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Heal The Heel Pain

Tue, 09 Aug 2011 10:01:39 -0600

"It Hurts When I Step Down In The Morning!" is something we hear everyday in our Thousand Oaks, CA Podiatry office. Several times a day in fact. Heel pain is one of the most common reasons people see a podiatrist. Although it is common, it is not normal and you shouldn't suffer from or deal with the pain. Plantar fasciitis is the most frequent cause of heel pain. The plantar fascia is a band of tissue that starts on the heel bone and extends all the way through your arch to the ball of your foot. The origin of the fascia on the heel bone gets inflamed and is very painful. There is usually a mechanical cause for the pain such as new or increased activity, new shoes or weight gain. Also, some foot types are predisposed to developing plantar fasciitis and it may have little to do with activity or shoes. The mechanical cause eventually causes inflammation which then causes pain. Sometimes a bone spur forms due to the pull of the fascia but is not often the source of pain.

The pain is usually pinpoint on the heel, often more towards the inside of the heel. It is most painful when stepping out of bed in the morning or when standing up after being seated for awhile. It is very sharp and knife-like. It starts off being only slightly bothersome but can progress to causing pain all day everyday and even cause you to limp. If ignored, the pain can lasts for months to years.

The mechanical cause of pain should be addressed first and foremost. That can be done with orthotics which are shoe inserts that support the arch and thus take tension off the fascia (reducing pull on the heel bone). Supportive shoes are also very helpful. An optimal shoe does not fold in the middle of the shoe (only at the ball of the foot) and has laces. If your heel is hurting, do not wear flip-flops or other flexible shoes and do not walk around barefoot, even in the house.

Supportive shoes and orthotics will reduce tension on the fascia, but there is still inflammation which causes pain. Icing is a good way to reduce inflammation. Rolling your heel and arch over a frozen water bottle is a good way to massage and ice the foot at the same time. Oral or topical anti-inflammatories can also be helpful. Oral anti-inflammatories work best when taken consistently everyday for about two weeks. A steroid injection into the heel is the best "quick fix". It works by directly blocking inflammation at the source. However, there is too much of a good thing and most doctors agree that giving more than 3 steroid injections into the same area within a year can be harmful to the neighboring healthy tissue (thus, only 3 steroid injections into the heel allowed per year). Even though steroid injections can be very helpful, you still need to be diligent with good shoes, orthotics, stretching and icing.

The Achilles tendon has fibers that wrap around the back of the heel and form part of the fascia. For this reason, Achilles stretches can be very helpful in reducing tension on the fascia. Stretches need to be performed at least twice daily for several weeks. Massaging the heel and arch with a golf ball or tennis ball is also very helpful. A night splint is something that is worn while sleeping or at rest and holds your foot 90 degrees to your leg to place a constant stretch on the Achilles. This can greatly reduce the amount of pain when stepping out of bed in the morning.

Other treatment options include physical therapy, a walking cast, a fracture boot, or taping the foot. Avoid high impact activities such as walking, running, or hiking and try cycling or swimming instead. Carrying extra weight can frequently cause heel pain so it is important to eat healthy and perform low impact exercises. Surgery is the last resort and usually not warranted since most people get better with the conservative treatment.

Heel pain is not always caused by plantar fasciitis so it is important to see your podiatrist for proper diagnosis. Because there are so many treatment options, it is best to discuss with your podiatrist what is right for you. Please visit our website at www.advpodiatric.com for more information and how to get in contact with one of our doctors. Heal the heel pain.

Numbness, Burning or Tingling in the Feet Can Be The Sign Of Something More Serious

Thu, 19 May 2011 07:25:34 -0600

There are many reasons for numbness and tingling in the feet. Sometimes the cause originates in the feet and other times it a systemic cause meaning there is a disease process in the body that manifests in the feet. The number one cause of burning/numbness/tingling/pins and needles sensation in the foot in the US is diabetes. Other common causes are alcoholism, vitamin B12 deficiency, hypothyroidism, HIV, and multiple sclerosis. Occasionally patients have “idiopathic peripheral neuropathy” which means there is no clear cause for the burning, numbness or tingling in their feet. Systemic causes usually result in burning, tingling or numbness in BOTH feet and often in a symmetric distribution (like the toes, ball of the foot, or entire bottom surface). A systemic cause of nerve sensations frequently occurs while at rest, especially in the evening and can even wake you from sleep.

