Foot, Ankle & Lower Leg Center

Wednesday, August 29, 2012

Stepping Back from an Active Lifestyle: Foot Pain

Plantar fasciitis can be a painful halt to an active lifestyle.

Posted on: Patch.com

I had the chance to sit down with my mother-in-law and ask her about her foot condition called plantar fasciitis, which causes heel and arch pain. The plantar fascia is a flat band ligament that attaches to the bone in the heel to the toes. If the plantar fascia gets damaged or inflamed it weakens and causes pain in the bottom of your feet.

Plantar fasciitis can affect anyone, especially people who are on their feet a lot. In addition, anatomical conditions such as high arches, flat feet, excessive pronation (rolling your feet inward) and having tight calf muscles can all have an impact on developing plantar fasciitis. Also, people who are overweight or wear poor-fitting shoes can be more prone to developing the condition.

People who have plantar fasciitis often experience pain in one foot, although it can be in both feet. They experience pain after they have been sitting and get up to walk or, if they have been standing for a long time, they have to get off their feet because of the pain.

My mother-in-law said, “I know when I wake up in the morning that I’m going to be in pain. The first few steps [I] take are the worst. However, I’ve learned how to manage the pain and my feet are functional. That’s all I can ask for.”

Doctors have several treatment options, but the first step is to manage the swelling and rest your feet. That can be a difficult thing for people who are used to an active lifestyle. There are also braces, medication and surgery that can help with the pain. You may also seek the advice of a podiatrist, who specializes in orthotics. Physical therapy may also be an option to relieve the inflammation and teach you how to strengthen the lower extremities and stretch the calf muscle.

If you suffer from plantar fasciitis and your doctor approves exercise, water aerobics is a great workout without the stress of full weight-bearing exercise.

If you suspect you could have plantar fasciitis, schedule an appointment to see your doctor. You don’t want to wait until you have severe symptoms to get treatment. Early intervention can help you get back on your feet.

Please call the Foot, Ankle & Lower Leg Center office in Las Vegas and the Henderson area anytime @702-878-2455 between Monday – Friday (9am to 5pm) and we would be happy to set up an appointment for you. Please visit our website @ www.FallCenter.com.

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 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.

Sunday, August 26, 2012

Back to School: How to Check For the Best Shoe Fit

Posted on: Patch.com

School starts in Edmonds on Sept. 5, and that means it’s a good time to check children’s feet and see if they grew during the summer.

Even though the weather is warm, flip flops and other open-toed shoes may not be the best choice for school.

“Girls often want to wear shores that are cute, I know there are cute shoes out there, but they are not always appropriate for school,” said Sandie Tracy, Health Services manager of nearby Northshore School District.

If a child is going to wear sandals to school, Tracy recommends they bring a pair of athletic shoes to school for use during physical education.

According to the American Podiatric Medical Association, there are three things to look for in a good shoe:

A stiff heel, check by squeezing both sides of the heel, it should not collapse
The toe of the shoes should bend with your child’s foot
A shoe should never twist in the middle

To make sure a child (or teen) is getting the proper fit in a shoe. The APMA has these tips:

Examine the shoe itself. It should have a firm heel counter (stiff material on either side of the heel), adequate cushioning of the insole, and a built-in arch. It should be flexible enough to bend where the foot bends—at the ball of the foot, not in the middle of the shoe.
The child’s foot should be sized while he or she is standing up and fully weight-bearing.
There should be about one-half inch of space (or a thumb’s width) between the tip of the toes and the end of the shoe. The child should be able to comfortably wiggle his or her toes in the shoe.
Have the child walk around the store for more than just a few minutes wearing the shoe with a normal sock. Ask the child if he or she feels any pressure spots in the shoe. Feel the inside of the shoe for any staples or irregularities in the glue that could cause irritation. Examine where the inside stitching hits the foot. Look for signs of irritation on the foot after the shoe is worn.
Shoes should not slip off at the heels. Children who tend to sprain their ankles will do better with high-top shoes or boots.
Both feet should be measured, and if they are two different sizes, shoes should be chosen that fit the larger foot best.

