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Achilles Tendinitis The Facts

Overview

Achilles TendonAchilles tendonitis is commonly seen in athletes who sustain an increase in training load, and is most often due to overuse. Tendons respond poorly to overuse, therefore healing is slow. This can leave a tendon pathologically defective, which decreases tendon strength and leaves it less able to tolerate load, thus vulnerable to further injury or tendinosis. Extrinsic factors contributing to this condition include training errors and inappropriate footwear. Intrinsic factors include inflexibility, weakness and malalignment. In other situations, there will be clinical inflammation, but objective pathologic evidence for cellular inflammation is lacking, and in these conditions the term tendinosis is more appropriate. Tendinosis is a degeneration of the tendon?s collagen in response to chronic overuse; when overuse is continued without giving the tendon time to heal and rest, such as with repetitive strain injury, tendinosis results. Even tiny movements, such as clicking a mouse, can cause tendinosis, when done repeatedly.




Causes

Tight or tired calf muscles, which transfer too much of the force associated with running onto the Achilles tendon. Not stretching the calves properly or a rapid increase in intensity and frequency of sport training can make calf muscles fatigued. Activities which place a lot of stress on the achilles tendon, such as hill running and sprint training, can also cause Achilles Tendinitis. Runners who overpronate (roll too far inward on their feet during impact) are most susceptible to Achilles Tendinitis. Runners with flat feet are susceptible to Achilles Tendinitis because flat feet cause a 'wringing out' effect on the achilles tendon during running. High arched feet usually absorb less shock from the impact of running so that shock is transferred to the Achilles tendon. Use of inappropriate footwear when playing sport or running e.g., sandals, can also put an extra load on the Achilles tendon. Shoes are now available that have been designed for individual sports and provide cushioning to absorb the shock of impact and support for the foot during forceful movements. Training on hard surfaces e.g., concrete, also increases the risk of Achilles Tendinitis. Landing heavily or continuously on a hard surface can send a shock through the body which is partly absorbed by the Achilles tendon. A soft surface like grass turf helps to lessen the shock of the impact by absorbing some of the force of the feet landing heavily on the ground after a jump or during a running motion.




Symptoms

There will be a gradual onset of achilles tendon pain over a period of weeks, or even months. The pain will come on during exercise and is constant throughout the training session. Pain will be felt in the achilles tendon when walking especially up hill or up stairs. This is because the achilles is having to stretch further than normal. There is likely to be stiffness in the Achilles tendon especially in the morning or after a long period of rest. This is thought to be due to adhesions between the tendon sheath and the tendon itself. Nodules or lumps may be found in the achilles tendon, particularly 2-4cm above the heel and the skin will appear red. Pain and tenderness will be felt when pressing in on the achilles tendon which is likely to appear thickened or swollen. A creaking sensation may be felt when press the fingers into the sides of the tendon and moving the ankle.This is known as crepitus.




Diagnosis

To diagnose the condition correctly, your doctor will ask you a few questions about the pain and swelling in your heel. You may be asked to stand on the balls of your feet while your doctor observes your range of motion and flexibility. The doctor may also touch the area directly. This allows him to pinpoint where the pain and swelling is most severe.




Nonsurgical Treatment

Treatment normally includes, A bandage, designed specifically to restrict motion of the tendon. Non-steroidal anti-inflammatory medication. Orthoses (devices to help to support the muscle and relieve stress on the tendon, such as a heel pad or shoe insert. Rest, and switching to an exercise, such as swimming, that does not stress the tendon. Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upper foot flexors. In extreme cases, surgery is performed, to remove fibrous tissue and repair any tears.

Achilles Tendinitis




Surgical Treatment

The type of surgery you will have depends on the type of injury you are faced with. The longer you have waited to have surgery will also be a factor that determines what type of surgery is needed. With acute (recent) tearing the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure). Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker rate of recovery after the surgery.




Prevention

If you're just getting started with your training, be sure to stretch after running, and start slowly, increasing your mileage by no more than 10% per week. Strengthen your calf muscles with exercises such as toe raises. Work low-impact cross-training activities, such as cycling and swimming, into your training.

Print "Symptoms Associated With Side Of Foot Pain"

Although itching and blistery feet may be a sign of Athlete's foot, those who have constant numbness or tingling in their feet may be suffering from a condition known as peripheral neuropathy. You can barely remember the last time you weren't bothered by foot pain. For most of us foot pain occurs at sometime in our life. Foot complaining of pain, too often? Foot pain around the ankle is quite common.

