Infracalcaneal Exostosis
An infracalcaneal exostosis is term that describe a large bony prominence or spur on the bottom of the heel bone or calcaneus. In some patients, this bone spur can actually be large enough to to be felt on the bottom of the heel.
The bone spur is caused by traction or pulling on the heel bone or calcaneus by tiny muscles on the bottom of the foot. Many people correlate “heel spurs” with plantar fasciitis. This is a false statement. The plantar fascia in actuality, inserts just lateral to the plantar heel spur. It is the small musculature that causes formation of the bone spur. The reason why the muscles do this is secondary to abnormal and uncontrolled foot mechanics.
Most patients have 1 – 1.5 inches of fat pad on the bottom of the heel that aids in cushioning and shock absorption for the calcaneus. In older patients who have experienced atrophy or thinning of the fat pad, the bone spur can be prominent and very painful.
Treatment includes cushioning of the infracalcaneal exostosis, wearing appropriate shoe gear to soften the impact of the heel with walking or running. Although not available in our office, some plastic surgeons and aestheticians are offering collagen injection therapy to the plantar aspect of the heel to aid in cushioning. It must be known that this is only a temporary solution and often requires multiple periodic injections.
For those patient who cannot find relief cushioning, padding or shoe therapy, surgery is a viable option. Surgery involves removing the plantar heel spur or infracalcaneal exostosis and making the bottom surface of the heel bone flat and smooth. A extended period of non-weightbearing is suggested due to possible risk of stress fracture with early walking following the surgery.
If you have a prominent heel spur on the bottom of the heel, please visit our office for a clinical evaluation. Call 972-542-2155 for an appointment today.
Neurologic Heel Pain
Please click the following link to read about the various causes of heel pain caused by nerve disorders.
Neurologic Heel Pain
Mechanical Heel Pain
Please click the following link to learn about the various types of mechanical heel pain:
Mechanical Heel Pain
Custom Molded Flipflops – FLOPTHOTICS!
Advanced Foot & Ankle Center is now offering custom molded flip flops. They are called Flopthotics. Custom molded orthotics are great, however, wearing them in tennis shoes all summer can sometimes be a drag. Enjoy the comfort and support of a custom orthotic with style and breatheability of a flipflop.
The casting process involves making a cast of the foot using a foam impression. The foam impression is then sent to Barcelona, Spain to Edser Labs for manufacturing. There is a guaranteed 10 day turn- around time for the flip flops.
Advanced Foot & Ankle Center is now offering a package deal in which a patient can get a pair of regular custom orthotics that fit into normal shoegear (the cost depends on your insurance benefits) and for additional $150.00, the Flopthotics can be casted for as well. If the regular custom molded orthotics are not purchased or not wanted and you only want the custom molded flipflops, the Flopthotics are $200.00. The Flopthotics are not a covered item through insurance. Take advantage of this wonderful deal offered. This deal will last for 90 days starting 4/28/2011.
Enjoy the summer in a pair of custom molded flipflops. Visit edserlabs.com for more pictures and additional information regarding the Flopthotics.
Call 972-542-2155 to schedule an appointment today. Advanced Foot & Ankle Center is located in McKinney, TX and Prosper, TX.
Facts about Diabetes Mellitus
This article contains statistics taken from numerous journal articles regarding the effect of diabetes and the problems that it can cause.
Incidence of Diabetes Mellitus
- 15% of the population of developed nations
- 16 million people in U.S have diabetes mellitus
- 15% of patients with diabetes will develop foot ulcers
- There are currently 2.4 million people with diabetic foot ulcers
- Foot and leg amputations are 15 times more likely in patients with diabetes
- 15% of people with foot ulcers will require amputations
Morbidity and Mortality
- Half of the non-traumatic foot amputations in the United States are the result of diabetes
- The 3 year survival rate after a leg or foot amputation is 50% in diabetic patients
- 50% of diabetic amputees will develop ulcers on the opposite limb
- 50% of those diabetic patients will lose the other limb in 3 years or die
Cost
- Total cost for diabetic care in 1997 = $98,000,000,000.00
- Diabetic foot care in 1997 = $6,000,000,000.00
- Non-operative care of a single foot ulcer = $7,000.00
- Average cost of care for an infected foot ulcer = $17,000.00
- Average cost of amputation and rehab = $45,000.00
Misconceptions
- 68% of patients with diabetic foot ulcers have neuropathy
- 32% of patients with diabetic foot ulcers have normal sensation
How effective are orthotics?
- Re-ulceration rate at one year = 58% if return to street shoes, 28% if return to therapeutic shoes with in soles
If you have diabetes and you have a diabetic foot ulcer, please come see us at Advanced Foot & Ankle Center to be looked at. Even if you do not have have a foot ulceration, but you have diabetes, there are things that can be done by Dr. Kory Williams and Dr. Eric Silvers to prevent future problems. Act now. The future of your foot health depends on it. Call 972-542-2155 to set up an appointment now.
The 5 Basic Types of Shoes for Running
The five basic types of running shoes are as follows:
1. Motion control running shoes
2. Stability running shoes
3. Cushioned running shoes
4. Trail running shoes
5. Racing running shoes
The motion control, stability and cushioned running shoes are fitted according to the runner’s foot type; which is either pronated, overpronated or supinated. The trail and racing shoes are fitted according to the type of race or terrain the runner will be running on.
Motion Control Shoes
These shoes are designed primarily for runners who have low arches, who are moderate to severe over pronators, and runners who are heavier and need extra support.
These shoes are manufactured to prevent a runner’s foot from rolling inward too much (over-pronating). These shoes tend to be more rigid, heavier, have a wider outsole and have a high density sole (medial post) on the medial aspect of the shoe where the arch lies.
The medial post is a wedge of high density EVA material that is inserted into the sole of the shoe on the medial side. The EVA material resists compression which ultimately reduces the amount the foot rolls inward with each running stride.
Stability Shoes
These shoes are best for runners who have medium arches and for those who are mild to moderate pronators.
Stability shoes offer features found in both motion control and cushioning shoes, but to a lesser degree. The primary function of these shoes is to support the foot without interfering the foot’s natural pronation. These shoes have excellent arch support and midsole cushioning. These shoes are not as restrictive as motion control shoes. These shoes have tendency to e curved inward slightly. This shoe is the best for most runners.
Cushioned Shoes
These shoes are best for runners who have high arches and for those runners who are supinators or under-pronators.
These shoes are designed to provide shock absorption and extra cushioning for people with high arches. These shoes are slightly curved in order to encourage pronation. These shoes are more flexible, have softer midsoles, and less medal support.
Trail Shoes
These shoes are best for off-road running, extra traction, durability, and for runners who need thicker more durable soles of the shoe.
These shoes are tough enough to withstand bad weather and rough terrain.
Racing Shoes
These shoes are best for runners who have no motion control problems and for those runners who need shoes for fast paced training or racing.
These shoes offer very little in terms of stability, cushioning or durability features. They are very lightweight. These shoes have a low heel and flexible forefoot. They are not recommended for runners with injures or pronating problems.
This information was excerpted from the Shoe Wearer’s Handbook by Clare Barron and Kent Basson, pages 46-49.
