Amongst all the exciting playoff basketball with March Madness, David Beckham will have plenty of time to watch all the action at home. He unfortunately suffered an Achilles Tendon rupture on March 14th during a match against Italian football club Chievo. Achilles tendon ruptures, although not too common, can be quite difficult to treat.
Achilles tendon tears/ruptures most frequently happen to the “weekend warrior.” They often happen to people who are a bit out of shape, and a few years removed from their heavy activity days. They go out for a random pick-up basketball or football game with friends, don’t warm up slowly and gradually, don’t stretch, and end up tearing their Achilles. They can also happen by overuse, improper footwear, certain drugs (such as steroids and an antibiotic class known as quinolones), and direct injury. People usually describe the injury as though they have been kicked in the back of the leg, hear or feel a loud pop, and feel a sharp and intense pain.
The Achilles Tendon functions as fibrous tissue that connects the heel to the muscles of the lower leg. It is a very strong tendon, but unfortunately has one downfall! There is an area known as the “watershed” region, which is where most of the tears occur. This is because it is an area of very poor blood supply, so it does not get as much nutrition from blood supply as the other areas. Depending on how bad the tear is, there are several different options for treatment.
If the tendon is only strained, then a regimen of rest, followed by strengthening and stretching can be implemented. In order to provide maximum rest, the foot and ankle can be casted or placed in some type of controlled motion boot. Not allowing the foot and ankle to move is crucial to hearling! If there is an actual tear, often times surgical intervention is necessary. They will cut out the part of tendon that is torn/damaged. At that point, with a small tear they can sometimes sew together the healthy portion of tissue, or with a larger tear they can use a graft or synthetic Achilles tendon to replace the one that was torn, and sew it in place of the tendon that was taken out.
Achilles tendon ruptures are an unfortunate injury to happen to anyone, but with proper care and treatment provided by your podiatrist, you can get back in to the game quickly!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Tuesday, August 24, 2010
Running pains?
As the nice weather embarks upon us, we find ourselves venturing outside more often to enjoy the great outdoors. For those of us who are getting back in to running, or increasing the training regimine, you may notice some areas are beginning to hurt! If what begins as a fun run, turns into moans and groans, read along to see what you can do to ease your pain.
Many people often experience pain along the front of their shins when they run. These so called “shin splints” can have you doubling over in pain, and put an immediate stop to your run, and destroy your desire to do so again. Medial Tibial Stress Syndrome (shin splints) can also be caused by other activities, including jumping, dancing, and sprinting. It is often attributed that the pain comes from the muscle group that lies on the front of the leg, which acts to bring the toes up towards the sky (dorsiflex the foot). What causes this muscle group to become aggravated is forceful slamming of the heel against the ground. Through normal running motion, your anterior muscle group picks your toes up towards the sky while your foot coasts in the air so you don’t trip. As the heel hits the ground, the muscles on the front of the leg work to hold the toes up (dorsiflex), but are placed under a very forceful contraction. This causes a rapid response of the muscles to “fire back” to counteract the force. Over time (period of minutes to hours), the muscles become fatigued and irritated, and cause the pain that can span the front of the leg.
Another possible cause is over-powering of the calf muscles. Since the two muscle groups are antagonistic (work against each other), if one is markedly stronger than the other, it can make a big difference. There are also a few aggravating factors, such as over pronation of the foot (where the arch collapses), insufficient time for a warm-up, over-training, or a chronic compartment syndrome. This is when the swelling of the compartment in the leg that contains the anterior muscle group cuts off blood supply to the muscles, causing immense pain, numbness, and skin color changes.. This is a very serious condition, so if you have any concerns that you may have this, see your podiatrist immediately!
The good news is that this nagging shin splint problem is very easily treated in most instances. In most cases rest, ice and non-steroidal anti-inflammatory medication can relieve symptoms. It is definitely encouraged to make sure you are providing ample time for a warm-up, and gradually increasing training activity to allow for your body to respond to the demands placed on it. One other very helpful pain-relief tool is custom made orthotics, to ensure your foot is in a proper alignment.
With this knowledge, make sure to not let shin splints ruin your summer outdoor activities. Enjoy nature in all its glory, pain free!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Many people often experience pain along the front of their shins when they run. These so called “shin splints” can have you doubling over in pain, and put an immediate stop to your run, and destroy your desire to do so again. Medial Tibial Stress Syndrome (shin splints) can also be caused by other activities, including jumping, dancing, and sprinting. It is often attributed that the pain comes from the muscle group that lies on the front of the leg, which acts to bring the toes up towards the sky (dorsiflex the foot). What causes this muscle group to become aggravated is forceful slamming of the heel against the ground. Through normal running motion, your anterior muscle group picks your toes up towards the sky while your foot coasts in the air so you don’t trip. As the heel hits the ground, the muscles on the front of the leg work to hold the toes up (dorsiflex), but are placed under a very forceful contraction. This causes a rapid response of the muscles to “fire back” to counteract the force. Over time (period of minutes to hours), the muscles become fatigued and irritated, and cause the pain that can span the front of the leg.
