Foot, Ankle & Lower Leg Center

Friday, July 6, 2012

Feet Facts FAQs

Published in MedicineNet.com (reviewed by Charles Partrick Davis, MD, PhD)

Q: All babies have flat feet. True or False?

A: True. All babies have flat feet. This is because their arches are not yet formed and because baby feet tend to be plump. Flat feet may persist into adulthood, though an arch may form as the child grows.

Q: People with flat feet are sometimes clumsy from prolonged walking or running. True or False?

A: True. Flat-footed people are sometimes clumsy and fatigued from prolonged walking or running. Shoes with built-in arch supports can help with these problems.

Q: When are feet their largest?

A: At the end of the day. Feet are at their largest at the end of the day. Because of this, the end of the day is the best time to buy shoes to ensure a proper fit.

Q: Shoes with heels should be no more than how high?

A: Two inches high. Switching to lower heels will help you avoid problems with the metatarsal bones. The lower you go, the more natural your foot position will be. Dr. Hillary Brenner, a spokeswoman for the American Podiatric Medical Association recommends choosing heels that are not more than two inches high. – “Even those should be worn in moderation,” she says

Q: Which foot condition mainly affects women?

A: Bunions. Common in ballet dancers, a bunion is a painful lump at the base of the big toe, which may cause the toe to bend unnaturally. It forms when the tissue or bone at the base joint gets displaced. This may happen after years of abnormal pressure and movement. Pointy-toed shoes are a common factor, which explains the prevalence of bunions among women. Pain relievers, pads to cushion the bunion, custom shoe inserts, or surgery may help. To avoid bunions, it is best to wear roomy shoes and avoid high heels.

Q: How many bones are in the human foot?

A: 26. The human foot has 26 bones.

Q: This condition causes the deformity of the second, third, and fourth toes?

A: Hammer toe. The term hammer toe refers to a common deformity of the foot in which either the second, third, or fourth toe is bent at the middle joint, so that the tip of the toe is bent downward while the middle of the toe is cocked upward resembling a hammer. The hammer toe deformity is the most common deformity of the small toes. The condition can be present at birth or can develop as a result of wearing poorly fitting shoes.

Q: Athlete’s foot is caused by bacteria found in places such as gyms, locker rooms, and nail salons. True or False?

A: False. Athlete’s foot is caused by a fungus, not bacteria. The medical name for athlete’s foot caused by a fungus is tinea pedis and can be contracted in many locations, including gyms, locker rooms, swimming pools, nail salons, airport security lines, from contaminated socks and clothing, and from direct person-to-person by contact. Another colorful name for this condition is “jungle rot,” often used by members of the armed services serving in tropical climates.

Q: Painful inflammation of the big toe usually indicates this type of arthritis?

A: Gout. The small joint at the base of the big toe is the most common site of an acute gout attack of arthritis. An acute attack of gouty arthritis at the base of the big toe is medically referred to as podagra. Other joints that are commonly affected by gout include the ankles, knees, wrists, fingers, and elbows.

Q: Foot amputation may result as a complication of which disease?

A: Diabetes. With diabetes, proper foot care is very important. Poor foot care with diabetes can lead to serious health problems, including possibly having to remove the foot or leg (amputation). It’s important to understand the connection between diabetes and foot care. A person with diabetes is more vulnerable to foot problems because diabetes can damage nerves and reduce blood flow to the feet.

Q: What are the worst possible shoes for your feet?

A: Flip-flops. According to podiatrist Andrew Shapiro, DPM, a spokesman for the American Podiatric Medical Association, the world’s worst shoe is not spike heels or pointy boots. Instead, the worst offender is flip-flops! This is because flip-flops offer no arch support and do not protect the foot at all, leaving feet exposed and prone to injuries. The solution: Unless you’re on the beach, wear real sandals, not flip-flops – the kind with a strap in the back that at least holds your foot inside the shoe. Worst Shoe Runners-Up are spike heels, ballet flats, pointy-toes pumps, and backless mules.

Q: Metatarsalgia is a condition describing acute pain in the ball of the foot. True or False?

A: True. Metatarsalgia is the medical term for acute pain in the ball of the foot. A common overuse injury, metatarsalgia can become chronic as a result of stress and pressure on the ball of the foot. This is often caused by shoes and actions that put an abnormal amount of pressure on the ball of the foot, such as high heels and high-impact sports.

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.

Tuesday, July 3, 2012

Peripheral Arterial Disease: What You Need to Know

Reviewed by: Quality Health’s Medical Advisory Board

By Maureen Ryan

So you have a cramp in your leg. It's just part of getting older, right? Well, maybe not. Recurrent pain in the legs is one symptom of peripheral arterial disease, or PAD. Up to 12 million people in the United States are living with this circulatory disorder. Knowing the signs, risk factors, and how you can manage PAD can do more than help you avoid a few aches. It could save your life.

