Patria Musumeci

Bottom Of Foot Pain In Morning

Fallen Arches Causes And Treatment

Overview

Flat Foot

Flat feet are a usually painless condition where the arches on the inside of your feet are completely collapsed arches so that the entire sole of your feet touch the floor when standing. Flat feet can develop after an injury to the foot, such as a ligament, tendon or muscle tear, or as a result of arthritis or they may develop because the condition runs in the family. People with flat feet often complain of their feet rolling inwards when walking or a feeling of their foot collapsing.

Causes

There are many different causes of flat feet, which can be separated into two main categories. The first category, congenital flat foot, is a condition that one is born with or is predisposed to at birth. This type includes the completely asymptomatic, pediatric flexible flat foot-by far the most common form of congenital flat foot. Flexible means that an arch is present until weight is put on the foot, at which time the arch disappears. This foot type is a result of the fact that all people are born with different physical features. Some people have bigger noses than others, just as some people have flatter feet (of course, there is no known correlation between the two). Any alteration in the many building blocks of the foot can influence its shape. At the other end of the spectrum, yet within the same category of congenital flat foot, exist several rare, more severe forms of flat foot. These severe conditions include Vertical Talus, Congenital Calcaneal Valgus, and Tarsal Coalitions - all of which are more rigid (no arch with or without weight on the foot) and definitely symptomatic. Luckily, these are much less common, but can usually be identified by specialists at the time of presentation and treated appropriately. The second category, acquired flat foot, develops over time, rather than at birth. Many different factors can contribute to the development of flat feet. These include the types of shoes a child wears, a child's sitting or sleeping positions, compensation for other abnormalities further up the leg, or more severe factors such as rupture of ligaments or tendons in the foot. Very commonly, the reason for flat feet is that the foot is compensating for a tight Achilles tendon. If the Achilles tendon is tight, then it causes the foot to point down, or to plantarflex (as occurs when stepping on the accelerator of your car). Even minimal amounts of plantarflexion can simulate a longer leg on that particular side, assuming that the other foot is in the normal position. The body therefore tries to compensate by pronating, or flattening out the arch, thereby making up for the perceived extra length on the affected side.

Symptoms

The majority of children and adults with flexible flatfeet never have symptoms. However, their toes may tend to point outward as they walk, a condition called out-toeing. A person who develops symptoms usually complains of tired, aching feet, especially after prolonged standing or walking. Symptoms of rigid flatfoot vary depending on the cause of the foot problem. Congenital vertical talus. The foot of a newborn with congenital vertical talus typically has a convex rocker-bottom shape. This is sometimes combined with an actual fold in the middle of the foot. The rare person who is diagnosed at an older age often has a "peg-leg" gait, poor balance and heavy calluses on the soles where the arch would normally be. If a child with congenital vertical talus has a genetic disorder, additional symptoms often are seen in other parts of the body. Tarsal coalition. Many people have no symptoms, and the condition is discovered only by chance when an X-ray of the foot is obtained for some other problem. When symptoms occur, there is usually foot pain that begins at the outside rear of the foot. The pain tends to spread upward to the outer ankle and to the outside portion of the lower leg. Symptoms usually start during a child's teenage years and are aggravated by playing sports or walking on uneven ground. In some cases, the condition is discovered when a child is evaluated for unusually frequent ankle sprains. Lateral subtalar dislocation. Because this often is caused by a traumatic, high-impact injury, the foot may be significantly swollen and deformed. There also may be an open wound with bruising and bleeding.

Diagnosis

If your child has flatfeet, his or her doctor will ask about any family history of flatfeet or inherited foot problems. In a person of any age, the doctor will ask about occupational and recreational activities, previous foot trauma or foot surgery and the type of shoes worn. The doctor will examine your shoes to check for signs of excessive wear. Worn shoes often provide valuable clues to gait problems and poor bone alignment. The doctor will ask you to walk barefoot to evaluate the arches of the feet, to check for out-toeing and to look for other signs of poor foot mechanics. The doctor will examine your feet for foot flexibility and range of motion and feel for any tenderness or bony abnormalities. Depending on the results of this physical examination, foot X-rays may be recommended. X-rays are always performed in a young child with rigid flatfeet and in an adult with acquired flatfeet due to trauma.

fallen arches surgery

Non Surgical Treatment

The simplest form of treatment is the use of custom fitted orthotics. For this, it is best to see a podiatrist, who is a trained medical professional that assesses feet and gives you a prescription for the orthotic. If the orthotics do not work - or if the deformity is very severe - then surgical management may be needed. There is a very wide range of procedures available, with varying downtimes and complexity. The simplest procedure of all is a simple calf release. This can be done at the back of the knee or the calf, and has a very quick recovery. It is a day-surgery procedure, and the patient can walk immediately after the surgery without the need for a cast. Recovery back to jogging can be as early as three weeks. The calf release stops the deforming force but obviously does not correct the arch itself. It is usually done in combination with some of the other procedures mentioned below. Done by itself, the patient will probably still require orthotics but by releasing the calf, it allows the orthotics to be much more effective. The other end of the spectrum is a complete reconstruction of the arch with bone work and screws to fuse joints.

