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	<title>Podiatry Portal &#187; Orthopedics</title>
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	<link>http://www.podiatry-portal.com</link>
	<description>Your Portal to the the latest Podiatry Information</description>
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		<title>Top of Foot Pain in Runners</title>
		<link>http://www.podiatry-portal.com/top-of-foot-pain-in-runners/174/</link>
		<comments>http://www.podiatry-portal.com/top-of-foot-pain-in-runners/174/#comments</comments>
		<pubDate>Sun, 22 Jan 2012 07:19:51 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[Sports Medicine]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=174</guid>
		<description><![CDATA[With the increased popularity of barefoot or minimalist running, there is an increased incidence of and injury that is being label TOFP (Top of Foot Pain) on many forums and blogs. There are a number of causes of pain on the top of the foot such as a ganglions, tendonitis and metatarsal stress fractures.  What [...]]]></description>
			<content:encoded><![CDATA[<p>With the increased popularity of barefoot or minimalist running, there is an increased incidence of and injury that is being label TOFP (<a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=52095">Top of Foot Pain</a>) on many forums and blogs. There are a number of causes of <a href="http://www.podiatryonline.tv/top-of-foot-pain.htm">pain on the top of the foot</a> such as a ganglions, tendonitis and metatarsal stress fractures.  What most of the barefoot or minimalist runners seem to be describing with the term, TOFP is a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=1980">dorsal midfoot interosseous compression syndrome</a> which occurs when the forefoot dorsiflexion moments on the rearfoot are too high for the tissues to tolerate and there is some compression over the dorsum of the foot between the tarsal bones and bases of the metatarsals. The <a href="http://podiatric.blogspot.com/2011/09/top-of-foot-pain-management-in-barefoot.html">treatment of top of foot pain</a> is to increase the forefoot plantarflexion moment with strapping, rearfoot striking, heel raises, calf muscle stretching and foot orthotics with the appropriate design feature. If the runner wants to continue barefoot or minimalist running then they need to use the foregoing to get over the injury and then gradually transition back to forefoot striking and away from the foot orthotics to allow the tissues to adapt to the load. In some cases the loads or dorsiflexion moments are so high, the tissues may never adapt.</p>
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		</item>
		<item>
		<title>Diagnosing a Baxters Nerve Entrapment</title>
		<link>http://www.podiatry-portal.com/baxters-neuritis/171/</link>
		<comments>http://www.podiatry-portal.com/baxters-neuritis/171/#comments</comments>
		<pubDate>Sun, 08 Jan 2012 02:18:33 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[heel pain]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=171</guid>
		<description><![CDATA[This can be challenging and often mimic plantar fasciitis, and can actually be caused by plantar fasciitis. Baxters neuritis is an entrapment of a branch of the lateral plantar nerve that innervates the abductor digiti minimi muscle. It has been claimed that up to 20% of cases of heel pain may be due to this. [...]]]></description>
			<content:encoded><![CDATA[<p>This can be challenging and often mimic plantar fasciitis, and can actually be <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=46934">caused by plantar fasciitis</a>. Baxters neuritis is an entrapment of a branch of the lateral plantar nerve that innervates the abductor digiti minimi muscle. It has been claimed that up to 20% of cases of heel pain may be due to this.</p>
<p>Clinically the distinction between a <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=37527">Baxters nerve entrapment</a> and plantar fasciitis is not clear, especially in the early stages. Usually the tenderness is more over the origin of the abductor hallucis muscle which may radiate laterally. Sometimes there are a slight parathesiaes present. Phalen’s maneuver may also elicit pain: this is done by inverting and plantarflexing the foot which will compress the nerve, due to narrowing of the porta pedis at the superior margin of the abductor hallucus muscle. Many patients also lose the ability to abduct the fifth digit (but some people can’t do this anyway!). They also tend not to have the poststatic dyskinesia that typical in plantar fasciitis unless it is also present. They also tend to describe a more radiating pain.</p>
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		<item>
		<title>The Foot Posture Index</title>
		<link>http://www.podiatry-portal.com/the-foot-posture-index/149/</link>
		<comments>http://www.podiatry-portal.com/the-foot-posture-index/149/#comments</comments>
		<pubDate>Mon, 06 Dec 2010 00:59:51 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=149</guid>
		<description><![CDATA[Most of the measurements that are carried out as part of a biomechanical assessment have been shown in a number of research projects to be unrepeatable. There are also the issues of which measurements are more important, such as the angle of the calcaneus, the height of the arch, the bulging of the midfoot, etc. [...]]]></description>
