A
Amputation
The word amputation generally means the severing or removal of a limb or part of a limb.
It is important to differentiate between amputation as a result of a surgical procedure and amputation due to a traumatic accident. Amputation as a surgical procedure is usually only carried out as a last resort to save the life of a patient or when a limb is so severely diseased that no recovery is possible.
Causes of Amputation
Some of the reasons that make a surgical amputation necessary may be: accidents, infections, gangrene or cancer. Emergency amputations are sometimes carried out at the scene of accidents by emergency medical teams when the victims are trapped in such a way that there is no other way to save their lives. There are still a number of amputations as a punishment for certain crimes.
Ankle-Foot Orthoses (AFOs)
AFOs are designed to provide support, proper joint alignment to the foot and ankle, assist or substitute for muscle weakness, and protect the foot and lower limb. This type of orthoses typically comes in either metal or plastic and come in rigid, semi-rigid and articulated.
Achilles Tendonitis
Achilles Tendonitis is a condition of irritation and inflammation of the large tendon in the back of the ankle. Although it is the largest tendon in the body, it is also the weakest and most prone to injury. It is also the most injury-prone due to its limited blood supply and the enormous stress placed upon it. The condition usually occurs in middle-aged athletes. Achilles tendonitis can worsen if not treated properly, so address the problem promptly as it will not go away on its own!
If your calf muscles ache or your Achilles tendon feels swollen or tight, you may be suffering from the condition.
Symptoms
- Pain, irritation and stiffness of the Achilles tendon and calf
- Inflammation of the Achilles tendon and surrounding area
- Limited range of movement
Causes
- Excessive rolling inward of the foot (over-pronation) while walking is the most common cause of Achilles tendonitis
- Flat feet or collapsed arches
- Short Achilles tendon
- Tight calf muscles
- Heel bone deformity
- Inadequate stretching prior to activity
- Improperly fitted shoes
- Inadequate arch support
- Sudden increase in physical/athletic activity
- Chronic overuse
- Direct trauma or injury to the tendon
Treatment and Prevention
If you are suffering from Achilles Tendonitis we can help. Come in for a free fitting and our qualified staff will advise on products to help relieve your Achilles tendonitis pain.
Bear in mind that Achilles Tendonitis injuries can worsen if they are not treated properly. Achilles Tendonitis injuries can be treated in a few different ways, depending on the severity of the injury.
- Proper foot support is crucial.
- Athletes, particularly runners, should incorporate a thorough stretching program to properly warm-up the muscles. They should decrease the distance of their walk or run, apply ice after the activity and avoid any uphill climbs. Athletes should use an orthotic device, heel cup, or heel cradle for extra support.
- If you are suffering from Achilles Tendonitis, excessive stretching could make the problem worse. Light stretches on the calf can also be helpful for the condition.
- A heel cup or heel cradle elevates the heel to reduce stress and pressure on the Achilles tendon. The device should be made with light-weight, shock absorbing materials. An orthotic device can be used to control over-pronation, support the longitudinal arch, and reduce stress on the Achilles tendon.
- Proper footwear help you walk properly and correct your balance can also help treat Achilles Tendonitis symptoms.
Ankle Pain
Ankle pain refers to any pain or discomfort in the ankles that may be caused by a variety of issues, from an injury to a medical condition.
Recommendations
Rest, Ice, Compression and Elevation. See a podiatrist to rule out a fracture or a ligament tear. Immediate treatment often results in complete healing and a return to normal function. For a recent injury, we recommend cold therapy, the Aircast ankle walker, and gel insoles. For ongoing, occasional ankle pain, we highly recommend arch supports or the ankle supports.
Shoe Recommendations
The high ankle shoes are designed to treat ankle varus, ankle varus is a condition where the ankles roll out, diminishing the stability and overall alignment of the body.
Arch Pain
Each foot has two arches – the longitudinal arch which runs the length of the foot, and the transverse arch which runs the width. The 26 bones, ligaments & muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact. Arch pain can occur whenever something goes wrong with the function or interaction of any of these structures.
Causes
Direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment, stress fractures, overuse, inflammatory arthritis, the tightness (or lack of) in the joints of the foot may all cause arch pain.
Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is the thick, connective tissue which supports the arch on the bottom of the foot. It runs from the heel forwards to the heads of the metatarsals. When the plantar fascia is damaged, the resulting inflammatory response may become a source of arch pain.
Stress fractures, plantar fasciitis, and acute and chronic arthritis are most commonly the result of repetitive micro-trauma injuries. Factors that commonly contribute to this type of injury can be running on uneven surfaces or surfaces that are too hard or too soft, wearing unsupportive shoes that have poor shock absorption qualities, or overdoing repeated bouts of exercise.
Symptoms
Pain and tenderness associated with plantar fascia strains are usually felt on the bottom of the foot, or at the heel area. Generally, in mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot “warm up”, but in more severe cases, pain may increase as use of the foot increases, or when the arch is stressed.
Point tenderness and looseness of a joint are indicators of a ligament sprain/fracture. Muscle injury may be present if pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance.
The tissues that compose the arch do not provide much protection. Things like stepping on a rock & other blows to the foot can result in pain, discolouration, swelling etc. These symptoms & any changes in how you walk may indicate more serious damage.
Proper evaluation and diagnosis of arch pain is essential in planning treatment. Four grades can be used to describe arch pain:
- Pain during activity only
- Pain before and after activity,but not affecting performance
- Pain before, during, and after athletic activity which does affect performance, and
- Pain so severe that performance is impossible.
Treatment
When you first begin to notice discomfort or pain in the area, you can treat yourself with rest, ice, compression, and elevation (RICE). One of the most successful, and practical treatments recommended by doctors are orthotic devices, sometimes referred to as arch supports.
Orthotics take various forms and are constructed of various materials, usually best recommended by your doctor to address the severity of your problem. All orthotic devices serve to improve foot function and minimize stress forces that could ultimately arch pain.
- Modification of activity – e.g. substituting high impact activities like running, with cycling & swimming etc may be advised..
- Purchase new shoes – Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months, more often if there is heavier usage.
- Custom Orthotics or Over the Counter Arch Supports may also improve the biomechanics of the foot & help ease the arch pain.
- Focus on muscle strengthening and flexibility. You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced.
- Follow up with your Doctor until you are better. They should advise on a plan for a gradual return to normal activities, once the pain is reduced and muscle strength and flexibility are restored.
