Exercising with Diabetes – Take Care of your Feet!

Published on:  Hive Health Media

For many people diagnosed with Type II Diabetes, there is a strong correlation between being overweight and the illness itself. Specialists recommend the obvious dietary changes to help manage and even in some cases, reverse this illness which has now reached epidemic proportions, but exercise is also a valuable management tool.

Exercise helps manage diabetes in two key ways:

1. By contributing to weight loss and weight management, which is connected to reducing your risk of diabetic related complications, and
2. By improving your circulation – a key risk for diabetes, particularly when circulation to your outer extremities like hands and feet is impaired. Reduced circulation results in loss of sensation and can greatly slow down the healing of ulcers, burns and other skin complaints.

Exercise also has a number of other benefits for diabetics or those in a pre-diabetic state, including lowering levels of ‘bad’ cholesterol (LDL) and increasing ‘good’ HDL cholesterol; lowering your blood sugar levels; lowering blood pressure; reducing stress and the risk of cardiovascular issues – and generally increasing your sense of wellbeing.

If you have had diabetes for some time, and you also have a weight issue, you need to take care with your choice of exercise, especially when you are first starting to increase your fitness.

For many, starting out with a fairly brisk 30 – 40 minute walk about three times a week will start to have beneficial effects.

When you are walking, aim to raise your heart rate above what it would be when you are sitting or resting, but you still want to be able to talk easily – in other words, don’t walk so quickly that you are puffing or out of breath.

Make sure you also have a good pair of shoes to wear and even consider investing in some special diabetic socks designed to prevent and reduce the risk of foot injury.

If you are buying a new pair of shoes for walking, you might also like to spend a little more to get some custom fitted orthotics made from shock resistant foam that helps to cushion your feet from impact and reduce the impact on your joints. Proper diabetes foot care makes a huge difference in your overall health and mobility – the last thing you want is to be restrained to the couch because of foot pain and injuries.

You might also like to do something to help improve your flexibility – beginner yoga or Tai Chi, or even some simple daily stretching exercises.

With any exercise program, let your doctor know before you begin and set yourself reasonable goals – being overenthusiastic to start with can result in injury and the muscular aches and pains might be enough to put you off.

Getting out in the fresh air and sunshine has lots of benefits too, and regular walking can be a lot of fun especially if you have a dog to walk, or you make a point of regularly meeting up with friends to walk in the park or around your local streets.

In the winter time, you can go walking around your local indoor shopping mall instead, or invest in something like a wii fit for your television or a few exercise videos that mean you can exercise at home.

Whatever you choose to do, start gently, wear good shoes and have fun!

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!

What Is Toe Jam?

Pubished by:  The Huffington Post

Belly buttons have lint,
Ears have wax, and
Toes have jam.

Do you know what really lurks between your toes?

Toe jam is common non-medical term used to describe the 'gunk' that accumulates between the toes. It is a combination of dead skin cells, sock debris, dirt, body oil residue, fungus and bacteria. Scabies, a parasitic skin mite, often burrows between the toes and is associated with poor hygiene.

Not all toe jam is the same, however. Believe it or not, toe jam can result in serious medical issues for some and should not be neglected.

Is it sock lint? Cotton socks may shred fibers (or fuzzies) that seem to find a resting place between the toes. Brand new socks are more likely to shed, so washing your socks before wearing them may limit this occurrence.

Is it skin a condition (dermatitis)? Some skin conditions (such as eczema, dyshidrosis and psoriasis) may result in flaking dry skin that may land between the toes and ball-up due to sweat. If you have skin problems on other parts of your body, then it is possible that it can manifest in the foot, as well, though diagnosis may be elusive and biopsies may be necessary. A variety of skin conditions may be managed with topical steroids. A word of caution: You should not place steroids on an infection, as it may cause a worse infection, so its important to have a proper diagnosis.

Is it a corn? Pressure spots between the toes develop a thickened layer of skin -- calluses and corns. A thick corn can become softened (soft corn) due to toe sweat/moisture and become gooey and smelly. This most commonly occurs between the fourth and fifth toes, and is associated with hammer toes. A neglected (or overgrown) corn may disturb the integrity of the skin and a secondary infection may settle in.