Surgical Treatment

Adult Acquired Flat Foot

Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.
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External Shoe Lifts For Leg Length Discrepancy

Overview

Many people don?t realise it, but one of their legs is longer (or shorter) than the other one. Over time, this can lead to degenerative osteoarthritis (OA) in the hip joint requiring a hip replacement. But the surgeon can?t just take the old hip joint out and put the new implant in. Careful planning, special surgical techniques, and adjusting of the implant component parts are important in preventing continuation or even worsening of the leg length discrepancy.Leg Length Discrepancy

Causes

A patient?s legs may be different lengths for a number of reasons, including a broken leg bone may heal in a shorter position, particularly if the injury was severe. In children, broken bones may grow faster for a few years after they heal, resulting in one longer leg. If the break was near the growth center, slower growth may ensue. Children, especially infants, who have a bone infection during a growth spurt may have a greater discrepancy. Inflammation of joints, such as juvenile arthritis during growth, may cause unequal leg length. Compensation for spinal or pelvic scoliosis. Bone diseases such as Ollier disease, neurofibromatosis, or multiple hereditary exostoses. Congenital differences.

Symptoms

Often there are few or no symptoms prior to the age of 25-35. The most common symptom is chronic lower back pain, but also is frequently middle and upper back pain. Same-sided and repeated injury or pain to the hip, knee and/or ankle is also a hallmark of a long-standing untreated LLD. It is not uncommon to have buttock or radiating hip pain that is non-dermatomal (not from a disc) and tends to go away when lying down.

Diagnosis

A qualified musculoskeletal expert will first take a medical history and conduct a physical exam. Other tests may include X-rays, MRI, or CT scan to diagnose the root cause.

Non Surgical Treatment

The object of treatment for leg length discrepancy is to level the pelvis and equalize the length of the two limbs. Inequalities of 2-2.5 centimeters can be handled with the following. Heel lifts/ adjustable heel lifts can be used inside a shoe where shoes have a full heel counter. Heel lifts may be added to the heel on the outside of the shoe along with an internal heel lift. Full platforms along the forefoot and rearfoot area of a shoe can be added. There are many different adjustable heel lifts available on the market. For treatment of a leg length discrepancy, consult your physician. They may refer you to a Physiotherapist or Chiropractor for determination of the type of LLD. A Certified Pedorthist (Canada) will treat a structural leg length discrepancy with a heel lift or in larger discrepancies a footwear modification.

Leg Length Discrepancy

what is a heel lift?

Surgical Treatment

In growing children, legs can be made equal or nearly equal in length with a relatively simple surgical procedure. This procedure slows down the growth of the longer leg at one or two growth sites. Your physician can tell you how much equalization can be gained by this procedure. The procedure is performed under X-ray control through very small incisions in the knee area. This procedure will not cause an immediate correction in length. Instead, the limb length discrepancy will gradually decrease as the opposite extremity continues to grow and "catch up." Timing of the procedure is critical. The goal is to reach equal leg length by the time growth normally ends. This is usually in the mid-to-late teenage years. Disadvantages of this option include the possibility of slight over-correction or under-correction of the limb length discrepancy. In addition, the patient's adult height will be less than if the shorter leg had been lengthened. Correction of significant limb length discrepancy by this method may make a patient's body look slightly disproportionate because of the shorter leg. In some cases the longer leg can be shortened, but a major shortening may weaken the muscles of the leg. In the thighbone (femur), a maximum of 3 inches can be shortened. In the shinbone, a maximum of 2 inches can be shortened.

What Are The Major Causes Of Heel Painfulness

Overview

Foot Pain

The most common cause of heel pain is inflammation due to injury of the soft tissue around your heel. The plantar fascia is the area of your foot most likely to be inflamed, which results in plantar fasciitis. With plantar fasciitis, you experience a sharp burning or stabbing sensation upon arising after walking or standing for prolonged periods. Your first steps each morning probably hurt, too. Heel pain is occasionally caused by excessive pounding on the heels. This is more common in the elderly and overweight individuals whose heel fat pads no longer function properly. Watch for a bruising sensation under the heel when standing and walking. If you think this is your issue, an insert with an artificial fat pad might help alleviate your discomfort. Heel pain is by far the most common foot complaint. There are many medical conditions that are associated with heel pain, including gout and other forms of arthritis.