Athlete’s Foot
Athlete’s foot is a skin infection caused by a fungus, usually occurring between the toes or on the soles of the feet. The signs of athlete’s foot can include dry skin, itching, scaling, and blisters. Blisters often lead to cracking of the skin. When blisters break, small raw areas of tissue are exposed, causing pain and swelling.
Treatment
Daily washing of the feet with soap and water or quality anti-fungal soap; drying carefully, especially between the toes; and changing shoes and socks regularly to decrease moisture. Reduce perspiration by using foot powder in shoes, and wear shoes of leather or canvas, or perhaps nylon mesh, which allow good air circulation. Avoid walking barefoot and use shower shoes whenever possible.
B
Brachial Plexus Injury
It is also called Erb’s Palsy or “Waiter’s tip” is an injury to the brachial plexus resulting in weakness or paralysis of the upper extremity. The patient often has an arm that hangs limp and is internally rotated at the shoulder. The elbow is extended but flexion of the wrist and fingers are preserved with the palm potentially facing up. This injury is common with difficult births (2-3 per 1000 births) symptoms will sometimes resolve with immobilization however, if no improvement is seen surgery is indicated.
Back pain relief products
Although the most common type of back pain comes from straining the bands of muscles surrounding the spine, it is not at all uncommon for back pain to be traced back to foot problems such as severe pronation. When your weight is improperly distributed across the feet your walking gait becomes uneven. This places greater strain on your ankles, knees, and even your lower back which over time may result in painful repetitive stress injuries. Wearing supportive shoes, especially when you exercise, or fitting your shoes with arch support inserts can be highly effective in preventing lower back pain and even relieving some lower back pain in its earliest stages.
For chronic or acute back pain footwear corrections alone will probably not provide adequate back pain relief. The use of a back support or back brace is recommended (and of course for persistent or severe back pain the value of a doctor’s diagnosis and treatment cannot be over-stated). Back supports and back braces allow for more ergonomic heavy lifting on the job, reduce the incidence of muscle spasms, and alleviate many types of back pain.
Ball of foot pain / Metatarsalgia
The metatarsal area is the region where the toes join the rest of the foot, an area often subjected to added pressure because of body weight., Metatarsalgia (commonly referred to as ball-of-foot pain)can occur in the region between the arch and the toes. Pain results when the balance between the metatarsal bones (long foot bones) is thrown off.
Metatarsalgia foot problem can be caused by several factors, including the following:
- Increased pressure on the metatarsal heads
- Wearing constricting footwear or high heel shoes
- Ligament injuries and joint irritation
- Calluses or skin lesions that cause the weight on the foot to be unevenly distributed
- Aging, which tends to thin out or shift the fatty tissue of the foot pad
- Activities that place tremendous pounding on the ball of the foot, such as jogging.
Treatment and Prevention
The vast majority of causes of Metatarsalgia can be alleviated or solved by the use of arch supports and better fitting shoes. Other treatments options for Metatarsalgia include:
- Taking anti-inflammatory medications can help reduce Metatarsalgia pain
- Choosing better shoes, such as low-heeled over high-heeled shoes
- Adding ball-of-foot cushions/ metatarsal pads to your shoes can reduce shock to the ball of the foot and provide cushioning to feet that have thinning fat pads
- Metatarsal pads can take pressure off very specific spots on the ball of the foot
Bunions
Bunions are a very common condition that affects women significantly more than men due to poorly fitted footwear. A bunion is a bony protrusion that can occur at the base of the big toe joint. This bony lump can cause friction and pain when wearing shoes. Bunions are frequently associated with inflammation of the bursa, a fluid-filled sac that helps cushion the bones of the foot. Another type of bunion, called a Tailor’s bunion or bunionette, forms on the outside of the foot on or at the base of the little toe joint. Smaller than a typical bunion, it is caused when the little toe is pressed in towards the big toe. With continued displacement of the big toe towards the smaller toes, a bunion can lead to the big toe resting under or over the second toe (a common condition called overlapping toes). It also can lead to a toe muscle deformity called hammer toes.
Symptoms
- Inflammation of the affected toe joint, foot and surrounding area
- Soreness on the side of the big toe
- Discomfort or pain when walking or wearing shoes
- Callus formation under the protrusion
- Difficulty fitting into shoes
Causes
- Excessive rolling inward of the feet (over-pronation) while walking
- Various arthritic, genetic and neuromuscular diseases
- Abnormal foot function
- Improperly fitted shoes
- Wearing shoes with a small toe box, especially common with dress shoes and boots that taper in the toe area
Treatment and Prevention
- In the early stages of bunion formation, soak feet in warm water
- Wear properly fitted shoes
- Wear a special bunion pad such as a bunion shield, gel sleeve, or gel toe cap to restore comfortable mobility.
- You can prevent a small bunion from becoming painful by wearing well-fitting shoes that have a roomy toebox and supplementing them with arch supports or orthotic insoles to ensure that your weight is evenly distributed across your foot.
- Gel toe separators promote comfortable toe spacing and can provide relief when a person’s bunion has progressed to the point where their big toe sits above or below the toe beside it.
- Wear rocker soled shoes to relieve pressure on the bunion
- Wear night splints
- If left untreated, surgery may be necessary
C
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition in which the median nerve is squeezed where it passes through the wrist. This often happens because the tendons in the wrist have become swollen and they press on the nerve. The median nerve controls some of the muscles that move the thumb and it carries information back to the brain about sensations in your thumb and fingers.
When the nerve is squeezed it can cause pain, aching, tingling or numbness in the affected hand. The symptoms tend to be worse at night and may disturb your sleep, but you may notice it most when you wake up in the morning. Hanging your hand out of bed or shaking it around will often relieve the pain and tingling.
You may not notice the problem at all during the day, though certain activities – such as writing, typing – can bring on symptoms. Sometimes the condition can be mistaken for something else. For example, pressure on nerves in the neck due to disc problems or arthritis can cause similar symptoms. A nerve conduction test may help if there’s any doubt about the diagnosis.
What causes carpal tunnel syndrome?
Carpal tunnel syndrome is a common problem. It’s often caused by work-related activities, such as typing, and repetitive movements, although some cases may be related to arthritis of the wrist, thyroid disease and pregnancy. Your risk of developing it may be greater if your job places heavy demands on your wrist or if you use vibrating tools.
Treatment:
If there’s a particular cause, like an underactive thyroid or arthritis, treating that condition may help. Other treatment will depend on how severe the nerve compression is. It’s important to get help quickly if your hand muscles are weak.
