Proper footwear is essential for a patient who is experiencing heel pain. Often the cause of heel pain can start due to improper shoe gear. A proper athletic shoe will help alleviate heel pain if it is the correct type of shoe for the patients foot.
Most people do not realize that there are many models or shoes available and most likely one will fit your specific foot better then others. It is very easy to buy and wear the wrong type of shoe without realizing it. By doing this your feet will continue to hurt, your arches will be tired at the end of the day and your feet will be sore in places that you didn't realize could hurt.
Depending on the specific foot type you have and your bio mechanics (the way you walk and run) can help determine the best shoe for your foot. A person with a high arched foot or a "pes cavus foot type" will be best fit in a cushion of neutral type of shoe. A person with a flatter foot or hypermobile foot or better known as "pes planus foot type" will need a moderate to maximum motion control shoe. A normal foot type is usually best fit in a light stability or mild motion control shoe.
Many times patients will come into our office and will be confused if they are in the correct shoes. When this occurs a shoe exam can be performed checking for heel counter rigidity, midfoot torsion stability, and forefoot flexion of the shoe. Once in the appropriate shoe a gait exam can be performed which includes the patient walking and running in their shoe gear. At that time it can be determined if an orthotic is necessary for your specific type of foot. An orthotic is a custom device that will fit into your shoe and help you function in a more ideal and neutral position.
So if your feet hurt, or you are not sure you are wearing the correct shoes, think about visiting a podiatrist who can help confirm what is the best shoe for your feet.
Wednesday, November 17, 2010
Tuesday, November 9, 2010
Laser Treatment for Fungal Toenails: You Have to Treat ALL of the Nails!
Laser Treatment for Fungus- Calling All Toenails!!!
I have been lasering toenails for quite some time now and only recently have come across more and more people wondering “Why not just laser the affected toenails? It would, after all, come out cheaper that way wouldn’t it?”
The simple answer is “No, not really.” But let me back this up so you can take my word for it.
Fungus is visible when the nail is grossly infected. What many do not realize, is that the process started long before you could see it with the naked eye. This alone is enough reason for the need to laser all ten toenails.
All too often I see patients who tell me that their nail fungus was only on one nail for the longest time. Then, all of a sudden, it has spread to others. Fungus is contagious! It does not just sit in one place. It gets in in your carpet, your bath mats, your shower tile. And worst of all, if you do have fungus, even in just one toenail, that fungus has already grossly contaminated your shoes! For your other nails there is no escape!
Think about how lasering only those affected nails singularly, ignoring all the others which are surely contaminated. How secure do you feel about that? If you had a bad cough and shortness of breath, how secure would you feel about going to a doctor who gave you cough medicine, but didn’t bother to listen to the pneumonia brewing in your lungs? Only treating the “visible” symptom, but not the underlying problem is a problem, whether it is lungs, nails or any other condition. Fungus brews until it has a large enough colony to “visibly” affect other nails or even a previously treated nail! What does that mean to the patient? It means more frequent trips to the podiatrist for yet another “spot” treatment. You will find, is that in the end, you will have coughed up (no pun intended!) what you should have to have all nails treated in the first place! Worse yet, the cycle may continue since only the nails with visible fungus are treated again! Who knows when it might end for you and how much time you will need to devote to these types of visits? Why take that chance?
What I do strongly believe, as do all the physicians at Foot and Ankle Associates of North Texas (FAANT), is that if you are going to spend your valuable time and finances to have this procedure preformed, the least we can do is treat all your toenails at once. This will greatly increase the odds of success! One very effective treatment in one visit!
Another thing to consider is FDA approval. Only one type of fungus-treating laser in the U.S. is FDA approved. Fortunately, we have this laser at FAANT!! This is something that should give you extra piece of mind! You are getting what we know is safe and effective! All ten toenails and FDA approval is money well spent!
I have been lasering toenails for quite some time now and only recently have come across more and more people wondering “Why not just laser the affected toenails? It would, after all, come out cheaper that way wouldn’t it?”
The simple answer is “No, not really.” But let me back this up so you can take my word for it.
Fungus is visible when the nail is grossly infected. What many do not realize, is that the process started long before you could see it with the naked eye. This alone is enough reason for the need to laser all ten toenails.
All too often I see patients who tell me that their nail fungus was only on one nail for the longest time. Then, all of a sudden, it has spread to others. Fungus is contagious! It does not just sit in one place. It gets in in your carpet, your bath mats, your shower tile. And worst of all, if you do have fungus, even in just one toenail, that fungus has already grossly contaminated your shoes! For your other nails there is no escape!
Think about how lasering only those affected nails singularly, ignoring all the others which are surely contaminated. How secure do you feel about that? If you had a bad cough and shortness of breath, how secure would you feel about going to a doctor who gave you cough medicine, but didn’t bother to listen to the pneumonia brewing in your lungs? Only treating the “visible” symptom, but not the underlying problem is a problem, whether it is lungs, nails or any other condition. Fungus brews until it has a large enough colony to “visibly” affect other nails or even a previously treated nail! What does that mean to the patient? It means more frequent trips to the podiatrist for yet another “spot” treatment. You will find, is that in the end, you will have coughed up (no pun intended!) what you should have to have all nails treated in the first place! Worse yet, the cycle may continue since only the nails with visible fungus are treated again! Who knows when it might end for you and how much time you will need to devote to these types of visits? Why take that chance?
What I do strongly believe, as do all the physicians at Foot and Ankle Associates of North Texas (FAANT), is that if you are going to spend your valuable time and finances to have this procedure preformed, the least we can do is treat all your toenails at once. This will greatly increase the odds of success! One very effective treatment in one visit!
Another thing to consider is FDA approval. Only one type of fungus-treating laser in the U.S. is FDA approved. Fortunately, we have this laser at FAANT!! This is something that should give you extra piece of mind! You are getting what we know is safe and effective! All ten toenails and FDA approval is money well spent!
Sunday, November 7, 2010
So another athlete down with nothing other than a darn toe injury!!
With Clemson running back Andre Ellington missing the next two games with a toe injury, it is unlikely that the Tigers will become bowl eligible. Sorry Clemson fans!
So what happened? Well, the same thing that happened to San Diego Chargers star running back, LaDainian Tomlinson. Turf toe strikes again! We have written about this before and I will waste no time to link you to our great turf toe article written and available for your perusal. Only wish Andre Ellington knew what he was in for. Being as young as he is, he will most likely heal without incident. Then again, being as young as he is, he may also jump back into what is left of the season a little sooner than recommended. If you are listening Andre, don’t do it! Let this heal and help avoid what could end up being an arthritic toe later on in life that may end your career sooner than intended!
Let this serve as yet another reminder to all of us, athletes or not, that the big toe is just that important! The mere jamming of the toe is enough to jump start an arthritic process. Micro tears in the cartilage cushioning the joint can become deep fissures down to the bone over time. These are allowed to wear down until there is no cartilage to cushion the joint and suddenly there is joint pain when before there was none!
Do not ignore joint pain! It is not normal. Even though it can go away, it will more than likely return more frequently over time and return with a vengeance. As podiatrists, we do not merely treat injuries; we pride ourselves as a profession of prevention! Recurrence prevention is just as important as eliminating the initial pain. Heed our recommendations if we point you to certain shoes or inserts or functional orthotics to better control any foot instability. The cliché is true, prevention is key!
With Clemson running back Andre Ellington missing the next two games with a toe injury, it is unlikely that the Tigers will become bowl eligible. Sorry Clemson fans!
So what happened? Well, the same thing that happened to San Diego Chargers star running back, LaDainian Tomlinson. Turf toe strikes again! We have written about this before and I will waste no time to link you to our great turf toe article written and available for your perusal. Only wish Andre Ellington knew what he was in for. Being as young as he is, he will most likely heal without incident. Then again, being as young as he is, he may also jump back into what is left of the season a little sooner than recommended. If you are listening Andre, don’t do it! Let this heal and help avoid what could end up being an arthritic toe later on in life that may end your career sooner than intended!
Let this serve as yet another reminder to all of us, athletes or not, that the big toe is just that important! The mere jamming of the toe is enough to jump start an arthritic process. Micro tears in the cartilage cushioning the joint can become deep fissures down to the bone over time. These are allowed to wear down until there is no cartilage to cushion the joint and suddenly there is joint pain when before there was none!
Do not ignore joint pain! It is not normal. Even though it can go away, it will more than likely return more frequently over time and return with a vengeance. As podiatrists, we do not merely treat injuries; we pride ourselves as a profession of prevention! Recurrence prevention is just as important as eliminating the initial pain. Heed our recommendations if we point you to certain shoes or inserts or functional orthotics to better control any foot instability. The cliché is true, prevention is key!
