25% of all musculoskeletal injuries are ankle sprains! What does spraining the ankle actually mean? The ankle joint is made up of three bones: the tibia, fibula and talus. These bones are held into proper position by a number of ligaments. The soft tissues surrounding the joint help stabilize the bones so they do not move too much in the wrong directions. Sprains usually occur during athletic activities but sometimes we step down or trip on a rug and put abnormal pressures on our ankle. Most often, a sprain occurs when the foot gets tilted inward or inverted. These abnormal forces causes stretching or tears to the ligaments that stabilize the joint.
The injured ligaments will lead to swelling, inflammation, and pain. If the injury is severe, there may be a fracture present. It is standard for doctors to order x-rays and do multiple different maneuvers to the foot and ankle to asses which ligaments are damaged and if any of the bones are broken. When no bones are involved, rest, ice, compression, elevation, and anti-inflammatory medication usually does the trick. When a fracture occurs there may be need for surgical intervention.
Many people recover from ankle sprains with no problems, but about 10% of ankle sprains do not improve with traditional therapy. In these patients, the ankle sprain was only part of the problem. Below the ankle is another joint between the talus and the calcaneus called the subtalar joint. Thus the talus bone is connected to both the ankle and the subtalar joint. You can imagine that if abnormal forces are put on the talus there will sometimes be damage to the ankle joint and the subtalar joint. Just as ligaments are torn or damaged at the ankle joint, ligaments can be damaged at the subtalar joint.
Unfortunately, it is nearly impossible to tell the difference between ankle instability and subtalar joint instability by physical evaluation. To evaluate the damage, radiographs have to be carefully evaluated and some non-traditional evaluations should be utilized. Placing the foot in specific forced positions is necessary to open up the joint spaces to assess the damage. These can be very painful and a local anesthetic may be necessary in order to complete the exam. Ultrasound has shown to be a great way to evaluate injuries, but not all medical care centers have this modality available. If this injury is caught early , the treatment is mostly non-surgical. Different immobilization devices and physical therapy can usually strengthen the ligaments. Occasionally the injury will become a chronic problem that requires surgery.
Since this injury is hard to assess and difficult to differentiate from ankle joint injuries, your doctor may have a difficult time recognizing the issue. It is important to communicate your symptoms and pain as thorough as possible. Knowing how the injury occurred and the position your foot was in when the injury occurred can be very useful information for your doctor to determine what ligaments were injured. If you had an ankle sprain that doesn’t seem to be getting better, it may be an unstable subtalar joint that is the root of your problems.
Wednesday, October 28, 2009
Wednesday, October 14, 2009
Here a Cankle, There a Cankle, Everywhere a Cankle Ankle!
We’ve all heard the term “cankle” but do we really know what it means? Media harps on Hillary Clinton’s cankles and other famous celebrities such as Kelly Clarkson and Katherine Hepburn. Cankle is a non-medical slang word to describe the absence of a defined ankle. The calf seems to extend strait down into the foot. As if the word did not have enough body parts to over criticize, we have not moved on to obsess over the size and appearance of our ankles!
A cankle a fully functional ankle and the so called “deformity” has no medical relevance other than self-esteem issues. The cause of cankles is merely due to a focal increase in adipose tissue or fat. It is thus largely associated with overweight individuals, but it is also widely seen in those who are physically fit. There is always that one part of your body that is really hard slim down. While some focus on the abs, thighs, or arms, some athletic individuals have discovered their cankles to be the problems area when trying to slim down.
Did my mom give me cankles? There does seem to be a family predisposition for the cankle syndrome. Just as some families have big noses or wide ears, some people have the genes for fat ankles. There is no medical proof that supports these claims but ask any cankle syndrome survivor and they can tell you their heart filled story on how cankles has stricken their family to wearing long wide-legged pants.
With the recent cankle phenomenon sweeping the nation, gyms and plastic surgeon have developed workouts and treatments to maximize your ankle appearance. The trick with you working out your cankle is to burn fat and thus a high cardio regimen is essential in the work out plan. In addition, defining your leg muscle will also decrease the appearance of the large ankle. Many people admit that the gym does not bring them close to their wanted appearance and have thus taken the road of liposuction.
Podiatrists, surgeons of the foot and ankle, do not recognize cankle as a medical term but take an increase of ankle size as a very serious matter. If your ankles seem to increase in size throughout the day or you feel as though your lower leg is swelling, this may be a sign of a more serious condition. Cardiovascular, and lymphatic diseases can cause increase swelling in the ankles. Trauma or injuries to the ligaments of the joint can also cause local changes to the ankle. The ankle is a very influential joint in ambulation and pain in this area should never be ignored. If you are worried your ankle size is secondary to a more serious issue, seeking medical attention is not unwarranted.
Got cankles? Be reassured that there are millions across the world battling the fatty ankle. Though you may feel like the only girl in the world who is self conscious about her ankle size, you are among many who avoid short skirts, high heels, and skinny jeans. You may want to discuss possible causes of edema in the lower extremities with your doctor if your ankle size has been increasing over time.
A cankle a fully functional ankle and the so called “deformity” has no medical relevance other than self-esteem issues. The cause of cankles is merely due to a focal increase in adipose tissue or fat. It is thus largely associated with overweight individuals, but it is also widely seen in those who are physically fit. There is always that one part of your body that is really hard slim down. While some focus on the abs, thighs, or arms, some athletic individuals have discovered their cankles to be the problems area when trying to slim down.
Did my mom give me cankles? There does seem to be a family predisposition for the cankle syndrome. Just as some families have big noses or wide ears, some people have the genes for fat ankles. There is no medical proof that supports these claims but ask any cankle syndrome survivor and they can tell you their heart filled story on how cankles has stricken their family to wearing long wide-legged pants.
With the recent cankle phenomenon sweeping the nation, gyms and plastic surgeon have developed workouts and treatments to maximize your ankle appearance. The trick with you working out your cankle is to burn fat and thus a high cardio regimen is essential in the work out plan. In addition, defining your leg muscle will also decrease the appearance of the large ankle. Many people admit that the gym does not bring them close to their wanted appearance and have thus taken the road of liposuction.
Podiatrists, surgeons of the foot and ankle, do not recognize cankle as a medical term but take an increase of ankle size as a very serious matter. If your ankles seem to increase in size throughout the day or you feel as though your lower leg is swelling, this may be a sign of a more serious condition. Cardiovascular, and lymphatic diseases can cause increase swelling in the ankles. Trauma or injuries to the ligaments of the joint can also cause local changes to the ankle. The ankle is a very influential joint in ambulation and pain in this area should never be ignored. If you are worried your ankle size is secondary to a more serious issue, seeking medical attention is not unwarranted.
Got cankles? Be reassured that there are millions across the world battling the fatty ankle. Though you may feel like the only girl in the world who is self conscious about her ankle size, you are among many who avoid short skirts, high heels, and skinny jeans. You may want to discuss possible causes of edema in the lower extremities with your doctor if your ankle size has been increasing over time.
Sunday, August 16, 2009
Summer Bumming Hard on Your Feet!
Though it is hard to admit in a heat wave, summer is coming to a halt. It won’t be long until the kids are at school, and pumpkin picking, football games, and turkey dinners will be on the agenda! Thankfully there is still a good month of sandals and barbeque left! But, are your feet still up for the summer challenge or has summer gotten the best of them already. You may need to pay special attention to your feet on the last stretch of fun in the sun!
Complaint: My feet are dry and cracked. My feet are itchy, red, and sometimes have blisters.
Cause: Believe it or not, both of these complaints will often root from the same problem! Warm, dark, humid environments create a delightful home for fungus! Dry feet are a sign of sweaty feet and sweaty feet are a precursor to fungal feet.
Prevention: The number one thing to avoid is going barefoot in public. Wear sandals around the pool, in the locker room, and in public showers. When possible wear sandals over shoes to allow your feet to breath. Wear dry shoes, change socks often and inspect your feet on a regular basis.
Complaint: I have calluses or corns making my feet ugly. I have thick skin on my foot and it hurts.
Cause: The summer shoe selection can be referred to as the podiatrist’s best resource for job security. Too often men and women put their feet in shoes or sandals that are nowhere near the shape of their foot. This causes the foot to rub against the shoe. Friction causes a buildup of skin that can become painful or unsightly.
Prevention: Wearing wide toed shoes or just properly fitting shoes can help with this problem! Over the counter creams and lotions can help soften the skin, but be careful with corn pads. They often make the problem worse over time. If the callus or corn is continuously painful see a podiatric physician to properly remove the ailment.
Complaint: I have warts. I have a hard, flat, bump on the bottom of my foot.
Cause: Warts are caused by the human papilloma virus. It only takes a small cut or opening in the skin to allow the virus into your skin. These opening are often unseen by the naked eye. Some people are more susceptible to getting warts and need to take extra precautions to avoid the virus.
Preventions: Avoid walking around barefoot, even in your own home! If your family members have warts, you can all get warts! Avoid at home or over the counter treatments. Picking at the wart or improperly removing them can make the wart spread and what started out as one wart can quickly multiply creating a mosaic of many warts.
So as summer comes to an end make sure you keep your feet healthy and safe. If you have any
questions or concerns about your foot health or other summer threats to your feet, seek medical help
from a foot and ankle specialist also referred as a podiatrist. They are trained to treat all foot ailments of children and adults.
Complaint: My feet are dry and cracked. My feet are itchy, red, and sometimes have blisters.
