bunionsThe foot is an intricate structure in the makeup the body. It supports the entire weight of the body and allows balance, speed and mobility on rough terrain. However it is subject to the deforming forces generated by being overweight, poor blood supply and poor footwear.

It is important to prevent foot deformities by wearing well fitting shoes.

Prolonged use of high heels can change the forces in the forefoot resulting in hallux valgus. Hallux valgus is characterised by:
1.    Lateral deviation of the big toe
2.    Progressive subluxation at the  big toe joint
3.    Soft tissue/bony swelling medially known as a bunion

The main problems experienced are pain at the bunion, shoe wear does not fit and it can be cosmetically unfavourable.

Solutions to this common problem can range from footwear modifications to
arch supports.

Often in the moderate to severe deformities surgery may be required.

  • Osteotomies may change the angle of the bone
  • Soft tissue procedures help release the tight tissues
  • Fusions of the bone may help in correcting the deformity permanently

Shoulder pain and Rotator cuff syndrome
Pain is the commonest symptom in the shoulder area. However pain in the shoulder is not necessarily ‘shoulder pain’

The common causes of pain can be
1. Referred from the cervical spine or from cardiac diseases
2. Shoulder joint osteoarthritis
3. Rotator cuff disorders
4. Nerve injury
5. Instability of the shoulder joint
rotator-cuff-syndromeThe rotator cuff is a specialised tendon that arises from the muscles (including the supraspinatus muscle) around the shoulder. The musculotendinous cuff passes under the bony arch of the acromion. Its main function is to stabilise the joint during abduction (i.e. lifting the arm).

Rotator cuff impingement syndrome is a painful disorder which arises from repetitive compression or rubbing of the tendon (mainly supraspinatus) under the arch.
This may result in a rotator cuff tear.

Rotator cuff pain typically appears on the front and lateral aspect of the shoulder and is exacerbated by abduction and internal rotation of the shoulder.

Treatment would comprise surgery to remove part of the bony arch compressing on the tendon as well as repair of any associated tear. This could be done arthroscopically using a camera system and mini incision.

If you are experiencing musculoskeletal problems or any of the above please contact dr RD Hariparsad, Orthopaedic Specialist.

  • Fields of interest:
  • Spinal surgery
  • Shoulder and hand surgery
  • Arthroscopy and sports medicine
  • Arthroplasty and joint replacements
  • Foot and ankle surgery
  • Orthopaedic trauma

This article was supplied by Dr. RD Hariparsad  MB CHB (Natal), DA(SA), H.Dip(ORTH), FC ORTH(S.A)


These tips are given to inform you only and are not intended to be exhaustive, nor a substitute for your own doctor’s care.