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Foot diseases tips for isolated doctor

E.I. HO-PUN-CHEUNG
E.I. HO-PUN-CHEUNG

The sports physician and the osteopath can effectively treat some non-surgical foot and ankle pathologies, such as: plantar myopathy; inter-metatarsal pain; calcaneal, fibular, long extensor common toes, Extensor of the hallux, posterior Tibial, flexor toes and hallux tendinopathies In my paper on Podiatry, presented at a few conferences and summarized in an article in the book Pathologies of the walk I had proposed some tricks learned here and there for some lesions of the foot. It goes from Bromhydrose to fatigue fractures, through the blisters and foot warmings. I was inspired by some of my research sponsored by the Army Health Service https://osteopathie-adhesiolyse.com/en/

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Doctor Thierry HO-PUN-CHEUNG Blisters, feet's bad smell, ingrown nail, tendinopathy FOOT's DISEASES Tips for isolated doctor Colloque m辿decine des missions ext辿rieures 2008
- scorch / bullae (blisters) - microtraumatic foot lesions favored by: - the constant wearing of shoes (RANGERS) - intense physical effort , not progressive - poor hygiene however, the foot = KEY SENSOR of the POSTURAL SYSTEM ANY DISTURBANCE of ground SUPPORT DISTURBANCE of POSTURE and FOOT roll at STEP CONSTRAINTS PATHOLOGIES on LOWER LIMB, SPINE and PELVIS 3
1. PLANTAR HYPERHIDROSIS 20% = WET SOCKS (even in winter) Aftermath : maceration + soft and fragile skin - scorch, blisters - Mycosis - Bromhidrose (horrible smell)
If FOOT ORTHOTICS = airing every day ANTIPERSPIRANT POWDER = Obstructs the pores by keratinization HYDROCORTISON CREAM EVERY NIGHT then 2 times per week For maintenance Irritating early ! TREATMENT of plantar HYPERHIDROSIS if failure IONOPHORESIS (Dermatologist otherwise cheap store) 4 sessions 30 min / week then 1 / week, then 1 / month
KERATOLYSIS PUNCTUATED +++ Bad smell (Corynebacterium) - povidone iodine = to lather - antibiotic gel: 2 times per day for 15 days - imidazole cream
classique = d辿faut de coupe2. NAIL EMBODIED = bad cut Stade 1: wearing shoes PAIN DENTAL WIRE / SUTURE WIRE STRAPPING
Stage 2: painful inflammatory bead Resection of the nail spur + Baths antiseptic toe + Povidone iodine gel bandage Stade 3: PERMANENT PAIN = INFECTION BUDDING PYOGENIC GRANULOMA : EMLA速 CURETTAGE / dermocorticoid Lysis If FAIL / RECIDIVISM: Partial EXTRACTION OF the NAIL LAME then matrix phenolization
3. FROSTBITE OF TOES warm bath = 38属C + ANTISEPTIC Aspirin 250 mg
BENIGN but PAINFUL CHANGE SUPPORT -TENDINOPATHIES -IMBALANCE WALKS Causes: plantar hyper support or excessive skin on per shoe / sock's fold SCORCH = diffuse painful irritation of the skin (burning 1) BLISTER = localized scorch and serous detachment of the dermis (superficial burns 2) 4. SCORCH and BLISTERS of FEET