- Splints
Wearing a resting splint can help prevent the symptoms occurring at night, or a working splint can be useful if your symptoms are brought on by particular activities. Splint prevents your wrist from bending thus preventing compressing the nerve. Your doctor can advise on where you can be fitted with a splint.
- Steroid injections
To reduce inflammation, your doctor can give you a steroid injection into your carpal tunnel. The injection may be uncomfortable, but the effects can last for weeks or months.
- Surgery
When the symptoms are severe and do not improve with above measures then surgery may be needed. A carpal tunnel release is the simple procedure involving releasing the ligament that forms the top of the tunnel on the palm side of the hand, therefore easing the pressure on the nerve.
Charcot Foot
Charcot foot is a sudden softening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the arch collapses and the foot takes on a convex shape, giving it a rocker-bottom appearance, making it very difficult to walk.
Prevention Is Key
In most cases of Charcot foot, only minor trauma causes the foot arch to collapse, so in order to prevent this possible outcome, it’s important to spend time examining your feet and wearing shoes that offer both comfort and support. People with Charcot foot or diabetes wear good, supportive shoes with a soft insole of micro cellular rubber to absorb shock. Extra depth oxfords are also a good choice for people suffering from Charcot foot.
Preventive Care
The patient can play a vital role in preventing Charcot foot and its complications by following these measures: Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. Get regular check-ups from a foot and ankle surgeon. Check both feet every day and see a surgeon immediately if there are signs of Charcot foot. Be careful to avoid injury, such as bumping the foot or overdoing an exercise program. Follow the surgeon’s instructions for long-term treatment to prevent recurrences, ulcers and amputation.
Cerebral Palsy (CP)
It is a term used to describe a group of disorders that affect movement control. It can be caused by injury to the brain before, during, or after birth. Cerebral palsy may be acquired after birth secondary to an accident, head injury or infections such as bacterial meningitis or viral encephalitis. Symptoms vary with each case.
D
Degenerative Joint Disease (DJD)
DJD is also referred to as osteoarthritis (OA) It may affect over 80% of people over the age of 60. Arthritis is a general term used for many conditions that result from the degenerative changes of the joint and its structures. DJD describes a slow and progressive loss of the cartilage structures that function as a shock absorber between two bones. Cartilage helps to provide a barrier and helps keep the joints flexible. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bone, causing further pain and stiffness.
Diabetes
Diabetes is a metabolic disorder in which the body does not produce or properly utilize the hormone “insulin”. Our bodies digest food for growth and energy in the form of glucose (sugar in the blood). Glucose is the main source of fuel for the body. After digestion the glucose passes into the bloodstream where it is used by the cells for growth and energy; transportation is accomplished by insulin a hormone produced in the pancreas. The amount of insulin produced by our body is regulated by what we eat. Patients that suffer from diabetes produce too little insulin and therefore cannot process the glucose properly. When this occurs, glucose overflows into urine and is passed out of the body. This translates into a decrease of fuel to the body.
This disease is categorized as Type I or Type II and has a significant effect on other systems and can lead to cerebrovascular and coronary artery complications, peripheral vascular impairment; visual impairment; and peripheral and autonomic nervous system impairments. To prevent ulcerations, skin breakdown and abrasions, patients are observed carefully for signs and symptoms of diabetic neuropathy, such as numbness or pain in the hands and feet, decreased vibratory sense, foot drop, and neurogenic bladder.
Diabetic Foot
Diabetes is a serious disease that can develop from the lack of insulin production in the body or due to the inability of the body’s insulin to perform its normal everyday functions. (Insulin is a substance produced by the pancreas gland that helps process the food we eat and turn it into energy.)
Diabetes disrupts the vascular system, affecting many areas of the body, such as the eyes, kidneys, legs, and feet. Indeed people with diabetes should pay special attention to their feet.
Did you know that diabetic foot wounds are the leading cause of hospitalization for diabetics?
Diabetic feet are vulnerable to the same foot problems as other feet: blisters, bunions, calluses, corns, athlete’s foot and other common foot conditions. Diabetic feet are simply less able to meet the challenge of maintaining healthy feet when confronted with external damage and environmental stresses. It is important to remember that severe and disabling diabetic foot problems are not inevitable. Even if you have suffered from diabetic foot complications in the past, controlling your blood sugar level, wearing diabetic shoes and socks at all times, using diabetic foot care products as needed, and practicing proper diabetic foot care techniques on a daily basis can improve and preserve the health of your diabetic feet.
Guidelines for Caring for Diabetic Feet
Prevent and Treat Diabetic Foot Problems Before They Affect Mobility
Diabetic foot problems are not inevitable and healthy diabetic feet are an achievable goal. There are two basic principles to a successful diabetic foot care plan: attention and prevention. Even for those who suffer from diabetic neuropathy or poor circulation, performing daily self-exams on your diabetic feet and taking immediate action at the first sign of diabetic foot complication symptoms can dramatically decrease your risk of developing diabetic foot ulcers and diabetic foot infections. Wearing diabetic shoes and socks at all times and using diabetic foot care products such as diabetic foot cream as needed, can help prevent diabetic foot injuries before they occur.
Your Daily Diabetic Foot Care Routine
To maintain healthy diabetic feet, do these things every day.
- Inspect your feet using our diabetic foot self-examination guidelines.
- Wash your feet with warm water and mild soap.
- Pat your feet dry rather than rubbing. Make sure your entire foot including the skin between your toes is dry.
- If you have dry skin, apply a diabetic foot lotion or cream to the top and bottom of each foot. Pay special attention to heels which can become dry and cracked. Do not apply lotion or cream to the skin between the toes.
- If your feet tend to sweat, use diabetic foot powder to prevent bacterial growth.
- Wear diabetic shoes and diabetic socks at all times, even when walking around your own home.
- Look inside your shoes for pebbles, sand, and other skin irritants before putting them on.
- Change your shoes and socks at least twice a day and more frequently if your feet tend to perspire. This gives shoes a chance to air out and prevents your feet from becoming overly accustomed to a single shoe’s sole.
How to Self-Examine Diabetic Feet and What to Look For
The first thing to remember when self-examining diabetic feet is to be thorough. Examine the top, bottom, and sides of each foot as well as the heel and in between the toes. If you have trouble seeing the bottoms of your feet, diabetic foot mirrors are available to assist you.
If you notice the following diabetic foot problems administer first aid as needed; then contact your doctor.
- Cracking skin between the toes. This is often a sign of athlete’s foot.
