Ankle pain is no fun especially on a great summer vacation. And it never fails, that you sprain your ankle getting off the plane just as you start your vacation. So what's the best thing you can do? Follow the RICE principle...Rest, Ice, Compress, Elevate.
After an injury, the first thing you will notice is swelling and pain. Rest will reduce the amount of swelling you have, thus improving your pain. If you are on a relaxing vacation, this should not be a problem. But otherwise, do your best to find a way to get off your foot.
Ice reduces the amount of bloodflow to the injured area which in turn reduces the amount of swelling. This ultimately improves your pain. Remember to never apply ice directly to your skin. Always protect your skin with a towel or sock to prevent frost bite.
Compression helps splint the injured ankle and control swelling. The more motion the ankle has immediately after injury the more painful it can be so applying an ACE bandage or some type of splint will improve pain, but also improve your long term recovery. Again, if you control swelling you improve your pain.
Elevation simply means getting your foot off the floor. Hip level or higher is ideal. Gravity can significantly worsen your pain from the simple fact that it makes swelling worse. Getting your foot off the floor lessens the pull of gravity on your injured ankle, thus (and you have to know what's coming by now) reduces swelling which reduces your pain.
Do I sound like a broken record? It's pretty simple. Injuries cause swelling, swelling causes pain. Control swelling, improve pain!
For more information on ankle sprains and all things foot and ankle related, visit our website at www.faant.com.
Tuesday, August 16, 2011
Tuesday, August 2, 2011
Got Sweaty Feet? We Have Solutions!
Wet, sloshy and sweaty feet that slide around in your sandals. That can’t feel good. Why don’t they stop sweating?
You’re not alone!
Hyperhidrosis, or excessive sweating, can be embarrassing and cause emotional stress. This disorder predominantly affects the palms, soles and under arms.
Hyperhidrosis may actually be a symptom of other medical conditions, medications, or over-activity of certain nerves that control the sweat glands.
We know what all this sweating does to your feet. Patients have an increased incidence of irritation, blistering, skin infections, foot odor, and can impact your personal and social life.
Treatments options include:
1. Foot powders
2. Anti-perspirants
3. Prescriptive medications
4. Herbal remedies
5. Acupuncture
6. Botox injections
7. Iontopheresis (Electrical stimulation to your feet while in the water)
8. Surgical sympathetomy (Destroying the nerves that are responsible for this sweating. Yikes!)
Here are some easy things you can start doing now:
1. Alter your diet and avoid hot, spicy food! If it makes your head sweat, guess what?
2. Chose natural materials such as leather for your dress shoes which allow your feet to breathe. Pleather is OUT!
3. When you are sitting on the couch, let those feet air out!
4. Wear the newer athletic synthetic socks that absorb sweat and change them often. Nylon hose or socks are the absolute worst!
5. Need to wear the nylon for your dress shoes and what about sandals?
Do we have the product for you!
If you do nothing else, pick up a few pairs of Summer Soles inlays for all your shoes and sandals. Check them out at www.summersoles.com Gets rid of wrinkles and makes your feet stop sweating?! What a bargain!
Thursday, July 28, 2011
Alex Trebek Tore Achilles Tendon...What Next?
It has just been released that Alex Trebek tore his Achilles tendon while fighting off a burglar in his hotel. Wow! So now what? Alex should be expecting surgery to fix that torn Achilles tendon and a year long recovery.
In trauma situations, the Achilles tendon can be injured by sudden forceful movements of the foot against the leg. Or blunt trauma to the tendon area can cause the tendon to tear or rupture. When this occurs, the person often feels a sharp pop or pull on the back of the calf and often describes a feeling of being shot in the leg. Instant swelling and bruising occurs with an inability to really use that foot. Without the Achilles tendon the foot has a tendinacy to "flop" on the leg.
On exam, the back of the leg will be swollen and bruised. Pain is usually not as bad as you would expect, but is still present. And there will be a gap along the leg just above the heel where the tendon is torn. In the office we do a simple calf squeeze test to check the tendon integrity. If you squeeze the calf and the foot fully points, all is good, no full tendon tear (normally). But if you squeeze and the foot just stays the same...not so good, the tendon is no longer attached.
Now we need to fix it because leaving it torn will cause drop foot and the need for long term bracing to walk. Fixing the tendon requires surgery where the 2 ends of the tendon are sutured back together. A fiberglass cast is applied to protect the tendon and there is no walking on that foot for 4-6 weeks.
