Sunday, December 28, 2008

The Demand For Safe Pedicures Spreading

The demand for safe pedicures is spreading across the country. Recently, "The Foot and Hand Spa" had opened in a podiatry office in Virginia. This is very similar to the spa opened over a year ago at Foot and Ankle Associates of north Texas named "Healthy Steps". There is a great health concern about the safety of pedicures in nail salons. For more information, read Dr Crane's article on "Deadly Pedicures". Book a safe pedicure today! Yout toes will thank you!!

Saturday, December 27, 2008

Poor Circulation in Diabetic Feet?

How do I know if I have poor circulation in my feet?

There is an increased incidence of peripheral arterial disease in diabetics. Peripheral arterial disease (PAD) is narrowing or blockage of arteries that results in poor blood flow to your legs. When you walk or exercise, your leg muscles do not get enough blood and you can get painful cramps. Peripheral arterial disease is also called peripheral vascular disease or simply poor circulation. Just like clogged arteries in the heart, clogged arteries in the legs mean you are at risk for having a heart attack or stroke. Plaque buildup in the legs does not always cause symptoms, so many people can have PAD and not know it. People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause.

One in every 20 Americans over the age of 50 had PAD and it is estimated that over 8 million are undiagnosed. Early detection of PAD has been shown to save limbs and lives, so if you have any of the risk factors you should undergo PAD screening by your podiatrist yearly or more often if symptoms occur.

The exact cause of plaque buildup in the limbs is unknown in most cases. However, there are some conditions and habits that raise your chance of developing poor circulation.

Your risk increases if you:
1. Are over the age of 50.
2. Smoke or used to smoke. Those who smoke or have a history of smoking have up to four times greater risk of P.A.D.
3. Have diabetes. One in every three people over the age of 50 with diabetes is likely to have PAD.
4. Have high blood pressure. Also called hypertension, high blood pressure raises the risk of developing plaque in the arteries.
5. Have high blood cholesterol. Excess cholesterol and fat in your blood contribute to the formation of plaque in the arteries, reducing or blocking blood flow to your heart, brain, or limbs. 6. Have a personal history of vascular disease, heart attack, or stroke. If you have heart disease, you have a one in three chance of also having PAD.
7. Are African American. African Americans are more than twice as likely to have
PAD as their white counterparts.

What are the symptoms of PAD?

Most patients with PAD have little or no symptoms until the disease is advanced; that’s why screening exams are so important. Those who do experience symptoms have reported these typical signs and symptoms:

1. Claudication: fatigue, heaviness, tiredness, cramping in the leg muscles (buttocks, thigh, or calf) that occurs during activity such as walking or climbing stairs. This pain or discomfort goes away once the activity is stopped and during rest.
2. Rest Pain: pain in their legs at night that often disturbs their sleep
3. Wounds or sores that heal very slowly or not at all
4. Color changes to the skin of their feet and lower legs
5. Cold, pale feet and legs
6. Decreased hair and nail growth on their feet

How is PAD Diagnosed?

Your podiatrist will start with checking the pulses in your foot and ankle, examining the skin for changes and wounds that are poorly healing. Often an ABI (ankle-brachial index) is evaluated which compares the blood pressure in your arms to your ankles. A Doppler exam may be ordered. This test uses sound waves to measure the blood flow in the veins and arteries in your arms and legs. If any of these exams are abnormal, your podiatrist may refer you to a vascular surgeon to discuss options for treatment.

How is PAD Treated?

The overall goals for treating PAD are to reduce any symptoms, improve quality of life and mobility, and prevent heart attack, stroke, and amputation. There are three main approaches to treating PAD: making lifestyle changes; taking medication; and in some cases, having a special procedure or surgery. Your physicians will determine the best treatment options for you, based on your medical history and the severity of your condition.

How Can I Prevent PAD If I am Diabetic?

The cornerstone of prevention is lifestyle changes.
1. Exercise is very important and you should aim for 30-45 minutes of moderate intensity exercise each and every day.
2. Stop smoking immediately and ask your doctor for help if you find you cannot.
3. Keep your cholesterol and blood glucose levels down. Aim for a HgA1C of 6!
4. Keep your blood pressure in the normal range.
5. Decrease stress.
6. If you are overweight or obese, aim for a normal weight and again, ask your doctor for help! A diet low in saturated fats, trans fats and cholesterol is also helpful.