Friday, October 29, 2010
Eleven Tips to Ease Arthritis Pain and Increase Mobility!
The little things you do can get your arthritis pain under control and increase your mobility. Lots of patient in my Grapevine, TX, office complain of arthritis pain in their feet and ankles as well as their knees, hips and back. The dynamic chain of our lower extremity biomechanics is all connected. Help your back by helping your feet, knees and hips! All the joints benefit!
When you have osteoarthritis, it is very common to cut back on most of your physical activities to minimize your pain. This inactivity often leads to more health problems, so it is important to find ways to keep the pain under control.
Here are my top eleven tips to keep you moving with arthritis:
1. Lose Weight. Every pound matters. Think that if you lose one pound, it takes three pounds of torque off your feet. Every extra pound puts more pressure on all your joints. Find a sound lifestyle changing diet and adjust your eating habits to slowly lose the weight.
2. Give yourself a break. Overuse can increase arthritis symptoms significantly. To ease your pain and the stress on your joints, take frequent breaks. Break large tasks into small ones.
3. Stretch. Athletes always ask, “To stretch or not to stretch, that is the question?” In patients with arthritis, stretching can really ease the pain in your joints, especially you foot and ankle. Learn to stretch properly and make it a daily habit.
4. Exercise. Exercise will help maintain mobility and flexibility as well as strength. Yoga or water workouts are good alternatives for patients with arthritis. If you don’t move it, you will lose it!
5. Heat it up. A hot water bottle, warm compresses or a heating pad can often relieve arthritis pain. Be careful not to make it too hot, especially if you have diabetes and a little neuropathy!
6. Talk to your doctor. There are many new options for pain relief, so don’t think you just have to live with it. Ask your doctors for options.
7. See a podiatrist. A podiatrist can help you with shoe gear, functional foot orthotics and even joint surgery that can relieve your pain. Talk to a podiatrist about options to ease your foot and ankle pain and/or balance the biomechanics of your lower extremity to let your joints function as optimally as they can.
8. See a physical therapist or chiropractor. Many times a little physical therapy or manipulation can help to ease your pain and get you moving in the right direction.
9. Try OTC options. Many people use over-the-counter arthritis pain relievers or topical analgesic creams to help with their pain. My favorite is Biofreeze.
10. Consider supplements. Many patients report relief from glucosamine and chondroitin supplements. Remember that you need to take them for at least a month to see if they help.
11. Start early. Get your arthritis pain under control early. It is much easier to get it under control and focus on a mobility regimen when you are younger. It is easier to lose weight in your 40’s than your 60’s.
Arthritis pain getting you down? Follow these tips to help control your pain and increase your mobility!
When you have osteoarthritis, it is very common to cut back on most of your physical activities to minimize your pain. This inactivity often leads to more health problems, so it is important to find ways to keep the pain under control.
Here are my top eleven tips to keep you moving with arthritis:
1. Lose Weight. Every pound matters. Think that if you lose one pound, it takes three pounds of torque off your feet. Every extra pound puts more pressure on all your joints. Find a sound lifestyle changing diet and adjust your eating habits to slowly lose the weight.
2. Give yourself a break. Overuse can increase arthritis symptoms significantly. To ease your pain and the stress on your joints, take frequent breaks. Break large tasks into small ones.
3. Stretch. Athletes always ask, “To stretch or not to stretch, that is the question?” In patients with arthritis, stretching can really ease the pain in your joints, especially you foot and ankle. Learn to stretch properly and make it a daily habit.
4. Exercise. Exercise will help maintain mobility and flexibility as well as strength. Yoga or water workouts are good alternatives for patients with arthritis. If you don’t move it, you will lose it!
5. Heat it up. A hot water bottle, warm compresses or a heating pad can often relieve arthritis pain. Be careful not to make it too hot, especially if you have diabetes and a little neuropathy!
6. Talk to your doctor. There are many new options for pain relief, so don’t think you just have to live with it. Ask your doctors for options.
7. See a podiatrist. A podiatrist can help you with shoe gear, functional foot orthotics and even joint surgery that can relieve your pain. Talk to a podiatrist about options to ease your foot and ankle pain and/or balance the biomechanics of your lower extremity to let your joints function as optimally as they can.
8. See a physical therapist or chiropractor. Many times a little physical therapy or manipulation can help to ease your pain and get you moving in the right direction.
9. Try OTC options. Many people use over-the-counter arthritis pain relievers or topical analgesic creams to help with their pain. My favorite is Biofreeze.
10. Consider supplements. Many patients report relief from glucosamine and chondroitin supplements. Remember that you need to take them for at least a month to see if they help.
11. Start early. Get your arthritis pain under control early. It is much easier to get it under control and focus on a mobility regimen when you are younger. It is easier to lose weight in your 40’s than your 60’s.
Arthritis pain getting you down? Follow these tips to help control your pain and increase your mobility!
Wednesday, October 6, 2010
Chronic foot and ankle injuries, why not wait?
I just had a friend tell me this. She has had pain and swelling in her ankle and is ready to have it addressed. Crazy thing is, her injury happened in 1996! Say again?! 1996?! And this prompted me to write about what happens if you wait.
With 26 bones, 33 joints on top of more than 100 tendons, ligaments and muscles, the foot has plenty of places it can injure. All of these parts make a whole in the function of the foot and ankle. And since the foot bone’s connected to the ankle bone and the ankle bone’s connected…well you get my drift. One component stretches, breaks, tears, strains and every other part has to bear the load of that one small part. With as much as we use our feet, one or some components have already given out to some degree.
So now we all have feet that are not in their perfect position to function at their best.
The aches and pains begin. Sure, Tylenol and Motrin are great band-aides. But they mask pain rather than fix what’s wrong. Keep it up and over time, the anti-inflammatories stop working. Not a good sign. The stress from years of small, meaningless injuries start adding up to more stress than your feet and ankles can handle. Now your injury is chronic. What does that mean? It means that you have ignored the small stuff and now your body is ignoring it too and won’t heal it on its own.
Good thing is, most of you are not a professional athlete, like Shaquille O’Neal, whose plantar fasciitis raised havoc on his ability to dunk those hoops! Bad thing is, whether you are Shaq or not, ignoring an injury or chronically re-injuring could have dire consequences.
I found this list off an article about athletic performance by Keith Wassung listing the following athletes using chiropractic care as part of body maintenance:
Joe Montana, Roger Craig, Keith Jackson, Emmit Smith, Chris Carter, Evander Holyfield Sugar Ray Leonard, Roy Jones, Jr., Wade Boggs, Penny Hardaway, Jon Smoltz, Ken Griffey, Jr. Mark McGwire, Ryne Sandberg,, Ricky Bell, Brett Butler, Dominique Wilkins, Michael Jordan, Scottie Pippin, Charles Barkley, John Stockton, Robert Parish, Gerald Wilkins, Lee Haney, Arnold Schwarzenegger, Dr. Frank Columbu, Irving Fryar, Brett Hall, Tiger Woods, Roberto Clemente Michael Carbajol, Bob Hayes, Muhammad Ali, Ed “Too Tall” Jones, Alex Karras, Gary Clark, Mark May, Charles Haley, Bill Fralic, Dan Marino, Warren Moon, Tim Dwight, Jack Dempsey,Fred Funk, Beth Daniel, Mary Lou Retton, Olga Korbut, Wayne Gretzky, Rocky Marciano, Dan O’Brien, Bruce Jenner, Donovan Bailey, Mac Wilkins, Dwight Stones, Mary Decker, Willie Banks, Nancy Ditz, Gregg Blasingame, Billy Jean King. Tracy Austin, John McEnroe, Ivan Lendl, Jim Connors, Jan Stephenson, Shawn Marion, Stephon Marbury, Barry Bonds, Vijay Singh,Steve Nash, LeBron James, Barry Zito, Grant Hill, Shaquille O’Neal
Why not podiatric care to maintain the only set of “tires” you have?!
The simple lesson here is, if you do not want to spend your golden years limping and kicking yourself for not addressing your foot and ankle pain sooner, get in to see your podiatrist when the injury happens! An acute injury is sooooo much easier to treat and your prognosis is soooo much better if you treat EARLY. And remember that with many injuries, though you may have healed, you are also more prone to re-injury. The best thing about early intervention is that you will also be informed of ways to prevent re-injury. Either way, that visit to your podiatrist could take you many more miles and that is golden!
The simple lesson here is, if you do not want to spend your golden years limping and kicking yourself for not addressing your foot and ankle pain sooner, get in to see your podiatrist when the injury happens! An acute injury is sooooo much easier to treat and your prognosis is soooo much better if you treat EARLY. And remember that with many injuries, though you may have healed, you are also more prone to re-injury. The best thing about early intervention is that you will also be informed of ways to prevent re-injury. Either way, that visit to your podiatrist could take you many more miles and that is golden!
