Equinus | Intelligent Management | A Series
“Equinus deformity is the most profound causal agent in foot pathomechanics and is frequently linked to common foot pathology.” from Biomechanics of the First Ray Part V: The Effect of Equinus Deformity | CH Johnson and JC Christensen in J. Foot Ankle Surg. 44: 114-120, 2005
It is my opinion that this ‘profound causal agent’ receives too little attention from us – the practitioners. I’m further convinced that the lack of attention is connected to no absolute definition of equinus.
Through this series, I propose to provide an absolute definition of equinus based on three very profound articles and other research. I will also elaborate on a treatment protocol using an ‘intelligent brace’ that I have invented.
My interest in equinus was piqued beyond my patient roster when healthy exercise began to result in equinus symptoms in my own right ankle. Running was giving me trouble, yet that very exercise was connected to a significant weight loss. When we are counseling patients toward a healthier life-style, we owe to them to be prepared to guide them through the process. The perfect situation would be wise exercise with no injury. When injury occurs podiatrists have the opportunity to help patients through to healthier feet.
In the next posts, I will discuss research in the articles mentioned earlier, share my opinions and my justification for the equinus definition that I believe is applicable and describe the breakthrough of the EQ/IQ brace.
As you read you may have questions. As doctors, trainers, therapists, you wonder where and how to obtain the EQ/IQ brace. As equinus sufferers, you will be seeking information that you can share with your doctor. You can contact me at Hoosier Foot and Ankle. You can call 317-660-2115 with questions or you can leave your message/question on the Contact Form available in the sidebar of the Hoosier Foot and Ankle website.
IQ/EQ Brace – Intelligent Equinus Management
I have designed a new brace for the treatment of equinus. Here are some of the highlights of the brace. Patients will not have to sleep in this. I am recommending using the brace 1/2 hour in the morning and 1/2 hour evening (15 minutes each of Gasctroc/Soleus and isolated Soleus).
IQ/EQ is an ambulatory brace that has a negative heel rocker sole which matches the amount of ankle flexion of 5, 10 or 15 degrees. There are hinges at the knee and ankle. The ankle hinge allows the doctor to set the exact degree of dorsiflexion in 5 degree increments. The knee hinge allows the knee to be locked into full extension; it can also be broken down to allow isolation of the soleus muscle. The wedge under the toe is to engage the Windlass mechanism to stretch the plantar fascia. The wedges for this will come in 35, 50 and 70 degrees.
I recently debuted the IQ/EQ brace at the AMPA convention in Boston. A presentation to my peers explained my motivation for inventing the brace – I had a personal foot injury where this type of treatment could be very effective.
Doctors, you can pre-order IQ/EQ braces for your patients. I can offer more than a $30 discount for pre-production orders. The price for the limited pre-production brace will be $170.00 with free shipping. Payment will be deferred until shipping day. Later the price will return to $200. Production begins soon; please contact me at 317-660-2115 or leave a message on the Hoosier Foot and Ankle website with your information. I will get back to you promptly with ordering details.
If you are suffering with foot pain from injuries or equinus, please contact our office for a consultation appointment. Or if you are working with a different podiatrist, please show this information to your doctor to get the ordering process in motion for you.
Your Pain Solution from Hoosier Foot and Ankle | Keys to The Future of Your Feet
Last week, I wrote about the PASSION that drives the team at Hoosier Foot and Ankle to care for patients and for their health and foot conditions.
That PASSION serves you, the patient, when we have the SOLUTION to the cause of your foot pain or discomfort.
We are trained and experienced in diagnosis and a broad range of treatments from consultation, to recommendation of conservative options, through non-invasive treatment such as Pulse Activation Shockwave Therapy (EPAT®) or CoolBreeze™ laser treatment for toenail fungus. Our team can perform necessary intervention, including surgery to provide your SOLUTION.
We appreciate the opportunity to have served many in the area, bringing about your SOLUTION. Please tell your friends and family who are suffering from foot pain and other issues about our services so we can work toward their SOLUTION.
If you haven’t been a patient at Hoosier Foot and Ankle, but you have foot pain, especially heel pain, call 317-660-2115 today to arrange a consultation. Or you may use the online appointment request option available 24/7 for your convenience.
Five Tips to Fix Your Aching Feet
Your feet are often the most neglected and ignored part of your body, until they hurt. Then each step or minute of standing reminds you how much you depend on your feet. Foot pain is not normal, and often signifies an underlying problem. There are some simple things you can try on your own to relieve your pain, but if these fail to help you should seek professional care.
- Proper Shoe Gear
Shoes are a very important initial treatment if you are experiencing foot pain. Here are some suggestions about shoes for aching feet:
- Get your foot measured by a qualified shoe fitter for both length and width, preferably at the end of the day.
- Wear the correct type of shoe for the type of activities you are doing. For everyday walking, consider a cross trainer or running shoe if possible. If you must wear dress shoes, visit a good shoe store for recommendations and make sure you try on several pairs.