More than anything, talk to your doctors about a comprehensive treatment plan for your diabetes that also decreases your PAD risks.

One in every 20 Americans over the age of 50 had PAD and the incidience is higher in diabetics. Most patients have little or no symptoms until it is too late!

Early detection of PAD has been shown to save limbs and lives, so if you have any of the risk factors you should undergo PAD screening by your podiatrist yearly or more often if symptoms occur.

Monday, December 22, 2008

Baby It's Cold Outside!

Yep – winter is upon most of the nation just in time for the holidays! Being in Texas, we tend to adjust for a day in the 20’s and back to 70 degrees the very next day. Just this morning, I elected(note the word elected) to run outside. The temperature was 19 degrees with a wind chill of four degrees. Taking deep breaths of air and smiling, I soon noticed I was the only person in my neighborhood that was outside. I noticed one of my neighbors giving me a thumbs up through their window. She was dressed in her cozy robe not at all looking like she wanted to join in on the fun I was having. Everything was feeling good except for one thing – my feet.
Oops I thought, I have really adjusted to living in a warm climate – wearing my thin running socks with running shoes of mostly mesh material it soon felt like I was dipping my feet in ice water with each stride. Did I stop? Of course not, by the end of five miles I had two ice bricks for feet. Returning back to the warmth of my house, my feet were a bit ticked off to say the least. I successfully kept the rest of my body warm however I failed to take care of the tootsies – nice going ace I thought to myself.

Winter weather can play havoc on your feet if you don’t take care of them properly. Just like fixing your hair or make up (guys, go with me on this) you need to care for your feet along with the rest of your fine self. Let’s think about our feet for a minute – take off those shoes and socks and follow along:

Look at your heels.
Do you see soft pink skin or dry cracks the size of the Missippi? If soft skin is not observed, use a daily moisturizing lotion recommended by your Podiatrist. In the evening, wear socks to bed after moisturizing. Can’t stand socks on your feet? Gel heel socks are a great alternative. The sock basically covers the heel area and allows the lotion you applied to sink into the skin and not your bedding. You can find them right at Healthy Steps. Any lotion will do and here’s a tip – it’s a GREAT stocking stuffer!

Check out your toes.
Are they well groomed or do your nails have ridges resembling the Ozark Mountains? When the weather turns cool then cold, most people forget about the importance of a good pedicure. Make it a point to write on your calendar a reminder for your monthly pedicure during the winter months. Go polish free or for the ladies, whip on a fabulous red for the holidays. Get your pedicure at a location where your safety is priority number one. Visit the Healthy Steps website for details on a safe spa. For the locals, call us and book an appointment!

Look at the bottom of your feet.
Do you see pretty skin or calloused skin? Again, a regular pedicure will keep your feet in check. Under no circumstances should you ever cut calluses off or allow a pedicurist to use a blade on your feet. When blades are used (they are also illegal in spas) it is an open invitation for infection. Pumice stones are a perfect way to reduce calluses. If however you have open sores or are a Diabetic, never attempt this on your own. See your Podiatrist for assistance.

Pumice Stone 101:
First, soak your feet in warm, not hot water with a few drops of beauty soap. Stay away from harsh soaps such as dish soap. The goal is to relax the skin without adding to the dryness. Relax and soak your feet for 10 minutes.

Take the pumice stone and dip it in the water. Allow the water to absorb into the pumice stone.

Slowly begin to rub the calloused area being careful to not cause the skin to open. Once the calloused is reduced, wash your feet with a gentle cleanser, dry the feet, apply lotion then cover with socks.

Repeat this process a few times a week and you will see results!

If by chance you were overzealous and bleeding occurred, stop the process immediately. Cleanse thoroughly with antibacterial soap and water, a dab of triple antibiotic ointment and a band aid. If you notice any redness, swelling or more than just a little discharge over the next few days, seek medical attention immediately! Once your foot completely healed, book an appointment with a medically supervised spa and leave the sloughing to the experts!

Happy Holidays Everyone – may you and your family have a safe and joyous holiday season!

Here is to a fine 2009!

Janet Dixon, C.Ped.
For your feet…for your life!