- Usually blisters are caused by friction, but they can also be the result of burns. Do not puncture a blister! Apply ointment and a bandage to the affected area.
- Small Cuts. Rinse the wound. Apply antibacterial cream to the affected area and cover with gauze and hypoallergenic tape.
- Dry Heels. This can lead to skin cracking which can in turn lead to diabetic foot ulcers. Apply a moisturizing diabetic foot cream or lotion. If cracks have already appeared contact your doctor immediately.
- Foot Swelling. Some diabetics use compression socks or hosieryto reduce diabetic foot swelling. This is not the right choice for all diabetic patients, so be sure to consult your doctor before beginning self-treatment.
- If you have no open foot sores, very mild calluses can be treated using the Personal Pumi Baron damp skin. Moderate and severe calluses must be trimmed by a podiatrist.
- Sores and diabetic foot ulcers.These most often occur on the ball of the foot or on the bottom of the big toe. When they occur on the sides of the foot it is usually a sign that your shoes are the wrong size. See a podiatrist for treatment immediately. If left untreated, ulcers in particular, can lead to gangrene and amputation.
- Changes in the color of skin on the feet.
- Changes in the temperature of the skin.
- Ingrown or fungus-infected toenails.
Diabetic Shoes
Just because you’re diabetic, it doesn’t mean you only have a few options when it comes to selecting fashionable diabetic shoes. At orthoshoes.com, we offer a grand selection of diabetic shoes that are not only functional and comfortable, but stylish. In addition to providing wound care and postoperative shoes for diabetics, we offer diabetic dress shoes, work shoes, boots, and other diabetic footwear that can help diabetics lead full and active lives without fearing for their feet.
Proper footwear is an important part of an overall treatment program for people with diabetes, even for those in the earliest stages of the disease. If there is any evidence of neuropathy or lack of sensation, wearing the right footwear is crucial. By working with their physician and a footwear professional, such as a certified pedorthist, many patients can prevent serious diabetic foot complications.
Objectives
Footwear for people with diabetes should achieve the following objectives:
- Relieve areas of excessive pressure. Any area where there is excessive pressure on the foot can lead to skin breakdown or ulcers. Footwear should help to relieve these high pressure areas, and therefore reduce the occurrence of related problems.
- Reduce shock and shear. A reduction in the overall amount of vertical pressure, or shock, on the bottom of the foot is desirable, as well as a reduction of horizontal movement of the foot within the shoe, or shear.
- Accommodate, Stabilize and Support Deformities. Deformities resulting from conditions such as Charcot-Marie-Tooth, fat pad atrophy, hammertoes and amputations must be accommodated. Many deformities need to be stabilized to relieve pain and avoid further destruction. In addition, some deformities may need to be controlled or supported to decrease progression of the deformity.
- Limit motion of joints. Limiting the motion of certain joints in the foot can often decrease inflammation, relieve pain, and result in a more stable and functional foot.
Choosing the Proper Shoes
If you are in the early stages of diabetes, and have no history of foot problems or any loss of sensation, any properly fitting shoe made of soft materials with a shock absorbing sole may be all that you need. It is also important for patients to learn how to select the right type of shoe in the right size, so that future problems can be prevented. The excessive pressure and friction from the wrong kind of shoes or from poorly fitting shoes can lead to blisters, calluses and foot ulcers, not only in the insensitive foot, but also in feet with no evidence of neuropathy. It is highly recommended that shoe fitting for patients with any loss of sensation be done by a professionally trained person who has vast experience.
In achieving proper shoe fit, both the shape and size of the shoe must be considered. You should try to match the shape of the shoe to the shape of your foot. This means that you should be sure your shoes have adequate room in the toe area, over the instep, and across the ball of the foot, and there should be a snug fit around the heel. When considering your correct shoe size, remember that the width is just as important as the length. The proper shoe size is the one where the widest part of the foot, which lies across the foot at the base of the toes, is in the widest part of the shoe. There should also be 3/8 to 1/2 inch between the end of the shoe and the longest toe. In addition, a shoe with laces is recommended to provide the adjustability needed for any swelling or other deformities and to allow the shoe to be fit properly without any danger of slipping off.
Prescription Diabetic Footwear
Many patients with diabetes need special footwear prescribed by a physician. Prescription footwear for patients with diabetes includes:
Healing Shoes
Immediately following surgery or ulcer treatment, some type of shoe may be necessary before a regular shoe can be worn. These include custom sandals (open toe), heat-moldable healing shoes (closed toe), and postoperative shoes. Visit our selection of wound care shoes.
Extra-depth Shoes
The extra-depth shoe is the basis for most footwear prescriptions. It is generally an oxford-type or athletic shoe with an additional 1/4- to 1/2-inch of depth throughout the shoe, allowing extra volume to accommodate any needed inserts or orthoses, as well as deformities commonly associated with a diabetic foot. Extra-depth shoes also tend to be light in weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot.
External Shoe Modifications
This involves modifying the outside of the shoe in some way, such as modifying the shape of the sole or adding shock-absorbing or stabilizing materials.
Orthoses or Inserts
An orthosis is a removable insole which provides pressure relief and shock absorption. Both pre-made and custom-made orthoses or inserts are commonly prescribed for patients with diabetes, including a special “total contact orthosis,” which is made from a model of your foot and offers a high level of comfort and pressure relief.. Whether a pre-made orthotic, a custom orthotic, or a prescribed orthotic is the right choice for you will depend on the severity of your foot condition.
Custom-made Shoes
When extremely severe deformities are present, a custom-made shoe can be constructed from a cast or model of the patient’s foot. These cases are rare. With extensive modifications of in-depth shoes, even the most severe deformities can usually be accommodated.
Conclusion
Hope Center takes good care of your feet and make sure you have the right foot wear. Whether you have been recently diagnosed or have had diabetes for many years, proper footwear can help prevent serious foot problems. Be sure to talk to your physician about the type of shoes, modifications and orthoses that are right for you.
- Links to Diabetic shoes
E
Epicondylitis
It is an inflammation or damage to the area of an epicondyle of bone. An epocondyle is a projection of bone above condyle (a rounded prominence at the end of a bone usually where the bone connects to another bone) where ligament and tendons are attached.
