Foot, Ankle & Lower Leg Center

Monday, February 27, 2012

High Heels Are Leading Cause of Ingrown Toenails

Posted on: Newswise; Source:Loyola University Health System

Newswise — High heels can cause a number of foot problems, yet most women aren’t willing to give their shoes the boot, according to podiatrists at Loyola University Health System (LUHS). Ingrown toenails are among the most common problems that result from high heels. This condition, also known as onychocryptosis, occurs when the toes compress together making the big toenails grow into the skin.

High heels and tight-fitting or pointed-toe shoes are a leading cause of ingrown toenails. These shoes create chronic pressure on the big toenails and prevent them from growing properly. Additionally, shoe pressure can cause the nail to puncture the skin leading to infection. Other causes can include trauma to the nail or fungal infections.

“Ingrown toenails can be painful, but many women are willing to cope with the discomfort in order to continue wearing their high heels,” said Rodney Stuck, DPM, professor of Podiatry Medicine, LUHS. “However, more serious complications can arise and cause permanent damage to the toenail, if they are left untreated.”

Dr. Stuck encourages women who wear heels to take these steps to manage ingrown toenails and prevent infection:

•Cut out a cardboard tracing of each foot and attempt to place it in the shoe when shopping for a new pair. If it does not fit, then the shoes are too narrow;
•Refrain from wearing tight hosiery;
•Limit the amount of time in heels;
•Wear heels on days that require limited walking or standing;
•Trim toenails straight across the top;
•Short soak of feet in lukewarm, soapy water or Epsom salts;
•Dry feet and toes thoroughly with a clean towel;
•Use a mild antiseptic solution on the toes.

If pain, swelling and discharge develop, the toe is likely infected. It will need to be treated by a podiatrist who may remove a portion of the affected nail to aid in treating the infection. If the condition recurs or persists, permanent removal of the nail can be accomplished with a minor, in-office surgical procedure.

Dr. Stuck warns that people with diabetes should be particularly careful of ingrown toenails. These individuals may have poor circulation, which makes healing difficult. They also may be more susceptible to nerve damage from their diabetes, which can prevent them from feeling pain in their feet.

“If diabetic women do not feel discomfort, they may neglect to treat the ingrown toenails until it is too late,” Dr. Stuck said. “If ignored, this condition, which is easily treatable, can lead to an amputation.”

In general, if you give your feet the attention they need, they will look and feel healthy. A bit of extra care will allow women who prefer fashionable high heels to continue to wear them.

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. 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!

Wednesday, February 15, 2012

Take the right steps to deal with bunion pain

Published: The Patriot-News

High heels can contribute to bunion pain.

Julie Rich had been battling a bunion since she was in middle school.

The 35-year-old Hampden Twp. woman recounts years of frustrating shopping trips to find shoes that she could tolerate and painful years of suffering with those she couldn’t.

“I kept wearing high heels; you know, sometimes fashion is important. But it got to the point where I couldn’t wear high heels anymore or any shoes at all, really,” said Rich, who, as a medical resident several years ago, finally elected to have surgery.

Rich isn’t alone in suffering with bunions. Statistics from the National Institutes of Health say almost 4.5 million people deal with them annually.

What exactly is a bunion?

“A bunion is a slow dislocation of the big toe joint,” said Dr. Helen Gold, podiatrist with Zlotoff, Gilfert, Gold & Associates in Hampden Twp. “The big toe is moving laterally toward the other toes and the metatarsal bone is moving away from the foot. The bump you see is actually the joint sticking out of the bone.”

Bunions are often thought of as being hereditary, but it’s really the foot structure that makes one prone to bunions that is hereditary, said Dr. Allan Grossman of the Harrisburg Foot and Ankle Center, with locations in Lower Paxton and Hampden townships.

The bunion is “a symptom of things like flat foot, abnormal foot structure, alignment or injury,” he said.

Certain shoes, particularly high-heeled, narrow or tight shoes and those with no support, such as flip-flops, can bring bunions on faster, podiatrists say. Both men and women can get bunions, but women tend to get them more because they won’t give up their fashionable heels.

Michelle Altland puts herself in that category. The 45-year-old Dillsburg woman said she wore heels constantly even after she started developing a bunion in her early 30s.