Another possible cause is over-powering of the calf muscles. Since the two muscle groups are antagonistic (work against each other), if one is markedly stronger than the other, it can make a big difference. There are also a few aggravating factors, such as over pronation of the foot (where the arch collapses), insufficient time for a warm-up, over-training, or a chronic compartment syndrome. This is when the swelling of the compartment in the leg that contains the anterior muscle group cuts off blood supply to the muscles, causing immense pain, numbness, and skin color changes.. This is a very serious condition, so if you have any concerns that you may have this, see your podiatrist immediately!
The good news is that this nagging shin splint problem is very easily treated in most instances. In most cases rest, ice and non-steroidal anti-inflammatory medication can relieve symptoms. It is definitely encouraged to make sure you are providing ample time for a warm-up, and gradually increasing training activity to allow for your body to respond to the demands placed on it. One other very helpful pain-relief tool is custom made orthotics, to ensure your foot is in a proper alignment.
With this knowledge, make sure to not let shin splints ruin your summer outdoor activities. Enjoy nature in all its glory, pain free!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Feet on Fire?
After spending time outdoors, ever notice that your feet are “feel like they are on fire?” Did you remember to put sunscreen on all the sun exposed parts, except your feet? There are important reasons to make sure you never leave your feet unprotected from the sun again!
Feet are an often a neglected area of the body when thinking of sun exposure. The consequences of forgetting to cover your feet can be not only painful, but also dangerous! Sunburn can be especially painful on the tops of ankles, feet and toes because skin is very sensitive there. You experience similar symptoms as with any burn; pain, redness, swelling, and eventually peeling or blisters. Sun burns are caused by ultraviolet (UV) radiations resulting in skin inflammation. The symptoms can start within 30 minutes of exposure, so always be sure to put on powerful sunscreen! UVA and UVB refer to different wavelengths in the light spectrum. UVB is more damaging to the skin and is more often the cause of skin cancer. Both UVA and UVB are also responsible for premature aging of the skin, wrinkles (photoaging) and sunburn. While sunburns to the feet are painful they can have, more devastating effects on your feet.
Sunburns can cause or exacerbate long term detrimental effects, including several different types of soft tissue tumors of your feet, which can be categorized into benign or malignant. Benign tumors are ones that may need to be biopsied to confirm their status. If these need treatment they usually heal uneventfully and biopsies do not reveal any cancerous cells. These benign tumors can include: eccrine poroma, ganglionic cysts, glomus tumor, intractable plantar keratoma, mucoid cyst, pigmented villonodular syntovitis, plantar fibromatosis, and synovial cysts. Malignant tumors of the foot are ones that are cancerous, and can be very dangerous if not treated quickly and properly. The malignant tumors of the feet include: malignant melanoma, kaposi’s sarcoma, and squamous cell carcinoma.
One treatment that is frequently used for lower extremity burns is the application of aloe lotion to soothe the burn. This can be applied as frequently as you would like, and is recommended to be applied at least three times per day while the burn is still in an active or acute phase. If the skin is blistering, or you feel you may have suffered third degree burns, you should seek medical attention. You should also be aware of any signs of heat stroke or heat exhaustion, as these can be a very serious systemic illness that can affect the functioning of your body and in severe cases of sunburn may lead certain organs shutdown!
Remember, apply suntan lotion to your feet and legs whenever you expect them to be in the sun for any extended period of time.
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Feet are an often a neglected area of the body when thinking of sun exposure. The consequences of forgetting to cover your feet can be not only painful, but also dangerous! Sunburn can be especially painful on the tops of ankles, feet and toes because skin is very sensitive there. You experience similar symptoms as with any burn; pain, redness, swelling, and eventually peeling or blisters. Sun burns are caused by ultraviolet (UV) radiations resulting in skin inflammation. The symptoms can start within 30 minutes of exposure, so always be sure to put on powerful sunscreen! UVA and UVB refer to different wavelengths in the light spectrum. UVB is more damaging to the skin and is more often the cause of skin cancer. Both UVA and UVB are also responsible for premature aging of the skin, wrinkles (photoaging) and sunburn. While sunburns to the feet are painful they can have, more devastating effects on your feet.
