Preferred Footcare of Muncie, LLC 765.284.4220

10/03/2024

Happy to see this on the far reaching effects of Upperline Health. We joined this organization for our patients to benefit. Nice segment.

Upperline Health - 5/9/24 Sponsored Content by Upperline Health Sponsored content disclaimer: The information and advice displayed in this story are those of individual sponsors or guests and not Nexstar Media Group, Inc.

06/29/2024

FYI....Drum Corps News, World we waited patiently for each week BITD.

DCI is digitally doing this again. http://dcitour.digital/

Did an article to go with the shoe list for them this inaugural edition.

05/23/2023

Nice article that reflects our experience over the years Nursing shoes.

This Nurse Appreciation Week, we asked a podiatrist for recommendations on the best shoes for nurses of 2023. His picks included brands like New Balance, Hoka, and Dansko.

07/10/2022

"shin splints". The garbage can term used for leg pain. Great analytic look at leg pain.

Medial Tibial Stress Syndrome: A Soft-Tissue Traction Injury??

Even though medial tibial stress syndrome (MTSS) is considered by many to be primarily a bone injury, there is still considerable debate as to what mechanical factors are most responsible for the injury to the bone of the medial tibia that results in MTSS. One of the proposed biomechanical etiologies for MTSS is that muscle or fascia exerts excessive traction or tension forces on the medial border of the tibia.

The posterior tibial (PT), flexor digitorum longus (FDL), flexor hallucis longus (FHL) and soleus muscles, in addition to the soleus fascia, have all been implicated as being possible sources for a traction injury to the medial tibia that could cause the pain of MTSS. The proponents of this possible etiology of MTSS state that since anti-pronation foot orthoses tend to lessen the pain of MTSS, it is likely that increased traction on any one, or all, of these muscles and fascial structures is the prime etiology of MTSS.

Unfortunately, the area along the medial tibial border, where MTSS most commonly occurs, is generally accepted to be located at the junction of the distal third and proximal two-thirds of the medial tibial border. This is not the location where any one muscle or fascial structure attaches to the medial tibial border.

In the illustration in their paper from 1994, Beck and Osternig clearly showed that the origins of neither the PT, FDL, FHL and soleus muscles correspond to the pain associated with MTSS (Beck BR, Osternig LR: Medial tibial stress syndrome: the location of muscles in the leg in relation to symptoms. JBJS, 76A:1057-1061, 1994). The location of MTSS pain is indicated by the large arrows in the distal medial tibial border in the illustration below.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.909.3865&rep=rep1&type=pdf

This problem with lack of soft-tissue structure attachment to the area of MTSS pain has led many to believe that the prime biomechanical etiology of MTSS is not soft-tissue traction, but rather that the main etiology of MTSS is excessive bone-bending of the tibial shaft during running and jumping activities. This is a very similar mechanism to that found with metatarsal stress reactions and metatarsal stress fractures, both being bone-bending injuries to the long bones of the foot, versus medial tibial stress syndrome and medial tibial stress fractures being bone-bending injuries to one of the long bones of the leg.

Further discussion on the reasons that most experts now consider MTSS to be a bone bending injury will be covered in future posts.

Kirby KA: Current concepts in treating medial tibial stress syndrome. Podiatry Today. 23(4):52-57, 2010.

https://www.hmpgloballearningnetwork.com/site/podiatry/current-concepts-in-treating-medial-tibial-stress-syndrome

07/10/2022

Medial Tibial Stress Syndrome: An Example of the Bone Stress Continuum Model

Medial tibial stress syndrome (MTSS) is thought to be caused by excessive bending moment acting on the tibia during running and jumping activities which causes increased medial tibial cortical tension stresses and bone injury. The bone injury first leads to MTSS, a "stress reaction" of the medial tibia border, then, if the stress continues over time, may lead to a medial tibial stress fracture (MTSF).

With MTSS, the stress reaction within the medial tibial border is evident on MRI as medial cortical bone edema with no fracture line (Frederickson M, Bergman AG, Hoffman KL, Dillingham MS: Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system, Am J Sports Med, 23:472-481, 1995).

https://www.ncbi.nlm.nih.gov/pubmed/7573660

The bone edema is likely due to microcracks (see microscopic section of bone below) developing within the medial tibial cortex which cause pain with running and tenderness with palpation of the medial tibial border, but generally no pain with walking.
As the stress continues in the weakened medial tibial cortex with continued running or jumping activities, MTSF may occur due to the microcracks forming into an actual stress fracture line which may also be most evident on MRI scan. MTSF will generally cause pain with both running and walking.

This gradual interval change in bone histology and MRI findings from normal bone to MTSS and then to MTSF over time with continued bone stress o is known as the Bone Stress Continuum Model, which was first suggested by Romani and colleagues in 2002 (Romani WA, Gieck JH, Perrin DA, Saliba EN, Kahler DM. Mechanisms and management of stress fractures in physically active persons. J Athl Train. 2002;37:306–314).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164361/

03/31/2022

Great read

What Is a Normal Foot?

I just recently had a short article published in the March 2022 issue of Podiatry Today magazine titled "What is a Normal Foot". In this article, I address the tendency of many podiatrists to think that if a foot does not meet some set of strict ideal structural values, that foot then cannot be determined to be "normal". Podiatry needs to move forward away from this podiatry myth since there are a range of normal structural values within the human population that still allow normal function, and not just one set of ideal structural values that people suggested a half-century ago as being "normal", with no research to support that conjecture.

03/23/2022

We see lots of post ankle sprain problems that continue to have those low dull aches years later. This is a nice article on the long term effects.

Anterior ankle impingement is the most common cause of pain in the front of the ankle joint. In this case, “impingement” describes an increase in pressure or impact at the front (anterior) of the ankle joint while walking. The associated pain is typically proportional to weight-bearing activity.

02/10/2022

Nice background on Bunion Treatment

An article by Jeffrey S. Hurless, DPM, of the American College of Foot and Ankle Surgeons. Learn about bunion surgery and bunion surgery alternatives. Surgery is the only way to remove a bunion, but there are a lot of ways to relieve bunion pain without stepping foot into an operating room.

01/19/2022

Pretty good article on walking and benefits.

Walking is one of the simplest, safest, and easiest ways to accomplish this goal. Here are some benefits of walking for fitness.

11/03/2021

https://www.healthyfeetstore.com/plantar-fasciitis-symptoms-treatment.html

Plantar Fasciitis is often the result of a sudden change in routine, but can also occur as a result of repetitive stress placed on the feet over time. This can place a lot of extra stress on the plantar fasciitis. Orthotics & inserts ensure that your weight is properly distributed across your foot.

10/14/2021

https://www.healthyfeetstore.com/article-prevent-foot-problems.html

“Doc, I wish I knew earlier…" Implementing healthy habits now can prevent long-term foot problems before they begin. There are four major preventative steps that patients can take right now to ensure healthy feet and prevent general and prolonged foot problems: