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!
Monday, May 10, 2010
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!
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