containing food purines - Turf Toe
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Turf Toe

Turf toe gets no respect. Let's take a closer look at the causes of turf toe and see how to treat it more effectively. Turf toe is actually a form of hallux limitus. Hallux limitus is classically described as pain and progressive decrease in the range of motion of the first metatarsal phalangeal joint (MPJ). The onset of hallux limitus is due to the following:


Types of Honey: Eight types of honey are described in ayurveda depending on the type of bee which collects it. They are Pouttika ,Bhramara .Kshoudra, Makshika , Chatra , Arghya ,Oudalaka ,Dala .


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 1. The first thing that most doctors agree on is the diet. High protein foods cause a build up of a chemical called purines. The purines raise your uric acid level and increases risk of another gout attack.

3. Volatile aromatic substances. 4. Ashes and water etc. Various ingredients of honey have helped it to become not only a sweet liquid but also a natural product with high nutritional and medicinal value.

"It has sweetness (madhura rasa) with added astringent as end taste (Kashaya anu rasa). It is heavy (guru guna), dry (ruksha) and cold (sheeta). Its effect on doshas is as follows It aggravates vata, scrapes kapha and normalizes pitta and rakta. It promotes healing process."

But before we go any further, we need to understand that the terms turf toe and hallux limitus aren't really synonymous. The fundamental difference between the two terms is the patient population that they affect. Turf toe is a term used in athletic circles referring to any injury of the great toe joint. Consequently, discussions about turf toe will focus on the first two causes of hallux limitus mentioned above; functional hallux limitus and direct physical injury. On the other hand, when we discuss hallux limitus, we're actually referring to a broader, 'non-athletic' patient population and need to include all three causes of hallux limitus.


Symptoms: Turf toe that is the result of functional hallux limitus is going to be insidious in onset. Functional hallux limitus will usually be seen in younger athletes as they attempt to increase their activity. It may not occur during the first athletic season, or the second, but when it does begin to cause pain, the onset will be more frequent and more severe, varying with activity. This profile of onset is simply due to the fact that the athlete is recreating the injury with every step. Turf toe caused by a direct injury to the joint may or may not be obvious. Athletes may not remember an incident of pain since they're often distracted by the event or game in which they're involved. The onset of direct injury to the joint may be abrupt, but also may be insidious becoming increasingly more painful as the season progresses. The joint pain will subside with rest only to recur with increased activity. It's not unusual to see symptoms of turf toe resolve in the off season only to recur with renewed exercise.

Some other good choices are blueberries, strawberries, raw pumpkin seeds, flax seeds, walnuts, raw foods like sprouts, wheat grass, and fresh salads. Also include more grains, fruits and vegetables instead of high protein foods.


Anatomy: The great toe joint, or first metatarsal joint consists of two bones. The proximal bone is the first metatarsal and the distal is called the proximal phalanx or hallux. These two bone move against each other in an up and down motion through what we refer to as the sagital plane. Biomechanics: The motion of the great toe joint is dependant upon the plantarflexion of the first metatasal. If the first metatarsal is limitied in its' ability to plantarflex, the joint will jam resulting in funtional hallux limitus, which as we know is one of the causes of turf toe.

If you find yourself or your loved one suffering from a gout attack, it is unlikely you would hesitate to seek professional help. The pain of an acute gout attack has been compared to the pain of childbirth.

5. Exercise is the fifth way to lower risk of gout attacks. Stretching exercises helps to strengthen the joints, and also increases your endurance and stamina. A sedentary lifestyle is not recommended for gout sufferers.

* Honey is very good for eyes and eye sight. * It quenches thirst. * Dissolves kapha. * Reduces effects of poison. * Stops hiccups. * It is very useful in urinary tract disorders, worm infestations, bronchial asthma, cough, diarrhea and nausea -vomiting.

Other conditions - synovitis, crystal deposition diseases such as gout, systemic arthritis, external physical influences such as Dupytren's contracture, etc.

Pouttika - This honey is collected by very large bees from the nectar of poisonous flowers. It increases vata, causes gout and burning sensation in chest.It is also sedative and reduces fat.

Gout is caused by elevated levels of uric acid in the fluids of your body. These uric acid crystals deposit in joints, tendons and kidneys, damaging the tissues and causing inflammation and pain. The pain is a result of countless needle-like crystals that form from the excess uric acid.

