Foot Care

9/30/2009
Jessica Gleason
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Pain Free Bunion Surgery

Bunions at the Dinner Table

Victoria Beckham, also known as Posh Spice, has made the news several times this year. Not because of her husband’s amazing talents or her singing career, but rather because of her feet. This Spice Girl has a very serious dilemma. Should she correct her bunions or should she continue to wear sexy shoes and deal with the pain?

A bunion deformity is when your big toe tilts toward your small toes. Over time, the big toe creeps further and further along and causes a bump to protrude out on the side of your foot. This bump is actually the bones that make up the joint at your big toe. There is not one thing that causes bunions. Simply wearing high heels will not lead to bunions though they may make the bunion worse. The most common factor linked to bunions is hypermobility of a joint in the mid-section of your foot.

To read more about bunion surgery click here. 

Labels: ankle foot pain podiatrist in Hillsborough podiatrist in Piscataway treatment

8/12/2009
Peter Wishnie, D.P.M.
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Cryotherapy in New Jersey

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 ailmentsof children an

Posted by Dr. Peter A. Wishnie at 1:37 PM 0 comments

To read more blog posts by Peter Wishnie click here.

Labels: cryotherapy foot foot health NJ pain podiatrist in Hillsborough podiatrist in Piscataway

Foot and Ankle Pain

How Lysacek won Gold on an Injured Foot

Date: 02/21/2010

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?

Date: 02/13/2010

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. .

Running Podiatrist's First Aid Kit

Five Items Every Runner Should Have On Their Holiday Wish List

Date: 11/25/2009

The holiday season is here yet again. With only a few weeks left before all the holiday madness begins it is time to start thinking about what to put on your holiday wish list for this year. If you are a runner or maybe just someone who will want to run off the extra holiday pounds below are 5 items that everyone will want to have on their list this year.

1) A new pair of running shoes - Let’s face it, running shoes tend to be one of those things many people push off replacing. Whether you are busy preparing for the holidays or if you are just really partial to one pair of running shoes, a new pair of shoes can really help to keep your feet and body injury free. Although experts vary on how often to replace a pair of shoes, a good standard to go by is to replace your shoes every 350 miles or six months, whichever comes sooner.

2) Moisture Wicking Socks - The best pair of shoes in the world won’t be nearly as beneficial without a good pair of moisture wicking socks. Although it may seem extreme to have to pay $5 for a pair of specialty socks when you can get a 5 pack of cotton socks for the same price, socks are one thing you don't want to skimp on. They help keep your feet and toes stay dry in order to prevent blisters from forming.

3) Nike Fit - I really have to hand it to Nike because the Nike Fit is an extremely helpful tool for runners of all skill levels. This device allows you to track your runs, pace, and states of each workout through a chip in your shoe that can later be downloaded on to your computer to monitor your runs. If Nike isn’t the right shoe for you, there are adapters you can purchase to use the technology with other brands of shoes.

4) Running Utility Belt - If you have ever run a long distance race then you have probably seen those people with the belts around their waist that have little pouches to held various items. This is a great item for people who are long distance runners. The belt is ideal to hold little bottles of water, gel food packs or even your keys or cell phone.

5) Road ID - Although this last item may seem a bit much it is one of those things that it is better to be safe than sorry. A Road ID is an identification bracelet that runners and cyclists wear in case of an emergency so they can be identified. Accidents happen every day between athletes and automobiles, Road ID is a simple way to protect yourself in case anything were to ever happen to you while you are out on a run.

With the holidays being right around the corner don't forget to add these 5 items to your wish list this year so that you can have the gear you need to run off all those extra holiday calories.
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Playing Sports Does Not Have to Mean Getting Hurt!

Date: 11/19/2009

Sports Injuries of the Foot and Ankle

Sports injuries of the foot and ankle generally fall into one of two categories: (1) Acute/Traumatic Injuries which occur due to a sudden force, or impact, on the foot or ankle, and (2) Overuse Injuries which result from overuse, lack of proper rest, lack of proper warm-ups, or poor conditioning.

But playing sports does not have to mean getting hurt. Warming up adequately, training effectively, using proper equipment for your sport, and recognizing and addressing the early warning signs of injury can reduce your risk of aches and pains.


The following is a list of some of the most common sports-related injuries of the foot and ankle:

Baseball—blisters, ankle sprains, muscle strains, stress fractures

Basketball—ankle sprains, Achilles tendonitis

Bicycling—Achilles tendonitis, plantar fasciitis, blisters

Dance—ankle sprains, dancer's fracture, sesamoiditis, plantar fasciitis, metatarsalgia, Achilles tendonitis, trigger toe

Football—shin splints, ankle sprains, Achilles tendonitis, turf toe, blisters

Golf—plantar fasciitis, stress fractures, blisters

Running—ankle sprains, Achilles tendonitis, blisters, plantar fasciitis, IT band syndrome, patellofemoral pain syndrome, piriformis syndrome, shin splints, stress fractures, muscle cramps

Skiing/Snowboarding—frostbite, muscle strains, ankle sprains

Soccer—ankle sprains, Achilles tendonitis, IT band syndrome, muscle cramps, blisters, patellofemoral pain syndrome, plantar fasciitis, shin splints, stress fractures

Tennis—Achilles tendonitis, ankle sprains, IT band syndrome, Achilles tendon rupture, stress fractures

Volleyball—Achilles tendonitis, Achilles tendon rupture, ankle sprains

While it is impossible to prevent every injury, research suggests that injury rates could be reduced by 25% if athletes took appropriate preventative action, including the following: be in proper physical condition to play a sport, play by the rules of the sport, wear appropriate protective gear, rest, warm-up, and avoid playing when in pain or when tired.


