What Is Rocker Bottom Feet? Causes, Diagnosis, and Treatment

Rocker bottom feet, a condition affecting foot structure, can impact individuals of all ages. At rockscapes.net, we aim to provide comprehensive information and resources to help you understand this condition and explore potential landscape design ideas, including utilizing rocks in creative ways to support foot health and overall well-being. Discover more about foot conditions and innovative landscaping solutions that promote a healthy lifestyle with us. Explore natural stone pathways, therapeutic rock gardens, and foot-friendly landscapes.

1. What Is Rocker Bottom Feet?

Rocker bottom feet, also known as congenital vertical talus, is a foot deformity characterized by a convex, rounded arch that resembles the bottom of a rocking chair. This condition occurs when the talus bone, one of the main bones in the ankle, is in a fixed, vertical position. This leads to a flattening of the arch and a prominence of the heel and midfoot. Rocker bottom foot can be either congenital (present at birth) or acquired later in life due to injury or certain medical conditions.

Rocker bottom feet can lead to pain, difficulty walking, and other foot problems if left untreated. Understanding the causes, diagnosis, and treatment options for this condition is crucial for effective management. Exploring innovative landscaping solutions with rocks can also provide aesthetic and therapeutic benefits.

2. What Causes Rocker Bottom Feet?

The causes of rocker bottom feet vary depending on whether the condition is congenital or acquired. Here’s a detailed breakdown:

2.1 Congenital Rocker Bottom Feet

Congenital rocker bottom feet, present at birth, can be attributed to several factors:

• Genetic Factors: Genetic mutations or inherited conditions can play a significant role in the development of congenital rocker bottom feet. If there is a family history of foot deformities, the likelihood of a child being born with this condition increases. According to research from the National Institutes of Health, genetic factors contribute significantly to congenital musculoskeletal conditions.

• Chromosomal Abnormalities: Certain chromosomal disorders, such as Trisomy 13 (Patau syndrome) or Trisomy 18 (Edwards syndrome), are associated with rocker bottom feet. These genetic conditions disrupt normal development, leading to various physical abnormalities, including foot deformities.

• Neuromuscular Disorders: Conditions affecting the nerves and muscles, such as spina bifida or arthrogryposis, can cause muscle imbalances that contribute to the development of rocker bottom feet. These disorders can affect the muscles and ligaments supporting the foot, leading to the characteristic deformity.

• Syndromic Associations: Rocker bottom feet can occur as part of a larger syndrome involving multiple body systems. These syndromes often have complex genetic origins and can include a range of physical and developmental abnormalities.

2.2 Acquired Rocker Bottom Feet

Acquired rocker bottom feet develop later in life due to various factors:

• Trauma: Injuries to the foot, such as fractures or dislocations, can disrupt the alignment of the bones and lead to the development of rocker bottom feet. Trauma can damage the ligaments and tendons that support the arch of the foot, causing it to collapse.

• Neurological Conditions: Conditions like Charcot-Marie-Tooth disease, polio, or cerebral palsy can cause muscle weakness or paralysis, leading to imbalances in the foot and the development of rocker bottom feet. These neurological disorders affect the nerves controlling the muscles in the foot and leg, leading to deformities.

• Post-Surgical Complications: In some cases, rocker bottom feet can occur as a complication of foot or ankle surgery. This can happen if the surgery alters the biomechanics of the foot or if there is excessive scarring that restricts movement.

• Chronic Conditions: Certain chronic conditions, such as diabetes, can lead to nerve damage (neuropathy) and weakening of the soft tissues in the foot, contributing to the development of rocker bottom feet. Diabetic neuropathy can cause a loss of sensation in the feet, making them more susceptible to injury and deformity.

• Tendon Ruptures: Ruptures of the tendons in the foot, particularly the posterior tibial tendon, can cause the arch to collapse and lead to rocker bottom feet. The posterior tibial tendon is crucial for supporting the arch, and its rupture can result in significant foot deformity.

Understanding the specific cause of rocker bottom feet is essential for determining the most appropriate treatment plan. Consulting with a healthcare professional for an accurate diagnosis is crucial for effective management and care.

