Category Archives: Blog

Foot Problems? Take Care of Your Feet!

Posted on Thu, Apr 17, 2014 @ 09:54 AM

Your feet are one of the most important parts of your body. Just about everything you do in a day involves using your feet. Feet give us the ability to be mobile and balanced and are the body’s primary shock absorber.  Feet take an incredible amount of wear and tear simply by bearing the weight of our body while we walk and stand. An average day of walking can bring a force to your foot that is equal to several hundred tons!                           

Hammertoe

 

To bring attention to the importance of the health of your feet, The American Podiatric Medical Association (APMA) has designated the month of April as National Foot Awareness Month.  It is estimated that 75% of Americans will experience some sort of foot pain in their lifetime.  Whether from birth defects, heredity, trauma, Arthritis, muscle & joint imbalances or daily neglect, foot conditions are among the most common health issues experienced. 

Feet are a crucial part to a healthy functioning life.  Paying attention to the hygiene of your feet and being alert to age related changes is important for your overall health. 

 Common Conditions Associated with Toes

One of the most common types of foot ailments treated today is bunions.  Bunions  also known as Hallux Valgus is a bony bump that forms on the joint at the base of your big toe. The big toe joint becomes enlarged, forcing the toe to crowd against the other toes. This puts pressure on the big toe joint, pushing it outward beyond the normal profile of the foot, and resulting in pain.  Bunions can be hereditary but may also be caused by shoes that are too narrow in the toe and forefront.

Another common condition is hammertoe. A hammertoe is a toe that is contracted at the middle joint- bent in a claw –like position.  It occurs mostly frequently in the second toe, but any of the other three smaller toes may be affected. This condition usually stems from a muscle imbalance, but like bunions, can be aggravated by ill-fitting shoes or socks.

Morton’s Toe and Overlapping Toes are two other common conditions.  Morton’s toe is a disorder where the second toe is longer than the big toe. A pronounce d Morton’s toe can alter the balance of your foot causing problems with your gait. Overlapping toes are toes that deviate and cross on the top of or under another toe.  Overlapping toes can occur in any of the toes and can cause extreme irritation if not corrected.

Pain in your feet should not be ignored. If pain persists or reoccurs you should consult with your podiatrist or other health care professional.

3-Point Products offer splints, designed for comfort and function, to help with hammer toes, bunions, overlapping toes and other foot and toe conditions. Please see our complete line of foot care products at http://www.3pointproducts.com/sidemenu/feet–toes/.    

 

                                       3pp Bunion Aider         3pp Toe Loop        
                       

Arthritis Treatment

Partial vs. Total Knee Replacement Surgery: What you need to know

Are you part of the .2%?

Each year, thousands of people in the United States have knee replacement surgery — about 600,000 to be exact, according to the Agency for Healthcare Research and Quality. Robert L. DeMaagd, MD, specialist with the Total Joint Center at Orthopaedic Associates of Michigan, sees his fair share.

“I do close to 300 knee replacements each year,” says Dr. DeMaagd. “That includes both partial and total replacements.”

Who is a candidate for knee replacement?

According to Dr. DeMaagd, most knee replacement patients are between 55-75 years old. “Typically knee replacement surgery is done for chronic osteoArthritis of the knee joint that has not been successfully treated with non-operative means like medication, bracing, injections, and physical therapy,” he explains. “Arthritis is an inherited trait, so for most people, it’s just a genetic wearing out of the joint.”

Time to move on

“Many of these non-operative treatments can be good for mild to moderate Arthritis, and you can go for years without joint replacement surgery,” Dr. DeMaagd says. “But after a while, those measures just don’t work. You have to move on to something else.”

That’s when patients typically contact OAM. “If the knee pain and stiffness are affecting a patient’s quality of life or getting in the way of normal daily activity, the patient is probably a good candidate for a knee replacement,” says Dr. DeMaagd.

Total vs. Partial: Do I have a choice?

Whether a patient is a candidate for a total knee replacement or a partial knee replacement depends primarily on the condition of the various parts of the knee.