Is it an infection (bacterial and/or fungal)? Fungus and bacteria propagate in areas that are moist, warm, dark and enclosed -- making the area between the toes an optimal home. Bacteria and fungus may simply reside here as innocent bystanders in the mix of toe jam, or they can cause an infection.

• Fungal infections (athlete's foot) are often itchy and associated with scaling. Other areas of the foot may exhibit a rash as well, and fungal toe nails may be present. Fungal infections often respond to simple measures -- attention to foot hygiene, frequent sock changes, keeping the toe spaces dry, powders and over-the-counter anti-fungals. More severe fungal infections may benefit from a health care professional evaluation.

• Bacterial infections may become more serious and travel up the foot and leg. This is a specific concern in people with diabetes who are at risk for limb-threatening infections. Intact skin is the best defense at preventing infection. An infection may appear as any of the following: redness, swelling, pain, colored drainage and malodor. A worsening bacterial infection should not be taken lightly and is a medical emergency. A health care professional may require antibiotics and some infections may need surgery.

Is it a scabies infestation? Scabies is not particularly a component of toe jam per se, but occurs in the presence of poor hygiene. Scabies is a highly contagious mite infestation of the skin (through direct contact), where the mite burrows beneath the skin causing a pimply rash and itching. A severe form of scabies can cause massive thickening of the skin and is common amongst immunocompromised individuals. Medically prescribed creams may resolve the infestation, as well aggressive washing of items that have been in contact with the mites (ie. socks, towels, sheets, etc)

Take Home Point = Prevention. Do your best to prevent toe jam from accumulating and becoming associated with a medical problem or issue. Keep your feet clean. Wash thoroughly between the toes with soap and water and be sure to dry your feet.

Toe jam exists and is not always innocuous ...

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!

Practice good foot health when traveling.......

Published by The Freeport News

It's that time of year when Bahamians are trekking to various parts of the globe on their annual summer vacation. Whether you are planning to climb the Rocky Mountains, shop until you drop in Miami or explore one of our beautiful islands traveling can take a toll on your feet, and an injury can ruin your entire vacation.

Before you make your next trip, here are some sensible travel tips to follow for good foot health when traveling.

If you are experiencing any pain or discomfort with your feet or ankles visit a podiatrist to find out what's causing the problem and have it treated before traveling. Remember, foot pain is not normal!

Review your travel itinerary and the activities planned to determine the kinds of shoes you will need to pack. Wear comfortable, supportive walking or athletic shoes with proper arch support along with socks to alleviate discomfort and prevent blisters.

Do not take new shoes that have never been worn on vacation. It is a good idea to condition and prepare your feet and legs for the activities you plan to perform during your vacation.

For example, if you plan to do lots of walking, several weeks before your trip, begin a regular walking program wearing the shoes you plan to travel with. Include hills if your vacation destination has a hilly terrain.

This will help you to enjoy your vacation more and prevent aches, pains or injury that may accompany a new workout routine.

When flying or driving for long periods of time, there is an increased risk of Deep Vein Thrombosis (DVT), which is a blood clot in the legs, especially if you have additional risk factors such as a recent surgery, bed rest, cancer, are older than 40 years, are obese and smoke.

The risk of developing a DVT from air travel is strongly linked to age, it's uncommon in young people and very common in the elderly. Studies have shown that three to five percent of travelers develop clots in their veins related to travel however precise numbers are very difficult to determine because travelers often have no symptoms and are unaware that they developed a clot.

An article published in The Lancet in 2001 estimated that one million cases of DVT related to air travel occur in the United States every year and that 100,000 of these persons die.

The Centers for Disease Control and Prevention (CDC), recommends when traveling for more than four hours you should get up and move around every two hours, drink plenty water, stay hydrated, reduce alcohol or caffeine consumption, avoid crossing your legs and exercise by flexing your feet and ankles, wiggle your toes and unlace your shoes if your feet swells.