Tuesday, December 16, 2008

Marathoners and Their Feet

I am one of them and perhaps you are as well. Whether you have completed one or 100 marathons, it’s the one thing no one can ever take away from you – the title of a Marathoner. Marathoners know the work, dedication, sweat and sometimes blood spared in order to meet the challenge of completing a 26.2 mile race.

This year, I headed out to the Dallas White Rock marathon to cheer on the many folks I knew from previous years of coaching beginning runners, my local running club friends and people who have met me at the practice where I work. They were running either their first or returning to run another marathon. I found myself in a new position as a spectator watching from the sidelines. The main person I along with co-workers monitored was Dr. Crane and her running buddies or “peeps” we so affectionately refer to. I found it great fun to spend the evening before the race creating cheer signs, digging out my cowbell from my first marathon and even found the dandy matching whistle. I was ready to get my cheer on and show my non running friends what the marathon experience is all about.

As I stood to the side of the start line on race morning which was also the finish line for the marathon. I felt a lump in my throat and noted tears forming as I watched thousands of marathoners start off on their 26.2 mile journey. Part of me wanted to drop my signs and chase after the runners. I turned away at one point and thought – how about next year? Do you think the body can pull off another marathon? I then realized I already committed to a half ironman so I snapped out of it and was proud knowing my brain was available to stop the planning another addicting 26.2 for myself.

Soon thereafter I found myself doing one thing….I was staring at the runners and walkers feet. I guess I really am turning into a foot biomechanics junky!

I watched so many feet during the race my neck was sore the entire day after the race. I had to bite my lip quite a few times as I noted many runners were truly in the wrong type of running shoes. Have they honestly trained for six plus months in these shoes? Did they change their shoes last minute hoping for an easier or faster race? Were they victims of poor fitting or did they simply pull a pair of running shoes off the store shelf thinking they have the right shoe? Are they wearing orthotics and shoes that are causing the over or under correction? The questions went on and on in my head.

I then thought about the countless articles and opinions about running shoes. The continual updates on models, the new technologies, the uber-svelt materials, the components, the list goes on and on. Perhaps we can chalk this up to information overload for runners? Take note: if you are a runner or a person who was invigorated by watching all shapes and sizes run, walk or even crawl to the finish line do yourself a favor – have your feet checked out by a Certified Pedorthist or a Podiatrist who understand runners and running. I watched hundreds cross the finish line in pain, some grabbing a hamstring, some limping, some tearing their shoes off and running barefoot looking for comfort after the miles. Each runner should have had a different shoe type for their feet, especially the guy who threw his shoes to the side and ran the last strides in bare foot. So not to recreate the wheel on running shoe shoes, here are a few tips to keep in the back of your head when shoe shopping and to help prevent future running injures:

1. Learn about your feet, not the runner next to you and not the associate’s feet who is selling you shoes. What is your biomechanics? What is each foot measurement? What is the right running shoe size?
2. Seek an understanding of what you about to or have already put your feet through with distance running. For example, do you know how much force you are placing on your feet with each stride? The amount of force is actually quite eye opening.
3. Make sure you understand the shoe that you are placing on your feet. What does the shoe do for biomechanical correction and is this shoe right for your foot type?
4. Change out your shoes every 300-400 miles if not sooner. I know some shoe manufactures claim up to 500 miles however, I have had the opportunity to run in many running shoes (that were correct for my foot type of course) and I have yet to run hit the 500 mile mark without having thoughts of chewing off my lower limbs to alleviate pain.
5. Give your shoes a rest. Shoes need at least 48 hours of rest to “bounce” back.
6. Try running in different brands over time. If you keep going back to shoe A, that is fine. Keep an open mind however as I mentioned earlier, shoes are always changing and for that matter so are your feet!

So here is to future marathons to run, walk or simply watch. It’s an amazing life changing event and is one you will never forget. By the way, Dr. Crane and her peeps did great given the challenges faced with Mother Nature. I am proud of them as we all should be for those who accepted the challenge. Now get up off your chair and go for a run….or buy some shoes!

Janet Dixon, C.Ped.
For your feet….for your life!

Sunday, December 14, 2008

Don't let this holiday be your last!

