Monday, September 09, 2013

Vamp disease (Compartment Syndrome of the foot)

Vamp disease describes an inflammatory swelling on the dorsal (top) aspect of the foot corresponding to the vamp of the shoe. The vamp covers the dorsum of the foot and includes the tongue. The throat of the shoe is the central portion of the vamp proximal to the toebox. The throat of the shoe dictates the maximal girth permitted by the shoe itself. The eyelets are on each side of the throat and will extend to the top of the collar. The eyelets in many athletic shoes extend onto the collar itself.

A tight lasted shoe can cause painful callus formation, disturbance to the long tendons with the potential to cause infection in the area. Compression from the vamp or tight lacing causes an anterior tarsal tunnel syndrome. Compression of the anterior nerves (deep and superficial peroneal nerves) may arise as a result of ankle sprains, trauma, tight fitting footwear or combination of same. Compartment Syndrome involves compression of nerves and blood vessels within an enclosed space. This leads to impaired blood flow and muscle/nerve damage. This type of neurological condition often occur in joggers and dancers, and can even be implicated in injuries resulting from athletes doing sit-ups with their feet hooked under a metal bar. The presence of oedema, ganglion and a bony hyperostosis can also cause nerve compression. The most common exciting factor of vamp disease is lacing shoes too tightly and conservative care involves shoe therapy. Good fitting footwear and appropriate lacing protocols will in most cases relieve symptoms. Minor modification to the tongue will also facilitate increase volume in a tight fitting shoe. Avoid slip on shoes with elasticated bands in close proximity to anterior of the foot. Other treatment options include: anti-inflammatories, cortisone injections, foot orthoses to stabilize the foot and surgery. Surgery usually involves decompressing the nerve and removing the exostosis or other etiological factors, such as a ganglion cyst, and sectioning the overlying extensor hallucis brevis tendon.

More info on lacing protocols
Ian’s Shoelace Site

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