Infracalcaneal Exostosis
An infracalcaneal exostosis is a term that describes 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 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.
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.
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 weight bearing 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.
Traumatic Heel Pain
If you have had trauma to the heel, please click on the following link to read more:
Traumatic Heel Pain
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
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 are a diabetic with a foot sore or ulceration, please come see us at Advanced Foot & Ankle Center for evaluation and immediate treatment. It is also advised that you seek foot and ankle evaluation if you are a diabetic and are not aware of any current foot or ankle issues. Dr. Eric Silvers has treated many diabetics with all types of foot and ankle problems for over 15 years. Please 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 be 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.