= that of a 1st degree burn disinfection moisturizer SCORCH Treatment BLISTERS Treatment A. FOR FINISH THE HIKE / WALK: AVOID INFECTION = never put a wire in the blister !!! DISINFECTION VACUUM with STERILE NEEDLE AND SYRINGE DRILL 3 HOLES Dry dressing protector Hydrocolloid B. AT THE END OF WALK: DISINFECTION if blister ceiling is torn : Cut it in a sterile way let it outdoors, otherwise DRESSING PROTECTOR
Until the skin tans: DRESSING PROTECTOR HYDROCOLLOID SOCKS = SEAMLESS if aggressive fold foothills of rangers HOOF OIL BEEF PLANTAR ORTHOSES if static disorder reduces hyper support Treat plantar hyperhidrosis and dry feet BLISTERS - SCORCH PREVENTION NB: Personal double-bind Study > 600 military : the anti-scorch creams and cushioned midsoles were ineffective !!! 3 days before the march: > 7 days before a long walk LEMON JUICE (citric acid)
Calcaneal tendon surrounded by sliding bursa 5. CALCANEAL BURSITIS 5.1. RETRO CALCANEAL BURSITIS = RUBBING OF THE RETROCALCANEAL FAT BURSA (Bovis bursa : located between the Achilles tendon and skin) PAINFUL SWELLING BEHIND THE CALCANEAL TENDON
5.2. PRE CALCANEAL BURSITIS = support of the rangers' foothills crushes this bursa between the calcaneal tendon and the posterior superior face of the calcaneus. failure lateral radiograph ? hypertrophy posterior superior part of the calcaneus tuberosity = Haglund Disease + - Surgical
exempted of shoes buttress Dynamic Manual Adhesiolysis速 Icings Bilateral heel damping = 1 cm high CALCANEAL BURSITIS TREATMENT SOFTEN THE FOOTHILLS OF THE RANGERS = HOOF OIL BEEF FLEXIBLE RANGERS If failure MESOTHERAPY
Dynamic Manual Adhesiolysis速 +++: Calcaneal Tendon, Soleus/Gastrocnemius, Plantar Flexors Stretching Strengthening 5.3. CALCANEAL TENDINOPATHIES (1/3 = BURSITIS) strapping : If compulsory Walk
painful foot edema + impotence = Thinking 6. STRESS FRACTURES
Tuning Fork Test (128Hz)+++ EXQUISITE PAIN attenuation of sound propagation STRESS FRACTURE + Auscultation (Barford Test): STRESS FRACTURE Treatment Treating a vitamin D (Hormone D) deficiency
= Dynamic Manual Adhesiolysis速 SOFTEN Plantar fasciae: - Shiatsu Massage Cushion +++ 7.1. CORPOREAL PLANTAR FASCIITIS 7. PLANTAR FASCIITIS Plantar pain + common in military > 40 years
7.2. PROXIMAL PLANTAR FASCIITIS Dynamic Manual Adhesiolysis速 If failure: corticosteroid infiltration to the insertion of FLEXOR PLANTARIS heavy backpack (up to 30 kg)
favored by FLAT VALGUS FEET of the older walkers + - PLANTAR ORTHOSES Analgesic TAPING 8. POSTERIOR TIBIALIS TENDINOPATHY Tibial post辿rieur TREATMENT Dynamic Manual Adhesiolysis速 + Strengthening FOOT ARCH
ACID Food proportion (uric acid and oxalic acid) which promote the precipitation of oxalate and sodium urate crystals in the fasciae-tendon-muscle tissues ADHESIONS limiting excess: MEAT, MEAT, DAIRY, peanut TEA black, COFFEE / WHITE FLOUR, SUGAR FACTORIES ALKALINE Food: FRUIT, VEGETABLE FEES Natural FOOD FORM Omega-3, vitamin D DIETARY common sense RULES Avoid CHRONIC DEHYDRATION which often precedes tendinopathy 9. Some GENERAL actions of PREVENTION
REPAY absolutely the "SLEEP DEBT" "This is the night that the body regenerates" Before a night march: "preventive nap