Sunburns can cause or exacerbate long term detrimental effects, including several different types of soft tissue tumors of your feet, which can be categorized into benign or malignant. Benign tumors are ones that may need to be biopsied to confirm their status. If these need treatment they usually heal uneventfully and biopsies do not reveal any cancerous cells. These benign tumors can include: eccrine poroma, ganglionic cysts, glomus tumor, intractable plantar keratoma, mucoid cyst, pigmented villonodular syntovitis, plantar fibromatosis, and synovial cysts. Malignant tumors of the foot are ones that are cancerous, and can be very dangerous if not treated quickly and properly. The malignant tumors of the feet include: malignant melanoma, kaposi’s sarcoma, and squamous cell carcinoma.
One treatment that is frequently used for lower extremity burns is the application of aloe lotion to soothe the burn. This can be applied as frequently as you would like, and is recommended to be applied at least three times per day while the burn is still in an active or acute phase. If the skin is blistering, or you feel you may have suffered third degree burns, you should seek medical attention. You should also be aware of any signs of heat stroke or heat exhaustion, as these can be a very serious systemic illness that can affect the functioning of your body and in severe cases of sunburn may lead certain organs shutdown!
Remember, apply suntan lotion to your feet and legs whenever you expect them to be in the sun for any extended period of time.
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Are your feet flat?
Do you notice your feet are as flat as a pancake when you walk? Does it seem like the only arch you see is at your local McDonalds? The more important question is, are your flat feet painful? Many people notice that they have flat feet, but never have any pain. As our flat-footed friends age, their feet oftentimes become painful. What is the root cause of all these flat feet?
Flat feet areoften be called by another term, known as pronation. Pronation is described as when the arch collapses during weight bearing, and the inside of the ankle seems to roll towards the ground. Pronation can be from a flexible flat foot, when the arch collapses as the foot hits the ground, or a rigid or structural flat foot, which stays flat no matter what stress the foot encounters.
There are many causes of flat feet. Some include obesity, pregnancy and repeated pounding ones feet against hard surfaces. If a close relative has flat feet the odds are good that you may develop this condition! There also is a higher association of developing flat feet if you have rheumatoid arthritis. Some other causes besides a congenital abnormality (something you’re born with) are a bone fractures or dislocations, torn or stretched tendon s, or neurologic weakness.
Flat feet can present differently in children and adults. In kids, flat foot usually presents as flexible or hypermobile flat foot. This condition is rarely painful. The prudent podiatrist may recommend custom molded orthtics to support the arches as their feet grow. If the Achilles tendon (along the back of the foot/lower leg) is tight, then this foot type can become problematic. Children very rarely a have a rigid flat foot, which is usually from a coalition (bones that do not move and are fused together). Adult acquired flat foot is usually more of a progressive deformity. The tendon on the inside of your ankle, the posterior tibial tendon, that goes into the foot weakens and sometimes even tears resulting in severe pain and total collapse of the arch.
What type of symptoms will you experience? Your feet can become painful when standing for long periods, or they may tire easily, with pain in the arch or heel. Oftentimes there is a chance of swelling in these areas. You may experience difficulty with moving your feet or heels. Sometimes difficulty or pain develops when you try to stand on your toes.
What type of treatments can be done? There are several methods of conservative treatment that can be implemented. To begin with your doctor will probably start with shoe modifications and custom molded orthotics, designed specifically to your feet, and non-steroidal inflammatory medications such as ibuprofen. Corticosteroids can also be injected into painful joints, along with rest, ice decreasedactivity, short leg casts, and custom designed ankle support braces. Depending on the severity and type of flatfoot you have, your doctor may put you on a stretching regimen for to lengthen your tight Achilles Tendon/Gastrocnemius (calf muscles). If the above treatments are ineffective,a course of physical may be indicated. When conservative measures have failed surgical intervention may be necessary. Some of the surgical procedures that can be performed include an arthrodesis (fusion of the major moving joints of the feet to correct the position of the foot/arch), osteotomy (cutting, shifting and /or reshaping a bone for better alignment), and/or tendon transfer (where a tendon in the foot/ankle is transferred to another area of the foot. The podiatric surgeon may also want to lengthen your Achilles tendon/calf muscles sometimes using several very small incisions.
If your feet are flat as a board, and causing you pain, make sure to consult your podiatrist. He or she will be able to properly diagnose this condition, and other foot/ankle ailments may be causing your pain. Pain free feet are happy feet so make sure you keep your feet happy throughout the summer months!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Flat feet areoften be called by another term, known as pronation. Pronation is described as when the arch collapses during weight bearing, and the inside of the ankle seems to roll towards the ground. Pronation can be from a flexible flat foot, when the arch collapses as the foot hits the ground, or a rigid or structural flat foot, which stays flat no matter what stress the foot encounters.
