Month: December 2015

Growing Pains

Posted on by Staff

Most cases of growing pains in the child are benign and they come right, but on rare occasions the symptoms are the same as some pretty nasty things, so for thos reason all cases of growing pains have to be taken seriously and properly investigated.

Growing pains are a common, benign condition in children, typically characterized by aching or throbbing sensations in the legs, most often felt in the thighs, calves, or behind the knees. These pains usually occur in children between the ages of 3 and 12 and often strike in the late afternoon or evening, sometimes waking the child from sleep. Despite the name, growing pains are not directly caused by growth spurts—bones grow gradually and don’t cause pain themselves. Instead, the discomfort may be linked to muscle fatigue or overuse from physical activity during the day.

The pain is typically bilateral, meaning it affects both legs, and is not associated with swelling, redness, or limping. That’s an important distinction because if the symptoms are persistent, occur in only one leg, or are accompanied by fever or swelling, it may point to something more serious like juvenile arthritis, infection, or injury, which requires medical evaluation. Growing pains often go away by morning, and children usually don’t have any pain during the day. The condition tends to come and go over time and may be more noticeable after particularly active days.

No single test can diagnose growing pains, so healthcare providers usually base the diagnosis on symptoms and physical exam findings, while ruling out more serious conditions. There’s no specific treatment, but symptoms can be relieved with gentle massage, stretching exercises, or warm baths. Some parents also find that applying a warm heating pad or giving a mild over-the-counter pain reliever like acetaminophen or ibuprofen (under a doctor’s guidance) helps. It’s also reassuring to explain to the child that the pain, while uncomfortable, is not dangerous or permanent.

Although growing pains are not harmful, they can be distressing—both for kids who experience them and for parents trying to comfort them. Open communication, reassurance, and a consistent bedtime routine can help ease the emotional and physical discomfort. It’s a good idea to keep a symptom diary if the pains are frequent, just in case patterns emerge or the doctor needs more context. And while growing pains are normal, anything unusual—like pain in one specific spot, persistent or worsening pain, or other symptoms like joint stiffness—should be evaluated to rule out other causes.

Most Useful Resources:
Growing Pains (Foot Health Forum)
Growing Pains (Podiatry TV)
Growing Pains (PodiaPaedia)
Growing Pains (Podiatry Arena)
Growing Pains in Children (Podiatry Arena)
Night-time foot pain in children (Foot Health Forum)
Growing Pains? (Podiatry Experts)
Growing Pains in Children (iPodiatry)
Take Growing Pains in Kids Seriously (Foot Health Friday)
Growing Pains (Foot Health Guide)
Growing Pains in the Leg: Throwing the kitchen sink at growing pains

Foot Posture Index

Posted on by Staff

Foot Posture Index is a composite measure of the posture of the foot based on 6 different observations of the alignment or posture of different segments of the foot.

Most Useful Resources:
Foot Posture Index (Foot Health Forum)
Foot Posture Index (Podiatry TV)
The Foot Posture Index (Podiatry Update)
Foot Posture Index (Clinical Boot Camp)
Foot Posture Index (PodiaPaedia)
Foot Posture Index (Podiatry Arena)
Foot Posture Index (Podiatry Arena)

Foot Health Practitioners

Posted on by Staff

Foot Health Practitioners are a group of unregulated practitioners in the UK who came into existence to get around the requirements of the Health Professions Council to be registered as a podiatrist.

Foot Health Practitioners (FHPs) in the UK form a distinct group within the wider foot care sector, often working alongside or independently from regulated professionals like podiatrists. While they are not subject to statutory regulation—meaning there is no legal requirement for registration with a government body—they typically complete specialized training through accredited colleges or private providers. These courses often range from a few months to a year and equip FHPs with essential skills in routine foot care, such as nail trimming, corn and callus removal, and basic diabetic foot monitoring.

Despite their unregulated status, many FHPs provide valuable services, especially in areas where access to NHS podiatry is limited or has long waiting lists. They often operate private practices, offer home visits, and serve communities that might otherwise struggle to get basic foot care. Their work is particularly appreciated among elderly clients or those with mobility challenges who benefit from regular maintenance of foot health to avoid complications. However, because they’re not regulated by the Health and Care Professions Council (HCPC), they are legally restricted from using the title “podiatrist” or performing advanced clinical procedures.

One of the key concerns surrounding unregulated practitioners like FHPs is the inconsistency in training standards and oversight. Unlike HCPC-registered podiatrists, who must adhere to strict educational requirements and professional codes of conduct, FHPs are not legally bound to the same levels of accountability. This can lead to confusion for patients who may not understand the difference in qualifications and scope of practice. While many FHPs are highly competent and ethical, the absence of formal regulation leaves the door open for potential variability in care quality.