Very simply, the knee is separated into three main compartments: the medial compartment (along the inside of the knee), the lateral compartment (along the outside of the knee), and the patellofemoral compartment (the front of the knee between the kneecap and thighbone).

“If two or three of the compartments are damaged by Arthritis, we would do a total knee replacement,” explains Dr. DeMaagd. “We would also do a total if the patient has a complication such as deformity caused by long-term Arthritis, or if they have severe ligament instability. These can’t be corrected with a partial replacement.”

Most patients who need knee replacement surgery need total joint replacement. However, in some cases, just one compartment is affected by Arthritis.

“Perhaps someone had some meniscus or cartilage taken out of their knee when they were young and only that portion of the knee has deteriorated. That person would be a perfect candidate for a partial knee replacement,” says Dr. DeMaagd.

The art and science of total knee replacement

“In a total knee, all the surfaces of the knee are recovered with metal and plastic devices,” explains Dr. DeMaagd. “Most people think the surgery ends there, but that’s really the simplest part of the procedure.”

Knee Arthritis can naturally wear away the joint on one side or another. This can cause deformity, where the patient becomes severely bow-legged or knock-kneed. Both conditions stretch the ligaments on one side of the knee and cause ligaments on the other side to tighten.

“The more difficult part of the procedure is balancing the ligaments and obtaining a good stable knee,” Dr. DeMaagd goes on to explain. “That’s where a lot of the science, but also the art of knee replacement come into play.” He says almost every total knee replacement he performs requires some degree of ligament work.

In the end, total knee replacements are considered to be very safe and effective for treating the pain and stiffness caused by osteoArthritis of the knee, particularly among the 55-75 year old population. Most people can get back to work and activities of daily life after about eight weeks, and the knee will be fully healed in about a year.

While there are restrictions — things like jumping from heights, running, and singles tennis aren’t recommended — people with a total knee replacement may golf, walk, bike, swim, play doubles tennis, and even ski at moderate levels.

But the science does have limitations. “After a full replacement, most people can feel they have a replacement knee,” points out Dr. DeMaagd. “While the pain is gone, they can definitely feel the difference — the replacement knee feels slightly mechanical, maybe a little stiffer than their real knee making it difficult to squat or kneel.”

Partial knee, full advantage

In a partial knee replacement, just one compartment of the knee is resurfaced — the inside or the outside. Additionally, this procedure usually doesn’t include the ligament balancing that’s done with a total knee replacement.

The big advantages are that the partial knee replacement is typically done in an outpatient setting and it’s less invasive, quicker to heal, and feels more like a normal knee than a full knee replacement. Partial knee patients usually experience more flexibility, as well, and are often able to squat and kneel after surgery.

“Many people who get a partial replacement feel their knee is almost back to normal,” says Dr. DeMaagd. “Most people can’t really tell the difference between a normal knee and a partial replacement.”

Initial recovery time is cut in half. “Most people are off crutches or a walker within several days and generally get back to most activities of daily living after about three to four weeks,” says Dr. DeMaagd. Full healing still requires about a year, and the same restrictions on high-impact exercises apply.

The good news is, if a patient qualifies for a partial knee replacement, they can expect to enjoy most of the same recreational sports and activities that they enjoyed pre-surgery — except without the pain.

Thumb Joint Pain

Can A Hand Therapist Help Treat My Pain?

Posted on Tue, Apr 08, 2014 @ 01:49 PM

Whether you have a ski related thumb injury, are recovering from hand surgery, suffer from mallet finger or have pain and stiffness in your hands from Arthritis— a Hand Therapist may be the answer.

While most people are familiar with Physical Therapists, you may be asking yourself  “What is a Hand Therapist”?   Simply put, a Hand Therapist is either a Physical Therapist or an Occupational Therapist who has specialized training in treating individuals with conditions affecting the hands and upper extremities.

A Certified Hand Therapist (CHT) represents the highest level of knowledge and therapeutic expertise in treating hand and upper extremity conditions. The requirements to become a CHT include a minimum of five years of clinical experience, with 4000 hours in hand therapy practice, as well as a board certified examination and annual continuing education.

