Is Rex Ryan a Frustrated Podiatrist?

A video was just released showing Rex Ryan, the NY Jets football coach and his wife, depicting Rex of having a foot fetish. It is this video that made me think of the endless times I get asked, “Dr. Wishnie, why did you become a podiatrist? Do you have a foot fetish?”

Let me first answer that as simply as, absolutely not. I usually tell my patient, “Do you think a gastroenterologist has a butt fetish?” Then I ask, “What body part is beautiful? At least the foot is an external appendage that I don’t have to go digging into any holes.”

Well, why did I become a podiatrist? Podiatrists see many different types of patients. We see patients ranging from the age of infancy to the geriatric. On one day I can see both an 18 month old baby and a 104 year geriatric. I can see patients with sports injuries, like ankle sprains, Achilles tendinitis, fractures and dislocations. I see runners who don’t want to stop running, no matter how bad their foot hurts. Then I see little old ladies who remind me of my grandmother.

As you can see, I love the diversity that podiatry offers. I also love the fact that I can usually get people feeling better immediately. See, when you are not feeling well and you go to your family physician, they say, “Take this pill and you will feel better in a week.” Then the patient asks, “Hey doc, what happens if I don’t take the pill.” The doctor answers. “Then you will feel better in seven days.”

A lot of people are afraid of going to the doctors. They are afraid of the pain that might be inflicted upon them. Then what happens if they delay in making an appointment? The pain and the problem usually worsen. In podiatry, we can treat a problem many different ways. If a child comes in with a plantar’s wart, we usually use a topical medication to kill this virus. We usually don’t have to use any needles or do any cutting. If you have a corn, which is dead skin on a toe due to a deformity called a hammertoe, we can trim it painlessly. The patient leaves the office immediately feeling better. If you suffer from heel pain, we can tape the foot and give medication to relieve the pain. Many times we need to give an injection but then the patient is walking out the office feeling ten times better.

Getting patients better quickly and seeing almost immediate results is very satisfying. Podiatry is a wonderful profession and with millions of active baby boomers turning 65 on a daily basis, podiatrists will be very busy and will be an extremely necessary profession for many years to come.

Hey Rex, if this football coaching doesn’t work out, I can help you get in touch with my podiatry school professors.

Dr. Wishnie is Finally Legal!

Today Marks the 21st Anniversary for

Family Foot & Ankle Specialists

We would like to thank all of our incredible patients as we celebrate our 21st anniversary! We have met so many amazing people through the years, many of which were patients when we first started. We have seen each other through a lot; marriages, children, grandchilren, birthdays and more. You are more than just patients to us, you are considered a special part of our family!



We hope you continue to grow with us for many years to come. Wishing everyone a safe holiday season,

The Doctors & Staff Of Family Foot & Ankle Specialists

Roethlisberger’s Shoe Made Out of Steel After Foot Injury.

The Pittsburgh Steelers will be taking a bit hit with Roesthlisberger’s foot. Originally reported as a foot sprained, some press releases are now reporting that the Steeler’s Quarterback has a broken bone in the foot. The official release from the Pittsburgh Stealers states that Roethlisberger injury is an aggravation of an old injury where scar tissue is present. So, is he going to play on Sunday?

It is believed that the Steeler’s Quarterback broke his fifth metatarsal bone. This bone is a long tubular bone located on the outside portion of the foot. The fifth metatarsal fractures are a highly researched topic and there are variable ways of treating this injury depending on the location. The majority of fractures in this bone can be treated conservatively with casting and rest. Occasionally, the fracture location or dislocation requires surgery and screw fixation.

Considering, that Ben has persisted that he will be playing on Sunday, we can assume this is a minor fracture that does not require surgery. He is currently ambulating in a walking boot and has been on light practice this week. The Steeler’s trainer stated that the Quarterback will be wearing a special shoe with metal plates protecting the injured area.

The fifth metatarsal is a common fracture site in athletes especially dancers. This is due to the extensive pivoting and jarring on the bone and surrounding tendons. Because of the bone’s location and soft tissue attachments, it does not take a traumatic event to break the bone. Simply landing on the foot wrong can cause such an injury. Recovery of most fractures in this area is easily treated with rest and decreased activity. Protection ambulation with a walking boot often all that is needed to make a full recovery.