Just a few extra words about running:


Running is one of the easiest ways for athletes to get injured. Running injuries are common and often affect the ankles and feet. The impact and stress of running is sometimes hard on the muscles and joints, especially if the early warning signs of an injury are ignored. The best way to avoid running injuries is to prevent them using tips such as these:
· Stretch, stretch, stretch!
· Wear Proper Footwear
· Replace Shoes as Needed
· Warm Up Properly
· Cross Train
· Avoid Overtraining
· Follow the Ten Percent Rule



A podiatrist can recommend the proper running shoe for your foot type. If you're not sure which shoe is right for you, consult your podiatrist.

Pain Free Bunion Surgery

A Different Kind of Bunion

Date: 10/21/2009

Ever wonder why the big toe joint is so achy? Does it feel stiff, sore, or swollen? Your big toe joint can go through a lot of abuse over years. It gets stubbed, jammed, and squeezed into shoes. All of this microtrauma can lead to long term damage. Who would have thought your big toe could be such a pain.
Hallux is another name for you big toe. Like any joint, your hallux joint consists of two bones with a layer of cartilage on both ends. The cartilage provides for a sleeker surface and absorbs shock to protect the bones from damage. When one suffers from arthritis it is due to a breakdown or damage to the cartilage that causes the bone to run up against bone. This rough friction causes swelling and pain.

Over the years your big toe joint can suffer damage from simple accidents like stubbing your toe in the middle of the right, dropping an object on your toe, and so many other things. Eventually, the cartilage gets damaged and is slowly destroyed. The first symptom of this destruction is limited joint motion. When we walk, our big toe joint should have about 65 degrees of motion. With joint damage, the amount of motion gets smaller and smaller and BAM! The pain hits you out of nowhere! All of a sudden you notice your big toe is stiff or rigid and oh so painful.

Hallux Limitus refers to a decrease in big toe joint motion and Hallux Rigidus is when there is complete loss of big toe joint movement. The early symptoms of hallux limitus consist of pain and stiffness in the joint when walking, standing, and especially squatting. There may be an increase in pain in colder temperatures and damp weather. There is often swelling at the joint. Over time the jamming of bone up against one another can cause new bone formation that forms a bump on the top of your joint. This bump is called a bone spur. This will cause the joint to be more painful and it will eventually lose complete motion or become rigid.

Patients often confuse this disease with a bunion because they both form a bump by the big toe. Though a bunion is also very painful, it is a completely different problem. Bunions are formed when your bones get displaced off to the side. Thus, the bump is on the inside of your foot. With hallux Limitus and Rigidus, the bump is on top.

The treatment for Hallux Limitus/Rigidus depends on how far along the disease has progressed. At early stages, it is important to promote motion at the joint. The more the joint is exercised, the better the outcome will be. This can be customized with orthotics and physical therapy. In cases of a more severe hallux limitus, surgery might be needed to remove the bump or sometimes the joint is replaced with a metallic joint implant. If the disease progresses to Hallux Rigidus, the therapy is surrounded around minimizing joint movement to decrease the pain. This can often be done with orthotics, but in most cases surgery is necessary.

Sometimes, the lack of motion at the big toe joint is asymptomatic. However, the person’s gait is altered and is suffering from knee or lower back pain or even pain on the outside of the foot. When you can’t push off with the big toe joint, you will need to apply more pressure on the outside of that foot. This can lead to pain in other areas of the body.

So, if you are suffering from pain along the big toe joint, do not hesitate to see a podiatrist. In the early stages of these deformities, surgery can possibly be prevented. If you are having back or knee pain, make sure your doctor checks your feet. Remember, if the ground floor is broken, then the other floors will crumble as well.




Bunions at the Dinner Table

Date: 09/27/2009

Victoria Beckham, also known as Posh Spice, has made the news several times this year. Not because of her husband’s amazing talents or her singing career, but rather because of her feet. This Spice Girl has a very serious dilemma. Should she correct her bunions or should she continue to wear sexy shoes and deal with the pain?

A bunion deformity is when your big toe tilts toward your small toes. Over time, the big toe creeps further and further along and causes a bump to protrude out on the side of your foot. This bump is actually the bones that make up the joint at your big toe. There is not one thing that causes bunions. Simply wearing high heels will not lead to bunions though they may make the bunion worse. The most common factor linked to bunions is hypermobility of a joint in the mid-section of your foot.

Hypermobility does not mean flexibility but rather movement when there is not suppose to be movement. Think of a table with four legs but one leg is a little off. The table is designed to be stable, but a tiny flaw causes it to tilt when you apply pressure to the surface. If you place some support such as a pack of napkins under the disabled leg, the table is no longer hypermobile. Detecting hypermobility in the foot is not as easy to notice as an uneven dinner table, but with careful examination, podiatric physicians are able to detect this problem that is often associated with bunions.

When treating bunions, the initial approach is conservative therapy of orthotics, padding, and strapping. These treatments are similar to the concept of putting the napkins under the unsteady table to make it less hypermobile. But, at some point the bunion gets to the point where surgical correction is necessary. Just as there is probably a dozen ways to take the unstable table to the shop and make it functional, there a dozen ways to correct a bunion. The skill of the surgeon is to determine what procedure is best to prevent the problem from reoccurring. To do this, the surgeon must identify the root of the problem. As we mentioned before, hypermobility is the most likely cause for most bunions.

Lets go back to the table example. If we wanted to correct our unsteady table, is it best to saw the other three legs down, or figure out why the one leg is shorter and try to correct the site where the problem exists. The reason that so many patients and doctors have trouble treating a bunion at its root is because of the crucial recovery time. A Lapidus procedure is the most reliable technique to correct bunions due to hypermobility. This procedure fuses, or unites, the two bones at the location of the hypermobility, which is along the midfoot region. The doctor could do the procedure and have a perfect operative result, but the most important part of the treatment is the patient’s ability to stay off their foot! After surgery, a patient has to be put in a cumbersome cast and is unable to bear weight on their foot for six weeks. With all bunion surgeries, the patient must exercise the big toe joint to ensure proper motion. Some recovery time may be spent with a physical therapist to assist in strength training your foot back into action.
It is essential that bunion treatments are done correctly the first time.