- Alternate your shoes daily.
- Replace worn shoes.
- Arch Support and Shock Absorption
Arch support and shock absorption can go a long way to decrease foot pain. However, this can be confusing due to the abundance of products available. Here are some tips to consider for an over-the-counter arch support:
- A support that is entirely soft acts as a cushion only and does not provide any support.
- Look for something costing in the range of $25 – 75; anything more is not worth the extra money and you would be better off with a custom made device from a professional.
- Look for an arch support that is multi-layer, with soft shock absorbing materials on the top and bottom with some type of supportive plastic material in the middle.
- Stretching
Tightness of the Achilles tendon (heel cord) is a common cause or component of several foot conditions. Stretching of the Achilles tendon is very helpful, but must be done correctly:
- Start facing a wall with one leg in front of the other and the toes pointing straight ahead.
- Lean into the wall with both hands against it.
- Bend the front knee and keep the back knee straight.
- As you lean forward, you should feel a slight stretch in your calf; hold this for 10 seconds.
- Come back out of the stretch. This counts as one stretch.
- Perform this 10 times on the back leg.
- Switch legs and perform 10 times on the other leg.
- RICE Therapy
RICE therapy is commonly used for acute conditions and simply stands for Rest, Ice, Compression and Elevation.
- Rest: You may need to discontinue any activities that aggravate your foot pain.
- Ice: 20 minutes three to four times a day. Should be avoided if you have poor circulation or are diabetic.
- Compression: Ace wrap or compression type of bandage. Should be avoided if you have poor circulation or are diabetic.
- Elevation: elevate the affected area, when possible, to heart level.
- OTC Anti-inflammatory Medication
Consider taking an over-the-counter anti-inflammatory medication according to package instructions and precautions if you are able. If you have questions about this, please consult your physician.
Your Feet and Your Health are Our Passion
At Hoosier Foot and Ankle, we all are committed to our new slogan and the three terms that describe this practice.
PASSION drives us to be ready to serve patients while treating your foot conditions. It’s almost something we can’t stop thinking about.
Our patients are always on our minds and hearts. We care about your feet, of course, but that is connected to your overall well-being. We want all of you to be back ON YOUR FEET. That is our goal.
We zealously pursue maintaining our clinics – it is such a blessing to have Dr. Shirley Catoire available so that we can meet your needs more effectively.
Please go thorough your days knowing that our intention is to have you dance – on your feet and/or in your hearts. Share our passion for good feet and good health within your own life.
Call 317-660-2115 to set up a consultation about your foot conditions — let’s not have things get away from you. Or you may use the online appointment request option available 24/7 for your convenience.
A Dozen Situations When You Should Seek A Podiatrist
Pain in your feet is not normal. When your feet hurt, you hurt all over and want relief. How will you get that relief? As yourself these questions:
1. Should you treat it yourself?
2. Should you seek treatment from a podiatrist?
When considering self-treatment, you can start with RICE therapy (Rest, Ice, Compression, Elevation). Anti-inflammatory medications can help with pain and swelling; just be sure to take them according to package directions. Proper shoe gear, fitted by a professional, is helpful for several painful conditions. Another consideration for self-treatment is an over-the-counter arch support to relieve pressure and support the foot.
Here are some situations where you should seek podiatric care:
1. If you experience pain that increases with activity. This could be a stress fracture or tendon injury. Both of these conditions require immediate care to prevent more serious problems.
2. Injuries that prevent you from putting weight on your foot due to significant swelling and pain require attention as soon as you can be seen by a podiatrist. This may mean going to the emergency room to be seen by the podiatrist on call.
3. Severe pain that lasts more than 24 hours can be the result of several conditions, therefore professional care is vital for diagnosis and treatment.
4. Open wounds or sores that are slow to heal on the foot should be seen by a podiatrist. If you have diabetes or poor circulation, you should seek immediate care within 24 hours of noticing the wound. The longer a wound is present, the higher the risk of infection.
5. If you have moles or other skin lesions on your feet that are irregular in shape or color, are painful, become open sores, or have changed appearance, you should see a professional as soon as possible to have a biopsy taken of the lesion. Your podiatrist will confirm a diagnosis and help generate a treatment plan once those results have been obtained.
6. Growths on the foot are not uncommon, but when they change or become painful, they should be examined.
7. Pain that wakes you up at night or when your legs are elevated, and is relieved by walking or dangling your feet is a common sign of poor circulation. Seeing a podiatrist is a good place to start your search for relief. After an examination and possibly some simple vascular testing, your podiatrist can make recommendations for further treatment and referrals as needed.
8. If you notice flattening of one arch, which may or may not be painful, you should seek care to determine the cause and plan subsequent treatment.
9. Changes in color of your foot or lower leg compared to the other side can indicate poor circulation (white discoloration), venous conditions (purple or blue discoloration), infection or gout (red discoloration). These conditions vary in severity, but should be evaluated.