When you are a professional athlete and have a record of 8-3, the rules of treatment are different than the average person’s. Winning games, egos, and pressure will push you in a direction that is not always the most beneficial for your body. It is probable that Roethlisberger’s foot break will not debilitate him or prevent him from throwing touchdown passes. It is also probable that his injury can worsen and the long term consequences of poor healing in the foot can mean chronic pain. Playing a a professional foot game in a metal shoe is not necessarily resting the injury.

Joints Under the Weather

It is that time of year when the air gets crisp and you enjoy evening walks through the leaves. Unfortunately, it is also the time of year when arthritis pain flares up. After the rain, before the storm, and changes of temperature seem to have a poor relationship with our joints. Much like pollen aggravated seasonal allergies; the change in seasons aggravates joints. Is the weather really the cause of your joint pain?

Science has not been able to justify the theory. It is believe that the change in weather alters the pressure and changes the pressure threshold within your body. The tissues are able to expand or swell to a greater capacity. A number of large studies closely examined arthritis pain and compared it to temperature and air pressure. Unfortunately, the research has not given us any concrete answers. So many of my patients relate their joints are better weather predictors than the weather man and I can’t disagree with them.

Whether it is an old wise tale or the cold hard truth, joint pain can put a halt to your fall activities. Arthritis has a number of different causes. Most arthritis is causes by years of wear and tear that leads to damage in the cartilage. Cartilage provides a glossy, lubricated surface that allows for smooth pain free movement. As the cartilage degenerates bone comes in contact with bone and the joint loses its ability to move freely without causing irritation. Irritation leads to inflammation and inflammation leads to pain.

To treat arthritis, we start with trying to decrease the inflammation. This can be done with Non steroidal anti-inflammatory, and corticosteroids. Depending on the degree of arthritis, decreasing the inflammation to decrease pain is nearly impossible. In the foot and ankle, arthritis is very difficult to combat because we never give our feet time to relax. We are constantly up on our feet and push through pain because we have to. When conservative care fails, many patients ask for surgery.

There are generally two surgical options for foot and ankle arthritis. The joint can be replaced with an artificial joint made of titanium or stainless steel. The joint can also be fused, eliminating motion at the site. Not everyone or every joint is suitable for a joint replacement or a joint fusion. Many are turned off by the thought of having a joint fused, but in many cases it is very suitable for the condition and the patient can quickly adjust. The big toe is a joint that gets fused often and has a very high patient satisfaction rate.

Arthritis can be a very difficult and aggravating disease to combat. In our busy lives and our growing concerns on staying active and healthy, joint pain can really hinder the ability to live life to the fullest. You can however give the weather man a run for his money with those weather predicting joints!!!<

Is Brett Favre’s Ankle Serious

The reason Favre is so enjoyable to watch is because you never know what is coming next. No one could have predicted the scene at Lambeau as the Green Bay Packers defeated their rival and hero, the Vikings with Bret Favre. Are you really a Hero when you play through injuries and avoid medical attention during a game?
I have read many articles trying to decipher this ankle injury, but the reports are vague only stating Favre suffers from two minor ankle fractures including a stress fracture and an avulsion fracture. I have also read a report that discusses a so called “heel” problems or injury. The reports say neither injury is severe and surgery is not necessary and the Vikings star is not practicing and resting in a controlled ankle motion boot (CAM Walker). Whether Favre will play on Sunday is still unknown.

I cannot predict or diagnose an injury without seeing them physically but here is what I know about Favre’s recovery time. Bone takes about 6 weeks to regain adequate strength after it breaks. Stress fractures heal faster since they are only hairline defects but still require a significant time of rest and decreased activity. Most stress fractures are secondary to overuse over time and not the result of a blunt trauma. Avulsion fractures result when ligaments or tendons pull off a piece of bone during a traumatic event. This injury most certainly happened after Favre was tackled. These injuries do not always need surgery, but they do require time to heal.

I find it interesting we nearly praise someone for playing through pain and injury when infarct they are only hurting themselves and their team. Ignoring an injury that is visibly impairing you can be very dangerous. I worry that many young men athletes think Favre’s actions are heroic. High school football injuries are getting a lot of attention this year. Many are suffering from damaging concussions and few have even died during a high school football game. Favre may be sending the wrong message to these young athletes. Your body does have a limit and ignoring a painful limp does not make you superhuman. It is after all just a game.

The future hall of famer, the Green Bay legend and the greatest quarterback of all time will always be remembered as a man who redefined the odds of the game and was at times above the game.