For more information on fitting and choosing shoes, check the APMA Web site.

Tuesday, August 21, 2012

Back-to-School Soccer Season

Published by American College of Foot and Ankle Surgeons

Prime time for foot, ankle injuries

Parents and coaches should think twice before coaxing young, injury-prone soccer players to "play through" foot and ankle pain, according to the American College of Foot and Ankle Surgeons.

"Skeletally immature kids, starting and stopping and moving side to side on cleats that are little more than moccasins with spikes–-that’s a recipe for foot and ankle sprains and worse," cautions Christopher Hendrix, DPM, FACFAS, a Memphis, Tenn. foot and ankle surgeon.

"Kids will play with lingering, nagging heel pain that, upon testing, turns out to be a stress fracture that neither they, their parents, nor their coaches were aware of," he said. "By playing with pain, they can’t give their team 100 percent and make their injuries worse, which prolongs their time out of soccer."

Hendrix said he has actually had to show parents x-rays of fractures before they’ll take their kids out of the game. "And stress fractures can be subtle–-they don’t always show up on initial x-rays."

Stress fractures, Achilles tendonitis, heel pain, ankle sprains, broken toes

Symptoms of stress fractures include pain during normal activity and when touching the area and swelling without bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and often require surgery, such as a break in the elongated bone near the little toe, known as a Jones fracture.

Constant running in soccer can place excessive stress on the foot. Pain from overuse usually stems from inflammation, such as around the growth plate of the heel bone, more so than a stress fracture, according to Hendrix.

"Their growth plates are still open and bones are still growing and maturing–-until they’re about 13 to 16. Rest and, in some cases, immobilization of the foot should relieve that inflammation," he said.

Hendrix added that Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes) are other types of overuse injuries.

Quick, out-of-nowhere ankle sprains are also common to soccer.

"Ankle sprains should be evaluated by a foot and ankle surgeon to assess the extent of the injury," said Hendrix. "If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture," Hendrix said.

Collisions between soccer players take their toll on toes.

"When two feet are coming at the ball simultaneously, that ball turns into cement block and goes nowhere. The weakest point in that transaction is usually a foot, with broken toes the outcome," he explained. "The toes swell up so much the player can't get a shoe on, which is a good sign for young athletes and their parents: If they are having trouble just getting a shoe on, they shouldn't play."

Treat injuries immediately

If you think your child has suffered any sort of foot or ankle soccer injury, consult a foot and ankle surgeon right away.

Monday, August 6, 2012

Foot Health Facts for Diabetics

Published by: American College of Foot and Ankle Surgeons (ACFAS)

Having diabetes increases the risk of developing a wide range of foot problems, often because of two complications of the disease: nerve damage (neuropathy) and poor circulation.

For those with diabetes, small foot problems can turn into serious complications, including:

· ulcers (sores) that don’t heal

· corns

· calluses

· cracked heels

· hammertoes

· bunions

· ingrown toenails

Untreated diabetes can result in other conditions, such as:

Diabetic peripheral neuropathy – this condition doesn’t emerge overnight. Instead, it usually develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy.

Charcot foot - a condition in which the bones of the foot, are weakened enough to fracture. With continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

To prevent complications of diabetes, patients are advised to follow diabetic foot care guidelines. Sometimes special diabetic shoes are prescribed to avoid pressure and rubbing on the feet caused by regular footwear.

Friday, August 3, 2012

Foot Injuries in Olympic Athletes and Beyond

Foot and Ankle Surgeons Offer Tips for Athletes of All Levels

Published on: American College of Foot and Ankle Surgeons (ACFAS)

The 2012 Summer Olympics have arrived, and according to foot and ankle surgeons from the American College of Foot and Ankle Surgeons (ACFAS), intense play performance throughout the games can cause an increased risk for foot and ankle injuries.

From plantar fasciitis to Lisfranc injuries to ankle sprains and stress fractures, Olympic athletes, including Jason Burnett, Jon Horton, Chellsie Memmel, Sam Mikulak, McKayla Maroney and others have dealt with their fair share of injuries as they prepared for and now compete in the Summer Games.