When the focus is on the cause of the problem and not how to immediately improve appearance, the patient will be much more pleased with the surgical results in the long run. If you are serious about getting your bunions corrected, then you must also take the doctor’s post-operative instructions serious. I wonder if this is what is holding Victoria Beckham back from getting her bunion fixed. This “A” list celebrity would rather run around in excruciating pain in an unsightly bunion to please all the Spice Girl fans. Back here in the real world, you can run around with your children or girlfriend’ pain free and bunion free if you take the time to treat it right!

Diabetic Foot Tips

How to Get Rid of Your Winter Alligator Skin

Date: 01/30/2010

Get Rid of My Dry Skin Dry skin! As the air gets cold, the moisture in the air decreases. The air will steal moisture from your skin and as a result, your skin will be drier this time of the year.

Chapped lips and itchy skin goes hand in hand (or foot and foot) with the season. If you already have dry or sensitive skin, the winter can be especially brutal. How to tackle the dry air or just dry skin in general. What else can cause dry skin? Having sweaty feet can cause dry feet! When your feet sweat, they are pulling out the moisture from your body. Thus, many will notice that after they allow their feet dry, their skin will be very dry.

Fungus, will also eat up the moisture in your foot and leave the skin dry and flakey. There are many different skin conditions that can cause dry skin. Psoriasis is the most common, but there are several other common conditions that will leave you dry. If the your feet are dry and cracking open, it is best to seek a medical professional such as a podiatrist to address the problem. When cracks or fissures are forming, there is often a systemic disease that is causing problems in the skin and other organs. If the condition has been there for many years or does not respond to at home treatments, a more aggressive treatment may be necessary that can be provided by medical professionals

When shopping for a lotion to sooth your skin, make sure to read the label. The lotions should be water based and contain little to no alcohol. Shea Butter is a natural moisturizer that does wonders to the skin on many different levels. It can be found in many common over the counter lotions today. If your feet are exceptionally dry, you can apply lotion to your skin at night and wear socks while you sleep. Creams are better than lotions for thick skin areas, like the soles of your feet.

Do not apply lotion between your toes and avoid this area with any moisturizing product. The skin between your toes in very thin and sensitive and can easily macerate when too moist. When shopping for shoes, choose light colors and materials that allow air flow. Synthetic materials tend to reflect heat and cause the feet to sweat. Socks can also help you control the moisture in your foot. Fabric made up of a mix of cotton and polyester can help wick away sweat from your foot and will decrease the amount of moisture that evaporates of your skin.

Whether it is the dry air or something you are fighting all year long, it may be time to give your feet a special gift this season. Fill up the bath, soak your feet, and enjoy some nice relaxing lotion. Soothing your feet is like soothing your soul.




Dance for Diabetes: Podiatry School Gives Back

Date: 01/20/2010

On January 16, 2010, Scholl College of Podiatric Medicine (SCPM) in conjunction with Rosalind Franklin University of Medicine and Science (RFUMS) hosted the 23rd Annual Dance for Diabetes at the Millennium Knickerbocker Hotel in Chicago, Illinois. This annual event helps raise money to donate to the American Diabetes Association (ADA) to help fund research on preventative medicine and education on Diabetes.

Scholl College of Podiatric medicine has been dedicated to raising money for the American Diabetes Association for the past 23 years due to its close professional tie to diabetes. Ask any podiatrist out there about diabetes link to their profession and they will go on for hours about how diabetes affects the lives of many of their patients.

In the past 20 years diabetes has become an epidemic in American society. Currently affecting more then 24 million people in the United States, Diabetes is projected to keep increasing in prevalence over the next decade if the Americans do not change their lifestyles. The reason for the huge increase in the number of people diagnosed with diabetes is strongly correlated to obesity rate of this country.

Diabetes is a disease that really affects the entire body but has special effects on the lower extremities which is why diabetics are frequent visitors to Podiatry offices. Diabetes leads to peripheral neuropathy which causes diabetics to lose sensation in their extremities. Peripheral neuropathy can lead to ulcerations of the feet which can lead to further complications such as infection.

Due to the fact that podiatrists see the devastating side effects of diabetes in their patients many of them become very passionate about raising awareness for Diabetes prevention and research. Undoubtedly this is why SCPM students and faculty work so hard every year to raise money through Dance for Diabetes to donate to the ADA. This year the college was pleased to announce that they donated $21,278 to the American Diabetes Association which is the second largest amount raised by the college in the last 23 years and the most donated since SCPM merged with RFUMS. Congratulations to the all the students and faculty at Scholl College of Podiatric Medicine for raising awareness for a cause that they feel so passionate about. Hopefully Dance for Diabetes will be a tradition that lives on for many years to come.

You Do Not Have To Live With Heel Pain

Does Your Pump Bump Have One or Two Humps?

Date: 10/28/2009

It sounds like a catchy lyric from the Black Eye Peas or Beyonce, but “Pump Bump” is a common term used among podiatric physicians. Do you have pain behind your heel? Do shoes irritate areas behind your heel and cause pain? Do you feel an abnormal bump behind your heel? It may be a bump that is irritated by your pump and thus a pump bump!

Pump Bump may also be referred to as a Haglund’s deformity as well as a retrocalcaneal bursitis. Typically, women most commonly complain of the irritation due to their selected shoes designed for fashion rather than comfort. The pain is sharp and along the side of the Achilles tendon insertion into the heel. Many of my patients find significant relief when they wear athletic shoes or backless shoes, but additional treatment is often needed to be completely pain free.

Typically a pump bump is caused by some abnormality in the heel bone. It may be that the heel bone tilts slightly out or pronates. Or, the heel bone may be tilted upward in a high arch. The Achilles tendon is only attached to the middle one-third of the heel bone. The upper one-third of the heel normally allows a nice gliding motion of the tendon like a pulley. When the heel bone is mal-positioned, the gliding motion is less smooth. Eventually, the unusual rubbing of the Achilles tendon causes irritation and the body develops a bursa. The bursa then becomes inflamed and causes pain in the heel.