There are many causes of flat feet. Some include obesity, pregnancy and repeated pounding ones feet against hard surfaces. If a close relative has flat feet the odds are good that you may develop this condition! There also is a higher association of developing flat feet if you have rheumatoid arthritis. Some other causes besides a congenital abnormality (something you’re born with) are a bone fractures or dislocations, torn or stretched tendon s, or neurologic weakness.
Flat feet can present differently in children and adults. In kids, flat foot usually presents as flexible or hypermobile flat foot. This condition is rarely painful. The prudent podiatrist may recommend custom molded orthtics to support the arches as their feet grow. If the Achilles tendon (along the back of the foot/lower leg) is tight, then this foot type can become problematic. Children very rarely a have a rigid flat foot, which is usually from a coalition (bones that do not move and are fused together). Adult acquired flat foot is usually more of a progressive deformity. The tendon on the inside of your ankle, the posterior tibial tendon, that goes into the foot weakens and sometimes even tears resulting in severe pain and total collapse of the arch.
What type of symptoms will you experience? Your feet can become painful when standing for long periods, or they may tire easily, with pain in the arch or heel. Oftentimes there is a chance of swelling in these areas. You may experience difficulty with moving your feet or heels. Sometimes difficulty or pain develops when you try to stand on your toes.
What type of treatments can be done? There are several methods of conservative treatment that can be implemented. To begin with your doctor will probably start with shoe modifications and custom molded orthotics, designed specifically to your feet, and non-steroidal inflammatory medications such as ibuprofen. Corticosteroids can also be injected into painful joints, along with rest, ice decreasedactivity, short leg casts, and custom designed ankle support braces. Depending on the severity and type of flatfoot you have, your doctor may put you on a stretching regimen for to lengthen your tight Achilles Tendon/Gastrocnemius (calf muscles). If the above treatments are ineffective,a course of physical may be indicated. When conservative measures have failed surgical intervention may be necessary. Some of the surgical procedures that can be performed include an arthrodesis (fusion of the major moving joints of the feet to correct the position of the foot/arch), osteotomy (cutting, shifting and /or reshaping a bone for better alignment), and/or tendon transfer (where a tendon in the foot/ankle is transferred to another area of the foot. The podiatric surgeon may also want to lengthen your Achilles tendon/calf muscles sometimes using several very small incisions.
If your feet are flat as a board, and causing you pain, make sure to consult your podiatrist. He or she will be able to properly diagnose this condition, and other foot/ankle ailments may be causing your pain. Pain free feet are happy feet so make sure you keep your feet happy throughout the summer months!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Tuesday, May 25, 2010
Dare to bare your Bunion!
With warm weather just around the corner, those feet you were hiding will soon be in sandals! Worried that all your friends will see your big bunion bumps? Do you have no idea what I am talking about so far?? Well enjoy the ride as we discuss all you need to know about the wide world of bunions!!
A bunion is when your big toe begins to move towards the rest of your smaller toes, and most likely is accompanied by a bump on the inside edge of the big toe. The problems that most people experience with bunions are red and calloused skin along the bump of the bunion, along with swelling of the big toe joint, with decreased range of motion and stiffness in the joint. The worst part of all though is some can experience PAIN during walking with any type of tight fitting shoes
Bunions can be caused by several factors. Bunions most commonly affect women, as types of shoe gear are often aggravating factors. Tight fitting shoes, especially high heels, can have a profound impact on developing buions. As the amount of hours per day, as well as number of years you spend in such ill-fitting shoes, the more likely a bunion will develop, or increase in severity. Bunions can also be genetic, or accompanied by another ailment, such as rheumatoid arthritis, or based on the type of foot you have. Pronation (a foot that rolls flat as you walk) or a splay type of foot, can also be predisposed to developing bunions.
Buions can be diagnosed through both a clinical evaluation by your podiatric physician, as well as taking an x-ray. X-rays are a very helpful tool, as your doctor will use the measurements he takes of a few different angles of the foot to determine the best option for treatment. With a very mild bunion that causes little pain or discomfort, it is advised to try and wear shoes with a wider toe box to provide more room for your feet, with the occasional Ibuprofen or aspirin for pain relief. There are also different types of spacing devices and braces that can be used to try and conservatively treat bunions, in addition to physical therapy to increase joint range of motion, as well as special custom molded inserts that allow for more room. If the bunion has been present for a long time, or is very painful or rigidly fixed, then surgery may be a good option. There are hundreds of different procedures, and variations of each procedure that can be done, all with excellent outcomes.