Hand Therapists typically work in hospitals, clinics, physical therapy or rehab centers and sports medicine facilities. They work closely with physicians and surgeons to treat patients with hand and post-surgical conditions. Through assessment and treatment, hand therapists help to reduce pain & swelling in hands and upper extremities and work with patients to gain strength, mobility and dexterity for a more functional and pain free daily life. 

In addition to rehabilitation after surgery, common conditions that Hand Therapists treat include:

  • Arthritic conditions related to the hand, wrist, elbow or shoulder
  • Sprains, fractures and dislocationshand therapist fitting a patient with a splint
  • Nerve or tendon damage
  • Tendonitis
  • Trigger Finger
  • Mallet Finger
  • Carpal Tunnel Syndrome
  • Ehler Danlos Syndrom(EDS)
  • DeQuervians Syndrome
  • Tennis and Golfer’s Elbow
  • Shoulder disorders
  • Fine Motor Coordination Deficits

The first visit with a Hand Therapist usually begins with a discussion of your problems and symptoms and an examination of your muscles, joints, nerves and ligaments.  Posture, range of motion, strength and sensation may also be measured.

Based on your evaluation, a treatment plan and goals will be formed. Heat/ice, massage, swelling reduction techniques, mobilization of joints and customized exercise programs may all be a part of your treatment plan.

Hand therapists are also trained in the evaluation and fabrication of splints. Your therapist may fit you for a custom splint/orthosis or recommend a prefabricated splint.  Splints can range from finger based to wrist immobilization to full arm orthotics.

 3-Point Products offer splints, designed for comfort and function, to help treat thumb, hand and wrist conditions. Please see our complete line of splints at www.3pointproducts.com.

The length of your therapy will depend on the severity of your condition or injury and the pace of your recovery.  Most people are pleased to find that working with a hand therapist results in decreased medical costs and a faster return to work and/or a productive lifestyle.

To find a Certified Hand Therapist in your area, please go to www.htcc.org/find-a-cht

Arthritis Treatment

Treat Your Feet (and Ankles)

Under pressure

Our feet and ankles are under a lot of pressure. The average person takes 8,000 to 10,000 steps per day. With each step, each ankle supports about five times a person’s body weight. While running, the pressure on our feet is about three or four times our body weight.

It’s no wonder so many people experience foot and ankle problems.

Foot and ankle injuries top the list when it comes to sports injuries in America. But you don’t have to be an athlete to be part of the club: 75 percent of Americans experience some type of foot pain in their lifetime.

The team of specialized foot and ankle care professionals at the Orthopaedic Associates of Michigan Foot & Ankle Center treat all kinds of foot and ankle pain and problems, but they specialize in complex cases that have been referred by other physicians.

Earlier this month, Robert S. Marsh, DO, specialist with the OAM Foot & Ankle Center, explored a few of the most common types and causes of foot pain, as well as ways to prevent it. In this post, OAM Foot & Ankle Center specialist Donald R. Bohay, MD, FACS, discusses treatments for some of the more common types of foot and ankle problems.

Call the doctor!

What are some of the problems that would bring a patient to the Foot & Ankle Center at OAM, and how would they be treated?

“In our practice, we see quite a variety of foot and ankle problems — they range from the simplest things like corns and calluses, all the way to complex deformity as a result of trauma or congenital condition,” says Dr. Bohay. “But one of the most common is plantar fasciitis — we probably see five to 10 patients a day with that diagnosis.”

Treating Plantar Fasciitis

Plantar fasciitis comes on when the ligament that supports the arch of the foot — or the plantar fascia — develops tiny tears and becomes irritated and inflamed.

“We believe the primary source of this problem is tightness of the calf muscle or the gastrocnemius,” explains Dr. Bohay. “We start simply with a stretching program and a night splint. That’s typically a three to six month program and most patients get relief.

“For patients who don’t improve with this type of conservative treatment, we offer an outpatient surgical procedure called a gastrocnemius release,” explains Dr. Bohay. “With this procedure, we’re able to lengthen the gastrocnemius and eliminate the underlying source of the problem.”

Following this procedure, patients wear a walking boot and can expect a recovery period of about two weeks.