Cause: Believe it or not, both of these complaints will often root from the same problem! Warm, dark, humid environments create a delightful home for fungus! Dry feet are a sign of sweaty feet and sweaty feet are a precursor to fungal feet.
Prevention: The number one thing to avoid is going barefoot in public. Wear sandals around the pool, in the locker room, and in public showers. When possible wear sandals over shoes to allow your feet to breath. Wear dry shoes, change socks often and inspect your feet on a regular basis.
Complaint: I have calluses or corns making my feet ugly. I have thick skin on my foot and it hurts.
Cause: The summer shoe selection can be referred to as the podiatrist’s best resource for job security. Too often men and women put their feet in shoes or sandals that are nowhere near the shape of their foot. This causes the foot to rub against the shoe. Friction causes a buildup of skin that can become painful or unsightly.
Prevention: Wearing wide toed shoes or just properly fitting shoes can help with this problem! Over the counter creams and lotions can help soften the skin, but be careful with corn pads. They often make the problem worse over time. If the callus or corn is continuously painful see a podiatric physician to properly remove the ailment.
Complaint: I have warts. I have a hard, flat, bump on the bottom of my foot.
Cause: Warts are caused by the human papilloma virus. It only takes a small cut or opening in the skin to allow the virus into your skin. These opening are often unseen by the naked eye. Some people are more susceptible to getting warts and need to take extra precautions to avoid the virus.
Preventions: Avoid walking around barefoot, even in your own home! If your family members have warts, you can all get warts! Avoid at home or over the counter treatments. Picking at the wart or improperly removing them can make the wart spread and what started out as one wart can quickly multiply creating a mosaic of many warts.
So as summer comes to an end make sure you keep your feet healthy and safe. If you have any
questions or concerns about your foot health or other summer threats to your feet, seek medical help
from a foot and ankle specialist also referred as a podiatrist. They are trained to treat all foot ailments of children and adults.
Sending Your Child's Feet to College
Some of you have been dreading this day since the day he/she was born. Some of you have been waiting anxiously since he/she became a teenager. Your bundle of joy is all grown up and on their way to college. Parents across the world are preparing their lectures on sex, drugs, and alcohol. There is so much they have to learn on their first adventure with independence. What parents often overlook at this vulnerable time in their child’s life is the “foot talk.”
Hear me out before you think I’m crazy. I don’t want to undermine the importance about talking to your child about sex, drugs, and alcohol, but there are other important conversations to have. Young adults can be afflicted with a magnitude of foot disorders that can be very embarrassing and socially limiting.
Sweaty, Smelly Feet!
How on earth will your son your daughters make any friends if they have the smelly feet dorm room! If you think your child’s feet stink, imagine confining all of their dirty socks and shoes and their feet in a small poorly ventilated, overheated dorm room. It may not seem like a big deal now, but it is a major problem that can lead to athletes foot and toenail fungus. In your 20s with a fungus farm growing on your feet… good luck meeting your life partner!
Bare feet among fungus, bacteria, and who knows what!
We have all heard the importance about wearing sandals in public showers, but what about public areas in general. How often do the hallways of the dorm or your child’s dorm room floors actually get cleaned? It is college, so we can only imagine what is on the carpet. All you need is a tiny cut or skin opening to get infections. Plantar warts can be very common among college students because the virus can easily transfer from person to person when everyone is walking around barefoot in their new home called the dorms!
Ladies are walking home barefoot because their feet hurt!
If you’re a woman, you know the pain induced by wearing cute shoes. After spending all night in those high heels at a party (I mean “library”), the girls’ kick off their heels to relieve their feet on the walk home. What’s on the sidewalks in a college town? The most dangerous is glass! I recently went to surgery for a young lady who had a piece of glass lodged in her foot for 3 months! This lucky girl avoided a severe infection, but that is not always the case.
Pedicure day with the girlfriends!
Whether your daughter is familiar with getting pedicures or not, the girls will hang out and do girly things like pedicures. Don’t forget your college driven child is broke, thus they are always looking for a good deal whether it is penny beer pitchers or affordable pedicures. A pedicure can be disastrous if the tools are not cleaned properly, the spa chairs are not flushed properly, and the pedicurist does not use proper precautions to not cross contaminate. Remember, people with foot fungus or bacterial infections get pedicures too. Now I’m not saying the more expensive the pedicure the safer it is, but remind your child to ask about the cleaning techniques of the pedicure instruments.
So if you don’t have enough to worry about sending your child off to college, here some more things to add to your list. If your child has sweaty feet, see a podiatric physician before all possible friends are running away from the odor. Remind your children to watch their feet and take note of any changes. Don’t wait 3 months before you seek medical help for glass lodged into the foot, toenails changing color, or flaky, itchy athlete’s foot.
Hear me out before you think I’m crazy. I don’t want to undermine the importance about talking to your child about sex, drugs, and alcohol, but there are other important conversations to have. Young adults can be afflicted with a magnitude of foot disorders that can be very embarrassing and socially limiting.
Sweaty, Smelly Feet!
How on earth will your son your daughters make any friends if they have the smelly feet dorm room! If you think your child’s feet stink, imagine confining all of their dirty socks and shoes and their feet in a small poorly ventilated, overheated dorm room. It may not seem like a big deal now, but it is a major problem that can lead to athletes foot and toenail fungus. In your 20s with a fungus farm growing on your feet… good luck meeting your life partner!
Bare feet among fungus, bacteria, and who knows what!
We have all heard the importance about wearing sandals in public showers, but what about public areas in general. How often do the hallways of the dorm or your child’s dorm room floors actually get cleaned? It is college, so we can only imagine what is on the carpet. All you need is a tiny cut or skin opening to get infections. Plantar warts can be very common among college students because the virus can easily transfer from person to person when everyone is walking around barefoot in their new home called the dorms!
Ladies are walking home barefoot because their feet hurt!
If you’re a woman, you know the pain induced by wearing cute shoes. After spending all night in those high heels at a party (I mean “library”), the girls’ kick off their heels to relieve their feet on the walk home. What’s on the sidewalks in a college town? The most dangerous is glass! I recently went to surgery for a young lady who had a piece of glass lodged in her foot for 3 months! This lucky girl avoided a severe infection, but that is not always the case.
Pedicure day with the girlfriends!
Whether your daughter is familiar with getting pedicures or not, the girls will hang out and do girly things like pedicures. Don’t forget your college driven child is broke, thus they are always looking for a good deal whether it is penny beer pitchers or affordable pedicures. A pedicure can be disastrous if the tools are not cleaned properly, the spa chairs are not flushed properly, and the pedicurist does not use proper precautions to not cross contaminate. Remember, people with foot fungus or bacterial infections get pedicures too. Now I’m not saying the more expensive the pedicure the safer it is, but remind your child to ask about the cleaning techniques of the pedicure instruments.
So if you don’t have enough to worry about sending your child off to college, here some more things to add to your list. If your child has sweaty feet, see a podiatric physician before all possible friends are running away from the odor. Remind your children to watch their feet and take note of any changes. Don’t wait 3 months before you seek medical help for glass lodged into the foot, toenails changing color, or flaky, itchy athlete’s foot.
Sunday, August 2, 2009
Why See a Foot Doctor?
It is interesting to me how many people ignore foot and ankle problems. My feet hurt. My toe looks funny. My foot doesn’t feel right. My ankle is sore. I can’t run because of foot pain. My ankle gives out. This should warrant one to suspect a problem but most turn a blind eye to their foot problems. When you have a tooth ache, you go to the dentist. When you can’t see well, you go to the eye doctor. When your child has a fever, you go to your family doctor. So, when you have foot and ankle pain, shouldn’t you see a foot and ankle doctor?
For whatever reason, people have become to believe that sore feet are a part of life. Instead of seeking medical help, we adjust our activities to avoid the pain. I can’t tell you how many people I have met that have halted their favorite hobbies because they thought they didn’t have the feet to do it anymore.
Sandy, a dear patient of mine once told me she was an avid runner in her youth, but after college she stopped running because her feet couldn’t “handle” it anymore. She never did anything about her foot pain except decreased her activities and wore “ugly shoes.” As a result of her new found sedentary lifestyle, she gained quite a bit of weight and is now suffering from type 2 diabetes. Her primary care doctor referred her to me to monitor her foot health, which now is in great jeopardy due to her diabetes. It breaks my heart that Sandy, not only gave up something she loved but also put her heath at risk because of treatable foot pain. Since Sandy’s first visit with me 1 year ago, we have eliminated her foot pain, greatly decreased her chance of diabetic foot complications, and Sandy has taken up more physical activities and lost almost 100Ib.
Just yesterday, I had a patient who recently returned from a family vacation in Walt Disney World. Jim was upset because after the first day his feet hurt so badly, he spent most of the time sitting on benches as the rest of his family toured the park. I hear similar stories all the time. He admitted to suffering from moderate heel pain prior to the trip, but had a desk job so he never noticed the pain except when he went golfing, a hobby he practically gave up because of his busy schedule. Thus, since he only rarely had foot pain, he didn’t think it was a big deal. The full day of walking through Disney World flared up his condition, and his heel pain became unbearable for the remainder of the trip. Once again this could have been prevented if he would have gone to a podiatric physician about his foot pain.
I told Jim, “If you have difficulty seeing while driving in the dark, you go to the eye doctor and get glasses even though you are not suffering from a problem all day long. If your feet hurt with activity, you should go to the foot doctor (podiatrist), and receive treatment even if your pain is not all day or every day.”