“I noticed my toe was starting to turn toward the other toes, but I didn’t do anything about it. At that age, I was still thinking I was invincible and assumed everything would be fine,” she said.

After she began working for a podiatrist, she got a foot X-ray and found out she had something called hallux ridgidus, which is decreased joint space in the big toe that causes pain and can contribute to a bunion, she said. She tried a cortisone shot and custom orthotics and finally gave up her heels — to no avail.

She had a successful bunionectomy several years ago and remains bunion free. “It took about three months after surgery until I realized, wow, I’m walking with no pain,” she said. “I wish now that I would’ve done it sooner.”

Doctors said they see bunions in patients of all ages, even those as young as 8 to 10 years old. Initial symptoms are often aches in the joint of the big toe when walking or standing. Other symptoms include the classic red bump on the side of the big toe, pain aggravated by pressure from shoes and the big toe turning toward the other toes.

“I advocate seeing a podiatrist as soon as you see symptoms because if you get help young enough, you can stop or slow down the deformity by doing strengthening exercises to build up the muscles. You can also wear an insert to hold the foot up to where it should be,” Grossman said.

On an initial visit, Grossman said he does a gait evaluation first to look for the mechanism that is causing the bunion and then look for ways to address it.

Before surgery, there are other things that people suffering with bunions can try.

“The most important thing is the type of shoe you wear,” Gold said. “The best type is a wide, smooth shoe with good arch support. Collapsing of the arch makes bunions happen faster.”

Flip-flops are about the worst type of footwear possible for people with bunions, she said. She also cautioned against shoes with a heel of more than two inches and shoes that are narrow in the front.

Patients can also try splints or pads, which will not correct the bunion but can ease the pain, or orthotics, which are custom-molded plates for the shoe that control the motion of the foot and prevent the metatarsal bone from moving away from the toes.

“If we see a bunion starting in a young person, we try orthotics right away to try to avoid surgery,” Gold said.

Of the hundreds of people they treat for this common foot problem, the minority opt for surgery, doctors said.

“Plenty of people live just fine with their bunions their entire life. However, if a bunion hurts so much that it is interfering with ability to do things or if it’s starting to push on the second toe and go under it, causing a hammer toe of the second toe, then we look at surgery,” Gold said.

There are about 100 kinds of bunionectomies that doctors perform, depending on what X-rays show about the structure of a person’s foot. The surgeries, which are usually outpatient, can involve breaking the metatarsal bone, removing the bump and realigning the soft tissue and joint. Sometimes a pin is inserted to hold the bone in place.

Rich began physical therapy before her surgery and continued it afterwards for a total of two to three months. “When you have a bunion, you adapt your walking to it so you need to readapt,” she said.

She was on crutches for three months after her surgery and took two weeks off work. “The surgery I had was very involved and intense, but in retrospect, it was worth it,” said Rich, who is still bunion free.

Living with bunions:

· Wear comfortable shoes that conform to the shape of your foot.

· Wear shoes with a wide and deep toe box.

· Always fit the larger foot — caused by the bunion — and have your feet sized each time you purchase shoes.

· Apply a commercial, non-medicated bunion pad around the bony prominence.

· If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling.

· Avoid high-heeled shoes over 2 inches tall.

· Seek professional podiatric evaluation and assistance with uncomfortable or noticeable bunions.

Source: American Podiatric Medical Association

Wednesday, February 8, 2012

What your feet could be telling you about your heart

If your feet and legs show signs of peripheral arterial disease, it's possible your heart health is at risk as well
Posted on: Michigan Live

If you’re wondering about the health of your heart, try looking at your feet.

The lowly, stepped-on, shoe-squished foot could very well hold clues about the state of your coronary arteries. If your feet show signs of poor circulation – or peripheral arterial disease – your heart could be suffering as well.

The feet may not invoke the same romantic notions as the heart – few sonnets or love songs are written in their honor – but they deserve a little love, podiatrists say.

The Michigan Podiatric Medical Association, as part of February’s heart health emphasis, is urging people to have a simple test to check circulation in their feet for signs of PAD, which occurs when the arteries become narrowed by plaque.