There are many conservative treatments for plantar fasciitis that when used accordingly are very successful. Your podiatric physician may refer you to a physical therapist to aid in your treatment and to teach you the most effective stretching techniques for your foot type and condition. You may also be advised to wear a night splint that stretches your tendons and fascia in your foot while you sleep. These treatments can significantly reduce the inflammation of your plantar fascia and thus reduce your pain. You should be wearing shoes that properly stabilize your foot and support your arch. Your podiatric physician can provide you with a prefabricated or custom orthotic that would give your achy foot the support it need. It takes time and therapy to improve the integrity of the tissue.

Athletes foot is a common skin condition causing itchy, flaky skin and a burning sensation usually between the toes. Flat feet are usually the result of one's own genetics inherited from their family. Flattening is a normal part of the walking cycle of the foot, and in fact this is how the body disperses much of the shock forces created with walking. However, in some individuals, the foot flattens outward too much. This changes the way certain muscles in the foot and leg have to function, which causes numerous changes to the feet over time. These changes can include chronic straining of ligaments and tendons, as well as the development of deformities that rely on structural imbalance like bunions and hammertoes. There are numerous ways to treat flat feet.

Sprain: When the fibers of the tissue tear due to overstretched ligaments, a sprain occurs, and a sprain is known to cause extreme pain. Muscle Injury: Overloading, overuse, over-stretching, or bruising of the muscles and tendons of the foot may lead to severe pain in the foot. Plantar Fasciitis: Planter fascia strains are generally felt as the pain at the bottom of the foot. This condition is known as plantar fasciitis. Wrong Shoes: Wearing narrow toed shoes may lead to development of a bunion, a big, hard, and painful protrusion at the base of the big toe, causing pain in the foot. Hammer Toes: As contraction of muscles leads to hammer or curled toes, it is often a cause of severe pain.

I recently stopped wearing them for a few months, and the heel pain returned, so I'm ordering more for my shoes. When I initially put your inserts into my shoes, they felt a bit strange, especially in my arches. Shoes with high heels can create much trouble for your feet.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Unlike the great Roman arches the ones in our feet are designed to be flexible- to "give and take"- upon impact with the ground. That is how the arches both absorb and reflect the force of impact back to the outside world. The arches in our feet are complex structures made up of 24 bones. One of the main sources of foot arch pain is a condition known as plantar fasciitis.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

The cause of plantar fasciitis is often unknown. Plantar fasciitis accounts for up to 9% of all running injuries. Other causes of this injury include poorly-fitting shoes, lack of calf flexibility, or an uneven stride that causes an abnormal and stressful impact on the foot. Embarking on an exercise program as soon as possible and using NSAIDs, splints, or heel pads as needed can help relieve the problem. Pain that does not subside with NSAIDs may require more intensive treatments, including leg supports and even surgery. With stretching treatments, the plantar fascia nearly always heals by itself but it may take as long as a year, with pain occurring intermittently. Heel cups are not very useful. Extracorporeal Shock Wave Therapy (ESWT).Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Hard Skin On Feet

There are different types of foot fungus that occur due to many factors both internally and externally, that can alter one's physical state, foot wise. Every day there are many women around the world that wish that they could change the way that their skin looks.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

This is a condition in which the subtaler joint in the foot over pronates (rolls in too much). Flat feet insoles have been used for years to help people with flat feet. It cups the heel and supports the arch but because it is not flexible it does not extend the full length of the foot. Corns and calluses are areas of hard, thickened skin that develop when the skin is exposed to excessive pressure or friction. They�commonly occur on the feet and can cause pain and discomfort when you walk. Corns are small circles of thick skin that usually develop on the tops and sides of toes or on the sole of the foot. Corns�are often caused by�wearing shoes that fit poorly or�certain designs that place excessive pressure on an area of the foot. Calluses are hard, rough areas of skin that are often yellowish in colour.