If you find yourself adjusting your daily activities or avoiding hobbies because of your feet, call your foot doctor today! No matter your age, your feet should not limit the way you live your life, but rather be walking you up and down every hill and through every garden life has to offer. Take care of your feet!
For whatever reason, people have become to believe that sore feet are a part of life. Instead of seeking medical help, we adjust our activities to avoid the pain. I can’t tell you how many people I have met that have halted their favorite hobbies because they thought they didn’t have the feet to do it anymore.
Sandy, a dear patient of mine once told me she was an avid runner in her youth, but after college she stopped running because her feet couldn’t “handle” it anymore. She never did anything about her foot pain except decreased her activities and wore “ugly shoes.” As a result of her new found sedentary lifestyle, she gained quite a bit of weight and is now suffering from type 2 diabetes. Her primary care doctor referred her to me to monitor her foot health, which now is in great jeopardy due to her diabetes. It breaks my heart that Sandy, not only gave up something she loved but also put her heath at risk because of treatable foot pain. Since Sandy’s first visit with me 1 year ago, we have eliminated her foot pain, greatly decreased her chance of diabetic foot complications, and Sandy has taken up more physical activities and lost almost 100Ib.
Just yesterday, I had a patient who recently returned from a family vacation in Walt Disney World. Jim was upset because after the first day his feet hurt so badly, he spent most of the time sitting on benches as the rest of his family toured the park. I hear similar stories all the time. He admitted to suffering from moderate heel pain prior to the trip, but had a desk job so he never noticed the pain except when he went golfing, a hobby he practically gave up because of his busy schedule. Thus, since he only rarely had foot pain, he didn’t think it was a big deal. The full day of walking through Disney World flared up his condition, and his heel pain became unbearable for the remainder of the trip. Once again this could have been prevented if he would have gone to a podiatric physician about his foot pain.
I told Jim, “If you have difficulty seeing while driving in the dark, you go to the eye doctor and get glasses even though you are not suffering from a problem all day long. If your feet hurt with activity, you should go to the foot doctor (podiatrist), and receive treatment even if your pain is not all day or every day.”
If you find yourself adjusting your daily activities or avoiding hobbies because of your feet, call your foot doctor today! No matter your age, your feet should not limit the way you live your life, but rather be walking you up and down every hill and through every garden life has to offer. Take care of your feet!
Saturday, August 1, 2009
Ingrown Nails Got You Hanging?
If you have an ingrown toenail, you can relate when I say the pain and discomfort is beyond aggravating. Trying to find comfortable shoes is sometime impossible. But what do you do about an ingrown toenail? Do you try to cut it out with a toenail clipper? Will it be there forever? Some people are scared to seek medical attention because they think they will have to get their nail removed. Though sometimes this is necessary, it is rare that it one will have to lose their entire nail.
An ingrown toenail is a nail that digs into the skin and cause pain, swelling, redness, and sometimes infections. It can be cause by genetics, trauma, or improper trimming. Stubbing your toe or dropping an object on your toe may result in an ingrown toenail. Many people cut their nails too short. This encourages the skin to surround the nail and the nail can then pinch the close confiding skin.
When you first notice the problem, there are some at home treatments to reduce the inflammation and pain. Soaking your foot in luke warm water with Epson salt may reduce some of the symptoms. Wearing wider shoes that decreases the pressure applied to the area will also help with the pain. It is highly discouraged to try to remove the ingrown portion of the nail yourself. Continuously cutting the nail inappropriately will worsen the condition. These areas are highly susceptible to infection. Thus at-home surgeries of the nail can be very dangerous. If you continuously feel discomfort from your toenail, it is recommended to see a foot and ankle doctor, also referred to as a podiatrist.
A podiatric physician can do a simple in office procedure to remove the offending nail border. The nail will continuously grow to be ingrown unless the matrix or the root of the nail is destroyed. When only the outside border is causing problems, the doctor can remove that portion of the nail and only kill the root of that area of the nail. Thus you will still have a nail but a small portion will be removed and will not grow back. Those concerned with cosmetics will be happy to know that the removal of the border of a nail often goes unnoticed by others when the condition is minor. If there is a serious infection present, the root of the nail will not be killed due to the reaction of the chemicals used with the infectious tissue. The nail boarder is removed and the injury is allowed to heal until the tissue is healthy to undergo chemical insult.
Though some need to undergo more invasive surgeries to remove the matrix, most have their problems solved by a simple 15 minute visit to the doctor. The most important thing to do is to keep your hands off your toenails. Do not try to pick at it or cut it because a small problem can become a big problem if you do not remove of it correctly.
An ingrown toenail is a nail that digs into the skin and cause pain, swelling, redness, and sometimes infections. It can be cause by genetics, trauma, or improper trimming. Stubbing your toe or dropping an object on your toe may result in an ingrown toenail. Many people cut their nails too short. This encourages the skin to surround the nail and the nail can then pinch the close confiding skin.
When you first notice the problem, there are some at home treatments to reduce the inflammation and pain. Soaking your foot in luke warm water with Epson salt may reduce some of the symptoms. Wearing wider shoes that decreases the pressure applied to the area will also help with the pain. It is highly discouraged to try to remove the ingrown portion of the nail yourself. Continuously cutting the nail inappropriately will worsen the condition. These areas are highly susceptible to infection. Thus at-home surgeries of the nail can be very dangerous. If you continuously feel discomfort from your toenail, it is recommended to see a foot and ankle doctor, also referred to as a podiatrist.
A podiatric physician can do a simple in office procedure to remove the offending nail border. The nail will continuously grow to be ingrown unless the matrix or the root of the nail is destroyed. When only the outside border is causing problems, the doctor can remove that portion of the nail and only kill the root of that area of the nail. Thus you will still have a nail but a small portion will be removed and will not grow back. Those concerned with cosmetics will be happy to know that the removal of the border of a nail often goes unnoticed by others when the condition is minor. If there is a serious infection present, the root of the nail will not be killed due to the reaction of the chemicals used with the infectious tissue. The nail boarder is removed and the injury is allowed to heal until the tissue is healthy to undergo chemical insult.
Though some need to undergo more invasive surgeries to remove the matrix, most have their problems solved by a simple 15 minute visit to the doctor. The most important thing to do is to keep your hands off your toenails. Do not try to pick at it or cut it because a small problem can become a big problem if you do not remove of it correctly.
Ingrown Nails Got You Hanging?
If you have an ingrown toenail, you can relate when I say the pain and discomfort is beyond aggravating. Trying to find comfortable shoes is sometimes impossible. But what do you do about an ingrown toenail? Do you try to cut it out with a toenail clipper? Will it be there forever? Some people are scared to seek medical attention because they think they will have to get their nail removed. Though sometimes this is necessary, it is rare that it one will have to lose their entire nail.
An ingrown toenail is a nail that digs into the skin and cause pain, swelling, redness, and sometimes infections. It can be cause by genetics, trauma, or improper trimming. Stubbing your toe or dropping an object on your toe may result in an ingrown toenail. Many people cut their nails too short. This encourages the skin to surround the nail and the nail can then pinch the close confiding skin.
When you first notice the problem, there are some at home treatments to reduce the inflammation and pain. Soaking your foot in luke warm water with Epson salt may reduce some of the symptoms. Wearing wider shoes that decreases the pressure applied to the area will also help with the pain. It is highly discouraged to try to remove the ingrown portion of the nail yourself. Continuously cutting the nail inappropriately will worsen the condition. These areas are highly susceptible to infection. Thus at-home surgeries of the nail can be very dangerous. If you continuously feel discomfort from your toenail, it is recommended to see a foot and ankle doctor, also referred to as a podiatrist.
A podiatric physician can do a simple in office procedure to remove the offending nail border. The nail will continuously grow to be ingrown unless the matrix or the root of the nail is destroyed. When only the outside border is causing problems, the doctor can remove that portion of the nail and only kill the root of that area of the nail. Thus you will still have a nail but a small portion will be removed and will not grow back. Those concerned with cosmetics will be happy to know that the removal of the border of a nail often goes unnoticed by others when the condition is minor. If there is a serious infection present, the root of the nail will not be killed due to the reaction of the chemicals used with the infectious tissue. The nail border is removed and the injury is allowed to heal until the tissue is healthy to undergo chemical insult.
Though some need to undergo more invasive surgeries to remove the matrix, most have their problems solved by a simple 15 minute visit to the doctor. The most important thing to do is to keep your hands off your toenails. Do not try to pick at it or cut it because a small problem can become a big problem if you do not remove of it correctly.
An ingrown toenail is a nail that digs into the skin and cause pain, swelling, redness, and sometimes infections. It can be cause by genetics, trauma, or improper trimming. Stubbing your toe or dropping an object on your toe may result in an ingrown toenail. Many people cut their nails too short. This encourages the skin to surround the nail and the nail can then pinch the close confiding skin.
When you first notice the problem, there are some at home treatments to reduce the inflammation and pain. Soaking your foot in luke warm water with Epson salt may reduce some of the symptoms. Wearing wider shoes that decreases the pressure applied to the area will also help with the pain. It is highly discouraged to try to remove the ingrown portion of the nail yourself. Continuously cutting the nail inappropriately will worsen the condition. These areas are highly susceptible to infection. Thus at-home surgeries of the nail can be very dangerous. If you continuously feel discomfort from your toenail, it is recommended to see a foot and ankle doctor, also referred to as a podiatrist.