Many of us will be traveling this holiday to see family, friends or just get away from the hussle and bussle of the season. Our minds are occupied with the many things that must be done before we reach our final destination. Did I get all the Christmas presents? Hope I didn't forget anyone? Where is my passport? How many times will I be frisked before I get on the plane? Who's making the cheese dip this year? But the one thing that no one thinks...Is this trip going to kill me?

Sounds crazy to ask such a question but it's a good question to ask yourself if you plan on traveling long distances. DVT or deep venous thrombosis is a clot that occurs in the large, deeper veins of the calf. It is caused by long periods of immobility. The veins do not have muscles in their walls like our arteries to force blood back to the heart. They work by getting squeezed by the muscles that surround them. When those muscles aren't moving, then the blood in those veins tends to get stagnant and that is when the clot forms. If the clot dislodges, it can travel to the lungs and become a pulmonary embolism or PE which can cause sudden death.

Symptoms of DVT include redness and swelling of the calf. The pain could be moderate to severe and can worsen if the foot is flexed or the calf is squeezed. If you feel feverish, short of breath or chest pains then immediate medical attention is necessary.

So how do you prevent this or at least lessen the likelihood that it can occur?

* Wear compression stockings during your trip. They will apply pressure to the calf muscle that will help push the blood back to your heart.

* If driving, take frequent breaks to walk around. Get out and stretch those legs! Get those muscles moving.

* If flying, try standing up and walking the aisle once an hour.

* When possible, massage the calves and pump your feet up and down to move the calf muscles.

* Taking an aspirin a few days before and during your trip can help as well, but make sure this does not interfere with your regular medications. Also if you take motrin, ibuprofen or aleve on a regular basis, these should not be combined with aspirin.

Just thinking ahead and doing simple things can prevent an ER visit or worse. If you think you have any of these symptoms, please seek medical attention immediately. We hope you have a safe and happy holiday!

Sunday, December 7, 2008

Cowboy's Marion Barber Breaks Toe and Can't Play! Why?!

Cowboy's injury woes continue. Marion Barber dislocated his right little toe in the first half against Seattle on Nov. 27 and did not practice all week. Team sources say it hurts too much for him to run on it. He did not join the team for the trip to Pittsburgh this weekend, so he is definately out for the game. All from a toe???? What's with the Cowboys? First Tony Romo is out with a pinky finger then Barber with a pinky toe!! Are they wimps?? What happened to being a tough football player? I remember Emmitt Smith playing with a seperated shoulder!

In all seriousness, a pinky toe injury can really hamper the running style of a running back. And, if you have ever broken your pinky toe; you know that it is almost impossible to wear a shoe comfortably. Toe dislocation with or without an accompanying fracture can take 4 to 8 weeks to heal. The treatment is to strap the toe to the next one and immobilize the foot. Very rarely do these need surgery and the worst case scenario is a enlarged toe that may develop a corn in a tight shoe. Life conitnues as we know it.

So, if my patients can survive broken and dislocated toes, why can't Marion Barber play? It's cold in Pittsburgh and his toe would be numb anyway!! Suck it up! Who gets to play running back this week? Felix Jones is out. Marion Barber is out. Guess it's time to pull someone from the practice squad. What a mess!! All from broken pinkies!

Monday, December 1, 2008

Holiday Foot Pain

Well our house had a great Thanksgiving holiday filled with turkey and way too much stuffing. But instead of putting up Christmas decorations like many others did, we decided to paint our living room. Why I don’t know, but after standing on a 10 foot ladder for hours I realized why foot injury and pain is so common this time of year. I would describe the pain in my feet as very uncomfortable and I found myself walking around the kitchen like a “burnt-toed chicken” as my friends from Georgia would describe it! My toes were numb and my arches were on fire. The only relief I found was making my husband do the ladder work.

This time of year everyone is going to put their feet through a grueling ritual of mall walking, Christmas shopping and house decorating. And come January 1st, the resolution to get back in shape and lose those holiday pounds will disappear quickly due to foot pain and the inability to exercise. This happens because we dramatically increase our activity this time of year without thought to what we are doing to our feet and legs. The pain comes from multiple factors: muscle fatigue in those small muscles of the foot, arch strain from wearing inappropriate shoes while walking for hours, shin splints, increasing walking time from 30 minutes a day to 5 hours in one weekend! And let’s not forget those 4 inch shoes that look great with that holiday outfit, but cause all your toes to go numb 30 minutes after wearing them!