Causes

Pain in the foot can be due to a problem in any part of the foot. Bones, ligaments, tendons, muscles, fascia, toenail beds, nerves, blood vessels, or skin can be the source of foot pain. The cause of foot pain can be narrowed down by location and by considering some of the most common causes of foot pain. Plantar fasciitis is the most common cause of heel pain. The plantar fascia, a band of tough tissue connecting the heel bone to the toes, becomes irritated or inflamed. Heel pain, worst in the morning when getting out of bed, is the most common symptom. Arch pain may also be present.

Symptoms

Symptoms of plantar fasciitis vary, but the classic symptom is pain after rest--when you first get out of bed in the morning, or when you get up after sitting down for a while during the day. The pain usually diminishes after a few minutes of walking, sometimes even disappearing, but the pain is commonly felt again the longer you're on the foot. Fasciitis can be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation of long-periods of standing, especially on concrete, by being overweight. It doesn't help that fascia doesn't heal particularly quickly because it has relatively poor circulation (which is why it's white in colour).

Diagnosis

The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.

Non Surgical Treatment

Shoes, orthoses, splinting and/or immobilization form the cornerstone for successful functional management of plantar fasciitis.When you take the overuse nature of plantar fasciitis into account and attempt to re-establish the windlass mechanism of the foot, there is an enhanced potential for success. Unfortunately, too little attention has been directed to appropriately managing the shoes worn during treatment for plantar fasciitis. Emphasising motion control and stability type athletic shoes (that provide a firm heel cup, instep rigidity, longitudinal integrity and a well-integrated shoe upper) can help decrease excess eccentric tissue strain. The shoe also serves as a vital and functional link between an orthotic and the foot. Orthoses have long been considered to be a reliable method for treating plantar fasciitis. Considerable debate has been waged over the benefits of over-the-counter (OTC), prefabricated and prescription foot and/or ankle orthoses. Heel cushions, heel cups and cushioning pads appear to provide immediate pain relief for many people who have plantar fasciitis.This relief is frequently short-lived and requires other treatment modalities for success.Neutral position taping and strapping of the foot provides temporary symptomatic relief of pain caused by plantar fasciitis. Although the functional benefits are temporary and likely do not last longer than 10 minutes with exercise, the soft tissue compression and symptomatic relief afforded by the strapping can last for nearly a week.

Surgical Treatment

Surgery is a last resort in the treatment of heel pain. Physicians have developed many procedures in the last 100 years to try to cure heel pain. Most procedures that are commonly used today focus on several areas, remove the bone spur (if one is present), release the plantar fascia (plantar fasciotomy), release pressure on the small nerves in the area. Usually the procedure is done through a small incision on the inside edge of the foot, although some surgeons now perform this type of surgery using an endoscope. An endoscope is a tiny TV camera that can be inserted into a joint or under the skin to allow the surgeon to see the structures involved in the surgery. By using the endoscope, a surgeon can complete the surgery with a smaller incision and presumably less damage to normal tissues. It is unclear whether an endoscopic procedure for this condition is better than the traditional small incision. Surgery usually involves identifying the area where the plantar fascia attaches to the heel and releasing the fascia partially from the bone. If a small spur is present this is removed. The small nerves that travel under the plantar fascia are identified and released from anything that seems to be causing pressure on the nerves. This surgery can usually be done on an outpatient basis. This means you can leave the hospital the same day.

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Prevention

Feet Pain

You can try to avoid the things that cause heel pain to start avoid becoming overweight, where your job allows, minimise the shock to your feet from constant pounding on hard surfaces, reduce the shocks on your heel by choosing footwear with some padding or shock-absorbing material in the heel, if you have high-arched feet or flat feet a moulded insole in your shoe may reduce the stresses on your feet, if you have an injury to your ankle or foot, make sure you exercise afterwards to get back as much movement as possible to reduce the stresses on your foot and your heel in particular, If you start to get heel pain, doing the above things may enable the natural healing process to get underway and the pain to improve.

Treating Mortons Neuroma

Overview

intermetatarsal neuromaA Morton's neuroma usually develops between the third and fourth toes. Less commonly, it develops between the second and third toes. Other locations are rare. It also is rare for a Morton's neuroma to develop in both feet at the same time. The condition is much more common in women than men, probably as a result of wearing high-heeled, narrow-toed shoes. This style of shoe tends to shift the bones of the feet into an abnormal position, which increases the risk that a neuroma will form. Being overweight also increases the risk of a Morton's neuroma.