A podiatric physician can do a simple in office procedure to remove the offending nail border. The nail will continuously grow to be ingrown unless the matrix or the root of the nail is destroyed. When only the outside border is causing problems, the doctor can remove that portion of the nail and only kill the root of that area of the nail. Thus you will still have a nail but a small portion will be removed and will not grow back. Those concerned with cosmetics will be happy to know that the removal of the border of a nail often goes unnoticed by others when the condition is minor. If there is a serious infection present, the root of the nail will not be killed due to the reaction of the chemicals used with the infectious tissue. The nail border is removed and the injury is allowed to heal until the tissue is healthy to undergo chemical insult.
Though some need to undergo more invasive surgeries to remove the matrix, most have their problems solved by a simple 15 minute visit to the doctor. The most important thing to do is to keep your hands off your toenails. Do not try to pick at it or cut it because a small problem can become a big problem if you do not remove of it correctly.
Why See a Foot Doctor?
It is interesting to me how many people ignore foot and ankle problems. My feet hurt. My toe looks funny. My foot doesn’t feel right. My ankle is sore. I can’t run because of foot pain. My ankle gives out. This should warrant one to suspect a problem but most turn a blind eye to their foot problems. When you have a tooth ache, you go to the dentist. When you can’t see well, you go to the eye doctor. When your child has a fever, you go to your family doctor. So, when you have foot and ankle pain, shouldn’t you see a foot and ankle doctor?
For whatever reason, people have become to believe that sore feet are a part of life. Instead of seeking medical help, we adjust our activities to avoid the pain. I can’t tell you how many people I have met that have halted their favorite hobbies because they thought they didn’t have the feet to do it anymore.
Sandy, a dear patient of mine once told me she was an avid runner in her youth, but after college she stopped running because her feet couldn’t “handle” it anymore. She never did anything about her foot pain except decreased her activities and wore “ugly shoes.” As a result of her new found sedentary lifestyle, she gained quite a bit of weight and is now suffering from type 2 diabetes. Her primary care doctor referred her to me to monitor her foot health, which now is in great jeopardy due to her diabetes. It breaks my heart that Sandy, not only gave up something she loved but also put her heath at risk because of treatable foot pain. Since Sandy’s first visit with me 1 year ago, we have eliminated her foot pain, greatly decreased her chance of diabetic foot complications, and Sandy has taken up more physical activities and lost almost 100Ib.
Just yesterday, I had a patient who recently returned from a family vacation in Walt Disney World. Jim was upset because after the first day his feet hurt so badly, he spent most of the time sitting on benches as the rest of his family toured the park. I hear similar stories all the time. He admitted to suffering from moderate heel pain prior to the trip, but had a desk job so he never noticed the pain except when he went golfing, a hobby he practically gave up because of his busy schedule. Thus, since he only rarely had foot pain, he didn’t think it was a big deal. The full day of walking through Disney World flared up his condition, and his heel pain became unbearable for the remainder of the trip. Once again this could have been prevented if he would have gone to a podiatric physician about his foot pain.
I told Jim, “If you have difficulty seeing while driving in the dark, you go to the eye doctor and get glasses even though you are not suffering from a problem all day long. If your feet hurt with activity, you should go to the foot doctor (podiatrist), and receive treatment even if your pain is not all day or every day.”
If you find yourself adjusting your daily activities or avoiding hobbies because of your feet, call your foot doctor today! No matter your age, your feet should not limit the way you live your life, but rather be walking you up and down every hill and through every garden life has to offer. Take care of your feet!
For whatever reason, people have become to believe that sore feet are a part of life. Instead of seeking medical help, we adjust our activities to avoid the pain. I can’t tell you how many people I have met that have halted their favorite hobbies because they thought they didn’t have the feet to do it anymore.
Sandy, a dear patient of mine once told me she was an avid runner in her youth, but after college she stopped running because her feet couldn’t “handle” it anymore. She never did anything about her foot pain except decreased her activities and wore “ugly shoes.” As a result of her new found sedentary lifestyle, she gained quite a bit of weight and is now suffering from type 2 diabetes. Her primary care doctor referred her to me to monitor her foot health, which now is in great jeopardy due to her diabetes. It breaks my heart that Sandy, not only gave up something she loved but also put her heath at risk because of treatable foot pain. Since Sandy’s first visit with me 1 year ago, we have eliminated her foot pain, greatly decreased her chance of diabetic foot complications, and Sandy has taken up more physical activities and lost almost 100Ib.
Just yesterday, I had a patient who recently returned from a family vacation in Walt Disney World. Jim was upset because after the first day his feet hurt so badly, he spent most of the time sitting on benches as the rest of his family toured the park. I hear similar stories all the time. He admitted to suffering from moderate heel pain prior to the trip, but had a desk job so he never noticed the pain except when he went golfing, a hobby he practically gave up because of his busy schedule. Thus, since he only rarely had foot pain, he didn’t think it was a big deal. The full day of walking through Disney World flared up his condition, and his heel pain became unbearable for the remainder of the trip. Once again this could have been prevented if he would have gone to a podiatric physician about his foot pain.
I told Jim, “If you have difficulty seeing while driving in the dark, you go to the eye doctor and get glasses even though you are not suffering from a problem all day long. If your feet hurt with activity, you should go to the foot doctor (podiatrist), and receive treatment even if your pain is not all day or every day.”
If you find yourself adjusting your daily activities or avoiding hobbies because of your feet, call your foot doctor today! No matter your age, your feet should not limit the way you live your life, but rather be walking you up and down every hill and through every garden life has to offer. Take care of your feet!
Back to School Shoe Shopping
If my kid doesn’t complain about sore feet, do I need to worry about what I put on his feet? Some children spend most of their days running around the yard barefoot all day and never complain about a thing until they step on a nail or thorn. Other children will wine all day about their feet hurting. So what do you need to be looking for when you are shopping for new shoes for the new school year?
My kid never complains!
Wow! Can we trade? Alright lets be serious all kids complain but not all kids complain about their feet. It is best to actively ask the child, “Do your feet hurt? Do you feel pain in your feet when you are out playing?” Some children ignore the pain because they are having so much fun. Think about how awesome it is to be on the soccer team or play in the park with your best buddies… You wouldn’t stop unless you had to. How many kids pee in their pants because they don’t want to stop playing?
There no special accommodation, devices, or exercises that are required for healthy foot living. There is a level of common sense that needs to come into play though… for some this is difficult. Kids shoes can be trendy, inappropriate, and can lead to pain.
Stay away from the following
· Pointy toes
· Platforms
· Flip flops
· Stilettos—Teenagers love to sacrifice comfort for style!
Standard Shoes for Back-to-School
· Good Athletic Shoes (light colors are preferred for the gym and will decrease sweating)
· A wide toe box for dress shoes
My Kid Does Complain about Their Feet!
It is not uncommon for children to have foot and ankle problems. The good news is that these are highly treatable! If your child is complaining about foot pain, seeing a podiatric physician will help prevent complicated problems in your child’s future. Common problems can range from flat feet to ingrown toenails. Treatment is often non-invasive and conservative. Children can be prescribed special insoles known as orthoses and physical therapy to help strengthen the weak or ill-working muscles, joints, and ligaments. Children tend to be extremely active, so podiatric physicians can work around sport schedules and care for their feet to optimized their performance and enjoyment of their preferred after school activities.
Save your child from grandma’s bunions and dad’s recurring ankle sprains. Seek consultation on your child’s foot pain from a medical professional such as a podiatric physician. Even if your child is not experiencing pain, remember to use common sense when shopping for this year’s new shoes!
My kid never complains!
Wow! Can we trade? Alright lets be serious all kids complain but not all kids complain about their feet. It is best to actively ask the child, “Do your feet hurt? Do you feel pain in your feet when you are out playing?” Some children ignore the pain because they are having so much fun. Think about how awesome it is to be on the soccer team or play in the park with your best buddies… You wouldn’t stop unless you had to. How many kids pee in their pants because they don’t want to stop playing?
There no special accommodation, devices, or exercises that are required for healthy foot living. There is a level of common sense that needs to come into play though… for some this is difficult. Kids shoes can be trendy, inappropriate, and can lead to pain.
Stay away from the following
· Pointy toes
· Platforms
· Flip flops
· Stilettos—Teenagers love to sacrifice comfort for style!
Standard Shoes for Back-to-School
· Good Athletic Shoes (light colors are preferred for the gym and will decrease sweating)
· A wide toe box for dress shoes
My Kid Does Complain about Their Feet!
It is not uncommon for children to have foot and ankle problems. The good news is that these are highly treatable! If your child is complaining about foot pain, seeing a podiatric physician will help prevent complicated problems in your child’s future. Common problems can range from flat feet to ingrown toenails. Treatment is often non-invasive and conservative. Children can be prescribed special insoles known as orthoses and physical therapy to help strengthen the weak or ill-working muscles, joints, and ligaments. Children tend to be extremely active, so podiatric physicians can work around sport schedules and care for their feet to optimized their performance and enjoyment of their preferred after school activities.
Save your child from grandma’s bunions and dad’s recurring ankle sprains. Seek consultation on your child’s foot pain from a medical professional such as a podiatric physician. Even if your child is not experiencing pain, remember to use common sense when shopping for this year’s new shoes!
