Category: P

Platelet-rich plasma therapy and feet

Posted on March 9, 2023 by - Medicines, P

Platelet-rich plasma (PRP) therapy is a treatment that involves the injection of a concentrated solution of platelets derived from the patient’s own blood into an area of the body that is experiencing pain or injury. Platelets are a type of blood cell that play a key role in the body’s natural healing process, as they contain growth factors and other proteins that help to promote tissue repair and regeneration.

PRP therapy has been used to treat a variety of musculoskeletal conditions, including foot pain caused by conditions such as plantar fasciitis, Achilles tendonitis, and osteoarthritis.

The procedure involves drawing a small amount of the patient’s blood, which is then processed in a centrifuge to separate out the platelets and concentrate them into a solution. This solution is then injected into the affected area of the foot using ultrasound guidance to ensure precise placement.

PRP therapy is generally considered a safe and minimally invasive treatment option, with few side effects or complications. However, as with any medical procedure, there are some risks involved, including infection, bleeding, and nerve damage.

While PRP therapy has shown promise in the treatment of foot pain, more research is needed to fully understand its effectiveness and long-term outcomes. It is important to consult with a healthcare professional to determine if PRP therapy may be an appropriate treatment option for your specific condition and individual health needs.

Plantar wart

Posted on March 9, 2023 by - Dermatology & nail pathology, P, Paediatrics

A plantar wart is a type of wart that grows on the bottom of the foot. It is caused by the human papillomavirus (HPV) and is typically transmitted through direct contact with infected skin or surfaces.

Plantar warts often appear as small, hard, rough growths on the heel or ball of the foot, and may be accompanied by pain or tenderness when standing or walking. They may also have tiny black dots on the surface, which are actually small blood vessels that have grown into the wart.

Treatment options for plantar warts include topical medications, such as salicylic acid, which can help to dissolve the wart over time. Cryotherapy, which involves freezing the wart with liquid nitrogen, may also be used to destroy the affected tissue.

In some cases, surgical removal of the wart may be necessary, particularly if conservative treatments are not effective or if the wart is causing significant pain or discomfort. This may involve excision of the wart, laser therapy, or other surgical procedures.

It is important to avoid picking or scratching at plantar warts, as this can spread the virus to other areas of the foot or to other people. Good foot hygiene, including regular washing and drying of the feet, can also help to prevent the spread of HPV and reduce the risk of plantar warts.

Plantar vein thrombosis

Posted on March 9, 2023 by - P, Vascular

Plantar vein thrombosis is a condition characterized by the formation of blood clots (thrombi) within the plantar veins, which are the veins located in the sole of the foot. This condition is relatively rare and can be caused by a variety of factors, including trauma to the foot, prolonged immobility, and certain medical conditions such as cancer and autoimmune disorders.

Symptoms of plantar vein thrombosis can include pain, swelling, and redness in the affected foot, particularly in the arch or heel area. The skin over the affected area may feel warm to the touch, and there may be visible veins that are enlarged or tender.

Treatment for plantar vein thrombosis typically involves the use of blood-thinning medications, such as anticoagulants or anti-platelet agents, to help prevent the formation of additional blood clots and reduce the risk of complications such as pulmonary embolism. Immobilisation and elevation of the affected foot may also be recommended to reduce swelling and improve blood flow.

In some cases, physiotherapy may be recommended to help improve range of motion, reduce stiffness, and prevent further complications such as post-thrombotic syndrome. This may include exercises to improve calf muscle strength and flexibility, as well as compression therapy to improve circulation and reduce swelling.

It is important to consult with a healthcare professional if you suspect you have plantar vein thrombosis, as prompt diagnosis and treatment can help prevent further damage and improve overall outcomes.

Plantar plate tear

Posted on March 9, 2023 by - Forefoot, P

The plantar plate is a fibrocartilaginous structure located on the bottom of the foot, which serves to support and stabilize the metatarsophalangeal (MTPJ) joints. A plantar plate tear is a common injury that occurs when the ligamentous fibres of the plantar plate are partially or completely torn.

Plantar plate tears are typically caused by repetitive stress or trauma to the foot, such as from running, jumping, or other high-impact activities. They may also occur as a result of degenerative changes associated with aging or certain medical conditions, such as rheumatoid arthritis.

Symptoms of a plantar plate tear can include pain, swelling, and tenderness in the ball of the foot, particularly when weight-bearing or walking. There may also be a feeling of instability or a “popping” sensation in the affected joint.

Physiotherapy treatment for plantar plate tears may include rest, ice, and immobilisation to reduce pain and inflammation. Manual therapy techniques, such as massage and joint mobilisation, may also be used to improve range of motion and reduce stiffness in the affected area.

