Foot deformities - Research Paper Example

FOOT DEFORMITIES An Overview Everyone wants to keep their independence of their life functions such as: locomotion, recreation, social interaction, and the like for as long as they live. In some occasions, however, this might be impossible even at an early age due to certain body deformities. A body deformity is described to be a body malformation, distortion or disfigurement and is often associated to abnormal bone growth or disorder which can be acquired through certain factors like: diseases, lifestyle; the aging process or can be genetically acquired.

In case of severely affected people with certain bone or ligament deformities, it is important for them and their families to acknowledge that certain needed type of medical care interventions from physicians and physical therapists are required to improve the overall well-being situation. It becomes important for a patient not only to improve his overall fitness and well-being but also enhance basically his bone health, motor skills, and muscle tensions of the bone so as to be able to cope up with stress as well as maintain good mobility and bone density.

With the help of physical therapists, subjecting the patients to different prescribed therapeutic body sessions, patients will be able to strengthen their muscle groups, and if possibly minimize deformities and its discomforts in the body. The succeeding discussions will cover 10 selected foot deformities with images, featured etiologies and treatments and possible interventions of a physical therapist in the process Selected Foot Deformities, Their Description, Causes and Treatment 1. Flat Foot is also known as fallen arches, pronation of feet, pes planus, pes planovagus; (See Image 1).

Flat foot is a foot condition common in infants and toddlers but it can also occur in adults if not corrected. Flat foot occurs when the tissues holding the joints or tendons in a foot or a pair of feet become loose. “It may also occur if “Tarsal Coalition” prevails. It is a condition wherein two or more bones in the foot fuse together as often seen in children” (“Flat Feet or Pes Planus, 2013). For treatment, if pain continues, a physician must assess the condition”. In other instances, “orthotic devices (shoe insets) may be recommended to support the arch.

If caused by tarsal coalition, a deeper intervention may be necessary. In severe cases, these may need surgery and physical therapy treatment after surgery” (“Flat Feet or Pes Planus, 2013). 2. Hammer or Mallet Toe – (See Image 2) A hammertoe is “a weakened muscle which makes tendons (the tissues connecting the muscles to the bone) shorter, thereby causing the toes to curl under the feet” (Stoppler, 2008). The most common complaint on this is the rubbing and imitation on the top of the bent toe.

If one has a hammer toe, patient must seek doctor’s advice. However, a sufferer can be relieved of such pain by wearing the right shoes, this can be remedied “by using custom made othotics as well as high and broad across the toes, called a wide toe-box shoe and no more than 2 inches of shoe heel” (“Understanding Hammertoes,” 2013). 3. Club Foot – (See Image 3) “Club foot is also termed as talipes equinovarus characterized by any of the following range of unusual positions of the foot such as: the heel of foot could be usually smaller than normal (for infants), foot may be pointed downwards, fronting the foot can be rotated towards the other foot and in extreme cases, the bottom of the foot can point up” (Club foot Overview 2013).

“This may occur due to congenital or present at birth or what they call as postural clubfoot. Club foot may be caused by a combination of genetic and environment factors or it can also be closely associated with spina bifida or effects after stroke or brain injury” (Clubfoot Overview, 2013). Club foot can initially have nonsurgical treatments such as casting or splinting. “There are two common methods of manipulation and casting. One is “Traditional” and Ponseti (Iowa) methods. Physical therapy methods may be applied to patients after surgery” (Clubfoot, 2011). 4. Pes Cavus or Claw Foot.

(See Image 4). This is the condition that occurs “If both tendons and ligaments constrict, in effect, this causes the toe’s joints to curl downwards and create discomfort or pain at the top part of the toe. Claw toes are two types: flexible and rigid” (Do You Have a Claw Toe? 2013). As remedy, the best alternative is to use suitable footwear in terms of size and quality material. “The shoe must have high and broad shoe area enough to provide room to minimize friction between the shoes and the toes or front foot.

For more comfort and to ease pain, the use of other conservative gel products designed to relieve pain and eliminate friction between the shoe and the toes such as gel toe shields and toe caps, are recommended as possible options” (Do You Have a Claw Toe? 2013). 5. Hallux valgus or Bunion. (See Image 5). “The medical community term ‘bunion’ as Hallux valgus. Bunion is a prominent a bump originating from a bone showing externally towards the inside of the foot around the big toe joint.