Causes

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common causes comes from wearing shoes that have a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box and overload pressure onto the forefoot. An injury or trauma to the forefoot may also lead to a neuroma. People at a higher risk of developing a Neuroma include people with certain foot deformities, such as bunions or hammertoes. Certain foot types, such as flat feet (Pronation) More flexible feet, and woman after pregnancy.

Symptoms

Normally, there are no outward signs, such as a lump, because this is not really a tumor. Burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. Night pain is rare. There may also be numbness in the toes, or an unpleasant feeling in the toes. Runners may feel pain as they push off from the starting block. High-heeled shoes, which put the foot in a similar position to the push-off, can also aggravate the condition. Tight, narrow shoes also aggravate this condition by compressing the toe bones and pinching the nerve.

Diagnosis

Patients with classic Morton?s neuroma symptoms will have pain with pressure at the base of the involved toes (either between the 2nd and 3rd toes, or between the 3rd and 4th toes). In addition, squeezing the front of the foot together can exacerbate symptoms. As well, they may have numbness on the sides of one toe and the adjacent toe, as this corresponds with the distribution of the involved nerve.

Non Surgical Treatment

Common treatments involve wearing different shoes or using arch supports. Resting the foot, massaging the toes and using an ice pack may work for some people. A GP or a podiatrist (foot specialist) may also recommend anti-inflammatory painkillers or a course of steroid injections. Numbing injections, in which alcohol and a local anaesthetic are injected into the affected area of the foot, may also be effective. In extreme cases, when the condition does not respond to treatment, day case surgery may be needed.intermetatarsal neuroma

Surgical Treatment

Majority of publications including peer review journal articles, surgical technique description and textbooks promote surgical excision as a gold standard treatment. Surgical excision is described as the most definitive mode of treatment for symptomatic Morton?s neuroma with reported success rates varying between 79% and 93%. Various surgical techniques are described, essentially categorised as dorsal versus plantar incision approaches. Beyond this the commonest technical variation described as influencing the outcome of surgery involves burying and anchoring transacted nerve into soft tissue such as muscle.

Prevention

Wearing shoes that fit properly and that have plenty of room in the toe area may help prevent Morton's neuroma.
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For Leg Length Discrepancy Podiatrists Prefer Shoe Lifts

There are actually not one but two unique variations of leg length discrepancies, congenital and acquired. Congenital implies that you are born with it. One leg is structurally shorter compared to the other. Through developmental stages of aging, the brain picks up on the step pattern and recognizes some variance. The body usually adapts by tilting one shoulder to the "short" side. A difference of less than a quarter inch is not very abnormal, demand Shoe Lifts to compensate and typically does not have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lift

Leg length inequality goes largely undiscovered on a daily basis, however this problem is easily fixed, and can reduce numerous instances of lumbar pain.

Treatment for leg length inequality commonly involves Shoe Lifts. They are affordable, ordinarily being less than twenty dollars, in comparison to a custom orthotic of $200 or maybe more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Mid back pain is the most common ailment afflicting people today. Around 80 million men and women suffer from back pain at some stage in their life. It is a problem which costs businesses vast amounts of money each year because of lost time and production. Innovative and superior treatment solutions are continually sought after in the hope of reducing the economical impact this issue causes.

Leg Length Discrepancy Shoe Lift

People from all corners of the world suffer the pain of foot ache due to leg length discrepancy. In a lot of these cases Shoe Lifts are usually of very useful. The lifts are capable of decreasing any discomfort in the feet. Shoe Lifts are recommended by countless certified orthopaedic orthopedists.

To be able to support the human body in a well-balanced fashion, feet have got a critical function to play. In spite of that, it is often the most overlooked area in the human body. Some people have flat-feet which means there may be unequal force placed on the feet. This will cause other areas of the body including knees, ankles and backs to be impacted too. Shoe Lifts guarantee that suitable posture and balance are restored.

Shoe Lifts For Leg Length Discrepancy

There are actually two different kinds of leg length discrepancies, congenital and acquired. Congenital implies you are born with it. One leg is structurally shorter in comparison to the other. Through developmental stages of aging, the human brain picks up on the walking pattern and recognizes some variation. Our bodies typically adapts by dipping one shoulder over to the "short" side. A difference of less than a quarter inch isn't very abnormal, doesn't need Shoe Lifts to compensate and commonly won't have a serious effect over a lifetime.