Strengthening and stretching exercises can help improve foot and ankle strength and flexibility, and may include exercises to target the plantar fascia and other supporting structures of the foot.

In some cases, custom orthotics or supportive footwear may also be recommended to help relieve pressure on the affected area and prevent further injury.

Surgical intervention may be necessary in cases of severe or chronic plantar plate tears, particularly if conservative treatment is not effective. It is important to consult with a healthcare professional if you suspect you have a plantar plate tear, as early diagnosis and treatment can help prevent further damage and improve overall outcomes.

Plantar fibromatosis

Posted on March 9, 2023 by - Connective tissue disorders, P

Plantar Fibromatosis, also known as Ledderhose disease, is a condition characterized by the growth of benign fibrous nodules or lumps in the plantar fascia, which is a thick band of connective tissue located on the sole of the foot. This condition is similar to Dupuytren’s contracture, a condition in which the same type of nodules occur in the hand.

The exact cause of plantar fibromatosis is unknown, but it is believed to be associated with genetic factors and certain medical conditions such as diabetes, liver disease, and alcoholism. The condition typically affects middle-aged and older adults, and is more common in men than women.

Symptoms of plantar fibromatosis can vary, but typically include the development of one or more firm, rubbery nodules in the arch or heel of the foot, which may be painful or tender to the touch. The nodules may grow slowly over time, and in some cases can cause the toes to curl or the arch of the foot to become flattened.

Treatment for plantar fibromatosis may include stretching exercises to improve range of motion, strengthening exercises to improve foot and ankle strength, and the use of modalities such as heat, ice, and electrical stimulation to reduce pain and inflammation. In some cases, custom orthotics or supportive footwear may also be recommended to help relieve pressure on the affected area.

Surgical treatment may be necessary in cases where conservative treatment is not effective, or if the nodules are causing significant pain or limiting mobility. Surgery typically involves removing the nodules or releasing the tightened fascia, and may be followed by physiotherapy to help restore normal function and prevent recurrence of the condition.

It is important to consult with a healthcare professional if you suspect you have plantar fibromatosis, as early diagnosis and treatment can help prevent further damage and improve overall outcomes.

Plantar fibroma

Posted on March 9, 2023 by - Connective tissue disorders, P

Plantar fibroma is a benign (non-cancerous) mass or nodule that develops in the plantar fascia, a thick band of tissue that runs along the bottom of the foot. It is also known as Ledderhose disease.

Plantar fibromas are caused by an overgrowth of fibrous tissue in the plantar fascia, and their development is thought to be linked to genetic and environmental factors. They are more commonly found in middle-aged and older individuals, and may be associated with certain medical conditions, such as diabetes, liver disease, and alcoholism.

Symptoms of plantar fibroma include a firm, rubbery lump or nodule on the bottom of the foot, typically located in the arch or heel. The lump may be painful or tender to the touch, and may make it difficult to walk or stand for prolonged periods of time.

Interventions may include:

  1. Manual therapy: Massage and other hands-on techniques can help reduce pain and improve mobility in the affected area.
  2. Stretching and strengthening exercises: Specific exercises can help improve flexibility and strength in the foot and ankle, and may help reduce tension on the plantar fascia.
  3. Footwear advice: Proper footwear with adequate arch support can help reduce stress on the plantar fascia and minimise symptoms.
  4. Cortisone injections: These injections can reduce the size and pain of the fibroma.
  5. Other modalities: The use of modalities such as ice, heat, ultrasound, or electrical stimulation can help reduce pain and inflammation.

In cases where conservative treatment is not effective, surgical intervention may be necessary to remove the plantar fibroma. It is important to consult with a healthcare professional if you are experiencing symptoms of plantar fibroma, as early diagnosis and treatment can help prevent further damage and improve overall outcomes.

Plantar fasciitis – what happens at a cellular level?

Posted on March 9, 2023 by - Frequently asked questions, Hindfoot, P

Plantar fasciitis is a condition that involves inflammation and damage to the plantar fascia, which is a thick band of connective tissue that runs along the bottom of the foot. At a cellular level, plantar fasciitis involves a complex interplay of inflammatory mediators and cellular responses.

One of the key cellular processes involved in plantar fasciitis is the release of inflammatory mediators, such as cytokines, from damaged tissue cells. These mediators trigger a cascade of cellular responses, including the activation of immune cells, the release of more inflammatory mediators, and the recruitment of additional cells to the site of injury.

As inflammation persists, it can lead to the breakdown of extracellular matrix components, including collagen and elastin fibres, which are important structural components of the plantar fascia. This breakdown can further weaken the tissue and contribute to ongoing inflammation and pain.