Metatarsalgia and stress fractures: similar pain, different treatments

Metatarsalgia and stress fractures are also fairly common foot problems, particularly among runners.

“Runners are a unique subset of our patient population,” says Dr. Bohay. “They typically have symptoms related to overuse or training errors, which can include metatarsalgia, or pain and inflammation in the balls of the feet, and stress fractures — tiny fractures in the metatarsals or toe bones.”

According to Dr. Bohay, the two conditions are sometimes confused, but treatments are different so it’s important to get an accurate diagnosis.

“When a patient has a stress fracture, the pain is primarily on the top of the foot,” says Dr. Bohay. “They’ll describe the symptoms as sharp pain when they walk or run. That is opposed to the patient who describes pain in the balls of their feet and says it feels like they’re walking on balls or marbles. That pain is typical of someone with metatarsalgia.”

An x-ray or other advanced imaging is used to confirm a stress fracture.

“Patients with stress fractures are treated with rest and immobilization for at least six weeks,” says Dr. Bohay. “That may mean a cast or a fracture brace, and possibly crutches.”

Treatment for metatarsalgia is different. “That is primarily treated with an orthotic device with a metatarsal pad,” explains Dr. Bohay. “The metatarsal pad is placed in the orthotic in a way that transfers the weight away from the head of the metatarsal bones, the source of the pain. The patient would wear this orthotic at least as long as they experience discomfort, but it’s likely something they would continue wearing to avoid return of the symptoms.”

RICE is good for ankle injuries

Metatarsalgia and stress fractures aren’t the only problems commonly brought on by running and other activities. Running, contact sports, and ordinary twists and turns can also lead to ankle injuries.

“In young athletes — high school and early college — we see a lot of ankle problems, mostly recurring sprains and strains,” Dr. Bohay points out.

“For the patient with an acute, or fresh, sprain, we recommend the well-known RICE treatment — rest, ice, compression, and elevation. We recommend that with or without a course of physical therapy for most athletes with an ankle sprain.”

As severity or frequency of injuries increases, so does intensity of treatment.

“We’ll step up treatment for athletes who have their sport compromised by their ankle instability, or those who have recurring sprains and strains. They’ll undergo more physical therapy, bracing techniques, and potential modifications in their sporting activity,” explains Dr. Bohay.

“If they don’t improve with conservative treatment and their sports performance continues to be compromised, they become candidates for ankle ligament reconstruction.”

This type of ligament reconstruction isn’t restricted to athletes, according to Dr. Bohay. “We can do the same operation on a 15-year-old football player that we can do on a 75-year-old hunter who, due to recurring ankle injuries, is having trouble walking the trails through the woods.”

But older adults tend to have their own set of problems when it comes to feet and ankles.

Where there are joints, there can be Arthritis

Arthritis is a condition of the joints that primarily affects older adults. The feet and ankles contain 33 joints, so it’s no wonder Arthritis of the mid-foot and ankle are among the more common diagnoses when someone over 50 is experiencing foot or ankle pain.

Joints and Bones of the Foot and Ankle. Credit: American Academy of Orthopaedic Surgeons

“In the middle of the foot, Arthritis presents as a standard achy, deep pain that gets worse with activity and may be accompanied by swelling along the top of the foot,” says Dr. Bohay. “Treatment is similar to treatment of Arthritis anywhere in the body. It typically includes activity modification, non-steroid anti-inflammatory drugs, modifications in shoes, and, sometimes, an orthotic device.”

But, because type and severity of Arthritis can vary dramatically, some patients don’t improve with these more conservative treatments.

“These people become surgical candidates,” says Dr. Bohay. “In the foot, that means a fusion of the affected joints. In this procedure, we remove the Arthritis and screw together the affected joint so it grows together and no longer causes Arthritis pain.”

Recovery can be long. Patients should expect to wear a cast for eight weeks and an immobilization boot for another four weeks. But they can also expect relief from their pain.

“Ankle Arthritis is another problem we see frequently among adults over 50, and it’s typically post-traumatic,” says Dr. Bohay. “These are the people who, when they were in their teens and 20s, had several ankle sprains that may or may not have been treated, or they may have broken their ankle skiing. Now they describe pain with activity and swelling above the ankle.