According to Maryland foot and ankle surgeon and Fellow member of ACFAS, Timothy Swartz, DPM, FACFAS, “One of the most common athletic foot injuries, plantar fasciitis, is a painful injury that is most commonly found in those who are on their feet a lot, like athletes. It can be caused by abnormally high or low arches, insufficient support in footwear or simply putting too much strain on one’s feet.”

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.

Plantar fasciitis is often treated conservatively with a period of rest, physical therapy, anti-inflammatory medications, orthotics and stretching.

While plantar fasciitis is considered a heel injury, a Lisfranc injury occurs in the mid-foot region, where the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The Lisfranc ligament is a tough band of tissue that joins two of these bones. This is important for maintaining proper alignment and strength of the joint. Injuries to the Lisfranc joint most commonly occur in athletes such as runners, horseback riders, football players and participants of other contact sports, or can occur from something as simple as missing a step.

“Although plantar fasciitis and Lisfranc injuries don't have a lot in common, what they do have in common is that they can be chronically symptomatic and it may be difficult to get an athlete back to his or her previous level of activity in a short period of time. A Lisfranc injury can also be mistaken for a foot sprain, but when not diagnosed and treated early, it can lead to more serious complications in the long run. Lisfranc injuries may occasionally be treated with immobilization and rest, but most require surgery to stabilize the joints. The specific mid-foot joints that are stabilized depend on the ligaments that are injured and may vary somewhat on a case by case basis,” Swartz said.

Other common injuries seen in athletes are ankle sprains and stress fractures. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

Stress fractures, on the other hand, are tiny, hairline breaks that can occur in the bones of the foot. According to Dr. Swartz, they can be caused by overtraining or overuse, improper training habits or surfaces, improper shoes, flatfoot or other foot deformities, and even osteoporosis. These tiny breaks in the bones of the feet can lead to a complete break if left untreated.

Athletes of all levels can benefit from these injury prevention tips from the American College of Foot and Ankle Surgeons to help keep them at the top of their game:

Wear supportive shoes. 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. Never wear flip flops or leisure shoes for athletic activities.
Remember to stretch after warming up as well as following rigorous playing to increase blood flow to the muscles and allow for more flexibility so injuries can be avoided.
And remember, just because you can walk on it doesn’t mean it’s ok to do so; Stress fractures may take days to appear in the form of bruising or swelling.
If injured, athletes should remember RICE: Rest, Ice, Compression and Elevation, and make an appointment with their local foot and ankle surgeon if the injury is not improving after a few days.

Sunday, July 29, 2012

Test of best sneakers for walking

One moderately priced pair gets high marks for comfort, cushioning and more.

By Good Housekeeping Research Institute | Good Housekeeping

After sizing up the new field of featherweight walking shoes, testers made the greatest strides in these pairs:

Easy Spirit Reinvent Walking Sneakers

(Photo: Easy Spirit)
GHRI Rating: A

Pros:

Consumer testers found this sneaker comfortable and fairly supportive
Most consumer testers liked the fit of the sneaker
Consumer testers thought these sneakers cushioned their feet well

Cons:

A few consumer testers thought this sneaker ran a half size big

Easy Spirit's Reinvent walking shoes earned rave reviews from our consumer testers. These affordable sneakers "feel like slippers," said one enthusiastic reviewer, while another praised that they "fit well and felt like I had nothing on my feet." That's likely due to the shoe's minimal design; its mesh upper and stretch lining allows the shoe to "hug or conform to the foot," says Karen Langone, D.P.M., a specialist in sports and fitness medicine in Southampton, N.Y., who evaluated the sneakers.

Though it looks similar to a regular running shoe, the Reinvent is lightened by the omission of a rubber outsole. The flexibility of the shoe can help strengthen the muscles of the foot, says Paul Langer, D.P.M., of Twin Cities Orthopedics. He cautions though that, for some, it "can also increase strain." If you love the shoes but are worried, ease yourself into the pair by increasing your mileage gradually. And be cautious wearing this pair out in the rain — Langer says the lack of an outsole might mean reduced traction on wet surfaces.