Many people have no symptoms of PAD during the early stages. By the time symptoms are noticeable, the arteries often are significantly blocked.

The classic symptoms of PAD – pain in the legs when walking or at rest – occurs in only 10 percent of the patients, said Dr. Gregory Pellizzon, an interventional cardiologist with Saint Mary’s Health Care. And even those symptoms can be confusing. Patients often wonder if the ache in their legs comes from aging or arthritis.

Some also have symptoms of heart disease, such as shortness of breath and discomfort in the chest, but don’t realize it because the pain in their legs limits their activity.

“It’s really hard sometimes to quantify what is slowing someone down,” he said.

“I think podiatrists are great at picking up on PAD,” Pellizzon added. “They know what to look for in terms of skin changes, leg changes and the signs on their feet. Nine times out of 10, they’re right.”

Dr. Marisha Stawiski, a Grand Rapids podiatrist, says she regularly checks patients for the subtle signs that could indicate PAD.

A loss of hair on the feet is one possible sign of poor circulation. That doesn’t mean that people who have always had smooth, rather hairless feet have PAD, she said.

“But if you have somebody with a lot of body hair and none on their feet and ankles, it could indicate an arterial issue,” she said.

Different pulses, very cold feet or a change in color also could indicate a problem.

If she sees any signs of PAD, Stawiski recommends a simple, non-invasive test called an ankle-brachial index. It compares the blood pressure in the ankles to the blood pressure in the arms.

The earlier PAD is diagnosed, the more likely treatment will be effective.

Patients might enroll in a supervised exercise program, which can improve PAD and their heart health, Pellizzon said. Medication can help the arteries relax so they can walk farther.

In some cases, patients have ulcers and sores that are not healing, which can indicate tissue loss in the legs. Intervention is needed to restore circulation and save the limb. Treatments include angioplasty, stents, a bypass or procedures to remove plaque from the arteries.

Stawiski said many of her patients see cardiologists and family doctors regularly because they have diabetes or other conditions that put them at high risk for PAD. But in many cases, she sees the patients’ feet more often – every two to three months.

“It’s good to have another set of eyes on them,” she said.

Those with risk factors for PAD should be screened or tested, podiatrists say. The risk factors include:
• Being older than 50
• Smoking (currently or previously)
• Diabetes
• High blood pressure
• High cholesterol
• Personal or family history of PAD, heart disease, heart attack or stroke
• Sedentary lifestyle (infrequent or no exercise)

SOURCE: Michigan Podiatric Medical Association

Tuesday, February 7, 2012

The Best Cross Training Shoes for Women with Knee Problems

Posted on: LiveStrong.com

Cross training simply refers to participation in a variety of workouts or training regimens in addition to your specialty. Cross-training shoes, then, must provide support during activities such as jogging, bicycling, weightlifting and sprinting. If you have knee or other joint problems, be careful to choose shoes that can properly protect and support you. Check with your doctor or therapist to confirm that your shoe selection is sufficient for your needs.

Features

More than anything else, cross-training shoes need to provide support and cushion for your body. If you have knee problems, seek help from a specialist to determine if you supinate, which is leaning out with the foot, or pronate, which is rolling the foot inward. Finding this out will help you determine how much and what type of arch support you need for your cross-training shoes.

Women's New Balance 1225

The women's New Balance 1225 cross training shoe is ideal for women of average weight. The arch support and extra cushion can be particularly beneficial for women who over pronate. They are lightweight and perfect for dancing or aerobics classes, as well as for more intense, high-impact exercises.

Orthaheel Women's Action X-Trainer

If you tend to have severe knee pain, choose a cross-training shoe geared specifically to support the impacted joints. Orthaheel shoes were invented by a podiatrist. The Orthaheel Women's Action X-Trainer can provide impressive support during a wide range of workout types.

ASICS GEL-Fluent TR 2

A lot of knee pain in women is caused or aggravated by the constant shock of intense movements. Wearing the ASICS GEL-Fluent TR 2 means that each step is cushioned with a scientifically formulated gel that absorbs much of this shock, helping relieve knee pain.

Nike Women's Free Trainer 7.0.IV

The Nike Women's Free Trainer 7.0.IV is primarily designed for women who routinely do cross training that is lower impact or involves lots of lateral movements. It is an extremely lightweight shoe that provides enough support for problematic knees without slowing you down.