Over time, chronic inflammation and tissue damage can lead to the formation of scar tissue and the thickening of the plantar fascia, which can further exacerbate symptoms of plantar fasciitis.

Interventions for plantar fasciitis aim to address these underlying cellular processes by reducing inflammation, promoting tissue healing, and restoring normal biomechanical function to the foot and ankle. By addressing the cellular mechanisms involved in plantar fasciitis, treatment can help alleviate symptoms, prevent further damage, and promote long-term recovery.

Plantar fasciitis

Posted on March 9, 2023 by - Hindfoot, P

Plantar fasciitis is a common condition that causes pain in the heel and bottom of the foot. It is caused by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot and connects the heel bone to the toes.

Symptoms of plantar fasciitis include pain and tenderness in the heel or arch of the foot, particularly upon waking in the morning or after prolonged periods of standing or walking. The pain may be described as sharp or stabbing, and may worsen over time if left untreated.

Interventions for plantar fasciitis may include:

  1. Stretching exercises: Specific stretches for the calf, Achilles tendon, and plantar fascia can help improve flexibility and reduce tension in the affected area.
  2. Strengthening exercises: Strengthening exercises for the foot and ankle can help improve stability and support the plantar fascia.
  3. Manual therapy: Massage, joint mobilisation, and other hands-on techniques can help reduce pain and improve mobility.
  4. Footwear advice: Proper footwear can help reduce stress on the plantar fascia and prevent further injury.
  5. Other Modalities: The use of modalities such as ice, heat, ultrasound, or electrical stimulation can help reduce pain and inflammation.
  6. Activity modification: Modifying or avoiding activities that exacerbate the symptoms of plantar fasciitis can help reduce pain and promote healing.

It is important to consult with a healthcare professional if you are experiencing symptoms of plantar fasciitis, as early diagnosis and treatment can help prevent further damage and improve overall outcomes. With appropriate physiotherapy care, most individuals with plantar fasciitis can expect to make a full recovery and return to their normal activities.

Physiotherapy for foot injuries

Posted on March 9, 2023 by - Other, P

Physiotherapy can be an effective treatment option for a wide range of foot injuries, including sprains, strains, fractures, plantar fasciitis, and Achilles tendonitis, among others. Physiotherapy can help reduce pain and inflammation, improve range of motion and flexibility, and strengthen the muscles and tissues of the foot and ankle.

The specific approach to physiotherapy for foot injuries will depend on the type and severity of the injury, as well as the individual’s overall health and fitness level. However, some common physiotherapy interventions for foot injuries may include:

  1. Manual therapy: This may include massage, joint mobilisation, and stretching techniques to help reduce pain and improve mobility.
  2. Exercise therapy: This may include a range of exercises designed to improve strength, flexibility, and balance, as well as to address any specific weaknesses or imbalances that may be contributing to the injury.
  3. Gait analysis and retraining: This may involve analysing the individual’s walking or running gait and making adjustments to improve biomechanics and reduce the risk of further injury.
  4. Modalities: This may include the use of heat, ice, ultrasound, or electrical stimulation to help reduce pain and inflammation and promote healing.
  5. Education: This may include advice on appropriate footwear, stretching and strengthening exercises, and strategies to avoid further injury.

It is important to consult with a healthcare professional if you are experiencing a foot injury, as early diagnosis and treatment can help prevent further damage and improve overall outcomes. With appropriate physiotherapy care, most individuals with foot injuries can expect to make a full recovery and return to their normal activities.

Peroneal tendon instability

Posted on March 9, 2023 by - Hindfoot, P

Peroneal tendon instability is a condition in which the peroneal tendons, which run along the outside of the ankle and foot, are not held in place properly and are prone to dislocation or subluxation (partial dislocation). This can cause pain, weakness, and instability in the ankle and foot.

Peroneal tendon instability is often caused by a combination of factors, including ankle sprains, chronic ankle instability, and anatomical abnormalities that affect the stability of the peroneal tendons.

Symptoms of peroneal tendon instability can include pain and tenderness along the outside of the ankle and foot, a feeling of snapping or popping in the ankle, weakness and instability, and swelling and stiffness.

Treatment for peroneal tendon instability may include non-surgical options such as physical therapy to strengthen the ankle and foot muscles, bracing or taping to provide additional support, and modification of activities to avoid aggravating the condition.

In some cases, surgical intervention may be necessary to repair or reconstruct the damaged peroneal tendons, particularly if non-surgical treatments are not effective or the instability is severe.

It is important to consult with a healthcare professional if you are experiencing symptoms of peroneal tendon instability, as early diagnosis and treatment can help prevent further damage and improve overall outcomes. With appropriate care, most individuals with peroneal tendon instability can expect to make a full recovery and return to their normal activities.