Long term, physical therapy is necessary to regain strength of the calf muscle and improve confidence in using that foot and leg. This process can take about a year before the patient returns to full unlimited activity.
Job well done, Alex, on fighting off the bad guys. We wish you a speedy recovery!
In trauma situations, the Achilles tendon can be injured by sudden forceful movements of the foot against the leg. Or blunt trauma to the tendon area can cause the tendon to tear or rupture. When this occurs, the person often feels a sharp pop or pull on the back of the calf and often describes a feeling of being shot in the leg. Instant swelling and bruising occurs with an inability to really use that foot. Without the Achilles tendon the foot has a tendinacy to "flop" on the leg.
On exam, the back of the leg will be swollen and bruised. Pain is usually not as bad as you would expect, but is still present. And there will be a gap along the leg just above the heel where the tendon is torn. In the office we do a simple calf squeeze test to check the tendon integrity. If you squeeze the calf and the foot fully points, all is good, no full tendon tear (normally). But if you squeeze and the foot just stays the same...not so good, the tendon is no longer attached.
Now we need to fix it because leaving it torn will cause drop foot and the need for long term bracing to walk. Fixing the tendon requires surgery where the 2 ends of the tendon are sutured back together. A fiberglass cast is applied to protect the tendon and there is no walking on that foot for 4-6 weeks.
Long term, physical therapy is necessary to regain strength of the calf muscle and improve confidence in using that foot and leg. This process can take about a year before the patient returns to full unlimited activity.
Job well done, Alex, on fighting off the bad guys. We wish you a speedy recovery!
Sunday, July 24, 2011
A Cut on the Foot Leads to Hospital Stay
Summertime is great in Texas. We have clear skies, very hot weather and plenty of lakes to cool off in. So you would think that a fun day on the lake with your friends should leave you with some funny stories to tell your children when they are old enough. But for one patient this weekend, it landed her in the hospital with urgent surgery and IV antibiotics...and did I mention pain...lots!
All you lake and river rats, take notes. This very pleasant young patient was enjoying a day on the lake when she cut her foot on broken glass on a sandy beach just at waters edge. She knew it was not just a small nick in the skin and immediately went to the local ER. She was treated and sent home with antibiotics and told to follow up with her physician to remove her stitches in a week. Within 3 days her foot become so red, swollen and painful that she took herself to another ER where she was admitted with a severe foot infection.
So what happened? She did all the right things. Unfortunately, she needed more aggressive antibiotics. What she had is called a laceration which is a traumatic cut in the skin. It it normally deeper than skin and often requires stitches to close the injury. Appropriate care of any laceration includes a deep cleansing to remove dirt and debris and any foreign objects that might be sitting in the wound. Sometimes this can be done in the ER, but there are times that cuts may need to be taken to the operating room for more aggressive "washing" or what we call incision and drainage. Once the wound is clean and sutures or stitches are used to close the skin, then healing occurs within 10-14 days.
So what happened here? The lake is what happened! Lakes, rivers, oceans and stock tanks are full of water borne bacteria and with our 100+ degree weather certain bacteria are thriving. These bacteria are very aggressive, not killed with basic antibiotics and cause severe infection. They can lead to tissue loss or even limb loss in unhealthy patients.
If you do happen to cut your skin while enjoying water activities, don't ignore it. Seek treatment right away and make sure you get antibiotics and a tetanus shot to prevent a possible surgery in the future!
Tuesday, July 19, 2011
Ingrown Toe Nail Hell!
There is no question about it. You have dug on that ingrown toenail one too many times and it has just about had it! It is swollen and red and painful and you just can’t get it out this time. Where do you go from here? Well, to your podiatrist by golly!
An ingrown toenail is a toenail that simply looks like it is digging into the skin surrounding the nail (aka, into the “nail fold”). Ironically, you can have a nail that looks ingrown but is not painful. That is perfectly ok! It is the nail that decides to step it up a notch and cause irritation to the nail fold that becomes a problem! Squeezing your toes into the stilettos seen at the royal wedding may just provide all the irritation it needs to get the ball rolling!
If you have ever had an irritated ingrown nail, you know what I am talking about. It feels like absolute self-induced torture trying to dig those out with your handy-dandy nail clipper. If the clipper or the toe is not clean enough, you can end up inviting all the nasty critters for a visit and end up with a nastier infection.