Today, we wonder if Childress and Favre are reading comic books or pretending to be Superman. You can’t play football with a broken ankle, a heel problem and tendonitis in your throwing arm. Well, Favre probably can but will he be any good? Favre has proven everything he possibly could on the field, now it is time to prove he can sit the bench. Not even Favre can go beyond his body’s limits.

Do You Suffer From Neuropathy?

This is a great article by my friend and fellow podiatrist, Dr. Andrew Schneider. I use Neuremedy in the office and have gotten some great results. "http://www.facebook.com/#!/notes/andrew-schneider/can-a-can-a-medical-food-help-control-the-symptoms-of-peripheral-neuropathy/427051660996"

The Dangers of Lawn Mowers

Some people enjoy cutting the lawn. Some give the job to their child or the neighbor. Who would think a common summer chore can be so dangerous? There are over 77,000 lawn mower injuries every year. Over 3,000 of them are in children. Some people even die after a lawn mower injury

I recently had a patient that lost part of his foot from a mower accident. It is devastating to see how much damage a blade can cause. After some research, I discovered exactly how much strength is behind the monster on wheels. Being hit by a mower blade is equivalent to being hit by a 21 pound object dropped from a height of 100 feet or 1.17 pounds traveling 232mph. This is three times the force of a 0.357 magnum gun!

Fortunately, these injuries are preventable, but we have to start taking our lawn mower chores more seriously. So many people choose to cut the grass bare foot. It feels good to have the grass between your toes but it is such a bad idea. First, there are a lot of things to step on especially in long grass where sharp object can be easily hiding. Secondly, the sharp mower blade can easily cut debris in the lawn into smaller sharper object. Though a shoe will not be strong enough to withstand the force of the blade, it will help decrease some severity of the injury.

Make sure you children understand the dangers of mowers. It is hard for a child to understand the complexity of a lawn mower. A push mower looks and sounds a lot like a vacuum. Since children are smaller, the injuries from a lawn mower are much more devastating than those seen adults. Adults will often lose toes or part of their foot, a child may lose their entire foot or part of their limb. Children are also more likely to put their hands near the blades and lose fingers, hands, and arms. There have also been many reports of accidentally running over children with the lawn mower. Remember to pay attention to what is behind you and tell your children they cannot come near you when you are cutting the grass.

These types of injuries are very prone to infections since the blade is so dirty. Luckily, early antibiotic treatments after such an injury cuts the rate of infection to a near minimum. If you suffer such an injury, it is imperative that you report to the ER immediately. The sooner you see a doctor, the less likely you will have complications from the injury.

My patient was lucky his injury was not more severe. He had 3 of his toes cut off with the blade and we then decided to remove his existing toes off to help him with ambulation and shoe fitting in the future. He is now walking normally; he is back to his normal job, and he is wearing normal shoes.

Knee Pain Is A Foot Problem

Up to 75% of athletes have chronic knee pain. Is your knee pain driving you crazy? There are a million different reasons why so many people suffer from knee pain. Henry (Hank) Aaron, a home run king, is one of many professionals that suffer from arthritis in the knee. Is there anything you can do to treat or prevent these aches and pains in the knee?

All arthritides are irreversible. Once you have arthritis, you will always have arthritis. The first thing to identify is what is causing the arthritis. Weight is a very important factor. The heavier a person is the more stress and strain that is place on the knee.

Many people attribute activities to knee problems. Though high stress, pivoting, and jarring activities put a lot of stress on the knee, it does not always lead to arthritis. More importantly, a person’s biomechanics can cause chronic increased forces and instability that leads to damage and injuries. The knee is the most unstable joint in the body.

Most other joints have boney boarders that help stabilize the joint. The knee is simply two bones separated by cartilage and ligaments and surrounded by muscles, tendons, and ligaments. These are all soft tissue structures. The knee is surrounded by two more stable joints in the body, the hip and the ankle. However, small problems in these joints easily affect the unstable knee joint. Thus, if someone has chronic ankle or hip problems, it is not unlikely that they will also suffer from knee problems.

Since soft tissues are the major stabilizers of the joint, they can be strengthened with physical therapy, strength training, stretching and range of motion exercises. A biomechanical exam can be done to assess your ankle and hip range of motion, stability and muscle tightness that causes changes in joint function. Most people benefit from several different forms of physical therapy and other treatments gauged at correcting the mechanics of the joint, such as orthotics, custom shoe inserts made by a podiatarist.