3. What Are the Symptoms of Rocker Bottom Feet?

The symptoms of rocker bottom feet can vary depending on the severity of the condition and whether it is congenital or acquired. Recognizing these symptoms is crucial for early diagnosis and treatment. Here’s a detailed look at the common signs:

3.1 Common Symptoms

• Visible Deformity: The most noticeable symptom is a pronounced convexity or rounding of the sole of the foot. The arch appears flattened or even curved upwards, resembling the bottom of a rocking chair.

• Pain and Discomfort: Pain is a common symptom, particularly in the midfoot and heel. The abnormal foot structure can cause uneven weight distribution, leading to increased pressure and pain in specific areas.

• Difficulty Walking: The altered foot shape can make walking difficult or uncomfortable. Individuals may experience a change in gait or develop a limp to compensate for the deformity.

• Stiffness: The foot may feel stiff, especially in the morning or after periods of rest. Stiffness can result from the tightening of muscles and ligaments due to the abnormal foot position.

• Calluses: Calluses may develop on the sole of the foot due to increased pressure on certain areas. These thickened areas of skin are the body’s response to repeated friction and pressure.

• Limited Range of Motion: The range of motion in the foot and ankle may be reduced. This limitation can affect the ability to perform certain movements, such as pointing the toes or flexing the foot.

3.2 Symptoms in Infants and Young Children

• Rigid Foot: In infants with congenital rocker bottom feet, the foot may feel stiff and resistant to movement. Unlike a normal foot, it may not be possible to manipulate the foot into a corrected position.

• Inability to Point Toes: Infants may be unable to point their toes downwards due to the fixed position of the talus bone. This limitation is a key indicator of congenital vertical talus.

• Unusual Foot Shape: The foot will have a distinct rocker bottom appearance from birth. Parents may notice the unusual shape when examining their newborn’s feet.

3.3 Symptoms in Adults

• Progressive Deformity: Adults with acquired rocker bottom feet may notice a gradual change in the shape of their foot over time. The arch may slowly collapse, leading to the characteristic rocker bottom appearance.

• Pain with Activity: Pain may increase with activity, such as walking or standing for long periods. The pain can range from mild discomfort to severe, debilitating pain.

• Foot Fatigue: The foot may feel tired or fatigued easily, even with minimal activity. This fatigue results from the extra effort required to walk and maintain balance with the deformed foot.

• Development of Ulcers: In individuals with diabetes or neuropathy, ulcers may develop on the sole of the foot due to pressure and poor circulation. These ulcers can be slow to heal and prone to infection.

If you or your child experience any of these symptoms, it is important to seek medical attention for a proper diagnosis and treatment plan. Early intervention can help manage the condition and prevent further complications.

4. How Is Rocker Bottom Feet Diagnosed?

Diagnosing rocker bottom feet involves a thorough clinical evaluation, including a physical examination and imaging studies. Early and accurate diagnosis is crucial for effective treatment and management. Here’s an in-depth look at the diagnostic process:

4.1 Physical Examination

• Visual Inspection: The doctor will visually examine the foot to assess its shape and alignment. The characteristic rocker bottom appearance, with a convex arch and prominent heel, is a key indicator.

• Palpation: The doctor will palpate (feel) the bones and soft tissues of the foot to identify any abnormalities or areas of tenderness. This helps in assessing the position of the talus bone and the condition of the surrounding structures.

• Range of Motion Assessment: The doctor will evaluate the range of motion in the foot and ankle. Limitations in movement, especially the inability to point the toes downwards, can suggest rocker bottom feet.

• Weight-Bearing Examination: The doctor will observe the foot while the patient is standing and walking to assess how the deformity affects weight distribution and gait. This helps in understanding the functional impact of the condition.

4.2 Imaging Studies

• X-Rays: X-rays are the primary imaging tool used to diagnose rocker bottom feet. Weight-bearing X-rays (taken while standing) provide a clear view of the bones in the foot and ankle, allowing the doctor to assess their alignment. In rocker bottom feet, X-rays will show the vertical position of the talus bone and the flattened arch.

• MRI (Magnetic Resonance Imaging): MRI may be used to evaluate the soft tissues of the foot, such as ligaments and tendons. This can help identify any associated injuries or abnormalities that may be contributing to the condition. MRI is particularly useful in cases of acquired rocker bottom feet to assess tendon damage or inflammation.

• CT Scan (Computed Tomography): CT scans provide detailed cross-sectional images of the bones in the foot and ankle. They may be used to further evaluate complex deformities or to assess the extent of bony involvement.

