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Monday, 20 July 2015 00:00

Systemic Diseases of the Foot

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There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

Monday, 13 July 2015 00:00

Ingrown Toenail Care

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An ingrown toenail is caused when a toenail grows sideways into the bed of the nail, causing pain and swelling. Sometimes this can become infected causing drainage and may become serious.

There are many risk factors that can predispose a person to this common condition. Cutting your nails too short, participating in sports, diabetes, being overweight, or having a fungal infection of the toe can all cause ingrown toe nails. Many people are genetically prone to ingrown nails and it can often be related to genetics. Often the problem can come from wearing ill-fitting shoes, or even from shoes that keep the feet slightly damp.

There are some things that you can do to prevent and treat these painful problems. Letting your toe nails grow a little longer will help prevent this condition. If you do develop an ingrown nail, soaking the toe in hot water will help prevent infection and lessen pain. You may want to add antibiotic soap or Epsom salts to the water. This will help to prevent infection.

Some experts also recommend placing small pieces of cotton under the affected part. This will help the toenail to grow up instead into in your nail bed. Resting with your feet up can reduce swelling and redness.

If your pain is so severe that it keeps you from everyday activities, it is time to see your podiatrist. Also, if you see a red streak running up your leg, or if your infection is spreading, see a podiatrist immediately. There are many quick treatments that can lessen your pain and have you walking with comfort.

One method of treating an ingrown toenail involves using a Band-Aid. Wrapping the affected toe with a Band-Aid will prevent infection and also keep the nail from growing out at painful angles.

If your podiatrist feels it is necessary, he or she may make a small incision and remove part of your toe nail. Medication will be placed in the nail bed to prevent re-growth of the problem nail parts. This will be done under local anesthesia and should lessen your discomfort in no time. You will be advised to stay off your foot for a day or so, but can then carry on normal activities.

Take care of your feet; you have many steps to take in your life. Walking in comfort should be a priority for a lifetime of healthy living.

Monday, 06 July 2015 00:00

Biomechanics in Podiatry

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Biomechanics and its related study deal with forces that act against the body and effect things like our movement. In podiatry, biomechanics are studied to determine the movement of the ankle, toes, and the foot itself, as well as the forces that impact them. Podiatrists who train in this specialty are able to effectively diagnose and treat conditions that affect people’s everyday movement.

Regardless of your lifestyle, age, or any other factors, many people experience foot problems throughout their lives. Twists and turns, improper balance, and added weight are just a few of the things that can add stress to the feet and limit the mobility everyone takes for granted. Pain in the feet and ankles can also trickle up towards the lower legs, knees, hip, and even back area, all effecting the way you move around on a daily basis.

The history of studying biomechanics dates back to ancient Egypt at around 3000 B.C., where evidence of professional foot care has been recorded. Throughout the centuries, advances in technology, science, and an understanding of the human body led to more accurate diagnosis of conditions such as corns for example. In 1974, biomechanics garnered a large audience when Merton Root claimed that changing or controlling the forces between the ankle and the foot, corrections of certain conditions could be implemented to gain strength and coordination in the area. Due to his research, we still use his basic principle of thermoplastic foot orthotics to this day.

As technology has improved, so have the therapeutic processes that allow us to correct deficiencies in our natural biomechanics. Computers can now provide accurate readings of the forces, movements, and patterns of the foot and lower leg. Critical treatment options can be provided to patients now who suffer from problems that cause their biomechanics to not function naturally. The best results are now possible thanks to 3D modeling and computing technologies that can not only take readings, but also map out what treatment will do to the affected areas.

These advanced corrective methods were able to come to light thanks to an increase in both the technologies surrounding biomechanics and also the knowledge of how they work naturally. For example, shoe orthotics is able to treat walking inabilities by realigning the posture deviations in patients caused by hip or back problems. Understanding foot biomechanics can help improve movement and eliminate pain, stopping further stress to the foot, so speaking with your podiatrist if you have any of these problems is highly recommended.

Are your shoes the right size? Many people are walking around with ill-fitting shoes. Picking the right shoe size is not rocket science, but there are a few things to remember when selecting your next pair.

Most shoe stores and department stores have rulers for measuring your feet, and these can give you an exact size. Be sure to measure with your shoe on. Measuring your foot will give you a different size than your shoe. If you do measure your foot size, you will need to add 1-2 inches to get the proper sizing.

Wiggle room is the most important factor when selecting shoes. Make sure that your toes are not cramped and that you can wiggle them. A rule of thumb is that there should be one inch between your toes and the tip of your shoe. If your shoes are not properly sized, you can experience foot pain, knee pain, blisters and swelling.

Don’t assume that you will always wear the same size in a shoe. Often manufacturers size shoes differently. The size you wear with one company may not be the same as the size you wear with another. Make sure that the company you buy from has a return policy. No one needs a closet full of shoes which they cannot wear.

It is advisable not to buy your shoes in the morning, but rather late in the day. Your feet actually swell as the day goes on and you need plenty of room to walk comfortably. Buying shoes in the morning that are snug is sure to cause problems once the day is done. Also, make sure that you are buying the right sizes for both feet. It is not uncommon for one foot to be larger than the other, and some people have to buy two separate sizes to accommodate different sized feet.

The biggest concern in buying shoes is comfort. Oftentimes people will buy shoes that are not the most comfortable in the store. People think that the shoes simply need to be “broken in”. If a shoe does not fit in the store, it will not fit at home either. Comfort should be the ultimate goal when purchasing a pair of shoes; your feet will thank you.

