Foot, Ankle & Lower Leg Center: 2012

Thursday, December 27, 2012

Keep Your Feet Safe at the Gym in the New Year

Published by: The American College of Foot and Ankle Surgeons

Don’t let foot injuries keep you from your fitness resolutions

In the New Year, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. The American College of Foot and Ankle Surgeons offers tips for foot safety while at the gym.

Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries. “If you do feel you’ve sprained your ankle, be sure to seek treatment right away,” Florida foot and ankle surgeon, Brandi M. Johnson, DPM, FACFAS, explains. “Untreated or repeated ankle sprains may lead to chronic ankle instability, a condition that causes persistent pain and a ‘giving way’ of the ankle.”

Wear the right shoe and sock—Wear well-fitting athletic shoes designed for the exercise or sport. According to Dr. Johnson, shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma or a thickening of the nerve tissue, in the foot and may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.

Use good technique— improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. “Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains,” Dr. Johnson says.

Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Never go barefoot while in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. “It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria. If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to see a foot and ankle surgeon for an examination,” Dr. Johnson says.

Above all, it’s important to listen to your body. If you experience an injury or pain, call your foot and ankle surgeon.

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 3 convenient locations to serve you. To take the first step to better foot health, call today @702-878-2455, Monday thru Friday, between 9am to 5pm and closed for lunch between 1pm to 2pm. Please visit our website @ www.FallCenter.com where all of your questions may be answered and also to schedule your appointment On-line.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques. At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care. Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems.

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions. Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,

Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs: Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Tuesday, December 11, 2012

Balancing act

Published by: American College of Foot and Ankle Surgeons

The wrong boot could lead to ankle, foot injuries

Winter’s popular women’s boots typically feature tall, spiked heels and narrow, pointed toes. These boots can make your feet unstable on snow- and ice-covered surfaces.

A stylish low-heeled winter boot is a lot more fashionable than a cast and crutches. We recommend women scuff-up the soles of new boots, or purchase adhesive rubber soles, to provide greater traction.

Falls from high-heeled winter boots can lead to a number of injuries, depending on how you lose your balance. If your ankles roll inward or outward, you can break your ankles. If your ankle twists, ligaments can be stretched or torn, causing an ankle sprain. Broken and sprained ankles can be present at the same time. Slipping or falling in these boots can also cause broken toe, metatarsal and heel bones.

If you do get hurt, call a foot and ankle surgeon for prompt evaluation and treatment. In the meantime, the “R.I.C.E.” method should be followed. This involves:

Rest. Stay off the injured foot, since walking can cause further damage.
Ice. To reduce swelling and pain, apply a bag of ice over a thin towel to the affected area. Do not put ice directly against the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
Compression. An elastic wrap should be used to control swelling.
Elevation. Keep the foot elevated to reduce the swelling. It should be even with or slightly above the heart level.

Tips to avoid winter ankle injuries:

· Keep areas around outside doorways well-lit so icy patches are visible

· Wear shoes or boots with a traction sole that can prevent slipping

· Check for slippery spots before getting out of a car or walking on stairs

· Avoid wearing high-heeled shoes outdoors

· Stretch and warm up before outdoor and indoor physical activities

Call the Foot, Ankle & Lower Leg Center office located in Las Vegas and the Henderson area, which we have 3 locations to serve you. Call to schedule your appointment

@702-878-2455 between 9am to 5pm, Monday thru Friday and closed for lunch between 1pm to 2pm. Please visit our website @ www.FallCenter.com where all of your questions may be answered and to also schedule your appointment.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,

Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs: Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Performance Center.

Wednesday, December 5, 2012

Obesity Doubles Ankle Fracture Risk

Study shows severity of ankle fractures increases as body mass index increases

Obesity nearly doubles the odds of a patient having the most severe category of ankle fracture, according to research published in a recent issue of the American College of Foot and Ankle Surgeons’ Journal of Foot and Ankle Surgery (JFAS).