The most common things we see during this season are heel pain or plantar fasciitis, neuromas, shin splints and Achilles tendonitis. All are due to fatigue and overuse. Pain can occur in the arches and heels as well as along the front of the legs. With neuromas, there is pain in the ball of the foot with a sensation of walking on a rock or a rolled up sock. Usually, the pain described will subside once the walking event is over and you can get off your feet and rest.

Follow these helpful tips for a pain free holiday experience:
1. Wear a good supportive shoe for long walking, standing or increased activity. A really good tennis shoe is just the thing to keep those feet comfortable and reduce foot and leg muscle fatigue.
2. Take frequent breaks during the activity and get off those feet. Give them a rest!
3. Stretching reduces muscle pain after a long day of walking. Good calf and arch stretches will keep you from walking with a limp the next day.
4. Roll, baby, Roll! When you are done with your day, roll your feet across a frozen bottle of water. Not only does this feel great, but it decreases the swelling along the arches and heels.
5. If you plan on hanging Christmas lights, remember safety is the key. Never do this alone! Wear stiff soled boots or tennis shoes to reduce arch strain from ladder rungs and give you a better standing surface.
6. Wear those nice heels to Christmas parties, but don’t stand all night! Wear comfortable shoes on your way to the party, then switch right before making your grand entrance. If you like dancing and want to wear heels, expect pain!

If you find that your foot, ankle or leg pain is not going away with rest, ice and a simple shoe gear change, then there may be something more serious going on that needs to be treated as soon as possible. Have a safe and happy holidays!

Tuesday, November 11, 2008

Tony Parker Blows Out His Ankle

Did you see the video of Tony Parker’s ankle injury in the game against the Miami Heat? Nasty! It made my ankle hurt! Looks like the San Antonio Spurs will be without him for a while. Ankle sprains can take 4 to 8 weeks to heal; and that’s assuming he doesn’t need his ligaments repaired and didn’t break anything. Preliminary reports say bad sprain, but that could mean anything. Watch the video and you will wonder if 4 weeks is enough to recover from that!

Ankle sprains are actually one of the most common sports injuries, especially in basketball. Many players actually suffer from chronic instability due to multiple ankle sprains over a period of years and little or no true rehab. Many younger athletes return to sport as soon as the swelling goes down and they can get their shoes back on and laced up. This is way too early! An ankle sprain actually messes up the proprioception in your ankle so your brain has trouble understanding where your ankle is in space. This makes you more unstable and prone to reinjury.

If you have an ankle sprain, you should be evaluated by a sports medicine podiatric foot and ankle surgeon if you have localized pain, swelling and bruising, as well as inability to walk more than 5-7 steps comfortably. Many a foot fracture has been missed in the emergency room when x-rays were taken only of the ankle and not the foot. The fifth metatarsal is often broken with the same mechanism of injury of an ankle sprain, so the foot should be evaluated as well. If severe ligament injury is suspected, an MRI can evaluate the grade of injury. This is really what decides whether surgery is needed for full recovery.

Treatment for ankle sprains really depends on the degree of severity, which can only be determined by your doctor. Initial treatment always includes “R-I-C-E” therapy – Rest, Ice, Compression, and Elevation. Pain and edema is usually controlled with NSAID’s (non-steroidal anti-inflammatories) like ibuprofen. Bracing or casting coupled with non-weightbearing on crutches may be needed in more severe injuries to rest and stabilize the ankle while it heals. Return to pain-free ROM and stability is the goal. Surgery is only recommended in Grade 3 severe injuries in athlete’s or in those patient’s who have had multiple ankle sprains and suffer from chronic ankle instability. Long-term ankle instability can often be avoided with an aggressive physical therapy program. Bracing should only be used in the short-term during rehabilitation because long-term bracing actually causes atrophy and decreased ROM.

Physical therapy is needed for all ankle sprains. The goals of physical therapy should be to regain full ROM, strength and yes, your friend and mine: proprioception. Regaining strength as well as overall balance training are the keys to successful rehabilitation of an ankle sprain. A maintenance program of ankle strengthening, stretching, and proprioception exercises helps to decrease the risk of future ankle sprains, particularly in individuals with a history of multiple ankle sprains or of chronic instability.