If the burning or tingling sensation is in just one foot or leg, you may have a compressed nerve in the lower back (specifically L4, L5, S1). When the problem is higher up then treating the foot is only for symptomatic relief and the problem is not truly being addressed. If you have a known back problem (compressed vertebrae, slipped disc, etc), it is important to inform your podiatrist during your appointment.

Sometimes tight shoes (especially laced shoes) can cause numbness in the foot, particularly during exercise when our feet swell. Occasionally patients have a bone spur on top of the foot in an unfortunate position where the nerve is pinched between the bone and shoes. This can be relieved by skipping eyelets in the shoe so the laces do not contact that area of the foot, applying a pad around (but not on) the spur, or surgically removing the spur.

If you are going to see a podiatrist for burning or numbness in the feet, it is important for you to take note of when you have the sensations (with activity or while at rest, with or without shoes), specifically where the sensations occur and what gives you relief. The more detailed you can be, the better the chance for accurate diagnosis and optimal treatmen

Foot or Ankle Injury? E.R.? OR Go Directly To The PODIATRIST

Mon, 02 May 2011 18:03:12 -0600

Sprained Ankle? Smashed Toe? Sports Injury? Gardening Accident? The list of urgent foot and ankle injuries can be extensive and expensive, but there are options! Instead of rushing over the the E.R. or urgent care, try calling a podiatry office. There are several advantages of going directly to the podiatrist for any and all foot and ankle problems. First and best of all: minimal wait time! We can always make room for urgent cases. Secondly, we take digital x-rays in our office that can be immediately processed and evaluated. This is good for the sake of the doctor because we need certain views (which are often not properly done in other settings) and good for the patient because he/she will not need a second round of x-rays. We apply splints and casts and dispense fracture shoes or boots on site. We can numb up a toe and reduce a fracture then splint it. Another advantage is that we are very savvy with numbing the foot and toes and make the procedure as comfortable as possible. Sadly, we often see patients who have had nail trauma or fractures and go to other facilities where numbing injections are not frequently given and thus they get stabbed much more than necessary which is very traumatic.

Money is always something to consider, especially during these hard economic times. A typical ER visit can cost well over $500. Usually the emergency room or urgent care center then recommends following up with a podiatrist anyway so there are additional costs involved. Why not save your money and go directly to the specialist where all your needs can be addressed at once AND in a timely fashion? This includes ankle fractures and Achilles ruptures. Even severe fractures can be splinted in the office and surgery can be scheduled in an outpatient setting.

Our Thousand Oaks office ALWAYS has a physician on call after office hours so if you are not sure where to go, we can help guide you. We see child and adult foot and ankle problems, injuries and general foot and ankle care. We can also open the office on weekends for an additional fee (which is probably still cheaper than going elsewhere!). It really does pay off in more ways than one by going directly to the podiatrist for all foot and ankle needs.

Got Gout? I don't think so.

Wed, 23 Mar 2011 19:43:17 -0600

Patients often come into our Thousand Oaks, CA office with pain in their foot and assume that it is gout. Gout affects approximately 1% of the population so it is not very common. It occurs more often in men >40 yrs of age, however, women can get gout after menopause. The incidence of gout in a healthy premenopausal woman is very low.

The most frequent presentation is in the big toe joint which becomes red, warm, swollen and is exquisitely tender. It is painful even to light touch and can cause limping. Acute attacks often strike in the middle of the night so patients wake up in the middle of the night with pain or the next morning. If you have a swollen painful joint it could be arthritis or infection. Infection is much more likely when there is some sort of opening to allow bacteria to get deeper such as a bug bite, cut, or injury. If there is no opening, the chance of infection is fairly low.

Gout is caused by uric acid levels building up in the blood then precipitating in the joint. Acute attacks always affect joints but can start to deposit uric acid in tissue in the ears, elbows or heels after years of chronic gout. The swelling and redness are very obvious during a gout attack and the pain is very localized.

Gout is exacerbated by certain foods such as organ meats (liver, pancreas), sea food, and alcohol. Ice usually alleviates pain in the foot but with gout it can actually make it worse. It can be helped by drinking lots of water, dairy products and cherry juice. It is associated with high blood pressure, kidney disease and obesity. It can also be caused by some medications such as low-dose aspirin (81 mg), some diuretics and some blood pressure medications.