On examination, the back of the heel will appear red, slightly swollen and painful to the touch. X-rays or ultrasound will often reveal some degree of boney deformity or mechanical disruption.

When changing shoes does not resolve the painful symptoms, it is necessary to see a podiatric physician to begin a treatment regimen that will hopefully keep you out of surgery. A heel lift can be put in the shoe. This will elevate the heel and reduce the area of friction on the shoe. NSAIDs are also used to decrease the inflammation, but it should be noted that if the shoe is still rubbing hard up against the bump the drugs will not be of great effect. Some of my patients have seen great relief by stretching their Achilles tendon 2-3 times a day. In addition, cryosurgery, which is a minimally invasive procedure helps relieve the inflammation along the heel. In most cases, the pain at the back of the heel is due to the constant pulling of the Achilles tendon along a sack of tissue in this area. This is called bursitis. Cryosurgery requires a very small incision along the area and then a probe that sends liquid nitrous oxide at a temperature of (-) 72 degrees is placed into the inflamed area. This reduces the inflammation, thus relieving the pain permanently. One can walk right away after the procedure with their regular sneakers.

Depending on the cause of your bump, orthoses may be necessary to correct the mechanical problem of your heel. Sometimes, the bump is unable to be resolved by the treatments and surgical excision of the bone bump is necessary.




Children Get Heel Pain Too and They are Not Faking IT!

Date: 10/28/2009

Many of us think that foot problems are one of the aches and pains of aging. But heel pain is not normal nor is it isolated to only adults. I have seen my share fair of children and teens that are having difficulty playing sports or participating in gym classes because of heel pain!

Sever’s disease is the most common cause of childhood heel pain and usually affects children 8-14 years of age. Traditionally, the disease was thought to affect males much more predominately, but now that we are seeing more young women athletes, the incidence is nearing the same between genders. Sever’s disease is medically described as osteochondritis of the calcaneal apophysis. This is an injury to the growth plate in the back of your heal. During development, all bones in the body start as cartilage and fill in with calcium and other minerals to create a strong skeleton. This process is referred to as ossification. The calcaneus, or heel bone, has two separate areas of ossification that are connected by the cartilaginous growth plate.

Because of overuse or tight muscles, these two ossification centers are pulled away from each other causing strain on the growth plate. Overtime simple activities such as running, jumping or even standing can cause severe heel pain. I will often see children limping into my office when they have this condition.

Luckily, this is a self limiting condition meaning it will eventually go away. Unfortunately, children will have to tone down their activity schedule to reduce the pain. It is important to make the children as comfortable as possible and keep them active in their favorite’s sports, but we also have to be reasonable in the treatment options. Physical therapy will help the child stretch the muscles to decrease the pull on the developing calcaneus and Thera-band exercises can be used to strengthen the area. Ice massages will also help decrease the inflammation which is the culprit of pain. Heel lifts placed in the shoes, to decrease the pressure of the Achilles tendon on the calcaneus , and orthoses can also bring relief. Occasionally, there is need for a cast to immobilize the area to ensure proper healing. Though NSAIDS can bring relief to pain, large does are not always recommended for children. Thus, I prefer to have children to try topical pain relievers first.

Since Sever’s Disease can last up to 18 months, it is important to treat it aggressively soon as possible. Thus the child is not stuck on the bench, disappointed in their inability to perform. It may be necessary to take a short break from vigorous sports or exercise to allow proper healing time, but that is much better than sitting on the bench for an entire year!

The Truth About Orthotics

Are Orthotics An Arch Support?

Date: 01/27/2010

Often orthotics are recommended, but are they just an arch support?

As opposed to an arch support that can be purchased at many stores, an orthotic has some distinct advantages:

1. Orthotics are designed to last for years, instead of months from an arch support.

2. An arch support (and most shoes) are designed for the average foot, but an orthotic is custom made for your foot.

3. Although an arch support will provide support to the arch, the orthotic supports the entire foot and cradles the heel.

4. An arch support may flatten with running or increased pressure, where an orthotic will be firm and maintain the position of the foot.

5. An orthotic actually improves or optimizes walking or running patterns by rotating the foot into "neutral position". In this position, the foot functions at the highest level.

Dr Brandt R Gibson, DPM
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
(801)756-0765
http://www.utahfootdoc.com/

Foot Product Reviews

Treat Peripheral Neuropathy With Neuremedy

Date: 04/06/2009


Order Neuremedy Here!!!

For years, people suffering with peripheral neuropathy have been told that there's nothing that can be done for them, other than taking medication to manage the discomfort. Peripheral neuropathy is a syndrome in which nerves are damaged and results in a numbness or pain in the lower extremity.

There are definite causes of neuropathy that can be found. For instance, it is a common occurrence with diabetes. The process that causes neuropathy in diabetics is the diminished capacity of the small vessels in the extremity. You can read more about diabetic neuropathy, its causes and treatment here.

Recent studies have shown that many people suffering from peripheral neuropathy have low plasma levels of the essential nutrient thiamine (vitamin B1). Thiamine is necessary for proper nerve function. Food alone is not sufficient to elevate the levels of the nutrient. In my practice, I've been using Neuremedy, which has a bioactive form of thiamine called benfotiamine. Benfotiamine has been used since the early 1960's to successfully treat tens of thousands of people suffering from peripheral neuropathy in Asia and Europe. Neuremedy does not have any adverse effects and does not interact with any medication.

Many of my patients, who have been previously told that there's nothing that can be done for them, have found improvement with taking Neuremedy. While it does not work for everyone, I have been impressed with the results so far.

If you'd like to purchase Neuremedy, visit your podiatrist or click here to order online.
For more information about Neuremedy, visit our website.

Dr. Andrew Schneider
www.tanglewoodfootspecialists.com

Children's Feet

Will My Child Outgrow Flat Feet?