Thursday, February 2, 2012

New hazards for high heel wearers

Study by American Podiatric Medical Association

APMA’s survey data on women and footwear was recently featured on NBC’s Today show.

http://video.today.msnbc.msn.com/today/46235875#46235875

Thursday, January 26, 2012

Fighting the five most common foot woes

Posted on: ARA via Bastrop Enterprise

(ARA) - From eating better foods to getting an adequate amount of sleep and exercise, we're a very health-aware society. So why is it that many Americans routinely overlook one of the cornerstones of good health?

While nearly 70 percent of Americans say they want to be healthier five years from now, just 51 percent recognize that foot health can be a key to achieving that goal, according to a survey from the American Podiatric Medical Association (APMA).

"Nearly eight in 10 adults have experienced some type of foot ailment in their lives. Yet despite the pain, close to three in 10 do nothing about it, simply choosing to live with their pain," says Dr. Michael King, a podiatrist and president of APMA. "Meanwhile, more than half of those surveyed said they had endured foot pain at some point in their lives but have not sought treatment from a podiatrist."

So what are the five most common types of foot problems and what causes them? Here are some tips from today's podiatrists:

* Nail problems are one of the most prevalent foot woes in both men and women. These problems can range from ingrown toenails to fungal infections. Ingrown toenails - a condition in which the corners of sides of a nail dig painfully into the soft tissue of the nail grooves - is the most common form of nail problem. To avoid ingrown toenails, trim nails straight across and don't dig into the corners. If a toenail becomes infected, see a podiatrist immediately for treatment. Those with diabetes, peripheral vascular disease and other circulatory disorders should seek a podiatrist's care on a regular basis to help prevent complications.

* Sweaty feet and foot odor are two foot conditions that are often experienced together. While stinky feet are definitely embarrassing, feet that sweat excessively can lead to other foot problems, even creating an environment conducive to the development of athlete's foot. Closed shoes make feet sweat, but in the winter you can't avoid wearing them. Instead, practice good foot hygiene. Wash feet daily with soap and water, keep shoes and socks dry, and choose socks that wick away moisture. Change shoes and socks regularly and consider rubbing cornstarch or applying antiperspirant directly onto the soles of your feet.

* Pain in the ball of the feet - Nearly one-third of adults have reported pain in the balls of their feet. Pain in this location can be caused by over-exertion, injury or ill-fitting shoes. To avoid, always wear well-fitting, supportive and activity-appropriate shoes when walking, running or engaging in other physical activity. If necessary, replace the insoles that came in the shoes with ones that provide additional cushioning.

* Heel pain - This type of pain can have many sources, including weight gain, excessive foot flattening, muscle imbalance, injury or even improper footwear. To kick heel pain to the curb, always be sure to warm up and stretch properly before and after exercise. If wearing high heels, opt for heels that are no more than two to three inches in height. For persistent pain, treatment can range from prescribed orthotic devices and medications to cortisone injections, physical therapy and rarely, surgery.

* Bunions - A bunion is an enlargement of the joint at the base of the big toe. Treatments range from self-remedies such as using a bunion pad around the bony prominence, to ice packs to reduce the swelling, and avoiding shoes that could irritate the bunion and even make the problem worse. For persistent pain, see a podiatrist for a full range of treatment options.

"While foot problems are common, that doesn't mean people should be resigned to living with pain," King says. "Consulting today's podiatrist can help people feel better sooner, and get back to living healthier lives."

Tuesday, January 17, 2012

Five Foot Tips to Keep Your Feet Healthy for 2012

Posted on: The Huffington Post

How to get your feet through 2012

Now that your feet have survived the partying, dining and dancing of New Year's Eve, it is now time to be nice to them again. We all make New Year's resolutions such as lose weight, exercise more, eat healthy, make more money, wear more sensible shoes -- OUCH! -- but how many people make resolutions to decide to take better care of their feet?

"The feet are the most neglected part of the body, everyone thinks they have perfect feet until they start to hurt, then they are not so perfect." The triggers to foot pain are many. Shoes, exercise and structural problems such as bunions and hammer toes can trigger foot problems as well as skin problems like corns, calluses, fissures and ingrown toenails. Medical problems can also trigger foot problems -- rheumatoid arthritis, diabetes and Raynaud's disease are the most common.

