Chilblains are a reasonably common problem once the weather is cooler. These are a painful and itchy reaction of the smaller blood vessels in the toes to the variations in temperature. They result in a painful red area, which later becomes a dark blue color should they become chronic. Chilblains have just lately been receiving some extra press in the media as a result of them being more common in those infected with the coronovirus, being given the term, COVID toes.

Chilblains are a seasonal condition and appear in all places in which the climate gets cold enough to result in the reaction in the skin. An instance of PodChatLive had a deep discussion of the problem of chilblains:

The easiest method to manage chilblains is usually to prevent these by keeping the feet warm. If a chilblain will develop then it must be kept warm and be protected to stop the skin from breaking down. There are several chilblain creams which you can use to help to promote the blood circulation.

Severs disease or calcaneal apophysitis is a prevalent condition of the heel bone in developing children. At the back of the heel bone is a cartilage area that most of the development of the heel bone takes place at and this problem is an overuse injury of that cartilage area. It is more likely in kids that are active, are overweight and are taller. The typical signs of Severs disease is pain at the back and sides of the heel bone, primarily after sports activity. Severs disease is regarded as a self limiting problem, because the child will invariably at some point grow out of it as soon as growth of the heel pain stops and the developing region of cartilage inside the bone merges with the rest of the heel bone. That doesn’t suggest it shouldn’t be treated and may not be treated before that growth ceases.

This episode from PodChatLive was a comprehensive discussion into the issue of Sever’s disease/Calcaneal apophysitis:

A great way to take care of this problem can be managing the child’s and parent’s expectations and also lifestyle to help keep the signs and symptoms under control. The strains have to be managed via modifying and restricting activity levels. This is often challenging and may take some negotiation with the child. If the discomfort is severe after activity, then ice may be used to help relieve that. Often a cushioned heel insert might help protect the heel. Long term the prospects is good as they will grow out of this by the mid-teenage years.

Type two diabetes has become so common, it is almost as though we have become complacent regarding it. The incidence is rising in most places despite public health strategies are attempting to take care of the obesity crisis that is supporting the diabetes challenge. Diabetes has a number of complications that all combine collectively to put the feet at significant risk from complications. These complications vary from a mild infection to the more critical complications like a need to amputate a leg a result of a spreading infection or deceased tissue. The complications associated with diabetes have an effect on a wide variety of tissues in the body.

In relation to the feet, diabetes affects the blood supply and therefore any injury to the foot is more likely to be serious as there is insufficient good blood flow allowing healing to occur. Diabetes also damages the nerves, so that if there is some injury, either major or minor such as a blister, then no pain is felt, so the foot continues to be damaged resulting in the complication a great deal more severe. The body has numerous functions to fight infection, but in diabetes the response to an infection is much more sluggish than in those without diabetes. Diabetes can also affect the eye and while the eyes are a long way from the foot, ample vision is needed to see any issues that may have occurred to the foot so it may be dealt with. Even the renal disease that frequently occurs in diabetes impacts wound healing after the injury has been done and the presence of disease in the kidney can affect what medicines, for example antibiotics, may be used and sometimes that range can be quite restricted.

It is for all these complications, and others not brought up, that those with diabetes have to take additional care of their feet. They need to check them routinely to make sure that there is no injury and if there is an injury they must get medical help quickly. Most importantly, they must be regularly managed by a foot doctor.

There is a old process from rural China that involved the binding of the foot of female young people to stop them from growing. It was a barbaric practice and was painful and disabling to the feet. It was done as a small foot was thought to be an attractive characteristic in the female and a greater dowry can be demanded by the family for the bride-to-be if the feet had been bound. There was a substantial market in these rural communities for the ornamental and finely crafted shoes that these people would need to wear because of the smaller and misshaped feet. Around 100 or so years ago societal pressures did start to mount to ban the practice and this largely was successful and it is not carried out nowadays. The practice needed to stop as it was so debilitating and painful for the girls. When they became a grownup, the harm had been done and there was very little that might be done to deal with the pain and disability. Having said that, you can still find many older woman alive that had their feet bound when they were young children.

There are apparently commonalities to this practice of chinese foot binding that could be seen these days. Several commentators like to link the practice these days of females who push their feet inside the high heel footwear as being the same as the practice. In rural China the technique was all about the female performing something which pleases the male, no matter the outcomes in terms of discomfort and deformity. The practice today of using tight fitting high heel shoes by females has outcomes in the terms of foot deformity and foot problems. It is also apparently done in the perspective of the female doing something which is agreeable to the eye of the male. There is some argument if the connection between the two practices really do justify the kind of exploration that they have been subjected to.

Bunions, or more precisely, hallux valgus or hallux abducto valgus occurs in many shapes or forms. The disorder is one of an enlargement of the big toe or hallux joint of the foot (bunion) and an angling over of the big toe or hallux laterally in the direction of the smaller toes (abduction and valgus). They become sore because of arthritis like symptoms from the deviation of the great toe or hallux and from stress on the enlargement of the bunion from the shoe. They’re one of the most frequent causes of pain in the feet and are caused by a combination of inherited features, weak biomechanics and also shoe fitting problems. Even though there are conservative options such as pads, splints, better shoe fitting, exercises and pain alleviation medicine which you can use, they don’t make the bunion go away nor straighten the hallux over the longer term. Often surgical treatment is the only permanent answer to bunions or hallux valgus. Nevertheless, unless the specific reason for the bunion had been attended to at the same time there’s a possibility that it may occur again.

There are various joints and bones involved in the development of bunions and each situation differs as differing amounts of each bone and joint are involved. Because of this the surgical repair must be directed at the bone or joint which is involved. If the great toe or hallux joint is just involved, then a straightforward chopping off the enlarged bone is perhaps all that is needed. If the angle of differing bones are a issue, then a V is going to need to be taken out of the bone and the bone reset. There are many different ways of carrying out that and it has been believed that this condition has more surgical options for it compared to all other problems!

The Austin bunionectomy is only one kind of procedure. This procedure entails removing the enlargement of bone and taking a v out of the head of the 1st metatarsal to realign it and hold it in position using a screw so it can heal. A special shoe or boot needs to be worn through the first few weeks following the surgery and go back to your typical footwear after about 4 weeks. It generally takes about 8 weeks to return to full activity levels following this surgery.