Date: 12/13/2009

Flat feet can also be referred to as pes plannus, pes planovalgus, valgo plannus, or pronation syndrome. It is commonly described as a foot without and arch. Flexible and Rigid flatfoot are the two basic forms. A flat foot is rigid when the arch appears flat when the child is sitting and when the child is standing. The flexible flatfoot is when the foot appears normal when the child is sitting, but the arch collapses when the child bears any weight on the foot. The flexible form is less severe and much more common.

Flatfoot is normal in children under three years old. Young children are very flexible and will appear to have flat feet. It is normal for the child’s foot to appear as it is rolled in and pointing outward until they past their toddler years. You may need to see a podiatrist if you child still appears flat as they near the age to attend school.

The podiatrist will evaluate the entire lower extremity to determine if the child is experiencing any weakness or pain. The child may complain of pain in the foot, ankle or the knee. The child may also have a history of clumsiness, or a voluntary decrease in activity. The doctor will take x-rays to evaluate the joints and alignment of the bones.

A tight calf is a common finding in all flatfoot patients. This may be a significant component to the patient’s present and future pain. Thus, it is common for children to undergo physical therapy to learn stretches and exercises that target the calf muscles.

The gold standard in treating flatfoot is orthotic therapy. Orthoses are custom made shoe inserts that assist in foot function. Since the orthoses are custom made, they are design to address the child’s specific foot structure and associated problems. These devices will help prevent the flatfoot from progressing and decrease the current pain that the child is experiencing.

Surgery is a treatment of last resort. In rare cases, a child will continue to have pain or disabling fatigue after all conservative treatments are attempted. Surgery is invasive and often unnecessary to control flatfoot pain, so it is not attempted until the doctor and parent have exhausted all other treatment options.

In these severe cases, where the child’s flat foot is flexible, an implant can be placed in the rear part of the foot. One type of implants is the Hyprocure. The procedure takes only seven minutes and is made with a tiny incision. The implant causes an immediate arch and rarely needs to be removed. This procedure is done in children with severe pain in the arch or where the arch is so collapsed it will lead to an arthritic condition when they get older.

Many parents worry about their children’s flat feet, but in most cases the children grow out of them by the time they reach kindergarten. At this age, we begin to worry that the child may actually have a flatfoot. Generally these feet are easily managed and the child can have a normal and active life with no limitations. Be aware of children’s feet and their pain. It is common for children to fall and cry, but it is not common for a child to have foot pain or fatigue. It is always better to treat the flat foot immediately on a conservative basis because once they reach the age of three it might be very difficult to correct.




Twitter / Home

Date: 10/19/2009

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Foot Pain in Kids

“Mom, My Heels Hurt!”

Date: 09/01/2009

It is that time of year again. Returning to school and those extra curricular activities. Kids are excited about sports and band practice, but this sudden increase in activity can cause them to have heel pain. Pediatric heel pain is nothing to ignore. It is not your typical adult heel pain caused by plantar fasciitis and will not go away with advil alone. It can be excruciating for some children to the point they cannot walk. So what is it really and why does it happen?

Calcaneal apophysitis is the medical term for inflammation of the growth plate in the heel caused by the pull of the plantar fascia below it and the Achilles tendon above it. As we grow, the bones in the legs get longer, but the muscles and tendons have to stretch to grow with them. If these structures are tight and have not reached the same length as the bones, then they pull much harder on the growth plates. This causes significant pain that usually occurs after activity and improves with rest. Other symptoms including swelling of the heels, pain with pressure and increased warmth.

Treating pediatric heel pain early is important. In our office, youf child will be fully evaluated including xrays to make sure that the growth plate is normal and the pain is not caused from other reasons like a stress fracture. Rest, ice and stretching are key factors in treating heel pain in children. Appropriate shoe gear, orthotics and physical therapy will also improve their pain and reduce recurrence. In severe cases, complete immobilization may be necessary.

If your child is complaining of heel pain, don’t ignore it. This pain can prevent them from participating in the activities they enjoy. At Foot and Ankle Associates of North Texas, we are here to get your children back in the game.

Keep Your Feet Feeling Young

Death of Nodar Kumaritashvili Reminds World of Dangerous of Winter Olympic Sports

Date: 02/28/2010

Even here in Houston, TX, where winter means we put on a light jacket, many are glued to the TV watching the Winter Olympics in Vancouver. The athlete’s focus and dedication is inspiring and we’re disappointed to see it come to an end after eighteen days of competition. I’ve overheard kids ask their [...]

Healthy Steps for Your Feet for your life

That thing to measure your feet....

Date: 03/04/2010

When you shoe shop, are your feet measured each time you enter the shoe department? Most likely, the answer is occasionally to never. When you shop for shoes, insist on your feet being measured for there is good reason! Plain and simple, your feet change in shape and size. Wearing the wrong size shoes whether they are too small or too large in length and width can drastically affect your foot health.

The tool used to measure your foot has quite a history. The Brannock device has been in use since 1927. Developed by Charles Brannock, it is the most widely used instruments in measuring feet to this very day. The device is made in different colors of green, purple, red or black with each color representing a specific foot such as Men, Women and Children. There are also Brannock devices for Ski Boot and Athletic shoe options.

When Mr. Brannock released his invention, no one else could match the shoe fit. In a short amount of time, word traveled of the exactness of the device. During World War II, the Army hired Mr. Brannock to ensure that boots and shoes fit enlisted men. From that request, he expanded his manufacturing facilities to allow his creation to service proper shoe fitting nationwide.

The Brannock device has an accuracy rate of ninety five to ninety six percent. Based on a linear size system, the difference in each size marker on the device is approximately 1/3 inch. For example, a Men’s size one is seven and two thirds inches. Each additional size is one third inch longer.

Measurement of width on the Brannock device works the same way. Each marker for width is separated by a distance of 3/16 of an inch. Nine widths are offered in the U.S. system and vary according to foot length. The widths are: AAA, AA, A, B, C, D, E, EE, and EEE.