Consuming one spoon of honey daily help us to lead a healthy long life. This article is copy righted. The author Dr.Krishna.R.S is an Ayurvedic Physician and web master of http://www.ayurveda-increaselibido.com

Doctors advise a sensible weight loss plan in the attempt to lower uric acid levels. But take it slow. Crash dieting can actually increase the amount of uric acid produced by the body and bring about an attack.

In many cases it has completely stopped the excruciating painful gout attacks. Statistics indicate in 2006, that gout affected approximately 3.5 million people in the United States. Gout is a form of arthritis which is caused by uric acid deposits in the joints. A rise in the blood's uric acid level is called hyperuricaemia. It occurs predominantly in men over 30, and in post menopausal women as the estrogen level lowers. A salt called monosodium urate (from the uric acid) forms needle like crystals in the joints. These crystals cause inflammation and pain. Gout sufferers describe a flare-up as a piercing stabbing pain in the swollen joints.

* Honey which is stored and is old helps in metabolism of fat and scrapes Kapha.
Ayurveda explains another special quality of honey. Honey is called as "Yogavahi" . The substance which has a quality of penetrating the deepest tissue is called as Yogavahi. When honey is used with other herbal preparations it enhances the medicinal qualities of those preparations and also helps them to reach the deeper tissues.

About the author:
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle
surgeon. Dr. Oster is also board certified in pedorthics. Dr.
Oster is medical director of href=http://www.myfootshop.comMyfootshop.com and is
in active practice in Granville, Ohio.

Oudalaka - Useful in skin diseases, and helps in modulation of voice. Dala - Dry and reduces vomiting. Amongst all the above "Makshika" is considered as the best type with immense medicinal properties.

Makshika - (Honey collected by small honey bees) very light and dry natured. Usefull in VataKapha diseases and kapha diseases Chatra - Heavy and cold in nature usefull in gout, Leucoderma (Shwitra), Arghya - Good for eyes but causes arthritis .

"Chakshushayam Chedi tritshleshmavishahidmaasrapittanut | Mehakushtakrimicchardishwaasakaasaatisaarajit || Vranashodhana sandhaanaropanam vaatalam madhu ||"

2. The second way of combating gout symptoms is drinking water. If you will simply drink 8 ounces of water with each meal, and between each meal, the water will help to flush out a lot of the impurities.

In Ayurveda honey is called as "Madhu". Its qualities are explained as follows. "Vaatalam guru sheetam cha raktapittakaphapaham | Sandhatru cchedanam ruksham kashayam madhuram madhu ||"

Think of turf toe (hallux limitus) as an isolated case of osteoarthritis limited to the first MPJ. Whether the injury is acute or due to repetitive loading, the result is a load that is applied to the subchondral bone that is greater than what the bone can tolerate. As the injury progresses, a series of micro fractures will develop in the subchondral bone. The typical soft spongy character of the metaphyseal bone changes to become brittle and hard. The result is that the articular cartilage looses its' underlying support and becomes susceptible to damage. Juxtachondral eburnation, osteophytes, lipping, spurring; call them what you like, but what you see on your x-ray is the slow progressive destruction of the joint.

There are two main types of gout, primary and secondary. Most (90%) of gout sufferers fall into the 'primary' category. This is a pattern with a cause that is generally unknown (idiopathic), although there are some genetic patterns that can lead one to tend toward elevated uric acid. Secondary gout is identified when uric acid is elevated in response to some other disorder (such as kidney disease). Some medicines (such as aspirin and diuretics) can lead to the onset of gout attacks because they decrease the excretion of uric acid from the body.

Nomenclature: First MPJ - the big toe joint Metatarsus primus elevatus - a functional or structural position of the first metatarsal First metatarsal - the foot bone making up the proximal portion of the big toe joint Hallux - the great toe

Ronconi, P., Monachino, P., Baleanu, P.M.,Favilli, G. Distal Oblique Osteotomy of the First Metatarsal for the Correction of Hallux Limitus and Rigidus Deformity. J. Foot Surg. 39:3, 154-160, 2000

In a nutshell, excess uric acid is the culprit of your gout pain. You will discover seven easy things you can do to decrease the substance at a steady pace in this article. This practice will lower your susceptibility to gout attacks tremendously.

* Cleanse the wounds. * It heals wounds. * Helps in quick healing of deep wounds. * Initiates growth of healthy granulation tissue. * Honey which is newly collected from bee hive increases body weight and is a mild laxative.

