Wednesday, June 25, 2008

calcaneal apophysitis (heel pain)...

calcaneal apophysitis (heel pain)
(Sever's disease)

Calcaneal apophysitis otherwise known as Sever's disease is a painful condition that occurs in the heel bone (calcaneaus) in patients generally between the ages of 10 to 15 years of age.

Calcaneal apophysitis is a disease of the growth plate of the bone.
As babies most of our bones are made up of cartilage. The bones have what is known as a growth plate. It is from this growth plate that each bone continues to form eventually becoming adult bones.That is why a calcaneal apophysitis is seen during development at ages 10-15; this is just before the bones fuse and finalize in their appearance. This type of condition is not limited to the heel bone.

The Achilles tendon attaches into the back portion of the heel bone. It is thought that the tension created by the Achilles tendon on that portion of bone 'pulls' that section of bone away from the remaining section of heel bone at the level of the growth plate and thus creates pain (note the blue arrows). Because of this mechanism, this condition is also known as a traction apophysitis.

Typically, the young patient will complain of pain on the inside and outside of the heel bone.
The pain will be worse during practice and will generally only improve somewhat when not participating in their sport, only to worsen once they play again. Obviously, this pain then limits their ability to compete.

One of the things that is often overlooked is the type of athletic shoe worn by the young athlete. An adolescent athlete may be heavy and strong enough to drive the cleats in the heel of the shoe into the ground, but not the cleats or studs in the forefoot which remain on top of the ground. This creates a relative dorsiflexion of the foot to the ankle and will increase the tension on the achilles tendon resulting in apophysitis. Turf shoes or sneakers with an elevated heel or the addition of heel lifts to the shoes should help negate this situation.

Additionally, athletic shoes that are too worn out in the heel area will also create this relative dorsiflexion of the foot on the ankle. Needless to say replacing worn out athletic shoes may go a long way to reduce the strain on the achilles tendon at the heel bone.

Diagnosis is made on the clinical history. X-rays should be taken to rule out a fracture in the area but the growth plate looks the same with or without this condition. Some clinicians feel that in an apophysitis the growth plate will look at bit more jagged than a normal heel, but I feel the interpretation is very subjective and not reliable.

As is a common theme on this site in regards to foot pain, walking on an injured area tends to delay healing so the pain of an apophysitis can linger. As much as the child does not want to hear it, in many cases rest is necessary to reduce the pain; this may mean giving up their sport.
Depending on the degree of pain the patient may try icing the heel both before and after practice. Anti-inflammatory medication may also be helpful taken 30 minutes before practice.

Many patients who suffer from an apophysitis have a tight heel cord which then puts more strain on the back portion of bone. To see if you have a tight heel cord as a precipitating cause of calcaneal apophysitis, see the section on achilles tendonitis.. If that is the case a gel heel lift can be very helpful to both take tension off the Achilles tendon and to cushion the heel.

Some doctors feel that feet that exhibit too much PRONATION are more prone to a calcaneal apophysitis due to the way the heel hits the ground when running (and walking) and that the best way to treat the problem is through the use of orthotics.If the child has a tight heel cord it is better not put them in orthotics because in that situation pronation is the way the child is compensating for the tight heel cord and to add an orthotic to this scenario will only increase the tension on the Achilles tendon. A better approach would be to strap the heel to not allow over pronation.

In any event, a calcaneal apophysitis is a self-limiting condition and will eventually resolve itself. The only variable is how long it will take in a given individual.( usually by age of 16 yrs )

Sunday, June 22, 2008

AVOIDING ALLERGIES: From Food or Feathers !!

Have you ever experienced itching and rashes after eating a lobster, a crab, or shrimps? Chances are you have an allergy. An allergy is an immune system response. The signs and symptoms of allergy are reactions of the immune system to substances or chemicals that are normally harmless. Just a little exposure to an allergen is enough to alert the immune system of the substance. Immediately, the immune system would signal for the release of histamine and other chemicals. The release of these chemicals triggers swelling, itching, mucus production, hives, rashes, and muscle spasms. The extent of the reaction is different from person to person. For some people, an allergic reaction could be life threatening and demand immediate medical attention. Life threatening reactions are called anaphylaxis. People with eczema and asthma usually have allergies connected with the disorders.