Orthotics are not just for your foot pain! You may not have any foot pain and still benefit from orthotics. Many of my patients are extremely active in sports and running. From weekend warriors to obsessive marathon runners, I have heard patients say their orthotics helped their knees, hip, back and everything in between. Biomechanics is the application of mechanical principles to the human body and is studied extensively by podiatrists. Many of the basic concepts are also applied in physical therapy and sports training are biomechanical in nature. Orthotics are devices that enhance function and compensate for biomechanical problems in the leg. Changing joint positions and alignment in the foot and ankle have a direct effect on your knee and hip.
Not everyone needs orthotics, but many people benefit from them.

My clinical experience has me convinced me that orthotics are necessary treatment modalities for a number of musculoskeletal disorders in the lower extremity including arthritis.

My broken Ankle was Fixed, so Why does it Still Hurt?

Some of us are very sensible and still end up in accidents. Some of us do foolish things and obviously end up in accidents. Whether it was a car accident, sport’s accident or a stupid accident, should we have to suffer for the rest of our lives? Ankle fractures are very painful and the surgery includes multiple screws and plates. The recovery period is long and hard. But one would think five, ten, twenty years down the road your ankle would be free from pain. For some, this is true. For others, and ankle fracture leads to lifelong arthritis and pain.

There are four bones that make up your ankle. The tibia, fibula, and the talus articulate with one another to make the ankle joint. Many ligaments surround the joint to stabilize the bones into proper alignment to provide optimal function. Typical ankle fractures involve the breaking of the tibia and fibula bones and damage to a number of ligaments.

To reestablish a competent joint, surgery is almost always necessary. The surgeon will realign the fragments and fixate them back into place using screws. Plates are also used to stabilize the injured area of bone. Essentially, the surgeon will reposition the bones as close as possible back to normal.

Unfortunately, many suffer long term effects from an ankle injury. When the bones break and the ligaments lose their integrity, the bones can slam into and damage the articluar cartilage. The talus, the other bone that makes up the ankle joint, has a thick layer of cartilage that is poorly vascularized. The poor blood flow to the cartilage and the extent of the damage can make it difficult for the body to self repair the injury. These injuries to the cartilage are difficult to assess during surgery. If a surgeon chooses to address these small and difficult injuries, it involves more studied, more procedures and more cost to the patient. Thus, many surgeons chose not to address the injury.

The majority of the time, the body does a sufficient job at repairing the cartilage damage. If the lesion is small, the body’s repair process works sufficiently. Occasionally the lesions are larger and lead to osteoarthritis or degenerative joint disease. It is believed that this may be the reason why some people have residual pain after an ankle fracture. Treating larger cartilage lesions is done by using grafts, preferably from the patients. They will take small pieces of cartilage from your knee or other joints. Some synthetic transplants can also be used. An ankle fracture surgery is already very complex and doctors are not certain treating the cartilage problem at the time of the ankle surgery is what is best for the patient. The longer a surgery takes, the higher the risk of complications.

Some are willing to accept that arthritis is an unfortunate side effect of ankle fractures, but many doctors are studying and researching ways to reduce the number of people living with pain after a fracture. Doctor’s want to make their patients feel better, but sometimes there are too many barriers to completely eradicate the pain. Please be assured that we are dedicated in helping you with your foot and ankle issues even if the battle seems impossible.

David Beckham’s Ruptured Tendon

The Soccer king will be sitting on the bench through the world cup because of an Achilles tendon rupture. Though the achillies tendon is the largest tendon in the body, it is not uncommon for it to completely rupture! Athletes are at greater risk to experience such an injury, but it is also common in the weekend warriors who have tighter muscles and are taking part of a strenuous sport.

The Achilles tendon connects the calf muscle to the heel bone. This area of tendon is the most common to injure due to the least blood supply. This area is also referred to as the watershed and is located several centimeters above the heel bone. The Achilles tendon is used to point the toes and push off the ground and is used with every step. Thus, it is common after injury to feel unsteady or awkward walking.