Always wear shoes or sandals while walking on the sand to prevent foot injuries from the hot sand and objects that may be hidden beneath the sand.

Walking barefoot exposes the feet to sunburn, as well as the virus that causes plantar warts, fungus that causes athlete's foot or nail fungus and many other infections. Persons with diabetes should never walk barefoot, indoors or outside.

For persons with lighter complexions, be sure to apply sunscreen to your legs and feet while basking in the sun. Apply sunscreen to the tops of your feet and legs regularly, at least every three to four hours to prevent sunburns and to protect against the harmful UV rays of the sun.

Take along a foot first aid kit and be prepared in case of a minor foot problem.

Pack adhesive bandages (eg. Band-Aids), foot pads, talcum powder, antibiotic or first aid cream and nail clippers in your toiletry bag. If you injure your foot or ankle while away, seek professional attention from a podiatrist.

After a long day of sightseeing, shopping, walking, hiking or whatever you have planned for your vacation, treat your feet well, massage them, rest them and keep them elevated, after all you will need them to do it all over again the next day.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!

Pregnancy, Diabetes, and Your Feet

Published on: Zimbio
 

There are so many changes the body undergoes during pregnancy that it becomes easy to ignore the changes in the feet. During pregnancy the body releases hormones that allow the ligaments to relax in the birth canal. The ligaments in the feet also relax, causing the foot to lengthen and widen. Many will complain of a shoe size increase by one or two sizes. In most circumstances, this flattening and widening of the foot is benign and no problems result.

In the diabetic, this change in foot size is important to recognize. Despite the increase in foot size, many moms will continue to wear the same size shoes. As a diabetic, properly fitting shoes are of utmost importance. Increased pressure on the foot can cause areas of rub or irritation and potentially result in ulceration. Once there is an ulceration, one is at risk for infection, delayed healing and further diabetic foot complications.

 

Diabetic neuropathy is the single greatest risk factor for developing foot ulcerations. Neuropathy is the loss of sensation in the feet commonly caused by diabetes. Many individuals will develop neuropathy before they are diagnosed with diabetes. Others will develop neuropathy years after being diagnosed with diabetes. Luckily, gestational diabetes is not typically associated with neuropathy.

 

Unfortunately, type I diabetics develop neuropathy much earlier than type II diabetics and may have neuropathy during their pregnancy. Regardless of the type of diabetes, it is still extremely important to have the feet evaluated to assess the status of the nerves. Even mild neuropathy increases the risk of ulceration. Wearing shoes which are too small causes an increase in friction and an increased risk of skin breakdown.

Wearing properly fitting shoes during and after pregnancy is of particular importance. Although the ligaments relax in the foot during pregnancy, they do not stay relaxed. The post-pregnancy foot is at higher risk for developing foot problems. There are multiple reasons contributing to the increased risk. The flattened foot places excess stress on the ligament that holds up the arch. The weight gain from pregnancy places excess stress on the feet. Moms are also carrying their baby, added weight which transmits to the feet. Moms are staying at home more often and walking around in slippers and flexible shoes which are generally not supportive.

To decrease your chances of foot problems during and after pregnancy follow these steps:

 

1. Check your feet everyday: This is an absolute necessity if you are a type I diabetic or if you have diagnosed neuropathy. It is a good habit to practice. Look for cuts, sores, bruises, openings or areas of irritation. Remember, if your nerves are not functioning properly, then you may not feel everything in your feet. If you cannot reach your feet, have a family member check your feet or place a mirror on the floor and put your feet over it.

2. Check your shoes before you put your foot in them.

3. Don’t walk around barefoot: Wear a supportive shoe, one that has a rigid sole and bends only where the foot bends (at the toes). If a shoe seems too confined, find a slipper which has a semi-rigid sole, or try a clog or slip-in shoe with a more rigid sole. The remaining aspect of the shoe can be soft and flexible and allow for swelling, but the sole should be rigid from the heel to the ball of the foot.

4. Buy shoes that fit your feet: Be aware of the changes your feet are going through. The feet are most likely widening and lengthening. Make sure the shoes don’t cramp the toes. Your feet will not shrink after the birth.