You owe it to yourself to shop in a location where a representative assists you in fitting shoes in lieu of selecting shoes from a display on your own. Never measure your feet by yourself as the tool is designed for a trained representative to measure your feet. Once your feet are measured, ask the representative for the length and width of each foot. You may be surprised to learn your feet may differ in size and that my friend is OK. The key is the shoe size you receive will be based on the longest and widest foot.

So now you know about the Brannock device...now go get your feet measured!
Healthy Steps was created for you with the proper fitting shoe and orthotic in mind. Whether you wear orthotics and need properly fitting shoes or are looking for shoes that are comfortable with style, let the staff at Healthy Steps be of service to you. Healthy Steps is a division of Foot and Ankle Associates of North Texas (FAANT). For more information or foot health tips visit our website at www.faant.com

The Houston Running Chronicles

Running Challenge: Chicago Winter Running

Date: 03/02/2010


For runners all across the United States, the change in seasons can have different effects on their running schedule and performance depending on where they live. For instance if it is summer time and you are from Houston, TX, then chances are that you are going to either run in the early mornings or late evenings when the suns strength is at a low. No matter where you are from the trick is to find out what time of day, equipment and running schedule will best complement you depending on where you live and what time of year it is. The following is a glimpse into my run today, February 24, in Chicago, Illinois.

I am trying to get back into shape for summer which will be here before we know it so I decide to face Mother Nature and start running outside. Before I get dressed for my run I look at the thermostat on my front porch and see that it is 33 degrees outside and the trees are moving around on my front lawn so I know that it is a little windy outside. I also take a look at the street and see that it snowed enough last night to leave a fresh layer of snow on the pavement, just enough to cover the ground. Taking the weather conditions into account I put on a pair of sweatpants, a sports tank top covered by a zip up turtle neck and all enclosed by an Under Armor fleece running jacket. Before I head outside I also put on a pair of mittens and a hat.

The first thing I notice as I begin my run is the tightness in my lungs. When the air is 33 degrees and your body is around 98 degree the temperature difference puts a strain on your lungs because you are not only breathing but your body is also trying to warm the air as you breathe it in. So it is a little hard to breathe but after about half a miles my body starts to get us to it.

The next thing I realize is that I am running with a little wider gait because the ground is slippery from the fresh coat of snow. My pace is definitely slowed because I would rather be cautious and not hurt myself than fall.

Around the 1 mile mark my body starts to go from cold to warm and as I begin to perspire under my 3 layers of clothing, I am forced to unzip my jacket a big and take off my mittens and but them in my pockets. The rest of the run goes pretty smoothly as my body has adjusted to the conditions, but as I get to the last half mile and my body is getting exhausted things start to break down. My nose starts to run uncontrollably, I can feel the bottoms of my earlobes throbbing in warmth under my hat and my toes start to numb. I know from experience that this is exhaustion setting in and my body is sensing this and attempting to tell me it is ready to stop.

I push through the last half mile and when I get back to my front porch I feel extremely warm and immediately begin to strip off the top layer of clothing. I know to only stay out side for a minute or two to walk around and catch my breath but not to stay to long as to get a chill.

Many factors play into running in cold snowy temperatures and only experience can help to prepare you for exactly what to wear, how to breathe and wear to step so you don’t slip. No matter where you live in the country different temperatures and conditions present different challenges, the trick is to listen to your body and think ahead of your run as to what to expect.

My Child's Foot

Does What You Eat In Pregnacy Help Your Child?

Date: 11/09/2009

As the father of 10 children, we (although my wife has done all the work) have gone through just a couple pregnancies.  Through each of these 10 pregnancies, my wife is always striving to make the best choices to have a healthy child.  There is a new study that may help protect our children from diabetes even before they are born.

New evidence is emerging for how important it is for pregnant women to eat good, nutritious food. Expecting mothers who eat vegetables every day seem to have children who are less likely to develop Type 1 diabetes, according to a new study from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Full Story .

Although this is pre-birth information.  It is worth considering what your child should be eating on a daily basis to preclude heart disease, circulation problems, diabetes and other systemic diseases.  Many of these problems will present with foot & ankle concerns in my office over their lifetime.

Dr Brandt R Gibson
Moutain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
www.UtahFootDoc.com

The Diabetic Foot

New APMA video for the Diabetic Foot

Date: 11/24/2009

The American Podiatric Medical Association has released a new video on the Diabetic Foot, including consequences of vascular compromise (decreased blood supply) to the foot.



To view the video clip on APMA's official YouTube channel, please CLICK HERE.


Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
http://www.UtahFootDoc.com

If the Shoe Fits...

I Am a Hippocrit!

Date: 02/03/2010

Podiatrist Demands you Wear Flip Flops?

We are nearing the time of the year that families, couples, and friends pack up their bathing suits and head south for a much needed vacation. You may be anxiously awaiting the sand, sun, and cocktails. Burring your feet in the sand beats the day to day routine of boots, snow, and cold toes. With the growing check lists for your upcoming departure, foot health may not be on your list of thing to prepare for, but maybe it should! The number most vital thing to pack to save your feet are sandals or Flip Flops!

It is not often that you hear a podiatric physician promoting flip-flops, but they can be very important in protecting you on your vacation. We often forget that viruses, bacteria, and fungus enjoy the warm weather as much as we do. Though walking around barefoot can be relaxing, it is dangerous. You can pick up warts, athletes foot, and bacterial infection just about anywhere. Always wear sandals by the pool and even in your hotel room on the carpet. Do you know who stayed in your room last and how well did they clean the carpet?

Walking barefoot in the sand is very relaxing until you step on a piece of glass, a sharp twig, a shell or whatever the last metal detector-vacationer dropped from his pocket. Flip flops do not offer you any support, but they do provide a barrier between you and something harmful. Wearing flip flops can prevent you from getting an open wound. You may be thinking so what; a little cut on my foot won’t ruin my vacation. Not only are you at risk of getting an infection, but you will also be in a lot of pain. Even a small cut is easily aggravated by the salt water in the ocean or the chlorine in the pool. Planning on going golfing? How will your cut feel after a full day of walking on the greens?