So just to clarify- if you are healthy, not taking any medications and have never had gout before, the pain in your foot is probably not gout. If your foot is not red, very swollen and/or exquisitely painful, it’s probably not gout. If your pain is vague and generalized, it’s probably not gout. Got gout? I don't think so. If, however, you think it may in fact be gout, be sure to see your podiatrist immediately to discuss treatment options.

Podiatrists For Orthotics: The Smart Choice

Tue, 15 Mar 2011 11:52:11 -0600

I recently ran into an acquaintance of my wife at Europa coffee house in Westlake Village, CA. As we did the standard “hello, how are you? How’s the family” exchange, She suddenly said, “Oh I totally forgot you were a foot doctor! I should’ve called you last week because I needed a new pair of orthotics and I didn’t know who to call!” Turns out she asked her chiropractor who made her a pair. She went on and on about how she had a pair that she had made in San Francisco from her podiatrist that she loved, but that was several years ago. She was extremely disappointed in the ones that her chiropractor had made for her and wanted to know if there was a difference in the types of orthotics.

This is a topic on which I wish I could educate everyone. Podiatrists are the best choice, the smartest choice when getting a pair of orthotics. Not only do podiatrists specialize specifically in the foot and ankle, but podiatrists attend a four-year medical school, post college to study…. THE FOOT! Podiatrists take two separate anatomy classes in their first year of medical school, one studying the entire body and the other of just the foot and ankle. Podiatrist also spend two years in the classroom studying biomechanics of the foot and leg as well as two years studying clinical biomechanics of the foot and leg and gait analysis. Podiatrists also attend a 3 to 4 year residency program that again specializes in the foot, ankle and gait. Not all people need orthotics and when a person does need them, there are dozens of different types of orthotics. To make an orthotic, podiatrists consider the patient’s foot or ankle problem, body weight, shoe type, activity level and many other factors. Believe it or not, Orthotics are a medical prescription device. Therefore, your feet need to be evaluated by a professional that specializes in feet to get you the correct medical device for your individual issue.

Prescription orthotics can be used to help treat foot, ankle, knee, hip and sometimes back pain. Most insurance companies will cover either part of all of your orthotic costs. So when making the choice of who to see for your foot pain or orthotic needs, make the smart choice.

Broken Toe Woe: Broken Toes Should Be Examined by a Podiatrist

Mon, 28 Feb 2011 20:32:29 -0700

Ignoring broken toes will not make them heal faster! We often see patients in the office who broke a toe several months ago and are still having pain. They often think "there is nothing to do for a broken toe" or are even told that by an urgent care, ER or primary care physician. Because the fracture is not treated appropriately, the toe can be swollen and painful for months and months. Most toe fractures can be treated with taping and a stiff-soled surgical shoe, however, sometimes a fracture warrants a controlled ankle motion (CAM) boot. When a fracture is significantly displaced or angled then, the toe is numbed and put back in place (reduced) and then splinted. If it cannot be reduced in the office then surgery is necessary to realign and hold in place with a pin or screw. A fracture takes 6-8 weeks to heal when treated properly. When ignored, it can take months to heal and then sometimes necessitate a bone stimulator or surgery. It is worth seeing a podiatrist for your broken toe to ensure proper treatment and expeditious healing.

Ingrown Toe Nails: Treatment Facts & Myths

Thu, 13 Jan 2011 21:09:42 -0700

Ingrown toe nails are common, particularly in the adolescent population. The most common causes are narrow/tight shoes, sweaty feet and trimming the nails too short. Some people have a genetic predisposition to ingrown toenails because the nail itself is curved on the sides. Often times, the nail starts to grow in and then the patient tries to “dig it out,” thereby making it worse and/or causing it to get infected.

Signs of an ingrown toenail include redness, swelling and tenderness. As it progresses, it can become a darker red or even purplish. Sometimes a growth of tissue develops that overgrows the nail - this is called a granuloma. The presence of pus indicates a worsening condition that should be treated by a podiatrist.