Bottom line: While some testers complained that they don't offer a ton of arch support, this pair is plenty comfortable and testers liked the amount of cushioning. High marks in nearly every category from consumer testers made the Reinvent an easy pick for the best tested lightweight walking sneakers.

Colors: Black, Grey/Purple, Navy/Charcoal, Medium Grey/Light Grey, Wine/Off White
Sizes: 5-11; Weight: 6.2 ounces; Price: Starting at $64.99

Rockport TruWalk Zero Walking Sneakers

(Photo: Rockport)
GHRI Rating: A-

Pros:

Consumer testers found this sneaker comfortable and fairly supportive
Consumer testers liked the fit of the sneaker
Consumer testers thought these sneakers cushioned their feet well

Cons:

Some consumer testers thought the sneaker felt slightly unstable because of the rounded sole
Expensive

The priciest shoes in our test, the Rockport TruWalk Zero sneakers also received one of the best scores from our consumer testers for fit. The pair "felt like I was walking on air," commented one tester, and, with its high-tech appearance, another thought the shoe was "great for walking and looks good too."

The Rockports feature a thicker, slightly rounded heel, which works to reduce strain on the foot. However, some users found that it made them somewhat unsteady in the shoe. However, because these sneakers are higher in the heel (compared to the forefoot) than other pairs we looked at, they might be beneficial for walkers with plantar fascia or Achilles issues, according to Karen Langone, D.P.M., a specialist in sports and fitness medicine in Southampton, NY.

For their good fit and comfort, these shoes were an easy pick for runners-up for our favorite lightweight walking sneaker.

Colors: Black/Gull Grey/Lavender, Warm Grey/White/Salmon Pink
Sizes: 5-11; Weight: 6.8 ounces; Price: $90, 6pm.com

Ryka Dash Walking Sneakers

(Photo: Ryka)
GHRI Rating: A-

Pros:

Consumer testers found this sneaker comfortable and supportive
Consumer testers liked the fit of the sneaker
Consumer testers thought these sneakers cushioned their feet well

Cons:

On the heavier side for a lightweight walking sneaker

Not quite ready to make the jump into a really lightweight walking sneaker? The Ryka Dash offers a great compromise. While it was one of the heavier shoes in our test, at 8.5 ounces, it still won't weigh you down. Plus, for that extra heft, you get more structure than other lighter walking shoes provide. The thicker midsole and rubber outsole give it better traction, according to Paul Langer, D.P.M., of Twin Cities Orthopedics, who evaluated at all the sneakers in our test. Of the shoes in our sample, the Rykas "would be the best choice for someone who is prone to foot pain," he said.

Our consumer testers didn't mind the extra weight either, rating the shoe highly for fit, feel, support, and cushioning. The sneakers were "extremely comfortable from the start," praised one volunteer, and another said the shoes were "very cushiony and airy when you first put them on." While not all were fans of the sporty look, its great fit trumped all, making it a solid pick for a walking sneaker.

Colors: Chrome Silver/Bougainvillea/Steel Grey, Metallic Lake Blue/Chrome Silver/Steel Grey/White, Black/Purple Wave/Metallic Steel Grey, White/Chrome Silver/Meadow Mauve/Steel Grey
Sizes: 6-11; Weight: 8.5 ounces; Price: $50, amazon.com

New Balance 895 Superlight Superfresh Walking Sneakers

(Photo: New Balance)
GHRI Rating: A-

Pros:

Consumer testers found this sneaker comfortable and fairly supportive
Consumer testers liked the fit of the sneaker
Consumer testers thought this sneaker cushioned their foot fairly well

Cons:

Some consumer testers didn't love the look of the sneakers

The New Balance 895 Superlight Superfresh may be the best of both worlds: While this sneaker is light, it still offers plenty of support and cushioning. In fact, testers found this shoe to be among the most comfortable in our test. "Feels like I'm stepping on yoga mat," one tester stated, and another said it, "felt like walking on clouds!" Most testers weren't big fans of the look, however, with one commenting they reminded her of "old lady" shoes, and another saying she would only buy a pair if it came in more "subdued" colors.

