I kekawrte chu a na reng em? A chhan chu i kekawr iptea thau pad (Heel Fat Pad Syndrome) avanga harsatna a ni thei!

I kal lai emaw, tlan lai emaw khan i kekawrteah natna nasa tak i nei tawh em? Needle-in a chil che ang maiin, emaw, mi pakhatin nasa taka a rawn beng ang maiin, a nih loh leh hliam tuar ang maiin a awm thei. He natna tibuaitu hian nitin hnathawh tur a ti harsa hle thei a ni. Hei hi a chhan ber pakhat chu kekawrte fat pad-a harsatna lo awm a ni a, chu chu vawiinah hian kan sawi dawn a, chu chu `(Heel Fat Pad Syndrome)` tih natna a ni.

`Heel Fat Pad Syndrome` tih hi eng nge ni?

A awlsam zawngin, i kekawr iptea thau pad a hring emaw, a elasticity a hloh emaw hi ``Heel Fat Pad Syndrome'' kan tih hi a ni. Kan kekawr hnuaiah, ruh chungah chuan , natural mattress ang maia thau hring hring a awm tih han ngaihtuah teh . Hei hian kan ke ruh (`heel bone` emaw `calcaneus`) chu kan kal a, kan tlan a, kan zuang a, lei a tihbuai loh nan a venghim a ni. Car chhunga ``shock absorber`` ang maiin a thawk a ni. Hun a kal zel a, chhan hrang hrang avangin he fat pad hi a chhe a, a cushioning property a tlahniam a, chu chu natna a lo awm tan hun a ni.

Hetiang natna hi `fat pad atrophy`, `fat pad syndrome`, emaw `heel fat pad atrophy` tih te hi i hre tawh mai thei.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Dik tak chuan Heel Fat Pad Syndrome hi kekawr natna thlentu pahnihna a ni a, Plantar Fasciitis hnuaiah a awm. Mahse, Plantar Fasciitis nen chuan an inthlau fo a, a natna lan chhuah dan chu a inang tlang thei hle. Chuvangin a chhan dik tak hriat chian a pawimawh.

``Heel Fat Pad Syndrome'' natna lan chhuah dan chu engte nge ni?

Heng symptoms te hi i nei em tih en rawh:

• Kal lai, ding lai emaw, tlan lai emawa kekawrte lai tak atanga lo chhuak, na tak, thuk tak, hliam ang maia natna.
• I kut zungtang hmanga i kekawr lai takah i hmet nasat chuan a hmaa ka sawi tawh ang bawk khan natna chu a rawn lang leh thin.
• Hun rei tak ding chungin, high- impact exercise (entir nan, zuang, tlan, gymnastics, basketball), emaw , pheikhawk bun lovin hmun khauh (thing, concrete, ceramic tiles ang chi) chunga kal hian natna chu a pung tih a chiang hle

Condition a na lo a nih chuan symptom lian tham i nei lo mai thei. A nih loh leh, kekawr bul lova i kal lai te, i tlan lai te, a nih loh leh i ke ruhte i kephah i hmet lai emaw hian a chang chuan natna tlemte chauh i nei thei bawk.

Hei hi a chhan berte chu engte nge ni?

He natna ``Heel Fat Pad Syndrome'' an tih hi zan khat thil thuah a lo awm lo. Hei hi a chhan ber chu hun kal zelah ``wear and tear'' a ni. A thlentu hi thil engemaw zat a awm a:

