Tips to Avoid Being Busted at an Online Casino

Online casinos are virtual casinos or virtual versions of real casinos. Online casino allows gamblers to play casino games online and also place bets on casino games online. It’s a popular type of gambling on the internet. There are currently around a dozen online casino.

Many Americans enjoy playing our favorite casino game online. A lot of people are doing it nowadays. This karte igra pasijans is particularly true for American gamblers. You can win big at the casino by placing your bets on the most popular game played by gamblers. It’s a fun and simple method to win money.

Casino online is nothing but virtual casinos. Many of these websites offer the exact same services and provide the same games. Some sites provide the traditional popular casino games such as blackjack and poker. Some sites also offer craps, roulette, baccarat, and roulette, as well as slots and video poker. Some sites only offer online slots, and don’t offer any other games. The gambler can choose the casino and the website they prefer.

We all enjoy playing our favourite casino games with our family and friends. This type of gambling is the most thrilling for those who love it. The chances of winning large sums of money are thrilling for them. Winning real money at these online casino sites can make players feel happy and satisfied. That’s why a lot of them have enjoyed lots of success and have become successful too.

There are a variety of bonuses offered by various online casinos. Bonuses can be compared to cash advances or winnings. They can increase the chances of a player winning large amounts of money. Different websites offer different kinds of bonuses. Some offer free spins on top games in the US, such as super slots, black jack and poker; these bonuses can boost the winning chances of players dramatically.

Online gamblers today are also enthused by the bonuses offered by casinos which allow players to play poker online without putting in any real money. This is a great option for gamblers who are not experienced. They can play poker at a casino for fun and practice the game with virtual chips. The best part about these bonuses is that the casino does not take any money from the free online pai gow poker with bonus player for playing. It’s all part of giving the players an opportunity to gain more experience. Online casinos usa provide many opportunities for practice to gamblers for free and thus, aid in enhancing their skills.

The US State Department has issued a notice concerning the regulation of online casino in the United States. In the notice, they remind all American casinos to strictly adhere to the laws governing taxation. Online gamblers must adhere to the requirements imposed by the Internal Revenue Service on the tax-paying transactions of its clients. The casino could be shut down in the event that any portion of the agreement is found illegal. For instance when an online casino is found to offer free play money, the player must deposit the winnings he took home into a separate banking account.

Additionally, players of mobile casinos are advised to make sure they have the latest version of the casino software installed on their devices. Because new mobile games may require an updated version of the software in order to function it, this is crucial. This is to ensure the gamer does not face any compatibility issues while playing games on his device. Users are also advised to download Google Android app to ensure they are updated with the latest software in a matter of minutes. Through the app, users will be updated on the latest news and apps which are released for the phones. This allows users to stay informed about all the latest offers in the market.

Diabetic Peripheral Neuropathy

What is it?

Peripheral Neuropathy is a nerve condition that affects the arms, hands, legs, and feet. The most common form of peripheral neuropathy is due to diabetes. People with diabetes have an abnormal elevation of their glucose and lack adequate insulin to metabolize the glucose. As a consequence, blood glucose damages the nerve. This can occur in any type of diabetes. It doesn’t matter if the patient is on oral antidiabetic drugs, on insulin, or is diet controlled. The nerve damage that occurs is considered to be permanent.

As the nerve damage occurs, the protective sensations are affected. These include a person’s ability to determine the difference between sharp and dull, hot and cold, pressure differences, and vibration. These senses become dulled and/or altered. The process begins as a burning sensation within the toes and progresses up the foot in a very “stocking distribution.”

What are the symptoms?

As the condition progresses, the feet become numb. Some individuals can feel as if they have worn socks on their feet, (in reality they are not). Other patients can describe the sensation as “walking on cotton,” or a water-filled cushion. Some patients complain of their feet burning at night, causing troubled sleep. The feet may also feel like they are cold, however, to the touch, they have a normal skin temperature.

The progression of the condition can be slowed or halted by maintaining the blood glucose levels in the range of ~ 100mg/dl to 200mg/dl. As the patient develops diabetic neuropathy, they are at a higher risk of developing skin ulcerations and infections. Areas of corns and calluses on the feet represent areas of excessive friction or pressure. These areas, if not properly cared for by a foot specialist, can typically break down and cause ulcerations. Ulcerations and infections are usually formed under these calluses, and they get unnoticed, as they are not painful. Ingrown toenails can progress to severe infections in individuals with diabetic neuropathy.