Bottom line: if you happen to try to imitate Tony Parker and fall down and go “Boom” playing basketball or any other sport, have your ankle sprain evaluated by a podiatric foot and ankle surgeon. Delaying treatment and rehabilitation can lead to life-long instability and a really bad jump shot!

Monday, October 27, 2008

Crazy Bony Growths Under the Toenails

Osteochondromas

Have you noticed your big toenail growing funky? Have you noticed a pain or bump at the end of your big toe? Is your nail changing but you don't think its fungus? There could be a really easy answer and solution for these symptoms!!

A lot of times people will walk around their entire life with big toenails that look and feel different than the rest of the toenails on their feet. If your big toenail has always been thickened or is painful when you touch it you could be suffering from what is called a subungal exostosis.

What is a subungal exostosis??

A subungal exostosis is a growth that most commonly occurs on the distal phalanx of your big toe, or at the end of your big toe directly under the nail. This type of lesion is a combination of both bone and cartilage and usually can easily be seen on X-rays.

How do I know if I have a subungal exostosis?

Many times these lesions are asymptomatic, but if you are having pain in your toenail, or your toenail grows weird then you need to have it looked at.

Most of the time these lesions are completly benign but because they cause discomfort the treatment for them is most often excision.

If they are disturbing the nail bed and causing your nail to grow funny then a podiatrist can easily remove the growth in an out patient surgery setting. The recovery from a surgery like this is quick and easy. Afterwards your nail will usually grow much more normal than before and be pain free!! So dont wait, if you are sick of your funny looking toenails have them checked out. You could be walking around with painful ugly toenails when there is an easy fix!

Tuesday, October 21, 2008

LaDainian Tomlinson Slowed By Turf Toe

The San Diego Chargers star running back, LaDainian Tomlinson, has been hampered all season by an early turf toe injury. This injury can be devastating and has ended many NFL careers. What is turf toe really? How can we avoid this pain in the toe?

What is turf toe?

Turf toe is a condition of pain in the base of the big toe. This usually caused from either traumatically jamming the toe, or pushing off repeatedly when running or jumping. The most common complaints are pain, stiffness and swelling. The pain can be so severe that pushing off in football is virtually impossible.

This injury is especially common among athletes who play on artificial turf, hence the name “turf toe”. The hard surface combined with running, jumping and cutting in football and soccer, make turf toe a frequent injury. Some also blame the choice of athletic footwear. The more flexible shoes, especially used in competition, provide less support to the forefoot joints, possibly contributing to the incidence of turf toe.

How does turf toe occur?

When a player sustains a turf toe injury they are actually tearing the capsule that surrounds the joint at the base of the big toe. Tearing this joint capsule can be extremely painful. Furthermore, tear of the joint capsule can lead to significant instability and even dislocation of the joint at the base of the toe. This may lead to accelerated cartilage wear and arthritis of the big toe known as Hallux limitis or rigidus. This wear-and-tear arthritis can end a promising career prematurely.

How is turf toe diagnosed?

Turf toe is diagnosed based primarily on the physical examination of the patient. X-rays may be taken to ensure there is no fracture or evidence of arthritis. Occasionally an MRI is needed to evaluate the surrounding tendons or to rule out an occult stress fracture.

What is the treatment of turf toe?
Treatment of turf toe consists of trying to control the inflammation of the joint capsule. Treatment protocol can include:
1. Rest
2. Ice
3. Elevation
4. Taping or padding to off-weight the toe joint
5. Anti-inflammatories
6. And in chronic cases steroid injections to the joint may be helpful
7. Long term use of a functional foot orthotic to balance the forefoot in the cleats is quite helpful.

Athletes diagnosed with turf toe should avoid stress to the joint for about three weeks to allow the joint capsule to heal. Once returning to activities, functional orthotics can be used to limit the motion of the big toe and prevent further damage to the joint capsule.

Will turf toe return?
Unfortunately, turf toe can return, often more severe than the initial injury, and rehabilitation may be very slow. LaDainian Tomlinson has been slowed by his injury all season and most likely will not be 100% until he can rest at the end of the season. Most athletes have trouble when they try to come back to sports too soon after sustaining a turf toe injury. Surgery is rarely needed for treatment of turf toe unless this has been a chronic injury and spurs are present in the joint limiting motion. If a bone spur has formed, and severely limits the motion of the toe joint, surgery to remove the spur may be helpful.