Trust me on this one. If you have had to dig out an ingrown nail several times a year, it will not go away the longer you fuss with it. It is riskier to keep fussing with it than getting over to your podiatrist office to have it taken care of. What does that mean? Well, for one, it means cleaner and more precise instruments, expertise and resolution to the problem. That means you likely won’t get it back for the rest of your life with one visit!!
A podiatrist can perform what is known as a “matrixectomy”. The “-ectomy” part of that term means “removing” and the “matrix” part of the word means the nail root in question. We, in essence, remove the portion of the nail root that is growing the portion of nail getting ingrown. It is very precise; removing only what is needed to keep the nail from getting ingrown and leaves the remaining nail intact. For the most part, once it is healed with a little TLC on your part, it never looks like anything was ever done! Only a very small percentage of nails try to grown back in the section removed. Overall, a very, very successful permanent result to your chronic problem!
Leaving an ingrown nail to get infected is leaving it too long! An antibiotic will only work to temporarily relieve the symptoms. As long as the nail is growing into the skin, you will continue to have the problem. Don’t wait to get in to see your podiatrist at the first signs of discomfort. I have seen too many 60-year-old patients saying they wish they would have done this 20 years ago. Don’t let this be you!
An ingrown toenail is a toenail that simply looks like it is digging into the skin surrounding the nail (aka, into the “nail fold”). Ironically, you can have a nail that looks ingrown but is not painful. That is perfectly ok! It is the nail that decides to step it up a notch and cause irritation to the nail fold that becomes a problem! Squeezing your toes into the stilettos seen at the royal wedding may just provide all the irritation it needs to get the ball rolling!
If you have ever had an irritated ingrown nail, you know what I am talking about. It feels like absolute self-induced torture trying to dig those out with your handy-dandy nail clipper. If the clipper or the toe is not clean enough, you can end up inviting all the nasty critters for a visit and end up with a nastier infection.
Trust me on this one. If you have had to dig out an ingrown nail several times a year, it will not go away the longer you fuss with it. It is riskier to keep fussing with it than getting over to your podiatrist office to have it taken care of. What does that mean? Well, for one, it means cleaner and more precise instruments, expertise and resolution to the problem. That means you likely won’t get it back for the rest of your life with one visit!!
A podiatrist can perform what is known as a “matrixectomy”. The “-ectomy” part of that term means “removing” and the “matrix” part of the word means the nail root in question. We, in essence, remove the portion of the nail root that is growing the portion of nail getting ingrown. It is very precise; removing only what is needed to keep the nail from getting ingrown and leaves the remaining nail intact. For the most part, once it is healed with a little TLC on your part, it never looks like anything was ever done! Only a very small percentage of nails try to grown back in the section removed. Overall, a very, very successful permanent result to your chronic problem!
Leaving an ingrown nail to get infected is leaving it too long! An antibiotic will only work to temporarily relieve the symptoms. As long as the nail is growing into the skin, you will continue to have the problem. Don’t wait to get in to see your podiatrist at the first signs of discomfort. I have seen too many 60-year-old patients saying they wish they would have done this 20 years ago. Don’t let this be you!
Monday, June 27, 2011
The Hikers Guide to Hiking Boots!
I had a great trip to the Grand Canyon and Sedona this past month and I will tell you why. I had the BEST hiking boots and shoes! So many of us enjoy roughing it outdoors and those trips can be less than peachy if your dogs are barking!
It can be so tempting to go shopping on-line for shoes. I know I have. There are on-line stores offering free returns and with such limited time in the day to shop, this method is very enticing! If you have some time before your trip, say at least 4-6 months to experiment, then have at it! If any of us that have any even remotely nearby access to a sporting goods store, I recommend going this route. Chances are you will not find the perfect hikers with the first pair you try on or the first store you hit for that matter.
When you do go shopping, take these pointers with you…
Go shopping towards the end of the day. Your feet swell more in the afternoon. No doubt your feet will be swelling even more than that during your trip!
Count on getting a pair of hikers at least one half to sometimes a whole size different than what you measure. There are several reasons for this:
1. What goes up, must come down. When you hike down, you will get a lot more in the way of the toes jamming repeatedly towards the end of the shoe. No exercise we do can mimic this. Some of the top sporting good stores, like REI, have a fake boulder in there shoe department. The rule of thumb is being able to “make your way down the boulder” without the tip of your big toe touching the end of the boot. If it does, try one half size larger.