5. Watch out for folds in your socks: A simple fold can cause rub or irritation on your feet. Swelling will be greater by the end of the day and the small crease that didn’t bother you in the morning can rub an open sore or blister on the toes. Serious consequences in diabetics can include ulceration and infection.

6. Dry your feet and between toes after showers: Increased moisture between your toes can lead to skin breakdown and eventual ulceration.

7. Don’t be a victim of fashion: Most moms will avoid high fashion during pregnancy, but many try squeezing into that strappy heel after. Wearing high heeled shoes puts excess stress on the ball of the foot, cramps the toes and increases the chances of ankle sprains. Tight shoes will increase the chance of ulceration for those with neuropathy.

8. Test the bath water before stepping in: If you have neuropathy, you will not recognize when the temperature is too hot. Check the water by inserting your hand into the water to wrist depth.

9. Don’t use a heating pad on your feet: Although the idea of heat on your feet may sound soothing after a long day, the heat will increase swelling and inflammation. Sore feet respond better to ice. Roll your foot over a frozen sports water bottle to help ease the achiness in the arch. Wear a sock while doing this and don’t put ice directly on your feet. The heating pad can cause burns in those who have neuropathy.

10. Don’t use any medication on the skin: Be careful of topical medications during pregnancy and during breast-feeding. Consult your doctor before use. Don’t use medicated corn pads from the local drug stores if you have neuropathy.

11. Visit your podiatrist: At the first sign of a problem, make an appointment with your podiatrist. Prevention is much easier than treatment.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!

Flip-flop fiascoes to sunburned toes: Tips for avoiding summer foot woes

Posted on: KRNV-TV

(ARA) - Relaxing on the beach, hiking through the mountains, trekking around a new city or just keeping up with all the kids' summer activities - however you spend summer vacation, your feet will carry you through it all.

During the course of these adventures, your feet may endure stubbed toes, miles of walking, hot sand, and possibly even some sunburn. So be kind to your tootsies, and take note of these tips for protecting your feet from summer heat, courtesy of the American Podiatric Medical Association (APMA):

Foot care on the road

You may be looking forward to a beach vacation or lounging by the pool at a luxury hotel. But even those fun activities can take a toll on your feet if you don't practice proper safety.

"Even if you're just lying still on your back soaking up the sun's rays, your feet are still vulnerable," says Dr. Michael King, president of the APMA. "You can seriously sunburn your feet. And no matter how up-scale your hotel is, athlete's foot can be present in all public pool areas."

To help steer clear of foot problems, walk barefoot as little as possible.  Going shoeless exposes your feet to sunburn, plantar warts, athlete's foot, ring worm and other infections, and increases the risk of injury. Wear shoes or flip-flops around the pool, to the beach, in locker rooms, and even inside your hotel room, as infection-causing bacteria can linger in carpets and on bathroom tiles.

Just as you rely on sunscreen and drinking plenty of water during the summer, these practices also help your feet. Apply sunscreen on your whole foot, especially the tops and fronts of ankles. Drink plenty of water throughout the day to help minimize foot swelling caused by the heat.

Always pack an extra pair of shoes, especially if you expect your feet will get wet. And take along a foot-care kit that includes sterile bandages, antibiotic cream, an emollient-enriched cream, blister pads and an anti-inflammatory pain-reliever.

Avoid flip-flop fiascoes

Ditching heavy boots and wearing lighter footwear is one of the great joys of summer. But be aware that not all types of footwear are good for your feet. Flip-flops, in particular, can cause problems.

"During warmer months, many podiatrists treat more foot problems, and they can often be traced back to the wearing of flip-flops," King says. "You don't have to give up wearing flip-flops altogether; certain types offer a superior amount of stability and support than others."

So, what's considered a bad flip-flop? Flip-flops with soles that freely bend and twist offer no support or stability. Choose flip-flops that bend only at the ball of the foot and that provide arch support, which cushions the foot and provides stability. High-quality soft leather for the thong part of the flip-flop will help you avoid blisters.