When Beckham injured his tendon, he screamed “Its broken, its broken!!!” Complete rupture of the tendon can be very painful and is sometimes described as getting shot in the leg. Like Beckham, many will mistake the injury for a broken bone. There is often an audible pop accompanying the injury. With a complete rupture, one will be unable to stand on their toes or walk on the injured leg. Partial tears can also occur and will have similar symptoms but one will still be able to walk.
Men are five times more likely to rupture their Achilles tendon than woman. We all know David Beckham is a real man and he also plays a high risk sport that involves jarring movements and a lot of quick steps. He also falls into the correct age bracket. The most common age of those who suffer an Achilles rupture is between 30 and 40. Beckham may be rocking out a 20 year old body, but he is actually 34 years old.

It is important to seek a physician for treatment as early as possible. The longer treatment is delayed, the worse the outcomes will be for repairing the tendon. The most desired treatment is surgery. Ideally, the ends of the tendon are reattached to one another. Occasionally, the tendon has endured significant damage and a graft is used in the repair. If one is not a surgerical candidate, casting can be done and a full recovery can be reached, but the patient is at a significantly higher risk to reinjure the tendon than those who have had surgical repair.
Unfortunately, you do not have to emulate David Beckham to suffer from such a limiting injury. Some fluke injuries, such as falling down the stairs, can cause an Achilles rupture. The best way to prevent a rupture is to stay healthy and flexible. It can take four to six months to recover from an Achilles tendon rupture and it may cost you the world cup!

How Lysacek won Gold on an Injured Foot

Winning an Olympic gold medal is the greatest accomplishment an athlete can have. All of the training, work and anticipation for the completion can be slammed into a halt if one suffers an injury near the games. Evan Lysacek has been struggling with a foot injury and was still able to put on a performance of a lifetime and win a gold medal.

Prior to the world championship, Lysacek suffered from a stress fracture in his foot. For this reason, he chose to remove the quadruple jump from his performance. After winning the competition, the champion spent time in a walking boot and had to rest from training in order to allow the fracture to heel. By the time the U.S. championship came around, Lysacek’s foot was back on track and he was fearless in performing a quadruple jump in his performance.

Stress fractures are small overuse fractures commonly seen in athletes. Unlike traumatic fractures, stress fractures are very small and thus referred to as a hairline fracture. These fractures can be very difficult to see on x-ray. Since the injury is so minor, the treatment is quite simple. Rest, rest and more rest is a straightforward treatment but a very difficult thing to do. Athletes have a very difficult time sustaining from their work out regimens; but if one does not rest, the stress fracture can progress to a complete fracture that would demands surgery.
Evan Lysacek was able to skate through his injury at the world championship, and then allowed himself to heal completely afterwards. Ignoring the injury or not allowing for proper healing, the fracture could have jeopardized his future in skating. After his quadruple jump at the U.S. championship, Lysacek started to feel similar foot pain all over again. He was not diagnosed with a stress fracture, but it was the wakeup call that he needed to focus on his training and performance techniques.

The quadruple jump is the most difficult trick a male ice skater can perform and only a few people in the world can execute it with grace and precision. Due to the difficulty, and the unnatural forces caused by the takeoff and landing of the jump, injuries can easily occur. Evan Lysacek knew his body’s limits and chose to discontinue training and performing quadruple jumps. This put him at a huge disadvantage in competitions, but this did not stop him from perfectly executing every element of his program.

All athletes, including the Olympic champions, YMCA junkies and weekend warriors need to pay closer attention to their body. You can only be a good as your body can handle. No one can be their best while injured. Lysacek dissected his body’s capabilities and was still able to walk away from Vancouver as a champion without the most prestigious element of an ice skating presentation. His performance had the world at the edge of their seats and he still kept his foot safe from reinjuring.

Being In Love May Reduce Foot Pain?

The University of California Los Angeles recently did a study that showed thinking of a loved one decreased a person’s pain. While having heat applied to their forearm, 25 women were asked to rate their pain levels. When the women were shown pictures of their significant others or when they were allowed to hold their significant others hand their pain level consistently reduced.

Love is patient, love is kind, but is love an anti-pain medication? When one is suffering from a serious illness, it is obvious that having support from loved ones helps one get through the rollercoaster’s of pain and suffering. But, can love help with your everyday aches and pains? According to this study it can!

Medically, there is no definitive answer on why this may happen. Pain can only be measured by the person’s perception of the pain. Thus there is great variation in pain from one person to another. This is what we refer to as “pain threshold.” One may say they have a high pain tolerance, meaning it takes a lot before the pain “affects” them. I see this often in my clinic when I give a people injections. Some people are 100% calm, cool and collected and don’t even blink when I prick them with the needle. Others are jumping for the chandelier and screaming at the top of their lungs when all I am doing is putting a relatively small needle under their skin.

