Midfoot fusions. Midfoot fusions are probably the most commonly performed procedures for flexible flatfoot reconstructions, and are indicated when the arch is collapsed. They may be performed in isolation as a stand-alone procedure, but are often combined with rearfoot procedures and tendon transfers to balance the foot. (Figures 4-5) Medial column procedures are the Lapidus arthrodesis (or Lapidus bunionectomy), and/or navicular cuneiform arthrodesis. 52-56 When instability (hypermobility) is the cause of the collapse, fusions are directed at restoring the stability of the arch. These medial column joints are non-essential joints of the foot, so fusion of these joints does not sacrifice overall foot function. 57 Addressing tight musculature around the area will also be of benefit. The ilio-tibial band (ITB) has a natural tendency to tighten up in runners and cyclists. It can be seen in this picture as the substance in white. It helps stabilize the outside aspect of the leg, and connects to the outer edge of the kneecap. Hence if it is tight, it can pull on the kneecap, causing CMP. In fact professional cyclists and runners, might get this ITB massaged DAILY during peak training periods! If you have CMP, doing some self massage to the ITB will almost certainly help as well! Ankle foot orthoses (AFOs). These braces are used for more serious/severe cases of flatfoot and/or less mild forms of flatfoot that have not responded to treatment with insoles. 11,12 An AFO is a device that supports the arch and extends upward on the ankle and lower leg to provide additional support for the foot. 13 These are also fabricated from a mold of the foot and ankle. More contemporary braces combine the benefits of a custom insole with those of an AFO, which is especially useful for patients suffering from chronic posterior tibial tendon dysfunction. Bone chips-medically termed osteochondritis dessicans-occurs when a fragment of bone or cartilage comes loose. This can result in pain and other symptoms. It most commonly affects the knee but can occur in any joint. Prompt treatment offers a good outcome and reduces the risks of long-term complications. A prosthetic leg or lower-limb prosthesis is an artificial replacement that is provided to patients who have undergone an amputation of a portion of one or both legs. Use of a lower-limb prosthesis requires acclimation and training. Hallus valgus is a condition which requires treatment. It will not heal without treatment. Surgical treatment is more beneficial than conservative treatment in improving the outcome. The carbohydrates we eat perform different functions. One type of carbohydrate is deoxyribose, which is a building block of genes. Other carbohydrates are converted to protein and used to build structures in the body. But the primary function of carbohydrates is to provide energy for the body. This requires the carbohydrates to be in the form of glucose. A bladder infection, also known as cystitis, is the most common infection of the urinary tract and can be bothersome and painful. Normally, it is not a serious condition but can turn into one if the offending bacteria spread to the kidneys. Women are much more likely to suffer from bladder infections. Baker cysts arise from the gastrocnemius and/or semimembranosus bursa in the posterior knee. The gastrocnemius bursa lies between the medial head of the gastrocnemius and the joint capsule and communicates with the knee joint. The semimembranosus muscle sends tendon insertions to the posteromedial tibia behind the MCL, and a direct head inserts more posterior and distal as well. These insertions are superior and posterior to the insertion of the conjoined pes anserinus tendons and the pes anserine bursa. Having flat feet is normal in babies until they are about two years old. More often than not, as parents we confused a child's fat feet with flat feet. Experts agree that any measure that will help the foot become stronger can only be beneficial and helps to prevent foot pain. Walking barefoot, especially in sand, helps the feet to become used to an ever-changing environment, and it encourages the various ligaments and muscles in the feet to become stronger. Another exercise that is said to be beneficial is to run on one's toes for as long as possible and to spend time spreading the toes as wide as possible, all in aid of strengthening the muscles and tendons in the feet. Stiff sole- the sole of the shoe needs to be stiff to resist foot collapse. Many shoes are highly flexible, and this does not help stabilize a flat foot. When examining a shoe for purchase, try to bend the sole of the shoe. If it bends towards the middle of the shoe, then the shoe is too flexible. If the sole bends near the toes or the ball of the foot, then the shoe will be more supportive. Also, try to twist the shoe. Grab the front and back of the shoe and try to twist and wring it like a drying towel.