The study, which was conducted among 280 patients, explored the association between obesity and severity of ankle fractures. It analyzed the X-rays of each patient’s ankle fracture and classified the severity of each one. Body mass index (BMI), age, diabetes, tobacco use, osteoporosis, sex and age were then assessed alongside each patient’s ankle fracture classification. The study attests that being overweight or obese is associated with an increased risk of musculoskeletal problems; specifically in this case, increased risk of having a severe ankle fracture. The increase in weight can have grave effects on the bone and joints, increasing the risk of osteoarthritis and (potentially) the need for total joint replacement at a younger age.

Obesity (classified as BMI of 30 kg/m² or greater) is becoming more prevalent in America and so are musculoskeletal issues associated with it. The healthy ankle joint allows for normal walking, and injuries to the joint, including fractures, can have devastating effects if not properly addressed. The recent study identified a correlation between more severe ankle fractures and obesity, especially for obese men younger than 25, and obese women older than 50.

Alan MacGill, DPM, AACFAS, a Florida foot and ankle surgeon and Associate Member of the American College of Foot and Ankle Surgeons, says, “We are seeing more severe injury patterns in the obese population compared to the non-obese. These severe ankle fractures tend to have a worse prognostic outcome compared to others.”

This is likely due to the fact that severe ankle fractures tend to be higher in the fibula, above the level of the ankle joint. The twisting motion of the injury not only breaks the bone but also tears the ligaments that hold the lower leg bones (fibula and tibia) together for stability of the ankle joint.

Dr. MacGill adds, “The findings of this study correlate with what I continue to see in my practice. It’s basic physics; as body mass increases, so does the kinetic energy associated with the injury. The higher the body mass, the greater the risk of more severe ankle injury.”

There’s not much that can be done to prevent these types of injuries, as ankle fractures cannot be predicted. But bearing the results of this study, this is yet another reason to maintain a healthy diet, exercise plan and body weight to possibly help decrease the likelihood of an ankle injury being more severe.

"The ankle is a relatively small joint that bears much more force than the knee or hip. Fractures of any sort that disrupt the integrity of the ankle can have devastating consequences, such as ankle instability, post-traumatic arthritis, and chronic joint pain, especially in those who are overweight. Because of the complexity of the joint, it’s important to have these and any other ankle injuries evaluated by a foot and ankle surgeon,” MacGill says.

Please call Foot, Ankle & Lower Leg Center office located in Las Vegas and the Henderson area, which we have 3 locations to serve you. Call to schedule you appointment @702-878-2455 between 9am to 5pm, Monday thru Friday and closed for lunch between 1pm to 2pm. Please visit our website @ www.FallCenter.com where all of your questions may be answered and to also schedule your appointment.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs, Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs: Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Performance Center.

Monday, December 3, 2012

American Diabetes Association Tour de Cure

Please come and join the Tour de Cure with the American Diabetes Association on Saturday, April 27, 2013 @ The M Resort on 12300 S. Las Vegas Blvd. Foot, Ankle & Lower Leg Center will be one of the sponsors there, so please stop by our table!

Register today to STOP DIABETES!

Step 1: www.diabetes.org/tourvegas

Step 2: Once on the NV page, select "Register to Ride"

Step 3: Select, "Start a Team", "Join an Existing Team" or "Ride as an Individual"

Individuals supporting someone with diabetes or Red Riders without a team can join Team Red! Ask 15 people for $10 and your ride fee is covered!

Vegas glam and new routes from The M Resort - 8-mile, 30-mile, 65-mile and 100-mile Route Options

New VIP Perks & Dinner Friday night - Great food, energy & support - $25 registration + $150 ride free

Register today by creating a team:
There are no team member minimum numbers of riders and each rider is responsible for his or her own ride fee! So by creating a team, you have a way to get exposure for your company or group and create momentum for the ride. Team members do not need to ride the same routes during the event.

To get others involved: Simply log in and send out emails from the team page with the easy, online tools. A link to YOUR team's page will automatically be placed at the end of the email.

Ask your friends, family and work associates specifically to Join a Team or Sponsor a Rider and help create a movement to STOP DIABETES!

Most current information and route details are on the Nevada event page. For information call Tracie Patten, ADA market manager: 702-369-9995 x7483 or tpatten@diabetes.org

Five Tips for Healthy Holiday Feet

Don’t let sore, achy feet ruin your holiday season. The American College of Foot and Ankle Surgeons offers five tips to healthy holiday feet.