So can being in love increase your pain tolerance? Plantar fasciitis is one of the most common causes of heel pain. I see several patients a day with this common foot problem and when I ask the patients to rate their pain on a scale from 1-10, I can never predict their response. There is absolutely no consistency on how much pain this problem causes. The description is always the same “It hurts the most in the morning or after rest.” But since everyone perceives pain on a different threshold, not everyone rates it the same number. I have never dove into my patients personal lives to discover whether a pain rated a 10 actually means that they just lost the love of my life and as a result their foot hurts.

There is no doubt in my mind that having someone supportive in your life that makes you happy can help you deal with or handle your pain with slightly greater ease, but there is always a reason for the pain. .

Winter De-Feet

Winter is knocking on our doors and bringing cold air to chill our bones. The cold air gives us so many reasons to snuggle up in bed or cozy up by the fire, but it also gives us so many reasons to enjoy the outdoors.

Skiing, ice-skating, snowshoeing, snowmobiling, and snowboarding are all common winter activities that expose our bodies to the cold. It is important to protect yourself from the cold weather. Many are unaware that you can still acquire cold injuries in weather above freezing! Sometimes we underestimate the weather, or sometimes we just don't have a pair of boots to go with our outfit. Whether on a ski hill or walking to work, you need to keep your feet protected from the cold.

Chilblains is an extremely common cold injury that does not involve freezing of the body's tissues. After exposure to cold weather, areas of the skin will be painful, red to purple, and swollen. The discomfort can last for days and eventually subsides. Occasionally, the affected area will permanently have an increased sensitive to cold Trench Foot occurs after the foot is exposed to cold and wet conditions. This was a common injury in soldiers of WWII. As in Chiliblains, none of the body's tissues are freezing but the cold weather does cause damage. The foot will be very painful, red, and blotchy. Depending on how long the foot was exposed and how cold the foot got, determines the severity. In rare cases, trench foot can lead to gangrene and the need of an amputation.

Frostbite is the actual freezing of the affected area and is the most severe of cold induced injuries. Ice crystals form and damage the surrounding tissues due to the lack of blood flow and heat. The longer the body is exposed or the colder the air, the more severe the injury. The skin may appear, pale, blue, red and will be extremely painful. Eventually the injury will cause nerve damage and loss of sensation. Blisters may form shortly after the injury.

The prognosis varies from mild complications to amputations. Those who are more susceptible to cold injures are children and elderly. Children have very small toes and fingers and therefore it is easier for these small areas to become cold. The elderly tend to have poor circulation and less mobility. Blood flow helps keep our extremities warm, thus anybody with poor circulation is at a greater risk for cold injuries. If you know you are going to be exposed to cold weather, make sure to dress for the occasion. Wear layers but make sure no area is too tight. Tight clothes can restrict circulation. Bring extra clothes and stay dry. If you have sweaty feet, try changing your socks as often as possible. Avoid drinking alcohol or using illicit drugs since these products can alter your perception of the weather. Take some time to warm up when you are getting cold. Going indoors and enjoying a cup of hot chocolate is sometimes the best part of playing outdoors!

A Painful Foot Tattoo

You can get a tattoo just about anywhere of anything. Surprisingly, the foot has become a tattoo hot spot. Young and old tattoo enthusiasts are racing to get their foot art. Even though the feet are one of the most painful areas to get a tattoo, their popularity is growing! Is it safe for anyone to get a tattoo on their foot?

The foot has many tendons, ligaments, bones, blood vessels, and nerves. The bottom part of the foot is nicely cushioned with fat, but the top of the foot has a very thin layer of skin and fat. Thus, there is very little protecting the delicate structures underneath. The less fat an area has, the more painful the tattoo sight. The skin is basically made up of three parts called the epidermis, dermis, and hypodermis. The epidermis is the skin that regularly flakes off on a daily basis. The dermis is deeper and is the layer that tattoo ink is injected into. The tattoo needle injecting the ink is not intended to go into the hypodermis that contains larger blood vessels and nerves. There are tiny nerve endings in the dermis and thus the tattoo procedure will be very painful. One reason that foot tattoos are extremely painful and tedious is due the fact that the skin is thinner on the top of the foot and there is little space between the layers.