Flat Feet
Flat feet can be present at birth, an early age, or can be hereditary. All too often, flat feet develop as a result of foot abuse, including wearing shoes that do not provide proper arch supports, standing or walking for long periods of time in high heels, or aging or heavy strain place on the feet. When the arch is fully collapsed or rolls inward, you have flat feet, meaning you are missing crucial arch support. People with flat fleet must therefore shift pressure from walking to other parts of the foot, which can cause intense pain. If left untreated, flat feet not only cause pain, but can lead to other more serious foot and lower body joint problems.
Recommendation for Treatment
Flat feet can be treated with supportive shoes and orthotics, for the shoes that support the arch. Footwear with a firm heel counter is recommended for extra support and stability.
F
Fracture Orthoses
Immobilization of Injured Area
It is also imperative the fracture site be immobilized while the bones are allowed to heal together in proper alignment. If motion is allowed at the onset of the rehabilitation process there is a high incidence of mal-union and/or poor reduction/alignment.
Reduction
This refers back to immobilization. The objective of a fracture orthosis is to maintain compression of the limb to in effect maintain alignment of the fracture.
Flat Feet
Flat feet can be present at birth, an early age, or can be hereditary. All too often, flat feet develop as a result of foot abuse, including wearing shoes that do not provide proper arch supports, standing or walking for long periods of time in high heels, or aging or heavy strain place on the feet. When the arch is fully collapsed or rolls inward, you have flat feet, meaning you are missing crucial arch support. People with flat fleet must therefore shift pressure from walking to other parts of the foot, which can cause intense pain. If left untreated, flat feet not only cause pain, but can lead to other more serious foot and lower body joint problems.
Recommendation for Treatment
Flat feet can be treated with supportive shoes and orthotics, for the shoes that support the arch. Footwear with a firm heel counter is recommended for extra support and stability.
G
Golfer’s Elbow
Also called Medial Epicondylitis is indicated by increased pain over the inner or medial side of the elbow. It is often a result of small tears in the flexor tendons that attach at the elbow.Common symptoms include: pain over the inside of the elbow, pain when lifting, or pain when flexing and supinating (turning your palm upward)
Common symptoms include: pain over the inside of the elbow, pain when lifting, or pain when flexing and supinating (turning your palm upward).
H
Heel Pain
Heel pain is a very common foot pain and it can be caused by several conditions or stressors. The heel bone is the largest bone in the foot and the first to hit the ground while moving, inviting a lot of stress to the heel area. Heel pain is generally due to an incorrect walking gait that puts too much stress on the heel bone and the soft tissues attached to it. Most common in active people 40 years old and older, heel pain oftentimes develops when there is an irritation in the ligament that runs along the bottom of the foot to the heel (plantar fascia). This can cause heel pain to occur in the front, back or bottom of the heel. Most people experience heel pain due to Plantar Fasciitis, Achilles Tendonitis, heel spurs or an injury.
Children’s heel pain has different causes than adult heel pain. If you’re interested in learning about children’s heel pain, please visit our Sever’s disease page.
Causes
Heel pain is usually caused by Plantar Fasciitis, which is inflammation and strain to the plantar fascia (the ligament that runs from the toe joints to the heel). Achilles Tendonitis is inflammation of the Achilles Tendon, which creates pain at the back of the heel. A heel spur is an abnormal bone growth that occurs on the heel bone where an injury or inflammation takes place.
Heel pain could also occur from an injury, feet repeatedly putting pressure on hard surfaces or being overweight.
Prevention
Orthopedic shoes with a shock-absorbing sole will protect the heel bone against injuries from hard surfaces. If you pronate incorrectly, wear arch supporting insoles and supportive shoes to correct your gait, reducing stress on your plantar fascia. Properly stretch your calves, Achilles Tendon and plantar fascia ligament in your feet to reduce chances of inflammation.
Treatment
Prevent and treat heel pain by wearing supportive and cushioning shoes and insoles. Insoles can be worn to support and cushion the feet, while preventing incorrect pronation which can eventually cause pain. Heel lifts will reduce the strain on the Achilles Tendon and heel cushions will soften the step for aching heels. After you feel heel pain, rest the injured foot, and use ice or anti-inflammatory medications to reduce pain and swelling. Use our doctor-recommended products to support your arch and foot to reduce heel pain or use our wound care products to protect your heel from stressors. If you are experiencing heel pain, have your foot evaluated by a doctor to learn about the cause and treatment options appropriate for you.
Heel Spurs
A heel spur is an abnormal growth of the heel bone, the largest bone in the foot which absorbs the greatest amount of shock and pressure. Calcium deposits form when the plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking.
Causes
Over-pronation (flat feet) is a common foot pain caused by heel spurs, 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.
The key is to identify what is causing excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support will help reduce the over-pronation and thus allow the condition to heal.
Other common treatments for heel spurs include:
- Stretching exercises
- Losing weight
- Wearing shoes that have a cushioned heel that absorbs shock
- Elevating the heel with the use of a heel cradle, heel cup, or orthotics.
We offer a wide selection of foot and heel comfort products. For example, heel cradles and heel cups provide extra comfort and cushion to the heel, reducing the amount of shock and shear forces experienced from everyday activities. Visit us in store and get a free fitting and free digital foot assessment.
K
Knee Orthosis
Functional knee orthoses are designed to aid in the stability of the knee joint secondary to ligament injury, postoperative reconstruction, meniscus damage, and for preventative protection. These orthoses are designed to provide maximum stability to the knee joint. Injury to the ligaments of the knee cause unwanted motion between the femur and the tibia. If left untreated, this can create significant joint laxity, lead to degenerative joint changes and put the patient at risk for further injury and cause subsequent damage to the surrounding structures. Functional knee orthoses can be made by the patient’s measurements or by a custom model of the patient’s leg.
M
Metatarsalgia
The metatarsal area is the region where the toes join the rest of the foot, an area often subjected to added pressure because of body weight., Metatarsalgia (commonly referred to as ball-of-foot pain)can occur in the region between the arch and the toes. Pain results when the balance between the metatarsal bones (long foot bones) is thrown off.
Metatarsalgia foot problem can be caused by several factors, including the following:
- Increased pressure on the metatarsal heads
- Wearing constricting footwear or high heel shoes
- Ligament injuries and joint irritation
- Calluses or skin lesions that cause the weight on the foot to be unevenly distributed
- Aging, which tends to thin out or shift the fatty tissue of the foot pad
- Activities that place tremendous pounding on the ball of the foot, such as jogging.