Your toes or heels should never hang off the edge of the flip-flop. Throw away flip-flops that are old, worn, cracked or frayed - no matter how much you loved them last season.

Finally, never wear flip-flops for doing yard work, playing sports, or taking long walks. Do wear good, supportive flip-flips at the pool, beach, or in public places.

Your feet will take you to a lot of cool places this summer. Keeping them safe and comfortable can maximize the fun during your next warm-weather adventure.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!

Bunions: When Do They Become Something To Worry About?

Posted by The Huffington Post

Look down at your feet -- would you know if you have a bunion?

Many people know the term 'bunion' and that it occurs on a foot, but don't know exactly what a bunion is.

Most people think a bunion is an abnormal growth of bone at the base of the big toe. This is incorrect (at least in most cases). A bunion is actually a structural problem where the big toe joint becomes subluxed and drifts towards the smaller toes. A displaced bone, called a metatarsal, becomes prominent on the inside of the foot. The bunion simply refers to the enlarged prominent 'knobby' area.

Bunions may progress in size and severity. A bunion may start of as minor issue and, over time, may develop into a severe disfiguring foot deformity. See below:

So if you have bunion, here are 10 important things you should know, as you consider treatment:

Not all bunions are painful.

1. The medical term is hallux abducto valgus.
2. They come in different sizes: small, medium, large or severe.
3. Genetics. You may have inherited your grandmothers feet.
4. They occur more often in women than men.
5. Pointy-toed shoes and high heels may result in bunions.
6. Bunions may get bigger over time, or not.
7. The bunion may cause problems with the lesser toes.
8. Non-operative treatments are mostly aimed at treating the symptoms.
9. Surgical treatment goals are to realign the natural position of the toe.

When to seek treatment?

There is not a specific point when bunion sufferers 'must' start treatment despite the bunion severity. Some people begin treatment with the smallest bunion while others neglect the condition until severe. Reasons to seek medical treatment are:

·  Presence of Pain? Pain and discomfort is the most common reason to seek treatment. Pain directly on the bunion is a symptom of direct shoe pressure. Joint pain suggests arthritic degeneration. Pain on the ball of the foot is concerning for altered foot biomechanics and a sign of a bigger problem. Pain should not be ignored.

·  Interference with Activity? Some people wait until a bunion interferes with activities before seeking medical treatment and I think this is a mistake. Impact activities (such as running, tennis) may be more challenging to perform. If left ignored, simple everyday walking may become problematic. You should take measures that keep you active and healthy.

·  Inability to Wear Certain Shoes? In this subset of patients, it's the sheer size of the bunion preventing fashionable shoes that motivates treatment -- not pain. These patients have learned to live with discomfort but chose fashion over foot health. Clearly, inability to wear shoes is a valid reason for intervention.

·  An Unsightly Bunion? Foot care experts are less concerned with cosmetic appearance as they are about pain, activity restrictions and overall foot function. Often insurance companies only cover medical bunion treatments if pain is present, regardless of size.

·  Overlapping toes? When the second toe has overlapped the big toe, it's an obvious indicator of a global foot problem, and is often associated with collapse of the foot. Interestingly, these problems are not always painful as the condition develops overtime and the pain may be muted, or patients have accepted a certain amount of foot discomfort. The driving force for treatment becomes secondary problems such as metatarsal stress fractures or inability to fit shoes.

How to limit progression of a bunion?

It is important to understand that not all bunions become worse (or bigger). Some bunions never change in size. Others may progress onto a major foot deformity. Genetics play a big role and you may be 'destined' to develop a 'bad' bunion. Below are non-surgical measures to mitigate pain as well as limit the progression.

·  Smart Shoe Selection: Avoiding shoes that are bad for your foot health may be the best preventive measure you can take. Pointy toes shoes directly pushes on the big toe inappropriately, and in my opinion are 'bunion formers.' If the bunion becomes irritated, then spot stretching the shoe limits symptoms. High heels may also contribute to bunions due to altered foot mechanics -- so limit time in them. Flip flops are considered a "poor footwear" choice by most health care professionals. Minimalist shoes seem to be a better lightweight alternative.

