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.