			<content:encoded><![CDATA[<p>Most of the measurements that are carried out as part of a biomechanical assessment have been shown in a number of research projects to be unrepeatable. There are also the issues of which measurements are more important, such as the angle of the calcaneus, the height of the arch, the bulging of the midfoot, etc. As a result of these problems, the <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/foot-posture-index/">Foot Posture Index</a> was developed. It relies on repeatable observations rather than unreliable measurements. The <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=50684">Foot Posture Index</a> is also a composite of a number of observations rather than one particular measurement or observations. The <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=1060">Foot Posture index</a> is useful in teaching, research and clinical practice.</p>
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		<item>
		<title>What exactly is sinus tarsi syndrome?</title>
		<link>http://www.podiatry-portal.com/what-exactly-is-sinus-tarsi-syndrome/116/</link>
		<comments>http://www.podiatry-portal.com/what-exactly-is-sinus-tarsi-syndrome/116/#comments</comments>
		<pubDate>Sun, 04 Apr 2010 09:52:31 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[sinus tarsi syndrome]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=116</guid>
		<description><![CDATA[Just what is sinus tarsi syndrome? What is the pathological process inovled in it.  An article in German in 2008 with English abstract reported that: We looked for mechanical and functional macroscopic structures in the canalis and sinus tarsi that can be associated with sinus tarsi syndrome in order to deduce therapeutic consequences.We found a [...]]]></description>
			<content:encoded><![CDATA[<p>Just what is sinus tarsi syndrome? What is the pathological process inovled in it.  An <a href="http://www.ncbi.nlm.nih.gov/pubmed/18219473?dopt=Abstract">article in German in 2008</a> with English abstract reported that:</p>
<blockquote><p>We looked for mechanical and functional macroscopic structures in the canalis and sinus tarsi that can be associated with sinus tarsi syndrome in order to deduce therapeutic consequences.We found a complex fibrous layer in the sinus and canalis tarsi that forms slips around the synovial sheats of the extensor tendons under the inferior extensor retinaculum. Both limbs run deep to the base of the sinus and canalis tarsi. The lateral band inserts into the sinus tarsi at the calcaneus, while the medial band inserts at the canalis tarsi at the talus and calcaneus. Instead of the term &#8220;interosseous ligaments,&#8221; we recommend referring to the &#8220;fundiform ligament&#8221; with one lateral and one medial band.Regarding function, one can assume that the medial band of these fundiform ligaments controls the talus at eversion and inversion together with the well-vasculated and well-innervated interarticular fat pads in the sinus and canalis tarsi. While contracting the long extensor muscles of the toes, the ligament forms a control mechanism for the longitudinal arch of the foot in the moving phase.A question is how variations in vascularization or disorders in innervation will alter the turgor of the pads of fat tissue. That is, such alterations would influence the distribution of synovia in the neighboring joints as well as the tension of the involved ligaments. </p></blockquote>
<p>And <a href="http://www.ncbi.nlm.nih.gov/pubmed/19028165?dopt=Abstract">Lee et al in the journal Arthroscopy</a>  reported that:</p>
<blockquote><p>Arthroscopic findings showed partial tear of the interosseous talocalcaneal ligament in 29 cases (88%), synovitis in 18 (55%), partial tear of the cervical ligament in 11 (33%), arthrofibrosis in 8 (24%), and soft-tissue impingement in 7 (21%).</p></blockquote>
<p>The both give some insight into what is actually going on with <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/sinus-tarsi-syndrome/">sinus tarsi syndrome</a>.</p>
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		</item>
		<item>
		<title>Should we classify plantar fasciitis treatments into two categories?</title>
		<link>http://www.podiatry-portal.com/should-we-classify-plantar-fasciitis-treatments-into-two-categories/108/</link>
		<comments>http://www.podiatry-portal.com/should-we-classify-plantar-fasciitis-treatments-into-two-categories/108/#comments</comments>
		<pubDate>Thu, 25 Mar 2010 08:04:37 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[plantar fasciitis]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=108</guid>
		<description><![CDATA[True plantar fasciitis is due to an overload in the plantar fascia, so the logical way to treat plantar fasciitis is to reduce that load. It could be assumed that any treatment is likely to fail long term if this load is not reduced. So should be consider plantar fasciitis treatments under the two categories [...]]]></description>