What is PAD?

When most people talk about having poor circulation, they're really describing peripheral arterial disease. You might also hear it referred to as peripheral vascular disease or hardening of the arteries. It's a condition in which blood can't flow well because your arteries are blocked. PAD most commonly affects the legs, but it can also disrupt blood flow to your heart, head, arms, kidneys, and stomach.

PAD often begins the same way that most other circulatory problems start. Smoking, diabetes, high cholesterol, and high blood pressure-the same factors that put you at risk for coronary heart disease-can damage the inner walls of your peripheral arteries. Lipids (blood-borne fats) infiltrate the damaged areas of your arteries, causing a buildup of fatty material called plaque. This leads to atherosclerosis in which plaque accumulates, your arteries harden, and the arterial pathways that carry blood become narrower and narrower. As pathways get narrower, blood cannot circulate to various body parts.

Why Worry?

Poor circulation can cause claudication (pain and numbness) in body parts where blood flow is restricted. Thus, arterial blockages may be the source of your leg cramp, and by the time you're feeling pain, your PAD may be very advanced. In fact, you may not start to feel any discomfort until arteries are blocked 60 percent or more.

If you don't start treating PAD at the first signs of trouble, you could see more serious symptoms such as:

· Increasingly severe pain

· Areas of the skin that are cooler to the touch (especially legs or feet)

· Skin discoloration

· Loss of body hair around the affected areas

· Sores that don't heal (usually on the toes and feet)

Left untreated, PAD can lead to severe health problems. It increases your risk of coronary heart disease, heart attack, stroke, transient ischemic attack ("mini-stroke"), and renal artery disease (disruption of blood flow to the kidneys). You can also develop gangrene, requiring the amputation of a toe, foot, leg, or arm; that risk is higher if you have diabetes.

Who Gets PAD?

PAD most often affects people who:

· Smoke

· Are 50 years or older

· Are African American

· Have diabetes

· Have high blood pressure

· Have high cholesterol

Even if you don't have any aches and pains, you should consider being screened for PAD if you fall into one or more of these high-risk groups. Many people suffer from "silent PAD," which means they have no pain or other symptoms, but they are still at risk for PAD-related health complications.

What Do I Do for My PAD?

Depending on your overall health and symptoms, you may be able to treat PAD by making lifestyle changes that include quitting smoking, eating a heart-healthy diet, and exercising. It's also important to manage high blood pressure, high cholesterol, and diabetes. Your doctor may prescribe medication to treat these pre-existing conditions or anti-platelet medications to lower your risk of heart attack and stroke. In very advanced cases, your doctor may recommend surgery to help improve blood flow to areas of the body that have poor circulation.

If PAD has affected your feet, you should practice good foot care to avoid injuries that could lead to infections. This includes keeping feet clean and moisturized, carefully cutting toenails, using foot powder, and having calluses or corns promptly treated by a podiatrist.

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.

Tuesday, June 26, 2012

Sunscreen on Your Feet

Published by: American College of Foot and Ankle Surgeons

Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and overlook applying sunscreen to the area

Doctors urge sunscreen use and exams to prevent skin cancer on feet

When at the pool or lake we all lather up with sun screen to protect our skin from the harmful rays of the sun. But do we remember to apply sunscreen to our feet?

Many don’t realize skin cancer can occur on the feet from unprotected sun exposure, and overlook applying sunscreen to the area. But, physicians from the American College of Foot and Ankle Surgeons warn skin cancer of the foot is prevalent and can even be fatal if not caught early.

While all types of skin cancer, including squamous cell and basal cell carcinoma, can be found on the foot, the most common is the most serious form, melanoma. Symptoms can be as subtle as an abnormal-looking mole or freckle found anywhere on the foot, and often go unnoticed without routine foot exams.

According to foot and ankle surgeon Thanh Dinh, DPM, FACFAS, early diagnosis is key to effective treatment for the condition. But because people aren’t looking for the early warning signs or taking the same precautions they do for other areas of the body, often times skin cancer in this region is not diagnosed until later stages.

“I advise my patients to regularly inspect their feet, including the soles, in between their toes and even under their toenails, for any changing moles or spots and to have any suspicious areas promptly examined by a foot and ankle specialist,” Dr. Dinh explains.

Sunday, June 24, 2012

Pedicure or Pedicurse? Proceed With Caution

8 ways to watch out for your tootsies at your next pedicure

Posted by: U.S. News & World Report

Short of going barefoot, nothing conjures the free spirit of summer like sandals. But given the way we treat our feet—whether we're running marathons or home from work and in shoes that pinch, press, and blister—it's no wonder they need grooming before flaunting.