Allergens could be anything depending on a person's response. Some people are even allergic to hot or cold temperatures, sunlight, or other physical stimuli. Allergic reactions could also be brought about by the use of certain cosmetics, jewelry, and insect bites. The most common allergens include: pollen from trees, grass, and weeds, mold, proteins found in the skin, saliva, and urine of domesticated animals, and dust mites.

In order to prevent activating your allergy to pollen, take a bath or shower before bedtime to make sure to get rid of pollen on your hair and skin. During dry, windy days, avoid going outside and close windows and doors. You might need to have air conditioner at home and in your car. If you want to fight molds, remove house plants and clean shower curtains often, including bathroom windows, wet walls, areas with dry rot, and indoor trash cans. To effectively kill a mold, you have to use a mixture of water and chlorine bleach. To prevent mold, increase the movement of air inside the house using fans or by opening doors and windows. You may also decide to use mold-proof paint on your bathroom and use a humidifier to reduce humidity in the house.

If you have severe allergy related to your pets, perhaps it would be best not to have a pet in the first place. However, you could also do well by giving your pet a daily bath and by using air filter. You could also consult your friendly veterinarian about reducing pet dander in the house.

You can never get rid of dust and dust mites, but you could reduce them. To do so, get rid of feather pillows, drapes, upholstered furniture, non-washable comforters, and soft toys. Use linoleum or wood instead of a carpet, although polished floors are the best option for you. Mop the floor often with damp mop and clean surfaces with damp cloth. Regular vacuuming is needed, especially on soft furniture, curtains, and floors. You may also need to install an air cleaner. Try not to use mattress pads, but cover mattress and pillows with plastic covers instead. Lowering the humidity of the house also helps fight off dust.

Saturday, June 21, 2008

PETS 4 PEOPLE With Allergies or Asthma....

You have probably heard about the health benefits of having a pet. Pets bring life and joy to their owners. Families with pets are generally healthier in many respects. If you, or someone you love, suffers from allergies or asthma, it is possible to experience the thrill and love of owning a pet. Here are some tips to consider when considering a pet.

Not everyone is allergic to pets. Just because you have asthma or allergies, does not mean you are certainly allergic to pets. I, have asthma and seasonal allergies, but have no problems with pets. In my home, I have three labs and two cats that give me no problems at all. In fact, I have more difficulty from the dust of the cat litter than anything. Despite my asthma and seasonal allergies, the pet dander doesn't affect me adversely.

If you or someone in your family does have allergies to pet dander, you still have options when considering a pet. If you are looking for a relaxing pet that will not give your allergies a rude awakening, consider setting up an aquarium. Fish won't set off your allergies. You can enjoy watching the beauty of the fish in the aquarium. The swimming and darting fish in many colors add life to your home.

Lizards, frogs, and snakes make good pets. Learn about reptiles and select the pet that is right for you and your family. Reptiles do not have pet dander that often spark allergic reactions.

When you think of a pet, what comes to mind for you? Frequently, people think of cats or dogs. Fish and reptiles do not seem like the perfect pet for some folks. They crave the cute and cuddly puppy or kitten. If you are this type of person, consider finding a breed of dog or cat that suits your needs. Hairless cats and dogs are available. Some think these pets are unattractive, but their skin feels fabulous. They feel baby soft.

If you crave the fuzzy fur feeling, consider a dog that doesn't shed. Eliminating the shedding often keeps allergies at bay. Schnauzers, poodles, and other breeds do not have the typical shedding problem often associated with other breeds of dogs. This may be a solution to your allergy or asthma situation.
If you suffer from allergies or asthma associated with pet dander, it is still possible to enjoy a pet in your home. Explore your options when considering a pet for your family. With a little research, you will soon

Find a pet that is just right for you. There is no need to suffer from allergies and asthma just for the love of pets.