Achilles Tendonitis

Overview

Achilles tendinitis is an overuse injury common in many sports that require lots of running and jumping. Once this condition becomes more chronic adhesions that form along the tissues and the injury becomes more of a tendinosis. Treatment for a tendinosis is much different that for a tendinitis, so it is important to recognize what stage the injury is at in order to treat it appropriately. An acute achilles tendinitis involves inflammation and would be treated with rest, ice, etc. Once the inflammation has decreased, research shows that eccentric exercises are beneficial. Once there is tendinosis, it becomes imperative to break up those adhesions with ART and prescribe appropriate stretches and exercises.




Causes

The majority of Achilles tendon injuries are due to overuse injuries. Other factors that lead to Achilles tendonitis are improper shoe selection, inadequate stretching prior to engaging in athletics, a short Achilles tendon, direct trauma (injury) to the tendon, training errors and heel bone deformity. There is significant evidence that people with feet that role in excessively (over-pronate) are at greater risk for developing Achilles tendinitis. The increased pronation puts additional stress on the tendon, therefore, placing it at greater risk for injury.




Symptoms

Signs and symptoms of Achilles Tendinitis generally include pain and stiffness along your achilles tendon, especially in the morning. Pain in the back of your heel that gets worse with activity. Severe pain the day after exercising. Swelling that gets worse with activity. If you feel a pop in the back of your heel or bottom of you calf, you may have ruptured or torn you achilles tendon.




Diagnosis

When diagnosing Achilles tendinitis, a doctor will ask the patient a few questions about their symptoms and then perform a physical examination. To perform a physical exam on the Achilles tendon, the doctor will lightly touch around the back of the ankle and tendon to locate the source of the pain or inflammation. They will also test the foot and ankle to see if their range of motion and flexibility has been impaired. The doctor might also order an imaging test to be done on the tendon. This will aid in the elimination of other possible causes of pain and swelling, and may help the doctor assess the level of damage (if any) that has been done to the tendon. Types of imaging tests that could be used for diagnosing Achilles tendinitis are MRI (Magnetic resonance imaging), X-ray, Ultrasound.




Nonsurgical Treatment

Treatment for Achilles tendonitis, depends on the severity of the injury. If heel pain, tenderness, swelling, or discomfort in the back of the lower leg occurs, physical activity that produces the symptoms should be discontinued. If the problem returns or persists, a medical professional should be consulted. If pain develops even with proper stretching and training techniques, the patient should consult a podiatrist to check for hyperpronation and adequate arch support. The addition of an orthotic may be enough to maintain good arch and foot alignment and eliminate pain. If damage to the tendon is minor, the injury may respond to a simple course of treatment known as RICE (rest, ice, compression, elevation). Patients are advised to rest the tendon by keeping off their feet as much as possible, apply ice packs for 20 minutes at a time every hour for a day or two to reduce swelling, compress the ankle and foot with a firmly (not tightly) wrapped elastic bandage and elevate the foot whenever possible to minimize swelling. A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen may be used to reduce pain, swelling, and inflammation.






Surgical Treatment

If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.




Prevention

Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic increases in sports training, if you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse, wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury, maintain a normal healthy weight.

What Are The Presenting Symptoms Of Hallux Valgus?