• Kum upa lam: Kan taksaa thil tam tak hi kum upat dan azirin a inthlak danglam thin. Chutiang bawkin kekawrte chunga thau layer chu a thim zauh zauh a, a chhunga thau awm zat pawh a tlahniam a, a elasticity pawh a tlahniam thei bawk.
• Weight gain: Kan thau chhoh zel chuan kan kekawrtea thau layer-a pressure a sang chho zel a. Hei hian a ti chhe nghal vat a, a flexibility leh cushioning property a hloh thin.
• Chhungkaw chanchin: I chhungkuaa mi tu emaw hian he natna hi a lo nei tawh a nih chuan, emaw, taksa inzawmna (connective tissue) tichhe thei natna (lupus emaw rheumatoid arthritis ang chi) i neih chuan he natna hi i vei theihna a sang zawk a ni.
• Trauma to the heel: Heel-a vuakna na tak, sang tak atanga zuang nghal mai ang chi pawh hi chutiang chhan a ni thei bawk.
• Gait imbalance: Kan kal dan (gait)-ah inthlauhna a awm a nih chuan – chu chu kan kein lei a rawn deng dan te, kan taksa rihna ke hrang hranga a insem dan te a ni – hun kal zelah kekawrte chunga thau layer chu a pianphung lo takin a chhe thei a ni.
• Ke structure: Mi thenkhat chuan an ke arch awmna (e.g. flat feet emaw high arches) awmnaah inthlak danglamna an nei a, kea kal danah harsatna an nei a, hei hian heel-ah pressure a siam belh thei a ni.
• Kekawr hak dik lo: Hei hi a chhan lian tak chu ke tanpui leh shock absorption pe lo pheikhawk emaw, pheikhawk emaw hman chhunzawm zel vang a ni Tichuan pressure zawng zawng chu kephah thlengin a lo thleng a, thau layer chu a chhe nghal vat thin.
• Hmun khauh tak chunga kal: Concrete emaw tiles ang chi hmun khauh tak takah pheikhawk tel lovin kal emaw tlan emaw hian kephah thau layer-ah nghawng lian tak a nei a ni.
• I tih fo thin thil thenkhat: I kekawrte leia a tlak fo thin (e.g. tlan, basketball, tennis, volleyball, gymnastics) leh hun rei tak ding reng hian he natna hi a thlen thei a ni.
• Corticosteroid Injection hmasa ber: A chang chuan ke natna leh hliam dang enkawlna atana hman thin corticosteroids an tih steroid injection hian heel fat layer chu a ti hring thei a, a side effect angin a ti tlem thei bawk. Heel-a steroid injection fo hian he hlauhawmna hi a tipung thei a ni.

Hei hi damdawi lam thil engemaw vang pawh a ni thei.

• Plantar Fasciitis: Hei hi i ke ruh atanga i ke ruh thlenga kal, plantar fascia an tih, ligament thuk tak inflammation a ni. Hei hian kephah a ti na bawk.
• Heel Spurs: Heel bone-a hling ang chi protrusions te tak te (`heel spurs`) a lo awm chuan ke ruh (ligaments)-ah pressure a siam thei a, ke ruh thau layer-a flexibility a ti tlem thei bawk.
• High arch feet: Mi thenkhat chuan an keah arch sang tak tak an nei a. Hei hian ke structure chu a tidanglam reng thei a, ke chhunga ligament te pawh a nghawng thei bawk.
• (Type 2 Diabetes): Type 2 Diabetes vei te hian thau layer-a thau leh protein pawimawh tak collagen an tih chu a chhe thei a.
• Lupus leh Rheumatoid Arthritis: Heng autoimmune natna te hian taksa connective tissue a nghawng a, kea connective tissue te pawh a nghawng a ni.

Engtin nge doctor-te hian he dinhmun hi an hriat theih?

Heel na nei doctor i pan chuan i medical history leh tuna i symptoms te a zawt hmasa ang che.

Hetiang thil hi i hre mai thei, a bik takin i ke ruh natna chungchang hi:

• Engtin nge a natna chu a awm? (e.g., a tight em, a hliam emaw, a throbbing em?)
• Nitin engtik laiin nge a natna chu i hriat?
• Eng ang thilin nge natna chu a tizual?
• He natna hi eng chen nge a awm tawh?
• Chawlh hahdam rualin natna a tlahniam em?

A dawtah chuan doctor chuan i ke taksa a enfiah ang. Kea structural problem awm leh awm loh leh kephah lai tak i press hian natna i neih leh neih loh an zawng ang. Tin, i ding lai leh i ding loh lai pawhin heel fat pad thickness an khaikhin thei bawk. Heel fat pad hrisel tak chu centimetre 1 leh 2 (inches 0.4 leh 0.8) inkar a thuk tur a ni. Heel fat pad hi khawih pawhin a khauh emaw, a nghet emaw a nih chuan a flexible lo tihna a ni. Hei hi he syndrome chhinchhiahna a ni thei bawk.