A similar type of foot problem is known as a tailors bunion. This has all the same type of causes, symptoms, and treatment, except the location is different. Tailors bunions occur at the other side of the foot, involving the joint of the 5th or pinky toe! Many people even opt to get both procedures done at the same time! With sandal weather quickly approaching, make sure to see your local podiatrist to address your bunions as soon as you can! You are entirely too busy and important to be living with pain!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
A bunion is when your big toe begins to move towards the rest of your smaller toes, and most likely is accompanied by a bump on the inside edge of the big toe. The problems that most people experience with bunions are red and calloused skin along the bump of the bunion, along with swelling of the big toe joint, with decreased range of motion and stiffness in the joint. The worst part of all though is some can experience PAIN during walking with any type of tight fitting shoes
Bunions can be caused by several factors. Bunions most commonly affect women, as types of shoe gear are often aggravating factors. Tight fitting shoes, especially high heels, can have a profound impact on developing buions. As the amount of hours per day, as well as number of years you spend in such ill-fitting shoes, the more likely a bunion will develop, or increase in severity. Bunions can also be genetic, or accompanied by another ailment, such as rheumatoid arthritis, or based on the type of foot you have. Pronation (a foot that rolls flat as you walk) or a splay type of foot, can also be predisposed to developing bunions.
Buions can be diagnosed through both a clinical evaluation by your podiatric physician, as well as taking an x-ray. X-rays are a very helpful tool, as your doctor will use the measurements he takes of a few different angles of the foot to determine the best option for treatment. With a very mild bunion that causes little pain or discomfort, it is advised to try and wear shoes with a wider toe box to provide more room for your feet, with the occasional Ibuprofen or aspirin for pain relief. There are also different types of spacing devices and braces that can be used to try and conservatively treat bunions, in addition to physical therapy to increase joint range of motion, as well as special custom molded inserts that allow for more room. If the bunion has been present for a long time, or is very painful or rigidly fixed, then surgery may be a good option. There are hundreds of different procedures, and variations of each procedure that can be done, all with excellent outcomes.
A similar type of foot problem is known as a tailors bunion. This has all the same type of causes, symptoms, and treatment, except the location is different. Tailors bunions occur at the other side of the foot, involving the joint of the 5th or pinky toe! Many people even opt to get both procedures done at the same time! With sandal weather quickly approaching, make sure to see your local podiatrist to address your bunions as soon as you can! You are entirely too busy and important to be living with pain!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Ever feel any burning, tingling, or a numbness in your feet?
Do the symptoms above describe how your feet feel from time to time? Are you a diabetic? Odds are, you could have what is known as diabetic peripheral neuropathy. What exactly is that, and how did you get it?
Peripheral neuropathy is a condition that most commonly produces symptoms such as burning, numbness, tingling, pain, and loss of muscle function and reflexes in extremities. The areas most commonly affected are the feet and hands. The symptoms can eventually spread "proximally," towards the legs and arms. Causes of peripheral neuropathy besides diabetes include: renal or liver failure, hypothyroidism, excess vitamin B6, deficiency of vitamin B12 or vitamin A, Guillian-Barre Syndrome, systemic lupus erythematosis, leprosy, and shingles, to name a few.
More specifically, diabetic peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is unfortunately something that as many as sixty to seventy percent of the diabetic population end up experiencing. People with a history of diabetes for over 25 years, or those with uncontrolled blood sugar levels tend to experience the most severe neuropathy symptoms. Once the neuropathy symptoms develop it is very imperative to see your podiatrist on a regular basis for routine and episodic diabetic foot care and risk management.
Your podiatrist will check your feet at a minimum yearly, to assess the skin, muscles, bones, circulation, and sensation of your feet. They will assess the protective sensation in your feet by using an instrument called a Semms-Weinstein 5.07 monafilament wire to determine the extent of your condition. They may also use a tuning fork to assess vibratory sensation.
There are several treatment options for diabetic peripheral neuropathy. First and foremost is to keep blood glucose levels in the normal range, as set by your endocrinologist and podiatrist. Other options include medications both by mouth and topically that is rubbed into the skin. Physical therapy can also help decrease the pain.
It is very important to assess your feet for any type of peripheral neuropathy, especially if you're a diabetic! , The chances of foot injury or infection increases tremendously once sensation to your feet is lost. Oftentimes diabetics cannot even feel something as small as a rock rubbing in their shoes. This can lead to an ulcer (an open wound that does not heal), and possibly progress even to an amputation. The literature indicates that of the 86,000 amputations per year, more than half are in diabetics. This number can drastically be reduced if proper foot care is instituted. Diabetics need to check their feet daily for any rashes, cuts, blisters, scabs, growths, swellings, redness/discolored areas, infections, calluses and for any other suspicious looking areas. Applying the proper lotion to the feet, wearing properly fitting shoes (Medicare does cover diabetic shoes and inserts for qualifying diabetics which look like regular shoes) are also crucial to good foot health. Take good care of your feet, and they will take good care of you for many years to come!