That said, there are voluntary registers and associations—such as the Alliance of Private Sector Practitioners and the British Association of Foot Health Professionals—that aim to uphold professional standards within the field. These organizations offer guidelines, continuing education, and ethical frameworks to promote safe and effective practice. Still, without statutory regulation, the onus remains largely on the public to research and choose their foot care provider wisely. Clearer differentiation and perhaps future regulatory reform could help improve transparency and protect both patients and practitioners.

Most Useful Resources:
Foot Health Practitioners (Foot Health Forum)
Foot Health Practitioners (Foot Health Practitioners Info)
Foot Health Practitioners (Podiatry Arena)

Foot Pain

Posted on by Staff

Foot pain is what Podiatrists do. There are plenty of good and bad resources on the web on foot pain.

Foot pain is a common complaint that can arise from a variety of causes—ranging from overuse and injury to underlying medical conditions. The human foot is a complex structure with 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments, all of which must work together smoothly to support body weight and enable movement. When any part of this intricate system is stressed or damaged, pain can develop in different areas such as the heel, arch, toes, or ball of the foot. The nature and location of the pain often provide clues to its cause.

One of the most frequent culprits is plantar fasciitis, a condition involving inflammation of the thick band of tissue (plantar fascia) that connects the heel bone to the toes. This typically causes sharp pain in the heel, especially during the first steps in the morning or after prolonged periods of rest. Other common causes include bunions, flat feet, high arches, Achilles tendinitis, and stress fractures. Footwear plays a huge role too—shoes lacking proper arch support, cushioning, or fit can gradually lead to discomfort or exacerbate existing problems.

Systemic conditions like diabetes, arthritis, and gout can also manifest as foot pain. Diabetic neuropathy, for instance, leads to nerve damage that causes burning, tingling, or numbness, especially in the feet. Rheumatoid arthritis can cause swelling and deformity in foot joints, while gout results from a buildup of uric acid crystals, often striking suddenly with intense pain in the big toe. These types of foot pain usually require medical management beyond just physical therapy or orthotic support.

Treatment depends entirely on the cause. For overuse injuries or inflammation, rest, ice, compression, elevation (RICE), and non-steroidal anti-inflammatory drugs (NSAIDs) may offer relief. Proper footwear, custom orthotics, stretching exercises, and weight management can go a long way in preventing recurrence. Chronic or severe pain should always be assessed by a healthcare provider, as ignoring it can lead to long-term dysfunction or more serious conditions. If your foot pain lasts more than a few days or interferes with your daily activities, it’s best to get it checked sooner rather than later.

Most Useful Resources:
Foot Health Forum (Foot Health Forum)
Foot Pain Info (Foot Pain Info)
Foot Pain (ePodiatry)
Foot Health Friday (Foot Health Friday)
Dr the Foot Without the Dr (Dr the Foot Without the Dr)

Foot Manipulation

Posted on by Staff

Foot manipulation and mobilization is commonly used to treat a wide range of foot problems ranging from the chronic problems that develop after and ankle sprain to heel pain to cuboid syndrome to bunions.

Foot manipulations refer to manual techniques used by professionals—like physiotherapists, chiropractors, osteopaths, or massage therapists—to mobilize or adjust the joints, soft tissues, and fascia in the feet. These techniques are often aimed at improving mobility, reducing pain, enhancing alignment, and restoring functional movement. Because the feet have 26 bones and over 30 joints each, they can easily become stiff or misaligned, especially due to modern lifestyles, poor footwear, or injuries.

There are several types of foot manipulations, ranging from gentle mobilizations to more direct joint adjustments. Mobilization involves rhythmic movements to gradually increase joint range of motion, while manipulations often use quicker, more precise thrusts to reposition a misaligned joint. These methods are often used for conditions like plantar fasciitis, metatarsalgia, ankle sprains, and general foot stiffness. Soft tissue techniques may also be applied to muscles and fascia, helping release tension and improve blood flow.

Beyond injury treatment, foot manipulations can also benefit posture and overall biomechanics. Since the feet are the foundation of the body, misalignment or restrictions there can ripple upward, affecting the knees, hips, or spine. Some practitioners even include foot manipulations as part of holistic or preventative care. However, like any manual therapy, it’s important to have them done by a trained professional to ensure safety and effectiveness—especially if there’s an underlying condition like arthritis, fractures, or neuropathy.

Most Useful Resources:
Foot Manipulation (PodiaPaedia)
Manipulation (Podiatry Arena)
Foot Manipulation (Foot Health Forum)
Manipulation (Podiatry TV)
Does foot manipulation work?

Forefoot Supinatus

Posted on by Staff

Forefoot supinatus is a common foot type in which the forefoot is inverted relative to the rearfoot. In comparison o a bony foefoot varus, the supinatus is a soft tissue contracture.

