Heel pain prevention and Orthopaedic treatment.

Heel pain is common in India. It is as common as having back, knee and shoulder pain.

Often this is attributed to lack of flexibility in the foot, aggravated by walking on very hard floor.

Walking outdoors or in surfaces with variation in the terrain helps us to put all the joints of the foot to use.

Hard floor which may look nice and easier to maintain, limits the weight transmission to some aspects of the foot.

Heel then takes the brunt of our weight on to the hard floor.

What to do to avoid heel pain?

Wear any cheppal indoors when walking on hard floor

Keep doing some flexibility exercises.

Go to these links and do the exercises

http://orthoinfo.aaos.org/topic.cfm?topic=a00310

More important spend some time walking on uneven surface on bare foot, may be go out for a walk in a pair of good trainer shoes.

Sometimes this pain can be refractory and you need to see an Ortho Surgeon.

We now have facilities to treat this pain with the proven treatment methods using injection or endoscopic methods.

I will write on endoscopic method of treatment in Orthopaedics in the future.

Warm Regards

Chockalingam

advantage of surgery to fix the fractured bone

The concrete of our body which when heals from a fracture takes time.

During this time, the patient will have pain and loss of use of the part of the body.

This is acceptable to rest the building which is being repaired for few weeks before you start using it

But for us, pain remains partly even with plaster and rest.

Loss of function of the part of the body for few weeks was acceptable in those days, but people want to return to normality as quickly as possible

The drawback of not being able to use the leg or the arm is immense, understood by the person who has fractured it

Thus surgery helps to fix the bone and keep it still. This relieves the pain and helps to start using the arm or the leg and so on.

I will share some examples in the future blogs

Bye for now

Warm Regards

Chockalingam

the Reinforced concrete of our body, the bone has fractured, what to do

When the Reinforced Concrete of a building breaks, you want to repair it. until then you protect the building by not putting any force.

This is exactly what you do when the bone fractures. You stop putting any force acting across it. meaning you rest the part which is fractured.

Put some ice fomentation, and keep the body part still with bandage or splint with piece of wood.

Repair, the bone does it itself.

But while it repairs, it puts the concrete in the fluid form which then sets like the concrete mixture of water, cement and the sand.

This process in building can take days to weeks and you wait by not putting the stress.

In the bone also, you have to rest the part by immobilizing in a plaster cast or by surgery.

The body then puts blood at the fractured site which then becomes the concrete mix called callus which is soft bone.

This will then change to the hardened concrete which is hard bone.

The plaster cast is not applied directly to the bone unlike the RC in a building. hence the patient will have pain during the initial setting phase with movements.

This is why the fracture treatment has progressed for pain relief and early return to function by surgery.

We will see this in my next blog

Warm Regards

Chockalingam

RC of our body: bone, fracture, weakness and how to prevent

When the building breaks with the RC weakened with time or force, one has to repair it or reinforce it, or sometimes replace it

Bones also do break as the its RC can become weak with time or otherwise called age of the person. This is called Osteoporosis.

In some instances the building was not done with good standard RC, then the building collapses prematurely.

Bones also break when its RC is defective. This happens when the defect is in the collagen namely the steel. These happen in children when they break the bone repetitively and with unusually small falls or without any injury.

Bone break when the hydroxyapatite is not not good. as you know the hydroxyapatite is made of calcium and phosphate. this is commonly seen in Vitamin D deficiency.

How then to look after this side of the bone which breaks.

1.Please read my earlier blog on Sunshine vitamin which is Vitamin D. get at least half an hour of exposure of sunlight to your body.

Remember our old tradition of applying oil to our skin and our parents made us to stand in the sunlight on sundays, may be they knew the science behind this.

Eating vegetables is good for the calcium and milk and milk products for the vitamin and calcium

2. as your parent gets older, understand that they are prone for fractures. get them to walk at least half an hour to one hour of the day.

how does this help, please read the previous blog on RC

3. if your child breaks bones often , consult a paediatrician, but remember this is very rare. Often the fact is that your child is very active and falls often which is not a bad thing.

4. Vitamin C is important for the collagen, that is steel. Fresh fruits and juices give plenty of this vitamin and keep the bones healthy

5. Both young and old, exposure to natural sunlight is important for Vitamin D. Unfortunately children do not play outside as we used to, and there is no decent place for the elderly to walk either.

As a society we need to dwell on this further

Warm Regards

Chockalingam

bone the reinforced concrete of our body, but more unique and how to look after your bones!

My close friend and colleague , taught me about the bone of our body as being RC. RC meaning Reinforced Concrete.

The concrete in building can take loads but if you bend it with the force of the wind and nature, it will break.

Then Engineers then came up with this concept of reinforcing Concrete with Steel. The Steel has good ability to withstand bending moment but not good in compression.

Our bone needs both these strength of withstanding taking the load of weight. The human bone has Hydoroxyapatite which is calcium and Phosphate with a particular ratio.

Human body more than a static building, needs more protection from bending moments. More in the sense that the body is in motion and the bone may not be vertical all the time.

Collagen is a structure which then acts as dynamic steel rearranged in different orientations. This is unlike a Reinforced concrete where the steel is in vertical orientation or horizontal most of the time.

Human bone  "which then has this collagen -steel and the Hydroxyapatite- the concrete" is quite dynamic. it can change the content and ratio depending on the amount of load you put in.

This is unlike the building where the ratio is already decided by the engineers.

How then to look after our bones. We need to give work for this steel and the concrete of our body to make it remain in good condition.

This will be in the form of weight bearing exercise like walking and bending exercise such as flexibility exercise such as yoga or pilate.


Hope this is useful

please free to post your comments

Warm Regards

Chockalingam

Seat Belt, what do i do when my family do not want to wear the seat belt

The common problem of family members not wanting to wear the seat belt needs to be tackled. Often the head of the family may even be a doctor who fully understands the importance of the seat belt. But he is not able to convince the family  members to wear the seat belt.

What does one do?

Switch off the ignition was the reply by one of my senior colleagues and i should agree with him.

What do you think?

If you care for someone, sometimes you have to be firm and tough, if need be, eh!!

Warm regards

S Chockalingam