Do the symptoms above describe how your feet feel from time to time? Are you a diabetic? Odds are, you could have what is known as diabetic peripheral neuropathy. What exactly is that, and how did you get it?
Peripheral neuropathy is a condition that most commonly produces symptoms such as burning, numbness, tingling, pain, and loss of muscle function and reflexes in extremities. The areas most commonly affected are the feet and hands. The symptoms can eventually spread "proximally," towards the legs and arms. Causes of peripheral neuropathy besides diabetes include: renal or liver failure, hypothyroidism, excess vitamin B6, deficiency of vitamin B12 or vitamin A, Guillian-Barre Syndrome, systemic lupus erythematosis, leprosy, and shingles, to name a few.
More specifically, diabetic peripheral neuropathy, also called distal symmetric neuropathy or sensorimotor neuropathy, is unfortunately something that as many as sixty to seventy percent of the diabetic population end up experiencing. People with a history of diabetes for over 25 years, or those with uncontrolled blood sugar levels tend to experience the most severe neuropathy symptoms. Once the neuropathy symptoms develop it is very imperative to see your podiatrist on a regular basis for routine and episodic diabetic foot care and risk management.
Your podiatrist will check your feet at a minimum yearly, to assess the skin, muscles, bones, circulation, and sensation of your feet. They will assess the protective sensation in your feet by using an instrument called a Semms-Weinstein 5.07 monafilament wire to determine the extent of your condition. They may also use a tuning fork to assess vibratory sensation.
There are several treatment options for diabetic peripheral neuropathy. First and foremost is to keep blood glucose levels in the normal range, as set by your endocrinologist and podiatrist. Other options include medications both by mouth and topically that is rubbed into the skin. Physical therapy can also help decrease the pain.
It is very important to assess your feet for any type of peripheral neuropathy, especially if you're a diabetic! , The chances of foot injury or infection increases tremendously once sensation to your feet is lost. Oftentimes diabetics cannot even feel something as small as a rock rubbing in their shoes. This can lead to an ulcer (an open wound that does not heal), and possibly progress even to an amputation. The literature indicates that of the 86,000 amputations per year, more than half are in diabetics. This number can drastically be reduced if proper foot care is instituted. Diabetics need to check their feet daily for any rashes, cuts, blisters, scabs, growths, swellings, redness/discolored areas, infections, calluses and for any other suspicious looking areas. Applying the proper lotion to the feet, wearing properly fitting shoes (Medicare does cover diabetic shoes and inserts for qualifying diabetics which look like regular shoes) are also crucial to good foot health. Take good care of your feet, and they will take good care of you for many years to come!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Saturday, March 13, 2010
Feeling the Blues from Heel Pain?
March Madness is coming underway, basketball fever is beginning to set in, and excitement is in the air! Before you take the court though, make sure that heel pain isn’t going to slow you down! One of the most common conditions that I treat as a podiatrist is something called Plantar Fasciitis. It is by far the number one cause of heel pain.
The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.
This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.
Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflammatory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.
This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.
Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflammatory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Wednesday, March 3, 2010
Diabetes and Proper Foot Care!
Diabetes is one of the most prevalent diseases in the world, affecting at least 220 million worldwide. It is broken down into two different types; type one requiring daily injections of insulin, and type two from ineffective use of insulin by the body. Over 90% of diabetics are in the type two category and obesity and inactivity are major contributing causes!
Insulin is needed by the body to break down sugar and store it as energy in the body. Whether your body doesn’t produce enough insulin, or your cells don’t respond to the insulin your body produces, it causes the sugar in your blood to rise. This is why diabetics need to check their blood sugar frequently!
Diabetes can have a devastating effect on certain areas of the body, including blood vessels, eyes, kidneys, nerves, and feet! This is what makes proper foot care so important for our diabetic population. Insurance companies are realizing the dangers of diabetes and are covering more frequent doctor’s visits to ensure that problems are identified as soon as possible. In between these visits I recommend you do the following.
First and foremost, keep your blood sugar as close as you can to normal values and exercise and diet as long as you are cleared by your primary care physician! This will keep your blood vessels and nerves in the best working order. Your PCP can help you determine your best blood sugar level.