Taking care of the foot at home

Simple things like trimming the toenails too close to the skin would be a huge risk to those patients with Diabetes. People with neuropathy must religiously inspect their feet daily. They should not soak their feet in the water of extreme temperature and use heating or ice pads on their feet. This can result in accidental burns to the skin. Barefoot walking should be avoided because of the risk of stepping on something sharp and not being aware of it. The inside of the shoes should be inspected before putting the shoes on to ensure that no foreign object is inside the shoe.

Treatment For Peripheral Neuropathy

Treatment for peripheral neuropathy is, for the most part, directed at the symptoms of the condition. vitamin supplementation may be helpful if the patient has vitamin deficiencies. Certain oral medications may ease the burning pain that can be prescribed by your doctor. Topical ointments should only be used with the advice of your doctor. Various therapies like Anodyne and Laser have helped the patients in managing pain and continue with their activities.

Peripheral Vascular Disease in Diabetic Patients

People suffering from diabetes are prone to various foot conditions. The two main conditions that are responsible for foot problems are Peripheral Vascular Disease (PVD) and Peripheral Neuropathy (PN). We will look at PVD in this article

People who have diabetes are prone to various foot conditions. The two main conditions that are responsible for foot problems are Peripheral Vascular Disease (PVD) and Peripheral Neuropathy (PN). We will look at PVD in this article

What is PVD?

It is a disorder of blood circulation that leads to the narrowing of blood vessels outside of your heart and brain. As the blood vessels become narrow, the blood flow to the body parts decreases. According to research, PVD is 20 times more prevalent in people with diabetes than in non-diabetic people. In diabetic people, prolonged high blood sugar level raises the risk of developing PVD. Longstanding high blood sugar can damage blood vessels, decreasing blood flow to the foot. This poor circulation can weaken the skin, contribute to the formation of ulcers, and impair wound healing. Other risk factors that may cause PVD are smoking, obesity, inactivity, and high cholesterol levels.

What are the symptoms of foot problems in diabetes?

One of the first symptoms of PVD is cramping leg pain during walking. Most commonly, this affects your calf muscles. However, it can occur in the thigh or hip muscles too. Some also experience pain in the toes, while sleeping.

As the disease progresses, leg or feet pain occurs even when you are not walking. Changes in the skin, including decreased skin temperature, thin, brittle, shiny skin on the legs and feet, and hair loss on the legs are noticed. Weakness or heaviness in the limbs or thickened and discolored nails are observed more often.

Another symptom of PVD is the small cuts or abrasions on the feet, especially on the pressure points that do not heal quickly.

PVD can eventually become a severe problem if not treated timely. It can lead to the development of foot ulcers and gangrene and may require amputation of the leg.

How is PVD diagnosed?

Diagnostic tests can include:

  • Ankle Brachial Pressure Index (ABPI): This method evaluates the blood supply to your feet by comparing it with the blood pressure in your both arms.
  • Treadmill Exercise Test: This test combines the ABPI with a treadmill test. The ABPI is done before and after you walk on a treadmill.
  • Duplex Ultrasound: It is a non-invasive investigation that uses a probe and jelly on the skin to look inside your leg and give a picture of your blood vessels.
  • Angiography: In this test, a dye is injected into the blood vessels, and then x-rays are taken to see the blood flow through the blood vessels. Other imaging techniques can also be used like Magnetic resonance angiography or CT Scan.

What is the treatment for PVD?

Treatment and management of PVD may include:

  • Lifestyle changes to control risk factors, including regular exercise, proper nutrition, and quitting smoking
  • Postural corrections while standing, sitting, and sleeping
  • Managing risk factors, including smoking, high blood pressure, and diabetes
  • Diabetic medications to lower the blood sugar level
  • Anti-platelet drug (prevents forming blood clots inside the blood vessels)
  • Peripheral vasodilators (relaxes/expand the blood vessels and increase the blood flow)

Invasive therapy:

For some people with severe vascular disease, invasive treatment such as balloon angioplasty or stent insertion may be considered. Bypass graft would also be an option.