Most bunions can be treated without surgery. But when nonsurgical treatments are not enough, surgery can relieve your pain, correct any related foot deformity, and help you resume your normal activities. An orthopaedic surgeon can help you decide if surgery is the best option for you. Whether you've just begun exploring treatment for bunions or have already decided with your orthopaedic surgeon to have surgery, this booklet will help you understand more about this valuable procedure. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Not only are the angles that form the bunion important, but the actual condition of the joint itself is also very important. If the cartilage making up the joint is too far eroded then even a procedure that creates perfect alignment of the joint is still going to be problematic for the patient. It is at this point that the surgeon has to decide to either remodel the joint or replace the joint with an implant or artificial joint. Unfortunately, the only real way to know the actual condition of the joint is to visually inspect it, once the foot is open. A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men. Some shoes can be modified by stretching the areas that put pressure on your toes. Splints to reposition the big toe and orthotics (special shoe inserts shaped to your feet) also may relieve pain. For bunions caused by arthritis, medications can be prescribed to reduce pain and swelling. Dr. Prateek Gupta M.S., M.ch-orth(Livepool),FICS(USA), D.Orth.(London), F.R.C.S - Orth(London), Consultant Orthopedics & Sports Surgeon. Sir Gangaram Hospital, New Delhi, India. When the above non-surgical treatment options have not worked, the health care provider will suggest undergoing a bunion surgery to correct the dislocation. The surgery can be performed by an orthopedic surgeon, who will loosen the tight tissues and shorten the long ones, so as to repair the tendons and ligaments present around the toe. Severe bunions can be corrected with the use of wires, plates and screws. There are different types of surgical procedures and the best procedure for you will be told to you by your surgeon. Bunion surgeries cannot be guaranteed for a total recovery. Often calluses and corns are developed as post operative complications. Orthotics, custom orthopedic foot supports, can help with mild hammer toes and bunions. They aren't a cure, but orthotics can make certain types of shoes more comfortable. Orthotics may slow down or perhaps prevent the progression of bunions and hammer toes. However, once the hammer toes and bunions become too large or severe an orthotic becomes just another thing occupying space in a crowded shoe. How does the nursery rhyme go? There was an old lady living in a shoe with so many hammer toes and bunions she didn't know what to do. Treat the pain with pain relievers, use pads to cover the bunions, buy shoe inserts, or surgery may be an effective option for you. Avoid wearing high heels and wear roomy shoes for comfort. Corn and calluses are dead thickened skin that is caused by friction. The thick skin forms to protect the sensitive skin on the foot. These will go away when you reduce the friction of the irritated area. Moleskin pads can eliminate corns and calluses can be trimmed or surgically removed. Other related procedures that may be used to help diagnose foot disorders include X-rays of the bone and foot. Please see these procedures for additional information. A bunion is an enlargement of bone or tissue around the metatarsophalangeal (MTP) joint of the great toe. It's often caused by patients wearing shoes that are too narrow around the toe box and can cause pain and deformity of the toes. If the patient's great toe is not overlapping or impinging upon the second toe, but he still has an obvious bunion, take a look at 727.1; this code specifically says 'bunion' and the ICD-9 definition is "enlarged first metatarsal head due to inflamed bursa; results in laterally displaced great toe." There is some controversy in the medical community about the benefit of physical therapy after surgery. I do not send all my patients for physical therapy; in fact in many cases I will just give them instructions in exercises and other things they can do at home to facilitate their healing (and only hope they actually follow my instructions). If after reading this page you are still "up in the air" as to what you should do about your bunion, may I suggest you visit the following web site for a personal account of one person's experience with a variety of non-surgical bunion treatments The bunion experiment TAILORS BUNION A bunion is caused by an abnormality in the position of the bones in the foot and big toe. Instead of being in line, meeting flatly end-to-end, the bone along the inside of the foot (the first metatarsal) and the first bone of the big toe ( hallux ) meet at an angle ( valgus deformity). The only way that they can be corrected is by surgery. In the past, surgical operations had meant being off one's feet and in plaster for up to three months. Called osteotomy, this conventional surgery involves cutting out a piece of bone and repositioning the two ends to try and straighten the toe.