			<content:encoded><![CDATA[<p>True plantar fasciitis is due to an overload in the plantar fascia, so the logical way to treat plantar fasciitis is to reduce that load. It could be assumed that any treatment is likely to fail long term if this load is not reduced. So should be consider plantar fasciitis treatments under the two categories of those that reduce the load and those that facilitate the healing?</p>
<p>Those treatments that reduce the load:</p>
<ol>
<li>Activity modification</li>
<li>Certain design parameter on foot orthotics</li>
<li>Low dye strapping</li>
<li>Calf muscle stretching</li>
<li>Surgical</li>
</ol>
<p>Those treatments that facilitate the healing:</p>
<ol>
<li>ICE and heat</li>
<li>Injection therapies (cortisone, nerve blocks etc)</li>
<li>Therapeutic ultrasound</li>
<li>Manual therapies (massage, manipulation, active release techniques etc)</li>
<li>Shockwave therapy</li>
<li>Cyrosurgery</li>
<li>Coblation</li>
<li>etc</li>
</ol>
<p>How successful will be the second group of therpies in the long term if the load is not addressed?</p>
<p>For the latest on <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/plantar-fasciitis/">plantar fasciitis</a>, see Podiatry Arena.</p>
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		</item>
		<item>
		<title>Debunking clinical biomechanics theories</title>
		<link>http://www.podiatry-portal.com/debunking-clinical-biomechanics-theories/99/</link>
		<comments>http://www.podiatry-portal.com/debunking-clinical-biomechanics-theories/99/#comments</comments>
		<pubDate>Sun, 13 Dec 2009 01:24:59 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[biomechanics]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=99</guid>
		<description><![CDATA[There are many theories that underpin the clinical use of foot orthotics. Each new theory that comes along is conisdered the greatest by the originator of the theory and the make extraordinary claims for it. On Podiatry Arena a number of clinical biomechanics theories get discussed and disected. In a thread on the Best Quotes [...]]]></description>
			<content:encoded><![CDATA[<p>There are many theories that underpin the clinical use of foot orthotics. Each new theory that comes along is conisdered the greatest by the originator of the theory and the make extraordinary claims for it. On Podiatry Arena a number of <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/clinical-biomechanical-theories/">clinical biomechanics theories</a> get discussed and disected. In a thread on the <a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=41287">Best Quotes of 2009</a>, were these gems that sum it up:</p>
<blockquote><p>Does anyone else get the idea that more than a few of these things, are just rehashes of old concepts which have since been superseded? Its almost like somebody who has heard of cars, but never seen one, gets a good look at a model T Ford, gets excited at how much less poo it creates, and how much faster it is than his horse, then rushes out to tell all his mates (who are already driving in ford Mondeo&#8217;s) how great this exciting new thing is!</p></blockquote>
<blockquote><p>It seems that you have found, as have a few other American podiatrists who have a financial interest in a product or method of treatment that many of the members of Podiatry Arena don&#8217;t take too kindly to clinicians who have never performed research, never had research published, and have no academic appointments, coming onto the premier international podiatric medical academic internet forum and proclaiming the virtues of their product or idea that they have anecdotally found works for them.</p></blockquote>
<blockquote><p>A new poster arrives with radically different ideas. The community refutes these ideas. The poster becomes frustrated and claims the refutation is simply because their ideas are new! They even become angry and accuse the arena community of being a closed clique. Its not! Its just that to change somebodies mind you must offer them more than &#8220;because I beleive it to be so!&#8221;</p></blockquote>
<p>And now we see a gem from regular poster, <a href="http://www.podiatry-arena.com/podiatry-forum/member.php?u=2791">Robert Isaacs</a>, that makes a parody of clinical biomechanical theories and the one-page-sales letter:  <strong><a href="http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=41531">Ways to Succeed in Biomechanics</a></strong></p>
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		<item>
		<title>Cuboid Manipulation</title>
		<link>http://www.podiatry-portal.com/cuboid-manipulation/91/</link>
		<comments>http://www.podiatry-portal.com/cuboid-manipulation/91/#comments</comments>
		<pubDate>Wed, 04 Nov 2009 00:33:59 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[cuboid syndrome]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=91</guid>