Complications of PVD

Complications most often occur because of decreased or absent blood flow. Such complications may include:

  • Amputation (loss of a limb)
  • Poor wound healing
  • Restricted mobility due to pain or discomfort
  • Severe pain in the affected extremity
  • Stroke (3 times more likely in people with PVD)

Prevention of PVD

To prevent PVD, take steps to manage the risk factors. A prevention program for PVD may include:

  • Quit smoking, including avoidance of second-hand smoke and use of any tobacco products
  • Dietary changes include reduced fat, cholesterol, and simple carbohydrates (such as sweets), and increased amounts of fruits and vegetables, low-fat dairy, and lean meats
  • Weight loss
  • Limiting or quitting alcohol intake
  • Medicine to reduce your risk for blood clots, as determined by your healthcare provider
  • Exercise 30 minutes or more daily
  • Control of diabetes and high blood pressure

happy feet; healthy you

To stay moving, you need to keep moving. 

You might not provide much thought to the health of your feet and ankles; however, it’s crucial to your mobility. Most individuals ignore issues with their feet till they cannot walk any longer. If you cannot walk, you’ll not be able to enjoy your favorite activities, as well as perform the routine activities of daily living like standing up to cook a meal or walking to a restroom. Aches and pains in the foot and ankle will prevent you from exercising. 

Most frequent issues for older adults include sprains, Achilles tendinitis, plantar fasciitis, hammertoes, and bunions. While you can’t prevent hammertoes or bunions, you can avoid other issues. 

1. Stretch

If you do not stretch your calves, hamstrings, and Achilles tendons, they’re going to contract and stop working correctly. “Stretching allows the muscles and tendons to do their job without putting too much pressure on the feet and ankles. It allows for more joint flexibility and allows the foot and ankle to accommodate uneven terrain better” Stretching for  10 to 15 minutes during the day, for best results.

To strengthen the muscles in your lower leg and foot, you should also try these exercises:

  • Standing calf raises: Lift yourself on your toes for 15 reps.
  • Heel walks: Lift the front of your foot off the floor. Balance on your heels and walk across the room.
  • Towel pulls: Place one barefoot on a towel. Grab the towel with your toes. Lift your heel, pull the towel taut, then repeat the toe grabs. Continue for the length of the towel.

2. Do weight-bearing activities

The force of resistance on your skeleton through weight-bearing activity stimulates cells that make your bones stronger, which helps you to maintain stability and avoid falls. The weight-bearing activity includes anything that’s done on your feet, such as walking, stair climbing, and dancing. About 30 minutes of weight-bearing exercise 3 to 5 times a week, is necessary. Resistance training is also effective

3. Lose Weight

While the occasional addition of weight to your skeleton promotes healthy bones, an excessive amount of weight will hurt your ankles. That’s because every step you take puts the equivalent of five to seven times your body weight on your ankle. Even a 2kg weight loss will reduce the strain and stress on the joint.

4. Wear comfortable shoes

Wear shoes that are wide enough to accommodate your toes, with excellent arch support if you have flat feet. Shoes that are too loose can cause blisters because they rub against your feet. Look at our shoe shopping blog for more tips on buying shoes.

Ankle Sprains – Management & Prevention

Ankle sprains are extremely common, accounting for 40 percent of all sports injuries and 10 percent of all muscular/skeletal injuries, according to a July 2016 summary in Podiatry Today. Sports mishaps, work miscues, and walking missteps can all lead to ankle sprains. Here’s what to do at home, and when to see a doctor or physical therapist help your ankle to heal.

As you step onto a cracked footpath or an overturned stone, or just an uneven surface, your foot and ankle could twist. Sports involving lateral or cutting actions, such as football, cricket, or tennis, can also cause sprains. 

The difference between a strain and a sprain is a matter of degree. “A strain is a mild stretch of a tendon or a ligament, whereas a sprain is more severe,” The sprain and strain are more soft-tissue, whereas a fracture would be an extreme injury where you break a bone.

People who have hypermobile or flexible feet tend to be more susceptible to ankle sprains, due to the extreme range of motion that occurs in the midfoot. Conditions such as extreme flatfeet, or structural and functional deformities in the rear or midfoot, make people vulnerable to sprains. Some patients have chronic, repetitive sprains. That can be attributable to an injury to the outer part of the ankle – the ligaments are just too loose. In some cases, patients may benefit from ankle-stabilizing surgery to tighten the ligaments.