Is the onset of turf toe always the same? Turf toe that is the result of functional hallux limitus is going to be insidious in onset. Functional hallux limitus will usually be seen in younger athletes as they attempt to increase their activity. It may not occur during the first athletic season, or the second, but when it does begin to cause pain, the onset will be more frequent and more severe, varying with activity. This profile of onset is simply due to the fact that the athlete is recreating the injury with every step.

 
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3. The third thing that helps to control gout is losing weight if you are overweight. When you are overweight your body does not metabolize food as efficiently as it could at a desirable weight.

7. Herbs can also be instrumental in fighting gout. Some of the herbs that are frequently used are sarsaparilla, and celery seed which helps clear toxins from the body and reduces inflammation.

When treating turf toe be sure to recognize the fact that there is no nerve innervation in articular cartilage. Pain associated with stage one turf toe (hallux limitus) is either synovial pain or bone pain. If we recognize that painful stage one turf toe (hallux limitus) may be due to bone pain, we then realize that turf toe should be treated aggressively to insure the long term viability of the joint.

Unger, K., Rahimi, F., Bareither, D., Muehleman, C. The Relationship Between Articular Cartilage Degeneration and Bone Changes of the First Metatarsophalangeal Joint. J. Foot Surg. 39:1 24-33, 2000

* Regular use of one tea spoon of garlic juice mixed with two tea spoons of honey help to control blood pressure. * One glass of warm water taken with two tea spoons of honey and 1 tea spoon of lemon juice in early morning reduces fat and purifies blood.

The medicinal quality, taste, texture, color, aroma of honey differs according to the geographical area and the species of plants from which it has been collected.

The contents of Honey are 1. Sugars like fructose, glucose, sucrose, maltose, lactose and other disaccharides and trisaccharides. 2. Proteins, fats, vitamins, minerals, enzymes and amino acids,

Functional hallux limitus - biomechanical function that results in metatarsus primus elevatus and subsequent repetitive jamming of the first MPJ. Direct physical injury - injury to the articular cartilage or subchondral bone. These injuries may be due impaction injuries or hyperextension/flexion of the first MPJ.

Therapeutic uses of Honey in Ayurveda The FAO Codex Alimentarius Commission defines honey as 'the natural sweet substance produced by honeybees from the nectar of flowers or from secretions coming from living organisms feeding on plants, that bees gather, transform and combine with specific ingredients, store and leave to ripen in the combs of the hive.'

Turf toe caused by a direct injury to the joint may or may not be obvious. Athletes may not remember an incident of pain since they're often distracted by the event or game in which they're involved. The onset of direct injury to the joint may be abrupt, but also may be insidious becoming increasingly more painful as the season progresses. The joint pain will subside with rest only to recur with increased activity. It's not unusual to see symptoms of turf toe resolve in the off season only to recur with renewed exercise.

2. As it is hygroscopic it speeds up healing, growth of healing tissue and dries it up. 3. Honey acts as a sedative and is very usefull in bed wetting disorders.

A cup of fresh parsley tea helps to lower excess uric acid. It also doubles as a diuretic which is useful for relieving water retention. Tea tree oil, dandelion, and nettle are also used on gout patients. You can soothe the foot joints by soaking in a cool foot tub with a few drops of rosemary oil.

* In cold, cough and congested chest mix 2 tea spoons of honey with equal quantity of ginger juice and should be consumed frequently. * A mixture of black pepper powder, honey and ginger juice in equal quantities, when consumed thrice daily help to relieve the symptoms of asthma.

Red wines such as port and Madeira contain the highest levels of purines. Eliminating alcohol ends gout attacks for many people who suffer from gout.

4. Honey is very good antioxident which restores the damaged skin and gives soft, young looks. 5. Honey has antibacterial properties due to its acidic nature and enzymically produced hydrogen peroxide.

* Honey should never be mixed with rain water, hot and spicy foods, and Fermented beverages like whisky, rum, brandy etc, Ghee and mustard. * Honey includes nectar of various flowers of which some may be poisonous. Poison has hot or Ushna qualities. When honey is mixed with hot and spicy foods the poisonous properties get enhanced and cause imbalance of doshas.

What causes gout is very simply an over abundance of uric acid. So what you need to do to combat the symptoms is to get rid of the excess uric acid. There are 7 easy ways to do this.