Foot Pain Causes And Treatments

Excellent for medical ailments– Crocs are perfect for people with foot conditions and deformities that are aggravated by shoes with toe boxes that are too tight. Crocs provide a wide and roomy toe box, with lots of room for toes to spread out and lie flat.Crocs also offer a supportive heel cup that makes them an excellent choice for people that have swollen feet (plantar fascilitis). The contoured foot bed is designed to promote stability and reduce excess pronation. Cold hand treatment and prevention includes wearing gloves and socks even when you are indoors. You can try the following tips for cold hand treatment and prevent this condition. With acute ankle sprains representing nearly 20 percent of the sports-related injuries suffered yearly in the United States, it is important for coaches and others associated with athletics to know the proper procedure for taping an ankle. In addition to taping injured ankles, most athletic trainers suggest ankle taping as an injury-prevention measure-especially for those athletes who have suffered previous ankle sprains. Taping an ankle is not a complicated procedure, but it does require a person to follow step-by-step guidelines to provide effective support of the injured ankle. 10.if have a history of athletes foot ppl can dust antifungal powder on feet to prevent getting it again    Wearing high-heeled shoes can also stretch the ligament beyond the tolerable limits and cause inflammation. Those suffering from plantar fasciitis are also at an increased risk of developing heel spurs. Heel spurs also known as osteophytes are abnormal bony outgrowths that may develop along the edges of the heel bone. Heel spurs form when the plantar fascia starts pulling at the heel bone or gets torn due to excessive stress. footwear along with tips on buying the right type of shoes that may help to prevent plantar fasciitis and heel spurs. Can Poorly-fitted Shoes Cause Heel Spurs and Plantar Fasciitis? Plantar fasciitis is associated with the inflammation of plantar fascia. While a sprained ankle usually heals quickly and is not a disabling injury, too many sprains due to athletics or other physical activities can weaken the overall strength of the ankle over time. Wrapping a sprain will decrease discomfort associated with a sprain and also add support to prevent this gradual weakening. Taping an ankle before strenuous activity can also be used to prevent sprains and injury. The researchers set up a prospective, experimental, randomized, double-blinded, and controlled clinical trial, where patients were treated either with steroids or with Botox for their painful feet. Both groups were shown the same series of physical exercises to help their recovery. Varicose veins – Twisted, enlarged veins near the surface of the skin. They most commonly develop in the legs and ankles. Varicose veins develop when you have faulty valves in your veins and weakened vein walls. Normally, the one-way valves in these veins keep the blood flowing efficiently against gravity up toward the heart. When these valves do not function properly, blood pools, pressure builds up, and the veins become weakened, enlarged, and twisted. This is called venous insufficiency. This is where Easy Feet comes in. Easy Feet is a fantastic new product that allows you to clean and massage your feet without having to bend over to do it. We have recommended many male consumers to try on a female size FiveFingers and have had great success. The only difference between a male and female FiveFingers is that, male "lasts" are slightly wider and longer than the female models. If your foot is smaller than the smallest male size, certainly try on a female size based on your measurement in inches -you may have much better luck! Alternately, if you are a woman and your foot is bigger than the largest female size, we encourage you to try one of our Men's models based on your foot measurement in inches. Â

What Is A Foot Callus & How Can It Be Treated?

The common symptom in all types of onychocryptosis is extreme pain. Apart from that the patient will also face some minor discomfort in placing the feet on the ground. The patient will also feel a pressure from the side of the nail and this happens as it is actually penetrating the skin down the side of the nail. After a nail penetrated inside the skin the toe is obviously to be infected. If not taken proper care, the infection may spread, making the toe inflamed and red. Apart from that a collection of pus may also develop. It is also helpful to actually injure a plant slightly when trying to force it to develop roots. When a plant is injured, it develops a callous over the wound as protection. This callous build up is necessary before roots will develop. Cutting just below a node on the bottom of a cutting causes the plant to develop callous and eventually, roots. If you or your child continuously gets warts, make sure to avoid walking barefoot. Change socks and shoes daily. Keep feet clean and dry, and pay attention to any changes that occur on your feet. Corns can usually be easily seen. They may have a tender spot in the middle, surrounded by yellowish dead skin. Treatment of corn use a pumice stone. Applying lanolin-enriched lotion to help the skin become soft around the corn can also be an option. Wearing a donut-shaped foam pad over the corn will also help relieve the pressure. Use non-medicated corn pads; medicated pads may increase irritation and result in infection. Treating foot corns by using removing ointments that contain acid can damage healthy skin on the other areas of the foot. Tailor's bunions may or may be painful deformities. If pain is present, it usually occurs with shoes. The area becomes painful when the bony prominence of fifth metatarsal head rubs against the shoe, resulting in pain and inflammation. Continued shoe friction against the tailor's bunion can cause swelling, redness and callus formation. On examination, there is pain when pressure is applied to the outside or bottom of the fifth metatarsal head. A fluid-filled pouch, called a bursa, may be found between the bone bump and the skin. This forms as a process of the body's protective mechanism to protect the bone against the friction from the shoe. The most common disorder is called sesamoiditis. This is inflammation of the sesamoid bone and is usually caused by repetitive trauma. It is commonly seen in young adults, athletes, dancers and women that wear high heel shoes. Most of the time, the pain from sesamoiditis is worse with shoes when weight bearing. The pain is located directly under the sesamoid where swelling and redness maybe noted. Try not to walk barefoot on hard or firm surfaces such as asphalt or concrete for any length of time, or protective calluses will begin to form on the soles of your feet On the lateral side of the ankle there are three ligaments that make up the lateral ligament complex. These include the anterior talofibular ligament (ATF), the calcaneofibular ligament (CF) and the posterior talofibular ligament (PTF). The very common inversion injury to the ankle usually injures the anterior talofibular ligament and the calcaneofibular ligament. The ATF ligament keeps the ankle from sliding forward and the CF ligament keeps the ankle from rolling over on its side. Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges. Another consequence of the jamming of the big toe joint is the development of bone spurs on the top of the joint. This bump on the top of the big toe joint can become painful as a result of shoe pressure. Pain within the joint is a common result of the limitation of movement of the big toe joint. With time, the big toe joint becomes stiff and painful to move. As the joint continues to degenerate more bone spurring occurs. If the condition is left untreated complete destruction of the joint can occur.

