common with athletes, especially runners and most of them nowadays use orthotics inside their shoes. Over-pronation affects millions of people and contributes to a range of common complaints including sore, aching feet, ball of foot pain, heel Pain, achilles tendonitis, bunions, shin pain, tired, aching legs, knee pain and lower back pain. The most effective treatment solution for over-pronation is wearing an orthotic shoe insert. Orthotics correct over-pronation, thereby providing natural, lasting pain relief from many common biomechanical complaints.

Symptoms

If ignored, overpronation can lead to complications such as hammer toes, corns and calluses, shin splints, hallux rigidus and many more foot and lower leg problems. Hammer toes appear when the toes are placed under too much pressure and the ligaments and muscles in the toes begin to reduce in size, leading to the curvature of the toes and making them look like little hammers. Overpronators can develop hammertoes if they don?t wear an appropriate pair of shoes. Corns and calluses also appear as a result of overpronation. They form in response to excess pressure, and overpronators may find that they have excessive hard skin on the balls of the feet and inside edge of the big toe. It is the body?s way of protecting against excessive forces and friction. They can be painful.

Diagnosis

To easily get an idea of whether a person overpronates, look at the position and condition of certain structures in the feet and ankles when he/she stands still. When performing weight-bearing activities like walking or running, muscles and other soft tissue structures work to control gravity's effect and ground reaction forces to the joints. If the muscles of the leg, pelvis, and feet are working correctly, then the joints in these areas such as the knees, hips, and ankles will experience less stress. However, if the muscles and other soft tissues are not working efficiently, then structural changes and clues in the feet are visible and indicate habitual overpronation.Foot Pronation

Non Surgical Treatment

Anti-Pronation Insoles provide a unique foot support system that aligns the lower body. The major cause of foot and leg pain is over pronation (rolling over of the feet) which causes excessive pressure on the muscles, ligaments and bones of the lower body. Running insoles treat the underlying cause of over pronation and prevent future occurrences of the associated foot or leg condition. A project conducted at the NIKE Sport Research Laboratory studied the effects of orthotics on rear foot movement in running. Nine well-trained runners who wore orthotics were chosen as subjects. The results of the study indicated that orthotics reduced rear foot movement by roughly one degree or approximately nine percent of the amount found in runners not using orthotics. The average reduction of the maximum velocity of pronation was fifteen percent. Thus this study indicates that orthotics and insoles control over pronation which will treat and prevent many sporting injuries.

Surgical Treatment

Calcaneal "Slide" (Sliding Calcaneal Osteotomy) A wedge is cut into the heel bone (calcaneus) and a fixation device (screws, plate) is used to hold the bone in its new position. This is an aggressive option with a prolonged period of non-weightbearing, long recovery times and many potential complications. However, it can and has provided for successful patient outcomes.
Overview

Sever's disease, also known as calcaneal apophysitis, is an inflammatory condition of the growth plate of the heel (calcaneus). Sever's disease is seen during periods ofSever's_Disease_x-ray active bone growth, particularly between the ages of 10 and 14 years old. Sever's disease is a self limiting condition, meaning that all cases of Sever's disease will disappear once bone growth is finalized and the growth plate of the heel closes. Skeletal maturity and closure of the growth plate occurs for most children at 15-16 years of age. The onset of Sever's Disease is insidious and found more in boys than girls.

Causes

At birth, most of our foot bones are still made of cartilage, which ossifies (becomes bony) over the first few years of life. At the back of the heel, there is a growth plate that is attached to the main body of the heel bone by a cartilaginous join. At about the age of 14-15 years, this area of cartilage between the growth plate and the heel bone ossifies, fusing the area to the heel. Sever?s disease occurs when there is too much motion or strain across the growth plate, resulting in this area becoming inflamed and painful.

Symptoms

Symptoms of calcaneal apophysitis may include Pain in the back or bottom of the heel, Limping, Walking on toes, Difficulty running, jumping, or participating in usual activities or sports, Pain when the sides of the heel are squeezed.

Diagnosis

A physical exam of the heel will show tenderness over the back of the heel but not in the Achilles tendon or plantar fascia. There may be tightness in the calf muscle, which contributes to tension on the heel. The tendons in the heel get stretched more in patients with flat feet. There is greater impact force on the heels of athletes with a high-arched, rigid foot. The doctor may order an x-ray because x-rays can confirm how mature the growth center is and if there are other sources of heel pain, such as a stress fracture or bone cyst. However, x-rays are not necessary to diagnose Sever?s disease, and it is not possible to make the diagnosis based on the x-ray alone.

Non Surgical Treatment

The doctor will talk with you about the best treatment plan for your child. As instructed, your child will Ice the heel 3-4 times a day for 15-20 minutes at a time. Use an ice pack or bag of frozen peas, or something similar. Never put ice directly on your child's skin. A thin cloth or towel should be between your child?s skin and the ice pack. Take anti-inflammatory medication, such as ibuprofen, as directed. Decrease the amount of running and jumping he or she does. Stretch the heels and calves, as instructed by the doctor. Regular stretching can help prevent Sever?s from coming back. Use a ?heel cup? or a cushioned shoe insert that takes pressure off the heel. In some cases, a cast is placed on the foot and worn for several weeks.
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