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Carbon Plate for Hallux Rigidus

I have been using these a bit lately. You know, you have a run of something in the clinic and then don’t see it for months. at the moment its using the carbon fibre plates for hallux rigidus.

I do have a bit of dilemma using them. Yes, they do work really well for hallux rigidus and pretty much every one that I have used them on lately has had a good outcome and that is supported by the evidence. However, I also know that they are going to interfere with the windlass mechanism and affect thing like Bojsen-Mollor high gear, low gear concept. We just do not know the long term impact of interfering with that. However, on the other hand, neither of those mechanisms is working too well becasue of the hallux rigidus. I guess this is just one of those occasions where you have to weigh up the options and make the compromise to get a good clinical outcome.

Personally, I prefer the ones that are more of a Mortons extension as that still does allow a somewhat more normal function of the lessor metatarsophaplangeal joints, so the compromises are not as much is the carbon plate covered the whole forefoot area.

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The ‘Breakfast of Champions’

I do not know when this started but in my travels, I got into the habit of having the traditional bacon and eggs for breakfast everywhere I traveled to. After a while I started posting the photo on Facebook to have a bit of fun. I called it my ‘breakfast of champions’. The Facebook posts always got some humorous replies, especially if the bake beans touched the bacon! It was just a bit of fun.

After a while, I decided I need to collect all the photos and put them in one place, so I built a website and went back through Facebook to collect all the photos in one place with some commentary about where I was and what I was doing there. See it here: Breakfast of Champions Travels

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Cream for Chilblains

Chilblain season has just finished for us here in Melbourne and I will have to admit that this year I have seen more than a few really serious cases – a few more than usual. One in particular was so bad and nothing neither I or her GP could do could make any headway to helpher. For the first time ever, I was serious when I said that they should move and live in a warmer climate. I have joked with patients in the past about this, but this time I was really serious.

I do find chilblains somewhat frustrating to treat as there is not a lot that can be done to help them and most treatments just tend to give some symptomatic relief while you wait for them to heal up and hope another one does not occur before that first one heals up. I have tried lots of things, various chilblain creams tend to only have limited effectiveness, but do help somewhat with a bit of symptomatic relief. They have been used historically with many claims made for chilblain creams.

The other intriguing phenomenon about chilblains is the number of people who say the used to have them and for some reason they just stopped. You can never elicit from anyone something that might have changed for them in the year that they stopped. They just stopped for no identifiable reason. That one is a mystery on me.

They certainly are more common in females, suggesting a role for hormones, but I am not aware of anything involving that to explain the pattern of them resolving and not occurring again for no reason.

All we can do is resort to creams etc and give very strong advice on preventing them… and very occasional suggesting they move to a warmer climate.

There is some good information on Podiatry Arena about chilblains. All the new research is published there as soon as it hits the press.

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Bunion Exercises

No sooner did I write a post about the bunion correctors did I get an email asking me what I thought about exercises for bunions? I not a big fan and have a similar view to those I have of bunion correctors.

Think about the force that are creating a bunion. Think about the force that comes from the biomechanics and the forces that come from the shoes. Do you think a bit of muscle strengthening is going to fix that? Unlikely. Yet if you get online and search you see so many touting bunion exercises as the holy grail to cure bunions. You will notice that not one of them can point to a single study or a bit of research that supports their claims.

So does that mean bunion exercises are useless?

Not necessarily. There is no evidence that they can correct bunions and the mechanism by which they could is based on flimsy evidence or nothing, but should you do them?

I have been getting patients for years to do exercises for their bunions, but not in the expectation or hope that will fix them, but in the expectation that they will keep the joint mobile and flexible. That is a good thing. That does tend to help with some of the aches that happen in the joint.

What bunion exercises should you do?

I recommend this one, its a band around the toes and you pull the feet apart – it goes a long way to help the mobility of the joint and that helps the symptoms:

bunion exercises

(Image courtesy FootStore.au)