		<description><![CDATA[Cuboid manipulation and mobilisation is probably a key part of the management of cuboid syndrome. Cuboid syndrome tends to occur when an unstable cuboid is rotated out of its position between the calcaneus and fifith metatarsal by the pull of the peroneus longus tendon leading to an alleged subluxed cuboid. The concept behind the manipulation [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.podiatryonline.tv/cuboid-manipulation.htm">Cuboid manipulation</a> and mobilisation is probably a key part of the management of <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/cuboid-syndrome/">cuboid syndrome</a>. Cuboid syndrome tends to occur when an unstable cuboid is rotated out of its position between the calcaneus and fifith metatarsal by the pull of the peroneus longus tendon leading to an alleged <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/subluxed-cuboid/">subluxed cuboid</a>. The concept behind the manipulation is to put the cuboid back in place. Often foot orthotics are needed in the long term to keep the cuboid bone more table.</p>
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		<item>
		<title>Heel Pain in Gout</title>
		<link>http://www.podiatry-portal.com/heel-pain-in-gout/82/</link>
		<comments>http://www.podiatry-portal.com/heel-pain-in-gout/82/#comments</comments>
		<pubDate>Fri, 23 Oct 2009 02:30:44 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[gout]]></category>
		<category><![CDATA[heel pain]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=82</guid>
		<description><![CDATA[Heel pain caused by gout is not common or is very common depending on who you talk to. Any atypical or typical heel pain that does not respond to the standard treatments should consider gout in the many differential diagnosis&#8217;s available. If the heel pain is due to gout, it should respond rapidly to a [...]]]></description>
			<content:encoded><![CDATA[<p>Heel pain caused by gout is not common or is very common depending on who you talk to. Any atypical or typical heel pain that does not respond to the standard treatments should consider gout in the many differential diagnosis&#8217;s available. If the <a href="http://www.goutonline.net/showthread.php?t=1835">heel pain is due to gout</a>, it should respond rapidly to a short course of colchicine.</p>
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		<item>
		<title>Functional Hallux Limitus</title>
		<link>http://www.podiatry-portal.com/functional-hallux-limitus/55/</link>
		<comments>http://www.podiatry-portal.com/functional-hallux-limitus/55/#comments</comments>
		<pubDate>Sun, 13 Sep 2009 11:12:33 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[clinical biomechanics]]></category>
		<category><![CDATA[functional hallux limitus]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=55</guid>
		<description><![CDATA[Is functional hallux limitus primary (as in sagittal plane theory) or is functional hallux limitus secondary (as in Root theory)? There is no answer and the debate between the two points of view has been going on for over a decade now. See some of the threads on Functional Hallux Limitus at Podiatry Arena for [...]]]></description>
			<content:encoded><![CDATA[<p>Is functional hallux limitus primary (as in sagittal plane theory) or is functional hallux limitus secondary (as in Root theory)? There is no answer and the debate between the two points of view has been going on for over a decade now. See some of the threads on <a href="http://www.podiatry-arena.com/podiatry-forum/tags/index.php?tag=/functional-hallux-limitus/">Functional Hallux Limitus</a> at Podiatry Arena for more on the debates on this. Recently it was suggested that <a href="http://www.clinicalbootcamp.net/functional-hallux-limitus.htm">functional hallux limitus</a> be conceptualized at a change in the dorsiflexion stiffness curve and should be considered as a continuum rather than an either/or as in present or absent.</p>
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		<item>
		<title>Factors assoicated with plantar fasciitis</title>
		<link>http://www.podiatry-portal.com/factors-assoicated-with-plantar-fasciitis/52/</link>
		<comments>http://www.podiatry-portal.com/factors-assoicated-with-plantar-fasciitis/52/#comments</comments>
		<pubDate>Sat, 12 Sep 2009 11:38:26 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[Orthopedics]]></category>
		<category><![CDATA[Sports Medicine]]></category>
		<category><![CDATA[plantar fasciitis]]></category>

		<guid isPermaLink="false">http://www.podiatry-portal.com/?p=52</guid>
		<description><![CDATA[This retrospective case control study in the Clinical Journal of Sports Medicine on Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners concluded that: A significantly greater maximum instantaneous load rate was found in the plantar fasciitis group along with an increased ankle dorsiflexion range of motion compared with the [...]]]></description>
			<content:encoded><![CDATA[<p>This retrospective case control study in the <a rel="nofollow" href="http://www.ncbi.nlm.nih.gov/pubmed/19741308?dopt=Abstract" target="_blank">Clinical Journal of Sports Medicine</a> on <strong>Biomechanical and anatomic factors associated with a history of plantar fasciitis in female runners </strong>concluded that:</p>
<p><em>A significantly greater maximum instantaneous load rate was found in the plantar fasciitis group along with an increased ankle dorsiflexion range of motion compared with the control group. The plantar fasciitis group had a lower arch index compared with control subjects, but calcaneal valgus was similar between groups. No differences in rearfoot kinematics were found between groups. </em></p>
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