When your feet hurt, do not ignore them. Wishing and hoping is not the best form of treatment!

If you injure your foot exercising, wearing the wrong shoes or just walking too much, be aggressive in treating the problem. Home care would consist of ice, over-the-counter anti-inflammatory medications such as Advil or aspirin, rest, elevation and wrapping if necessary. Inspect your shoes to make sure they fit properly and there is adequate room for your toes to wiggle around in the toe box of the shoe. Make sure you have proper arch support in your shoes. Soft insole liners can also be placed in your shoes for instant comfort and cushioning.

Inspect your feet regularly; it can make a difference in preventing infections in your feet.

Nail fungus can start off in a tiny little area of the nail and can expand to the entire nail if not detected early. Check for cracks in the skin between your toes and heels after showering. Ingrown toenails can develop without any warning due to cutting your nails incorrectly or from tight shoes. Cut your nails straight across and round the edge with a nail file, and also check to make sure you have enough wiggle room in your shoes. Cracks in your heel are known as fissures and, if not properly cared for, can cause pain standing and walking in shoes or sandals. Using moisturizing cream with urea will help eliminate those types of foot problems.

Select the right shoe for the right activity.

Whatever sports activity you participate in, use sports-specific shoes. Running shoes are for running, aerobic shoes are for aerobics, tennis shoes are for playing tennis. Wearing shoes that are not designed specifically for the sport you are performing can lead to potential foot problems such as plantar fasciitis, arch spasms, heel spurs and tendinitis. Most athletic shoes do not have adequate arch support. Custom made orthotics made by a podiatrist or medical professional will provide the additional arch support needed. Alternatively, over-the-counter arch supports that can be found on line or at sporting good stores will also provide the necessary support your foot needs.

Home remedies for your feet can be dangerous if you do not know what is in them

Be careful when using over-the-counter home remedies because they might increase the problem. Some over-the-counter wart products have salicylic acid in them that could be dangerous if you are a diabetic or have circulatory problems. Always check the back of the package and read the ingredients and warnings.

If you are a diabetic, get regular foot checks to prevent potential foot problems

Diabetes is a small blood vessel disease and leads to circulatory problems because it will clog up the small blood vessels in your feet. The wound-healing can be prolonged due the lack of proper blood supply to the affected area. Diabetics who accidentally cut the skin on their feet or develop a skin infection because of an open sore must aggressively treat those problems. Always check your feet after bathing to ensure that there are no skin problems looming.

Friday, January 13, 2012

3 Easy Steps for Treating Dry, Cracked Heels

Posted on Yahoo

Source: 3 Easy Steps For Treating Dry, Cracked Heels

Cracked heels can be a problem, especially in the colder months when the air lends itself to dry skin. On top of that, these fissures can worsen as a result of the pressure put on your heels throughout the day - especially if you're a fan of foot-imbalancing stilettos. Along with being less-than-aethestically-pleasing, untreated cracked heels can split even further, causing pain (and in some cases, infection). Prevention is key: moisturize daily, get pedicures as needed, and drink plenty of water to save your feet. But what do you do when your cracks are already out of whack? Find out how to do your own at-home treatment when you read more.

Step 1: Soak. Before heading to bed, soak feet in warm (not hot) water for about 10 to 15 minutes to cleanse and help promote circulation in the feet. Add Epsom salts, honey, oil, or milk to soothe and soften.
Step 2: Exfoliate. Now massage on an exfoliating foot scrub to stimulate skin and slough off dead skin. Rinse off and pat dry. Other options: use Stridex pads, which contain salicylic acid, to help gently remove flaking, or a good old-fashioned pumice stone. But whatever you do, do not pick at, peel, or try to cut off dead pieces of skin. That can lead to unnecessary irritation and even infection.
Step 3: Hydrate: To finish, apply a thick lotion, salve, or cream liberally to the feet. Cover with socks and let the moisturizer work its magic while you sleep. Repeat the process every day for about a week to reveal beautifully soft heels. And if the fissures still remain, head to the podiatrist for a professional's opinion.