LETS HEEL THE HEEL!

My heel hurts when I walk.  I cannot run anymore!  Hiking causes a lot of pain!

These are very common complaints I get nowadays with the every changing lifestyle of the population.  This healthy lifestyle is very good at combating other diseases like heart disease and obesity.  Therefore, we must not let heal pain stop us from doing the things we love.

Where is your pain?

The areas above are two of the most common.  They are commonly diagnosed as "ACHILLES TENDINITIS".

The word "achilles" refers to the largest tendon in the body which attaches to the heel.  For movie aficionados, you will remember this in the movie "Troy" starring Brad Pitt.  Achilles was an invincible warrior who was lamed by an arrow shot to his heel by the Trojan prince called Paris.

(from the Guardian Newspaper, UK)

"Tendinitis" on the other hand refers to inflammation of a tendon.

Though pain in the achilles is not exclusively due to inflammation, it is probably the most common reason.  Other causes include tears of the achilles and gout.  This has led to a broader term called "tendinopathy".

Pain in the achilles can be in two specific regions: A - "achilles tendinopathy" and B "insertional achilles tendinopathy".  

PAIN AND SWELLING

Pain and swelling are the most common symptoms.  Frequently it occurs whilst walking. This will lead to a limp and abnormal gait.

TREATMENT

In most circumstances, mild symptoms can be treated with anti inflammatory medication.  Stretching and physical taping has shown some benefit but the balance between physiological and pathological inflammation is difficult to gauge.  

The use of steroids is very controversial.  Steroids are potent anti inflammatory medication either used orally or injected.  Especially when given by an injection to the achilles, may lead to rupture.

Rupture of the achilles tendon

(from orthobullets)

Repeated bouts of achilles tendinopathy does lead to degenerative changes in the tendon. This may lead to ruptures of the achilles tendon.

Should conventional methods of treatment fail, other specialised methods of treatment can be instituted to resolve Achilles Tendinopathy.  This can range from highly specialised injections to surgical intervention.  Please discuss this with your Consultant Orthopaedic, Foot and Ankle Surgeon.

by

Dr Khairul Faizi Mohammad

Consultant Orthopaedic, Foot and Ankle Surgeon

Kuala Lumpur Foot Ankle Clinic (KLFAC)

Pantai Hospitals 

(Cheras and Kuala Lumpur)

T: +603-91452951

w:  KLFAC.com

DO YOU HAVE HEEL PAIN?

DO YOU HAVE HEEL PAIN?

Heel pain or "sakit tumit" is a very common condition.  It can be due to many reasons such as high levels of activity, poor shoeware and trauma.  This is a very debilitating condition and only those whose have suffered it will know how it affects ones life.

The heel is an area in which a multitude of problems could occur.  The diagnosis is made depending on the specific symptoms and its location.

Some of the symptoms that you may suffer from are sharp pains (eg like stepping on a nail), tightness or a stretching pain or numbness / radiating pain.  All of this will differ in magnitude and its location and specific examinations will provide vital evidence to conclude a diagnosis.

The typical locations of heel pain are shown below.

Some diagnoses are more common than others.  Typical diagnoses are plantar fasciitis and achilles tendinopathy.  Other rarer diagnoses include tarsal tunnel syndrome.  These diagnosis are not clear cut as the heel is a small area and there may be a significant overlap between one and another.  

Treatment options will depend on the diagnosis made and its best discussed with your Consultant Orthopaedic Foot and Ankle Surgeon.

Don't let heel pain ruin your life!

Dr Khairul Faizi Mohammad

Consultant Orthopaedic, Foot and Ankle Surgeon

Kuala Lumpur Foot Ankle Clinic

Pantai Hospitals (Cheras and Kuala Lumpur)

T: +603-91452951

www.klfac.com

 

HAPPY CHINESE NEW YEAR from KLFAC

May the year to come bring everyone good health and prosperity!