A châng chuan, a dinhmun dik tak finfiah tûr leh ke ruh natna thlentu dang (e.g., ke ruh tliak, ke ruh tliak) tih loh nân, X-ray, ultrasound scan, a nih loh leh MRI (Magnetic Resonance Imaging) tih a ṭha thei bawk.

Hei hi eng enkawlna nge ni?

Thu lawmawm tak chu he natna hi in lama enkawlna awlsam tak (`conservative treatments`) hmanga enkawl theih a ni fo thin. Heng enkawlnate thil tum ber chu:

• Natna leh hliam tihziaawmna.
• Fat layer awmsa venhim nan.
• Fat layer tihchhiat belh zel tur venna.

A nasat deuh thenkhatah chuan enkawlna buaithlak zawk (`advanced techniques`) a ngai thei bawk. Chungte chu heel-a thau layer thickness tihpun nan thil dang dah belh a ni.

Enkawl dan awlsam (conservative) te:

• Chawlh hahdam: I ke chu a theih ang anga chawlh tir rawh. High-impact activities (vigorous jumping leh running ang chi) kekawr natna thlen thei te chu tihtlem rawh.
• Ice hnawih: Natna thlen thei thiltih i tih zawh chuan i kephah ah minute 20 vel ice pack hnawih thin ang che. Hei hi ni khatah vawi eng emaw zat i ti thei a ni.
• Damdawi: Over-the-counter damdawi hmang hian natna leh hliam tihziaawm theih a ni. Entirnan, ibuprofen (Advil®, Motrin®) leh naproxen (Aleve®) te hi a ni. Amaherawhchu, damdawi eng pawh ei hmain doctor rawn hmasa phawt a tha ber.
• Orthopaedic footwear: Orthopedic kekawrte ha la, chu chuan support leh cushioning tha tak a pe a, a bik takin kekawrte tan. Podiatrist emaw, chutiang pheikhawk hralhna specialty store emaw hnen atangin thurawn i la thei ang.
• Taping your heel: Hei hi heel bone hnuaia heel bone dah a, heel-ah special tape hmanga support leh cushioning pek dan a ni. I doctor emaw physical therapist emaw chuan hetiang tih dan tur dik tak a kawhhmuh ang che.
• Heel cup, shoe insert leh cushioned socks: Heel cup, shoe insert leh cushioned socks, damdawi dawr emaw online-a lei theih te hian i kekawrte tan extra cushioning leh support a pe a ni.
• Exercise program: I doctor emaw physical therapist emaw kaihhruaina hnuaiah i bawnghnute ruh tizau thei stretches leh ke leh khup leh hip alignment dik tak neih theihna tur leh imbalances siam that theihna tur rehabilitation exercise te i zir thei ang.

Enkawl dan hmasawn (complex) te: 1.1.

• Injectables: Hetiang hian natural emaw synthetic emaw liquid filler material hrang hrang chu heel thau layer-ah hian a thickness tihpun nan inject a ni. Entirnan, dermal fillers a awm a, chutah chuan Poly-L-lactic acid leh Hyaluronic acid ang chi thil a awm a. Silicone pawh hi a chang chuan hman a ni a, mahse a hman chungchangah hian sawiselna a awm a, a chhan chu taksa hmun dangah a kal thei a, a nasat em avangin a natna a thlen thei a ni. Heng dermal fillers te hian thla 6 atanga thla 12 vel a nghawng tlangpui. I nunphung, i activity level, taksa rih zawng, leh kum ang chi thilah a innghat.
• Fat grafting (or autologous fat transplantation): Hei hian i taksa peng dang (i kawr emaw, i pum emaw atanga thau tlem te lak a, tihfai a, i kephah chhunga thau pad-a dah (transplantation) a huam a ni. Hei hi outpatient procedure a ni tlangpui. A result hi dermal filler aiin a rei zawk.
• Allografting: Hetiang hmang hian mi dang (donor) atanga lak chhuah thau tissue hman a ni . Fat cells chauh hman a nih avangin taksain a hnawl theihna chance a tlem hle. Hei hi surgical procedure a ni bawk. Thil dang aiin a dam rei deuh (tissue thar chu tissue awmsa nen a inzawm theih nan kar 6-8 vel a ngai thei). He enkawlna hian kum 5 vel chhung chu natna tihziaawmna a pe thei niin an sawi.

