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.

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

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!

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!

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!