With 26 bones, 33 joints on top of more than 100 tendons, ligaments and muscles, the foot has plenty of places it can injure. All of these parts make a whole in the function of the foot and ankle. And since the foot bone’s connected to the ankle bone and the ankle bone’s connected…well you get my drift. One component stretches, breaks, tears, strains and every other part has to bear the load of that one small part. With as much as we use our feet, one or some components have already given out to some degree.
So now we all have feet that are not in their perfect position to function at their best.
The aches and pains begin. Sure, Tylenol and Motrin are great band-aides. But they mask pain rather than fix what’s wrong. Keep it up and over time, the anti-inflammatories stop working. Not a good sign. The stress from years of small, meaningless injuries start adding up to more stress than your feet and ankles can handle. Now your injury is chronic. What does that mean? It means that you have ignored the small stuff and now your body is ignoring it too and won’t heal it on its own.
Good thing is, most of you are not a professional athlete, like Shaquille O’Neal, whose plantar fasciitis raised havoc on his ability to dunk those hoops! Bad thing is, whether you are Shaq or not, ignoring an injury or chronically re-injuring could have dire consequences.
I found this list off an article about athletic performance by Keith Wassung listing the following athletes using chiropractic care as part of body maintenance:
Joe Montana, Roger Craig, Keith Jackson, Emmit Smith, Chris Carter, Evander Holyfield Sugar Ray Leonard, Roy Jones, Jr., Wade Boggs, Penny Hardaway, Jon Smoltz, Ken Griffey, Jr. Mark McGwire, Ryne Sandberg,, Ricky Bell, Brett Butler, Dominique Wilkins, Michael Jordan, Scottie Pippin, Charles Barkley, John Stockton, Robert Parish, Gerald Wilkins, Lee Haney, Arnold Schwarzenegger, Dr. Frank Columbu, Irving Fryar, Brett Hall, Tiger Woods, Roberto Clemente Michael Carbajol, Bob Hayes, Muhammad Ali, Ed “Too Tall” Jones, Alex Karras, Gary Clark, Mark May, Charles Haley, Bill Fralic, Dan Marino, Warren Moon, Tim Dwight, Jack Dempsey,Fred Funk, Beth Daniel, Mary Lou Retton, Olga Korbut, Wayne Gretzky, Rocky Marciano, Dan O’Brien, Bruce Jenner, Donovan Bailey, Mac Wilkins, Dwight Stones, Mary Decker, Willie Banks, Nancy Ditz, Gregg Blasingame, Billy Jean King. Tracy Austin, John McEnroe, Ivan Lendl, Jim Connors, Jan Stephenson, Shawn Marion, Stephon Marbury, Barry Bonds, Vijay Singh,Steve Nash, LeBron James, Barry Zito, Grant Hill, Shaquille O’Neal
Why not podiatric care to maintain the only set of “tires” you have?!
The simple lesson here is, if you do not want to spend your golden years limping and kicking yourself for not addressing your foot and ankle pain sooner, get in to see your podiatrist when the injury happens! An acute injury is sooooo much easier to treat and your prognosis is soooo much better if you treat EARLY. And remember that with many injuries, though you may have healed, you are also more prone to re-injury. The best thing about early intervention is that you will also be informed of ways to prevent re-injury. Either way, that visit to your podiatrist could take you many more miles and that is golden!
The simple lesson here is, if you do not want to spend your golden years limping and kicking yourself for not addressing your foot and ankle pain sooner, get in to see your podiatrist when the injury happens! An acute injury is sooooo much easier to treat and your prognosis is soooo much better if you treat EARLY. And remember that with many injuries, though you may have healed, you are also more prone to re-injury. The best thing about early intervention is that you will also be informed of ways to prevent re-injury. Either way, that visit to your podiatrist could take you many more miles and that is golden!
Tuesday, September 21, 2010
Foot and Ankle Injuries in Golfers
Most of the time, injuries that occur in the foot and ankle during golf activites are either due to overuse type injuries or traumatic injuries. Overuse injuries are more common and are commonly directly related to the mechanics of the golf swing.
The golf swing can be broken down into the following phases:
Set up
Takeaway
Downswing
Impact
Follow-through
At set up: The weight should be evenly distributed on both feet with slightly more weight on the inside of the balls of the feet. During the takeaway or back swing phase, the front foot should pronate, placing more pressure on the inside of the foot while the back foot stays stable as it receives more weight. At times the heel of the front foot will come off the ground to promote a full shoulder turn.
During the downswing: Weight will rapidly shift to the front foot until impact, at that point the weight should be evenly distributed between both feet. A lateral shift of the hips and knees will occur during downswing that continues through the impact of the ball and will continue slightly into the follow-through phase.
During the follow-through phase, the front foot supinates and the back heel comes off the ground with the weight of the back foot being placed on the big toe.
The most common golf injuries that occur in the foot and ankle are heel pain, metatarsalgia, Mortons Neuroma and tendinitis. Most of the time these injuries occur due to an increase of the motion in the feet.
Most common complaint in golfers is an intermetatarsal neuroma. Typically these occur in the third interspace and is almost always in the non-dominant foot. In other words if you swing the foot with the right then the neuroma is more likely to develop in the left foot. The nerve becomes irritated and is more noticeable in longer shots. As the forefoot inverts and the rearfoot supinates the interdigital nerve becomes irritated within the interspace. Symptoms include burning, tingling, numbness and shooting pains into the toes. Treatment begins with NSAIDS, Ice, Injection therapy and custom orthotics. One important treatment option is to adjust the mechanics of the swing to decrease the inversion/supination of the foot. Abduction of the front foot will help decrease the inversion at the end of the swing and decrease the irritation of the nerve.
Extensor Tendinitis: another complaint that we commonly see with golfers. This is due to driving the golf cart. It is often caused after driving a hilly course and using the brake to much. The motion of depressing the brake on a golf cart can cause a strain on the extensor digitorum longus tendons and causes irritation of those tendons. Symptoms include top of the foot pain and sometimes swelling. If this sounds like something you may have developed try alternating feet that use the brake. Using the heel to depress the brake may also help.
Lateral Ankle Pain: Occurs due to excessive motion of the rearfoot during the golf swing follow through. The forces that are applied during the follow through phase cause an abduction of the knee on the non-dominant limb and a supination on the foot on that side with eversion of the rearfoot. Symptoms include lateral ankle pain, lateral midfoot pain and swelling to the foot and ankle. Treatment starts with stabilizing the ankle with a compression brace or ankle brace. Trying to abduct the front foot toward the target and away from the midline of the body in the stance position when the golfer is addressing the ball will help take pressure off the lateral ankle.
Hallux and Subungal Hematomas: this occurs when the golfer applies excessive pressure to the big toe during the golf swing. Typically this occurs at the end of follow through and will only happen on the dominant foot. It occurs due to a jamming of the toe into the top of the shoebox. With repetition the subungal tissue will be injured and blood will form under the nail plate. Symptoms include pain in the hallux, pain with pressure on the hallux and a discolored big toenail. Treatment includes draining of the toenail or removal of the toenail.
We talked at the beginning that most golf injuries are caused by an increase motion of the foot. Studies have found that custom orthotics, which are devices that are made specifically for your feet are able to increase balance and allow golfers to drive the ball farther.
The golf swing can be broken down into the following phases:
Set up
Takeaway
Downswing
Impact
Follow-through
At set up: The weight should be evenly distributed on both feet with slightly more weight on the inside of the balls of the feet. During the takeaway or back swing phase, the front foot should pronate, placing more pressure on the inside of the foot while the back foot stays stable as it receives more weight. At times the heel of the front foot will come off the ground to promote a full shoulder turn.
During the downswing: Weight will rapidly shift to the front foot until impact, at that point the weight should be evenly distributed between both feet. A lateral shift of the hips and knees will occur during downswing that continues through the impact of the ball and will continue slightly into the follow-through phase.
During the follow-through phase, the front foot supinates and the back heel comes off the ground with the weight of the back foot being placed on the big toe.
The most common golf injuries that occur in the foot and ankle are heel pain, metatarsalgia, Mortons Neuroma and tendinitis. Most of the time these injuries occur due to an increase of the motion in the feet.