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Foot diseases tips for isolated doctor

  • 1. Doctor Thierry HO-PUN-CHEUNG Blisters, feet's bad smell, ingrown nail, tendinopathy FOOT's DISEASES Tips for isolated doctor Colloque m辿decine des missions ext辿rieures 2008
  • 2. - scorch / bullae (blisters) - microtraumatic foot lesions favored by: - the constant wearing of shoes (RANGERS) - intense physical effort , not progressive - poor hygiene however, the foot = KEY SENSOR of the POSTURAL SYSTEM ANY DISTURBANCE of ground SUPPORT DISTURBANCE of POSTURE and FOOT roll at STEP CONSTRAINTS PATHOLOGIES on LOWER LIMB, SPINE and PELVIS 3
  • 3. 1. PLANTAR HYPERHIDROSIS 20% = WET SOCKS (even in winter) Aftermath : maceration + soft and fragile skin - scorch, blisters - Mycosis - Bromhidrose (horrible smell)
  • 4. If FOOT ORTHOTICS = airing every day ANTIPERSPIRANT POWDER = Obstructs the pores by keratinization HYDROCORTISON CREAM EVERY NIGHT then 2 times per week For maintenance Irritating early ! TREATMENT of plantar HYPERHIDROSIS if failure IONOPHORESIS (Dermatologist otherwise cheap store) 4 sessions 30 min / week then 1 / week, then 1 / month
  • 5. KERATOLYSIS PUNCTUATED +++ Bad smell (Corynebacterium) - povidone iodine = to lather - antibiotic gel: 2 times per day for 15 days - imidazole cream
  • 6. classique = d辿faut de coupe2. NAIL EMBODIED = bad cut Stade 1: wearing shoes PAIN DENTAL WIRE / SUTURE WIRE STRAPPING
  • 7. Stage 2: painful inflammatory bead Resection of the nail spur + Baths antiseptic toe + Povidone iodine gel bandage Stade 3: PERMANENT PAIN = INFECTION BUDDING PYOGENIC GRANULOMA : EMLA速 CURETTAGE / dermocorticoid Lysis If FAIL / RECIDIVISM: Partial EXTRACTION OF the NAIL LAME then matrix phenolization
  • 8. 3. FROSTBITE OF TOES warm bath = 38属C + ANTISEPTIC Aspirin 250 mg
  • 9. BENIGN but PAINFUL CHANGE SUPPORT -TENDINOPATHIES -IMBALANCE WALKS Causes: plantar hyper support or excessive skin on per shoe / sock's fold SCORCH = diffuse painful irritation of the skin (burning 1) BLISTER = localized scorch and serous detachment of the dermis (superficial burns 2) 4. SCORCH and BLISTERS of FEET
  • 10. = that of a 1st degree burn disinfection moisturizer SCORCH Treatment BLISTERS Treatment A. FOR FINISH THE HIKE / WALK: AVOID INFECTION = never put a wire in the blister !!! DISINFECTION VACUUM with STERILE NEEDLE AND SYRINGE DRILL 3 HOLES Dry dressing protector Hydrocolloid B. AT THE END OF WALK: DISINFECTION if blister ceiling is torn : Cut it in a sterile way let it outdoors, otherwise DRESSING PROTECTOR
  • 11. Until the skin tans: DRESSING PROTECTOR HYDROCOLLOID SOCKS = SEAMLESS if aggressive fold foothills of rangers HOOF OIL BEEF PLANTAR ORTHOSES if static disorder reduces hyper support Treat plantar hyperhidrosis and dry feet BLISTERS - SCORCH PREVENTION NB: Personal double-bind Study > 600 military : the anti-scorch creams and cushioned midsoles were ineffective !!! 3 days before the march: > 7 days before a long walk LEMON JUICE (citric acid)
  • 12. Calcaneal tendon surrounded by sliding bursa 5. CALCANEAL BURSITIS 5.1. RETRO CALCANEAL BURSITIS = RUBBING OF THE RETROCALCANEAL FAT BURSA (Bovis bursa : located between the Achilles tendon and skin) PAINFUL SWELLING BEHIND THE CALCANEAL TENDON
  • 13. 5.2. PRE CALCANEAL BURSITIS = support of the rangers' foothills crushes this bursa between the calcaneal tendon and the posterior superior face of the calcaneus. failure lateral radiograph ? hypertrophy posterior superior part of the calcaneus tuberosity = Haglund Disease + - Surgical
  • 14. exempted of shoes buttress Dynamic Manual Adhesiolysis速 Icings Bilateral heel damping = 1 cm high CALCANEAL BURSITIS TREATMENT SOFTEN THE FOOTHILLS OF THE RANGERS = HOOF OIL BEEF FLEXIBLE RANGERS If failure MESOTHERAPY
  • 15. Dynamic Manual Adhesiolysis速 +++: Calcaneal Tendon, Soleus/Gastrocnemius, Plantar Flexors Stretching Strengthening 5.3. CALCANEAL TENDINOPATHIES (1/3 = BURSITIS) strapping : If compulsory Walk
  • 16. painful foot edema + impotence = Thinking 6. STRESS FRACTURES
  • 17. Tuning Fork Test (128Hz)+++ EXQUISITE PAIN attenuation of sound propagation STRESS FRACTURE + Auscultation (Barford Test): STRESS FRACTURE Treatment Treating a vitamin D (Hormone D) deficiency
  • 18. = Dynamic Manual Adhesiolysis速 SOFTEN Plantar fasciae: - Shiatsu Massage Cushion +++ 7.1. CORPOREAL PLANTAR FASCIITIS 7. PLANTAR FASCIITIS Plantar pain + common in military > 40 years
  • 19. 7.2. PROXIMAL PLANTAR FASCIITIS Dynamic Manual Adhesiolysis速 If failure: corticosteroid infiltration to the insertion of FLEXOR PLANTARIS heavy backpack (up to 30 kg)
  • 20. favored by FLAT VALGUS FEET of the older walkers + - PLANTAR ORTHOSES Analgesic TAPING 8. POSTERIOR TIBIALIS TENDINOPATHY Tibial post辿rieur TREATMENT Dynamic Manual Adhesiolysis速 + Strengthening FOOT ARCH
  • 21. ACID Food proportion (uric acid and oxalic acid) which promote the precipitation of oxalate and sodium urate crystals in the fasciae-tendon-muscle tissues ADHESIONS limiting excess: MEAT, MEAT, DAIRY, peanut TEA black, COFFEE / WHITE FLOUR, SUGAR FACTORIES ALKALINE Food: FRUIT, VEGETABLE FEES Natural FOOD FORM Omega-3, vitamin D DIETARY common sense RULES Avoid CHRONIC DEHYDRATION which often precedes tendinopathy 9. Some GENERAL actions of PREVENTION
  • 22. REPAY absolutely the "SLEEP DEBT" "This is the night that the body regenerates" Before a night march: "preventive nap