Shoe Lifts

Leg length inequality goes mainly undiagnosed on a daily basis, however this problem is very easily solved, and can eliminate quite a few instances of chronic back pain.

Treatment for leg length inequality commonly involves Shoe Lifts. They are very reasonably priced, often priced at less than twenty dollars, compared to a custom orthotic of $200 or maybe more. When the amount of leg length inequality begins to exceed half an inch, a whole sole lift is generally the better choice than a heel lift. This prevents the foot from being unnecessarily stressed in an abnormal position.

Back pain is the most widespread ailment afflicting people today. Over 80 million people have problems with back pain at some stage in their life. It's a problem that costs employers millions each year as a result of lost time and production. Fresh and improved treatment methods are continually sought after in the hope of minimizing the economical impact this issue causes.

Shoe Lifts

People from all corners of the world experience foot ache as a result of leg length discrepancy. In most of these situations Shoe Lifts might be of worthwhile. The lifts are capable of reducing any pain and discomfort in the feet. Shoe Lifts are recommended by countless specialist orthopaedic practitioners".

So that they can support the human body in a nicely balanced manner, your feet have got a significant role to play. Irrespective of that, it is often the most overlooked zone of the human body. Some people have flat-feet meaning there is unequal force placed on the feet. This will cause other areas of the body such as knees, ankles and backs to be affected too. Shoe Lifts guarantee that proper posture and balance are restored.
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What Are The Signs And Symptoms Of Posterior Calcaneal Spur

Posterior Calcaneal Spur

Overview

Heel spur is a thorn-like, bony protrusion of the heel bone, which can become inflamed through irritation, thus causing pain. A heel spur forms at the tendon attachments on the muscles of the heel bone as a result of micro-injuries to the tissue caused by overstraining. As part of the healing process for these micro-injuries, the body stores bone material in the tendon attachments as a repair mechanism. Heel spurs can develop over a very long period without causing major complaints. However, irritation of the area surrounding the ossified tendon attachment can cause inflammations. Left untreated, the inflammations can in turn lead to increased ossification and thus to permanent degradation with a risk of chronic manifestation. The normal rolling procedure that we all use when walking is then frequently no longer possible.

Causes

You are more likely to develop plantar fasciitis and heel spurs if you are Active. Sports that place excessive stress on the heel bone and attached tissue, especially if you have tight calf muscles or a stiff ankle from a previous ankle sprain, which limits ankle movement eg. running, ballet dancing and aerobics. Overweight. Carrying around extra weight increases the strain and stress on your plantar fascia. Pregnant. The weight gain and swelling associated with pregnancy can cause ligaments to become more relaxed, which can lead to mechanical problems and inflammation. On your feet. Having a job that requires a lot of walking or standing on hard surfaces ie factory workers, teachers and waitresses. Flat Feet or High Foot Arches. Changes in the arch of your foot changes the shock absorption ability and can stretch and strain the plantar fascia, which then has to absorb the additional force. Middle-Aged or Older. With ageing the arch of your foot may begin to sag - putting extra stress on the plantar fascia. Wearing shoes with poor support. Weak Foot Arch Muscles. Muscle fatigue allows your plantar fascia to overstress and cause injury. Arthritis. Some types of arthritis can cause inflammation in the tendons in the bottom of your foot, which may lead to plantar fasciitis. Diabetes. Although doctors don't know why, plantar fasciitis occurs more often in people with diabetes.

Calcaneal Spur

Symptoms

Bone spurs may cause sudden, severe pain when putting weight on the affected foot. Individuals may try to walk on their toes or ball of the foot to avoid painful pressure on the heel spur. This compensation during walking or running can cause additional problems in the ankle, knee, hip, or back.

Diagnosis

Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.

Non Surgical Treatment

There are various ways to treat heel spurs. The first is to rest and apply ice to the afflicted area. Shoe inserts and night splints can also treat plantar fasciitis, and in turn, heels spurs. Unless you have stomach sensitivities, you may want to consider taking over-the-counter anti-inflammatory medication such as naprosyn to lower the swelling. A physical therapist can recommend gentle exercises and stretches to relax the tissue around the heel bone to relieve the tension. Even with these treatments, a stubborn heel spur may not go away. A physical therapist may decide to inject cortisone into the area to decrease inflammation, but that can cause other problems such as plantar fascial rupture and fat pad atrophy. Extracorporeal shock wave therapy is also an option, which uses energy pulses to apply microtrauma around the heel spur. Surgery is also an option but is not suggested unless the heel spur lasts more than a year. To prevent heel spurs from returning, shoe inserts can relieve the pressure on the plantar fascia. Also continue the recommended stretches and exercises.

Surgical Treatment

Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.