On a nice tropical evening, it is so enjoyable to take a walk on the boardwalk or watch the sunset off the deck. Where there is wood, there are splinters! I see a number of patients every year with splinters in their foot. Sometimes, they remember the exact moment the stubborn piece of wood found a home in their foot, other times they had no idea their pain was being caused by a splinter. Two things can happen with a splinter in your foot. First, the wood harvests bacteria and can cause a local infection. The area will be red, hot, swollen, and some drainage from the wound site may be noted. If possible, your body will identify the splinter and immediately wall it off to prevent an infection. This walling off mechanism may cause a painful cyst that would need to be surgically excised.

It is very rare for a podiatric physician to tell you to wear your flip-flops. Vacationing is a great time to pull out the flip flops and use them for your safety. It should be noted that flip flops only provide protection and do not provide any support. Thus, if you are doing a lot of walking or standing, you should be wearing a more supportive shoe gear.




Back to School Shoe Shopping

Date: 08/01/2009

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!

Peripheral Neuropathy

Neuropathy Can Be Improved With Alternative Medications

Date: 03/08/2010

As I continue to see increasing numbers of patients with nerve changes to their feet, I am continuing to review traditional and alternative medications for the treatment of these disorders.  Instead of telling my patients that nothing can be done for peripheral neuropathy, I continue to find information that can improve the symptoms.

In a small clinical study run for six months comparing Evening Primrose oil and a placebo, Evening Primrose oil was shown to produce significant improvement of neuropathy over this time.  It was taken at a dosage of 2000mg (2grams) twice a day to get this improvement.  Although the study was small and many individuals don't get the same results, it has been shown to work and should be considered.

Why does it work?  Evening Primrose oil contains an essential amino acid gamma-linolenic acid (GLA) that works with the body to protect nerves and rebuild nervous tissue.  At the above dosage, a patient is getting 360mg a day.  Many people are also trying ALA (alpha-linolenic acid) to get the same results. 

For additional treatment options for peripheral neuropathy, visit our website.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com

Foot & Ankle Health

A Picture Of Health

Date: 11/21/2009

If you had a microscope into your body, an x-ray of the structures, and a mirror into the innermost parts of your body, would you take a look? Maybe you would be even more interested if this picture could help limit future pain or prevent future disease.

As I continue to see patients day to day, many would love to find ways to prevent the foot and ankle problems that are now interfering with their lives. Some even look for options to ensure they can stay active. I feel this information is important and should be available to everyone that desires it.

For this reason, we have created a new free report that will let you not only stay active, but help you understand how careful foot and ankle care can prevent pain, keep you active and even give you a picture into your overall body health.

Request this report and Optimize What You Were Born With...

Dr Brandt R. Gibson
Mountain West Foot & Ankle Institute
American Fork, Utah
http://www.utahfootdoc.com/

Utah Running Doctor

Should I Change My Running To Increase Speed?

Date: 11/10/2009

Here on the internet, I have seen articles on barefoot running, including a recommendation to run 100 miles barefoot, and I have seen recommendations to run on the forefoot or midfoot.  I recently have adjusted my running to increase speed and wanted to discuss some of these claims.  Before it all, I recommend that you continue what is normal for you!

Forefoot or midfoot running has been said to increase speed of long-distance runners.  This is based on a single study that found that 23.7% of runners used a midfoot pattern and that in this study these runners were faster.  It is based on the fact that sprinters run on their toes (forefoot running).  More recent studies, however, including one by Dr Hamill, a professor of kinesiology at the University of Massachusetts at Amherst, have shown some benefits to each type of running.  Rearfoot running, for example, has been shown to be more energy efficient.  No significant speed differences were shown, when all other factors were as efficient as possible.  My recommendation, therefore, is that you not try to adjust your running pattern to forefoot or midfoot from rearfoot or even to rearfoot from forefoot/midfoot.

Barefoot running is a subject that should be considered carefully.  If you walk and run barefoot already, then again I would not recommend you change. If you are thinking about it because of some book or website, please consider the following recommendations from the APMA:

Barefoot running has become an increasing trend, and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.


Barefoot running has been touted as improving strength and balance, while promoting a more natural running style. However, risks of barefoot running include a lack of protection, which may lead to injuries such as puncture wounds, and increased stress on the lower extremities. Currently, inconclusive scientific research has been conducted regarding the benefits and/or risks of barefoot running.

The American Podiatric Medical Association, along with the American Academy of Podiatric Sports Medicine, encourages the public to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of their running and training programs.

Again, my recommendations (and the pattern I am following) is to continue to run in the way that is natural for you.  Run smart and keep running for a longtime to come.  I will be speeding up my running, but through natural processes of speed work and careful training regimen.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com




Running In The Snow...Yes It Can Be Done Safely

Date: 10/30/2009

Although it is only October, we have already seen a couple snow storms.  In fact, my yard still has a little snow.  This brings to mind the trouble many of us have running on the roads when ice and snow become common.  I would like to give a couple traction options for running in the snow:



•STABILicers SPORT - An adjustable slip-on cleat that can be placed under a walking or running shoe to add traction.    This is a good option for walking, but not as good an option over a running shoe.  It may interfere with the ability to run as would be done without the cleats.  It does a great job, however of limiting slipping.









•Kahtoola MICROspikes  - Strategically placed steel spikes that easily slips over shoes.  This product works well in minimizing slip on packed snow or ice and allows running or walking in winter conditions. 



For a video of this product in use: see http://www.kahtoola.com/microspikes_video.html











•Yaktrax Pro -  A device that also slips on the shoes, but works much better in producing traction without the sensation of having something on the foot.  In fact, these are quite light and work well even when running at full speed.  This is the item I will be utilizing when running in the snow this year.