2. I always recommend wearing hiking socks when you know you’ll be doing a lot of hiking. Even though they are bulkier, the wool or synthetic sweat wicking blends do a much better job at keeping your feet dry than cotton. I tried socking liners this trip underneath the socks and wow, what an improvement over a sock alone! A sock liner will help prevent blisters. More of a bonus is that you can get away with washing the liners, which dry in a snap, and wear the same pair of socks for a few days without them getting too grungy!
If the boot does not feel good off the bat, try on a different style. It is worth paying the extra if what you like is not on sale. You will have these boots for years to come! If it is not a matter of comfort, but one of heel slippage, most of the better sporting stores have sales persons who know how to adjust the lacing to control slippage.
Consider the terrain you plan on encountering. Assuming you do not have any major ankle problems or weakness, consider trying on a pair of hiking shoes, rather than boots, or a shorter boot rather than one that goes up past the ankles. Hiking shoes or shorter boots are lighter and may suit you more. This really is a matter of comfort. For anyone with ankle weakness, stick to a higher boot. You won’t risk a sprain at the start of the trip!
Consider what others say about the shoe or boot you are eyeing. There are several sites to look up your brand and style for comparison. Sites such as consumersearch.com for instance, will give you reviews from various other sites and magazines.
Last but not least, make sure what you buy is water proof or very resistant. Read the labels well. If they are not and you really like them, add the water repellant spray to your shopping cart and avoid bringing home athletes’ foot as a souvenir!!
Happy trails to you!!
It can be so tempting to go shopping on-line for shoes. I know I have. There are on-line stores offering free returns and with such limited time in the day to shop, this method is very enticing! If you have some time before your trip, say at least 4-6 months to experiment, then have at it! If any of us that have any even remotely nearby access to a sporting goods store, I recommend going this route. Chances are you will not find the perfect hikers with the first pair you try on or the first store you hit for that matter.
When you do go shopping, take these pointers with you…
Go shopping towards the end of the day. Your feet swell more in the afternoon. No doubt your feet will be swelling even more than that during your trip!
Count on getting a pair of hikers at least one half to sometimes a whole size different than what you measure. There are several reasons for this:
1. What goes up, must come down. When you hike down, you will get a lot more in the way of the toes jamming repeatedly towards the end of the shoe. No exercise we do can mimic this. Some of the top sporting good stores, like REI, have a fake boulder in there shoe department. The rule of thumb is being able to “make your way down the boulder” without the tip of your big toe touching the end of the boot. If it does, try one half size larger.
2. I always recommend wearing hiking socks when you know you’ll be doing a lot of hiking. Even though they are bulkier, the wool or synthetic sweat wicking blends do a much better job at keeping your feet dry than cotton. I tried socking liners this trip underneath the socks and wow, what an improvement over a sock alone! A sock liner will help prevent blisters. More of a bonus is that you can get away with washing the liners, which dry in a snap, and wear the same pair of socks for a few days without them getting too grungy!
If the boot does not feel good off the bat, try on a different style. It is worth paying the extra if what you like is not on sale. You will have these boots for years to come! If it is not a matter of comfort, but one of heel slippage, most of the better sporting stores have sales persons who know how to adjust the lacing to control slippage.
Consider the terrain you plan on encountering. Assuming you do not have any major ankle problems or weakness, consider trying on a pair of hiking shoes, rather than boots, or a shorter boot rather than one that goes up past the ankles. Hiking shoes or shorter boots are lighter and may suit you more. This really is a matter of comfort. For anyone with ankle weakness, stick to a higher boot. You won’t risk a sprain at the start of the trip!
Consider what others say about the shoe or boot you are eyeing. There are several sites to look up your brand and style for comparison. Sites such as consumersearch.com for instance, will give you reviews from various other sites and magazines.
Last but not least, make sure what you buy is water proof or very resistant. Read the labels well. If they are not and you really like them, add the water repellant spray to your shopping cart and avoid bringing home athletes’ foot as a souvenir!!
Happy trails to you!!
Tuesday, May 31, 2011
Pregnancy Foot Woes!
It helps to come from a place of experience, and having had three children, I can definitely relate to the whole "pregnancy foot woes" thing and it isn’t fun.
