Foot, Ankle & Lower Leg Center: August 2011

Tuesday, August 16, 2011

How Young Is Too Young for High Heels?

Posted on: The Huffington Post

French Vogue recently illustrated a 10-year-old model, Thylane Loubry Blondeau, in a high fashion photo shoot wearing makeup and skyscraper high heels. This has gained media attention and debate over the appropriate age for young girls to be portrayed in such a manner.

But how young is too young for a girl to wear high heels?

High heels are considered to be a poor foot health choice by most health care professionals, as they may lead to bunions, hammer toes and general foot pain. However, it is important to note that these conditions do not happen over night and are thought to be the result of long-standing high heel use.

From a medical point of view, there is a specific concern with young girls wearing high heels and pointy-toed shoes because their bones are more malleable and can be structurally deformed as they grow. Simply put, bone growth occurs from a cartilaginous precursor that becomes calcified and hardened. The softer growing bone can be deformed and misshapen by external forces (such as high heels). This is the physiology behind the Chinese foot binding.

Until young girls stop growing, there is a significant risk to cause bone and joint deformations within the foot. Sure heel height, duration of time spent in the heel and frequency of wear are all contributing factors to developing high-heel associated foot problems -- but the risks are clear.

From a purely bone-related standpoint, females reach skeletally maturity around age 14. This does not mean that this the proper age for one to begin wearing high heels, nor am I indicating that high heel wearing is safe at all for young girls and adolescents. But parents should strongly consider avoiding shoe gear that can have a life-long impact on the foot prior to maturity of the foot. And remember, even after skeletal maturity, the risk of developing foot problems still exists.

What do you think?

Please call the Foot, Ankle & Lower Leg Center office in Las Vegas 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!

Thursday, August 11, 2011

Are Your Feet Marathon Ready?

Published by: The Huffington Post

Your feet need to be in tip-top shape if you expect to run 138,336 feet to actually finish a marathon.

Being that your feet are the connection to the ground, they have to primed and steps should be taken to avoid injury that can slow you down or knock you out of the race. So whether you are training to win or simply running to run, it is important to know what foot problems can occur, and hopefully treat them before they become a marathon-breaker.

Specific Marathon Foot Issues: No matter how experienced a runner, the foot is always susceptible to running injuries, and this risk amplified during marathon training. On marathon day, however, there is specific injury risk because runners tend to me more committed to "running though" a problem (new or old).

A method to remember marathon-related foot problems is the mnemonic "ABCD":

Abrasions & Blisters
Bone Breaks
Cramping & Tendon Problems
Disorders of the Toenail

Provided below are explanations of marathon-related foot injuries as well as preventative measures. Should you, the reader (or runner), have any additional preventive solutions or tips for any of the running ABCD's, please share them. --

Abrasions & Blisters: Pressure points and repetitive irritation set the stage for abrasions and blisters. Common runner pressure spots are on the top of the toes, big toe joint area and the back part of the heel. Runners with bunions and hammer toes are more likely to have skin irritation. An abrasion is a simple break in the skin, whereas a blister is lifting of the skin with a fluid collection beneath it.

 Preventive Solutions: Prevention is best form of treatment. Keep skin thoroughly moisturized, as dry skin is more prone to tearing. Callused areas should be targeted, and urea creams are specifically useful in breaking down excessive skin build-up. Callus/corn removers should be used cautiously as they contain salicylic acid and can excessively deteriorate tissue, leading to open sores.

 Socks are important in the battle against skin irritation when running long distances. Specialty socks have specific protective cushioned areas dedicated to pressure spots.

 Ill-fitting footwear is one of the main reason for friction, so it's important to have sneakers that best fit your foot type. Also, carefully inspect the stitching at the front of the sneaker where the toes bend to be sure that it does not rub when fully extended. Newer sneakers are more likely to be problematic.

Bone Breaks: Fractures (aka bone breaks) are the most serious problem that a runner could develop. They typically start as a microscopic fracture (stress fracture) and can progress onto a through and through break. Most common are metatarsal stress fractures involving the second toe region. Heel strike runners may be more susceptible to stress fractures of the heel bone.

An acute stress fracture is often present with varying degrees of pain, swelling, and sometimes redness, though stress fractures may occur without you even knowing it. Running with a stress fracture is not medically advised, and most health care professionals would recommend calling off the race. Runners who don't heed such advice may fully fracture through the bone which could lead to bone displacement (malalignment) -- a potentially serious problem. Some people may have brittle bones making them more likely to develop a bone injury. Certain foot types seem to be more prone to stress fractures -- very flat feet or very high arched feet.