Thursday, July 9, 2009
Feet Fit for Moon Walking
His dance moves defined gravity. There was no performance that did not leave the entire audience speechless. Michael Jackson even designed and patented a shoe to successfully pull off one of his memorable dance moves. But even Michael Jackson suffered from foot and ankle injuries. Shortly before being inducted in the Rock n’ Roll Hall of Fame, Jackson suffered a foot injury that kept him from moon walking his way into history. Dancing, like many sports, puts your foot and ankle at high risk for injury. So how does a professional or amateur dancer prevent such injuries? Here are some helpfull suggestions.
The most common dancing injuries are sprains, fractures, tendonitis, blisters, toenail injures, and bruises. The first step to prevent these injuries is to inspect your shoe gear. Depending on what type of dancer you are, will determine what types of shoes are most appropriate. Unfortunately, many dances require shoes that are not healthy for your feet. Such as many ballroom dances that requires women to wear high heels. Heels can cause instability and compression issues. When shoes are not your friend on the dance floor, there are other common practices that you should become familiar with to prevent injury.
A thorough warm up is always necessary to get your muscles warm and loose. This will greatly decrease the likelihood of strains and sprains. Paying attention to your pains is also extremely important. Pain and discomfort can indicate an underlying problem that may be treatable. Seeing a podiatrist to examine your foot and ankle prior to increasing your dancing regimen can greatly reduce the risk of injury. A trained podiatric physician can asses risk factor for foot and ankle injuries and provide treatment and therapies to improve your foot function.
Children are also at great risk of suffering from foot and ankle injuries while dancing. The bones in the foot are still developing late into childhood. For some dances, it is necessary for the child to be examined before being allowed to do certain moves. For an example, going up onto Pointe can be very dangerous and damaging to the foot if done prior to the growth plate closure. The only way to be certain that the growth plates are closed is through x-rays.
Before you jump on the dance floor, take time to watch the moves carefully so you fully comprehend the demands on your body. Understanding your bodies’ limitations is key. Learning taping and padding techniques can help you accommodate your ailments and further prevent future injures.
If you are dreaming about being the next Michael Jackson, you need to be prepared to deal with foot and ankle issues. Luckily, these ailments are often temporary and treatable, but they often take time and rest.
The most common dancing injuries are sprains, fractures, tendonitis, blisters, toenail injures, and bruises. The first step to prevent these injuries is to inspect your shoe gear. Depending on what type of dancer you are, will determine what types of shoes are most appropriate. Unfortunately, many dances require shoes that are not healthy for your feet. Such as many ballroom dances that requires women to wear high heels. Heels can cause instability and compression issues. When shoes are not your friend on the dance floor, there are other common practices that you should become familiar with to prevent injury.
A thorough warm up is always necessary to get your muscles warm and loose. This will greatly decrease the likelihood of strains and sprains. Paying attention to your pains is also extremely important. Pain and discomfort can indicate an underlying problem that may be treatable. Seeing a podiatrist to examine your foot and ankle prior to increasing your dancing regimen can greatly reduce the risk of injury. A trained podiatric physician can asses risk factor for foot and ankle injuries and provide treatment and therapies to improve your foot function.
Children are also at great risk of suffering from foot and ankle injuries while dancing. The bones in the foot are still developing late into childhood. For some dances, it is necessary for the child to be examined before being allowed to do certain moves. For an example, going up onto Pointe can be very dangerous and damaging to the foot if done prior to the growth plate closure. The only way to be certain that the growth plates are closed is through x-rays.
Before you jump on the dance floor, take time to watch the moves carefully so you fully comprehend the demands on your body. Understanding your bodies’ limitations is key. Learning taping and padding techniques can help you accommodate your ailments and further prevent future injures.
If you are dreaming about being the next Michael Jackson, you need to be prepared to deal with foot and ankle issues. Luckily, these ailments are often temporary and treatable, but they often take time and rest.
Sunday, July 5, 2009
Super-Pregant Feet
It was recently announce that Ariana Lima and her basketball star husband are expecting their first baby. This Victoria Secret Supermodel is not along. Heidi Klum also recently announced she too is pregnant. When supermodels are pregnant they still find a way to uphold their image. We see them on TV strutting their stuff in high heels and designer gowns. Unable to drink or drug, how do celebrities keep the smile on their face with all the extra weight and tight shoes? The secret: Good Actresses! So, how does the real woman deal with the aches and pains of pregnancy?
My Feet Have Swollen and They Won’t Deflate!
The most common complaint among the child bearing is foot swelling. During the nine months, your baby grows into a healthy young baby and your feet grow about a half a size! Your feet swell because of the weight and position of the baby in its temporary home. This along with the added weight cause stretching of many of the tendons and ligaments in your foot. Thus, your foot gets bigger. For some, once the swelling subsides, they can go back to their old shoes. For many, their pre-baby shoes are off to the donation box. To cut down on the swelling, the most effective treatment is compressive stockings. Other treatment options are to rest with your feet elevated, stretch, and of course make sure that your shoes fit you properly. You never know when your feet are going to go on a growth spurt!
No Pain; No Gain!
In the process of nurturing a gift of joy in the womb, your body takes a severe beating. Pregnancy can be very traumatic on the expecting mother’s feet and will cause pain, pain, and more pain. As the pregnancy progresses, the feet are taking on an increasing amount of weight. This extra weight changes how we walk and move our body. To compensate for these changes, the foot tilts inward and the arch is decreased. This causes increases stress on the plantar fascia that helps support the arch. Plantar Fasciitis is inflammation of this fascia and is the cause horrible heel pain. Though the pain usually subsides after the pregnancy, the pain is often unbearable. To address the pain, women are advised to wear shoe inserts to support the foot and ice the painful areas. It is often recommended to get custom made orthoses prior or early in the pregnancy to prevent future foot aches and pains.
Cramping your Style!
As one would expect when a life is growing in another, there is an increase in blood volume. In order to prevent hypertension, the body dilates the vessels to decrease the flow and pressure. This may lead to a decrease in oxygen delivery to muscles far away from the heart and lungs because it takes longer for fresh blood to get to the sight. A lack in oxygen supply is what often causes leg and foot cramps. To relieve the cramping, one should increase the blood flow. Thus, it is best to walk this one out!
At the end of the day, there is no big secret to pregnancy and comfort. All women experience the ups and downs of bringing life into the world. Foot pain is one of the many road bumps along the way. I wish I could say it was the worse, but the teen years will probably give you more pain and heartache than the 9 months and 12 years prior combined.
My Feet Have Swollen and They Won’t Deflate!
The most common complaint among the child bearing is foot swelling. During the nine months, your baby grows into a healthy young baby and your feet grow about a half a size! Your feet swell because of the weight and position of the baby in its temporary home. This along with the added weight cause stretching of many of the tendons and ligaments in your foot. Thus, your foot gets bigger. For some, once the swelling subsides, they can go back to their old shoes. For many, their pre-baby shoes are off to the donation box. To cut down on the swelling, the most effective treatment is compressive stockings. Other treatment options are to rest with your feet elevated, stretch, and of course make sure that your shoes fit you properly. You never know when your feet are going to go on a growth spurt!
No Pain; No Gain!
In the process of nurturing a gift of joy in the womb, your body takes a severe beating. Pregnancy can be very traumatic on the expecting mother’s feet and will cause pain, pain, and more pain. As the pregnancy progresses, the feet are taking on an increasing amount of weight. This extra weight changes how we walk and move our body. To compensate for these changes, the foot tilts inward and the arch is decreased. This causes increases stress on the plantar fascia that helps support the arch. Plantar Fasciitis is inflammation of this fascia and is the cause horrible heel pain. Though the pain usually subsides after the pregnancy, the pain is often unbearable. To address the pain, women are advised to wear shoe inserts to support the foot and ice the painful areas. It is often recommended to get custom made orthoses prior or early in the pregnancy to prevent future foot aches and pains.
Cramping your Style!
As one would expect when a life is growing in another, there is an increase in blood volume. In order to prevent hypertension, the body dilates the vessels to decrease the flow and pressure. This may lead to a decrease in oxygen delivery to muscles far away from the heart and lungs because it takes longer for fresh blood to get to the sight. A lack in oxygen supply is what often causes leg and foot cramps. To relieve the cramping, one should increase the blood flow. Thus, it is best to walk this one out!
At the end of the day, there is no big secret to pregnancy and comfort. All women experience the ups and downs of bringing life into the world. Foot pain is one of the many road bumps along the way. I wish I could say it was the worse, but the teen years will probably give you more pain and heartache than the 9 months and 12 years prior combined.
Friday, May 15, 2009
Ped Egg Over-Easy
Isn’t it great that you can buy cheese pre-grated. I had to grate cheese for dinner last night and I realized how awkward and difficult it was to use a cheese grater. If only the grater fit nicely in your hand like those Ped Eggs I see on commercials. Maybe that is what I’ll do next time; use a ped egg to grate my cheese because I surely wouldn’t be caught dead taking that device to my body.
It seems like every time you turn on the TV or walk through the pharmacy there is a Peg Egg waiting to be bought. With over 75% of the population suffering from foot problems, almost everyone is looking for a foot product to fix their problems. Is Peg Egg the answer to all of our problems? Personally, I think this gadget is better suited in the kitchen rather than the medicine cabinet.