It has been a normal occurrence for Bunions to have the big toe rests under or over the second toe” (“Do you have Bunions? 2013). Another form of bunion is known as “Tailor’s Bunion or “Bunionette” which forms on the outside of the foot towards the joint at the little toe. Bunions are often caused by arthritis and further aggravated by wearing improper to tight footwear on the toes’ area. As temporary relief for pain, one can soak the feet in warm water. However the best remedy is to wear properly fitting shoes.

One may also use recommended forefoot products intended for bunion treatment. 6. Metatarsus Adductus. (See Image 6) “Other terms for this deformity are hooked-foot metatarsus varus and bean-shaped foot ” (POSNA, 2013). This foot deformity manifests usually during infancy or childhood where there is inward divergence of the forefoot relative to the hind foot. “The true cause of this deformity is still unknown” (POSNA, 2013). For treatment, POSNA suggests corrective serial casting can be useful.

Splinting in reverse-last shoes is suggested after casting to maintain correction. This is to minimize the risk of producing a skew foot” (POSNA, 2013). 7. Morton’s toe. (See Image 7). “This is a foot disorder manifested with the second toe growing longer than the big toe” (“What is Morton Toes?” 2013). In most cases, this causes pain and discomfort that can lead to other foot problems. Chances are the condition can be treated with what they call orthotics or devices such as shoe inserts that provide support to the foot.

Initially, “using the right fit of shoes will help alleviate the pains associated with Morton’s toes and help correct the problem” (“What is Morton Toes?” 2013). 8. Heel Spurs or Calcaneal Spur. (See Image 8). It was reported that: “A heel spur brings extreme pain at the rear foot while standing or walking. It comes as an abnormal growth of the heel bone, the largest bone that absorbs most of the shock and pressure. On the other hand, the plantar fascia, a broad band of fibrous tissue, runs from the heel to the forefoot.

The grown of heel spur depends largely on calcium materials that form and the positioning of plantar fascia” (Do You Have Heel Spurs, 2013). In addition, “People with unusually high arches (pes cavus) or flat feet (result of over pronation) can develop heel spurs when plantar fascia becomes over-stretched. Notably, women have higher incidence of heel spurs because of the different types of the footwear they wear. The best treatment for heel spurs is to determine what causes the excessive stretching of the plantar fascia.

Other treatments include stretching exercises which can be supervised by a PT” (Do You Have Heel Spurs? 2013). 9. Skew Foot. (See Image 9). Some doctors also “refer skew foot as “Z”-foot” (Killian, 2009). “Skew foot is a foot deformity where the front part of the foot is skewed or bent sideways” (Healthgrades, 2013). In fact, “Skew foot is a result of a long-standing untreated adductus deformity. Treatment of skew deformity is rarely successful by non-operative means. Appropriate surgical procedures addressing the metatarsal adductus component and flat foot component can be used for the correction of the dysfunctional or symptomatic skew foot” (Wan, S.C. 2006). 10. Hugland’s Deformity.

(See Image 10). “Haglund's deformity is a bony enlargement of the back of the heel bone. Sometimes it's called “pump bump” because the deformity often occurs in women who wears pump” (APMA, 2013). APMA reported that: “If anyone carries high arches, a tight Achilles tendon, or a tendency to walk on the outside of your feet, more likely one can develop Haglund's deformity than other people. Wearing shoes with a firm, rigid back also contributes to the development of Haglund's Deformity.

Treatment options include shoe modification, medication, mobilization and surgery depending on the severity of deformity” (APMA, 2013) Conclusion The role and intervention of Physical therapist (PT) intervention is recognized critical in patients undergoing adjustments due to their incapacities brought about by foot deformities or any bone related deformities, for that matter. PT intervention becomes necessary when it addresses the patients relief of pain, improves one’s life functions like mobility, social interaction and self-confidence, among others.

The different foot deformities and their gravity will determine how or what extent a PT can help maximize patient’s individual overall performance. The road to recovery and confidence build-up in patients cannot be possible without the aid of a PT’s expertise. Adaptive equipment, stretching exercises, use of gravity-eliminated activity post operatively and joint protection concepts are just some of the key ways how a PT becomes an essential teaching partner in this endeavors. References American Podiatric Medical Association (APMA). (2013) Hugland’s Deformity.