Forefoot supinatus is a positional deformity of the forefoot, commonly seen in patients with flatfoot (pes planus) or other structural imbalances. It refers specifically to the inversion (upward and inward tilt) of the forefoot relative to the rearfoot, not due to a bony abnormality but rather due to soft tissue adaptation. It’s often a flexible deformity, meaning that the bones are not fixed in this position and the forefoot can be manually corrected to a neutral or pronated position. This makes it different from rigid forefoot varus, which is a structural and non-reducible condition.

The key thing with forefoot supinatus is that it’s usually a compensatory mechanism. When someone has excessive rearfoot pronation—basically, their heel rolls inward too much during walking—the forefoot can adapt by inverting to try and keep the medial column (the inner part of the foot) in contact with the ground. Over time, soft tissues on the lateral (outer) side of the forefoot can tighten, leading to a maintained supinated position even when the person is non-weight bearing. This is often assessed clinically by checking the flexibility of the forefoot in a non-weight-bearing position.

Diagnosing forefoot supinatus involves a combination of physical examination and sometimes gait analysis. A podiatrist or orthopedist might look at the subtalar joint, assess rearfoot and forefoot alignment, and determine whether the forefoot can be corrected manually to a neutral or pronated position. A positive “Hubscher maneuver” (also known as the Jack test) can indicate flexibility in the arch, which may help distinguish supinatus from more rigid deformities. It’s also important to differentiate it from forefoot varus, as the treatment approach differs significantly.

Treatment for forefoot supinatus focuses on addressing the root cause, typically the excessive rearfoot pronation. Custom foot orthoses with medial arch support and possibly forefoot posting can help realign the foot and offload stress from compensatory structures. In some cases, stretching and strengthening exercises are prescribed to restore muscular balance and improve flexibility. Since the condition is positional and soft-tissue based, early intervention can often correct or significantly improve the deformity without the need for surgery.

Most Useful Resources:
Forefoot Supinatus (PodiaPaedia)
Help needed with forefoot supinatus? (Podiatry Arena)
Forefoot Supinatus (Foot Health Forum)
Student with questions on forefoot varus and supinatus (Podiatry Arena)
The effect of forefoot varus on the hip and knee and the effect of the hip and knee on forefoot supinatus … (Running Research Junkie)

Fibromyalgia and the Foot

Posted on by Staff

Fibromyalgia is a miserable chronic pain condition that affects the whole body including the foot.

Fibromyalgia is a chronic condition characterized primarily by widespread musculoskeletal pain, accompanied by fatigue, sleep disturbances, memory issues, and mood disorders. It’s classified as a central sensitization syndrome, meaning that the brain and spinal cord process pain signals abnormally, often amplifying sensations that wouldn’t typically cause discomfort. This heightened sensitivity can make everyday activities feel painful or exhausting, even when there’s no obvious injury or inflammation present.

While the exact cause of fibromyalgia remains unclear, researchers believe it results from a complex interplay of genetic, environmental, and psychological factors. Many individuals report the onset of symptoms following a physical trauma, surgery, infection, or significant psychological stress. Genetics appear to play a role too — fibromyalgia tends to run in families, suggesting a hereditary predisposition. Neurotransmitter imbalances, especially involving serotonin, norepinephrine, and dopamine, are also suspected to contribute to the disorder’s impact on pain perception and emotional regulation.

Diagnosing fibromyalgia can be tricky, mainly because its symptoms mimic those of other conditions like chronic fatigue syndrome, rheumatoid arthritis, or lupus. There’s no definitive lab test for it; diagnosis usually hinges on clinical evaluation and ruling out other illnesses. The American College of Rheumatology’s criteria include a widespread pain index (WPI) and symptom severity (SS) scale, with symptoms persisting for at least three months. Patients often experience what’s referred to as “fibro fog” — a cognitive impairment that affects memory, focus, and mental clarity.

Managing fibromyalgia is a long-term, multidisciplinary effort. There’s no cure, but symptoms can be controlled through a combination of medication, lifestyle adjustments, physical therapy, and psychological support. Medications like duloxetine, pregabalin, and low-dose antidepressants are commonly used to manage pain and mood. Regular low-impact exercise, such as swimming or yoga, often helps improve function and reduce symptoms over time. Just as crucial are stress-reduction techniques like mindfulness, cognitive behavioral therapy (CBT), and good sleep hygiene — all of which can significantly improve quality of life for those living with fibromyalgia.

Most Useful Resources:
Fibromyalgia and the Foot (PodiaPaedia)
Fibromyalgia and Heel Pain (Podiatry Arena)
Fibromyalgia (Foot Health Forum)
Fibromyalgia (Podiatry TV)
Have you got fibromyalgia? (Miracle Cures)
Fibromyalgia Forums (Forum Finder)
A cure for fibromyalgia …. not (Sunday Soapbox)