Many people suffer from calluses and they can be very unsightly and very painful. For years, my patients have asked me advice on lotions and pumice stones, but now I’m frequently being asked about the Ped Egg. My answer: It is not safe! The Ped Egg is made up of sharp metal blades that literally cuts or shaves your skin off. Why would that ever be a good idea? Calluses are accumulation of dead hard skin. If painful, the callus can be reduced by medical professionals using a scalpel. This involves a delicate technique to prevent open lesions, bleeding, and infections. This type of callus is a sign of improper foot structure or gait. To treat, the doctor not only takes down the callus with instruments but also treats the patient with devices and or therapy to correct the underlying problem. The fact that patients may be self treating these problems with a glorified cheese grater is downright scary!
Most people experience rough dry skin because of improper shoe gear. This problem is easy to treat with specific lotions, stones and a change in shoes. The dry dead skin should be sloughed off to remove the dead skin and not any of the live, healthy skin underneath. Imagine if you had an old piece of furniture and the paint was chipping off. To remove the paint but save the chair, you would use a sander to just take off the top damaged layer. You would never think to take a chain saw, a chisel, or ax to the chair unless you wanted to completely destroy it. If you want to lose your foot then the Ped Egg is right up there with the chain saw. If you actually want to save your foot and have it look all nice and pretty than stay away from the fancy cheese grater.
With all jokes aside, the Ped Egg can be very dangerous for people with diabetes, peripheral vascular disease or any other disease that compromise the healing process or the immune system. Sometimes it only takes a tiny cut for some to get a devastating infection. Any product that has the potential of cutting the skin should be used with severe caution or not at all.
Friday, May 8, 2009
Testing the Foot
How to test the Foot
As you sit in the doctor’s office, you may notice pamphlets on all sorts of different complications and treatments. You may also come across information on diagnostic testing such as Magnetic Resonance Imaging, Computed Tomography, and Ultrasound. What do these words mean? Do you really need to have these tests done?
When seeing a podiatric physician for the first time, they almost always take x-rays. Weather you have toe pain or ankle pain, an x-ray can give the doctor valuable information. Since doctors are human, they cannot see what is happening inside of your body. X-rays are a rather inexpensive way to take a glance underneath the skin and screen for any issues. Often, x-rays tell the doctor enough to confirm a diagnosis and treatment plan but sometime the x-ray cannot provide a clear diagnosis. The doctor must then order some more advanced studies.
Computed Tomography (CT scan) is a more advanced form of traditional x-ray. A CT scan takes digital technology and combines it with x-ray to create cross sectional images of the body or foot. Imagine cutting your foot with an egg slicer and being able to visualize the bones and soft tissue layer by layer. This is exactly what is done with a CT scan. This allows the physician to more precisely examine the size and location of the issue or complication. With a better understanding of the issue, the doctor can then better treat the issue.
Magnetic Resonance Imaging (MRI) is a very popular diagnostic test. Rather than using x-rays, MRI uses a magnetic field and radiofrequencies to produce images of the body. Unlike x-rays or CT scans, MRIs do not emit any radiation. A MRI is often used to evaluate soft tissue injuries or suspected problems. Since the MRI functions via a magnet there are some limitations for patients with pacemakers, artificial valves or other foreign artifacts in the body.
Ultrasound is a very popular diagnostic test because it is real time imaging. This means that the test can be performed in the office and the results are seen immediately. The device looks much like the ultrasound used on pregnant women but they are not quite the same. Ultrasound used on the foot is done at a different frequency to better capture the structures in the foot rather than the uterus. In general the ultrasound sends out sound waves that, depending on the tissue, get absorbed or bounced back to the probe. The information collected from the hand held probe is transformed into an image on the computer.
Though there are many other tests available, these are the three most popular advanced imaging test utilized by podiatric physicians. Remember that your foot is attached to your body. There are many different pathologies that can arise. Everything from a tumor to a neuroma can appear in the foot. It is important that a podiatrist fully evaluates every condition to rule out some very serious conditions. These tests also help to evaluate the severity of common conditions which leads to more appropriate treatment.
As you sit in the doctor’s office, you may notice pamphlets on all sorts of different complications and treatments. You may also come across information on diagnostic testing such as Magnetic Resonance Imaging, Computed Tomography, and Ultrasound. What do these words mean? Do you really need to have these tests done?
When seeing a podiatric physician for the first time, they almost always take x-rays. Weather you have toe pain or ankle pain, an x-ray can give the doctor valuable information. Since doctors are human, they cannot see what is happening inside of your body. X-rays are a rather inexpensive way to take a glance underneath the skin and screen for any issues. Often, x-rays tell the doctor enough to confirm a diagnosis and treatment plan but sometime the x-ray cannot provide a clear diagnosis. The doctor must then order some more advanced studies.
Computed Tomography (CT scan) is a more advanced form of traditional x-ray. A CT scan takes digital technology and combines it with x-ray to create cross sectional images of the body or foot. Imagine cutting your foot with an egg slicer and being able to visualize the bones and soft tissue layer by layer. This is exactly what is done with a CT scan. This allows the physician to more precisely examine the size and location of the issue or complication. With a better understanding of the issue, the doctor can then better treat the issue.
Magnetic Resonance Imaging (MRI) is a very popular diagnostic test. Rather than using x-rays, MRI uses a magnetic field and radiofrequencies to produce images of the body. Unlike x-rays or CT scans, MRIs do not emit any radiation. A MRI is often used to evaluate soft tissue injuries or suspected problems. Since the MRI functions via a magnet there are some limitations for patients with pacemakers, artificial valves or other foreign artifacts in the body.
Ultrasound is a very popular diagnostic test because it is real time imaging. This means that the test can be performed in the office and the results are seen immediately. The device looks much like the ultrasound used on pregnant women but they are not quite the same. Ultrasound used on the foot is done at a different frequency to better capture the structures in the foot rather than the uterus. In general the ultrasound sends out sound waves that, depending on the tissue, get absorbed or bounced back to the probe. The information collected from the hand held probe is transformed into an image on the computer.
Though there are many other tests available, these are the three most popular advanced imaging test utilized by podiatric physicians. Remember that your foot is attached to your body. There are many different pathologies that can arise. Everything from a tumor to a neuroma can appear in the foot. It is important that a podiatrist fully evaluates every condition to rule out some very serious conditions. These tests also help to evaluate the severity of common conditions which leads to more appropriate treatment.
Why Do My Legs Hurt?
Peripheral arterial disease (PAD) is becoming more and more prevalent in America. Our love of fast food and convenience has lead to almost 10 million Americans to be diagnosed with PAD. Our body naturally starts forming plaques in our arteries. This is part of the aging process. Unhealthy lifestyles though cause abnormal increases in plaque and as we get older, these high levels of plaque hardens and causes narrowing of the blood vessels. Arteries supply the body with blood rich in oxygen. If the vessels narrow, the body is not getting the appropriate amount of oxygen to the organs and muscles. Thus, those with PAD are four times more likely to have a heart attack and almost three times more likely to have a stroke.
Who is at Risk? Those with diabetes have a significant risk in developing PAD. So much so, that the American Diabetes Association recommend everyone with diabetes over the age of 50 should be tested. Other high risk factors are high blood pressure, high cholesterol, family history of heart disease, or being overweight. Smoking will also increase your likelihood of developing PADS by four times.
The first signs and symptoms of PAD are often first seen in the legs and feet. This is why we highly encourage high risk patients to pay close attention to pain, discomfort or open lesions in the legs and feet. One will often feel like their legs get tired or painful when walking or climbing exercise. When experiencing this pain, it will go away with rest. This is termed intermittent claudicating and is a sign that your muscles are not getting enough oxygen. One may also feel numbness or tingling, coldness, changes in color, hair loss on the legs and feet. These are all be signs of a serious problem, but some people who have PAD do not appear with any of these symptoms. Thus it is very important to still get tested if you are at risk.
How to get tested? If you are experiencing any of symptoms above or are at high risk of getting PAD, you should consult a health care provider. Testing for PAD is noninvasive, pain free, quick and easy! The examiner will either use a standardized machine or manually take your blood pressure on your arm, ankle and other areas on your leg. Significant changes in your blood pressure in your legs and or ankle is diagnostic of PAD.
What to do if you have PAD. It is important to take the steps to adjust your lifestyle to prevent the progression of the disease. It is advised that patients stop smoking, lose weight, and exercise to improve blood flow. All treatment plans should be thoroughly discussed with your doctor to know what options are right for your body. The doctor may prescribe blood pressure medication, encourage physical therapy, and in critical conditions, surgery may be necessary.
Those suffering from PAD are at an increased risk of having several foot issues including non-healing ulcers. PAD patients should visit a podiatrist regularly for foot screenings and management of foot and ankle problems. A growing number of the American population are having foot and leg amputations due to the effects of diabetes and PAD. Many of these amputations are highly preventable when people take the appropriate steps to care for their feet and consult a podiatric physician when suffering from any foot and leg pain or abnormalities.
Who is at Risk? Those with diabetes have a significant risk in developing PAD. So much so, that the American Diabetes Association recommend everyone with diabetes over the age of 50 should be tested. Other high risk factors are high blood pressure, high cholesterol, family history of heart disease, or being overweight. Smoking will also increase your likelihood of developing PADS by four times.
The first signs and symptoms of PAD are often first seen in the legs and feet. This is why we highly encourage high risk patients to pay close attention to pain, discomfort or open lesions in the legs and feet. One will often feel like their legs get tired or painful when walking or climbing exercise. When experiencing this pain, it will go away with rest. This is termed intermittent claudicating and is a sign that your muscles are not getting enough oxygen. One may also feel numbness or tingling, coldness, changes in color, hair loss on the legs and feet. These are all be signs of a serious problem, but some people who have PAD do not appear with any of these symptoms. Thus it is very important to still get tested if you are at risk.