·  Counteract Muscle Spasms: Muscle spasms within the foot are often due to a muscular imbalance, and an important warning sign that muscles are trying to stabilize bone structure. Strained muscles are less effective at stabilizing the foot and a bunion may progress. Deep massage and mineral foot soaks ease tension in the foot.

·  Foot Strengthening: It's important to keep your foot muscles strong to counteract the muscular imbalance. Perform simple toe exercises daily -- such as picking up marbles (or a handkerchief) with your toes. Commercially available toe exercising devices may have therapeutic benefits but studies do not exist demonstrating efficacy.

·  Arch Supports: Bunions and foot deformities tend to occur in people with flat feet and/or ligamentous laxity. Arch supports provide extrinsic structure and promote a more 'proper' alignment and may limit bunions from getting bigger. Over the counter inserts are a good first start. Doctor-prescribed molded orthotics have the benefit of being custom to your foot and therapeutically tweaked.

·  Pain Medication (Oral & Topical): Non-steroidal anti-inflammatory medication is commonly recommended to decrease pain and inflammation. Topical treatments also help manage inflammation and pain symptoms. Capsaicin cream/ointment (derived from spicy chili peppers) is a potent pain reliever that works via a neurochemical pathway. Be sure that the skin overlying the bunion is intact, otherwise capsaicin will cause an intense burning sensation. Topical products containing methyl salicylate distract the pain perception by causing cooling/warming skin sensations. Topical corticosteroid cream may temporarily reduce inflammation and should be used intermittently because it may cause thinning of the skin as well as hypopigmentation.

·  Bunion Padding: A pad limits direct pressure and may prevent the pain cascade altogether. Chronic bunion inflammation can result in deeper bone problems, so prevention is beneficial. More importantly, a properly placed pad may provide a physical blockade that prevents the bunion from pushing out. Pads may be composed of felt, moleskin or gel.

·  Toe Spacers & Bunion Splints: The purpose of this intervention is to physically place the big toe in a more normal position. A toe spacer (often made of silicone) is worn while walking. A bunion splint is a useful device (worn while sleeping) to physically realign the big toe.

If you have a bunion, do what it takes to take care of your feet and prevent progression. If the above measures don't help, then surgery may be inevitable.

Please call the Foot, Ankle & Lower Leg Center office anytime @702-878-2455 between Monday – Friday and we would be happy to set up an appointment for you.  Please visit our website @ www.FallCenter.com or www.walkwithdiabetes.com.   The Foot, Ankle & Lower Leg Center has Diagnostic imaging:  Digital X-Rays, Ultrasound or Advanced Imaging will be used to aid in the diagnosis.

Dr. Anthony Ricciardi at the Foot, Ankle & Lower Leg Center has completed training in endoscopic/minimally invasive surgery for chronic heel pain and nerve pain, foot and ankle joint replacement for restoring pain free motion, arthroscopic surgery, bunion surgery, fracture repair, flat foot correction, external fixation for complex deformities and extensive experience in peripheral nerve surgery including diabetic peripheral neuropathy and reconstructive surgery of previously failed foot surgical procedures.  In addition to his surgical training Dr. Ricciardi focuses on sports medicine of the foot and ankle through regenerative techniques using the patient’s own blood/platelets for healing chronic foot and ankle problems (pain) as a result of repetitive sport injuries.  This cutting edge technology enables patients to continue training with little or no down time.  Dr. Ricciardi continues to be active in teaching and training other podiatric surgeons on innovative surgical techniques in foot surgery.  Dr. Ricciardi is Board Certified by the American Board of Podiatric Surgery, a Fellow of the American College of Foot and Ankle Surgeons and Fellow of the Association of Extremity Nerve Surgeons.  Dr. Ricciardi’s vision is to bring each patient the most current state of the Art Technology and personalized treatment options to meet their Foot and Ankle needs (from conservative care to surgical options).  Dr. Ricciardi believes in quality service and puts his patients first!