It may be so severe that people who have the condition are usually kept awake at night because of the pain. Because the calcaneus or the heel bone is the largest bone that can be found in the foot, it usually hits the ground first when the individual walk, causing foot pain. Another cause is due to strain on the ligament at the foot bottom, called plantar fascistic. Athletes also tend to develop heel pain from stress fractures.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Orthotics, on the other hand, do most of their work on the heel and ball of the foot repositioning the foot for maximized function. First, try doing your own version of deep tissue massage by rolling a frozen cola bottle or can from the heel forward into the arch. Do stretching but the key to good stretching is not to stretch too hard so generally avoid weight bearing (standing) stretches but sit on a soft surface like your bed and pull the foot backward on the leg as far as it will go, holding for 20 seconds and relaxing for 5 seconds. Wrap a pillow around your foot with duct tape and walk for a block or two. You will come back with your foot hurting more because your foot sank down deeper into the soft surface, allowing the ligament to stretch more. For myself, when I'm in a hurry, I use a foot file from Sally's.

The important question is how to choose the best one out of so many creams for getting rid of dry skin. I suffer from awful hard skin it will never go away ever I keep it at bay best I can but once a week I have to attack my feet with various devices I own. Scholl Cracked Heel Repair Cream - You still have to file the skin down first but once you've done that its ok but nothing special. Clean your feet using cotton wool dipped in surgical spirit at night. This helps to keep the skin dry and remove cracks. Particular fabrics that socks are made of can cause the feet to sweat more. You have put on your boots because the winter has showed its teeth and then you realized that you have neglected your feet a lot. Exfoliate your feet every week.

Pictures, Remedies & Treatment

A bunionette is similar to a bunion, but it develops on the outside of the foot. Kate Middleton is barely seen out in public engagements without her trusty nude LK Bennett high heels on. When she made a pre-Olympic visit to a judo center however, she gamely kicked off her heels to step on the mat. Pain is a symptom common to many foot conditions, and pain medications are a good solution for most types of foot pain.

Elderly people wearing shoes with thick inflexible soles may be unable to sense the position of their feet relative to the ground, significantly increasing the risk for falling. If shoes need breaking in, place moleskin pads next to areas on the skin where friction is likely to occur.

Skin conditions that involve open sores, lesions, or contagions may also be treated with medical ointments and bandages or wraps. Skin disorders that are temporary and merely cosmetic in nature can often be treated with medicated make-up, over-the-counter skin care products, hygiene techniques, and small lifestyle changes. In addition, some skin conditions can be treated or improved with changes in diet. Some skin disorders cannot be prevented; genetic conditions and disorders that are brought on by other illnesses cannot be avoided. However, it is possible to prevent some skin disorders. Learning about proper skin care and skin disorder treatment can be very important for skin health. Some conditions require the attention of a doctor, while others can be safely addressed at home.

The olive oil acts as a soothing agent and smoothens the skin. You could also add one cup of honey to a gallon of water and soak your feet in it. The honey moisturizes the skin and acts as a natural antiseptic, thereby healing the cracked soles. After allowing the skin to soak for 15 - 20 minutes gently scrub off the dried skin by using a pumice stone.

A lot of professionals believe that common physical activity may be the answer to gout. You'll want to have an expert to look at the concerns with your feet. The feet might be experiencing pain for a lot of numerous reasons. The deep tissue massage is ideal for people experiencing chronic muscle pain on their upper and lower back, legs, and shoulders. A deep tissue massage frees our muscles of toxin build-up that is usually the main cause of pain and muscle immobility. Some massage therapists call it pressure therapy" since it involves applying pressure to specific points on the foot. A foot massage is a very relaxing way of addressing problems with your body's internal organs. A trained massage therapist can also put pressure on different meridians or energy lines on the sole and side of the feet to determine the cause of illness. A sports massage is ideal of active individuals that are engaged in sports or intensive work-outs. However, they may be contagious for weeks after symptoms go away.

Also, giving the affected foot regular massages using massage oils or essential oils is an alternative therapy that people are readily adopting to garner some much-needed respite from the symptoms of foot neuropathy. The main aim should be keeping the feet warm and dry.