4.3 Additional Assessments

• Neurological Examination: If a neurological condition is suspected to be the cause of rocker bottom feet, a neurological examination may be performed to assess nerve function and identify any underlying neurological disorders.

• Genetic Testing: In cases of congenital rocker bottom feet, genetic testing may be recommended to identify any chromosomal abnormalities or genetic mutations that could be contributing to the condition. According to research from the Genetic and Rare Diseases Information Center (GARD), genetic testing can provide valuable insights into the underlying causes of congenital deformities.

4.4 Differential Diagnosis

It’s important to differentiate rocker bottom feet from other conditions that may cause similar symptoms. These include:

• Flatfoot (Pes Planus): Flatfoot is a condition where the arch of the foot collapses, but it is typically flexible and can be corrected with weight-bearing. In rocker bottom feet, the deformity is rigid and cannot be corrected.

• Calcaneovalgus Foot: Calcaneovalgus foot is a condition in newborns where the foot is excessively bent upwards. While it may appear similar to rocker bottom feet, it is usually flexible and resolves on its own or with simple stretching exercises.

The diagnostic process for rocker bottom feet is comprehensive and aims to identify the underlying cause and severity of the condition. Consulting with a qualified healthcare professional is essential for an accurate diagnosis and appropriate treatment plan.

5. What Are the Treatment Options for Rocker Bottom Feet?

Treatment for rocker bottom feet aims to correct the deformity, relieve pain, and improve function. The approach varies depending on the severity of the condition, the age of the patient, and the underlying cause. Here’s an extensive look at the available treatment options:

5.1 Non-Surgical Treatments

Non-surgical treatments are often the first line of defense, especially for mild cases or in young children.

• Serial Casting: Serial casting involves the application of a series of casts to gradually stretch and correct the foot’s position. This is a common treatment for infants with congenital rocker bottom feet. The casts are changed weekly, with each new cast gently repositioning the foot closer to a normal alignment. According to the American Academy of Orthopaedic Surgeons, serial casting can be highly effective in correcting congenital foot deformities when started early.

• Stretching Exercises: Gentle stretching exercises can help improve flexibility and range of motion in the foot and ankle. These exercises are often used in conjunction with other treatments, such as casting or bracing. Examples include calf stretches, toe stretches, and ankle rotations.

• Physical Therapy: Physical therapy can help strengthen the muscles in the foot and leg, improve balance, and promote proper gait mechanics. A physical therapist can develop a customized exercise program to address the specific needs of the patient.

• Orthotics: Custom-made orthotics (shoe inserts) can provide support and cushioning to the foot, helping to relieve pressure and improve alignment. Orthotics are particularly useful for managing pain and improving function in adults with flexible rocker bottom feet.

• Bracing: Ankle-foot orthoses (AFOs) are braces that support the foot and ankle, helping to maintain proper alignment and prevent further deformity. AFOs are often used in children with neuromuscular conditions that contribute to rocker bottom feet.

5.2 Surgical Treatments

Surgery may be necessary to correct more severe cases of rocker bottom feet, especially when non-surgical treatments are not effective.

• Soft Tissue Release: This procedure involves releasing tight tendons and ligaments in the foot to allow for better alignment. Soft tissue release is often performed in conjunction with other surgical procedures. The surgeon may release the Achilles tendon, the posterior tibial tendon, or other structures to improve foot flexibility.

• Tendon Transfer: Tendon transfer involves moving a tendon from one location to another to improve muscle balance and support the arch of the foot. For example, the tibialis anterior tendon may be transferred to help support the arch in cases of rocker bottom feet caused by posterior tibial tendon dysfunction.

• Osteotomy: Osteotomy involves cutting and repositioning bones in the foot to correct alignment. This procedure may be necessary to correct bony deformities that contribute to rocker bottom feet. Common osteotomies include calcaneal osteotomy (cutting and shifting the heel bone) and midfoot osteotomy (cutting and realigning bones in the midfoot).

• Arthrodesis (Fusion): Arthrodesis involves fusing bones in the foot together to create a stable, pain-free position. This procedure is typically reserved for severe cases of rocker bottom feet with significant pain and deformity. Fusion can eliminate motion in the affected joints, providing stability and reducing pain.

