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Monday, 28 December 2015 23:02

Nerve Disorders of the Foot and Ankle

Similar to well known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.

Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.

Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.

Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.

If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition.  If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.

Monday, 21 December 2015 23:59

When is Foot Surgery Necessary

Foot surgery may be necessary for a variety of reasons, but it is normally reserved for cases in which less invasive procedures have failed to help with the problem. Cases in which surgery may be deemed necessary include, but are not limited to, surgically removing deformities of the foot (such as bone spurs and bunions), problems with arthritis that have caused severe bone issues within the foot, and reconstruction to attend to injuries caused by accidents and congenital malformation (such as club foot and flat feet). Foot surgery may be necessary for individuals of all ages and races.

If you find yourself in need of foot surgery, the reason why the surgery has been found to be necessary will dictate exactly what kind of surgery you need. If you have to have a growth, such as a bunion, removed, then you may undergo a bunionectomy. If your bones need to be realigned and fused together, then you may undergo a surgical fusion of the foot. If it is nerve pain and problems that you are enduring, then you may need to undergo surgery in which the tissue that surrounds the painful nerve is surgically removed. Normally other, less serious treatments are first applied when a problem is discovered, but if those treatments are found to be ineffective, surgical techniques are considered and used.

Even though surgery of the foot is usually reserved as a last resort by most physicians, there are some benefits if you and your doctor choose to use surgery to fix the problem. The first is that the pain associated with the issue is normally relieved, which means that you can finally resume the activities your foot problem was preventing you from participating in. The second benefit is that, once you have the surgery completed, the problem is generally eliminated since it has finally been addressed.

History of podiatry has shown that foot surgery techniques continue to advance every year. Endoscopic surgery is just one of the many advancements that have been made in the field of foot surgery. As technology improves, foot surgical techniques will also continue to improve. Many procedures can now be completed using a very small incision and smaller, more refined instruments. Because of these better tools, surgeries are becoming less invasive, and recovery time has become a great deal shorter. Shorter recovery periods mean that you will be back on your feet in no time.

Monday, 14 December 2015 22:57

Solutions for Cracked Heels

Cracked heels can make life very frustrating when sandal season comes around, and can be very embarrassing. However, not only are they an aesthetic issue, they can also tear stockings, socks, and even wear out shoes faster. When severe, they may cause pain or infection.

Cracked heels are a problem for those who are athletic, who may walk a lot, and who have dry skin especially. Those who use medication that dry the skin, swim a lot, wear certain types of shoes, and who are diabetic may have trouble with cracked heels. Seniors whose skin produces less oil also may have trouble with cracked feet. There is no one way to develop cracked feet, and there is no cure.

Today, the market consists of numerous products that have a variety of ingredients to promote healing. Some of these are over-the-counter, and some are prescribed by a doctor; especially for those who have chronic dry feet and heels.

Some doctors may recommend wearing socks at night for those with rough skin. This helps further healing, and helps any creams put on the feet to stay on longer and better sink into the skin.

One way to alleviate dryness that causes cracked heels is by using moisturizers both day and night. Another way is to make sure the skin is clean and dry at all times. Using a pumice stone to remove dead skin before putting on moisturizer can also help, as cracked heels will not respond to the cream unless the outer layer of skin is first removed through exfoliation. After exfoliation, lotion or ointment will be absorbed by the skin more easily.

Foods that produce healing and balance can also help the skin from within. Everything that is put into the body can either help it or hurt it, and foods that give the body staying power will permeate through, especially through the first line of protection, the skin. Additionally in helping cracked heels, taking supplements of omega-3 fatty acids and zinc can be very beneficial.

Nevertheless, not all products that say they will help cracked feet will help. Seeing a professional is best if nothing else being tried works. A podiatrist should be able to give the best advice to help with this problem.

Monday, 07 December 2015 22:54

Foot Therapy for Sports Injuries

Whether in practice or in the game, athletes put their bodies through great stress. Some sports tax and demand more from the body than others, but every sport has an element of inorganic movement or unnatural motion. For ample, in softball, a pitcher winds up and flings her body with incredible amounts of dexterity in order to get the most ideal velocity out of her pitches. This motion, incredibly taxing on the body, can cause serious injury.

With regards to athletic injuries, one of the most common issues resides in the feet. Whether a damaging fracture that leaves athletes sidelined or simple turf toe, foot injuries can be very frustrating and painful. Regardless of sport, athletes require use of their feet in some fashion. This is why foot therapy is so vital in order to get athletes back on the right track and training again to return to the field.

No matter the injury, the best way to speed up the recovery period is to receive physical therapy. Physical therapy as a founded practice has proven to work for millions of people. Physical therapists are trained specifically to help people return to proper form from any injury, having gone through years of schooling in order to do so.

During physical therapy, you will go through organized training in order to get back into form. Sometimes training can be quite difficult, especially in the beginning when there is more pain and the foot feels awkward. To alleviate that you will do basic twisting and stretching exercises in order to get flexibility and foot mobility back up. The therapist will also massage the injured area in order to activate and relax muscles. Over time you will eventually move up to strengthening exercises, designed specifically so that activation of the injured area is ensured.

Foot therapy for sports is a modern science miracle. Devoid of fancy chemicals and terminology, physical therapy is an evidence based practice that is well designed as any other. Due to huge advancements and knowledge of muscles and joints, physical therapists can turn catastrophic injuries around so athletes can return to the game once more. 

 
Monday, 30 November 2015 22:50

Effect of High-Heels on the Feet

For hundreds of years, women have been wearing various kinds of high-heels for mostly aesthetic reasons. Women who wear high-heels appear to be taller and to have longer and thinner legs, and the wearer’s gait and posture changes. Though high-heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high-heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen, which can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot, by forcing the toes into a small toe box, high-heels can cause or may worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing very high-heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high-heels.  High-heels causes the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like this. By limiting the natural motion of the foot during walking, high-heels also cause an increased in stress on the knees.

Similarly, the back may also be affected by high-heels because it causes the back to go out of alignment. If high-heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high-heels can never be worn. If worn occasionally, they will not cause serious problems. They should not be worn every day in order to avoid the long-term physical health problems of the feet, knees, ankles, and back like mentioned above.

Monday, 23 November 2015 22:49

Rheumatoid Arthritis in the Feet

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, 16 November 2015 22:46

Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that is not onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

The symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the materials, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

Monday, 09 November 2015 22:43

Keeping Children's Feet Healthy

Having healthy feet in childhood can help prevent medical problems later in life, namely in the back and legs. As children grow, their feet require different types of care from birth to school-age.

Although babies do not walk yet, it is still very important to take care of their feet.

  • Avoid putting tight shoes or socks on his or her feet
  • Allow the baby to stretch and kick his or her feet to feel comfortable

As a toddler, kids are now on the move and begin to develop differently. At this age toddlers are getting a feel for walking, so don’t be alarmed if your toddler is unsteady or ‘walks funny’.  Be sure the child wears comfortable and protective shoes so that they can grow into their feet properly.

As your child gets older, it is important to teach them how to take care of their feet

  • Show them proper hygiene to prevent infections such as fungus
  • Be watchful of any pain or injury
  • Have all injuries checked by a doctor as soon as possible
  • Comfortable, protective shoes should always be worn, especially at play

Children of all ages are constantly developing and growing, and as a parent you want to make sure that nothing is hindering their maturation. This includes caring for their feet, as healthy feet are important in order to live a normal, fulfilling life.

Monday, 02 November 2015 22:43

Biomechanics in Podiatry

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.

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.”

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