Using Listerine for severe foot conditions can be wrong for example, for example, if you have cuts and wounds in case of toenail fungus, cracked heels, warts, corns and calluses, you must go for taking medical assistance to get relief from this painful and severe condition of feet. But some says feet skin gets green spots on feet while using cool mint Listerine. So it can be used confidently as it is reliable home remedy to treat feet problems. Plain cornstarch makes a great foot dusting powder.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Metatarsal Pain

According to STARTHealthCare, three out of four Americans experience foot problems in a lifetime despite the fact that only a small group of individuals are born with foot problems. Calluses are caused by friction, and because feet tend to slide in sandals, calluses build up more quickly in summer.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Being the son of parents counted among the throng of Americans displaced by the Great Depression has given Devin a deep rooted passion for causes dealing with the poor and the working class. Just click here: and then select the orange Connect” button on the left-hand side of the page. Personally, I've had the pain of experiencing a miscarriage and I know how devastating it is. Our very first pregnancy, one that we planned for and wanted so badly, ended in a miscarriage shortly after our very first ultrasound in 2004. We talked to our doctors before trying to get pregnant. Some people don't understand that you can't just get over the death of your child. That pain never goes away, never gets easier to bear, and never subsides. We were fortunate enough to conceive our 2nd child (my 3 1/2 yr old son) just 8 weeks after our miscarriage, but having our son didn't change the fact that our first child wasn't with us anymore. Claw differs are occasionally designated.

If you want you could add a few drops of olive oil to the water in which you have dunked your feet. The olive oil acts as a soothing agent and smoothens the skin. Using a clean towel, dry your feet well; paying close attention to drying the skin between the toes.

The author of the article recommends the patients suffering from any foot disorder to take services of Nagler Foot Center for satisfying results and reasonable charges. A plantar callus is a thickened amount of skin that can develop on the bottom of the foot where your heel bone connects to your toes. The skin forming the callus can be gray or yellowish in appearance, dry, hard, painful and flaky. To treat a plantar callus, a doctor can trim away the thick skin with a scalpel.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Well, corns (Heloma) are small and round: they also have a hard thickening bit of skin in the middle and are very painful. They usually affect your smaller toes; and wearing poorly fitted shoes can cause excessive friction and rubbing of the skin to form a corn. When people opt to use products containing Aloe Vera, such as gels and creams, they can prevent and remove corns. Common foot problems and nail deformities in our aging population.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain

Causes Of Pain In The Big Toe And Ball Of The Foot

Bunions (medical term hallux valgus”) are formed when the big toe drifts in the direction of the second toe, forming a painful and abnormal joint angle. Bunions are bumps at the base of the big toe, on the outer side of the toe. This site uses cookies to improve your experience. Patients with bunions will often display pain over the prominent bump on the inside of their forefoot (the medial eminence). Severe foot pain that limits your everyday activities, including walking and wearing reasonable shoes. You may find it hard to walk more than a few blocks (even in athletic shoes) without significant pain. This entry was posted in Hallux Valgus and tagged Hallux Valgus Bookmark the permalink Both comments and trackbacks are currently closed. Although bunions are usually obvious from the pain and unusual shape of the toe, further investigation is often advisable. Blood tests may be advised to see if some type of arthritis could be causing the pain. Based on this evaluation, your doctor can determine whether you need orthopaedic shoes, medication, surgery or other treatment. Look for an angular, bony bump on the side of the foot at the base of the big toe. A few people may obtain relief with ice packs. Have both feet measured. Bunion surgery can make your toes less flexible, meaning you may not be able to return to the same level of physical activity as before the operation. The success of your surgery will depend on the skill and experience of the surgeon, the severity of your bunions, the type of surgical procedure you have and your ability and willingness to rest after the Mallet Toe operation. Bunion surgery may be up to 85% successful in people who have it. However, after you have had surgery, there is no guarantee your foot will be perfectly straight or pain free. Surgery may reduce the flexibility of your big toe joint and you may experience stiffness in the area where the bunion was. If not, surgery may be your next option.Plantar Fasciitis,Pes Planus,Mallet Toe,High Arched Feet,Heel Spur,Heel Pain,Hammer Toe,Hallux Valgus,Foot Pain,Foot Hard Skin,Foot Conditions,Foot Callous,Flat Feet,Fallen Arches,Diabetic Foot,Contracted Toe,Claw Toe,Bunions Hard Skin,Bunions Callous,Bunion Pain,Ball Of Foot Pain,Back Pain This means that the foot will be numbed with an anesthetic, and an anesthesiologist will provide intravenous medications to relax and provide sedation (often referred to as twilight). Some patients choose to have the hardware removed simply because they want it out, or if it is irritating the skin from underneath. I traveled all the way to do this surgery with Dr. Blitz. Yes really this time cause we had a pleasant time, plus we, I did my surgery. I would recommend people coming here and doing the surgery. I was coming here to do one foot and ended up doing two. But you know, as we, as we, we communicate with his office, with the clinic we thought, we felt that there was some sort of relief because it was proficient. Bunions are more common in women than men. To me, surgery was a much better choice because the "bunion lifestyle" of dealing with pain, finding shoes that fit "right" and all of the home remedies was just becoming a major hassle. We know that foot bunions occur in about 30% of the population of most Western countries but only 3% in Eastern countries. They are seen most commonly in women and become more common as people get older. Tight-fitting shoes are thought to be the main cause of bunions.. Shoes such as high heels and shoes with tight toe boxes (eg womens fashion shoes and cowboy boots) are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. Footwear is not the only cause of a bunion. Avoid activities that lead to bunions. The base of the big toe pushes outward on the first metatarsal bone - which is the bone directly behind the big toe - forming a bunion. Forms when your big toe pushes against your next toe, forcing the joint of your big toe to get bigger and stick out. Also develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis. The pain often returns after prolonged rest or extensive walking.