Let’s face it; we all walk a lot, some of us more than others. Selecting the best shoes for your particular lifestyle is essential. By properly sizing your shoes and buying the proper comfort level, your feet will be dancing all day long. 

Monday, 22 June 2015 00:00

Heel Pain

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Heel pain is a stressful condition that effects day to day activities. Running and walking causes stress on the heel because the heel is the part of the foot that hits the ground first. This means that the heel is taking on your entire weight. Diagnosis and treatments for heel pain can be easily found through your podiatrist.

One of the main causes of heel pain is a condition known as plantar fasciitis. The plantar fascia is a band of tissue that extends along the bottom of the foot, from the toe to the bottom of the heel. A rip or tear in this ligament can cause inflammation of these tissues, resulting in heel pain. People who do not wear proper fitting shoes are often at risk of developing problems such as plantar fasciitis. Unnecessary stress from ill fitting shoes, weight change, excessive running, and wearing non-supportive shoes on hard surfaces are all causes of plantar fasciitis.

Achilles tendonitis is another cause of heel pain. Similar to plantar fasciitis, inflammation of the Achilles tendon will cause heel pain due to stress fractures and muscle tearing. A lack of flexibility of the ankle and heel is an indicator of Achilles tendonitis. If left untreated, this condition can lead to plantar fasciitis and cause even more pain on your heel.

A third cause of heel pain is a heel spur. A heel spur occurs when the tissues of the plantar fascia undergo a great deal of stress, leading to a separation of the ligament from the heel bone entirely. This results in a pointed fragment of bone on the ball of the foot, known as a heel spur.

Treatments for heel pain are easy and effective as long as problems are addressed quickly. The most common solution is simply taking stress off the feet, particularly off of the heel. This will ease the pain and allow the tendons and ligaments to relax. In the case of both plantar fasciitis and Achilles tendonitis, icing will reduce swelling of any part of the foot and anti-inflammatory medication is highly recommended. Properly fitting your shoes and wearing heel pads or comfort insoles will also reduce the risk of developing heel pain. Stretching before and after exercises such as running will help the foot muscles prepare for stress and lower the chances of inflammatory pain. In extreme cases, relieving heel pain might require surgery. Always make sure to discuss these symptoms and treatment options with your podiatrist to keep yourself active and pain free.

Monday, 15 June 2015 00:00

Morton's Neuroma

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Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones. Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.
If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

Running may seem like a simple thing to do, but in reality it is a complex movement that puts stress on the ligaments, bones, and joints of the body. Because of this, selecting the correct running shoe is important for increasing performance and avoiding risk of injury. Running shoes should be selected based on your foot type. Considerations such as trail versus road shoes are important, but your foot type dictates the degree of cushioning, stability and motion control you require. The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes. Professionals there can measure your arch type, stride and gait and let you know your shoe needs for future reference.

The design of running shoes is created around the idea of pronation. Pronation is the rolling of your ankle from outside to inside when your foot strikes the ground, which is natural. If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more. Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy. Those considered neutral runners pronate correctly and do not need running shoes that help correct their form. Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types. However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation and require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling. Even while standing, those who severely overpronate display ankles that are angled inward. It is not uncommon for them to have flat feet or bowed legs as well. The tendency to overpronate may cause many injuries. Areas that tend to become injured are the knees, ankles, and Achilles tendon. If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control. Motion-control shoes are straight and firm; shoes of this type do not curve at the tip. The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes.

A less common problem is underpronation. Underpronation, also called supination, is when the feet are unable to roll inward during landing. Those who underpronate have feet that lack flexibility and high arches. This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees. This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact. Those who underpronate need shoes with more cushioning and flexibility. If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

Monday, 01 June 2015 00:00

Plantar Fasciitis Treatment Relieves Heel Pain

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A new treatment option which combines ultrasound waves and steroid injections was found to be effective in patients suffering from plantar fasciitis, according to a groundbreaking study from the University of Genoa in Italy.

The plantar fascia is a connective tissue in the heel that stretches the bottom length of your foot. Plantar fasciitis is the inflammation of this connective band, causing heel pain and overall discomfort while walking or standing. Although the condition is completely treatable, traditional methods can take up to a year to start being effective.

These conventional treatments include arch support, night splints, certain exercises, and overall rest and staying off your feet. The previous effective method for curing plantar fasciitis was shockwave therapy, in which sound waves are directed to the area where the pain is being experienced, often the heel. Despite the success of shockwave therapy, it could be considered somewhat slow, requires several sessions before any results are noticed, and is comparably expensive. However, even shockwave therapy does not cure the pain caused by plantar fasciitis in every patient.

The study, conducted by Luca M. Sconfienza, M.D., examined the effects of a new technique that combined ultrasound-guided methods, similar to shockwave therapy, with a steroid injection directly the plantar fascia. Because of the added steroid injection, the method becomes a one-time outpatient procedure involving a small amount of local anesthesia, in which a needle punctures the affected area and causes a small amount of bleeding that aids in the heeling of the fascia. This technique is referred to as dry-needling.

Dr. Sconfienza determined that 42 of the 44 patients involved in the new procedure had their symptoms, including pain, disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”

Monday, 25 May 2015 00:00

Rheumatoid Arthritis in the Feet

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Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Monday, 18 May 2015 00:00

Athlete’s Foot

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Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athletes foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow, thrive, and spread, this is the most commonly affected area, but it is known to grow in other places. However, for obvious reasons, the term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as obviously the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. On top of this, the extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. While it is hard to completely avoid, you can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, as these are not desirable conditions for tinea to grow. If you do happen to get athlete’s foot, treating it with topical medicated creams, ointments or sprays will not only help eliminate it but also prevent it from coming back.

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