In the early phase of an ingrown toe nail when there is mild tenderness and redness, applying antibiotic ointment and a band-aid to the toe, along with wearing wider shoes can resolve the problem. Soaking in Epsom salts may provide some relief and occasionally oral antibiotics can help clear up an infection; however, the source of the pain and/or infection is the nail itself and thus the best way to treat the problem is to remove that part of the nail. This involves numbing the toe and removing a small portion of the nail which will grow back in 9-12 months.

For patients who struggle with ingrown nails more than three times per year, it is recommended to have that portion of the nail permanently removed. The procedure for that also involves numbing the toe, removing a small sliver of the nail and then applying a chemical called phenol which kills the cells that make the nail so that it does not grow back in that area.

Preventative measures can include using a band-aid or tape to pull the skin away from the nail, placing a piece of cotton between the nail and the skin or using Vaseline to massage the skin away from the nail as the nail grows out. The goal is to allow the nail to grow beyond the skin edge and then keep it that length so it can no longer grow into the skin. Cutting the nail straight across is preferable. Cutting a “V” into the center of the nail is a myth and does not prevent ingrown toenails. Wearing wider shoes can provide pain relief and prevent ingrown nails.

If you suspect you have an ingrown toenail you should see your podiatrist to discuss appropriate treatment options. Please resist the temptation to be a bathroom surgeon!

Pain in the Ball of your Foot? It Could be a Neuroma

Sun, 09 Jan 2011 20:45:15 -0700

Patients with neuroms suffer from one or more of the following:

Pain in the ball of the foot towards the toes
Occasional clicking sensation
Burning/numbness/tingling in the toes
The sensation that the sock is balled up in the shoe

The above-mentioned symptoms are consistent with a condition called a Morton’s neuroma. A neuroma occurs when tissue immediately surrounding the nerve becomes inflamed or thickened. The term “oma” usually implies a tumor, but a neuroma is not a true tumor. The nerve lies just below a ligament that connects the metatarsal heads. When the nerve is enlarged, it snaps over the ligament, causing the clicking sensation in the foot.

Pain occurs during weight-bearing, especially during activities that force you to bend your toes, such as gardening, frequent use of ladders or running. Pain is typically worse while barefoot or wearing flexible shoes such as slippers or flip-flops. Initially, the pain can occur sporadically and feel more like a numbness or vague discomfort. But it can progress to sharp pain that occurs with every step. Neuromas that are left untreated can cause pain for years and even can cause complete numbness in the toes.

The nerve most often affected is the one that runs between the third and fourth metatarsal heads (metatarsals are the long bones in the foot and the heads of the bone are what create the “ball” of the foot). The big toe is labeled as the first toe and the pinky toe is the fifth toe, so it is most often at the bottom base of the middle toes where the pain occurs. Pain is localized to the bottom of the foot or the toes and can hurt when squeezing the metatarsal heads together because it pinches the nerve. It is usually not a neuroma when pain is primarily on the top of the foot.

There are several treatment options for neuromas. Conservative treatment options consist of icing, oral anti-inflammatories, stiff-soled shoes, orthotics or a pad that goes on the shoe insert to spread the metatarsal heads apart and give the nerve more room. High heeled shoes should be avoided. The best shoe for this problem is one that does not bend at the toes such as a clog, hiking shoes/boots or certain athletic shoes. It is advised to avoid walking barefoot. If these treatments do not help, the next step is a series of steroid injections to reduce the inflammation around the nerve. The last option is surgical excision of the nerve, which leaves permanent numbness in the affected toes.

If you suspect you have a neuroma you should see your podiatrist to discuss the best treatment plan for you!

The New Bunion Surgery ... Or Is It?

Mon, 18 Oct 2010 18:34:06 -0600

A bunion is an enlargement of bone at the great toe joint that can cause your great toe to touch, under-ride or over-ride the second toe. This deformity, if left alone, can often lead to debilitating pain and difficulty wearing shoes. Podiatric/Orthopedic Foot & Ankle surgeons have long used the tried and true method of surgical correction by using a bone cut known as an osteotomy to realign the bone to a more straightened position. This cut is then fixated with a screw and done in combination with appropriate soft tissue release to complete the surgical correction. These osteotomies have names to it, such as the common Austin to the Juvara (base wedge osteotomy). Other osteotomies that have been used are the SCARF, Logriscino, and Reverdin. All of these procedures have their own criteria on their use and often are used in conjunction with other procedures to fully correct the bunion. In severe cases, a joint fusion may be needed, which is a procedure called a Lapidus.