A châng chuan, i ke ruh, i ke, i ke, i ke, i khup, a nih loh leh i hip-a pianpui emaw, i taksa piansualna emaw chuan i kal laiin i taksain i rit a sem dân a thlak danglam a, chu chuan i nun nasa takin a nghawng a, ni tin thil tih theih loh a nih chuan, doctor-te chuan chu piansualna siam ṭhat nân operation neih an ngaihtuah thei a ni.

Enkawl loh chuan eng nge thleng ang?

``Heel Fat Pad Syndrome'' tih natna hi enkawl lovin i ngaihthah chuan harsatna a thlen thei a ni:

• Natna chu a la chhunzawm zel ang. I nunphung a tihniam thei a ni.
• Kea kal te, infiamna te, nitin hna thawh te chu a harsa ta hle.
• Natna tihziaawmna turin i kal dan chu i hriat lohvin i thlak danglam thei a, chu chuan taksa ruh dangte chu a tul lovah pressure a siam thei a, tlu leh hliam dang tuar theihna a tipung thei a ni.

Hetiang dinhmun hi engtin nge kan ven theih ang?

Chhungkaw chhunga kal kum emaw, genetic predisposition emaw nena thil thlengte hi kan titawp vek thei lo nain, nunphung thenkhat thlak danglamin, invenna tur ruahmanna siamin he natna (Heel Fat Pad Syndrome) hi kan vei theihna tur hlauhawmna hi kan tihziaawm thei a ni:

• I ke nena inmil tur, heel support tha tak nei, leh cushioning nei tur pheikhawk ha fo ang che. High-impact activity i tih hian athletic shoes dik tak ha rawh.
• Kekawr kekawr sang tak bun fo loh tur. I taksa rih zawng chu i keah inang tlangin an sem darh lo va, chu ai chuan i ke hmun bik pakhat (a tam zawkah chuan hmalam)-ah pressure tam zawk an pe zawk a ni.
• Heels-a pressure nasa tak thlen thei thiltih, tlan, basketball, leh gymnastics te chu tihtlem rawh. Chutiang thil tih zawhah heel fat pad chu a dam leh theih nan hun pe rawh.
• Taksa rihna hrisel tak vawng reng rawh. Thau lutuk hian i kekawrte pressure a tipung a ni.
• A theih ang anga kekawr bul lo kal loh tur a ni a, a bik takin hmun inthlau leh khauh lo (tile, thing, cement ang chi)-ah chuan kal loh tur a ni .
• I pheikhawk zawng zawng kha check fo thin ang che. I pheikhawk kephah chu kawng khat emaw kawng dangah a chhe tawh a nih chuan (a sir khat a chhe zawk ang chi), emaw, pheikhawk chhunga cushioning-in a thlawp tawh loh chuan pheikhawk chu thlak leh rawh.

He `(Heel Fat Pad Syndrome)` hi a dam kim thei ang em?

Dik tak chuan Heel Fat Pad Syndrome hi "absolute long-term cure" tih hi a awm lo. Kan tar leh kan kal, tlan, leh kan zuang (natural wear and tear) hian heel fat pad hi eng emaw chen a tlahniam leh a hring hi thil awmdan pangngai a ni. Mahse, kan sawi tawh ang khan, ke ruh natna, hliam tihziaawmna tur leh fat pad tihchhiat belh zel tur venna atana a tul anga hma i lak chuan i nunphung i tichangtlung thei ngei ang a, i thil tih nuam tak takte chu i ti chhunzawm zel thei bawk.

`(Heel Fat Pad Syndrome)` leh `(Plantar Fasciitis)` te hi eng nge an danglamna?

Hei hi mi tam tak buaina hmun a nih avangin heng dinhmun pahnih inkara danglamna pawimawh tak tak thenkhat hriat a pawimawh hle.

Ngaihtuah teh, ``Plantar Fasciitis`` hi i ke hnuai lam atanga i ke ruh thlenga kal, i ke hnuai lam atanga i ke ruh thlenga kal, ``plantar fascia`` chak lohna, a hring emaw, a hring emaw a ni. He ``plantar fascia`` hi i ke ``arch`` tanpuitu a ni.