Treatment and Prevention
The vast majority of causes of Metatarsalgia can be alleviated or solved by the use of arch supports and better fitting shoes. Other treatments options for Metatarsalgia include:
- Taking anti-inflammatory medications can help reduce Metatarsalgia pain
- Choosing better shoes, such as low-heeled over high-heeled shoes
- Adding ball-of-foot cushions/ metatarsal pads to your shoes can reduce shock to the ball of the foot and provide cushioning to feet that have thinning fat pads
- Metatarsal pads can take pressure off very specific spots on the ball of the foot
O
Orthosis
An orthopedic appliance or apparatus used to support, align, prevent, or correct deformities or to improve the function of movable parts of the body. Orthoses are also called braces or calipers. Plural orthoses
Orthoses are named according to what bones, joints, portion or the body they encompass:
Spinal/Neck/Back
• CO = Cervical orthosis or neck brace
• LSO = Lumbo-sacral orthosis = back support
• TLSO = Thoraco-lumbo-sacral orthosis = back support/body brace
Lower Extremity
• AFO = Ankle foot orthosis
• FO = Foot orthosis = foot insert or foot orthotic
• HKAFO = Hip knee ankle foot orthosis
• KO = Knee orthosis or knee brace
• KFO = Knee ankle foot orthosis
Upper Extremity
• HO = Humeral orthosis
• EO = Elbow orthosis
• WO = Wrist orthosis
• WHO = Wrist hand orthosis
• SEWHO = Shoulder elbow wrist hand orthosis
P
Prosthetics – Replacements for Missing Limbs
Prosthetics is the term used for all aids, which replace missing limbs or body parts. They are employed whenever a physical deficit needs to be compensated for, after for example the amputation of a body part caused through accident (trauma), vascular diseases, diabetes, congenital disorders, cancer or degenerative tissue disease. Prosthetics have a very wide range of applications, from replacement fingers to artificial legs. They vary greatly in appearance and in use. What was in the past a simple peg-leg, is today a highly specialized and individually tailored high tech carbon fiber prosthetic leg, sometimes with the refinement of knee joint controlled by a micro-processor. There have also been remarkable developments in the field of arm prosthetics. Steel and leather prosthetics, which are operated by means of belts and muscle movement alone, are now being replaced by myoelectric devices, incorporating small battery driven motors to carry out hand functions. Naturally, there are still wood and leather prosthetics around, but these are becoming rarer. New low weight materials (i.e. carbon fiber) with better functionality or with a more lifelike and natural appearance (silicon cosmetic covers) have greatly improved conditions for prosthetic wearers. The level of amputation and needs and abilities of the patient are paramount in deciding which prosthesis is most suitable for each individual. Training in the care and use of the prosthesis by specially trained therapists is essential.
Recognized leader in Pakistan
The Hope Rehabilitation Center offers a full range of prosthetic/orthotic services. It is a recognized leader in improving the lives of people with disabilities through the use of the latest in prosthetic and orthotic technology.
Prosthetics in Pakistan
The Hope Rehabilitation Center offers a full range of prosthetic/orthotic services. It is a recognized leader in improving the lives of people with disabilities through the use of the latest in prosthetic and orthotic technology.
Innovative Technology & Traditional Quality of ‘HOPE’
Hope’s modern facility is a key to providing best quality and superior patient care. We offer innovative technology and quality treatment combined with a professional “patient friendly” and respectful environment. Or patients and referring professionals continually comment to our staff that our facilities are the most professional, comfortable, and friendly they have ever visited. Such unique experiences are the essence of Hope Orthotic and Prosthetic Systems.
Our facility is managed by dedicated practitioners/partners who have spent years obtaining a formal education in medicine, surgery and engineering and expanding their knowledge by regularly attending continuing education programs. We stress on intensive continuing education for the entire staff. We regularly conduct in-service lectures and demonstrations for our practitioners and other members of the rehabilitation team at our facilities or in clinic or hospital settings.
In order for our referring physicians and patients we have 24-hour access to our staff. And true to our national tradition, neither snow nor rain deters us since most of our staff is equipped with at least one drive vehicle and also we have a mobile workshop unit.
Our location is close to the most prestigious hospitals, rehabilitation centers, and nursing homes in its area.
We are proud of our professional stature in the communities we serve and we have a close working relationship with our affiliating physicians, physical therapists, and rehabilitation team participants.
New components, innovative techniques, creative designs, and advanced technologies are all part of the compassionate, goal-oriented treatment each patient receives at House of Orthotic & Prosthetic Excellence (HOPE).
P & O
Prosthetics and orthotics combines knowledge and understanding of the human body with the application of forces and evaluation of mechanical components. Central to prosthetics and orthotics is the prosthetic and/or orthotic user and their psychological, social and cultural needs.
Prosthetics and orthotics is an autonomous profession and practice is characterised by reflection and systematic clinical reasoning, which combine to provide a problem solving approach to patient-centred care.
PROSTHETISTS & ORTHOTISTS
Prosthetists and orthotics assess, diagnose, treat, and manage a broad range of problems associated in particular with the neuromuscular and musculoskeletal systems. They work collaboratively with other health-care professionals to provide integrated treatment.
Prosthetists provide prosthetic management for people who have an amputation or congenital loss of a limb. People can lose their limbs due to diseases such as diabetes, vascular disease, cancer or trauma. Some other people are born without a limb. Prosthetists analyse the mechanical loss and prescribe the most suitable prosthesis to meet these requirements.
Orthotists provide orthotic management for people with a wide range of conditions such as rheumatoid arthritis, cerebral palsy, diabetes, and strokes. These conditions can affect all parts of the body from the feet up to the head. Orthotists assess the patient’s needs, diagnose the problem and treat the patient by prescribing the most suitable orthosis to meet these requirements.
Polio
Poliomyelitis, commonly referred to as polio, is an incurable acute viral infection. If the virus enters the central nervous system, it can cause muscle weakness and flaccid paralysis to affected muscle groups. Spinal polio is most common, and often directly affects muscle groups in the feet and legs. One in every 200 persons infected with polio leads to irreversible paralysis (usually in the legs). Among those paralysed, 5%-10% die when their breathing muscles are immobilized by the virus.
There is no cure for polio. Polio can only be prevented by immunization. A safe and effective vaccine exists – the oral polio vaccine (OPV). OPV is essential protection for children against polio. Given multiple times, it protects a child for life.
Tremendous achievements have been made in the global fight against polio since 1988 when the World Health Assembly resolved to eradicate the disease. The number of polio cases worldwide has decreased by more than 99%, from more than 350,000 in 1988 to 223 cases in 2012. The number of endemic countries has decreased from over 125 in 1988 to just three – Afghanistan, Nigeria and Pakistan.