 

Happy Chinese New Year from the Management of Kuala Lumpur Foot Ankle Clinics

 

www.klfac.com

KUALA LUMPUR FOOT ANKLE CLINIC (KLFAC) - Official website

LAUNCHING OF THE OFFICIAL WEBSITE FOR KUALA LUMPUR FOOT ANKLE CLINIC (KLFAC)

After many months of hard work, we have finally completed the official website to the Kuala Lumpur Foot Ankle Clinic (KLFAC).  This website does not replace the blog as we will constantly update the blog with advances and information.  This will then be transcribed to the website.

www.klfac.com

 

 

I hope this website is informative and will be able to reach out to all those who suffer from foot and ankle problems or those who are interested in the field.

 

 

 

Dr Khairul Faizi Mohammad

 

Consultant Orthopaedic Foot and Ankle Surgeon

 

Kuala Lumpur Foot Ankle Clinic (KLFAC)

DATUK LEE CHONG WEI STRUCK BY ANKLE INJURY- dr khairul faizi mohammad (KLFAC)

LATERAL LIGAMENTOUS COMPLEX INJURY

Our Champ in pain after his injury

Lateral ligamentous injuries are very common injuries.  It can be due to repeated sprains to the ankle or a single inversion injury such as what happened to Datuk Lee Chong Wei (our nations No1 Badminton Player).  If we review the footage below, we can clearly see the stressed on the outer aspect of his ankle during the impact.

http://www.badmintonlink.com/Watch-Videos/2012_Thomas_Cup_Goup_C_Day_3_Lee_Chong_Wei_injury_retired

This is a very serious injury for our No 1 player.

Please read this for more information on the injury and its treatment.

http://footandankleproblems.blogspot.com/2011/06/ankle-instability-severe-sprains-dr.html

From the Management of Kuala Lumpur Foot Ankle Clinic (KLFAC), we pray for a speedy recovery!

Dr Khairul Faizi Mohammad

Consultant Foot and Ankle Surgeon

Kuala Lumpur Foot Ankle Clinic

Pantai Hospitals

(CHERAS (HQ), KUALA LUMPUR, AMPANG)

ARTHRITIS OF THE ANKLE - DR KHAIRUL FAIZI MOHAMMAD

Weight bearing Xrays of a patient with arthritis of the ankle

Weight bearing Xrays of the ankle with arthritis

Swollen and deformed ankle with arthritis

TOTAL ANKLE REPLACEMENT

TOTAL ANKLE REPLACEMENT

Osteoarthritis (also known as arthritis) of the ankle is a condition which results in damage and loss of the cartilage which lines the bones of the tibia and talus.  The smooth characteristics of the cartilage is loss which wil subsequently lead to inflamation and deformity. 


SYMPTOMS OF ANKLE ARTHRITIS

The main symptoms of ankle arthritis are pain, stiffness, swelling and deformity.  The severity of the pain will depend on the severity of the arthritis.  It may occur with excessive amounts of activities in the early stages and with every step taken when it is severe. 


CAUSES OF ANKLE ARTHRITIS

The main cause of ankle arthritis is previous trauma to the ankle joint such as ankle fractures and repeated ankle sprains.  The ankle is a small joint compared to the hip and knee.  It receives a tremendous amount of weight with each step especially during running. 

Varying deformities in the knee and hip will also cause malalignment of the leg.  This will also accelerate ankle arthritis.

Read more about ankle sprains here:

http://footandankleproblems.blogspot.com/2011/06/ankle-instability-severe-sprains-dr.html


DIAGNOSIS OF ANKLE ARTHRITIS

The diagnosis of ankle arthritis is clinicaly made by your Foot and Ankle Surgeon and is aided by investigations like plain Xrays, CT scans. and sometimes MRI.


TREATMENT OF ANKLE ARTHRITIS

The treatment of ankle arthritis can be divided into 2: Non surgical treatment and Surgical Treatment.