Most common complaint in golfers is an intermetatarsal neuroma. Typically these occur in the third interspace and is almost always in the non-dominant foot. In other words if you swing the foot with the right then the neuroma is more likely to develop in the left foot. The nerve becomes irritated and is more noticeable in longer shots. As the forefoot inverts and the rearfoot supinates the interdigital nerve becomes irritated within the interspace. Symptoms include burning, tingling, numbness and shooting pains into the toes. Treatment begins with NSAIDS, Ice, Injection therapy and custom orthotics. One important treatment option is to adjust the mechanics of the swing to decrease the inversion/supination of the foot. Abduction of the front foot will help decrease the inversion at the end of the swing and decrease the irritation of the nerve.
Extensor Tendinitis: another complaint that we commonly see with golfers. This is due to driving the golf cart. It is often caused after driving a hilly course and using the brake to much. The motion of depressing the brake on a golf cart can cause a strain on the extensor digitorum longus tendons and causes irritation of those tendons. Symptoms include top of the foot pain and sometimes swelling. If this sounds like something you may have developed try alternating feet that use the brake. Using the heel to depress the brake may also help.
Lateral Ankle Pain: Occurs due to excessive motion of the rearfoot during the golf swing follow through. The forces that are applied during the follow through phase cause an abduction of the knee on the non-dominant limb and a supination on the foot on that side with eversion of the rearfoot. Symptoms include lateral ankle pain, lateral midfoot pain and swelling to the foot and ankle. Treatment starts with stabilizing the ankle with a compression brace or ankle brace. Trying to abduct the front foot toward the target and away from the midline of the body in the stance position when the golfer is addressing the ball will help take pressure off the lateral ankle.
Hallux and Subungal Hematomas: this occurs when the golfer applies excessive pressure to the big toe during the golf swing. Typically this occurs at the end of follow through and will only happen on the dominant foot. It occurs due to a jamming of the toe into the top of the shoebox. With repetition the subungal tissue will be injured and blood will form under the nail plate. Symptoms include pain in the hallux, pain with pressure on the hallux and a discolored big toenail. Treatment includes draining of the toenail or removal of the toenail.
We talked at the beginning that most golf injuries are caused by an increase motion of the foot. Studies have found that custom orthotics, which are devices that are made specifically for your feet are able to increase balance and allow golfers to drive the ball farther.
Monday, June 28, 2010
Podiatry Visits Save Diabetic Feet!
New Study Demonstrates Dramatic Impact of Podiatric Care
Patients with diabetes who receive medical and surgical care provided by a podiatrist are less likely to suffer hospitalization or amputation than patients who do not receive care from a podiatrist, according to a new study from Thomson Reuters. Thomson Reuters is an internationally respected research firm with expertise in the health-care market.
The study examined records for more than 32,000 patients with diabetes under 65 and matched health and risk factors for those who had podiatry visits to those who did not. Care by a podiatric physician, defined as at least one pre-ulcer visit, was associated with lower risk of hospitalization and amputation. The results were presented at the American Diabetes Association Scientific Sessions this weekend in Orlando, Florida.
"The dramatic results of the study demonstrate the important role of today's podiatrist," said APMA President Kathleen Stone, DPM. "As a profession, we make a significant impact on patient outcomes and health-care costs. As more diabetic patients receive high-quality medical care by podiatrists prior to developing ulcers, we will see even greater reductions in cost and improvements in patients' quality of life. The next step is to confirm these findings with prospective pilot programs that identify high-risk patients and provide preventive foot care services by podiatrists."
The importance of regular podiatric care for EVERY diabetic cannot be emphasized enough! If you or a family member suffers from diabetes, go to www.faant.com and request our free book, “Got Diabetes”. It is full of helpful information to keep diabetic feet out of the hospital!
Patients with diabetes who receive medical and surgical care provided by a podiatrist are less likely to suffer hospitalization or amputation than patients who do not receive care from a podiatrist, according to a new study from Thomson Reuters. Thomson Reuters is an internationally respected research firm with expertise in the health-care market.
The study examined records for more than 32,000 patients with diabetes under 65 and matched health and risk factors for those who had podiatry visits to those who did not. Care by a podiatric physician, defined as at least one pre-ulcer visit, was associated with lower risk of hospitalization and amputation. The results were presented at the American Diabetes Association Scientific Sessions this weekend in Orlando, Florida.
"The dramatic results of the study demonstrate the important role of today's podiatrist," said APMA President Kathleen Stone, DPM. "As a profession, we make a significant impact on patient outcomes and health-care costs. As more diabetic patients receive high-quality medical care by podiatrists prior to developing ulcers, we will see even greater reductions in cost and improvements in patients' quality of life. The next step is to confirm these findings with prospective pilot programs that identify high-risk patients and provide preventive foot care services by podiatrists."
The importance of regular podiatric care for EVERY diabetic cannot be emphasized enough! If you or a family member suffers from diabetes, go to www.faant.com and request our free book, “Got Diabetes”. It is full of helpful information to keep diabetic feet out of the hospital!
Thursday, May 20, 2010
The Oustide of My Foot Really Hurts!
What is the lateral column of my foot? The lateral column of the foot consists of the calcaneus,the cuboid and 4th and 5th metatarsal bones. Many things can cause you to have lateral column pain including arthritis, biomechanical abnormalities (the way you walk), acute fractures secondary to trauma, or overuse syndrome.
There are certain types of foot structures that make you more likely to develop lateral column foot pain. An adducted foot type can cause an increase in mechanical pressures that can result in lateral column pain. Increased plantar pressures on the lateral column may also be seen in a neutral or supinated foot type. Pronation or flat feet can also lead to lateral column pain.
The most common cause of lateral column pain is known as cuboid syndrome or subluxation of the cuboid bone. This is often difficult to diagnose as the symptoms are not specific. X-rays will be negative because there is not any bone damage with this disease. Often the diagnosis is based on your history and physical and evaluation of your gait cycle. Most often the pain is greater with propulsion and disappears when sitting or pushing on the foot.
Joint stability plays a large role in the development of cuboid syndrome. If your foot is able to pronate during the beginning phase of propulsion it allows certain tendons (peroneus longus) to gain a greater mechanical advantage leading to the subluxation of the cuboid bone. This allows the ligaments and capsule that surround the joints to become irritated and inflamed and cause pain.
How do you treat Lateral Column Pain?
An evaluation of your gait will be one the first treatments. At this time proper shoe gear will be discussed. Accomodative padding,taping, bracing and physical therapy can help with reducing inflammation and pain. Many times the foot needs to be manipulated to allow the bone to sit back into its normal position. Custom orthotics may be necessary to address the biomechanics of your feet.
There are certain types of foot structures that make you more likely to develop lateral column foot pain. An adducted foot type can cause an increase in mechanical pressures that can result in lateral column pain. Increased plantar pressures on the lateral column may also be seen in a neutral or supinated foot type. Pronation or flat feet can also lead to lateral column pain.
The most common cause of lateral column pain is known as cuboid syndrome or subluxation of the cuboid bone. This is often difficult to diagnose as the symptoms are not specific. X-rays will be negative because there is not any bone damage with this disease. Often the diagnosis is based on your history and physical and evaluation of your gait cycle. Most often the pain is greater with propulsion and disappears when sitting or pushing on the foot.
Joint stability plays a large role in the development of cuboid syndrome. If your foot is able to pronate during the beginning phase of propulsion it allows certain tendons (peroneus longus) to gain a greater mechanical advantage leading to the subluxation of the cuboid bone. This allows the ligaments and capsule that surround the joints to become irritated and inflamed and cause pain.
How do you treat Lateral Column Pain?
An evaluation of your gait will be one the first treatments. At this time proper shoe gear will be discussed. Accomodative padding,taping, bracing and physical therapy can help with reducing inflammation and pain. Many times the foot needs to be manipulated to allow the bone to sit back into its normal position. Custom orthotics may be necessary to address the biomechanics of your feet.
Tuesday, May 18, 2010
Meet the Doctors of FAANT
Check out the new video to introduce the doctors of Foot & Ankle Associates of North Texas. Meet the Doctors of FAANT
Monday, May 17, 2010
Can I Wear Nail Polish with Fungus on my Nails?
It’s a bum rap! You have fungus on your toe nails and all you want to do is cover it up! Nothing better than nail polish to do that, but you know enough about fungus to know that fungus thrives in moist dark places. Nail polish gives that fungus a wonderful place to grow and thrive! What’s a girl to do??
Well, for starters, it is so very important to look beyond the nail itself and look at your foot surroundings. Where do you walk? What do you wear?
We do not know exactly how you got your fungus, but we want to keep it from happening again. Keeping your surrounding as “fungus-free” as possible will help! Let’s go over the key pointer to keeping fungus at bay.
1. Spray your shoes with an anti-fungal spray. It helps keep the fungus away!
Throw away your old grungy gardening shoes if they are not rubber or those old favorite canvass shoes you’ve had forever.
2. If you have sweaty feet, change your socks once during the day to keep the moisture down. The less moisture you have, the less than ideal environment a fungus has to grow.
