Description.
Typically pain in the heel or arch of the foot. Very common to have pain after rest that reduces with light walking. Can be significant with long periods of physical activity. Caused by flat feet, falling of the longitudinal arch, intense physical activity or simply aging. Proper diagnosis is essential. Treatments include proper shoes for support, taping of the arch, arch supports or custom orthotics, steroid injections, laser, physiotherapy and occasionally immobilization of the foot.
Orthotics are custom inserts used to correct improper foot function. Excessive stress on bones, joints, and soft tissue caused by poor biomechanics, will eventually cause foot pain. A properly designed custom orthotic can relieve that pain by properly supporting the ligaments, joints, muscles and bones of the feet.
For an orthotic to be optimally effective, a prior medical diagnosis by a recognized foot doctor, such as a podiatrist, is essential. As well, most extended medical insurance providers will only reimburse orthotics prescriptions made by podiatrists, or other recognized professionals.
“I was having a lot of pain in the arch of my foot and it seemed to get worse with exercise. Another podiatrist had told me I had plantar fasciitis and prescribed orthotics to me but they weren’t helping at all. It was getting to the point where the pain was preventing me from exercising (I am really active, used to play a lot of basketball, and still love to run and train for triathlon). The podiatrists at Vancouver Podiatry assessed my feet, cast them and had an orthotic made for me in no time at all. After 1-2 weeks of wearing the new orthotic, my foot pain subsided and I have never looked back. I am really glad I went to Vancouver Podiatry.” Michael Millman
For more difficult assessments or patients with severe biomechanical deformities, Vancouver Podiatry offers the F-scan Plantar Pressure Analysis System. The F-scan allows for 3-Dimensional analysis of the foot while in motion and can help to determine whether an orthotic would control the motion of the foot. The F-scan is also helpful in determining why a particular orthotic may not be alleviating symptoms.
Orthotics come in many different forms. They can be made from rigid or soft materials. Rigid materials include metal, plastic and carbon-graphite composites. Soft materials include leather, poron, vylyte and EVA.
There are several ways to construct an orthotic. The most common method is to make a plaster impression of the foot while holding the foot in the proper position. A more recent method is to take an optical impression of the foot using a computer scanner. A truly functional orthotic must capture the 3-dimensional shape of the foot. It is also critical that the foot be in the proper position when the impression of the foot is made. This is why an orthotic should never be made from a mold taken of the foot when a patient is standing and the foot is collapsed.
Orthotics can help you restore balance, improve sports performance, walk comfortably in high heels, and reduce or, better still, eliminate foot, back and leg pain. Orthotics are custom-made inserts that fit inside the shoe to decrease abnormal foot motion. Until recently, making orthotics required plaster casting – complete with pouring, casting, molding and construction.
The podiatrists at Vancouver Podiatry are pleased to offer their patients all the benefits of 3-D laser optical casting. Both plaster and optical casting rely on the clinician holding the foot in the correct neutral position for accuracy. Both methods also provide an accurate three-dimensional contour of the foot. The difference is that in order to be 100% accurate, plaster casting requires total contact of the plaster with an immobilized foot, which can be difficult to achieve.
Optical casting, on the other hand, gives a data sampling every four hundredths of an inch and as such, has been found to be more accurate than plaster. With optical scanning we check the scan to see if it corresponds to the biomechanical examination. If discrepancies are apparent, another scan be quickly taken with very little effort. Offering improved speed and accuracy in orthotic casting, Vancouver Podiatry Clinic is pleased to introduce the next generation of 3-D lasers in our clinic.
Hallux limitus is the development of degenerative arthritis in the big toe joint (first metatarsophalangeal joint) that progressively limits motion in the joint (when the motion is completely gone, the condition is called hallux rigidus). The condition is also characterized by loss of joint space, spur formation and pain. Orthotics can offer some early relief for hallux limitus by removing stress from the joint.
Restoration of joint motion in cases of hallux limitus and rigidus can be achieved surgically by performing the Tricorrectional Osteotomy on moderately progressed joints and joint implantation or fusion on severely affected joints. The Tricorrectional osteotomy removes a wedge of bone from the metatarsal to allow the joint to shift plantarly and proximally. This decompression and plantar flexion osteotomy allows the joint to move normally and removes the deforming force causing the degenerative joint.