RICE Right Away

The standard regimen for most ankle sprains is RICE – rest, ice, compression, and elevation. Start with RICE as an immediate home remedy:

  • Rest: It takes about 24 to 48 hours to get swelling down and stabilize the ankle before you should test it with significant activity,
  • Ice: Fill a bag with ice to place on your ankle to reduce swelling. If an ice pack is not available, place a package of frozen peas or other frozen packets around your injured ankle.
  • Compression: Compressing the ankle pushes swelling out of the joint, A compression wrap or ankle brace also provides support and stability to the ankle.
  • Elevation: Propping your foot and ankle on a stack of pillows to raise it above the rest of the leg will temporarily relieve swelling, preventing it from moving down into the foot.

Over-the-counter medications like paracetamol work well for mild ankle pain. With obvious dislocation, fracture, or extensive bruising, tenderness, and increasing swelling consider seeing a specialist immediately. An X-ray is indicated if 48 hours after the injury you put weight on your ankle and it still hurts. Physical therapy is an option if ankle-sprain recovery is lagging. A physical therapist might suggest crutches, if needed, and offer a variety of treatments. It takes soft tissue at least four to six weeks to get stronger after an acute injury, so it’s better not to rush back into action.


The most important point to keep in mind when talking about ankle injuries, then, is to prevent the condition from becoming chronic or recurrent.

  • Wear proper, well-fitting shoes when you walk, run or exercise.
  • Get your foot analyzed by a foot specialist to check on flat feet, ankle stability, etc.
  • Stretch gently and adequately before and after athletic or recreational activities.
  • Avoid sharp turns and quick changes in direction and movement.
  • Consider taping the ankle or wearing a brace for strenuous sports, especially if you have a previous injury

Understanding Glycemic Load

Different carbohydrate-containing foods affect blood glucose differently — an effect quantified by measures known as the glycemic index and glycemic load.

The glycemic index (GI) assigns a numeric score to a food based on the rise in blood sugar after eating a standard amount (50 grams) compared with the rise after eating 50 grams of pure glucose. Foods are ranked on a scale of 0 to 100, with pure glucose given a value of 100.

The lower a food’s glycemic index, the slower and lower blood sugar rises after eating that food. A glycemic index of 55 or below is considered low; 70 or above is considered high. In general, the more cooked or processed a food is the higher its GI, and the more fiber or fat in a food, the lower the GI.

The glycemic index tells just part of the story because it indicates only how fast a particular carbohydrate-rich food raises blood sugar. What it doesn’t tell you is how high your blood sugar could go when you eat the food, which is partly determined by how much carbohydrate is in a serving of a particular food. To understand a food’s complete effect on blood sugar, you need to know both how quickly it makes glucose enter the bloodstream and how much glucose it can deliver.

Understanding glycemic load

A separate measure called the glycemic load gives a more accurate picture of a food’s real-life impact on blood sugar. The glycemic load is determined by multiplying the grams of carbohydrate in a serving by the glycemic index and dividing by 100. A glycemic load of 10 or below is considered low; 20 or above is considered high. Watermelon, for example, has a high glycemic index (80). But a serving of watermelon has so little carbohydrate (6 grams) that its glycemic load is only 5.

Some nutrition experts believe that people with diabetes should pay attention to the glycemic index and glycemic load to avoid sudden spikes in blood sugar. A review by the Cochrane Collaboration (an international group of health authorities who evaluate evidence from randomized clinical trials) found that people who followed a low-GI diet lowered their HbA1c levels by 0.5 percentage points — and they were also less likely to experience hypoglycemia. To put that effect into perspective, the FDA considers a drop in HbA1c of as little as 0.4 of a percentage point to be meaningful when assessing drugs to treat diabetes.

The American Diabetes Association acknowledges the value of the glycemic index and glycemic load, saying that “substituting low-glycemic-load foods for higher-glycemic-load foods may modestly improve” blood sugar control. But it also says that the total amount of carbohydrates in a food, rather than the food’s glycemic index or load, is a stronger predictor of what will happen to blood sugar. Some dietitians feel that focusing on the glycemic index and glycemic load adds an unneeded layer of complexity to choosing what to eat. The bottom line? Following the principles of low-glycemic-index eating is likely to be beneficial, as it essentially encourages a high-fiber diet that is moderate in carbohydrates, but reaching and staying at a healthy weight is more important for your blood sugar and your overall health.