 Preventive Solutions: Over stressing the foot is what often leads to fractures. Pain may also be an indicator that you are training beyond the current capability of your foot, so it may be necessary to scale back. Pain should not be ignored, and any could be a sign of a fracture, so seeking professional medical care is recommended.

 More cushioned sneakers do not necessarily offer more protection from developing an injury, and running form may be more important. Nonetheless, properly fitting running sneakers are important to help you become more in tune with your running technique. Depending of foot structure, orthotics may help balance the foot and take pressure off those spots prone to stress fractures.

 Proper nutrition is important in maintaining strong bones. Vitamin C is necessary for collagen formation, a precursor to bone. Calcium is needed for proper bone health and Vitamin D helps promote Calcium absorption. Eating a balanced meal should be a part of your overall health plan.

Cramping & Tendonitis: Biomechanical and structural problems within the foot tend to manifest as shin splints, arch cramping, plantar fasciitis and/or tendinitis. Less experienced runners tend to develop these problems and is commonly the result of training past the capabilities of your foot. Tight musculature may also be at the root of cramping and shin splints. These problems tend to be self-limited and resolve with targeted treatment programs, but can set you back in terms of being marathon ready.

 Preventive Solutions: Building strength and stamina slowly is the best method to avoid injury. Be sure to incorporate a thorough stretching program to keep muscles and tendons stretched and warmed up. Weak muscles within the foot can be strengthened with specific foot training programs. Ease cramping in the foot with post-run Epsom salt baths. Deep tissue massage is also a helpful measure.

 Arch supports (orthotics) can help manage arch pain by providing support and perhaps better alignment of the foot in certain people. Of course, foot type plays a big role in selecting the proper amount of support. Running in the wrong-type of sneaker for your foot may be responsible for discomfort, so changing sneakers may be beneficial. A break from running may be necessary to resolve the problem. Runners with persistent problems should seek the advice of a health care professional.

Disorders of the Toenail: A black toenail is a problem that every marathon runner has experienced, and is the result of bleeding beneath the nail plate. Pressure and friction from repetitive running seem to be the culprit. The damaged nail can be painful and often results in the toenail falling off. Fortunately, a black toenail doesn't typically interfere with training and common is self-limiting.

 Preventive Solutions: Prevention is difficult, as the black toenail is often the result of prolonged toenail irritation from the intense mileage of training. Again, properly fitting shoes with enough room for the toenails are helpful. Keep toenails well trimmed to not create a fulcrum for the nail to become lifted. It is unclear if moisturizing the toenails offers any protective benefit but a soft nail may, theoretically, be less prone to damage. Should you develop an acute painful black toenail, then medical attention may be needed to alleviate the active collection of blood. An irritated loose nail may become infected and this can be serious.

By the time marathon day rolls around, and if you have avoided or overcome injury during your training and your feet are pain free, then you likely have feet that are ready to start a marathon.

Diabetics' health care team must include podiatrist

Pubished by: MyCentralJersey.com

Diabetics can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications, but most can avoid serious issues by having their feet checked by a podiatrist annually and following some simple tips.

Most importantly, diabetics should work with their physician to manage their blood glucose levels; check their feet every day for red spots, cuts, swelling and blisters; and seek medical attention if injuries are found.

Foot problems most often happen when there is nerve damage called diabetic neuropathy. Although it can cause pain, neuropathy also can lessen the ability to feel pain, heat and cold. This can lead to injuries going unnoticed.

Diabetics also may have skin and skin structure problems in their feet, such as dry, cracked skin, corns and calluses, eczema and fungal infections because their nerves no longer control oil and moisture.

They also may suffer from poor blood circulation leading to abnormal healing and in the most severe cases, gangrene. Guarding against infection is essential for diabetics. High blood glucose levels make it harder for the body to fight infection.

Calluses, if not trimmed by a podiatrist, can become ulcers (open wounds), which in turn can get infected and cause osteomyelitis (bone infection), which may lead to amputation.

Luckily, there are many things that can be done to keep feet healthy, including:

Wash feet every day.

Dry them carefully, especially between the toes.

Keep your skin soft and smooth.

Rub a thin coat of skin lotion over the tops and bottoms of feet, but not between toes.

If toenails can be seen and reached, trim them when needed.

Trim toenails straight across and file the edges with an emery board.

Wear shoes and socks at all times.

Never walk barefoot.