Retrieved November 20, 2013 from http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1862 Clubfoot (2013). Retrieved November 20, 2013 from http://www.webmd.com/a-to-z-guides/clubfoot-topic-overview?page=2 Clubfoot Overview. (2011). Retrieved November 20, 2013 from http://www.nlm.nih.gov/medlineplus/tutorials/clubfootoverview/op869102.pdf Do you have claw toe? (2013). Retrieved from November 20, 2013 from http://www.foot.com/site/foot-conditions/claw-toes Do you have bunions? (2013). Retrieved November 21, 2013 from http://www.foot.com/site/foot-conditions/bunions Do you have heel spurs? (2013). Retrieved November 21, 2013 from http://www.foot.com/site/foot-conditions/heel-spurs Flat Feet (Pes Planus)-The Art of Caring (2013) .

Retrieved November 19, 2013 from http://twinboro.com/body/foot/conditions/flat-feet-pes-planus-nj.html Healthgrades. (2013). Skewfoot.Retrieved November 20, 2013 from http://www.rightdiagnosis.com/s/skewfoot/intro.htm Killian, J. (2009). Skewfoot. Retrieved November 20, 2013 from http://www.orthopedicsforkids.com/PDFs/Feet/Skewfoot%202009.pdf Metatarsus adductus and skewfoot deformity.(2013). Retrieved November 20, 2013 from http://www.ncbi.nlm.nih.gov/pubmed/16598908 Moyer, Catherine, DPM. (2012) What is a Hammer Toe?

Retrieved November 20, 2013 from http://foothealth.about.com/od/womensfoothealth/a/What-Is-A-Hammertoe.htm Stoppler, M.C. (2008) Pictures of Hammertoes. Retrieved November 20, 2013 from http://www.medicinenet.com/image-collection/hammertoes_picture/picture.htm Therapeutic Strategies for Osteogenesis Imperfecta (OI):A Guide for Physical Therapists and Occupational Therapists.(n.d). Retrieved 20 November 2013, from http://www.oif.org/site/DocServer?docID=741 The Pediatric Orthopaedic Society of North America (POSNA).

Metatarsus Adductus (2013). Retrieved November 20, 2013 from http://www.posna.org/education/studyguide/metatarsusadductus.asp Understanding Hammertoes – Diagnosis and Treatment (2013). Retrieved November 19, 2013 from http://www.webmd.com/a-to-z-guides/understanding-hammertoes-treatment Wan S.C., (2006). Metatarsus adductus and skewfoot deformity. Clin Podiatr Med. Surg. 23(1):23-40. vii-viii.Retrived November 20, 2013 from http://www.ncbi.nlm.nih.gov/pubmed/16598908 What is Morton’s toe? (2013). Retrieved November 20, 2013 from http://www.

experts123.com/q/what-is-mortons-toe.html Images of Foot Deformities Image #1 Flat Foot Image #2 Hammer Toes Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.advancedfoottexas.com/wp-content/uploads/2010/06/flatfoot2.jpg&imgrefurl=http://www.advancedfoottexas.com/2010/06/flatfoot-deformity/&h=1224&w=1632&sz=823&tbnid=wzmsc6Cn2YMXbM:&tbnh=122&tbnw=162&zoom=1&usg=__IpQWO16pV9YicLbuppunGPngbJg=&docid=uaA89vEyqZ_c-M&sa=X&ei=mqGJUvzxMtGviQf_kYCQAw&ved=0CDIQ9QEwAw Retrieved from: http://www.

medicinenet.com/image-collection/hammertoes_picture/picture.htm Retrieved from: http://www.google.com.ph/imgres?imgurl=http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/media/medical/hw/hwkb17_030.jpg&imgrefurl=http://www.webmd.com/pain-management/toe-joint-deformities&h=300&w=460&sz=33&tbnid=4-6dM2oZ0bfEcM:&tbnh=115&tbnw=176&zoom=1&usg=__iB94Mp1ck30OgZ6_QVQ6sy33HeY=&docid=6ap1rShrpeIQjM&sa=X&ei=_ZCKUv_uDuOCiQf674HwAg&sqi=2&ved=0CD0Q9QEwCQ Image #3 Club Foot Image #4 Claw Foot or Pes Cavus Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.