3 principles of low-glycemic eating

  • Eat non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts.
  • Eat grains in the least-processed state possible: “unbroken” grains such as brown rice, whole barley, millet, wheat berries, and whole-kernel bread; or traditionally processed grains such as stone-ground rice, red rice, or whole-grain bread.
  • Let concentrated sweets — including high-calorie foods with a low glycemic index, such as ice cream — be an occasional treat instead of a staple. Don’t drink more than one-half cup of fruit juice a day. Eliminate sugar-sweetened drinks

Adapted from Ending the Food Fight by David Ludwig with Suzanne Rostler (Houghton Mifflin, 2008). and ISSUE #5 OF 6 of HMS email series. Image from

Practicing Good Foot Care for Diabetics

Peripheral and autonomic neuropathy are common diabetes complications. Diminished blood flow from the blockage of the arteries feeding the foot can impair pain sensation and impede the body’s infection fighters. People with these conditions must carefully check their feet and toes every day for a possible injury. Here are some basic steps to help take care of your feet:

  • Know your feet. Take a good look every day to see if you’ve cut or bruised your feet without realizing it. Pay attention to any growths or discoloration. If your foot swells or color changes, for example, it could be a sign of a ligament/tendon tear, bunion, hammertoe, fractured bone, or poor circulation.
  • Practice good foot hygiene. Wash your feet every day. Dry them thoroughly, especially between the toes. Moisturize any dry skin (but not between your toes), or dust with foot powder to keep your feet dry.
  • Cut the nails straight across to avoid ingrown toenails, which can lead to infection. However, be careful when wielding the scissors: if you’ve lost sensation in your feet, or if your nails have hardened, consider having your nails trimmed by a clinician at FootSecure.
  • Protect your feet. Wear shoes with ample cushioning and socks that protect against friction. Make sure your shoes fit by having your foot measured every time you buy a new pair. Avoid high heels or shoes with pointy toes. If you must wear such shoes for dressy occasions, try to limit the amount of time they are on your feet.
  • Lose weight if you’re overweight. Every extra pound increases the pressure on your feet.
  • Exercise regularly. Exercise, such as walking, improves circulation.
  • Don’t smoke and drink in moderation. Smoking impairs circulation. Avoid excessive consumption of alcohol, which can impair nerves already at risk because of diabetes. (drinking as no more than two standard drinks per day for men under age 65 and one drink per day for women. – A drink is defined as 300ml beer, 150ml of wine, or 30ml of hard liquor.)
  • Learn when to seek help. If you have diabetes, you’re also more prone to complications. If you develop any foot problems, you must see a doctor. Don’t try to treat yourself at home.
  • Use appropriate footwear and orthotics. Therapeutic shoes and inserts for people with diabetes, are important to reduce ulceration and foot and leg amputations. Ask your doctor about the customized orthotics, friction-free footwear, or any other foot devices that you may require.

Adopted from ISSUE #4 OF 6 IN AN E-MAIL SERIES from HMS

Understanding Flat Foot

What’s a flat foot?

Our feet and our entire body keep changing. If we eat too much, we get fat; if we don’t exercise, we get weak; aging changes everything.

The 26 bones that give our feet structure depend on semi-elastic bands of connective tissue called ligaments to keep them together and nested against each other. Ligaments are very good at resisting short-term, forceful stretches but are susceptible to long-term stretches that make them longer and looser (e.g. prolonged standing on hard floors).

As the ligaments get looser, they can’t hold the bones together like they used to, so the arches and general structure of the foot slump. As the structure slumps closer to the floor, foot function becomes abnormal. The foot will feel more fatigued in the early stages, then develop pain and/or deformities as the altered function causes progressive tissue damage.

Some people are born with loose ligaments and have flat feet as a child. Many people will have a good arch structure as a child but will stretch out their ligaments as time goes on.

What are the causes of the flat feet?

Many people who have flat feet were born with it. All mobile functions such as walking, running, etc. are possible with flat feet. However, the flexibility and mobility of the feet can get affected with increasing age. People with severely pronated feet are predisposed to straining the tibialis posterior tendon on the inside of the ankle as it tries to resist this movement. With time, the tendon can stretch, tear or rupture allowing the flat foot to worsen. Injury/trauma to the rear foot can result in an abnormal position or arthritis and cause a flat foot. There are some medical conditions (e.g. arthritis, gout, diabetes) that can predispose to inflammation of the tendon or arthritis of the major joints of the rear foot which can result in flat feet.