• Plantar fasciitis chhinchhiahna ber chu kephah natna (throbbing pain) a ni. He natna hi a tlangpuiin ke ruh chhung lam, ke ruh bulah a awm thin. A châng chuan ke arch-ah pawh natna hi a darh thei bawk.
• I ke i han hrual chuan i ke ruhroah a tightness leh pulling sensation i nei thin.
• A pawimawh ber chu zing khum atanga i tho hmasak ber a, step hmasa ber i tih hian a natna hi a na ber a ni. Tlemte kal hnua natna chu a reh ang maiin lang mahse, keah rit i dah chhunzawm chuan ni tawp lamah chuan a natna chu a zual leh thin.
• Medical examination neih laiin `plantar fascia` chu press a nih chuan na tak leh hliam na tak a awm a, chu chu needle hmanga kah ang mai a ni.

Mahse, `(Heel Fat Pad Syndrome)` ah chuan:

• A natna chu ke ruh lai takah a awm a, thuk tak, hnai tak atanga thlir chuan a hliam ang mai a ni.
• He natna hi hun rei tak chhunga kea kal, ding emaw, high-impact activities tih emaw hian a tam ber. Sandals tel lova hmun khauh tak chunga kal hian a na zual hle.
• He natna hi ni engtik lai pawhin, zanah emaw, chawlh lai pawhin a awm thei.
• Heel Fat Pad Syndrome hi Plantar Fasciitis aiin ke pahnih ah a rualin a awm tam zawk.

Pawimawh: A châng chuan heng dinhmun pahnih hi a awm dun thei a ni. Tin, `(Plantar Fasciitis)` vei chuan a hnuah `(Heel Fat Pad Syndrome)` a nei thei bawk. Chu chu engtin nge a lo awm tih i hria em? ``Plantar fascia`` a chhiat chuan ke rit zawng hi kea kal emaw tlan lai emaw hian a insem tha lo hle. Tichuan, heel-a fat pad-ah pressure tam zawk dah a ni a, chu chuan rang taka tihziaawm a tum a ni.

Calcaneal stress fracture chungchang tlem han zir ila.

Thil pakhat i hriat belh tur a ni. I ke ruh chhunga ruh awm chu calcaneus an ti a. Running ang chi che repetitive hian calcaneus ah hian crack emaw break emaw te te a thlen thei. Hei hi stress fracture an ti a. Calcaneal stress fracture i neih chuan i kephah leh i kekawr hnunglam a na ang. He kephah natna hi hun kal zelah a pung zauh zauh ang. A tirah chuan activity lai chauh a awm ang a, mahse a hnuah chuan i ke a chawlh lai pawhin a na tan ang. I ke ruh natna hi stress fracture vang a ni em tih hriat nan ruh scan, CT scan emaw MRI scan emaw i neih a ngai mai thei.

A tawp berah chuan hriat reng tur (Take-Home Message) .

Chuvangin, a awlsam zawngin, heel fat pad syndrome chu kan ke heel area-a thau thuk tak, cushion ang maia awm, kan taksa rihna thlawptu leh shock laka min humhimtu hloh hi a ni. Hei hi thil tam tak avanga lo awm thei a ni a, chung zingah chuan kum upa lam, kephah tichhe thei thil tih te, taksa rihna tihpun te, leh kea kal laiin taksa rihna insem dan inang lo te pawh a tel. A lan chhuah dan ber chu ke ruh lai takah natna na tak, thuk tak a ni.

A tha ber chu, chawlh hahdamna, natna tidamtu, ice, kekawr hak dik, leh i doctor-in a tih angin exercise ang chi enkawlna awlsam tak takte hian he natna hi a enkawl thei fo thin. A nasat deuh thenkhatah chuan enkawlna hmasawn zawk a awm bawk.

Persistent heel pain i neih chuan ngaihthah suh. Doctor hnenah thurawn dil ngei ang che. Buaina chu eng nge ni tih i hriat hma chuan enkawlna dik tak i tan thuai thei ang. Tichuan, chu natna chu a na zual loh nan i veng thei ang a, i dam thuai thei a, nitin hnathawhnaah hlim takin i kal thei bawk ang!

` Heel na, heel fat pad syndrome, plantar fasciitis, kekawr thau pad, ke na, kekawr natna, kekawrte cushion