When we think about it, feet don’t rank very high on the list of important things to think about when we are pregnant. Fitness however, ranks way up there! Go figure, when your feet hurt, you are not too motivated to get moving. The extra pounds can really pile up (My weakness was SAMS-size Cheetoes!). The more pounds, the more foot pain, the more foot pain… well, you get my drift!
Feet need to rank higher on our list of things to think about! I’ll make it easy by doing the thinking for you!!
Tip #1: Don’t walk around barefoot
“Barefoot and pregnant” is a nice cliché, but is not a good idea for so many women suffering with foot pain. The additional weight can sometimes be too much for some feet to handle. Wearing a slipper with an arch support is a great idea! Remember the ligaments loosen everywhere with pregnancy (not just at the hips!) and this can cause increased flattening of the arch. That is why many of us go up in shoe size and never go back down even long after a pregnancy.
Tip #2: Buy new shoes!
Yes, yet another good reason to go shoe shopping! We cannot expect our feet to remain the same size during or after pregnancy. It is a great idea to get your feet re-sized about 4-5 months into your pregnancy
Tip #3 Take a load off!
Swelling during pregnancy is very common. We hold on to more fluid when we are pregnant. You can end up with achy extremities and those nasty spider and varicose veins. It is important to elevate your feet to the level of the heart for a good 15-20 minutes (those your legs will take what you can give them!) several times a day. If you can’t get off of them completely, then at least sit with your feet propped up and don’t cross your legs. Avoid anything binding at the knees or ankles. Stay cool since heat can aggravate swelling! And please don’t forget to control salt intake! More sodium equals more swelling!
Tip #4 Wear supportive shoes when out and about
When you’re feeling marvelously pregnant and you want to style it up, your best bet is a nice supportive shoe. If you insist on a heel, choose a wedge of no more than 1.5 inches. Any more than that puts 75% of your ever increasing body weight on those poor feet. That can cause serious compression of the fat pad in the balls of our feet and we can’t get that or add that fat pad back. Yes, there is fat we want to keep! You may not feel the effect immediately, but with the wearing down of the fat pad, you may end up feeling like you are “walking on bones” with chronic pain to the balls of the feet as your post-pregnanacy years wear on.
When we think about it, feet don’t rank very high on the list of important things to think about when we are pregnant. Fitness however, ranks way up there! Go figure, when your feet hurt, you are not too motivated to get moving. The extra pounds can really pile up (My weakness was SAMS-size Cheetoes!). The more pounds, the more foot pain, the more foot pain… well, you get my drift!
Feet need to rank higher on our list of things to think about! I’ll make it easy by doing the thinking for you!!
Tip #1: Don’t walk around barefoot
“Barefoot and pregnant” is a nice cliché, but is not a good idea for so many women suffering with foot pain. The additional weight can sometimes be too much for some feet to handle. Wearing a slipper with an arch support is a great idea! Remember the ligaments loosen everywhere with pregnancy (not just at the hips!) and this can cause increased flattening of the arch. That is why many of us go up in shoe size and never go back down even long after a pregnancy.
Tip #2: Buy new shoes!
Yes, yet another good reason to go shoe shopping! We cannot expect our feet to remain the same size during or after pregnancy. It is a great idea to get your feet re-sized about 4-5 months into your pregnancy
Tip #3 Take a load off!
Swelling during pregnancy is very common. We hold on to more fluid when we are pregnant. You can end up with achy extremities and those nasty spider and varicose veins. It is important to elevate your feet to the level of the heart for a good 15-20 minutes (those your legs will take what you can give them!) several times a day. If you can’t get off of them completely, then at least sit with your feet propped up and don’t cross your legs. Avoid anything binding at the knees or ankles. Stay cool since heat can aggravate swelling! And please don’t forget to control salt intake! More sodium equals more swelling!
Tip #4 Wear supportive shoes when out and about
When you’re feeling marvelously pregnant and you want to style it up, your best bet is a nice supportive shoe. If you insist on a heel, choose a wedge of no more than 1.5 inches. Any more than that puts 75% of your ever increasing body weight on those poor feet. That can cause serious compression of the fat pad in the balls of our feet and we can’t get that or add that fat pad back. Yes, there is fat we want to keep! You may not feel the effect immediately, but with the wearing down of the fat pad, you may end up feeling like you are “walking on bones” with chronic pain to the balls of the feet as your post-pregnanacy years wear on.
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