“Our first course of treatment is the same as is offered for people with mid-foot Arthritis: modify activity and footwear and non-steroid anti-inflammatories,” continues Dr. Bohay.

Like those with mid-foot Arthritis, patients whose symptoms don’t improve with conservative treatment may be candidates for ankle surgery.  Surgery to treat severe ankle Arthritis falls into two categories: ankle fusion (called arthrodesis) or ankle replacement.

Dr. Bohay and his colleagues at the OAM Foot & Ankle Center specialize in the most advanced ankle fusion and replacement surgeries.

“There is still much innovation and research happening in the area of total ankle replacements,” says Dr. Bohay. “But we have reached the point where implants routinely improve the quality of life for patients with severe ankle Arthritis.”

For more on related foot and ankle research, watch for an upcoming blog post featuring OAM Foot & Ankle Specialist John G. Anderson, MD.

Thumb Joint Pain

Treatments to Help Reduce Swelling and Pain In Hands

Posted on Tue, Mar 18, 2014 @ 12:43 PM

Do you or someone you know wake up every morning with pain and stiffness in your hands or fingers?  Do you suffer from Arthritis, tendinitis or a repetitive stress injury?  If so, you know that the aches and pains associated with these conditions can severely disrupt the movements in your everyday life.

Rest, splinting /braces and anti-inflammatories are well known treatments in helping to deal with daily pain and stiffness.  There are other less known treatment techniques that you may not be aware of as well.  Contrast baths, therapeutic gloves and the use of exercise putty are all very effective in reducing swelling and inflammation in hands and joints.

Contrast baths are a hot/cold hydrotherapy immersion technique which involves immersing the joint in cold water followed by the immediate immersion in warm water.  This technique goes back hundreds of years and can be used to reduce swelling or to aid in recovery from exercise.  The theory behind contrast baths is because heat dilates the blood vessels and cold causes them to get smaller (vasoconstriction), contrast baths help to increase the blood flow to the affected area creating a pumping action that forces circulation.

To Take a Contrast Bath–

  • Fill one large bowl with very warm, not hot water and one with very cold – not icy water. Place a sponge or washcloth in each bowl

  • Starting with warm, plunge your hand into the water and gently squeeze the sponge for 2-3 minutes

  • Do the same in the cold water for 1 minute

  • Return back to the warm for 2-3 minutes

  • Cold for 1 minute

  • Do 3-4 rotations ending with warm water

 (It is recommended that you discuss this treatment technique with your health care provider before starting a new therapy.)

Therapeutic Gloves are another method that can help support the affected joints and minimize swelling. Through mild compression, therapeutic gloves help to decrease pain and stiffness.  Normally the gloves are designed to be tight fitting and are made of a nylon- spandex fabric. Most gloves can be worn day and night and may have the fingertips cut out so you can easily touch and grip. Therapeutic gloves also help to improve circulation and add warmth to your hands.

Two examples of gloves for people who suffer from hand ailments include the IMAK Arthritis Gloves and the Isotoner Therapeutic Gloves. The IMAK Arthritis Gloves were designed by an orthopedic surgeon and have earned the Arthritis Foundation’s Ease of Use Commendation for its design. The Isotoner Therapeutic Gloves were designed with a Certified Hand Therapist and offer a seamless support feature where the seams are on the outside- away from pain sensitive areas like the base of the thumb.  

Imak <a href='' target='_blank'>Arthritis</a> Glove  
 
  



IMAK Arthritis Glove
 
 

Isotoner Therapeutic Glove





 

  Isotoner Therapeutic Glove

Using Exercise Putty is a third method for helping to reduce stress and pain in hands. Light exercises with putty can help to develop hand muscle strength and increase range of motion and flexibility which both aid in reducing pain and inflammation.

3pp Exercise Putty                                        

3pp Putty for hand strengthening
 

 Here are a few examples of exercises that can be done with exercise putty:

3pp Putty exercises for hands

 







For additional hand exercise suggestions please read our blog-

Hand Exercises for Sufferers of Arthritis Pain.

Arthritis Treatment