Diabetic Foot Treatment Powerpoint

All of these complications can be prevented without surgery if the disease is addressed quickly enough. Treatment started as soon as the first sign of disease appears can protect the foot or ankle from collapse. Without weight-bearing pressure, the fractured bone may not move or collapse to any great degree, and with proper treatment the anatomy of the involved joints can stay relatively intact. This requires strict non-weight bearing on the involved leg until the active fracturing phase of Charcot neuroarthropathy is over. The time required for this is usually at 3 months, but can be longer. Your doctor will give you diagnostic examinations to rule out if you have pre diabetes. Blood glucose test and oral glucose tests are the primary diagnosing procedures done. He will give you recommendations and advice on what you should do when results come up. Preventing diabetes is like learning its risk factors. When you feel you have the risk factors try to avoid them, or if not, then lessen them. Preventing the disease is much easier than what you will do when you already have acquired it. Heberprot-P was approved five years ago and over this period it has been commercialized in 18 countries, including Venezuela, Bolivia and Ecuador. It’s American Diabetes Month, and if you’re among the 25 million Americans who have the disease, you may know that foot care is extremely important. Nervous system impairment, also called neuropathy, is a major complication of diabetes that can cause you to lose feeling in your feet. That means you may not know right away if you have hurt yourself, which could lead to infection, according to the American Orthopaedic Foot & Ankle Society (AOFAS). Call your doctor immediately if you experience any injury to your feet. Even a minor injury is an emergency for a patient with diabetes.diabetic foot ulcer Eruptive xanthomatosis is another condition caused bydiabetes that's out of control. It consists of firm, yellow, pea-likeenlargements in the skin. Each bump has a red halo and may itch. This conditionoccurs most often on the backs of hands, feet, arms, legs, elbows, knees and buttocks. The disorder usually occurs in young men with type 1diabetes. The person often has high levels of cholesterol and fat (particularly hyperchylomicronemia) in the blood. Like diabetic blisters,these bumps disappear when diabetes control is restored. DigitalSclerosis This condition happens to about one third of people whohave type 1 diabetes. The only treatment is to bring blood sugar levels undercontrol. DisseminatedGranuloma Annulare Diabetes can result in excruciating foot pain caused by the damage to the nerves and problems in circulation. Read on to know more about the causes and diabetic foot pain symptoms. Can diabetes be cured by natural herbal remedies? Well, the variety of Ayurvedic medicine for diabetes mentioned in the following article definitely suggest that it is possible! More often than not, diabetes is accompanied by a lot of afflictions affecting various parts of the body. Here's an insight into diabetes and skin problems that accompany it. According to recent studies, it is found that magnesium deficiency can cause diabetes. Here is detailed information about the relation between the two. My sister is taking the enzyme and has also noticed great results. She has for many years had lumps in her legs that have made it very painful to walk or stand. She noticed that after just 2 weeks on Serrapeptase, that in her shopping in Walmart, which normally she can only walk for about 10 minutes, she had been there over 40 minutes and noticed the reduced pain. She has also had several surgeries for her sinus condition over the years and has noticed a clearing of that problem also. She has called several times to thank me for sending her the first bottle. diabetic foot cream