For foot care, make sure to wash your feet daily with warm water and soap. Dry them thoroughly, especially between your toes. It is important to apply a mild moisturizing lotion or cream on your dry skin, especially your heels, daily. Never go barefoot, and look into having special diabetic shoes custom made for your feet. Medicare provides this as a benefit for diabetics. Make sure to check your feet daily for any cracks, open lesions, redness or swelling. Also, if you have pain that doesn’t go away or numbness you should be concerned. If any of these develop, make an appointment with your podiatrist! Make sure that you do not treat any calluses, corns, or perform nail care by yourself without consulting with your podiatrist first. It is probably better to have these tasks performed by your podiatrist! Make sure to check inside your shoes, as many diabetics have neuropathy (little or no feeling in their feet), and even a small rock inside a shoe can create an open lesion that can progress to an ulcer, or worst case scenario an amputation! Regular visits to your podiatrist, as well as doing your part in between visits, are the best way to maintain good foot health.
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Thursday, February 25, 2010
Toe Nails Turning Colors?
While you are sitting at home enjoying the Winter Olympics, have you noticed that your toenails are beginning to change colors? Instead of the healthy, light color the nail bed used to be, they have now become more of a yellowish or brownish color? Have you noticed that your nails are somewhat brittle with underlying debris? If this sounds like some or all of your toes you probably have something called onychomycosis। One of the contributing factors causing these ugly nails are tight shoes which crowd your toes, keeping them warm, moist and tight. Exercise can also cause repetitive micro-trauma, allowing for fungus to invade the nails. Using community showers without shower sandals or spending a lot of time around locker rooms and swimming pools can expose your feet to fungus. In addition, systemic conditions such as Diabetes can also make it easier for fungal infections to develop.
Fungal nails can be diagnosed by your local podiatrist, with the use of a few simple tests such as a KOH test or fungal culture। These tests involve taking a sample from under the nail, after the nail is trimmed back। Other conditions can cause the nail to look as if it has a fungal infection, so the condition must be diagnosed before it can be treated। There are several options available for treatment। There are topical agents, which include antifungal creams, lotions, gels and polish that are applied directly to the affected area। Oral antifungals are usually more effective at killing the fungus, but may cause side effects। The worse of which can be liver damage। Blood work is usually drawn before you start to make sure your liver enzymes are normal। Topical agents are used on superficial fungal conditions. Whereas, the orals are used for more severe, thickened nails.
Exciting new technology is now being researched for the treatment of mycotic (fungal) nails, including the use of lasers and UV light। Much of this data and research is currently undergoing FDA trials, so keep checking with your podiatrist on new available technology! A new fungal polish has been approved by the FDA but will not be available until the fall of 2010.
Ways to prevent from getting fungal nails can include avoiding tight fittings shoes, staying away from certain athletic surfaces, always wearing clean socks, washing and drying feet daily, and switching between a few different pairs of shoes। Fungus loves warm, dark and damp environments, so try to provide dryness, light for your feet। Take care of your toes, and they will take care of you! If you are worried you may have fungal nails, call your local podiatrist before summer and sandal season begin!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Fungal nails can be diagnosed by your local podiatrist, with the use of a few simple tests such as a KOH test or fungal culture। These tests involve taking a sample from under the nail, after the nail is trimmed back। Other conditions can cause the nail to look as if it has a fungal infection, so the condition must be diagnosed before it can be treated। There are several options available for treatment। There are topical agents, which include antifungal creams, lotions, gels and polish that are applied directly to the affected area। Oral antifungals are usually more effective at killing the fungus, but may cause side effects। The worse of which can be liver damage। Blood work is usually drawn before you start to make sure your liver enzymes are normal। Topical agents are used on superficial fungal conditions. Whereas, the orals are used for more severe, thickened nails.
Exciting new technology is now being researched for the treatment of mycotic (fungal) nails, including the use of lasers and UV light। Much of this data and research is currently undergoing FDA trials, so keep checking with your podiatrist on new available technology! A new fungal polish has been approved by the FDA but will not be available until the fall of 2010.
Ways to prevent from getting fungal nails can include avoiding tight fittings shoes, staying away from certain athletic surfaces, always wearing clean socks, washing and drying feet daily, and switching between a few different pairs of shoes। Fungus loves warm, dark and damp environments, so try to provide dryness, light for your feet। Take care of your toes, and they will take care of you! If you are worried you may have fungal nails, call your local podiatrist before summer and sandal season begin!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Sunday, February 14, 2010
Ankle Sprain Causing You Pain?