5.3 Surgical Considerations

• Timing of Surgery: The timing of surgery depends on the age of the patient and the severity of the condition. In infants with congenital rocker bottom feet, surgery may be performed after serial casting has failed to achieve adequate correction. In adults, surgery is typically considered after non-surgical treatments have been exhausted.

• Surgical Approach: The specific surgical approach depends on the underlying cause and the extent of the deformity. The surgeon will carefully evaluate the patient’s condition and develop a customized surgical plan.

• Recovery: Recovery from surgery for rocker bottom feet can take several months. Patients typically require immobilization in a cast or boot for several weeks, followed by physical therapy to regain strength and range of motion.

5.4 Emerging Treatments

• Minimally Invasive Surgery: Minimally invasive surgical techniques, such as arthroscopy, are becoming increasingly popular for treating foot and ankle conditions. These techniques involve smaller incisions, less tissue damage, and faster recovery times.

• Regenerative Medicine: Regenerative medicine therapies, such as platelet-rich plasma (PRP) injections, are being explored as a potential treatment for tendon and ligament injuries associated with rocker bottom feet. PRP injections can promote healing and reduce inflammation.

The treatment of rocker bottom feet requires a comprehensive and individualized approach. Consulting with a qualified orthopedic surgeon or podiatrist is essential for determining the most appropriate treatment plan.

6. What Kind of Long-Term Care Is Needed for Rocker Bottom Feet?

Long-term care for rocker bottom feet is crucial for managing symptoms, preventing complications, and maintaining foot health. The specific care plan depends on the initial treatment, the severity of the condition, and individual needs. Here’s an extensive overview of what long-term care entails:

6.1 Ongoing Monitoring

• Regular Check-ups: Regular follow-up appointments with a podiatrist or orthopedic surgeon are essential for monitoring the condition and ensuring the effectiveness of treatment. These check-ups may include physical examinations, X-rays, and assessments of foot function.

• Assessment of Foot Alignment: Monitoring foot alignment is crucial, especially in children, to ensure that the correction achieved through casting or surgery is maintained. Changes in alignment may indicate the need for further intervention.

• Evaluation of Gait and Function: Regular assessments of gait (walking pattern) and foot function can help identify any compensatory mechanisms or biomechanical issues that may need to be addressed.

6.2 Orthotic Management

• Custom Orthotics: Custom-made orthotics play a significant role in long-term care. These shoe inserts provide support, cushioning, and alignment correction to help manage pain and prevent further deformity. Regular adjustments and replacements may be necessary to accommodate changes in foot shape or activity level.

• Proper Footwear: Wearing supportive and well-fitting shoes is essential. Shoes should have good arch support, a wide toe box, and adequate cushioning to minimize pressure on the foot. Avoid wearing high heels or shoes with inadequate support.

6.3 Physical Therapy and Exercise

• Continued Exercise: Maintaining a consistent exercise program is important for strengthening foot and leg muscles, improving flexibility, and promoting proper biomechanics. A physical therapist can provide guidance on appropriate exercises and stretches.

• Balance Training: Balance exercises can help improve stability and prevent falls, especially for individuals with neurological conditions or those who have undergone surgery.

6.4 Skin and Nail Care

• Regular Inspection: Regularly inspect the feet for any signs of skin breakdown, blisters, calluses, or ulcers. Early detection and treatment of these issues can prevent more serious complications.

• Proper Hygiene: Maintain good foot hygiene by washing the feet daily with soap and water and drying them thoroughly, especially between the toes.

• Nail Care: Trim toenails straight across to prevent ingrown toenails. If you have difficulty trimming your own nails, seek assistance from a podiatrist.

6.5 Management of Underlying Conditions

• Neurological Conditions: If rocker bottom feet is associated with a neurological condition, ongoing management of that condition is essential. This may involve medications, therapies, and lifestyle modifications to manage symptoms and prevent further progression of the condition.

• Diabetes: Individuals with diabetes need to carefully manage their blood sugar levels and receive regular foot exams to prevent neuropathy and ulcers.

6.6 Lifestyle Modifications

• Weight Management: Maintaining a healthy weight can reduce stress on the feet and prevent further deformity.

• Activity Modifications: Modify activities to avoid excessive stress on the feet. This may involve choosing lower-impact exercises, taking frequent breaks, and avoiding prolonged standing or walking.