1. If the shoe fits, wear it—When hitting the dance floor or the shopping malls during the holiday season, don’t compromise comfort and safety when picking the right shoes to wear. Narrow shoes, overly-high-heeled ones or shoes that aren’t worn very often, such as dress shoes, can irritate feet and lead to blisters, calluses, swelling and even severe ankle injuries. “To ward off problems, choose a shoe that has a low heel and fits your foot in length, width and depth while you are standing,” says Tennessee foot and ankle surgeon Christopher Hendrix, DPM, FACFAS. “Be proactive, protective and preventive with your selection of appropriate shoes for the occasion.”

2. Don’t overindulge in holiday cheer— Did you know your feet can feel the effects of too much holiday cheer? Certain foods and beverages high in purines, such as shellfish, red meat, red wine and beer can trigger extremely painful gout attacks, a condition when uric acid builds up and crystallizes in and around your joints. “Oftentimes, it’s the big toe that is affected first since the toe is the coolest part of the body and uric acid is sensitive to temperature changes,” Dr.Hendrix says.

3. Be pedicure-safety conscious—Before you head for your holiday pedicure, remember nail salons can be a breeding ground for bacteria, including MRSA. To reduce your risk of infection, choose a salon that follows proper sanitation practices and is licensed by the state. Consider also purchasing your own pedicure instruments to bring along to your appointment.

4. Watch for ice and snow—Holiday winter wonderlands can be beautiful but also dangerous. Use caution when traveling outdoors; watch for ice or snow patches along your trail. The ankle joint can be more vulnerable to serious injury from falling on ice. “Ice accelerates the fall and often causes more severe trauma, because the foot can move in any direction after it slips,” Dr. Hendrix explains. If you do experience a fall, take a break from activities until you can be seen by a foot and ankle surgeon. Use R.I.C.E. therapy (Rest, Ice, Compression, and Elevation) to help reduce the pain and control swelling around the injury.

5. “Listen” to your feet—Don’t let foot pain ruin your holiday fun; inspect your feet regularly for any evidence of ingrown toenails, bruising, swelling, blisters, dry skin or calluses. ”If you notice any pain, swelling or signs of problems, make an appointment with your foot and ankle surgeon,” Dr. Hendrix says. “Often, especially for diabetics, what may seem like a simple issue can turn into a larger problem if medical care is delayed.”

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Thursday, November 8, 2012

Diabetic Foot Care Guidelines

Published by the American College of Foot and Ankle Surgeons
Diabetes can be dangerous to your feet – even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result you could develop a blister or a sore. This could lead to an infection or a non-healing wound that could put you at risk for an amputation.

To avoid serious foot problems that could result in losing a toe, foot, or leg, follow these guidelines.

Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.

Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. Use only lukewarm water – the temperature you would use on a newborn baby.

Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and carefully dry between the toes.

Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes – that could encourage a fungal infection.

Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toe nails. If you have concerns about your nails, consult your doctor.

Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.

Wear clean, dry socks. Change them daily.

Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).

Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.

Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.

Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.

Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.

Take care of your diabetes. Keep your blood sugar levels under control.

Don’t smoke. Smoking restricts blood flow in your feet.

Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Monday, November 5, 2012

What causes foot pain and how to deal with it...

Published by Tampa Bay Times

Imagine walking around the earth — about 25,000 miles — four times. That's how many miles the American Podiatric Medical Association estimates the average person puts on his or her feet in a lifetime. But most of us don't pay much attention to our feet until they hurt — and sometimes we wait until they really hurt.

That's too bad. Because if you seek help early, "most people can be treated with conservative measures," said Dr. Heidi Stephens, a foot and ankle surgeon and associate professor of orthopaedic surgery at USF Health.

Address your foot pain early, and you'll likely relieve it with simple measures such as bracing, taping, padding, stretching, changing shoes, placing orthotic inserts in shoes, taking anti-inflammatory medication or steroid injections. If all that fails, then "we talk about surgical options," Stephens said.

Most foot problems can be prevented, and the ones that can't — bunions, for example, may be genetic — can at least be minimized with commonsense measures. And that doesn't mean being sentenced to life in ugly shoes. "We know we're fighting a losing battle on that one," said Dr. Timothy Runyon of St. Anthony's Hospital and the Tampa Bay Sports Medicine Center in St. Petersburg.

