stubborn capsulitis
Displaying items by tag: stubborn capsulitis
Tuesday, 20 July 2021 15:21
Dr. Timothy Young Discusses Stubborn Capsulitis Part 2
Again, I have had this problem before and as mentioned in prior blogs I did many of the appropriate initial treatments listed in my previous blogs. The next step to consider is some of the other alternative treatments. We used to do cortisone injections for this, and we do that very rarely now. There is a non-cortisone anti-inflammatory called Injectable Sterile Traumeel that has much decreased potential risk for damaging the capsule (unlike cortisone). There is also PRP–platelet rich plasma. This can be very effective especially when combined with shockwave treatment. Shockwave treatment can also be done as a stand-alone procedure. The problem with some of these additional treatment options is that they often take several months to really be effective. That's where it's hard to do this but one needs to have patience. Again, that's where cross training can be helpful such as cycling or aqua jogging. For my capsulitis as mentioned, I did the typical initial treatments. I wore special orthotics modified for the capsulitis, I have shoes with a good rocker design, I don't go barefoot at home. I work on stretching my calf and I have a night splint . I stopped running for exercise and only did walking.
Finally, I had to have shockwave treatment. I had a series of 5 treatments, and it did take several months but the symptoms have completely resolved. Because I have significant pronation I am vulnerable to reoccurrence of this problem.
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Wednesday, 14 July 2021 16:46
Dr. Timothy Young Discusses Stubborn Capsulitis
I have had this condition myself. We are talking about capsulitis of the second metatarsal phalangeal joint (MTP joint) in the ball of the foot, near the base of the second toe. There have been previous blogs about the potential cause of this problem. Treatment has to address the underlying cause and foot structure as much as possible. If the calves are tight, then they have to be stretched and use a night splint or even have a gastroc recession surgery. If there is a bunion and the whole first metatarsal is not bearing is fair share weight then it can cause stress overload to the next in line second metatarsal. Orthotics and foot taping often help this.
Sometimes it's not enough and sometimes especially if there is damage to the capsule such as the plantar plate, we then have to correct the bunion and consider surgery on the second metatarsal. But there are other cases that don't require surgery. It still imperative to do all the other treatments. The correct shoes with a forefoot rocker, sometimes zero drop shoe such as Altra Shoes can also help. Avoiding the activity that seems to aggravate this also can be critical. For example, if you're runner or speed walker, you may have to put that on hold or do cross training until her symptoms have completely resolved. For myself, this seemed to come on after I had resumed running after several months off. I had to make sure my orthotics were still appropriate for this problem. I wore correct shoes. I had to stop running and cross train. I worked on stretching my calf and I have a night splint also.
If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.
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