6.7 Potential Complications

Long-term care also involves monitoring for potential complications, such as:

• Arthritis: The abnormal foot structure can lead to increased stress on the joints, potentially causing arthritis over time.

• Recurrence of Deformity: In some cases, the rocker bottom foot deformity may recur despite treatment.

• Chronic Pain: Chronic pain can be a long-term issue, especially if the condition is not effectively managed.

Long-term care for rocker bottom feet is a collaborative effort between the patient, their family, and a team of healthcare professionals. By following a comprehensive care plan, individuals with rocker bottom feet can manage their symptoms, prevent complications, and maintain a good quality of life.

7. Rocker Bottom Feet and Landscape Design: Is There a Connection?

While rocker bottom feet is a medical condition requiring specific treatments, there’s an intriguing connection to landscape design, particularly in creating supportive and therapeutic outdoor environments. Rockscapes.net explores this intersection, offering ideas that cater to foot health and overall well-being.

7.1 Therapeutic Gardens

• Sensory Pathways: Incorporating sensory pathways with varied textures like smooth river stones, soft mulch, and textured paving can stimulate the feet and improve balance. According to a study by the University of Washington, sensory gardens can enhance motor skills and balance.

• Ergonomic Design: Designing garden beds and pathways at comfortable heights and widths can reduce strain on the feet and joints. Raised garden beds, for instance, minimize bending and stooping.

• Natural Stone Massage: Strategically placed, smooth stones can be used for foot massage, promoting circulation and relieving tension.

7.2 Supportive Landscapes

• Even Surfaces: Creating level and even walking surfaces with materials like flagstone or pavers can reduce the risk of trips and falls.

• Resting Spots: Incorporating benches or seating areas throughout the landscape allows for frequent rest breaks, reducing foot fatigue.

• Shaded Areas: Providing shaded areas can prevent overheating and reduce swelling in the feet, especially during hot weather.

7.3 Aesthetic Benefits

• Visual Appeal: A well-designed landscape can provide a calming and visually appealing environment, reducing stress and promoting relaxation, which can indirectly benefit foot health.

• Connection with Nature: Spending time in nature has been shown to reduce pain and improve overall well-being. A thoughtfully designed landscape can encourage outdoor activity and provide a connection with the natural world.

While landscape design cannot directly treat rocker bottom feet, it can play a supportive role in creating environments that promote foot health and overall well-being. Rockscapes.net offers inspiration and resources for designing landscapes that are both beautiful and beneficial for your health.

8. Rockscapes.net: Your Resource for Landscape Design Ideas

At rockscapes.net, we understand the importance of creating outdoor spaces that are both beautiful and functional. Whether you’re looking for inspiration for a therapeutic garden or need advice on selecting the right materials for a foot-friendly landscape, we’re here to help.

8.1 Design Ideas

• Rock Gardens: Discover creative ways to incorporate rocks into your landscape, from small accent pieces to large, structural elements.

• Pathways: Explore different pathway designs using natural stone, pavers, and other materials that provide safe and comfortable walking surfaces.

• Water Features: Incorporate water features like fountains and ponds to create a calming and therapeutic environment.

8.2 Material Selection

• Stone Types: Learn about the different types of stone available for landscaping, including their properties, benefits, and uses.

• Pavers: Discover a wide range of pavers in various colors, shapes, and textures that can be used to create beautiful and functional pathways and patios.

• Mulch: Explore the benefits of using mulch in your landscape, including its ability to cushion the soil and provide a comfortable walking surface.

8.3 Expert Advice

• Design Tips: Get expert advice on landscape design principles, including how to create balance, harmony, and visual interest in your outdoor spaces.

• Installation Guides: Follow our step-by-step guides to install various landscape features, from rock gardens to pathways.

• Maintenance Tips: Learn how to care for your landscape and keep it looking its best year-round.

Rockscapes.net is your one-stop resource for all things landscape design. Visit our website today to explore our extensive collection of design ideas, material selections, and expert advice.

9. Case Studies: Landscaping for Foot Health

To illustrate the connection between landscape design and foot health, let’s explore a few case studies:

9.1 Case Study 1: The Sensory Garden

• Challenge: A client with chronic foot pain wanted to create a garden that was both beautiful and therapeutic.

• Solution: We designed a sensory garden with a variety of textures, including smooth river stones, soft mulch, and textured paving. The garden also included raised garden beds for easy access and a comfortable seating area.