The podiatrists at Vancouver Podiatry have extensive experience treating the foot ailments of athletes in many sports, and have developed long-term relationships with several professional and national level teams. Vancouver Podiatry specializes in treating active people and athletes for injuries involving the foot and ankle.
There is a definite link between abnormal gait patterns and sports injuries. By controlling the mechanics of the foot and ensuring that the patterns of movement are correct, the risk of injury is reduced and the improved efficiency in their movement allows the athlete to become more proficient at their sport.
“Dr. Mathews resolved my neuroma after I had been told by two other doctors not to have the surgery as the recovery was long and the results not a sure thing. He suggested a new surgical technique to release the neuroma. After the surgery, I was walking around in ten days and had no pain by week three! The surgery has been a complete success after suffering for five years with pain, ineffective orthotics and cortisone injections. Thank you, Dr. Mathews.” A.J.
Morton’s neuroma is an inflammation of the nerve in the ball of the foot caused by an entrapment of the nerve between the metatarsal heads. The nerve becomes enlarged and is irritated by the metatarsal heads applying pressure on it. Symptoms of a Morton’s neuroma are pain and numbness in a specific spot in the ball of the foot, sometimes extending into the toes. At times the pain may be absent and, at other times, severe enough to require immediate removal of the shoe. The condition tends to get worse with time and can be a very debilitating disorder. When conservative treatments fail to relieve pressure from the nerve, a neurectomy (surgical removal of the damaged nerve) has traditionally been performed.
At Vancouver Podiatry we use the Fox System Arc 1264 nW laser for soft tissue deformities such as plantar fasciitis and Achilles tendonitis. The laser has the power to break down damaged collagen tissue and allow for regeneration of healthy fascia and tendons. Laser sessions typically occur on chronic injuries that have failed to heal Appointments last 30 minutes and allow for full physical within one week of treatment.
Lasertechnik Germany, A.R.C. Laser: The leading brand for laser technology
Pain under the ball of the foot, typically base of 2nd or 3rd toes. Feels like walking on swollen ball under the forefoot that gets more intense with more activity. Most painful barefoot without any support or cushioning. Caused by collapse of the transverse arch of the foot or with a bunion deformity. Treatments include proper shoes, custom orthotic support to raise the transverse arch or surgical re alignment.
A bunion is a mal-aligned big toe joint that causes inflammation of the overlying skin and soft tissue. Bunion pain is caused by either pressure on the tissues overlying the bunion, or from within the joint itself. Bunions are corrected by realigning the bone and joint of the first metatarsal and then removing the excess bone.
The Tricorrectional Bunionectomy (TCB) procedure a minimally invasive procedure that allows permanent correction while back into shoes in two weeks. The TCB provides a stable shifting of the bone with cannulated screw fixation which allows for immediate weight bearing of the foot and holds the bone in place for faster healing. Following TCB, patients are immediately able to stand and bear weight. They are back into athletic shoes on day 15 and in most cases, are resuming their regular physical activity by five weeks. Surgeries are performed with IV sedation and local anesthetic at False Creek Surgical Centre and Skin Works Surgical Centres in Vancouver BC. Patient leaves the surgical centre within a few hours of surgery, in most cases walking on the foot immediately.
90% of bunion surgeries performed by Vancouver Podiatry employ the TCB procedure. Lapidus procedures are reserved for the 10% of bunions that are too severe to benefit from TCB. These procedures require 6 to 8 weeks of non-weight bearing cast immobilization and a longer recovery time.
The Podiatrists at Vancouver Podiatry focus a substantial part of their practice on elective forefoot surgery. In particular, our podiatrists have a keen interest in offering the latest procedures for bunions, hallux limitus, neuromas and hammertoes. The doctors at Vancouver Podiatry perform a specific type of minimally-invasive bunion surgery called ‘Tricorrectional Bunionectomy’. Our Vancouver Podiatrists have recently incorporated both the StayFuse procedure for hammertoes and the Minimally Invasive Neuroma Decompression (MIND) for morton’s neuromas. Surgeries are performed with IV sedation and local anesthetic at False Creek Surgical Centre and Skin Works Surgical Centres in Vancouver BC. Patient leaves the surgical centre within a few hours of surgery, in most cases walking on the foot immediately.
604.264.1377