Top 10 Causes Of Lower Left Back Pain

Please note, however, that simply doing theseexercises once or twice a week isn’t going to do much for you in the long run.If you want to get rid of your back pain, you need to carry out these exercisescontinuously, and be dedicated. Miracles won’t happen overnight, your bodyneeds time to adjust and feel better. Dedication is key, and patience is a virtue. With your back to the wall, place ball against the glute and wall, twist hips side to side and feel for tight spots in the glute. Find a tight spot and let pressure rest for 10-30 seconds. Exercise can help reduce chronic back pain. Repetition is the key to increasing flexibility, building endurance, and strengthening the specific muscles needed to support the spine. Exercise should be considered as part of a broader program to return to normal home, work, and social activities. In this way, the positive benefits of exercise not only affect strength and flexibility but also alter and improve patients' attitudes toward their disability and pain. Exercise may also be effective when combined with a psychological and motivational program, such as cognitive-behavioral therapy. Massage therapy can help some patients with chronic or acute back pain, especially when combined with exercise and patient education. Cognitive-Behavioral Therapy Once your initial back pain subsides, try going for a walk. Don't carry anything and keep your head up. This kind of gentle exercise can reduce back spasms and improve your mood. If the walk doesn't reduce or eliminate the pain, it will at least take your mind off of it. To get temporary relief from back pain, consider both ice and heat for at-home treatment. Ice is most effective in reducing pain from a recent injury as it helps to reduce inflammation. Meanwhile, heat is more effective at penetrating deeply to soothe more serious injuries related to chronic back pain. As people get older, so do their bones. They age just like every other part of the human body, and they need care in order to stay healthy and function at their optimum level. Degenerative disc disease affects many people. It can be crippling and can make it very difficult to live a normal life. Cervical spine degenerative disc disease makes it difficult to do everyday, normal things due to decreased movement ability. There is treatment for this medical condition, but how much help and how much mobility each patient gets back is questionable. Lower back and leg pain can be caused by lack of flexibility or bearing too much of body's weight. It is important to both stretch and strengthen these muscles so that you can give yourself better support, whether you sit at a desk all day or have an active job. Two exercises-the Downward Facing Dog and a Hamstring Stretch-can be performed within the comforts of your own home. Exercising in the water is a great way to stay active while dealing with the pain associated with spinal stenosis. Being in the water takes the pressure off of the back and allows the vertebrae to move more loosely without pain. If you are in search of some good yoga music or meditation music for practicing yoga or meditation, then Spirit Voyage has something to offer you. Spirit Voyage is an online record label music company. A huge collection of serene spiritual music including A Hundred Blessings, Into Grace, Yoga Revolution, Buddha Lounge 7, etc. Will fill the air with the soothing tones and induce a tranquil ambiance around. This company also takes pride in offering its collection of yoga DVD which can guide the yoga practitioner to do the right poses and postures. computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays. Many of the physical changes that can cause low back pain during pregnancy may contribute to an achy back now, especially if you've given birth very recently. Other factors come into play during the postpartum period too. Patients may experience pain or numbness, which can occur in both legs, or on just one side. Other symptoms include a feeling of weakness or heaviness in the buttocks or legs. Symptoms are usually present or will worsen only when the person is standing or walking upright. Often the symptoms will ease or disappear when sitting down or leaning forward. These positions may create more space in the spinal canal, thus relieving pressure on the spinal cord or the spinal nerves. Patients with spinal stenosis are not usually able to walk for long periods of time, but they may be able to ride a bicycle with little pain. Spondylolisthesis

Is Bunion Surgery Right For You?