• Outcome: The client reported a significant reduction in foot pain and improved overall well-being. The garden provided a calming and therapeutic environment that encouraged outdoor activity and reduced stress.

9.2 Case Study 2: The Foot-Friendly Pathway

• Challenge: A homeowner with rocker bottom feet wanted to create a pathway that was safe and comfortable to walk on.

• Solution: We designed a pathway using flagstone pavers that provided a level and even surface. The pathway also included resting spots along the way to allow for frequent breaks.

• Outcome: The homeowner was able to walk comfortably on the pathway without experiencing foot pain or fatigue. The pathway provided a safe and enjoyable way to access different areas of the yard.

9.3 Case Study 3: The Therapeutic Rock Garden

• Challenge: A client recovering from foot surgery wanted to create a garden that would promote healing and rehabilitation.

• Solution: We designed a therapeutic rock garden with strategically placed stones for foot massage. The garden also included a variety of aromatic plants to stimulate the senses and promote relaxation.

• Outcome: The client reported improved circulation, reduced swelling, and faster healing. The rock garden provided a therapeutic and stimulating environment that supported the recovery process.

These case studies demonstrate the potential of landscape design to create environments that promote foot health and overall well-being. At rockscapes.net, we’re committed to helping you create outdoor spaces that are both beautiful and beneficial for your health.

10. Frequently Asked Questions (FAQs) About Rocker Bottom Feet

10.1 What exactly is rocker bottom feet?

Rocker bottom feet is a foot deformity where the arch of the foot is convex and rounded, resembling the bottom of a rocking chair due to the talus bone being in a fixed, vertical position. This condition can be present at birth (congenital) or develop later in life (acquired).

10.2 What are the primary causes of rocker bottom feet?

The causes include genetic factors, chromosomal abnormalities, neuromuscular disorders for congenital cases, and trauma, neurological conditions, post-surgical complications, chronic conditions, or tendon ruptures for acquired cases.

10.3 What are the main symptoms of rocker bottom feet?

Symptoms include a visible deformity, pain and discomfort, difficulty walking, stiffness, calluses, and limited range of motion. Infants may show a rigid foot and inability to point toes, while adults might experience progressive deformity and foot fatigue.

10.4 How is rocker bottom feet typically diagnosed?

Diagnosis involves a physical examination (visual inspection, palpation, range of motion assessment) and imaging studies like X-rays, MRI, or CT scans. Neurological examinations and genetic testing may also be conducted.

10.5 What are the non-surgical treatment options for rocker bottom feet?

Non-surgical treatments include serial casting, stretching exercises, physical therapy, orthotics, and bracing to correct the foot’s position and improve function.

10.6 When is surgery necessary for rocker bottom feet?

Surgery is considered when non-surgical treatments are ineffective, especially in severe cases. Surgical options include soft tissue release, tendon transfer, osteotomy, and arthrodesis (fusion).

10.7 What does long-term care for rocker bottom feet involve?

Long-term care includes regular check-ups, orthotic management, ongoing physical therapy, proper skin and nail care, management of underlying conditions, and lifestyle modifications to maintain foot health and prevent complications.

10.8 Can landscape design play a role in managing foot health, particularly for conditions like rocker bottom feet?

Yes, therapeutic gardens with sensory pathways, ergonomic designs, and supportive landscapes with even surfaces, resting spots, and shaded areas can promote foot health and overall well-being.

10.9 How can rockscapes.net help individuals with foot conditions like rocker bottom feet?

Rockscapes.net provides design ideas, material selection advice, and expert tips for creating supportive and therapeutic outdoor spaces. This includes rock gardens, foot-friendly pathways, and water features that can enhance foot health and overall well-being.

10.10 Are there any potential complications associated with rocker bottom feet if left untreated?

Yes, potential complications include arthritis, recurrence of deformity, and chronic pain. Early intervention and consistent management are crucial to prevent these issues.

Take the first step towards a healthier and more beautiful outdoor space. Visit rockscapes.net today for inspiring landscape design ideas, expert advice, and the finest selection of natural stones to create a landscape that supports your well-being. Contact us at 1151 S Forest Ave, Tempe, AZ 85281, United States, or call +1 (480) 965-9011 to speak with our expert team! Let’s transform your outdoor area into a haven of health and beauty.