Management of Chronic Conditions in the Foot and Lower Leg Content Strategist: Rita Demetriou-Swanwick Content Development Specialists: Catherine Jackson/Nicola Lally Project Manager: Umarani Natarajan Designer/Design Direction: Christian Bilbow Illustration Manager: Jennifer Rose Illustrator: Antbits Management of Chronic Conditions in the Foot and Lower Leg Edited by Keith Rome BSc(Hons), MSc, PhD, FCPodMed, SRCh Professor in Podiatry and Co-Director, Health and Research Rehabilitation Institute, Department of Podiatry, School of Rehabilitation and Occupation Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand Peter McNair DipPhysEd, DipPT, MPhEd(Distn), PhD Professor of Physiotherapy and Director, Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand Foreword by Christopher Nester BSc(Hons), PhD Professor, Research Lead: Foot and Ankle Research Programme, School of Health Sciences, University of Salford, Salford, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2015 © 2015 Elsevier Ltd All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). ISBN 978 0 7020 4769 5 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. The publisher’s policy is to use paper manufactured from sustainable forests Printed in China Preface The interpretation of the patient’s history, the extrac- predisposing factors, diagnosis, impairments, func- tion of information from key laboratory and clinical tion, quality of life, and management strategies. We tests, along with the decision-making process to find have asked our authors to provide not only a discus- the best treatment solution for the patient’s predica- sion of the latest advances, but also to be thought ment, is a challenging but enjoyable endeavour for the provoking and to consider the less straight-forward clinician. features of each condition and provide suggestions for Nevertheless, in the past decade, there has been new paths of research. Each chapter is further sup- rapid growth in research activity focused upon risk ported by additional commentary from an internation- factors, diagnosis, and treatment. In some instances, ally renowned researcher who highlights the key the growth has been bewildering and hence particu- elements of the work and provides a supplementary larly difficult for clinicians to stay abreast of current perspective of the particular clinical condition. thinking in each aspect of practice, and subsequently Given the aforementioned growth in knowledge be confident in their decisions. concerning these conditions, it seemed logical to find The book includes the following clinical condi- a group of authors who were highly regarded for tions: osteoarthritis, rheumatoid arthritis, gout, stress their research and or clinical contributions to their fractures of the lower leg, Achilles tendinopathy, rear- respective professions. We are very thankful to our foot entities, forefoot entities, and cerebral palsy. Thus authors for sharing their expertise. They have devoted not all conditions that might be encountered are a large amount of their time, for which we are very covered. However, we believe that the book provides appreciative and grateful. The authors represent a a sufficiently detailed account of a set of disorders that broad spectrum of professions, and all recognize that encompasses key changes to pathology in muscle, for the patient to receive the best possible care tendon, and joints that might be found across the an interdisciplinary approach to their treatment is majority of conditions affecting the lower leg, foot, required, and this attitude is apparent throughout and ankle. Our choice of material reflects discussions the book. with clinicians, clinical researchers, and senior stu- We wish to thank the people that we have worked dents concerning those conditions that would be with at Elsevier for their patience, support and kind most valuable to them. Furthermore, these enquiries attitude in all aspects of the publication process. Their extended to the level of complexity and comprehen- advice and standards of excellence have been invalu- sion that they wished to see in such a text. As a result, able in bringing this book to completion. Finally, we the book is not written as an early undergraduate text thank those who read the book as it evolved for their but rather for those close to being qualified or already critical comments and ideas for improving its content in practice. and presentation. Each chapter is organized into sections that are consistent across the book, thus enhancing the ease Keith Rome that the book can be read. These sections include Peter McNair vi Foreword Anyone working in or interested in healthcare provi- it will also support those building policy and manage- sion, health policy, or health-related research will ment strategies more broadly in the clinical areas already understand the major factors that will shape covered. the nature of health and wellbeing in the future. That That the editors have drawn upon an international you will have heard a great deal about ‘the aging and multiprofessional authorship in each of the areas population’, the increase in ‘long-term conditions’, applauds the clear commitment to quality and trust- and the ‘obesity epidemic’ and so on should not blunt worthy information. The inclusion of reviewer com- the very real impact that these issues will have on the mentaries is a useful change in style and assists further lives of everyone. Much of future healthcare need will in the reader contextualizing the information pro- be shaped by these issues, but also by some of the vided. It also builds trust in the information in each activities that healthy people choose to engage in: chapter. running and triathlons remain the fastest growing That the editors used their relationships with clini- sports in the world, and so we look set to challenge cal colleagues to shape the focus and style of the book our musculoskeletal systems to the maximum whether reflects their commitment to meeting the real needs we are healthy or live with the daily challenges of of people working in practice, and their commitment a chronic condition. Understanding the underlying to research knowledge informing the care patients causative mechanisms, the identification of and man- receive. A broad view of the needs of patients is offered agement of chronic conditions is already an imperative throughout, a welcome departure from traditional in practice, but it is an area that, given the issues texts that narrowly define objectives in too-clinical above, will only grow. terms. Inclusion of specific sections on impairments, Thankfully, researchers and clinicians have been function, and quality of life reflect this ethos, since it busy on these topics for a considerable time. More seeks to connect clinical realities to real-world patient fortunately still for you, the need for research-led experiences. Furthermore, patient-reported outcome information and data to support management of measures and health behaviour strategies are a consist- chronic conditions has clearly energized the editors ent feature of this text. and authors