Wear comfortable shoes that fit well and protect the feet.

Check inside shoes before wearing them.

Protect feet from hot and cold.

Wear shoes at the beach and during any outdoor activities.

Test water temperature before bathing.

Keep blood flowing to feet.

Wiggle toes and move ankles up and down for five minutes, two or three times a day.

Eat right and exercise.

Following these simple tips can help diabetics avoid foot problems!

Friday, August 5, 2011

4 ways to make sure your child's shoes fit

Published by: The Asheville Citizen-Times

Fall represents one of the peak times for children's shoe shopping.

Parents need to keep in mind these tips from podiatrist Dr. Richard Stanley and the American Podiatric Medical Association as they peruse the shoe aisle for the young feet in the family:

1. Buy for fit, not size: Don't assume that because your child has grown out of one size that he or she needs the next size in the new pair of shoes, Stanley says.

“The biggest mistake I see people make is buying a size instead of fit,” he said, adding that sizing may vary from brand to brand or even within a brand.

So, make sure your child tries on both shoes, and that the shoes fit both feet. If one foot is larger than the other, as is frequently the case, make sure that the shoes fit both feet.

If you have to use a shoehorn, it's probably too tight, Stanley said.

2. Make sure the shoes are flexible: Shoes should bend with a child's toes. Also, grab the shoes from both ends and try to bend them. If a shoe bends in the middle or if you can twist it around, there's not enough support.

Also try the heel, Stanley said. If you can press it down easily, it does not offer enough support.

3. Don't buy shoes that are too stiff or too big.

“Kids' feet are really flexible,” Stanley said, “and you don't want to have a shoe that's going to mold the foot.”

Nor do you want a shoe that's too big. Loose shoes may slide up and down, causing blisters. If you can put your finger down the back of the heel, the shoe is too big, he said.

4. Avoid shoes that pinch the toes: “If you can kill a cockroach in a corner with a toe, you don't want to be in it,” Stanley cautions. This holds for pointy-toed shoes for women as well as cowboy boots.

Wednesday, August 3, 2011

Tips to keep kids' feet healthy through warm weather adventures

Posted on WVTV-TV

(ARA) - With the myriad of activities children take part in during warm weather months, they need to get the most mileage possible out of their little feet.

Keeping kids moving is a good thing; encouraging children to exercise is a key component in the battle against childhood obesity. Kids may slow down if their feet hurt, so it's important for parents to be aware of their child's foot health.

"Just as untreated foot problems can hinder an adult's life, they can have serious long-term repercussions for children," says Dr. Michael King, president of the American Podiatric Medical Association (APMA). "No matter the cause or severity of the problem, the health of a child's feet should not be taken for granted."

Even the most caring parent can underestimate a child's foot problems. In fact, 35 percent of parents with children younger than 18 said they would not be motivated to take their child to a doctor for treatment of foot or leg pain, according to an APMA study. And only 25 percent said they would take their child to a podiatrist - a doctor who specializes in treating the feet and ankles.

With warm weather activities comes extra wear and tear on children's feet and on the flip-flops, sandals and sneakers kids like to wear. As you watch kids sprint through their warm weather fun, keep this advice from APMA in mind:

Right shoe, right size

Children's feet grow, often very quickly. Shoe and sock sizes may change every few months, and shoes that don't fit properly can irritate the feet. Always measure your children's feet before buying them shoes, and watch for signs that the shoes are irritating their feet. These signs include red spots, blisters and general complaints of foot pain.

Always take your children shoe shopping, because every shoe fits differently. Plus, allowing them a say in the shoe-buying process can help promote healthy foot habits down the road. Always buy for the larger foot, since feet are seldom the same size. Have your children try on shoes with whatever socks or tights they'll most often be wearing with them. Never buy shoes that need a "break-in" period. Shoes should be comfortable immediately.

Never hand down footwear. Just because a shoe size fits one child comfortably, doesn't mean it will fit another child as well. Finally, be sure to look for shoes that provide adequate support for a child's very active feet. The shoe's heel cup should be stiff. The sole of the shoe should bend with the child's toe but be rigid in the middle. APMA recognizes shoes and products that are good for feet with the APMA Seal of Acceptance. You can learn more about these products at www.apma.org.

Foot pain is not normal, both in children and adults. Today's podiatrist - the foot and ankle specialist - can help parents relieve children's foot problems and help keep them healthy and active. Additionally, many podiatrists specialize in pediatric foot problems.To find a podiatrist near you, visit www.todayspodiatrist.com.