Therapeutic uses of Honey: 1. As it contains sugars which are quickly absorbed by our digestive system and converted into energy, this can be used as instant energizer.

4. The fourth way to lower gout symptoms is to cut out the alcohol. Alcoholic beverages increase uric acid in the body, and they also inhibit the excretion of uric acid.

Few Home remedies with Honey * Mix 2 tea spoon of honey with carrot juice and consume regularly. This helps to improve eyesight and is very helpful for those who sit before computer for long hours.

So we have to limit or avoid foods such as: organ meats, sweetbread. anchovies, herring, mackerel, red meat, poultry, shellfish, fish roe, scallops, asparagus, mushrooms, cauliflower, dairy foods, peas, lentils, and beans.

Conventional treatment for the symptoms of gout is the anti-inflammatory drug colchicine. Isolated from the autumn crocus, colchicine has a strong effect to combat inflammation (though it has no effect on uric acid levels!). This provides most sufferers relief within the day, although the drug may be difficult for many to tolerate due to digestive side effects.

To prevent gout attacks, the following lifestyle should be considered: ' Avoid alcohol, a major influence in initiating attacks. ' Follow a low-purine diet. This includes organ meats, meat, shellfish, yeast, and sardines, mackerel, etc. ' Reduce excess food intake including processed carbohydrates, excess fat and excess protein.

The first sign of gout is usually an intense pain during the night. The attack is commonly brought on following a day or evening of excess in alcohol, food, some drugs, or surgery. If the attack progresses, fever and chills will follow. Recurring attacks are common (90%), mostly occurring in the first year. While chronic gout is quite rare, gout sufferers do have a higher risk of kidney dysfunction and kidney stones.

By implementing these 7 easy ways to reduce gout pain, you should be well on the way to pain free joints.

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Gout: A Foe for your Toe Gout is a misunderstood malady. Despite the intense pain that gout can bring, it is a condition that is rarely makes the glossy pages of a magazine. If you are ever personally hit with the sudden onset of gout, classically (50% of the time) seen as a sudden and excruciating pain in the big toe, you will have a newly found interest in the following information.

What's the actual physical change that takes place in the joint with turf toe? As an easy analogy, consider the changes that takes place when an apple falls from a height and is damaged. The skin of the apple appears intact but the underlying pulp is damaged. In the case of turf toe (hallux limitus), think of the skin of the apple as the cartilage of the joint and the damaged pulp of the apple is the subchondral bone. Mild cases of turf toe (hallux limitus), result in little damage to the subchondral bone and will merely exhibit signs of inflammatory change within the joint. Most authors would refer to these cases as stage one turf toe (hallux limitus). More severe cases result in damage to the joint surface, the subchondral bone or both. These are the stage two and three cases of turf toe (hallux limitus) that show visible change on x-ray. As the subchondral bone becomes increasingly damaged, it will create an uneven supporting surface for the cartilage. An increase in activity results in uneven loading of the joint due to the compression injury of the subchondral bone.

References: Lombardi, C.M., Silhanek, A.D., Connolly, F.G., Dennis, L.N., Keslonsky, A.J. First Metatarsophalangeal Arthrodesis for Treatment of Hallux Rigidus: A Retrospective Study. J. Foot Surg. 40:3, 137-143, 2001

Treatment of turf toe varies with the type of healthcare provider and includes the use of rest, shoe modifications, orthotics, steroid injections and surgery. The success of non-surgical care will vary with the degree of injury, the rate at which the injury is healing and how much osteoarthritis has occurred. We see varying degrees of success with orthotics that promote plantarflexion of the first ray, effectively treating metatarsus primus elevatus and peroneus longus dysfunction. Simple arch supports can make a significant difference in the symptoms of turf toe. Should our patient not respond to conservative care in a reasonable time period, we are not reluctant to suggest surgical revision to address the problem whether it be revisions of the joint defect, shortening of a long first metatarsal or structural revision of metatarsus primus elevatus. As mentioned before, the clinical appearance of dorsal lipping or visible radiographic changes are suggestive of moderately advanced osteoarthritis, a condition that is only repaired by joint revision or replacement.


Differential Diagnosis: The differential diagnosis of turf toe includes; Arthitis Fracture Gout Joint infection Joint or bone tumor Synovitis

However, gout sufferers are overwhelmingly (95%) male.

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