3. Use an anti fungal powder on your feet if you tend to sweat a lot.
4. Spray “Scrubbing Bubbles” or “Lysol Tub and Tile” type stuff weekly on your shower tiles.
5. Wash your bath mats weekly. We don’t know what critters are thriving in them.
6. Shampoo your carpet if you haven’t done that in a while. We don’t know what critters are thriving in them either.
7. Give your shoes a breather by not wearing the same pair twice in a row.
8. Get sterile pedicures and stay away from the soaking tubs that have whirlpool effect. They can never get the tubing cleaned properly.
9. Bring your own polish and flip flops to the nail salon.
And yes, we are back full circle to the nail polish thing! It can matter what type of polish you use. Nail polish with Tea tree oil is becoming very popular for a reason. It has been found that tea tree oil is a natural fungal suppressant. What does this mean? It means you can have fungus and wear nail polish too!! Dr. Remedy nail polish with tea tree oil offers just what you have been looking for. I was so impressed with this product and got such good feedback on it, that I recommended them in my article on foot health in the April 2010 issue of Southern Living magazine. Beautiful colors and protection too! Lucky you!
Well, for starters, it is so very important to look beyond the nail itself and look at your foot surroundings. Where do you walk? What do you wear?
We do not know exactly how you got your fungus, but we want to keep it from happening again. Keeping your surrounding as “fungus-free” as possible will help! Let’s go over the key pointer to keeping fungus at bay.
1. Spray your shoes with an anti-fungal spray. It helps keep the fungus away!
Throw away your old grungy gardening shoes if they are not rubber or those old favorite canvass shoes you’ve had forever.
2. If you have sweaty feet, change your socks once during the day to keep the moisture down. The less moisture you have, the less than ideal environment a fungus has to grow.
3. Use an anti fungal powder on your feet if you tend to sweat a lot.
4. Spray “Scrubbing Bubbles” or “Lysol Tub and Tile” type stuff weekly on your shower tiles.
5. Wash your bath mats weekly. We don’t know what critters are thriving in them.
6. Shampoo your carpet if you haven’t done that in a while. We don’t know what critters are thriving in them either.
7. Give your shoes a breather by not wearing the same pair twice in a row.
8. Get sterile pedicures and stay away from the soaking tubs that have whirlpool effect. They can never get the tubing cleaned properly.
9. Bring your own polish and flip flops to the nail salon.
And yes, we are back full circle to the nail polish thing! It can matter what type of polish you use. Nail polish with Tea tree oil is becoming very popular for a reason. It has been found that tea tree oil is a natural fungal suppressant. What does this mean? It means you can have fungus and wear nail polish too!! Dr. Remedy nail polish with tea tree oil offers just what you have been looking for. I was so impressed with this product and got such good feedback on it, that I recommended them in my article on foot health in the April 2010 issue of Southern Living magazine. Beautiful colors and protection too! Lucky you!
Monday, May 10, 2010
Getting the Most Out of Your Podiatry Visit
You finally have time to see your podiatrist. You have questions. You need answers. We are really here to help. We understand everyone has different needs and expectations. We do our best to provide that while we visit with you. Predictably those needs and expectations change with every visit.
The best way to help us with your concerns is to analyze the specifics of each concern before your visit with us. Here are some questions we will surely ask you. Answering these will greatly help with your diagnosis.
1. “Where does it hurt?” Yes, though it is true that sometimes pain is everywhere, but pain does tend to originate from a certain area of the foot and spread. Find your most tender spot. Many times we cannot “make it hurt” on exam because your pain is what we call “functional”. This means it only happens when you are “functioning” whether this is walking, running or whatever. If you can’t find it by merely pressing on it, then do what it is that causes it with your shoes off so you can visualize its where-a-bouts.
2. “How long has it been hurting?” We need a ball park figure.
3. “What causes the pain?” We would like to know about what brings your pain on. Is it there with the first step in the morning? After or during activity? Was there a definite traumatic even that started it or maybe a pair of shoes?
4. “What makes it feel better? What have you tried treatment-wise?” Many times I hear that nothing was tried only to discover on further discussion that sticking to a low heel or a different shoe helps. We want to know! Does getting off the affected area do the trick? Icing? Medication? You get the drift!
Just one more thing! Many patients have never seen a podiatrist before and when we see them for the first time they feel the need to address EVERTHING that has ever bothered them. Though they scheduled their appointment to discuss their heel pain, once the doctor enters, they produce a laundry list of other things they also would like us to talk about. If you have many issues you would like to discuss, please remember that although we would like to address everything bothering your feet and ankles, one problem may require more time than others. It makes a world of difference in the quality of care we can provide during your visit, that you let the person scheduling your appointment know the most pressing problems you would like us to address at your appointment so they can give you enough time on the schedule. Understand, not all problems may be addressed that first visit. And do understand that if some problems take precedent over others the day of your appointment and we do not have a chance to devote the proper amount of time to another, we will commit more time to it on your next appointment.
These tips will allow your podiatrist to give your feet the exceptional care they deserve!
The best way to help us with your concerns is to analyze the specifics of each concern before your visit with us. Here are some questions we will surely ask you. Answering these will greatly help with your diagnosis.
1. “Where does it hurt?” Yes, though it is true that sometimes pain is everywhere, but pain does tend to originate from a certain area of the foot and spread. Find your most tender spot. Many times we cannot “make it hurt” on exam because your pain is what we call “functional”. This means it only happens when you are “functioning” whether this is walking, running or whatever. If you can’t find it by merely pressing on it, then do what it is that causes it with your shoes off so you can visualize its where-a-bouts.
2. “How long has it been hurting?” We need a ball park figure.
3. “What causes the pain?” We would like to know about what brings your pain on. Is it there with the first step in the morning? After or during activity? Was there a definite traumatic even that started it or maybe a pair of shoes?
4. “What makes it feel better? What have you tried treatment-wise?” Many times I hear that nothing was tried only to discover on further discussion that sticking to a low heel or a different shoe helps. We want to know! Does getting off the affected area do the trick? Icing? Medication? You get the drift!
Just one more thing! Many patients have never seen a podiatrist before and when we see them for the first time they feel the need to address EVERTHING that has ever bothered them. Though they scheduled their appointment to discuss their heel pain, once the doctor enters, they produce a laundry list of other things they also would like us to talk about. If you have many issues you would like to discuss, please remember that although we would like to address everything bothering your feet and ankles, one problem may require more time than others. It makes a world of difference in the quality of care we can provide during your visit, that you let the person scheduling your appointment know the most pressing problems you would like us to address at your appointment so they can give you enough time on the schedule. Understand, not all problems may be addressed that first visit. And do understand that if some problems take precedent over others the day of your appointment and we do not have a chance to devote the proper amount of time to another, we will commit more time to it on your next appointment.
These tips will allow your podiatrist to give your feet the exceptional care they deserve!
Saturday, May 1, 2010
Brett Farve Contemplating Ankle Surgery, Are Your Ankle Unstable Too?
Brett Favre is at it again! He may be the most indecisive man of our era. Every year we sit and wait to see whether or not he will retire. This year, we have even more to look forward to. Is he going to have surgery for his ankle? Brett Favre released a statement that he is considering having a minor surgery to repair his ankle injury. I wonder how long it will take him to make this decision. No statement has been released of the actual diagnosis or the procedure needed but Favre did mention possible removal of bone spurs at the ankle joint.
Bone spurs at the ankle joint are often caused by osteoarthritis or degenerative joint disease. Osteoarthritis of the ankle is common after several ankle sprains or many ankle sprains over many years. Over time, the wear and tear of the joint will lead to damage of the cartilage and bone. As the bone breaks down, new bone is formed. The new bone, or osteophyte, can cause irritation of the surrounding tissues and lead to pain and inflammation.
For Brett Favre, his normal daily activities don’t cause severe ankle pain but complex workouts and games do cause pain and irritation. He has made statements discussing his ankle pain as non-debilitating. I assume that his ankle problems are due to bone spurs and scar tissue that has build up in the ankle joint from repeated ankle sprains or other injuries. This is often referred to as ankle impingement syndrome.
Surgery for this condition is very minor and can be performed with only small incisions. An arthroscope is used to view and inspect the joint. A shaver can then be used with the scope to remove any access tissue and debris in the area of the joint. The bone spurs can also be removed without large skin incisions. These types of procedures are termed minimally invasive and have faster recovery time. If Brett Favre is suffering from impingement syndrome, he can have the procedure done and be back to normal activity within 4-8 weeks.