"Women love their high heels. Instead, I try to educate women and help them at least find the appropriate high-heeled shoes and make sure they fit properly." More on that later. First, take a load off your feet and read about the most common foot problems and how to deal with them.

1. Bunions

Bunions are those bony bumps on the side of the foot at the base of the big toe. As they grow, they cause the toe to turn in, toward the second toe.

Causes: Genetics, foot shape, flat feet and wearing tight shoes all put too much pressure on the big toe joint.

Symptoms: Pain, redness and swelling at the base of the big toes; other toes may become painful as the big one crowds them.

What to avoid: High heels, narrow shoes and shoes with a pointed toe box.

What to do: Anti-inflammatory medication, orthotics in shoes to improve arch support and relieve pressure on toes, wearing a foot splint at night.

Next steps: When other toes become painful, you can't find comfortable shoes or daily activities are disrupted, you might consider surgery. Most procedures involve shaving down the bump and realigning the bones of the big toe; usually outpatient. Recovery varies depending on procedure chosen. "The one I like has you walking without crutches in two or three days," said Stephens. "You can do low-impact exercise in two months and high-impact in three months. No shoe shopping for six months."

2. Heel pain or plantar fasciitis

Plantar fasciitis strikes along the bottom of the foot, the ligament that supports the foot arch and connects the heel bone to the toes.

Causes: A weak arch that allows the foot to roll inward, or pronate; flat feet; tight calf muscles or Achilles tendons; running, walking or standing for long periods especially on hard or irregular surfaces; aging; being overweight; wearing shoes that don't fit well, are worn out or are poorly cushioned.

Symptoms: Pain while walking or standing, especially with first steps of the day or after rest. You may find pain improves with activity, then worsens as the day progresses. Foot pain, while climbing stairs or standing on toes (to reach high, for example) also is a sign to watch for.

What to avoid: Don't go barefoot; take a break from pounding exercise like running and jumping rope.

What to do: Stretch the foot and calf muscles with simple exercises throughout the day. Wear shoes with good arch support and well-cushioned soles. Try orthotics to improve arch support and cushion the heel. Lose weight. Try anti-inflammatories. In severe cases, steroid injections, physical therapy or wearing a walking cast to force the foot to rest can be tried.

Next steps: Only about 5 percent of people may need surgery, which usually involves cutting the plantar fascia ligament to release tension along the bottom of the foot. According to Stephens, patients can be up and walking within a couple of days and must wear a protective boot for two to three weeks.

3. Neuroma

Also known as Morton's Neuroma, this is a swollen, thickened nerve in the ball of the foot that can feel like your foot's on fire.

Causes: Toes squeezed together because of tight, narrow shoes, especially high heels.

Symptoms: Sharp, shooting, burning pain in the ball of the foot (usually between third and fourth toes) that worsens with walking.

What to avoid: Tight, high-heeled and/or pointed shoes. Sports and activities that put pressure on the toes.

What to do: Get shoes with lots of toe room; use ice and anti-inflammatories. Get pads for the ball of the foot. Use a device that spreads the toes so they don't squeeze the nerve. Try steroid injections.

Next steps: "This is one you want to treat early to prevent chronic inflammation and swelling, which can cause a wad of scarring around the affected nerve," said Stephens. If it gets too severe, surgery can be performed to remove the affected nerve through an incision on the top of the foot.

4. Achilles tendon problems

Also known as tendonitis, this involves the tendon that connects the calf muscle to the heel bone and allows you to stand up on your toes or push off from your toes when you walk or run. Overuse and abuse, such as during sports, can cause tiny tears in the tissue around the tendon. In severe cases, the tendon can tear or rupture completely.

Causes: This can happen to athletes who engage in repeated pushing off or stop and go movement. But it also happens to out-of-shape middle-aged people who suddenly put a lot of stress on the tendon, or who fail to warm up before exercise. Shoes with poor arch support can be a factor. But an actual rupture usually only happens during vigorous exercise or sports.

Symptoms: Swelling in the ankle area, mild to severe pain that may come on gradually or occur only with walking and running. Athletes notice weakness, less foot strength or less movement in the ankle. A rupture of the tendon usually causes a sudden, sharp pain, a popping sound and collapse.