10. An ingrown toenail that is causing pain or becomes red and swollen requires a simple in-office procedure to permanently remove the ingrown portion of the toenail.
11. Thickening and discoloration of your toenail which becomes painful or spreads to other nails can be treated by either topical or oral medications or laser treatment.
12. A foot deformity that is progressively getting worse should be evaluated and your treatment options reviewed.
Little Flat Feet Grow Up to be Big Flat Feet That Hurt
The little flat baby feet are so sweet. Sometimes their flat condition causes pain that is not necessary for children, sometimes it doesn’t seem to bother. But, flat feet for an adult can spell misery that is difficult to relieve.
Proper diagnosis and early correction brings a new outlook on life to the child whose feet are painful. That is one of the best things I can see; the happy face of a kid without painful feet.
That same proper diagnosis and early correction can give an adult a more pleasant foot life as the years go by without developing pain and discomfort from long term flat feet.
The video shows a corrective procedure that inserts a subtolar implant into the foot. The specific implant is an MBA implant and acts as an internal arch support. It is often used done with a Gastroc Recession. I have the skills to perform this or other corrective treatment for flat feet.
If flat feet are an issue for you or someone you care for, call 1-800-615-1363 today for a consultation appointment at one of our five clinics. Or you may use the convenient online appointment request which is available 24/7.
Let’s work together early for proper diagnosis and an action plan to keep the feet in your family happy feet.
Ron Thought He Would Have to Give Up His Daily Constitutional
Ron is interested in being mobile. He enjoys the exercise and getting out in the neighborhood to walk every day. So, when a pain hit his foot and made walking misery, he was faced with giving up his pleasant daily constitutional OR find a solution.
I’m honored that he chose to become a patient at Hoosier Foot and Ankle and pleased that we found the solution for his chronic foot pain.
Ron is happy to be back out in the fresh air again, enjoying his walking activity. I appreciate that he took a minute to film his story for you.
Emmett’s Opinion | Testimonials Encourage Dr. DeHeer and Other Patients
When one person shares their experience with you, it just helps make the decisions for your own foot care.
When Emmett sat down in front of my camera recently and told of his experience receiving corrective treatment, I was pleased to hear from him. I’m always pleased when a procedure helps a patient; I’m really encouraged when someone will candidly share a story as Emmett does. Now, I know that you have his success on which to base some of your research and your choices.
Thank you for your attention to my blog and for taking the time to listen to Emmett’s comments. Again, seeing that his procedure made a difference in his quality of life and that of his family is an example of part of my reward when working with patients.
Emmett’s testimonial and future comments are located on the Hoosier Foot and Ankle Testimonials at this website.
Do You Need a Podiatrist?
Pain in your foot is not normal and the difficulty comes in trying to decide when you can treat yourself and when you should seek treatment by a Podiatrist . You can start with RICE therapy (rest, ice, compression, elevation). Anti-inflammatory medications can help with pain and swelling, which should be taken according to package directions. Proper shoe gear, fitted by a professional, is helpful for several painful conditions. Another consideration for self treatment is an over-the-counter arch support to relieve pressure and support the foot. Here are some situations where you should seek podiatric care.
- If you experience pain that increases with activity, this could be a stress fracture or tendon injury. Both of these conditions require immediate care to prevent more serious problems.
- Injuries that prevent you from putting weight on your foot due to significant swelling and pain require attention as soon as you can be seen by a podiatrist. This may mean going to the emergency room to be seen by the podiatrist on call.
- Severe pain that lasts more than 24 hours can be the result of several conditions; therefore professional care is vital for diagnosis and treatment.
- Open wounds or sores that are slow to heal on the foot should be seen by a podiatrist. If you have diabetes or poor circulation, you should seek immediate care within 24 hours of noticing the wound. The longer a wound is present, the higher the risk of infection.
- If you have moles or other skin lesions on your feet that are irregular in shape or color, are painful, become open sores, or have changed appearance; you should have a biopsy of the lesion to confirm a diagnosis and help generate a treatment plan once those results have been obtained.
- Growths on the foot are not uncommon, but when they change or become painful, they should be examined.
- Pain that wakes you up at night or when your legs are elevated, and is relieved by walking or dangling your feet; is a common sign of poor circulation. Seeing a podiatrist is a good place to start. After an examination and possibly some simple vascular testing, your podiatrist can make recommendations for further treatment and referrals as needed.
- If you notice flattening of one arch, which may or may not be painful, you should seek care to determine the cause and subsequent treatment.
- Changes in color of your foot or lower leg compared to the other side can indicate poor circulation (white discoloration), venous conditions (purple or blue discoloration), infection or gout (red discoloration). These conditions vary in severity, but should be evaluated.
- An ingrown toenail that is causing pain or becomes red and swollen requires a simple in office procedure to permanently remove the ingrown portion of the toenail.
- Thickening and discoloration of your toenail which becomes painful or spreads to other nails can be treated by either topical or oral medications.
- A foot deformity that is progressively getting worse should be evaluated and your treatment options reviewed.