orthopediatrics.com/binary/org/ORTHOPEDIATRICS/images/page/child_foot_clubfoot_anatomy04.jpg&imgrefurl=http://www.orthopediatrics.com/docs/Guides/clubfoot.html&h=400&w=400&sz=78&tbnid=RYfx9V-zw14pnM:&tbnh=128&tbnw=128&zoom=1&usg=__cin9ELhqg7cIUXlZLX3nYKzXoCA=&docid=BDzZ0KY6E4lpXM&sa=X&ei=T4yKUtD-CqmCiQex1YHwAg&sqi=2&ved=0CDQQ9QEwBQ Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.thetagoeclinic.co.uk/pages/files/images/pes.jpg&imgrefurl=http://www.thetagoeclinic.co.uk/pages/pes_cavus.

html&h=194&w=310&sz=20&tbnid=G5SsGaBQFKsCdM:&tbnh=118&tbnw=189&zoom=1&usg=__OmzJX0I2ZITw-77ylNff3swBQYE=&docid=EX-ZyOoWs6nQCM&sa=X&ei=5I2KUpyhEuPpiAfxpYHgAg&ved=0CDsQ9QEwCA Image #5 Hallux valgus or Bunion Image #6 Metatarsus Adductus Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.drwolgin.com/SiteImages/bunion%2520ap%2520photo%2520w%2520text.jpg&imgrefurl=http://www.drwolgin.com/Pages/Bunion.aspx&h=640&w=490&sz=329&tbnid=K9M28fngp1hCmM:&tbnh=131&tbnw=100&zoom=1&usg=__rMGLgnHhEzLZ_GTousMFu8Hmk34=&docid=m-kcYVWfn9NMxM&sa=X&ei=EpCKUuQ1yJ2IB-qqgeAE&ved=0CDQQ9QEwBA Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.

fpnotebook.com/_media/OrthoPedsFootMTAbottom.jpg&imgrefurl=http://www.fpnotebook.com/ortho/peds/MtrsAdcts.htm&h=486&w=441&sz=36&tbnid=pfdfu_6xkcKUPM:&tbnh=129&tbnw=117&zoom=1&usg=__pMPJ_T8qVo1VnaDZTPmweKEFSCs=&docid=3KtHwTNNxIRtoM&sa=X&ei=nCmKUv3rFuT6iQfL8ICAAw&ved=0CC8Q9QEwAw Image #7 Morton’s Toes Image #8 Heel Spurs Retrieved from: http://www.google.com.ph/imgres?imgurl=http://a3.ec-images.myspacecdn.com/profile01/151/571a82bb613b4a8bac24504f516f4f22/p.jpg&imgrefurl=http://www.myspace.com/bombtwinz/photos/error&h=168&w=170&sz=8&tbnid=BwBTVvhHJxSKBM:&tbnh=129&tbnw=131&zoom=1&usg=__utRFUypp1D57vSbyiDJb48LWSmg=&docid=7N4zj8baBsweRM&sa=X&ei=xNGKUoCSCs-uiQfe34DYAw&ved=0CDsQ9QEwBw Retrieved from: http://healthfavo.

com/heel-spur-or-calcaneal-spur.html Image #9 Skew Foot Image #10 Hugland’s Deformity Retrieved from: http://www.google.com.ph/imgres?imgurl=http://imaging.cmpmedica.com/consultantlive/images/photo_clinic_03/2003/w_0302ConPPE3SkewA.jpg&imgrefurl=http://www.consultantlive.com/display/article/10162/33387&h=209&w=266&sz=15&tbnid=sVy4YrQ3sIkMgM:&tbnh=111&tbnw=141&zoom=1&usg=__Pl3AvYL2nwGLb3SQUEOk5STygoE=&docid=xnPKzajDAH6lAM&sa=X&ei=oeSKUrejB-iwiQf7pYGQAw&ved=0CC0Q9QEwAQ Retrieved from: http://www.google.com.ph/imgres?imgurl=http://www.

myfootshop.com/images/medical/ortho/haglunds_deformity_mod.jpg&imgrefurl=http://www.myfootshop.com/detail.asp?condition%3Dhaglunds%2520deformity&h=313&w=489&sz=42&tbnid=8QKes-_HVdvUrM:&tbnh=113&tbnw=177&zoom=1&usg=__7tZcArMeRm_UnQR-MFeSUqB7DXg=&docid=C6mp_daeOpxPVM&sa=X&ei=p_SKUrDQC4aEiAfoxoHgAg&ved=0CDAQ9QEwAQ