Considering the surgery is minor and the recovery time is short, it surprises me that there is even a debate on whether or not he will have surgery. If he has surgery, will he be a Viking for one more year? If he does not have the surgery, will he actually retire? I have a feeling we won’t know until the first game of the season. Brett Favre’s career has been full of drama, and we will add this to his epic tale. Football legend debates minor surgery for non-debilitating ankle injury. Neither are career ending but retirement has not been taken off the table!
For more info and a short video by Dr Giacalone on ankle pain click here!
Bone spurs at the ankle joint are often caused by osteoarthritis or degenerative joint disease. Osteoarthritis of the ankle is common after several ankle sprains or many ankle sprains over many years. Over time, the wear and tear of the joint will lead to damage of the cartilage and bone. As the bone breaks down, new bone is formed. The new bone, or osteophyte, can cause irritation of the surrounding tissues and lead to pain and inflammation.
For Brett Favre, his normal daily activities don’t cause severe ankle pain but complex workouts and games do cause pain and irritation. He has made statements discussing his ankle pain as non-debilitating. I assume that his ankle problems are due to bone spurs and scar tissue that has build up in the ankle joint from repeated ankle sprains or other injuries. This is often referred to as ankle impingement syndrome.
Surgery for this condition is very minor and can be performed with only small incisions. An arthroscope is used to view and inspect the joint. A shaver can then be used with the scope to remove any access tissue and debris in the area of the joint. The bone spurs can also be removed without large skin incisions. These types of procedures are termed minimally invasive and have faster recovery time. If Brett Favre is suffering from impingement syndrome, he can have the procedure done and be back to normal activity within 4-8 weeks.
Considering the surgery is minor and the recovery time is short, it surprises me that there is even a debate on whether or not he will have surgery. If he has surgery, will he be a Viking for one more year? If he does not have the surgery, will he actually retire? I have a feeling we won’t know until the first game of the season. Brett Favre’s career has been full of drama, and we will add this to his epic tale. Football legend debates minor surgery for non-debilitating ankle injury. Neither are career ending but retirement has not been taken off the table!
For more info and a short video by Dr Giacalone on ankle pain click here!
Wednesday, April 28, 2010
Foot pain ruining your golf swing?
Golfing in Grapevine, Texas should not be limited by foot pain this spring!
The barrier to a perfect golf swing could lie in your big toe. Or your heel. Or on the ball of your foot. The physicians at Foot and Ankle Associates of North Texas in Grapevine, TX, say these are the three areas of your feet most likely to cause pain that can ruin your golf swing.
Behind these pain-prone spots can lie stiff joints, stretched-out tissues and even nerve damage. But pain relief is possible and frequently does not require surgery.
According to FAANT, the three most common painful foot conditions that can ruin your golf swing are heel pain, arthritis and pinched nerves.
1. Arthritis can cause pain in the joint of your big toe that makes it difficult to follow-through on your golf swing.
2. Heel pain typically results from an inflammation of the band of tissue that extends from your heel to the ball of your foot. People with this condition compare the pain to someone jabbing a knife in their heel. Heel pain can make it uncomfortable for golfers to maintain a solid stance during crucial portions of their golf swing.
3. Neuromas are nerves that become thickened, enlarged and painful because they’ve been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other in a golf swing.
Several other painful conditions can also cause instability during your swing. Some athletes and former athletes develop chronic ankle instability from previous ankle sprains that failed to heal properly. Motion-limiting arthritis and Achilles tendonitis can also affect your balance. Ill-fitting golf shoes may cause corns and calluses that make standing uncomfortable.
For the majority of golfers and other patients the doctors at FAANT recommend simple treatments such as custom orthotic devices (shoe inserts), stretching exercises, changes to your shoes, medications, braces or steroid injections and physical therapy. However, if these conservative measures fail to provide adequate relief, surgery may be required.
“Foot pain is not normal. With the treatment options available to your foot and ankle surgeon, a pain-free golf swing is clearly in view,” says FAANT. “When your feet aren’t in top condition, your golf swing won’t be either.”
For more information on foot and ankle conditions, visit www.faant.com
The barrier to a perfect golf swing could lie in your big toe. Or your heel. Or on the ball of your foot. The physicians at Foot and Ankle Associates of North Texas in Grapevine, TX, say these are the three areas of your feet most likely to cause pain that can ruin your golf swing.
Behind these pain-prone spots can lie stiff joints, stretched-out tissues and even nerve damage. But pain relief is possible and frequently does not require surgery.
According to FAANT, the three most common painful foot conditions that can ruin your golf swing are heel pain, arthritis and pinched nerves.
1. Arthritis can cause pain in the joint of your big toe that makes it difficult to follow-through on your golf swing.
2. Heel pain typically results from an inflammation of the band of tissue that extends from your heel to the ball of your foot. People with this condition compare the pain to someone jabbing a knife in their heel. Heel pain can make it uncomfortable for golfers to maintain a solid stance during crucial portions of their golf swing.
3. Neuromas are nerves that become thickened, enlarged and painful because they’ve been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other in a golf swing.
Several other painful conditions can also cause instability during your swing. Some athletes and former athletes develop chronic ankle instability from previous ankle sprains that failed to heal properly. Motion-limiting arthritis and Achilles tendonitis can also affect your balance. Ill-fitting golf shoes may cause corns and calluses that make standing uncomfortable.
For the majority of golfers and other patients the doctors at FAANT recommend simple treatments such as custom orthotic devices (shoe inserts), stretching exercises, changes to your shoes, medications, braces or steroid injections and physical therapy. However, if these conservative measures fail to provide adequate relief, surgery may be required.
“Foot pain is not normal. With the treatment options available to your foot and ankle surgeon, a pain-free golf swing is clearly in view,” says FAANT. “When your feet aren’t in top condition, your golf swing won’t be either.”
For more information on foot and ankle conditions, visit www.faant.com
Tuesday, April 13, 2010
Barefoot Running Good or Bad for You?
Barefoot running has become a growing trend. It has gained a lot of popularity due to the publication of the book "Born to Run". This books talks about the story of the Mexico-based Indians who for centuries have been running without shoes at distances sometimes greater than the distance of a marathon.
People are heavily debating the issue of shoes vs barefoot. The book "Born to Run" claims that the Tarahumara Indians are able to run great distances barefoot without being injured. They also claim that there is no proof that expensive running shoes are actually doing there job to prevent injuries. The book suggests that everyone should go back to how our earliest ancestors ran: barefoot.
Barefoot advocates claim that running shoes cause injurues and that it is more natural to run without shoes. Some say that you must be completly barefoot to reap the full benefits while others say it is best to wear a "minimalist shoe" that have thin soles and are lightweight.
So if Barefoot Running is so great how come there have not been more barefoot runners breaking the finishing tape at races. Are these athletes worried that if they trained barefoot they might injure themselves??
If runners ask me how I feel about barefoot running I tell them this:
There are many athletes and runners out there that do run with shoes and are not injured and have never had injuries. I tell my patients that if they want to try running barefoot that it would be safer running in a lightweight racing flat. If you do decide to run barefoot make sure you pick a soft surface. I also make sure to inform all my patients that there is no scientific evidence that barefoot running produces less injuries than running in shoes. Also the book focuses on a group of people that have been raised barefoot in their daily lives. Most of us have been in shoes since we were ambulatory, so due to this our skin toughness, muscles, ligaments, tendons and bones have developed differently.
No matter what you decide shoes or no shoes, be careful and remember if something hurts to seek medical attention.
People are heavily debating the issue of shoes vs barefoot. The book "Born to Run" claims that the Tarahumara Indians are able to run great distances barefoot without being injured. They also claim that there is no proof that expensive running shoes are actually doing there job to prevent injuries. The book suggests that everyone should go back to how our earliest ancestors ran: barefoot.
Barefoot advocates claim that running shoes cause injurues and that it is more natural to run without shoes. Some say that you must be completly barefoot to reap the full benefits while others say it is best to wear a "minimalist shoe" that have thin soles and are lightweight.
So if Barefoot Running is so great how come there have not been more barefoot runners breaking the finishing tape at races. Are these athletes worried that if they trained barefoot they might injure themselves??
If runners ask me how I feel about barefoot running I tell them this:
There are many athletes and runners out there that do run with shoes and are not injured and have never had injuries. I tell my patients that if they want to try running barefoot that it would be safer running in a lightweight racing flat. If you do decide to run barefoot make sure you pick a soft surface. I also make sure to inform all my patients that there is no scientific evidence that barefoot running produces less injuries than running in shoes. Also the book focuses on a group of people that have been raised barefoot in their daily lives. Most of us have been in shoes since we were ambulatory, so due to this our skin toughness, muscles, ligaments, tendons and bones have developed differently.
No matter what you decide shoes or no shoes, be careful and remember if something hurts to seek medical attention.