How to get tested? If you are experiencing any of symptoms above or are at high risk of getting PAD, you should consult a health care provider. Testing for PAD is noninvasive, pain free, quick and easy! The examiner will either use a standardized machine or manually take your blood pressure on your arm, ankle and other areas on your leg. Significant changes in your blood pressure in your legs and or ankle is diagnostic of PAD.
What to do if you have PAD. It is important to take the steps to adjust your lifestyle to prevent the progression of the disease. It is advised that patients stop smoking, lose weight, and exercise to improve blood flow. All treatment plans should be thoroughly discussed with your doctor to know what options are right for your body. The doctor may prescribe blood pressure medication, encourage physical therapy, and in critical conditions, surgery may be necessary.
Those suffering from PAD are at an increased risk of having several foot issues including non-healing ulcers. PAD patients should visit a podiatrist regularly for foot screenings and management of foot and ankle problems. A growing number of the American population are having foot and leg amputations due to the effects of diabetes and PAD. Many of these amputations are highly preventable when people take the appropriate steps to care for their feet and consult a podiatric physician when suffering from any foot and leg pain or abnormalities.
Tuesday, April 21, 2009
Keeping the Elderly Walking
As we get older, our health continues to weaken. Every time we take a trip to the doctor’s office we pray nothing new comes up. Time and time again we hear the same old story, “you need to make sure you exercise to stay healthy.” Whether you have hypertension, diabetes, or high cholesterol, your doctor is going to prescribe exercise! So how does an elderly person stay fit? Walking is everyone’s favorite activity! It is often the safest and easiest type of physical activity to participate as we age. Here are a few tips to help you stay healthy and safe while walking.
Walking Tip #1: Warm up and Cool down
It may seem silly and useless, but taking time to warm up and cool down before walking is very important. It allows an increase of blood flow to your muscles. This increases the oxygen levels available to your muscles. As you exercise, your muscles use the oxygen to create energy. If the oxygen is depleted, your body creates lactic acid which causes pain and your muscles to get tired faster. A warm up will help prevent this from happening. Stretching is an import part of a warm up and cool down. Having tight muscles can cause many different problems and can be painful. Stretching can also help prevent injuries.
Walking Tip #2: Buy a good pair of shoes that fits!
We all want to watch our budget, but walking shoes is not a place to cut corners. You should shop for your shoes in the afternoon. Your feet will swell throughout the day; thus, to ensure you have a properly fitted shoes you should avoid buying them in the mornings. Also make sure you have ample space in the toe box. You should be able to wiggle your toes around in your shoes. Try on several different brands and different sizes and walk around with them on both feet. This is the only way to find a comfortable shoe!
Walking Tip #3: Your feet should not hurt!
You may experience some pain when you begin your new walking schedule. You should pay close attention because this is not a normal occurrence. Self treatment may lead to more significant problem. You should contact a podiatric physician who will be able to accurately asses your pain and treatment options.
Walking Tip #4: Walk on softer surfaces!
As we get older, we lose our protective fat pad on the bottom of our feet. This increases the pressure on our bones and may lead to stress fractures. These types of injuries are more common in women but can also occur in men. Try to walk on grass, or dirt paths rather than hard cement if possible. Through softer ground may be better for stress fractures, make sure the ground is even to prevent ankle sprains or falls.
Walking Tip #5: Make a plan and get a friend!
Changing your lifestyle to include exercise is a huge undertaking. It is not easy to always stay motivated. It works best to build a plan and schedule that you can adhere to the best. Talk over your plan with your doctor to make sure it is appropriate for your health concerns. Find a friend or local walking groups to join. This will make the experience more enjoyable and rewarding!
Walking Tip #1: Warm up and Cool down
It may seem silly and useless, but taking time to warm up and cool down before walking is very important. It allows an increase of blood flow to your muscles. This increases the oxygen levels available to your muscles. As you exercise, your muscles use the oxygen to create energy. If the oxygen is depleted, your body creates lactic acid which causes pain and your muscles to get tired faster. A warm up will help prevent this from happening. Stretching is an import part of a warm up and cool down. Having tight muscles can cause many different problems and can be painful. Stretching can also help prevent injuries.
Walking Tip #2: Buy a good pair of shoes that fits!
We all want to watch our budget, but walking shoes is not a place to cut corners. You should shop for your shoes in the afternoon. Your feet will swell throughout the day; thus, to ensure you have a properly fitted shoes you should avoid buying them in the mornings. Also make sure you have ample space in the toe box. You should be able to wiggle your toes around in your shoes. Try on several different brands and different sizes and walk around with them on both feet. This is the only way to find a comfortable shoe!
Walking Tip #3: Your feet should not hurt!
You may experience some pain when you begin your new walking schedule. You should pay close attention because this is not a normal occurrence. Self treatment may lead to more significant problem. You should contact a podiatric physician who will be able to accurately asses your pain and treatment options.
Walking Tip #4: Walk on softer surfaces!
As we get older, we lose our protective fat pad on the bottom of our feet. This increases the pressure on our bones and may lead to stress fractures. These types of injuries are more common in women but can also occur in men. Try to walk on grass, or dirt paths rather than hard cement if possible. Through softer ground may be better for stress fractures, make sure the ground is even to prevent ankle sprains or falls.
Walking Tip #5: Make a plan and get a friend!
Changing your lifestyle to include exercise is a huge undertaking. It is not easy to always stay motivated. It works best to build a plan and schedule that you can adhere to the best. Talk over your plan with your doctor to make sure it is appropriate for your health concerns. Find a friend or local walking groups to join. This will make the experience more enjoyable and rewarding!
Thursday, March 19, 2009
Can You Buy Foot Products From a Catalogue?
While flying home from a medical conference, I noticed that airplane shopping magazines have everything. You can buy jackknife watches, home acupuncture kits, and even the world’s largest crossword puzzle. Amazing! You may notice that the magazine is full of advertisements for healthcare products. You can buy hearing aids, back adjusters and tons of different foot products. All while flying thousands of miles above your doctor’s office. So how reliable are these products?
Almost everyone has achy feet. Studies have shown that 75% of the American population has at least one foot problem. What a great market! Though we all have achy feet, there are thousands of reasons why our feet hurt. Do these products address your problem? If you have achy feet and have not yet seen a podiatric physician then I highly recommend that you refrain from wasting your money on products. If you have heel pain, it is not always planter fasciitis. Unless you have a diagnosis from your podiatric physician, you should not be using products to treat any foot disorder.
What if you have a diagnosis? When a doctor diagnosis’s you with a disorder, they develop a treatment plan that treats you and your specific conditions. Podiatric physicians know more about the foot and ankle than any other profession. With a combination of education and experience, podiatric physicians can map out a step by step process that will give you the best road to recovery. If you use products that are not a part of their treatment plan, you may interfere with your own healing! Talk to your doctor before trying something new. It may hurt you more than it will help you. Also, make sure to talk to your doctor about products you have used in the past. This is valuable information for the doctor because it may be the reason you are still or again experiencing problems.
What if your doctor already talked to you about using a product? Your doctor should discuss their treatment plan with you. High in the air, you see a devise that looks just like the one he showed you in the office. Should you take advantage of the low prices in the sky? Just because two products look the same, does not mean they are made the same. There is constantly being new products developed and researched but not all foot products have reliable studies to back up their claims. Many of the products that podiatric physicians provide are only found in physician offices and often a special licenses and education is needed to provide such products. These products always have legitimate studies that approves their use, but only someone who has training can really determine if it is the right product for you. Your foot is very complex and the devices and products provided in the doctor’s office are made with your foot’s anatomy and biomechanics in mind. Many of the products you find outside of the office are made with your pocketbook in mind.
Here are some helpful hints to guide you through the foot mall. Shoes should be made to support your feet not to fit in your back pocket. If you can fold the shoe or sandal up to a compactable size it is probably not going to support your foot well. There is a country song that says “Shoes don’t stretch and men don’t change.” Maybe you forgot but shoes come in multiple sizes. If they don’t fit buy the next size up. Let that “I’ll change for you” boy buy the shoe stretcher. Check your doctor’s website for products. Your podiatric physician can provide you with products approved by the American Podiatric Medical Association. Your physician is not there to take advantage of you; they are there to make you feel better. They provide you with a product because it is in their treatment plan to make you better. Most other places do not care if get better as long as you buy.
Almost everyone has achy feet. Studies have shown that 75% of the American population has at least one foot problem. What a great market! Though we all have achy feet, there are thousands of reasons why our feet hurt. Do these products address your problem? If you have achy feet and have not yet seen a podiatric physician then I highly recommend that you refrain from wasting your money on products. If you have heel pain, it is not always planter fasciitis. Unless you have a diagnosis from your podiatric physician, you should not be using products to treat any foot disorder.
What if you have a diagnosis? When a doctor diagnosis’s you with a disorder, they develop a treatment plan that treats you and your specific conditions. Podiatric physicians know more about the foot and ankle than any other profession. With a combination of education and experience, podiatric physicians can map out a step by step process that will give you the best road to recovery. If you use products that are not a part of their treatment plan, you may interfere with your own healing! Talk to your doctor before trying something new. It may hurt you more than it will help you. Also, make sure to talk to your doctor about products you have used in the past. This is valuable information for the doctor because it may be the reason you are still or again experiencing problems.
