Category: Uncategorized

Any Good Options for Chilblains?

By admin,

Short version: not really.

Chilblain are painful reactions to changes in skin temperature in those with risk factors that affect the vascular reactivity in the skin. They are common in the colder climates and unheard of in the warmer climates, so they are a seasonal problem. There is not a lot of good research on chilblains, which leads to a lot of treatments and interventions based on anecdotes. You see a lot of advice being asked in forums from those who are exasperated with them.

The problems and dilemmas of diagnosis, pathophysiology and treatment of chilblains was discussed on a recent PodChatLive on chilblains:

This discussion highlighted the limited affect of chilblain creams and the need to really just protect the foot and let the lesions heal up when they develop.

Severs Disease or Calcaneal Apophysitis

By admin,

This is a bit of a debate about of this painful condition in children should be called Severs disease or calcaneal apophysitis. They are both the same thing. Severs disease is the more common traditional name and Calcaneal apophysitis is the less common, but technically correct name.

It is not a disease and the trend is to no longer name conditions after people, so it is correct that the name Severs disease should be dropped and the replaced with the name calcaneal apophysitis. But, when it comes to the search engines like Google, the vast majority of searchers are fro the phrase, Severs disease and very few people searching for the name calcaneal apophysitis.

This issues was discussed in this episode of PodChatLive:

The best way to treat this condition is manage the load, expectations and lifestyle and perhaps used a cushioned heel insert.

What to do about a plantar plate tear?

By admin,

A plantar plate tear is a common cause of pain under the ball of the foot (metatarsalgia). The plantar plate is a strong ligament under the metatarsophalnageal joints that support the integrity of the joint. The typical symptom of a plantar plate tear is pain under and just in from of the joint on palpation and on weightbearing. Often a diagnostic ultrasound is used to help in the diagnosis, but it is usually obvious to clinicians doing the appropriate clinical tests.

The best way to “fix” a plantar plate tear is usually with strapping to hold the toe downwards (plantarflexed) to rest the painful area and relieve the strain on that area. This often needs to be used for at least a month or so for it to heal up properly.

More recently clinicians have been using the Fix Toe device instead of the strapping as it is more practical to use over the longer term.

What to do about a plantar plate tear?
The Fix Toe device

This can be used over the longer term rather than having to resort to strapping which can get dirty and is ‘fiddly’ to have to apply fresh every few days.