Though the sneaker is flexible, be wary of wearing it in wet conditions or on uneven surfaces, says Paul Langer, D.P.M., of Twin Cities Orthopedics who reviewed all of the sneakers in our test; the shoe lacks a rubber outsole, so it doesn't offer great traction, he said. Nonetheless its good fit and lightweight support make it one of our top picks for a lightweight walking sneaker.

Colors: Silver/Grey, Black/Grey/Yellow, White/Pink
Sizes: 5-12; Weight: 6.3 ounces; Price: Starting at $79.95

Easy Spirit RealLife Walking Sneakers

(Photo: Easy Spirit)
GHRI Rating: B+

Pros:

Consumer testers found this sneaker comfortable
Consumer testers liked the fit of the sneaker
Consumer testers thought these sneakers cushioned their feet well

Cons:
Consumer testers did not find this sneaker very supportive

Due to the strap fastening instead of laces, "easy to put on and take off" was one of the most popular attributes of this shoe among testers. Several testers compared these sneakers to slippers. One even went so far to say that they felt "like walking on pillows." Unfortunately, that soft, unstructured feel also led testers to complain that the shoes lacked the support they were looking for in a good walking sneaker. Most weren't big fans of the style either.

Easy Spirit eliminated the rubber outsole, which may mean less traction on wet surfaces, according to Paul Langer, D.P.M., of Twin Cities Orthopedics, who evaluated all of the sneakers in our test.

For the price, the shoes are a good alternative to lace-up walking sneakers, but if you're looking for a serious workout sneaker, you may want to look elsewhere, according to Karen Langone, D.P.M., a specialist in sports and fitness medicine in Southampton, NY, who also reviewed our test shoes. The Easy Spirits "could be a good shoe for casual wear," she said, "but may not suit all for fitness walking."

Colors: Blue Silver, Beige Gold, Sizes: 5-11, Weight: 6.5 ounces, Price: $55 at Amazon

Skechers GoWalk Walking Sneakers

(Photo: Skechers)
GHRI Rating: B

Pros:

Consumer testers found this sneaker fairly comfortable
Consumer testers thought these sneakers cushioned their feet fairly well
Extremely lightweight

Cons:
Consumer testers did not think this sneaker was very supportive

The number one comment from our testers was that the Skechers GoWalk sneakers were "comfortable." Our testers liked the "squishy" cushioned sole in these shoes too, but the lack of arch support left many wanting more. The sneakers come in a fun palette of bright colors, but a number of testers felt that these lace-less shoes definitely weren't their style. On the plus side, at 4.2 ounces, the Skechers were easily the lightest pair in our test, and they also came in at the lowest price. But you'll want to think twice before picking up this pair for serious workouts; the shoes are best for casual wear, not walking workouts, said Karen Langone, D.P.M., a specialist in sports and fitness medicine in Southampton, NY, who reviewed all the shoes in our test.

Colors: Aqua, Black, Pink, Navy, Purple, Gray; Sizes: 5-11; Weight: 4.2 ounces
Price: $59 at onlineshoes.com

Avia A9616W Walking Sneakers

(Photo: Avia)
GHRI Rating: B

Pros:

Consumer testers found this sneaker fairly comfortable and supportive
Consumer testers thought this sneaker cushioned their foot fairly well

Cons:

On the heavier side for a lightweight walking sneaker

The Avia A9616W shoes feature a rounded sole for a "rocker" effect, but you'll want to be sure to stick to firm, flat surfaces on your walks, warned Paul Langer, D.P.M., of Twin Cities Orthopedics, who evaluated all of the shoes in our test. "Any uneven surface can increase the risk of falls" in this pair, he said. Testers also complained of feeling "off-balance" and "unstable" and wished the shoes offered more support for lengthy walks. These shoes were among the heaviest in our test, and our volunteers didn't love the look, but several consumer testers appreciated the breathable mesh upper and several commented on the shoe’s comfortable feel.

Colors: Chrome Silver/Zuma Pink/White, While/Bouganvilla/Chrome Silver, Black/Detox Blue/White
Sizes: 5.5-11; Weight: 9.0 ounces; Price: Starting at $33