Fact: Your feet require some TLC. More facts: Salon pedicures can be rife with risks. In fact, some foot baths might as well be renamed cesspools, hotbeds of germs that can lead to bacterial, viral, and fungal infection. Not to sound biblical, but customers have gone home with boils. Unsanitary tools aren't much better, and can spread infections such as hepatitis.

So the next time you treat your toes to a pedicure, follow these tips for feet as happy as they are healthy.

1. Shun the razor. Never, ever let a nail technician put a razor to your feet and be wary of doing so yourself. The practice can lead to permanent damage along with upping your risk of infection through cuts and the possible transference of blood between customers. Callouses provide cushioning between you and the ground, and removing too much of the toughened skin can make it hurt to walk. A much gentler option is to soften your feet with a pumice stone, foot file, or exfoliating scrub, according to the American Podiatric Medical Association (APMA).

2. Don't cut corners. Go for a shape that's square, not oval. Round toenails are more likely to dig into skin, causing painful ingrown toenails, says Hillary Brenner, a Manhattan-based podiatric surgeon and an APMA spokesperson.

3. Beware of the foot bath. "Do not use the foot spa if you are not sure it is disinfected and safe to use," warn the Environmental Protection Agency and Centers for Disease Control and Prevention in a fact sheet on preventing infections from salon foot spas. To reduce the risk of infection from bacteria that can grow in foot spas, salons should use an EPA-registered hospital disinfectant between each customer, and nightly, and according to the directions, which usually call for 10 minutes of disinfection, according to the government groups.

For your part, hold off on the foot bath if you have any cuts, scrapes, scabs, bruises, or open sores on your legs or feet as broken skin eases the passage of germs into your body. The EPA and CDC also include bug bites on this list, which seems to ensure no one could ever possibly be fit for a pedicure, given the coinciding seasons of pedicures and bugs. Also, skip the pre-pedicure shave to avoid causing any nicks. The APMA suggests scheduling your spa pedicure early in the morning, since "salon foot baths are typically cleanest earlier in the day." Brenner advises patronizing nail salons that use disposable plastic bins inside the foot bath to lower your risk of infection.

4. Don't feed your feet to the fish. The trend of using so-called "doctor fish" to eat up dead skin on people's feet is one you might want to skip—if your state hasn't already banned the practice. A letter published this month in Emerging Infectious Diseases found that these fish, imported from Asia to salons in the United Kingdom, carried a range of potentially dangerous bacteria.

5. Keep away from the cuticle. "The cuticle is the nail's protective barrier and should not be pushed back, which can damage it and increase the risk of infection," according to the American Academy of Dermatology, which warns that buffing nails too intensely can harm your cuticles as well.

6. Use your own tools. Because germs can spread through tools that aren't properly cleaned, it's best to bring your own. That includes emery boards, which can't be sterilized due to their porous nature. Pedicure tools can be found for a variety of prices in most beauty supply stores. Some salons even sell individual kits they then keep on hand for regular customers.

7. Skip the salon and see a podiatrist. A doctor's office doesn't exude the pampered feel of a salon. But that may be changing. Podiatrists are increasingly offering medical pedicures, which include paraffin wax for dunking and softening feet along with chemical-free, anti-fungal nail polish, Brenner says. These treatments come with a cost—anywhere from $80 to $150, says Brenner, who notes an alternative could be a simple callous removal. Inspired by the results of her own facial peels, Brenner has begun offering her patients chemical foot peels, which shed the top layer of skin to reveal smooth feet.

8. Do it yourself. For an at-home pedicure treatment, Brenner advises soaking your feet for 10 to 15 minutes two to three times a week in an Epsom salt solution, made of two cups of Epsom salt per gallon of tepid water. Follow that with a foot scrub (Brenner likes the apricot scrub by St. Ives) and a thick coating of moisturizer like shea butter. At that point, you've done most of the leg work, so to speak, and you can leave the polish to the professionals.

Warning signs. Infections from the nail salon can often look like bug bites, which worsen and enlarge and can cause pus and scarring, according to the EPA and CDC. Yellowed nails or scaling skin around the base of the foot indicate fungal infections, while anything "red and angry looking" is likely a bacterial infection, Brenner says. Determining the existence of hepatitis requires a blood test.

Thursday, June 21, 2012

Health Tip: Help Prevent Warts on the Feet

Don't walk barefoot

Posted on HealthDay News

(HealthDay News) -- Plantar warts -- warts that specifically affect the feet -- are caused by viruses and can be quite painful. Children and teens seem to get them more often than adults.

The American Podiatric Medical Association offers this advice for how to prevent warts on the feet:

· Unless you're strolling on a sandy beach, don't walk barefoot.

· Put on a fresh pair of socks each day, and alternate shoes each day.

· Make sure your feet are always dry and clean.

· Inspect your child's feet regularly.

· Do not touch warts on another person or on another part of the body.

· Pay attention to unusual growths on the skin. Seek prompt medical attention if you find any.