With any open procedure, there is some convelescense with it. In most of these procedures, patients can be weight-bearing immediately after with a protected walking boot or surgical shoe. Some will require almost 6 weeks of non-weight bearing with cast immobilization and crutches. As people's lives become busier, patients needing bunionectomies are looking for other alternative procedures to allow them to recover faster and return to work quicker. One company has taken that concept and developed a new device that not only will correct the bunion with minimal dissection, but offer a quicker return to work and activities. This device is known as the Arthrex Mini TightRope.

Here's the overview of the procedure: three small incisions are used. First incision is used in the first interspace to release the tight lateral structures. Second incision is medial right over the bunion and used to resect the medial eminence. Third incision is just lateral to the second metatarsal to allow tightening of the tight-rope. After releasing the lateral structures and resecting the medial eminence, appropriate drill holes into both the first and second metatarsals are prepped for insertion of the tight-rope. The tight-rope is then inserted and tightened to preference through the third incision. All incisions are closed and dressed. Protected weight-bearing for four weeks in a walking boot or stiff-soled surgical shoe. (Click here if you want to watch the video of the Arthrex Mini TightRope procedure.)

Sounds easy enough ... Makes sense to use the tight-rope device to pull the deformity back into the corrected position, right?

Early results show promise of this procedure due to its ease and quick recovery. My hesitation with this procedure is the long term effects. Will the tight-rope hold up long term with normal exercise? Will the rope lose its tension over time? More importantly, will the right-rope cause stress fracture in the second metatarsal at the thin part of the shaft? There are already documented patients that have had this complication and with not much relief of pain from the original bunion pain. Some have needed to convert to the open procedure to either remove the device and/or go to the traditional osteotomy.

I personally have not had much experience with the procedure. The concept of it makes sense, but my only reservation is the long-term effect and the potential issues with the second metatarsal. I still recommend to my patients the traditional osteotomy for the moderate to moderately severe bunion and use the fusion for the more severe bunions/revisional bunions. In my hands, these have given me excellent results with high satisfaction rate from my surgical patients. My advice is to speak to your surgeon regarding his or her expertise on this new procedure and make your own informed decision. Seek second or third opinions if necessary. Do what you feel is best for you.

-Dr. Peng has been with Advanced Foot & Ankle Center for more than 4 yrs. To make an appointment to see him or any of the other doctors in the group, please call 805-496-2383.

High Heeled Shoes: History of the Trend, Risks and Honest Advice

Mon, 04 Oct 2010 21:09:35 -0600

Why do women wear high heeled shoes? According to Smith and Helms, the tendency to wear high heels is motivated by a general psychological mechanism that drives women to engage in cultural practices that make them desirable to men (1). High heeled shoes make women seemingly more appealing to men by shortening the calf, shortening the stride, lengthening the leg, toning the legs and making the foot appear smaller and thus more feminine. There are various heights of heels and according to several high fashion shoe designers, a low heel is less than 2.5 inches, a mid heel is 2.5-3.5 inches and anything above 3.5 inches is considered a high heel.

Shoes date back to 3500 BC as depicted on Egyptian murals, however, at this time they were associated with the upper class. Throughout the ages, heels have been worn by both men and women and have been associated with both upper class and lower class. The heights have varied and styles have come in and out of vogue. For the most part, however, women continue to consistently wear high-heels in spite of the pain and/or potential injury the shoes pose.

Thanks to a new fad, now infants can also enjoy high heeled shoes. The heel itself is made of fabric and not intended to be walked on, thus they are indicated for infants who have not yet begun weight-bearing. These are obviously just for looks and serve no function.

High heels for children are primarily for play and dress up. They should not be worn while running and they should have a broad heel that is no more than 1 inch in height so as to reduce the risk of injury. Ideally they are worn on flat surfaces only as children at this age do not have the necessary coordination to adapt to uneven surfaces in a heeled shoe.