What to do: Rest — for weeks or even months. Anti-inflammatories, stretching, well-cushioned shoes, shoe inserts such as a wedge-shaped heel lift. Immobilizing the ankle with a walking boot or a lace-up brace. "For many athletes, the ankle brace is all they need to continue their sport," said Stephens. Physical therapy may be prescribed.

Next steps: In severe cases, surgery can be performed to repair the tears or reattach the ruptured ends of the tendon.

Wait! There's more! More reasons your feet hurt:

• Calluses, corns, blisters: Generally develop from poorly fitting shoes or even socks.

• Warts: Caused by a virus and can spread. May need to be professionally removed!

• Ingrown toenails: Avoid by keeping nails cut straight across.

• Toenail fungus, athlete's foot: Can be addressed by keeping feet dry, changing shoes and socks often, avoiding tight shoes. If you get pedicures, bring your own instruments and sanitize them at home. Medication and laser therapy are available for fungus if it's really bothersome.

• Swelling of feet or ankles: Can be caused by poor blood flow, injury, medication side effects, heart, liver, kidney disease. If one leg swells painfully, you may have a blood clot. Seek medical help right away.

• Peripheral neuropathy: Poor blood flow to the feet; bumps and sores become easily infected. Caused by, diabetes and certain drugs, particularly those for cancer.

• Arthritis: May cause painful deformity of the toes.

• Gout: Causes pain, redness, swelling in big toe. See your doctor. Medication and diet changes can help.

• Heel spurs: A bony growth usually from ill-fitting shoes, standing for long periods or being overweight.

TIPS FOR SHOE SHOPPING

What woman hasn't suffered through an event wearing a pair of killer shoes, complete with pointy toes or staggeringly high heels — or both? An occasional evening won't do too much damage, provided you don't topple off your sky-high heels and break an ankle.

But if you love heels, consider a stylish pair of platforms rather than thin-soled shoes. "They have more stability in the long run. The shoe should be inflexible in the forefoot and the heel area firm," says Dr. Timothy Runyon of St. Anthony's Hospital and the Tampa Bay Sports Medicine Center in St. Petersburg.

This Rockport Women's Janae Platform Pump ($78 to $140 at amazon.com) fits the bill. Alternate with lower heels to protect your Achilles tendon — try walking from your car to the office in comfier shoes, then slip on the heels. But note: Ballet flats aren't so great for your feet either. You're better off with a low heel and good arch support.

You live in Florida, you wear flip-flops. The cheap flimsy ones may seem fun, but your feet won't think so, especially if you have plantar fasciitis. Invest in a pair with some arch support like these from Spenco ($44 at Zappos). They're particularly comfy if you have bunions. But remember, they're not for distance walking — gripping them with your toes causes strain over the long haul.

Minimalist running shoes — some of which, like this ZEMgear Men's Terra Barefoot Running Shoe ($70 at runoutlet.com) even fit your toes like gloves — are all the rage. But not among doctors.

"I'm seeing lots more fractures in athletes who use them for long distances and competitions. They're not designed for that," said Runyon, who is team podiatrist for the Tampa Bay Rays and runs marathons in his spare time. Save these trendy numbers for short, 15-minute runs on grass, he advises.

Most of us could use more support, especially for sports. These Brooks Adrenaline GTS 12 shoes are lightweight but supportive enough to win praise from a man who's a 260-pound triathlete.(Similar models are available for women.) They're $110 at Zappos. But unless you're familiar with running shoes, you'd do well to go to a local vendor like Feet First to be fitted with shoes that meet your needs. As Runyon noted, your dress shoe size may not be the same as your athletic shoe size.

Also, when was the last time you had your feet measured? If it's been a while, it's probably time to have a proper measurement taken, especially if you've lost or gained a significant amount of weight, or if you've had a baby. Over time, feet can get both wider and longer, and denial will only lead you to the foot doctor.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays. Your treatment plan is designed to resolve your condition without surgery whenever possible. When surgery is needed, your feet are in the hands of leading physicians with expertise in the latest minimally invasive techniques. As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs, Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following “Center of Excellence” treatment programs: Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Performance Center.