While polio is essentially a disease of the past, an increasing number of people who have had polio are developing a condition called post-polio syndrome (PPS).
Post-polio syndrome (PPS) can cause a wide range of symptoms which can have a serious impact on everyday life. Fatigue, muscle weakness and muscle and joint pain are just some symptoms that are experienced by polio suffers.
Polio Leg Brace
Poliomyelitis, commonly referred to as polio, is an incurable acute viral infection. If the virus enters the central nervous system, it can cause muscle weakness and flaccid paralysis to affected muscle groups. Spinal polio is most common, and often directly affects muscle groups in the feet and legs.
While polio is essentially a disease of the past, an increasing number of people who have had polio are developing a condition called post-polio syndrome (PPS).
The symptoms of PPS usually develop gradually and can include:
- increasing muscle weakness
- fatigue
- muscle and joint pain
- breathing or sleeping problems
- sensitivity to the cold
Although PPS is rarely life threatening, it can greatly interfere with everyday life, making it difficult to get around or carry out some tasks and activities.
The damage to the nervous system from polio can range from a slight loss of mobility to permanent paralysis of the thigh muscles. Physiotherapy combined with treatment with an orthosis can help the person affected to regain the greatest possible mobility and independence following acute illness.
Polio leg braces can assist a patient in strengthening weak joints, helping to keep the feet and legs in the correct positions, and in preventing deformation and development or recurrence of muscle contractions. They are available in a variety of styles and materials to target various muscle groups and meet the needs of the individual patient. The most common types are
- Ankle-foot orthosis ( AFO )
- Knee-ankle-foot orthosis ( KAFO )
- Hip-knee-ankle-foot orthosis ( HKAFO )
Ankle-foot orthosis (AFO) braces attach just below the knee and keep week ankles from rolling. Knee-ankle-foot orthosis (KAFO) braces are full leg braces that fit around the top of the leg to stabilize knee muscles. Hip-knee-ankle-foot orthosis (HKAFO) braces add an additional corrective belt around the hips to force correct alignment of the legs.
Pes Cavus
Definition
A foot with an excessively high arch.
Overview
Pes cavus occurs in up to 15% of the population, of which 60% will develop foot pain. Common complaints associated with pes cavus include pain under the metatarsal heads and the heel, lateral ankle sprains, and footwear issues. Custom orthoses should be designed to address the pathomechanics of problematic cavus foot based on the evidence in the literature.
Clinical Goal for Orthotic Treatment
The orthosis for the treatment of pes cavus foot must accomplish several specific goals:
- Increase plantar surface contact area.The overload on the metatarsal heads is a result of limited plantar surface contact due to the high arch and limited ankle joint dorsiflexion. Increasing plantar surface contact with an orthosis ensures that more of the foot is bearing weight in the arch and the metatarsal heads are bearing less weight for less time.
- Resist excessive supination. Lateral ankle instability and a laterally deviated subtalar joint axis (STJ) are frequently associated with high arched feet. This lateral position of the STJ axis results in excessive supinatory torque around the subtalar joint axis. The prescribed orthosis should be designed to resist this excessive supination.
- Resist both excessive pronation and supination forces. Rearfoot instability is an extension of the laterally deviated subtalar axis. However, in flexible pes cavus feet, midtarsal flexibility complicates the later portion of the stance phase of gait. The forefoot pathology produces midtarsal joint supination that leads to excessive pronation of the rearfoot. Some pes cavus feet suffer from both lateral ankle instability at midstance and rearfoot pronation at late midstance. It is essential that the prescribed orthoses is designed to provide resistance to both excessive pronation and supination forces.
Plantar Fasciitis
Do you suffer from intense heel or arch pain? It could be Plantar Fasciitis. Plantar fasciitis is a very painful injury, and the most common cause of heel pain. The plantar fascia is a thick band of tissue that runs along the bottom surface of the foot connecting the heel bone to the ball of the foot. Excessive stretching of the tissue while running or walking can cause tiny tears that lead to irritation, inflammation and pain on the bottom of the heel, the arch of the foot or both locations. If left untreated, plantar fasciitis can cause other conditions like heel spurs. Our heel bone is the largest bone in the foot and absorbs the most amount of shock and pressure. Plantar fasciitis is most painful with your first steps in the morning or after a long rest because the plantar fascia contracts and becomes less flexible while you are off your feet. Just like muscle tissue, the plantar fascia contracts and becomes less flexible when it is cold and inactive. The pain may decrease as the day progresses and the plantar fascia is stretched and warmed up with use. However, the pain may return after long periods of standing, walking or running. This is especially common if you are wearing shoes with inadequate arch support.
Causes
With Plantar fasciitis, the bottom of your foot usually hurts either on the heel just slightly inward from the center (which is the most common area of pain), or in the arch of your foot (less common), or in both places. The pain is often acute either first thing in the morning or after standing up after being off your feet for a while. Just like muscles, when the plantar fasciia is cold and inactive, it contracts and becomes less flexible. This is what makes that first step out of bed or after resting so painful. After you walk for a while, the tissue warms up making it more pliable and the pain often subsides somewhat.
- Intense pain in the heel and/or arch (of one foot or both)
- Pain with first steps in the morning or after long periods of rest.
- Over-pronation, or excessive rolling inward of the foot while walking, is the most common cause of plantar fasciitis.
- Tight calf muscles or Achilles tendons, the band of tissue that connects the calf muscles to the heel bone
- Flat feet or high arches
- Improperly fitted shoes
- Inadequate arch support
- Standing, walking or running for long periods, especially on hard surfaces
- Excess body weight
Treatment and Prevention
- There are many ways to help treat and prevent plantar fasciitis:
- Stretch your feet and legs regularly, especially before standing after long periods of rest
- Elevate the injured foot
- Ice and massage your foot
- Wear a night splint to keep plantar fascia stretched
- Choose low-impact alternatives to jogging or aerobics
- Lose excess body weight
- Add gel heel cups
- Add arch supports to your shoes
- Replace shoes that don’t fit or provide adequate arch support
Orthotics and Splimts
- Supportive athletic, casual or dress shoes
- Rocker soled shoes
- Custom arch supports (orthotics)
- Over-the-counter arch supports (orthotics)
- Night splints
- Massage tube
- Foot massage balls
R
Rehabilitation
Rehabilitation includes all measures aimed at reducing the impact of disabling and handicapping conditions and enabling the disabled and handicapped to achieve “Social Integration”. This aim can never be achieved if different professionals work in isolation. So it is of paramount important that all professionals responsible for the rehabilitation of disables, work in close collaboration as a “Team”.