So best of luck continuing to run even in the cold winter months here in Utah.  Run Smart and Be Safe!


Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com

Diabetic Foot Problems

Sock It To You!

Date: 03/19/2009

The Perfect Sock

We use them almost every day. They come in all different forms and sizes and some even come with bells and bows. What am I talking about? Your socks! Do you ever wonder if your socks are feet friendly? Believe it or not but socks made out of the wrong fabric or that are poorly made may worsen some common foot conditions.

The American Podiatric Medical Association (APMA) recommends the following when shopping for socks:

Purchase a sock made of a polysynthetic blend. This material will best wick away moisture from the foot, which can prevent blister formation and irritation.

Avoid socks with large seams at the toe or in other areas. Those with diabetes or decreased circulation, who have an increased chance of developing irritation and blistering of the foot skin, should seek out seamless socks whenever possible.

Choose thickness of sock material based on personal preference and comfort.

Evaluate each sock’s fit, making sure that there is no loose fabric around toes or heels.

Conversely, socks that are too tight can decrease circulation and comfort.

If you suffer from sweaty feet also known as hyperhydrosis, it is especially important to buy the correct socks. You may think 100% cotton is the best way to go but a blend of cotton with other natural materials will do a better job of wicking away moisture. Choosing the right sock will keep your feet dryer and less stinky. Maybe you will think again when buying your husband’s socks!
Noticing the importance of choosing the right socks, the APMA recently recognized and gave the seal of acceptance to two new sock products. Injinji Footwear Performance Series Tetratsok has a patented anatomical, five toe-design that separates toes with an anti-friction seamless membrane. The sock is made out of a combination of coolmax wicking fiber, and a durable shell cover of nylon and lycra. This helps protect the foot from slipping and sliding in your shoe.
The Takeda Legwear Big Toe R x L socks are designed specifically for the right and left feet. This allows for a snug and comfortable fit. BigToe R x L socks is also made from Coolmax fabric to keep moisture away from your skin.

They next time you buy socks, take a closer look at the materials. Slip them on and see how they fit. Are they snug? Can you feel the seams? Are there any knobs of fabric that are rubbing against your feet? Just as importantly are your shoes. If your shoes are too tight, it will exacerbate the effects of poor quality socks. Make sure your shoes are the right size and gives you room to wiggle your toes.




Diabetes and Foot Ulcers

Date: 02/11/2009

There are over 23 million American with diabetes, and another 57 million with pre-diabetes. Many argue that diabetes is becoming an epidemic. As technology continues to advance the efficiency of our world, it also takes away the need for physical exertion. In order to get the exercise necessary to stay healthy, we have to “go work out.” Most of us are dropping the ball on this; and thus, America is gaining weight. This combined with fast food and fat filled diets are causing diabetes to be on a continual rise. Unfortunately, many underestimate the severity of the disease. Diabetes is a very serious condition that has many complications which includes blindness, cardiovascular disease, kidney failure, and foot ulcerations. These complications are acquired over time and greatly increase mortality rates. A person diagnosed with diabetes before the age of 40 will lose 15-20 years of their life!
Out of all of the complications linked to diabetes, the complication that causes the most hospitalizations is foot ulceration. Many of these ulcers may lead to amputations and this greatly increases the mortality rate. A person has a better chance of survival with colon or breast cancer than they do having a diabetic amputation. There are several reasons why diabetes has such strong effects on the feet; all of these complications combine into a formula for disaster if one does take proper measures to protect their feet and their health.
Causes foot ulcers 1o1
1) Macrovascular/Microvascular complications. Diabetes is the inability of the body to control blood glucose levels. The rise in blood glucose, or hyperglycemia, is when there is excess sugar in your blood stream. This can facilitate clot formation and increase your chance of heart attack and stroke, but more commonly leads to micro vascular complication that decreases your blood flow in small vessels and in your extremities. A decrease in blood supply in an area, such as the foot, makes it difficult for your body to keep those tissues healthy.
2) Foot deformities. The excess sugar in circulation can deposit in tissues and joints and lead to foot deformation. Diabetics may see changes in their foot structure or feel pain with motion. In very serious cases, the foot develops Charcot’s foot. In this instance, the bones in the foot are actually being destroyed. The deformity is often described as the foot becoming a” bag of bones.” These deformations change how forces are applied across the foot. Normally, when walking, weight is nearly evenly distributed across your foot, deformations cause increases in pressure at certain areas. This facilitates tissue break down
3) Peripheral Neuropathy. Neuropathy is the loss of nerve function. The nerves most commonly affected are sensory nerves. Over time, diabetics experience nerve damage due to the increased levels of sugar. Initially, this damage presents as tingling and burning but eventually leads to loss of feeling. Thus, diabetics lose the ability to feel pain, the body’s natural warning sign. It is very dangerous for diabetics to be unable to perceive a problem in the foot. For an example: If one steps on a piece of glass, they would be unaware and walk around on the glass all day.
Preventing Ulcers 101?
1) Controlling your blood sugar levels with diet and exercise is the best way to prevent all diabetic complications. When diet and exercise is not enough, there are medications that can assist your body in maintaining appropriate amounts of sugar in your blood.
2) Inspect your feet regularly. Look in-between your toes under and all around. Watch your feet for any changes in appearance, temperature, and feeling. Before or when changes are noted, contact a podiatric physician. A podiatric physician can help prevent and accommodate changes in your feet due to diabetes.
3) Avoid walking around barefoot, in sandals, or any other open shoes. This leaves your feet vulnerable to getting cuts, bruises, bumps, and infections.
Diabetes is a multisystem disease that can cause many complications. Foot ulcers are highly prevalent, but also highly preventable. It is important to consult your physician to help you control your blood sugar levels. Podiatric Physicians are foot specialist that have extensive training in diabetic feet and wound care. They will provide you with the best care to prevent foot ulcers and amputations, the leading cause of diabetic hospitalizations.