Watch out for common signs and symptoms

  • A low/ flat arch
  • Pain/discomfort in the foot, knee, calf muscles, back, or the neck
  • Associated deformities (e.g. bunions, hammertoes, etc.)
  • Difficulty in finding comfortable shoes
  • Difficulty in walking/running
  • Stiffness in the foot
  • Corn / callus formation


Clinical examination and obtaining detailed patient history help in the correct diagnosis. X-rays help to evaluate the extent of the deformity and any arthritis or deformity within the joint. Specialist scans help to evaluate the tendons and joints. A detailed gait analysis can help to diagnose the contributing factors toward flat feet.


In many cases, conservative treatments are sufficient to resolve the symptoms and prevent tendon damage. However, rigid or painful flat feet require evaluation by a foot specialist.

The treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly a cast. If this fails to improve the pain, surgery may be necessary. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces. In more advanced cases, surgery may be needed to clean or repair the tendon or fuse some of the joints of the foot into a corrected position.

Flat feet in older adults can be treated with pain relievers, customized orthotics, and sometimes surgery.


Most cases are not preventable.

Pain Management

There are several things that you can do to try and relieve your symptoms:

  • Wear good-fitting shoes
  • Perform exercises to keep the muscles flexible and strong
  • Avoid high heels
  • Wear a pad over any prominent deformities

You can also visit a foot specialist if the above remedies do not help in subsiding the pain

Role of the Orthotics in the management of flat foot

How your feet load during the process of walking, can place increased stress on your feet. This loading process can be controlled through the usage of customized shoe orthotics/inserts (customized orthotics). Customized orthotics help reduce discomfort but are unlikely to resolve any established deformity. In acute cases, a period of immobilization may be required, and in severe cases may need an ankle-foot orthosis.

Non-symptomatic, flexible flat feet do not require treatment. If you have pain due to flexible flat feet, a customized orthotic (arch-supporting insole/insert in the shoe) can bring relief.

With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long-distance running easier and less tiring because they correct for the abnormality.

Achilles Tendinitis

Tendons are thick cords of tissue that connect muscles to bone. The Achilles Tendon, located at the back of the ankle joint, connects the calf muscles to the heel bone. The Achilles is the most powerful tendon in the body. It can lift eight to 10 times a patient’s body weight under distress. This tendon helps in balancing the body, pushing the legs forward while walking, and bouncing the legs while running or jumping.

Achilles Tendonitis is a term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common, especially among people who are active in sports, due to the repetitive action.

Common Causes of Achilles Tendonitis are:

·      Over-training or unaccustomed use – “too much too soon”

·      Sudden change in training surface – e.g. grass to bitumen

·      Flat (over-pronated) feet

·      High foot arch with tight Achilles tendon

·      Tight hamstring (back of thigh) and calf muscles

·      Toe walking (or constantly wearing high heels)

·      Poorly supportive footwear

·      Hill running

·      Poor eccentric strength

Older athletes are more prone to Tendonitis than younger athletes.


Swelling and Pain are the most prominent symptoms, associated symptoms are stiffness, and loss of strength.

Management of Achilles Tendonitis

Rest and ice can ease the pain of tendinitis. Stay off your foot or ankle as much as possible and apply ice for up to 15 minutes at a time, three to four times a day. Stretching and activity modification is advised. Treating tendinitis would be to achieve the following

·      Pain Reduction

·      Improve the range of pain-free motions of the tendon

·      Restore eccentric muscle strength

·      Normalize foot biomechanics

·      Restore Power, Proprioception, and Agility

·      Return to sport

Functional foot orthosis would help in achieving all the above goals in the management of tendinitis. In the worst-case scenario where the tendon is ruptured or torn, surgery needs to be considered immediately. Most of these injuries take six months or more to adequately rehabilitate. It is not uncommon for a patient to return to activities too quickly and re-injure the tendon. Careful monitoring of a return to full activity is important and the patient must have patience during this period.

Foot Health

Your feet work tirelessly day in and day out. Often times they are one of the most under-appreciated parts of the human body.

