Posts for: January, 2020

January 29, 2020
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For years we have been helping patients suffering from knee pain.

In the first few weeks of this new year we have been asked to help several personal friends, all approaching or having passed that magical age of 50. All are still very actively participating in what would be considered high level recreational sports and have been diagnosed with osteoarthritis  in their knees or OA for short.

It is an extremely common condition, more than 4.6 million Canadians have been diagnosis with this condition, and while most are mature it can, as in my case manifest itself much earlier in life.

Most frequently used forms treatment involve the use of self or physician prescribed 

anti-inflammatories, modification of activity, knee bracing, and surgical intervention when orthopaedic surgeons deem it suitable. Some of this OA is as a result of acute trauma to the joint, many are overuse and biomechanical in nature and like many conditions we treat most are multifactorial in origin and progression.


So the question is what does an individual do with diagnosed OA off the knee?.

 If we limit our activity, then we gain weight and loose muscle tone both of which will further exacerbate the problem. Research shows that many orthopaedic surgical intervention do little to extend the life span and functionality of the joints and may accelerate functional instability and cartilage degeneration. In traumatic cases it may be necessary to surgically repair or stabilize the structures but strengthening is a key component to success.


How can a Chiropodist/Podiatrist help treat OA in the knee?

To answer that we have to accept that normal function of the knee is dependant upon a stable functional base. Without stability there can be either excessive internal or external rotation of the leg and joint, or hyperextension or limitation of knee flexion. These functional instabilities usually arise from structural misalignments we were born with or acquired over time. For us, the greatest challenge comes in identifying the origin of the instability and how it manifests itself during gait. In our clinics the most beneficial tool used in understanding the complex mechanism of functional compensation is our PediGait video analysis system.  This HD camera system allows us to view our patients from every angle and slow their gait cycle down and compare side by side and before and after images. Additionally,  it provides us with a baseline and thus a comparable history of progression throughout the treatment and subsequent management of each patient. .This information allows us to make necessary changes to footwear, daily habits, therapies and where necessary, design of functional orthotic devices for daily use.  Only then are we able to improve functional control allowing the other members of the therapeutic team to work their magic through rehab and strengthening.

Too frequently we are presented with new patients who, post knee, ankle or hip surgery, have  turned to us as a last option to improve their mobility. Often we discover that they have been walking in slippers, sandal or barefoot the majority of time during their recovery.  While we cannot reverse the ravages of OA, we can help limit the advancement of the disease and enable healing to occur in the best possible environment.


January 08, 2020
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As we slide deeper into winter and the holidays have passed, it's easy to slip into bad habits with regards foot health. The temptation to spend considerable time at home in socks, fuzzy slippers or bare feet can aggravate preexisting structural foot problems. Most of our homes have fashionable, beautiful, hypoallergenic and ghastly floor surfaces upon which we spend vast numbers of hours toiling and working.
It's no coincidence that the two largest groups of patients we treat for first time onset planter heel pain or planter fasciitis, are new retirees and those who have recently transitioned to working from home. One of the very first and sometimes only steps we urge them to take towards recovery is to dedicate a specific comfortable, but supportive shoe to become their staple indoor footwear. If they happen to be orthotic wearers and have an old pair of devices they should place those in their indoor shoe permanently. Slippers are generally too flexible and diminish any benefit that might be derived from the inserted orthotic. To further drive this point home I callously recommend they hang on to their slippers and give them to someone they really don't like. Kidding of course!