Adolescence is usually the first time a girl wears heels. At this time the heel should be 1-2 inches in height and worn for only short periods of time. There is a condition that involves destruction of the growth plate of a metatarsal head called Frieberg’s disease that is associated with wearing high heeled shoes since they increase pressure in the ball of the foot (the metatarsal heads). This can lead to permanent joint arthrosis and thus time spent in heels should be limited during the adolescent growth phase. Frieberg’s is not always painful during the process but manifests as pain later in adulthood when the joint is completely broken down (3).

Adulthood is when most women spend the most time in heels. Depending on the profession, some women wear high heels more than others. A study in England did not find a correlation between profession (and shoes worn) with foot pain and/or deformity later in life. The study did find, however, that women who wore heels throughout adulthood had an increased incidence of bunion deformity (4). Stilettos and true “high” heels are better worn at this phase in life due to better coordination and balance. However, these types of heels place significantly more pressure in the forefoot and lead to ball of foot pain. Several companies now make flats that roll up so you can carry them in your purse to have available when your feet start hurting. These should be utilized to minimize long-term damage to the foot, ankle and leg.

Balance and fall prevention is the main concern with shoe gear in the elderly. As women age, it becomes more important to wear shoes with a heel no more than 1.5 inches high, a wider heel for more support, as many straps across the foot as possible, and a back to the heel. A wedge-type shoe is always preferable for any age but especially in the elderly to better distribute pressure throughout the entire foot. There are several brands of shoes that have a relatively low heel, a wider toe box and a platform sole that also accommodate orthotic inserts which is ideal for patients with foot deformities or balance issues. Given that over 80% of elderly women have some form of foot deformity, this type of shoe clearly benefits most women.

The risk of high heels include fall, ankle sprain, ankle fracture, neuroma, bunions, hammertoes, metatarsalgia (ball of foot pain), blisters, corns, and calluses. Several studies have also documented an increased load through the knee which can lead to increased incidence of knee osteoarthritis. High heeled shoes also shift the center of gravity forward in the body which can lead to low back pain. One study examined the effect on the Achilles tendon and found that long-term use of high-heeled shoes induces shortening of the calf muscle and increases Achilles tendon stiffness, reducing the ankle’s active range of motion (4). When the Achilles tendon shortens over time then women actually have more pain in flat shoes and find themselves limited exclusively to heeled shoes for comfort. A tight Achilles tendon can also cause plantar fasciitis which is very painful and can become chronic if not properly treated.

It is obvious that women will continue to wear high heeled shoes, even against the advice of medical professionals as they have done for hundreds of years. In order to best avoid long-term complications of heel wear, it is best to limit time in heels to 2-3 hours at a time, limit heel height to less than 2 inches and wear heels only for special occasions. Heels with material in the arch and around the heel provide more support. For women who must wear heels for work then it is best to wear a walking shoe for commuting. Daily stretching for the calf and Achilles will limit the amount of Achilles shortening over time and help prevent foot pain.

1 Smith EO, Helms WS. Natural Selection and High Heels. Foot & Ankle Int. 1999: 55-57.
2 Blitz NM, Yu JH. Freiberg’s infraction in Identical Twins: A Case Report. Foot & Ankle Surgery. 44 (3); 2005: 218-221.
3 Dawson J, Thorogood M, et al. The prevalence of foot problems in older women: a cause for concern. J Public Health Med. 24 (2); 2002: 77-84.
4 Csapo R, Maganaris CN, Seynnes OR, Narici MV. On muscle, tendon and high heels. J Exp Biol. 2010;213:2582-2588. doi:10.1242/jeb.044271.

Running Barefoot - Fad or Fiction?

Thu, 09 Sep 2010 08:30:00 -0600

Barefoot running has become an increasing trend and a possible alternative or training adjunct to running with shoes. While anecdotal evidence and testimonials proliferate on the Internet and in the media about the possible health benefits of barefoot running, research has not yet adequately shed light on the immediate and long term effects of this practice.

Barefoot running has been touted as improving strength and balance, while promoting a more natural style. However, the risks of barefoot running include a lack of protection, which may lead to injuries such as puncture wounds and increased stress on the lower extremities. Currently, scientific research has been inconclusive regarding the benefits and/or risks of barefoot running. Your best choice is to consult a podiatrist with a strong background in sports medicine to make an informed decision on all aspects of your running and training programs.

