What to do about chilblains?

chilblains

Chilblains are painful lesions on the toes that only happen seasonally in the colder climates. They occur due to a spam in the very small muscles that control the diameter of the small blood vessels that are warmed by too quickly after they are cold. This causes damage to the tissues and releases inflammatory mediators. The result is the above red and painful lesions on the toes. Despite being a common problem, there are still many aspects of chilblains that are not fully understood.

The best way to deal with chilblains is to not get them in the first place. They can be prevented by keeping the feet warm with good socks and footwear. If a chilblain does develop, then the best way to deal with them is use a soothing cream that can stimulate the circulation. If the skin is broken, then the area needs to be properly protected to prevent infection and facilitate the healing of the wound.

This chilblains video from PodChatLive is an in-depth look at the topic of chilblains:

How long does Severs disease last

How long does Severs disease last

Severs disease is a common problem of the growing area of the heel bone in children. It is more appropriately called Calcaneal apophysitis as its NOT a disease. As its a problem with the growing plate at the back of the heel bone, it will go away on its own when the growth stops in that bone which is typically around the mid-teenage years. That does not been it can not be helped and has to last that long. It is more common in those who are more active.

Just how long does Severs disease last?

There is no clear answer to this except the one that it will be gone by the mid-teenage years. How quick the pain goes away earlier than that will depend on what treatment is given and how much activity levels are reduced.

Typical Severs disease is treated with modifying or reducing activity levels (load management), education about the nature of the condition and the use of shock absorbing heel pads.

Severs disease will get better quicker if there is a greater reduction in the loads or activity levels and it will take longer if activity levels are not reduced by much.

This edition of the video live stream from PodChatLive on Calcaneal apophysitis is well worth a listen to as the hosts speak with an expert on Severs disease. They do address just how long that it lasts.

What is Supination Resistance

Supination resistance is an attempt to measure the force that is needed to supinate the foot. It is used in the clinical assessment of patients and in the prescribing of foot orthotics. In foot orthotic prescribing, the “rule” is that the more force needed to supinate the foot, so the more rigid and inverted the foot orthotic should be. If that force is low, then softer and more flexible foot orthotics can be used. The supination resistance force also correlates with some pathologies in the foot.

PodChatLive had an episode on supination resistance to bring together all the key researchers on the topic (embedded above). Podiatry Arena has a lot of threads on the supination resistance and this blog post explains it in great detail.

Can a Plantar Plate Tear Heal on its Own?

A plantar plate tear is a common reason for pain under the ball of the foot, typically just below and distal to the 2nd and 3rd metatarsophalangeal joints. You often see the question in forums about if a plantar plate tear can heal on its own?

It is highly unlikely that a plantar plate tear will be able to heal on its own. Almost always, some form of treatment or intervention. The cause of the problem in the plantar plate from a tear or a “pre-tear” (dysfunction) is always due to a mechanical overload. If that overload is still there, then can not heal on its own. However, if you limp and reduce activity levels, then that mechanical overload is reduced so it might heal up on its own, eventually.

The use of strapping or tape to reduce the mechanical overload by preventing the toe from flexing can certainly give it time to heal on “its own”. Most cases will need to use treatments such as the strapping, stiff-soled or rocker sole shoes or foot orthotics to off-load that mechanical overload to allow it to heal. However, those interventions do not always work or work quickly enough, then that is when a surgical repair is indicated.

Archies Arch Support Thongs

In Australia, they call thongs what the rest of the world call flipflops. In Australia, such footwear like these thongs are an important part of the laid back lifestyle, so for those that need to wear foot orthotics, they either do not wear them or they can not wear thongs or flip flops. That is where these Archies Arch Support Thongs come in. They were developed in Australia by a physiotherapist to provide some sort of arch support on a thong or flip flop.

They have about 2.2cm of arch support built into them which is very similar to what most premade orthotics have in them, so they are a sensible viable alternative or adjunct to foot orthotic therapy.

The Archies Arch Support Thongs are selling very well in Australia and are highly recommended there by Podiatrists. A lot of podiatry clinics sell them and a lot of them use them for themselves and their families. For more on the Archies, see these links.