2013- Teens & flip-flops

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According to Scott Schumacher, president of the British Columbia Association of Podiatrists in , flip-flops can be particularly hard on young, apparently sturdy teenaged feet. This is because even into the mid-teens, new bone is growing in the heel. The Achilles tendon and the plantar fascia attach to a growth plate. Walking causes the connective tissues to pull, and in the mid-teens, the weak point is the growth plate. Wearing flip-flops exacerbates the problem. As a result, kids 14 to 15 – a prime flip-flop-wearing population – are especially susceptible to heel pain. A few years ago, the American College of Foot and Ankle Surgeons noted growing reports of heel pain among 15- to 25-year-olds and blamed the trendy everyday use of flip-flops as the key cause. It goes without saying that overweight or sedentary people put more strain on their feet when they walk. References: Lee, J. (2008) Flip-flop Fuss, Vancouver Sun...

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2013 – Hammertoes: Flip-flops make for gripping stuff

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According to Shroyer of Austin University “(w)hen you wear flip-flops, you kind of scrunch your toes to keep the flip-flop on your foot. 1). Hence the characteristic flip-flop shuffle that can be described as an unnatural, toe-gripping, foot-slapping gait, he explains. It is this gripping action that leads to the following signs and symptoms of hammertoes: Contracture and eventually flexion deformity of one or both interphalangeal joints of the second, third, fourth, or fifth (little) toes. The first joint or metatarsophalangeal (MTP) joint is cocked upward (mild hyperextention), middle joint or proximal interphalangeal joint (PIP) bends downward as well as the tiny joint at the end of the toe or the distal interphalangeal (DIP) joint are curled downward like a claw 2). Depressed top of toe deformity. Second toe involvement most common especially when the second toe is longer than the great toe. Associated hallux valgus deformity at the great toe. Corns or plantar calluses develop secondary to abnormal pressures and are located at the distal toe, the dorsum of proximal interphalangeal joint (ITP) and beneath the metatarsal heads that leads to pain or irritation when wearing proper shoes causing people to revert to plakkies for comfort. High longitudinal arch and a rigid foot 3) Pain over the dorsal aspect of the PIP joint. Occasional pain over the plantar area of the metatarsal head, especially if the MTP joint is hyperextended, subluxed, or dislocated. In addition, patients with MTP instability often complain of pain over the dorsal part of the MTP joint, and they may describe the sensation of a lump in the plantar area of the MTP joint. Patient assessment It is important that the visual assessment is done while the patient is standing. This is to appreciate its functional significance 4). Accompanying deformities, such as hallux valgus, combined hammertoe and rotational deformity, and cavus foot deformity, must be recorded. 5) Passive correction of the deformity should be attempted, because this will help determine which treatment options are appropriate for the patient. 6) References: Auburn University . AU study shows that overuse of flip-flops can lead to orthopaedic problems http://wireeagle.auburn.edu/news/359 http://www.eorthopod.com/public/patient_education/6482/claw_toes_and_hammertoes.html http://www.fpnotebook.com/Ortho?Foot?HmrT.htm Houglum, P.A. (2005). Therapeutic Exercise for Musculoskeletal Injuries.  Champaign, Ill. : Human Kinetics  http://book.google.co.za http://www.emedicine.com/orhoped?TOPIC457.HTM...

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2013 – Footwear flops that affect posture

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By Erika Kruger Photographs; Martin Van Niekerk, Shufti Pics Summer is here and so are patients arriving at the massage practice wearing flip-flops or in local parlance, the all-time popular plakkies. People’s views on this form of footwear flip-flops between near veneration by wearers  (‘It is so comfortable and easy to wear – absolute freedom!’) and health professionals blaming overuse of the plakkies for a host of podiatric problems and postural imbalances. Personal observation has led me to conclude that patients’ complain of pain in the feet and in the lower legs more often in the summer months than during winter. Questions about their preferred footwear, usually indicate extensive use of plakkies. Despite claims that it feels just like walking barefoot, flip-flops might not be a healthy choice after all. A study conducted by a doctoral student in biomechanics at the University of Auburn, Alabama, confirms this. 1) Justin Shroyer started his investigations into a possible link between wearing flip-flops and lower leg and foot pain, by observing 39 college-age female and male volunteers wearing thong-style, flat-soled flip-flops and then regular athletic shoes while walking on a platform that measured the force they exerted when their feet struck the ground. He also filmed them as they walked to study differences in the movements of their hips, legs, knees, ankles, feet and toes. The visual and other data was then digitised and analysed. Shroyer’s conclusions confirmed that despite the freedom and comfort wearers profess, plakkies first of all do not provide enough stability for the foot and secondly can lead to postural imbalances resulting in back ache. 2) SHOCK ABSORPTION Flip-flops provide little support and shock absorption, and as a result, they provide little comfort and protection against the impact from walking. Without suitable cushioning on the feet, over time the impact will cause pain in sensitive areas of the back and spine, particularly in the discs, joints and ligaments. 3) STABILITY Physiatrist Dr Chritina Lasich explains that a shoe has everything to do with how ones back feels. 4) She compares shoes to tires – both “provide for your comfort (ride quality), your stability (support), and your posture (alignment). Shoes form the foundation of the body.” According to the American Podiatric Medical Association (APMA) flip-flops do not fit any of these requirements – it doesn’t provide any arch support, heel protection or shock absorption and causes problems like tendonitis, arch-pain and sprained ankles. 5) The problem is that flip-flops “don’t really hold on the foot like most shoes do, so we use the tendons and muscles to hold them on,” says Dr. Greg Cohen, a podiatrist at Long Island College Hospital in Brooklyn, N.Y. 6) Unlike a good shoe...

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