Are ankle sprains are one of the most common lower extremity ankle injuries for both athletes and the rest of us. The literature states that inversion (when the foot turns inward) ankle sprains are most common, happening about 85% of the time. This is because increased range of motion in the “inverted” (turned in) and “plantarflexed” (downward pointed) position can also tear ligaments in the ankle, with a severe sprain. One of the most common sports ankle sprains are encountered in is basketball. This is usually caused by a player jumping and landing awkwardly on another player’s foot, leg, or twisting their ankle. Other things that can cause ankle sprains include stepping on an uneven surface or in a hole, especially when wearing shoes with a platform or heel.
Ankle sprains can be a debilitating injury, and sometimes people never truly recover from one if not treated properly. They are usually graded in three different stages, ranging from a mild strain of the ligaments, to a full rupture. Symptoms of ankle sprains include severe pain, feeling or hearing a pop/snap, swelling, bruising, and an inability to walk. Dwight Freeney suffered a severe ankle sprain, but was able to play in the Super Bowl because his medical staff performed round-the-clock treatment and rehabilitation. Kobe Bryant also suffered a severe ankle sprain, causing him to unfortunately miss the NBA All-Star game. Athletes usually have fewer problems rehabbing an ankle sprain because they have an extensive medical support team. Those not fortunate enough to be in the same position must take their future ankle stability into their own hands. As the saying goes, a bad ankle sprain can sometimes be worse than a clean break! With this in mind, it is important that you receive immediate medical attention so a proper treatment plan can be started. This could include ice, elevation, compression, bracing, physical therapy, and rest. Future complications of an untreated ankle sprain can include ankle instability, recurrence of ankle sprains, decreased range of motion, swelling that remains forever, and arthritis. If you feel you may have suffered an ankle sprain, do yourself a favor and see your local podiatrist!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Ankle sprains can be a debilitating injury, and sometimes people never truly recover from one if not treated properly. They are usually graded in three different stages, ranging from a mild strain of the ligaments, to a full rupture. Symptoms of ankle sprains include severe pain, feeling or hearing a pop/snap, swelling, bruising, and an inability to walk. Dwight Freeney suffered a severe ankle sprain, but was able to play in the Super Bowl because his medical staff performed round-the-clock treatment and rehabilitation. Kobe Bryant also suffered a severe ankle sprain, causing him to unfortunately miss the NBA All-Star game. Athletes usually have fewer problems rehabbing an ankle sprain because they have an extensive medical support team. Those not fortunate enough to be in the same position must take their future ankle stability into their own hands. As the saying goes, a bad ankle sprain can sometimes be worse than a clean break! With this in mind, it is important that you receive immediate medical attention so a proper treatment plan can be started. This could include ice, elevation, compression, bracing, physical therapy, and rest. Future complications of an untreated ankle sprain can include ankle instability, recurrence of ankle sprains, decreased range of motion, swelling that remains forever, and arthritis. If you feel you may have suffered an ankle sprain, do yourself a favor and see your local podiatrist!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Wednesday, February 3, 2010
Kids in high heels causing early bunions?
Fashions newest controversial topic surrounds young children, and believe it or not, the wearing of high heels. These so coined “kiddie” or “kitten” heels have been spotted all across America, and these girls aren’t playing dress-up. It is a growing trend for celebrities and the general public alike to put their children in high heels, some as young as three months old! Having your children follow in the current trend can be very detrimental to the permanent structure of their feet. I strongly encourage all parents to not let their children participate in such behavior! Although formal studies with children have not yet been conducted, this is because there has never been such a trend until recently.
Women across the world know that high heel shoes can be very uncomfortable, especially when wearing them for extended periods of time. They can lead to many common foot conditions, including: calluses, corns, neuromas, bunions, and most importantly foot pain! Although it has been said that high heels are not the only cause of bunions, they are definitely a contributing factor. Putting a child in high heels can potentially do a great deal of damage, mainly for the reason that their foot is still growing. Since their bones are still growing, the point of the shoe can cause bunions, and the heel in the back increases pressure to the toes. This is not the right recipe for future adult happy feet! Realistically speaking, fashionable shoes are necessary at times. They should definitely be used in moderation when possible. Parents, don’t let your children grow up too quickly!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Sunday, January 24, 2010
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
Welcome!
Greetings!
Welcome to the first blog for Dr. Isidore Steiner, DPM. Dr. Steiner is a podiatrist in Michigan, who has been serving Oakland and Livingston Counties since 1980 at five different locations. The purpose of this blog site is to inform the public of common foot and ankle conditions and ailments. Please check back frequently, email questions, and leave comments! Enjoy!
Welcome to the first blog for Dr. Isidore Steiner, DPM. Dr. Steiner is a podiatrist in Michigan, who has been serving Oakland and Livingston Counties since 1980 at five different locations. The purpose of this blog site is to inform the public of common foot and ankle conditions and ailments. Please check back frequently, email questions, and leave comments! Enjoy!
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