Prevention and early treatment is really the key! If you are experiencing pain in the joint after running in practice, your shoes should be evaluated for a functional orthotic to balance your biomechanics and hopefully avoid significant turf toe.

Monday, October 20, 2008

Lumps in Your Feet? May Be A Plantar Fibroma

So, I saw this patient the other day with large lumps on the bottom of her foot. She complained of pain when walking on the lumps and denied any trauma. She said they just “popped up”. After examining the lumps, I diagnosed her with plantar fibromas.

These are thickenings of the plantar fascia or the ligament on the bottom of the foot. They can be genetic, occur from trauma or just appear with no reason. She had tried changing shoes, but this did not change anything.

Conservative care for plantar fibromas includes:
· padding or custom orthotics to offload the lumps
· deep tissue massage
· physical therapy
· injection therapy
· topical verapimil

I explained the surgical treatment was removal of the lump along with a large section of the plantar fascia to reduce recurrence. But this condition has a 20% recurrence rate even with removal of the fascia. So all attempts at conservative care should be made.

If you are experiencing "lumps" in your feet or pain when walking, see a podiatrist today! Not all lumps are fibromas, a small amount are cancer. Early detection is the key! For more information, visit our website! Lots of great foot information!

Monday, October 6, 2008

Don't Mess around with Ingrown Toenails!

Ouch!! An ingrown toenail hurts! Ingrown toenails hurt because the nail is curving into the skin. This causes a red, swollen, irritated and painful toe. Dont wait till the toenail is dripping pus, you dont need to live with the discomfort or pain.

Before you start performing foot surgery in your bathroom STOP. Remember that most of the time the toenail is ingrown in a place to deep for you to reach. By digging at your toenail you increase the risk of infection and cause yourself more pain.

Here are some tips to determine if your toenail is ingrown:

1. Push on your nail, does it hurt???

2. Is your toe red in color?

3. Is your toe swollen and painful

4. Do you have liquid or pustular drainage present?

Instead of digging at it, have it checked out by a podiatrist who is trained to remove the nail without pain. It may only need to be cut differently or you might need a portion of the nail removed. Even in the worst cases, most people are back to full activity after a couple of hours or at the latest the next day. You might also need an antibiotic to help get rid of the infection. If you think you have an ingrown get it checked out.

Don't mess around with ingrowns! For more information you can go to our website.

Sunday, September 28, 2008

Funky Toenails

Have you noticed those toenails changing color? Are they yellow, black or brown? Getting thicker or really flaky? And quite possibly a little musty odor in those socks? This all sounds like nail fungus or medically described as onychomycosis.

Anyone can develop nail fungus. It is a common organism found in the environment that once finds a warm, dark, moist place to grow (under your toenails!) it florishes. Those 5 year old tennis shoes don't help either. You can easily transfer the fungus living in those shoes to your toenails. Do you enjoy frequent pedicures? Do you allow your nails to catch a breather? Continual polish on nails increases the suspectibility of getting a fungal infection.

The diagnosis is made with a clinical exam where clippings of the toenail are sent to a labratory where the fungal elements can be seen under a microscope. Once this has been detected, there are 3 options for treatment. There are a couple of topical medications that can resolve a mild fungal nail infection is used properly meaning every day for at least 6-9 months. Some cases may be so severe that an oral medication may be used in combination with the topicals to work from inside out to cure the infection. When one nail is involved and topicals have not worked, then removing the nail and allowing it to regrow without fungus is also another option.

No matter what treatment option you and your doctor decided, it will take at least 6-9 months to notice improvement or resolution. Nail fungus does not have an overnight cure! Oh, and don't forget to change those tennis shoes every 8-10 months!!

Saturday, September 20, 2008

Who Needs Orthotics and Why

Dr Crane discusses in this video the benefits of functional foot orthotics.
Who needs orthotics? Why?
Watch and learn...if you have a question for any of the doctors at Foot & Ankle Associates of North Texas, contact us and we will add it to the series of Q & A on the blog.




Healthy Steps...For Your Feet...For Your Life!