Extra Pounds Add Stress to Feet and Ankles

Mon, 28 Jun 2010 20:06:44 -0600

People with foot and ankle problems tend to weigh more than people who don't, suggesting that the extra weight may be bad for the feet, according to survey findings released in the July 21 Reuters Health. Among more than 6,000 people who responded to the survey, those who said they had foot and ankle pain, had undergone foot surgery, or consulted a doctor about foot pain, tended to weigh more than people who did not report similar problems.

Iron & Calcium Can Help

Mon, 17 May 2010 12:59:43 -0600

It's widely known that calcium helps build strong bones. But according to Tufts University Health & Nutrition Letter, iron is another important nutrient associated with bone health because it helps produce an integral component of bone called collagen. However, iron is only effective in bone building when the recommended 800-1200 milligrams of calcium are consumed as well.

When Should You see a Podiatrist?

Mon, 17 May 2010 12:55:43 -0600

It's not always immediately obvious as to whether your foot ailments can be treated at home or if there is more to the problem that really requires the expertist of a Board Certified Podiatrist. Here are a few red flags that may help you determine whether your foot issues are in need of professional treatment.

• You have persistent pain in your feet or ankles.
• You have noticeable change to your nails or skin.
• Your feet are severely cracking, scaling, or peeling.
• There are blisters on your feet.
• There are signs of bacterial infection, including:
• Increased pain, swelling, redness, tenderness, or heat.
• Red streaks extending from the affected area.
• Discharge of pus.
• Fever of 100°F(37.78°C) or higher with no other cause.
• Symptoms that do not improve after two weeks of treatment with a non-
  prescription product.
• Spreading of the infection to other areas, such as the nail bed, or skin under the
  nail, the nail itself, or the surrounding skin.
• Your toenail is getting thicker and causing you discomfort.
• You have heel pain accompanied by a fever, redness (sometimes warmth) or
   numbness or tingling in your heel, or persistent pain without putting any weight or
   pressure on your heel, or the pain is not alleviated by ice, aspirin, (or ibuprofen or
   acetaminophen).
• You have diabetes or certain diseases associated with poor circulation and you develop
   athlete`s foot. People with diabetes are at increased risk for a severe bacterial
   infection of the foot and leg if they have athlete's foot.

Common Digital Deformity in Children

Mon, 17 May 2010 12:52:30 -0600

Examination of children's feet is an integral part of podiatry. Often, children have structural imbalance of the feet that may go unrecognized and can lead to other deformities and imbalances within the skeletal system. When detected early, these imbalances of the feet, some of which are related to the bone structure, are treated so that a sturdier foundation can be provided for during later years.

Deformities of the toes are common in the pediatric population. Generally they are congenital in nature with both or one of the parents having the same or similar condition. Many of these deformities are present at birth and can become worse with time. Rarely do children outgrow these deformities. Common digital deformities are underlaping toes, overlapping toes, flexed or contracted toes and mallet toes.

What is a Foot and Ankle Surgeon

Mon, 17 May 2010 12:11:05 -0600

Foot and ankle surgeons are first and foremost Podiatrists. More importantly, they are the surgical specialists of the podiatric profession. Foot and ankle surgeons treat a wide variety of foot and ankle conditions:
• Structural conditions
• Trauma-related injuries
• Skin and nail conditions
• Congenital deformities

What is a Podiatrist

Mon, 10 May 2010 12:25:46 -0600

A Podiatrist is the foremost authority and medical specialist of one of the most intricate and complex anatomical structures ever designed -- the human
foot and ankle.

A podiatrist is the only medical specialist educated, trained, licensed, and certified for exclusive treatment of the foot and ankle. In order to receive the degree of doctor of podiatric medicine, podiatrists must successfully undergo a lengthy, rigorous course of education, training and testing in such diverse areas as biomechanics, orthopedics, radiography, pharmacology, sports medicine, dermatology and surgery.

Although wondrous in design and function, the human foot can also be struck by numerous ailments, some of which are life-threatening. Additionally, many disorders first manifest themselves in the foot. Podiatrists are often the first healthcare professionals to diagnose these disorders.

Podiatrists also play a critical role in the care, treatment and management of the diabetic, elderly and circulation-impaired. The diagnosis, intervention and treatment by podiatrists may save patients from amputation, restore mobility or prevent other serious, more costly problems, by early detection and appropriate treatment.