Foot Facts

Together your two feet have more than a quarter of the bones in your body – 52 bones, 66 joints, more than 200 muscles, tendons, and ligaments. An average person living for about 80 years, taking about 8000 to 10000 steps a day, would walk about 2lakh kilometers, i.e. 5X times the equatorial circumference of the earth. The pressure on the feet when walking is about 1.5x the body weight and while running is about 4x to 5x the runner’s body weight.

Gait Cycle

This gait cycle describes the mechanics of the way you walk. It starts when one heel strikes the ground and ends a few seconds later when that same heel hits the ground again. Foot care specialists often analyze a patient’s gait cycle to look for structural and functional problems.

Effects of Aging on the Feet

You can suffer foot pain at any age, but there are natural changes in the foot that come with aging. Whatever foot issues may affect you, it helps to understand the normal changes that occur throughout life.

Birth to age 30

An infant or toddler’s foot has an enviable amount of fat padding underneath it, partly to protect bones that are still forming. Indeed, the bones in a baby’s foot are initially composed of cartilage, the same flexible substance that lines joints and is found in ears and noses. Some of the bones do not completely form until the late teens. As children grow and begin to walk, they develop an arch, and their feet strengthen. Feet are generally strong, supple, and problem-free through the third decade of life. This is why so many people in their 20s are able to dance the night away or run a 10-mile race without physical consequences or regrets.

The 30s and 40s

In your 30s and 40s, your feet undergo a series of negative changes related to aging. Muscles stiffen, while tendons and ligaments become less resilient. You lose some of your natural shock absorptions mechanisms. Although your feet may start to bother you by your mid-30s, it’s generally in the 40s that real problems develop. For some people, this is the time that bunions or hammertoes begin to emerge. Nail fungus becomes more common as a result of age-related changes in the nails.

Age 50 and over

Generally, by this age, you’ve put 100,000 kilometers on your feet. By age 50, 50% of the fatty padding on the soles of your feet is lost, and the shoe size would have to be bigger than the one in the ’20s. Ligaments and tendons would have lost some of their elasticity (which also predisposes them to potentially painful ruptures or microtears). If you’ve given birth, you have another reason for the increase in shoe size: hormones released during pregnancy also cause ligaments to relax.

Menopause, too, can affect foot health. Unless countered by medications or exercise, the loss of estrogen and other hormonal changes generally lead to lower bone density, resulting in osteoporosis if enough bone mass is lost. This condition can raise the risk of stress fractures (hairline breaks) in any of the bones of the foot. Unless treated appropriately, stress fractures can worsen and cause the bones to shift out of place.

Studies evaluating older people who live in a community setting show that 20% to 30% of seniors have chronic foot pain. Causes include bunions, corns, and calluses, along with systemic problems that become more common with age, such as diabetes, obesity, and osteoarthritis.


Nails and foot skin health are important, too. The skin grows thinner and drier with age; the nails may become thicker or more brittle. If nails are thick and yellow, it may indicate a health problem.

“To him whose feet hurt, everything hurts.” Socrates

Your feet mirror your general health, Over 300 different foot ailments have been listed in the medical books. Three out of four individuals in the US suffer from some kind of a foot ailment in their lifetime, and in 2018 10.2 million people visited a doctor with complaints of foot pain. Any misalignment in the foot would cause aches and pains in the knee, hip, lumbar, thoracic, and cervical (lower and upper back including the neck) regions.

Foot problems are rarely life-threatening, but they are annoying and painful. At times, however, untreated foot problems can have life-altering consequences, especially for people with diabetes. About 30% of people with diabetes will develop, diabetic peripheral neuropathy (DPN), and 19% of the diabetics, will end up with having a Diabetic Foot Ulcer (DFU) India, in some cases, these conditions lead to complications that require amputating a toe or foot. About 100,000 amputations due to diabetes complications are done every year in India.

Things are not soo gloomy! many of these conditions can be prevented or treated with orthotics, therapeutic footwear, medications, and elective and non-elective surgeries. A variety of factors may predispose you to develop problems in the feet, including inherited tendencies and aging, which you cannot control.

But the ‘one’ that you can control is your choice of shoes. Pushing your feet into high heels or narrow shoes or any uncomfortable, worn-out shoe/sandals or chappals can also put undue strain on your feet.