1.  Non Surgical Treatment

Non surgical treatment of ankle arthritis involves anti inflammatory pain relief, shoewear modification, physiotherapy and injections of viscosupplements.  I personally do not inject corticosteroids into the joint.

http://footandankleproblems.blogspot.com/2009/01/injections-into-ankle.html


2.  Surgical Treatments

Surgical treatments of ankle arthritis can include keyhole surgery (arthroscopy of the ankle joint), realignment surgery, fusion surgery and  Total Ankle Replacements (TAR). 

http://footandankleproblems.blogspot.com/2009/08/anterior-ankle-arthroscopy-dr-khairul.html

If you have symptoms of ankle arthritis or questions regarding ankle arthritis, please contact you Consultant Orthopaedic Foot and Ankle Surgeon:

Dr Khairul Faizi Mohammad

Head, Consultant Orthopaedic Foot and Ankle Surgeon

Kuala Lumpur Foot Ankle Clinic (KLFAC)

Pantai Hospital

(CHERAS, KUALA LUMPUR and AMPANG)

03-91322022 ext 3333 (Mrs Vijay for appointents)

PLANTAR WART, PLANTAR KERATOSIS, VERUCCAS, CORNS etc

All the above refer to the same thing.  Hard warts are the most common viral infection of the skin. Plantar warts grow on the plantar surface, or the sole, of the foot. They can be found anywhere in this area but tend to produce symptoms in areas of pressure and friction. The virus that causes warts, the human papilloma virus (HPV), infects only the superficial layer of skin, producing a thickened callus-like growth that, if located in an areas subjected to pressure, can become quite tender.

Although warts characteristically resolve spontaneously, it may become necessary to treat warts that negatively affect an individual's ability to walk. The incubation period (the period of time between infection and the production of the visible skin lesion) is unknown but has been estimated to vary from months to years. Historical evidence is of little benefit in attempting to determine how one's wart was acquired. There are at least 120 different types of human papillomavirus, and only certain types are responsible for skin warts. Certain virus types tend to infect specific anatomical areas, like the plantar surface of the foot. Warts are ubiquitous infections, with least one-half of adults infected during their lifetime. The current prevalence of plantar warts in adults is unknown, but it is a fraction of the estimated 7%-10% of adults with all types of wart infections.

Treatment  involved removing the wart and accertaining whether there is a mechanical factor causing abnormal pressure to that particular area.  The wart may be removed chemically with Salicylic acid preparations.  Be sure to follow package directions because over-application of these products can burn the skin. Periodically sand and retreat the wart. It can take several months to get rid of a large one using these treatments. Warts can spread, so monitor your feet closely and treat warts when they are small

Laser treatment: New technology has enabled doctors to use lasers to destroy the wart. The procedure, performed in the physician's office, is expensive and is likely to result in some scarring. Its efficacy in comparison to other destructive approaches in unproven.

Cryotherapy: Freezing warts with liquid nitrogen is frequently successful. This causes the wart to turn black and eventually fall off within a few days. If used properly, there should be no scarring.

Curettage and Desiccation: After injecting a local anesthetic, the physician uses an electrical or ultrasonic device to destroy the wart, the remainder of which is removed with a curette. This technique is likely to cause a scar.

Note: The excision of warts is not recommended since the surgery may leave a painful scar and it is common for warts to return in the scar tissue

Here in the Kuala Lumpur Foot Ankle Clinic, we prefer Cryotherapy at it can be done within the clinic setting and causes the least amount of complications.  Please click onto this link to see how cryotherapy is applied:  Cryotherapy and its applications.

If you have any questions, please consult your Consultant Foot and Ankle Surgeon.

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Dr Khairul Faizi Mohammad

Consultant Orthopaedic, Foot and Ankle Surgeon

Kuala Lumpur Foot Ankle Clinic

Pantai Hospitals (Cheras, Kuala Lumpur, Ampang)

Kuala Lumpur Foot Ankle Clinic (Cheras): Monday - Saturday 0900 - 1300
Kuala Lumpur Foot Ankle Clinic (KL): Monday and Thursday 1400 - 1630
Kuala Lumpur Foot Ankle Clinic (Ampang): Wednesday 1400 - 1630

Telephone:

Cheras: +603-91322022 ext 3333 (Vijay)
Kuala Lumpur: +603-22960888 (Block B clinics - Aida)
Ampang: +603-42892828 (Mawar)