Monday, September 8, 2008

Got Sweaty Feet?

Is playing footsie out of the question? Sweaty feet stink! No pun intended! Not only do they stink, but it is a real bummer when you can't wear those awesome sandals since the last time you almost slipped out of them! You already know powder doesn't cut it and have probably "Googled" for help by now! This is where I come in!

Let's try keeping it simple! There are now anti-perspirants made with a stronger concentration of aluminum chloride (the active ingredient that reduces sweating) specifically for under your arms and, yes, your feet! You don't even need a prescription for some of them anymore!

Tired of practically twisting your ankle from slipping and sliding out of your shoes and sandals? If you haven't tried Summer Soles inlays, you will be in for a treat! These wafer-thin inlays for your shoes and sandals literally wick the sweat off your feet so your feet feel dry and they don't slosh around. You know these things are great when people like you say that Summer Soles have changed their lives!

Yes, it this doesn't work, then see me (or another podiatrist is you are not so fortunate to live in the Dallas-Fort Worth area )!

Good foot advise means good feet for a lifetime!

Dr. Adriana Karpati is double board certified in foot surgery and wound care and has special interest in aesthetic foot surgery, diabetic limb salvage and childhood foot problems. She practices with Foot and Ankle Associates of North Texas, located in Grapevine, Texas.
For more information on various foot conditions or on Dr. Karpati, please visit our website.

Hot Burning Heels?

Got Hot Burning Heels?

Do you know that heel pain is the most common complaint we see in our office?

You could have plantar fascitiis, but did you also know that your pain could be caused by a bone spur, a broken bone or a torn ligament? Heel pain could also be caused by a recent gain in weight, tight calf muscles, sudden change in exercise regiment or improper shoes.

Most people think if they ignore the heel pain that it will go away or at least the pain will get better. I am here to tell you that the pain will not go away and most likely it will get worse! A lot of times we can not remember hurting ourselves and we cant even remember when the pain started, the important thing to know is that if you have heel pain you can get rid of it, no one should have to walk around day to day with pain in their feet.

A few things to think about if you are suffering from heel pain..
- are your shoes old?
- Do your feet feel tired at the end of the day?
- Is the pain worse in the morning when you get out of bed?
- Are you stretching before and after you exercise?
- Do you have to stand for long periods of time when you work?
If the answers to any of these are yes then you should have a docotor look at your feet. Most times conservative treatments can get rid of your pain and make your feet feel new again.

Wednesday, September 3, 2008

Do Socks Matter?

What’s in Your Sock Drawer?

I get asked everyday about the types of shoes people should buy, but what about socks? Why do we ignore a very basic part of our shoe gear? New technology has invaded our home, offices and gym bag. It’s changed the way we correspond, drive our cars, listen to music, cushion our running shoes and yes….even our socks have taken a technology based transformation.

New technology has made fabrics lighter, healthier, more comfortable, more-wicking, and more durable. Using a variety of new-age fabrics and even old-fashioned cotton blends can help keep feet dry, leaving them more comfortable and blister-free. My favorite socks are double layer Coolmaxx which keeps my tootsies dry and blister free. Since your feet spend much of their time covered in some kind of footwear, it is essential to choose the right socks for your needs. From fabric to fit, making sure your socks are the right ones for the job are essential. (Yes, socks come in sizes just like shoes!)

Here are some sock buying tips from the trenches:
- A sock with a poly/cotton blend is the best for everyday wear. Sweat wicking blends like Coolmaxx or Dry-weave are best for running. If you have a chronic fungal infection or itchy feet, you may like socks impregnated with silver or copper to decrease the fungus and bacteria collecting in between your toes.
- It really is all about fit. Socks should fit like a glove. No loose fabric or bunching up around the toes and especially no contracting or curling your toes because they are too small! Thin or thick, just make sure they fit and don’t make you shoes too tight.
- Diabetics and those with circulation problems or blister problems at the tips of your toes should wear specialty seamless socks. These are available in many types and sizes.
- All socks should be tried on with the appropriate shoes. Don’t try on your running socks with dress shoes…that’s a recipe for buying the wrong socks!
- When in doubt, visit Healthy Steps, our therapeutic shoe store. We have lots of socks and can help you with your choices for everyday and running…..