In simple terms, a tattoo is a wound with a dye injection. The skin which is a protective barrier to bacteria is broken and a foreign object, the dye, is injected into the sight. The body reacts to the dye and “walls it off” to protect the rest of the body from this foreign object. As a result, a permanent tattoo is formed. Most tattoos do not lead to serious complications, but occasionally a foot tattoo can go sour. It is important to keep the tattoo sight clean and protected after the procedure. Unfortunately the foot is often in socks and shoes that can harbor bacteria. The foot also bears a lot of weight and can put stress on the structures surrounding the tattoo and the tattoo itself. Many have to resort to flip flops or other non-supportive shoes for days to weeks before returning to their normal shoes. If your feet are not used to being in unsupportive foot gear, this may lead to generalized or focal foot pain. Still, it is more important to keep the tattoo sight clean since the complication is much more severe than not wearing proper shoe gear. Once the tattoo sight has healed, one should go back to wearing socks and supportive shoes during regular day activities.

Since tattoos are wounds, there is a population that should avoid getting a tattoo on the lower extremity and especially the foot. Peripheral Arterial Disease (PAD) is an extremely common disease among diabetics, and all people over 50 years old. It is the aging of the arteries that causes the vessels to be narrower than normal and thus decreases the blood supply to the feet. Wounds need blood and oxygen to heel. Remember, a tattoo is a wound and it also needs blood and oxygen to heel. Thus, if you have diabetes or PAD, your wound could turn into an ulcer that is limb threatening. People with lymphatic diseases and those who are have lost feeling in their feet are also at increased risk for developing an ulcer.

If you are interested in expressing body art on your feet, make sure your feet are healthy! Visit your podiatrist to have a foot exam to evaluate the health of your feet. If you have decreased pulses or sensation, your cool foot statement could lead to a not so beautiful wound or even an amputation!

Aaron Rodgers and Brett Favre: The Foot Comparison!

You cannot watch football this season without hearing about Brett Favre and Aaron Rodgers. They have been over analyzed in every way possible. So much attention surrounds the legend and the rising star who replaced him. They have faced each other twice already this season, both with a Favre victory, yet the discussions don't seem to subside for a moment. So, to add on to this intense analysis, let us explore the foot injuries of the two athletes!

Prior to the Viking and Packer game, Favre had his first report on the Viking's injury list with foot pain. Nothing more was said about the issue other than that he had a sore foot. The irony of the situation is that after the game, Rodgers suffered from a foot and a toe sprain. Is this the beginning of the end? Did Favre get the last word through foot injuries?

A sprain describes an injury in which a ligament between two bones is stretched, damaged or torn. A Grade 1 injury is fairly mild with only minor damage to the ligament. A Grade 2 injury is a partially torn ligament and a Grade 3 is a ligament that is completely torn. With a grade 1 injury, the recovery time is short with very few possible complications.

On the other hand, a grade 3 can takes months to heal and is often extremely painful. Foot sprains are rare in the general population, but are common in sports that put the foot in abnormal twisting positions. Such injuries usually result in a grade 1 or grade 2 damage and complete recovery can be seen within the season with much improvement in only weeks.

Treatment consists of rest, icing, strapping, and anti-inflammatory drugs. A sprained big toe is better known as turf toe. This usually results when the big toe is abnormally hyper-extended. This injury can often be more debilitating than a foot sprain because of the important role the big toe plays in pushing off the ground when running. The grading system is the same as a foot sprain with Grade 1 being a minor injury and grade 3 being more severe.

To prevent further damage with the ability to continue activities, taping techniques have been proven quite effective. The severity of the foot injuries of Favre and Rodgers has been downplayed and seeing their continued performance on the field allows us to assume they are minor.

Still, these injuries can be very painful and increases the risk for a more severe injury. To prevent further injuries, both players should be undergoing physical therapy and switch to a more stable shoe gear. The cleats and the flexibility of football shoes increase the chance that the foot will be twisted in a position that could worsen the injury.

Rodgers' first line of treatment should be to have more protection on the field. It is likely that the injury resulted after one of his many sacks this season. Favre, has age working against him. Younger athletes tend to recover better and faster than older athletes, but Favre has proven that age does not define his ability to play football. Only time will tell if these injuries will advance to a more serious problem that will take them off the field.

The likelihood of these injuries progressing is unlikely since they seem to be only presenting with minor symptoms. Thus, the live football drama series of Favre versus Rodgers will continue.