Plantar Fasciitis, heel pain and heel spurs are best treated with simple, non-surgical methods. However, the longer the heel pain has been present, the longer it takes to fix. Heel pain is best treated by doing some simple stretching exercises, combined with wearing foot orthotics. This way the tension on the Plantar Fascia is being released, treating the cause of the problem, not just the symptom. 2) Arch Pain Treatment of Achilles Tendontis includes rest (or reduced activity), calf stretching and ice packs. Orthotics are recommended to support the arches, thereby reducing the stress on the achilles tendon. 4) Ball of Foot Pain (Metatarsalgia) Even though bunions can be hereditary, most often bunions are related to wearing shoes that are too tight, too narrow and too high causing pressure on the natural anatomy of the forefoot. The joint at the base of the toe flexes with every step and continued pressure on this area causes the joint to continue to enlarge causing increasing pressure, pain, swelling and redness. Warm Epsom salt soaks, bunion pads, bunion night shields, bunion bandages, and even orthotics can provide temporary relief of pain but it is making the decision to wear properly fitting shoes which is the best treatment decision of all. The most common cause of hallux valgus is poorly fitting shoes, according to the American Academy of Orthopaedic Surgeons. Shoes with a tight toe box that push the toes together can lead to the formation of a bunion. High-heeled shoes are the worst for this condition. In fact, the American Academy of Orthopaedic Surgeons state that studies have shown that the majority of women in the U.S. wear shoes that are too small, and over half of them have bunions. Other factors like improper foot mechanics due to altered arch height play a role. Hallux valgus can also result from genetic factors and conditions like arthritis and neurological disorders. Shoes is the major from the shoe, uppers, soles, heels and lasts for a couple of elements, to be familiar with the basic composition in the footwear can assist you from the many sneakers make a sensible decision. Toe cap is definitely the tip of the shoe to offer room for digits, the top of the shoe is often round, or it could possibly be pointed, decided to digit place sizing. Most procedures involve accessing the bones and joints in question through an incision in the top of the foot. In some cases, screws, wires, stitches or plates may be used to stabilize the bones and joints. The most common type of surgery is involved to realign the bones of your toe. Ligaments and tendons are also tightened and also the swelling is also shaven away. And if these need surgery, then it is very much crucial and the reason behind the matter is also addressed by the doctor. But be sure to do it perfectly as if you fail to try this then a extra surgery is needed when bunion returns in a few years. So be careful about the treatment process as your age and the mobility of your joint is also an important factor for your recovery after the process is done. Osteoarthritis and other joints diseases can often be linked with bunion. Corrective surgery may be required in severe cases, and in cases where no treatment can relieve the pain. As for corrective surgery, there are many types. The type of surgery to be done will depend on the problem type found in one's soft tissue and toe bones. Hallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women. Your feet take a pounding every day from walking,standing, exercise, working and shoes. When you add a foot disorder to theequation, each painful step reminds you of how much stress your foot takes. Arecent study by the American PodiatricMedical Association showed that there is a 75% chance ofyou having some type of foot aliment during your lifetime. While there arenumerous foot conditions, some conditions are much more common than others.Understanding these conditions and what you can do to help yourself can be thefirst step back towards a pain-free lifestyle. There are few self-treatment options for thiscondition, but here are a few things you can try on your own to help.