What if your doctor already talked to you about using a product? Your doctor should discuss their treatment plan with you. High in the air, you see a devise that looks just like the one he showed you in the office. Should you take advantage of the low prices in the sky? Just because two products look the same, does not mean they are made the same. There is constantly being new products developed and researched but not all foot products have reliable studies to back up their claims. Many of the products that podiatric physicians provide are only found in physician offices and often a special licenses and education is needed to provide such products. These products always have legitimate studies that approves their use, but only someone who has training can really determine if it is the right product for you. Your foot is very complex and the devices and products provided in the doctor’s office are made with your foot’s anatomy and biomechanics in mind. Many of the products you find outside of the office are made with your pocketbook in mind.
Here are some helpful hints to guide you through the foot mall. Shoes should be made to support your feet not to fit in your back pocket. If you can fold the shoe or sandal up to a compactable size it is probably not going to support your foot well. There is a country song that says “Shoes don’t stretch and men don’t change.” Maybe you forgot but shoes come in multiple sizes. If they don’t fit buy the next size up. Let that “I’ll change for you” boy buy the shoe stretcher. Check your doctor’s website for products. Your podiatric physician can provide you with products approved by the American Podiatric Medical Association. Your physician is not there to take advantage of you; they are there to make you feel better. They provide you with a product because it is in their treatment plan to make you better. Most other places do not care if get better as long as you buy.
The Effect of Ankle Injuries on Your March Madness Office Pool
There are two things for which March is known: green beer and basketball. This week, Americans are enjoying both. Whether you are a twelve year old boy or a grandma involved in the nursing home pool, it seems like everyone is talking about March madness. But did you know that just the last week there were five foot or ankle injuries among the players competing in the NCAA tournament. Before you turn in your bracket, you may want to take some of these injuries into consideration.
Robert Sacre, Gonzaga Bulldogs; Liam mcMorrow,Marquette Golden Eagles; Ty Lawson, North Carolina Tar Heels; Teondre Williams, Oregon Ducks; and Jonnie West, West Virginia Mountaineers have all had foot or ankle injuries within the last week and all of their teams have advanced into the tournament. Whether or not these injuries will affect the teams is questionable, but what we should be asking is why these injuries are happening so late in the season. At this point, the athletes should be at their prime strength, so why are the falling apart?
Basketball, like all sports, puts significant stress on your body especially your foot. Running causes an increase in forces on your foot and ankle three to six times your body weight. When a forward goes up for a rebound, they come down to contact the ground with a forces six times their body weight. Our body is designed to compromise and adjust for these forces, but if we do them too fast, we can cause damage to our body. This is why athletes go through training. Even with the best training, such as that provided to college athletes, your body can still get injured!
Ankle sprains are the injury seen most often on the court. Once an athlete has one ankle sprain, they are much more likely to have another one because the ligaments are weekend. Ligaments are small fibrous bands of tissue that connect bones to other bones. This along with muscles allows the skeletal system to have a considerable amount of stability. If a ligament gets stretched or injured, it will never recover to have the same amount of strength that it did before the injury. Therefore, once you have an ankle injury, you are much more prone to have one in the future.
So why aren’t athletes spraining their ankles every day.
Physical Therapy helps your body regain as much strength and function as possible. Since muscles also contribute to stability, a physical therapist will adjust the patient’s exercises to strengthen the muscles in the areas prone to injury. This type of therapy is the most beneficial and is why your podiatrist often suggests physical therapy for most types of injuries.
Basketball shoes are quite a bit different than the cross trainers or running shoes we all have stashed away in our closets. Basketball shoes or high tops come up higher to give your ankle more support. You put a lot of stress on your body jarring back and forth, running up and down the court and jumping up for the rebound. Simply changing your shoe gear can do wonders to reducing injuries on the court.
In addition, some people are more prone to ankle sprains due to biomechanical weaknesses, or simply put, the way their foot and ankle moves when they walk or run. This can innate weakness can be eliminated with a properly made custom orthotic that controls excessive foot motion.
Though the NCAA offers some of the best training and resources to their athletes, some injuries are inevitable. If you ever roll your ankle, take a stumble, or hear a POP, make sure to contact your podiatric physician as soon as possible. The earlier you seek medical attention by a highly trained doctor in the foot and ankle or a podiatrist, the better the outcome of your injury will be.
Wednesday, January 21, 2009
What is That Tingling, Burning Feeling in My Feet?
Morton’s Neuroma
A neuroma is a thickening of a nerve and can occur anywhere in the body, even the foot. Morton’s neuroma describes a neuroma of a specific location in the foot, between the third and fourth metatarsals. This is located on the balls of foot between the third and fourth toes. Clinicians may refer to this benign growth as a tumor. In medical terms this is a correct description but this is not an indication of cancer. The enlarged nerve is benign, meaning it will not become invasive or become cancerous.
Though a morton’s neuroma is not a medical emergency, it can cause severe pain and impede on your daily life. Some patients describe the pain as walking on a marble, but the most often complaint is a burning, sharp pain. Tingling and numbness is also common.
It is thought that the nerve becomes enlarged due to repetitive irritation or pressure. Over time, this irritation leads to a neuroma and pain. Wearing shoes that are tight, too small, or with a heel can aggravate the pain because it causes increased irritation. The pain may also be caused by running or other sports. Flexing and relaxing your toes causes compression on the nerve, and the balls of your foot takes on the most weight during walking or running. Since this is the area where the neuroma is located, doing such activities can elicit a lot of pain.
The podiatric physician will take x-rays of a patient with such pain to rule out a fracture or other foot disorders. The doctor will also attempt to elicit the pain by squeezing the foot. This will not only cause pain, but there the doctor will also hear a clicking sound due to the neuroma shifting between the bones.
There treatment ranges from conservative treatments to surgery. Like all treatment plans, surgery should be a last resort for when all other treatments fail. The pain may be greatly reduced by changing shoe gear, but this is often not enough. It is very common for your podiatric physician to prescribe a custom orthotic. Many patients find relief by not only wearing orthotics but also wearing a pad under the balls of their foot. A podiatric physician can properly fit and provide such padding. Non-steroid anti-inflammatory drugs, such as Advil, can also be used to help reduce the pain but should not be used long term. Your doctor may also suggest a steroid injection which has a greater effect on relieving the pain. Stretching, massages, and icing has also shown to relieve pain.
If the pain has increased due to physical activity, it is suggested to take some time off from the activity to allow your foot to rest and heal. It may be better to take on activities that cause less impact on the foot. Excises’ such as swimming or bicycling may be good alternatives.
Neuromas are not life threatening, but they do cause alterations in your life. You should consider wide toed shoes with plenty of room for your toes to wiggle. The pain most often subsides with conservative treatment, but in rare cases surgery is necessary. Unfortunately, the procedure removes the entire nerve and will leave numbness of the effected toes. Thus, you and your podiatric physician should try to avoid surgery if possible.
A neuroma is a thickening of a nerve and can occur anywhere in the body, even the foot. Morton’s neuroma describes a neuroma of a specific location in the foot, between the third and fourth metatarsals. This is located on the balls of foot between the third and fourth toes. Clinicians may refer to this benign growth as a tumor. In medical terms this is a correct description but this is not an indication of cancer. The enlarged nerve is benign, meaning it will not become invasive or become cancerous.
Though a morton’s neuroma is not a medical emergency, it can cause severe pain and impede on your daily life. Some patients describe the pain as walking on a marble, but the most often complaint is a burning, sharp pain. Tingling and numbness is also common.
It is thought that the nerve becomes enlarged due to repetitive irritation or pressure. Over time, this irritation leads to a neuroma and pain. Wearing shoes that are tight, too small, or with a heel can aggravate the pain because it causes increased irritation. The pain may also be caused by running or other sports. Flexing and relaxing your toes causes compression on the nerve, and the balls of your foot takes on the most weight during walking or running. Since this is the area where the neuroma is located, doing such activities can elicit a lot of pain.
The podiatric physician will take x-rays of a patient with such pain to rule out a fracture or other foot disorders. The doctor will also attempt to elicit the pain by squeezing the foot. This will not only cause pain, but there the doctor will also hear a clicking sound due to the neuroma shifting between the bones.
There treatment ranges from conservative treatments to surgery. Like all treatment plans, surgery should be a last resort for when all other treatments fail. The pain may be greatly reduced by changing shoe gear, but this is often not enough. It is very common for your podiatric physician to prescribe a custom orthotic. Many patients find relief by not only wearing orthotics but also wearing a pad under the balls of their foot. A podiatric physician can properly fit and provide such padding. Non-steroid anti-inflammatory drugs, such as Advil, can also be used to help reduce the pain but should not be used long term. Your doctor may also suggest a steroid injection which has a greater effect on relieving the pain. Stretching, massages, and icing has also shown to relieve pain.
If the pain has increased due to physical activity, it is suggested to take some time off from the activity to allow your foot to rest and heal. It may be better to take on activities that cause less impact on the foot. Excises’ such as swimming or bicycling may be good alternatives.
Neuromas are not life threatening, but they do cause alterations in your life. You should consider wide toed shoes with plenty of room for your toes to wiggle. The pain most often subsides with conservative treatment, but in rare cases surgery is necessary. Unfortunately, the procedure removes the entire nerve and will leave numbness of the effected toes. Thus, you and your podiatric physician should try to avoid surgery if possible.