S
Scoliosis
Scoliosis is abnormal side-to-side curvature of the spine. The spinal curve may develop as a single curve (shaped like the letter C) or as two curves (shaped like the letter S). In children and teens, scoliosis often does not have any noticeable symptoms and may not be noticeable until it has progressed significantly. The two most common forms are degenerative and idiopathic scoliosis (adolescent).
Adolescent Idiopathic Scoliosis (AIS) affects children during adolescent growth periods. The cause is unknown, hence it is called idiopathic. It is usually painless and affects both boys and girls. Girls tend to be associated more with AIS as it progresses to need treatment, either a scoliosis brace or surgery, more frequently in girls.
Diagnosis
Scoliosis is usually detected by the school nurse, doctor or parents before the child is diagnosed by an orthopedic or scoliosis specialist.
Diagnosis is usually made by the doctor after radiological (X-ray) tests have been done to show the location of the curve apex, the angle of curvature (Cobb angle) and the skeletal maturity (Risser score). These results will lead the doctor to determine the prescribed treatment. As a rule of thumb doctors will use the following table as a guide.
Most people have some curvature of the spine and a Cobb angle of 10 or less is considered ‘normal’.
Treatment
Three orthopedically approved options exist for combating scoliosis: observation, bracing, or surgery.
| Cobb Angle | Treatment |
| <25 degrees | Observation and follow up |
| 20-45 degrees | Scoliosis Brace |
| >40 degrees | Surgery |
The Goal of Bracing
A scoliosis curve usually does not improve without surgery. However, studies have shown that wearing a scoliosis brace as prescribed can often prevent the progression of scoliosis. As such, wearing a brace can be an effective way to keep a scoliosis curve’s Cobb angle relatively small and manageable.
A scoliosis curve that is 50 degrees by the time an adolescent reaches skeletal maturity (about age 14 or 15 for girls and 16 or 17 for boys) will continue to progress throughout adulthood.
These types of curves are likely to become a severe deformity that requires surgery. Therefore, the goal of bracing is to avoid a major surgery by either stopping curve progression altogether or at least preventing it from reaching 40 or 50 degrees at the time of skeletal maturity.
How Bracing Works
Bracing treatment aims to apply corrective forces on the spine to release load on the concave (inner) part of the curve and increase load on the convex (outer) part of the curve.
The idea is that a bone experiencing compression will grow less and a bone experiencing distraction (less or no compression) may grow more. Bracing tries to slow down the scoliosis curve’s bone growth on the side that needs to be slowed, and speed up growth on the side that needs to speed up.
While bracing will not typically reverse or correct with bracing, it can slow or reduce any progression of the curve until the child reaches skeletal maturity. After this point, the bones are unlikely to so the curve is unlikely to progress (provided it is less than 40 degrees).
The exact mechanisms of bracing are still being studied. However, literature indicates that the brace needs to be rigid (hard) in order to apply strong and consistent pressure on the scoliosis curve to have an effect.
Hope provides custom made Scoliosis brace which are made of special plastic to apply strong consistent pressure against the lateral curve.
Stump Care
The goals in caring for the stump are to maintain a good shape and good position for fitting an artificial limb. This means taking active steps to:
- avoid swelling
- keep the full range of motion (prevent contractures)
- maintain strength
After operation, it’s crucial to remember these important factors for the health of your residual limb:
Properly position and move the residual limb
Make sure that the residual limb is in the correct position. This helps to prevent muscle tightening, which would ultimately prevent a full range of motion upon healing. Avoid spending a lot of time with the arm or leg hanging down. A newly amputated limb should be kept lifted high up most of the time.
Rehabilitation, including stretching and strengthening of residual muscles
With the help of rehabilitation exercises, the muscles in your residual limb can remain limber. Doing those exercises will help prevent contracture, which is the shortening and tightening of the residual muscles.
Desensitization to the amputation site
Shortly after the amputation site has healed, the skin in that area will be very sensitive to touch. For some, this sensation can even be painful. Desensitization of the area can help to keep those issues to a minimum. Rubbing the area, and gently touching it can help to desensitize the skin. Over time, as the amputation site begins to desensitize, increased pressure can help prepare you for prosthesis fitting.
Shaping of the residual limb, with the use of a compression bandage and shrinker sock
Once the wound has healed, the limb is most likely still going to be swollen. To reduce swelling, and be sure that it will fit into the socket of a prosthesis (or prosthetic limb), it must be “shaped” with the use of compression bandage or shrinker sock. The shrinker sock, also known as a compression stocking, is a tapered sock that will apply pressure evenly to the bottom of the residual limb, helping to reduce swelling. The sock should be worn as often as possible.
Daily care and hygiene of the residual limb
Preventing infection and skin problems can easily be done with daily hygiene for the residual limb. Wash it at least once a day, and scrub it gently with a washcloth, mild antibacterial soap, and warm water. Be sure that the limb is dried completely, this will help keep moisture from being trapped beneath the shrinker sock. Each day, wear a clean shrinker sock. These socks can be washed with mild soap and warm water, rinsed, and air dried.
Stump Shrinkers
At some point after your surgery, your healthcare providers will discuss several things with you including the use of shrinkers, desensitization, positioning, contracture prevention, exercise, phantom sensation and phantom pain. To manage post-operative edema, you may be prescribed a shrinker as a means of compression therapy.
Shrinkers are elastic garments that are simply pulled on or wrapped around the limb. They are typically used when the suture line is reasonably healed. Both methods help to expel excess fluid that remains inside the limb. This helps to prepare you to wear a prosthesis by providing an appropriate limb shape. Studies have found that shrinker socks are more effective than elastic bandages when it comes to reducing the volume of a residual limb. A shrinker sock is worn continuously unless the prosthesis (or prosthetic limb) is on, or the patient is bathing.
Sprain
This refers to trauma to a ligament that causes pain and at times disability depending upon the severity of the injury to the structure.
W
Walker Boots
Walker boots are designed to aid in foot and ankle stability and limit range of motion of the lower extremity. Walker boots are designed with a solid or articulating ankle joint to accommodate for the treatment of injuries, fractures, chronic conditions or disease. Each orthosis has a removable inner lining to protect the skin from breakdown, malleolar (ankle) pads for additional stability and comfort, and a rocker bottom sole to provide smooth walking pattern.