Tailor Bunion Articles

Diabetics must be extra careful with corns and calluses. Because of poor circulation and decreased nerve functioning in the feet, diabetics have an increased risk of infection from corns and calluses. The same applies to anyone who is not diabetic but has poor circulation or decreased nerve sensitivity in the feet. Self-care of corns, calluses and other foot problems could put you at risk for infections and trauma. Seek out the care of a certified foot care nurse who is trained in diabetic foot care such as at McDermott Footcare. Experiment with different shoes. Play with your style. At least find something that you can wear to less important days/nights. Footwear plays a large role in the development as well as the prevention of foot and toe problems such as bunions , calluses and corns , and hammer, claw, and mallet toes Shoes that don’t fit properly make these conditions worse and more painful. A bunion is an enlargement of bone or tissue around the joint at the base of the big toe that causes a bump on the joint. The big toe may turn toward the second toe (displacement), and the tissues surrounding the joint may be swollen and tender. In our hectic lives, we tend to tune in to the external and tune out the body and all it is warning us about. We need to pay attention for our own health as well as that of our children. A proper and early diagnosis can help prevent a lifetime of pain. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage. FootRestore can bring relief while you sleep by removing pressure from the metatarsals. Attractive to some and a nuisance to others, this bony bump at the base of the big toe joint can become extremely painful as it worsens. Soft, wide shoes or sandals are generally the most comfortable footwear options for bunions Ensure that the toe box is wide enough to allow your toes to wiggle and that there is no stitching on the side of the bunion bump. You may also require custom-made orthotics or foot slings, in case the bunion is associated with faulty foot biomechanics. Stop pretending that your feet are the size of little dogs when they are really the size of big dogs. Measure your feet always!!!! ARCH PAIN. As mentioned with heel pain, the lack of support to the shoe often will cause inflammation of the plantar fascia. However, instead of the heel , the scource of pain will be located at the arch. The plantar fascia begins at the heel but fans out to the forefoot. Lack of support will often cause excessive stretch to the fascia along the arch thus leading to pain. Women experience pain when they wear high heels because their feet slide forward into the shoes, inevitably forcing their bodies to redistribute their weight while creating unnatural pressure points and disrupting the natural alignment of our body. Many times a little tender loving care is all that is needed. Soak the affected area in warm water until the skin softens (usually about 10-15 minutes). Then remove the loosened skin with a pumice stone or other device specifically for corn or callus removal. The rough, thick skin will come off in small pieces due to the abrasion effect of the stone. Do not over do this on the first treatment. Soaking and pumice will take several or even many treatments to make a great difference in the size of the corn or callus. Rochester Wellness in Dubai (United Arab Emirates) & Muscat (Sultanate of Oman) is looking forward to introducing Medical Foot Care Clinics to deliver better patient-centered care. The best multi- disciplinary clinics world-wide are created one step a time. This new service for Rochester Wellness is a welcome addition to our Rehabilitation & Home Care programs. We believe this reinforces our commitment to providing accessible health care programs in Oman. If you have to remove your shoes (i.e. religious places) it is best to visit early morning or late in the evening. When the ground is hot it can blister your feet. Will my bunion come back after surgery?” is a popular question from patients. In most cases, the surgery outcome will be maintained in the long term. However, recurrence is possible. Certain foot types, such as those with (excessive motion of the foot joints), might be prone to recurrence. These patients should pay closer attention to shoe choices and consider using orthotics after surgery. Sometimes, the condition recurs because an incorrect procedure was performed. In those cases, a less than ideal procedure might have been chosen in exchange for a shorter recuperation. After spending four weeks in the surgical shoe or the fracture brace I allow patients to start wearing loose-fitting shoes or open shoes in the warmer weather. At this time they may start to increase their walking a bit. I advise them that they will most likely not be doing exercise until six to eight weeks after surgery. Initial exercise includes walking and using a stationary bike. After eight to ten weeks they may start to do an elliptical machine or more weight bearing exercises. At eight weeks, I advise them that they may start using any shoe that they fit into. Do file the corn or callus with an emery board or pumice stone every several days after bathing to reduce the amount of hard tissue. The act of bathing or showering moistens and loosens the superficial hard skin, and makes it easier to file this tissue off without having to sand away like the foot was a piece of wood. Don't use medicated corn pads or liquid corn remover. These chemicals, which are mainly skin acids, can eat away at the good surrounding skin and cause chemical burns if improperly applied. Diabetics, those with poor sensation, and those with poor circulation should especially avoid using these products.