Jeffrey Conforti, D.P.M.
2 Sears Dr., Suite 201
Paramus, NJ 07652

201-986-1900

 

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age.

Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever's disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid sports activity which only worsens the problem. Over the counter pain medications targeted at relieving inflammation can be helpful for reducing the amount of heel pain. Combined with rest and pain medication, a child with Sever's disease should wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect just one heel of either foot as well as the heels of both feet. It is important to have a child experiencing heel pain get an examination by a foot doctor who can apply the squeeze test, which compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

Treatment methods should usually continue for at least 2 weeks and as long as 2 months before the heel pain goes completely away and the child can resume normal physical and athletic activities again. A child can continue doing daily stretching exercises for the legs and feet to prevent the heel pain of Sever's disease from returning.

 

Exercise for Your Feet

Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.

For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.

Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.

Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works muscles.

Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.

In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis, as well as to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage which encourages circulation in the feet as well as muscle relaxation.

 

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also called tibial nerve dysfunction, is an uncommon form of misfiring peripheral nerves in the foot. Peripheral nerves are the nerves that carry signals from the brain and spinal cord to the other parts of the body. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.


Common causes of tarsal tunnel syndrome involve pressure or an injury. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee, or trauma to the tibial nerve can result in tarsal tunnel syndrome. Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome. However, tarsal tunnel syndrome can appear without an obvious cause in some cases.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of affected leg, with primary problems occurring on the bottom of the foot. The foot muscles, toes and ankle become weaker, and curling toes or flexing the foot becomes difficult. If the condition worsens, the person may develop infections and ulcers on the affected foot because of the lack of sensation. The affected foot can become permanently deformed, and sensation loss, particularly in the toes, is sometimes permanent.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition.

Occasionally, a person with tarsal tunnel syndrome can recover without specific treatment, but over the counter pain medication is still used to reduce the discomfort associated with the condition. Treatments for more severe tarsal tunnel syndrome focus on regaining sensation and strength in the affected toes and foot. Patients may receive physical therapy and prescription painkillers if the pain isn't managed by over the counter pain relievers. A surgery designed to lessen pressure on the tibial nerve can help in some cases. The surgeon enlarges the patient's tarsal tunnel, a ligament and bone structure in the foot that the tibial nerve passes through, relieving some of the pressure on the tibial nerve.

 

Solutions for Cracked Heels

Cracked heels can be embarrassing, and can make life frustrating when sandal season comes around. But not only are they an aesthetic problem – they can also tear stockings, socks and even wear out shoes faster at the back, and when severe may cause pain and infection.

Cracked heels are a problem for many who walk a lot, who are athletic, and who have especially dry skin. Those who are using certain kinds of medication that will dry the skin, who swim a lot, wear certain kinds of shoes, and those who are diabetic may also have trouble with cracked heels. Seniors may have more trouble with cracked heels than others, since the skin’s production of oils decreases with age. There is no one way to get cracked heels, and there is no one cure for them.

Today there are numerous products on the market that have a variety of ingredients to promote healing. Some of these products are over-the-counter and some come from a physician’s prescription pad--especially for those who have chronic dry feet and heels.

Some doctors recommend for those with rough skin to wear socks at night when they sleep. This helps promote healing of the skin on the heels and helps any creams put on the feet stay on longer and better sink into the skin.

Using moisturizers both day and night is one way to help alleviate the dryness that causes cracked heels. Making sure that the skin is clean and dry at all times is another way. Using a pumice stone to remove dead skin before applying a moisturizer can also help, as many times cracked heels will not respond to moisturizers unless the thick outer layer of skin is first removed through exfoliation. Lotion or ointment applied after exfoliation will be absorbed by the skin much more easily.

Eating a well-balanced diet with foods that promote body healing and balance can also help the skin – from within. Whatever is put into the body can either help it or hurt it and foods that give the body staying power will permeate throughout, especially through the first line of protection--the skin. Taking supplements of omega-3 fatty acids and zinc may also help cracked heels.

Not all products that say they will help cracked heels actually work. See a professional for foot care if nothing being tried is working. A podiatrist or a dermatologist should be able to give information and advice to help with the problem.

 

Toenail Fungus

For many people, toenail fungus can be not only unsightly but also embarrassing. The condition is frustrating as it can be very persistent and difficult to get rid of. Fortunately, there is a number of available treatment options for toenail fungus.

Lamisil is considered to be the most effective treatment for toenail fungus though any anti-fungal treatment can be used. Look for the ingredient terbinafine when it comes to products that focus on killing fungal growth. Utilizing a product containing terbinafine will damage the cell membrane of the fungus organism even though the results are not immediate. Apply the medication on a routine basis and be sure to wash and dry the affected area thoroughly. The fungus requires air, moisture, and your skin to live.

It may also help to take other precautions when it comes to fungal nails. Applying talcum powder inside shoes can absorb sweat and moisture. Also be sure to wear sandals or loose-fitting, open-toed shoes which can improve air-flow around the feet and keep them dry. These types of shoes also expose your feet to light, which is not favorable for fungus growth. Wear socks that dry quickly and wick moisture can also help control fungal growth.

Though Lamisil and other terbinafine-based medications are effective, they may also cause a variety of undesirable side effects. If this kind of medication does not sync with you, there are several natural remedies to try. Regular applications of tea tree oil, hydrogen peroxide, alcohol or Vicks VapoRub to the affected area may also solve the problem.

Your physician can also recommend soaking your toenails in a gentle bleach solution, with anecdotal evidence suggests that Listerine and vinegar are possible effective soaking solutions. They may be simple treatments but require consistency and of course patience. Your local pharmacy may also carry topical products manufactured specifically for toenail fungus.

Laser surgery is a more immediate treatment if you are looking for a quick removal of the toenail fungus. However, do not cut the toenail fungus using any kind of scissors, even toenail scissors. It should be advised that once your fungus infection is cured, you will need to throw out old pairs of shoes to avoid reinfection.

Foot & Ankle Medical & Surgical Care
                                                 
Paramus, NJ Location
2 Sears Drive
Paramus, NJ 07652
201-986-1900
 
 
Affiliated With
Hackensack University Medical Center
The Valley Hospital
Board Certified, American Board of Foot & Ankle Surgery
Board Certified, American Board of Podiatric Orthopedics
 

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