Monday, April 12, 2010
Pretty Feet for Summer!
As ecstatic as I am about getting an article into Southern Living magazine, I am even more so about getting the word out nationally on how to get those feet summer-ready!
You will find some surprisingly easy ways to keep the skin on your feet healthy, soft and oh, so smooth! As important as it is to get your feet hydrated, it is just as important to keep your nails safe from those little nasty dermatophytes lurking around (that would be the “fungus among us!”). Keep my pointers in mind next time you hit the nail salon!
And always remember, at Foot and Ankle Associates of North Texas, we are committed to providing you with the exceptional healthcare solutions to keep your feet “summer-ready” the whole year through!
You will find some surprisingly easy ways to keep the skin on your feet healthy, soft and oh, so smooth! As important as it is to get your feet hydrated, it is just as important to keep your nails safe from those little nasty dermatophytes lurking around (that would be the “fungus among us!”). Keep my pointers in mind next time you hit the nail salon!
And always remember, at Foot and Ankle Associates of North Texas, we are committed to providing you with the exceptional healthcare solutions to keep your feet “summer-ready” the whole year through!
Thursday, April 8, 2010
Medial Tibial Stress Syndrome
One of the most common injuries that occurs among running and jumping athletes...
Medial tibial stress syndrome also been called "shin splints" is the most common injury in the legs of active individuals. Females are more commonly affected, along with 22 percent of all injuries in aerobic dancers. Anyone participating in running or jumping acitvites are likely to develop this stress syndrome.
The pain from MTSS only occurs during the activity (running) with the pain diminshing rapidly within five minutes of activity cessation. If the pain persists during walking activites the suspicion for a stress fracture is high. Most common side effects are diffuse pain and tenderness that occur along the distal aspect of the medial tibial border (inside along the ankle bone)
How is MTSS diagnosed?
Most physicians will start with x-rays but most of the time they will get an MRI which is more specific test and has the abilty to diagnose the injured athlete.
How do I treat MTSS?
After the diagnosis has been made of MTSS, ice should be applied for 20 minutes multiple times a day. Activites should be reduced, patients should focus on exercising on softer surfaces, and wear appropriate shoe gear at all times. Custom foot orthotics are recommended for the vast majority of these patients. Orthotics are able to shift the ground force; as well as reduce subtalar pronation which helps reduce the bending motion of the tibia (which is why we get MTSS in the first place)
Understanding the disease is the key to getting an athlete back to their activites as soon as possible. If you think that your symptoms sound like these make an appointment with your podiatrist.
Medial tibial stress syndrome also been called "shin splints" is the most common injury in the legs of active individuals. Females are more commonly affected, along with 22 percent of all injuries in aerobic dancers. Anyone participating in running or jumping acitvites are likely to develop this stress syndrome.
The pain from MTSS only occurs during the activity (running) with the pain diminshing rapidly within five minutes of activity cessation. If the pain persists during walking activites the suspicion for a stress fracture is high. Most common side effects are diffuse pain and tenderness that occur along the distal aspect of the medial tibial border (inside along the ankle bone)
How is MTSS diagnosed?
Most physicians will start with x-rays but most of the time they will get an MRI which is more specific test and has the abilty to diagnose the injured athlete.
How do I treat MTSS?
After the diagnosis has been made of MTSS, ice should be applied for 20 minutes multiple times a day. Activites should be reduced, patients should focus on exercising on softer surfaces, and wear appropriate shoe gear at all times. Custom foot orthotics are recommended for the vast majority of these patients. Orthotics are able to shift the ground force; as well as reduce subtalar pronation which helps reduce the bending motion of the tibia (which is why we get MTSS in the first place)
Understanding the disease is the key to getting an athlete back to their activites as soon as possible. If you think that your symptoms sound like these make an appointment with your podiatrist.
Monday, March 1, 2010
Fine Tune Your Feet
On any given day we don’t hesitate to shower to keep ourselves clean, brush our teeth to prevent cavities. We take vitamins and exercise for healthy bodies and a strong heart. We work hard to keep everything in tune to keep ourselves going.
But what do we really do to keep our feet healthy? Aren’t our feet literally what is going to keep us going?? How many of us truly give them the attention they deserve? We only seem to start caring when they start complaining!
Foot fact: By the time we are 50 years old, we will have walked 75,000 miles! A lot of us active types are reaching that milestone much quicker! What happens at that mile mark? Well, we are at a much higher risk for developing arthritis in our feet. This with losing up to 50% of the shock absorbing fat in the balls of our feet can equal a very big OUCH!
Ingrown toe nails, bunions, hammertoes, corns, calluses, foot fungus, painful feet, to name a few, are all signs of foot abuse and neglect.
It is time to fine tune our feet!
When was the last time you really gave your feet a good look-over? That alone can make you aware of a potential problem before it starts to cause pain. Make it a habit to give them a check up every few months.
When was the last time you have your shoe size checked? Our feet spread and grow the more we use them. Next time you go shopping for shoes, take the extra time to have your feet sized. Many of you will be surprised how much they have grown!
Do you like to walk barefoot? I urge you to reconsider. When you rely on your own feet to cushion the blow of your body weight, you can count on wearing down your arch and the fat that cushions the ball and heel of your feet. In your golden years, when you are having a hard enough time keeping your health in check and your body is stiffer, you are going to wish you at least had a good set of feet to carry you through.
Do you really need to cram your foot into those stylish shoes? Yes, I do when I am going to a nice dinner or function. They do make us look great. Unfortunately, your feet can’t talk or they would be screaming for mercy!! Give them a break and alternate with a nice round toe, low or no-heeled, well-padded leather variety and your feet will that you by giving you that extra mileage!
What exercise are you choosing? Daily pounding or non-impact? Makes a big difference! Again, alternate your pounding run or step class with the ellipse, bike, swim, arc trainer or stair master. Wear and tear from a repetitive task can lead to stress fractures, tendonitis, muscle strain. The list goes on and on.
Finally, if you do have foot pain, don't wait and hope it will go away. Pain is not normal. A quick check with a podiatrist means a quicker recovery!
But what do we really do to keep our feet healthy? Aren’t our feet literally what is going to keep us going?? How many of us truly give them the attention they deserve? We only seem to start caring when they start complaining!
Foot fact: By the time we are 50 years old, we will have walked 75,000 miles! A lot of us active types are reaching that milestone much quicker! What happens at that mile mark? Well, we are at a much higher risk for developing arthritis in our feet. This with losing up to 50% of the shock absorbing fat in the balls of our feet can equal a very big OUCH!
Ingrown toe nails, bunions, hammertoes, corns, calluses, foot fungus, painful feet, to name a few, are all signs of foot abuse and neglect.
It is time to fine tune our feet!
When was the last time you really gave your feet a good look-over? That alone can make you aware of a potential problem before it starts to cause pain. Make it a habit to give them a check up every few months.
When was the last time you have your shoe size checked? Our feet spread and grow the more we use them. Next time you go shopping for shoes, take the extra time to have your feet sized. Many of you will be surprised how much they have grown!
Do you like to walk barefoot? I urge you to reconsider. When you rely on your own feet to cushion the blow of your body weight, you can count on wearing down your arch and the fat that cushions the ball and heel of your feet. In your golden years, when you are having a hard enough time keeping your health in check and your body is stiffer, you are going to wish you at least had a good set of feet to carry you through.
Do you really need to cram your foot into those stylish shoes? Yes, I do when I am going to a nice dinner or function. They do make us look great. Unfortunately, your feet can’t talk or they would be screaming for mercy!! Give them a break and alternate with a nice round toe, low or no-heeled, well-padded leather variety and your feet will that you by giving you that extra mileage!
What exercise are you choosing? Daily pounding or non-impact? Makes a big difference! Again, alternate your pounding run or step class with the ellipse, bike, swim, arc trainer or stair master. Wear and tear from a repetitive task can lead to stress fractures, tendonitis, muscle strain. The list goes on and on.
Finally, if you do have foot pain, don't wait and hope it will go away. Pain is not normal. A quick check with a podiatrist means a quicker recovery!
Wednesday, February 17, 2010
What is Peripheral Neuropathy and how do I know if I have it??
Peripheral Neuropathy is a medical condition in which the nerves that travel from your brain and spinal cord function improperly. Most people will complain that they are experiencing burning, tingling, numbness, and or shooting pains to their lower extremities. Most of the time the symptoms of neuropathy will begin in the feet. Numbness in the toes or in the ball of the foot seems to be where most people feel these sensations first.
What causes Neuropathy?
There are over 100 causes of peripeheral neuropathy. Some of the more common ones include diabetes, thiamine deficiency, alcoholism, trauma, exposure to toxins, autoimmune diseases, and infections. Sometimes no cause can be determined.
Can you treat Neuropathy?
Yes, a treatment plan can be formed based on the cause of your neuropathy. If you are Thiamine deficient (easily determined with a blood test), you can begin to take supplements of thiamine and the symptoms should eradicate.
Neuremedy is another option for treating neuropathy.
What is Neuremedy?
Neuremedy is a medical supplement that helps treat dysfunctional nerves allowing them to impulse correctly. It contains benofotiamine and has been determined to be safe and successful in treatment of neuropathy. Neuremedy is able to help alleviate the symptoms of neuropathy by delivering a highly bio active form of the micro-nutrient thiamine to the nerve cells.
Is Neuremedy safe?
The active ingredient in Neuremedy is benfotiamine. It has been used since the early 1960's to successfully treat neuropathy. It has been proven to be safe and effective. It does not have any known significant adverse effects and can be safely taken with medicines and supplements.
How Quickly does Neuremedy work?
Most people begin to notice a reduction of symptoms within the first two months of taking the supplement. Unfortunately neuremedy does not work for everyone. Ask your doctor if Neuremedy is right for you.
Peripheral Neuropathy is a medical condition in which the nerves that travel from your brain and spinal cord function improperly. Most people will complain that they are experiencing burning, tingling, numbness, and or shooting pains to their lower extremities. Most of the time the symptoms of neuropathy will begin in the feet. Numbness in the toes or in the ball of the foot seems to be where most people feel these sensations first.
What causes Neuropathy?
There are over 100 causes of peripeheral neuropathy. Some of the more common ones include diabetes, thiamine deficiency, alcoholism, trauma, exposure to toxins, autoimmune diseases, and infections. Sometimes no cause can be determined.
Can you treat Neuropathy?
Yes, a treatment plan can be formed based on the cause of your neuropathy. If you are Thiamine deficient (easily determined with a blood test), you can begin to take supplements of thiamine and the symptoms should eradicate.
Neuremedy is another option for treating neuropathy.
What is Neuremedy?
Neuremedy is a medical supplement that helps treat dysfunctional nerves allowing them to impulse correctly. It contains benofotiamine and has been determined to be safe and successful in treatment of neuropathy. Neuremedy is able to help alleviate the symptoms of neuropathy by delivering a highly bio active form of the micro-nutrient thiamine to the nerve cells.
Is Neuremedy safe?
The active ingredient in Neuremedy is benfotiamine. It has been used since the early 1960's to successfully treat neuropathy. It has been proven to be safe and effective. It does not have any known significant adverse effects and can be safely taken with medicines and supplements.
How Quickly does Neuremedy work?
Most people begin to notice a reduction of symptoms within the first two months of taking the supplement. Unfortunately neuremedy does not work for everyone. Ask your doctor if Neuremedy is right for you.
Monday, January 11, 2010
What Are These Labs For?
You go into your podiatrist office to have your foot problem evaluated and you walk out with a lab form for some tests. Why do you need them and what do they mean?
Well, laboratory tests are an important tool to help us evaluate your health. Diabetics, people with swollen joints, people with foot pain symptoms that are unusual, people going on a new medication and people with infections are all candidates for blood work. Here are some of the more common labs ordered by your podiatrist, what they are for and what abnormal levels could mean:
Glucose: This tells us how much sugar is in your blood. We usually order this if you are a diabetic and we want to get a measure of your recent sugar levels or if you are not diagnosed diabetic but we suspect you may be. Too high a value is seen in diabetics. You will also see an elevation if you did not fast for this test.
Hemoglobin A1c (HgA1c): If you are a diabetic and we want to know how well you have controlled your blood sugars over the past 3 months, this test will let us know.
Blood Urea Nitrogen (BUN) is a waste product made by the liver. It is excreted by the kidneys. We see high values in people on high protein diets, people who exercise strenuously, and people who have problems with their kidneys. We will order this test if we are placing you on a medication that is processed by the kidney and want to make sure your kidney is functioning properly.
Creatinine is a waste product from muscle breakdown. This is also ordered to evaluate kidney function. A high value here with a high BUN could also mean you have kidneys that are not working well.
Uric Acid is normally excreted in urine. When your body is not excreting this properly, or if your body is producing too much of it, you could end up with gout, a condition that results in joint pain. If you have a swollen joint, we may order this to rule out gout.
If you have a swollen joint or joints and we are trying to further determine a cause, we may also order a Rheumatoid panel. This includes the Rheumatoid Factor (RF) test along with other autoimmune-related tests, such as an ANA (antinuclear antibody)along with other markers of inflammation, such as a CRP (C-reactive protein) ESR (erythrocyte sedimentation rate and along with a CBC (Complete Blood Count) to evaluate the body’s blood cells.
When we decide to put someone on a medication that may affect their liver, or we suspect that they may have liver damage, we may order a panel to check out their liver function. They may include AST, ALT, ALP, SGOT, SGPT, and GGT and Alkaline Phosphatase, Bilirubin, Albumin, total protein.
There are patients who present with weakness of their lower extremity. CPK level is a test we order to help make this determination. If CPK is high in the absence of cardiac history or strenuous exercise (both of which could also cause an elevation), it could indicate skeletal muscle disease.
If we are trying to heal a wound and suspect possible poor healing secondary to nutrition and overall health, we may order Albumin and Globulin levels.Hemoglobin (Hgb) and Hematocrit (Hct) may also be ordered as low levels also contribute to nutritional deficiencies causing anemia
If we suspect an infection, these tests help us evaluate the severity of the infection as well as how well a particular antibiotic is working against it. Usually, the higher the value, the more severe the infection. These labs include: C-Reactive Protein (CRP), White Blood Count (WBC), Sedimentation Rate (SED rate)
It is important to get these requested labs as soon as we order them to help you with your treatment. Doing so will help “get you back on your feet” in no time!!
Well, laboratory tests are an important tool to help us evaluate your health. Diabetics, people with swollen joints, people with foot pain symptoms that are unusual, people going on a new medication and people with infections are all candidates for blood work. Here are some of the more common labs ordered by your podiatrist, what they are for and what abnormal levels could mean:
Glucose: This tells us how much sugar is in your blood. We usually order this if you are a diabetic and we want to get a measure of your recent sugar levels or if you are not diagnosed diabetic but we suspect you may be. Too high a value is seen in diabetics. You will also see an elevation if you did not fast for this test.
Hemoglobin A1c (HgA1c): If you are a diabetic and we want to know how well you have controlled your blood sugars over the past 3 months, this test will let us know.
Blood Urea Nitrogen (BUN) is a waste product made by the liver. It is excreted by the kidneys. We see high values in people on high protein diets, people who exercise strenuously, and people who have problems with their kidneys. We will order this test if we are placing you on a medication that is processed by the kidney and want to make sure your kidney is functioning properly.
Creatinine is a waste product from muscle breakdown. This is also ordered to evaluate kidney function. A high value here with a high BUN could also mean you have kidneys that are not working well.
Uric Acid is normally excreted in urine. When your body is not excreting this properly, or if your body is producing too much of it, you could end up with gout, a condition that results in joint pain. If you have a swollen joint, we may order this to rule out gout.
If you have a swollen joint or joints and we are trying to further determine a cause, we may also order a Rheumatoid panel. This includes the Rheumatoid Factor (RF) test along with other autoimmune-related tests, such as an ANA (antinuclear antibody)along with other markers of inflammation, such as a CRP (C-reactive protein) ESR (erythrocyte sedimentation rate and along with a CBC (Complete Blood Count) to evaluate the body’s blood cells.
When we decide to put someone on a medication that may affect their liver, or we suspect that they may have liver damage, we may order a panel to check out their liver function. They may include AST, ALT, ALP, SGOT, SGPT, and GGT and Alkaline Phosphatase, Bilirubin, Albumin, total protein.
There are patients who present with weakness of their lower extremity. CPK level is a test we order to help make this determination. If CPK is high in the absence of cardiac history or strenuous exercise (both of which could also cause an elevation), it could indicate skeletal muscle disease.
If we are trying to heal a wound and suspect possible poor healing secondary to nutrition and overall health, we may order Albumin and Globulin levels.Hemoglobin (Hgb) and Hematocrit (Hct) may also be ordered as low levels also contribute to nutritional deficiencies causing anemia
If we suspect an infection, these tests help us evaluate the severity of the infection as well as how well a particular antibiotic is working against it. Usually, the higher the value, the more severe the infection. These labs include: C-Reactive Protein (CRP), White Blood Count (WBC), Sedimentation Rate (SED rate)
It is important to get these requested labs as soon as we order them to help you with your treatment. Doing so will help “get you back on your feet” in no time!!
Subscribe to:
Posts (Atom)