Foot, Ankle & Lower Leg Center

Monday, May 7, 2012

Athletics not the lone culprit in creating foot problems

Published on: Delaware Online

There are many common foot problems that runners may come across during years of repetitive impact. The most commonly known issue is called plantar fasciitis, which is a tightening or inflammation of the plantar fascia, the tendon that supports the arch. It is painful and sometimes difficult to resolve.

However, runners and athletes are not the only ones who are affected by foot problems, especially uncommon ones. Anyone who deals with foot pain knows that even the thought of getting out of bed and taking that first step, each and every day, can ruin a day that hasn't even started yet. Some issues are a direct result of athletics, but many are more an issue of ill-fitting footwear or just plain genetics.

Athlete's foot, which is also known as ringworm of the foot, is a fungal infection of the skin that causes scaling, itching and flaking of the affected area. It is caused by fungi and is typically transmitted in moist areas where people walk barefoot, such as showers and locker rooms. Athlete's foot mostly affects the feet, but it can spread to other parts of the body, including the groin area.

The fungi that cause athlete's foot can live on shower floors, wet towels and footwear, and it spreads with contact. Hygiene plays a big role in managing athlete's foot, so wearing flip flops in a public shower or locker room and avoiding the sharing of towels are good preventive steps.

Athlete's foot is usually treated with a topical medication and has a high rate of cure along with keeping the feet dry and practicing good hygiene. Severe cases may require the use of an oral antifungal. The use of anti-itch creams is not recommended, as the symptoms may be alleviated, but the high moisture content of the cream will exacerbate the fungus.

A bunion is when your big toe points toward the second toe. This causes a bump to appear on the outside of your foot on the big toe. Bunions are more common in women and can run in families. Many times, they are caused by wearing high-heeled, narrow-toed shoes.

The symptoms of a bunion include red, calloused skin along the inside edge of the big toe and a bony bump at the site. There is pain over the big toe joint, which is made worse by pressure from wearing a shoe. Again, the big toe will turn toward the other toes.

Wearing wide-toed shoes may solve the problem and alleviate the need for more treatment. There are also foam pads that protect the bunion and spacers that separate the first and second toes -- such products are available in many drugstores.

For relief when walking around the house, you can cut a hole in the side of an old pair of comfortable shoes so there is no pressure on the bunion site. Finally, a podiatrist will know if surgery is recommended. Surgery reduces the pain for many, but not everyone. Even after surgery, you will need to be judicious about shoe choices.

A neuroma, commonly known as Morton's neuroma, is a painful condition that affects the ball of your foot, usually the area between the third and fourth toes. It may feel like you are standing on a pebble. This is because the neuroma involves a thickening of the tissue around one of the nerves leading to your toes. It causes a sharp, burning pain in the ball of the foot, and the toes may also sting, burn or feel numb. The neuroma may also occur in response to an irritation or injury.

Common treatments for neuromas are changing footwear and using arch supports, but if these do not help, you should see a doctor. The doctor may prescribe corticosteroid injections to reduce inflammation or even surgery. Doctors do not completely understand what causes Morton's neuroma, but they do know that there are certain high-risk factors: wearing high heels and ill-fitting shoes; certain high impact sports, such as running and jumping, or sports with tight shoes, like skiing and rock climbing; and foot deformities like bunions, hammertoes, flat feet or excessive flexibility.

Finally, plantar warts are a form of the human papilloma virus occurring on the sole or toes of the feet. They are usually self-limiting, but treatment is recommended to lessen the symptoms and pain.

Like athlete's foot, infection occurs from walking on moist surfaces. The virus enters the skin by direct contact, through tiny cuts or abrasions. Those most commonly affected are children and teenagers and people with weakened immune systems. Diabetics should see a doctor.

A plantar wart looks like a tiny head of cauliflower with black spots in the center, and it may be painful when standing or walking. There are several methods of treatment, including acid peels, topical chemotherapy, laser treatment and surgical removal. Duct tape has not been proven to be effective. Most plantar warts do not require treatment and go away in a couple of years.

Taking care of your feet is one way to ensure a happy life. If your feet hurt, you are reminded of it every step of every day.

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!

Sunday, May 6, 2012

Plantar Wart Prevention for Competitive Dancers

Contemporary dance shoe

Published by: Yahoo Sports

If you count yourself among the legions of competitive dancers who use Dance Moms as their weekly guilty pleasure, you may recall that Paige (one of the young dancers at the Abby Lee Dance Company) ended up with a nasty case of plantar warts during the show's second season. The poor girl could barely walk, much less dance with such painful plantar warts on her feet. So she had them removed before proceeding to dance through the equally painful post-surgery period. And all was happy again at the Abby Lee Dance Company. Or as happy as things are going to get on a drama-laden reality show.

Plantar warts are an unfortunately common occurrence in dance studios. These warts are caused by a specific strain of the human papillomavirus. Spread through direct contact, plantar warts affect a full ten percent of the U.S. Population.

While not exactly life-threatening, plantar warts can be very painful, often putting competitive dancers on the sidelines for weeks at a time. For this reason, prevention is absolutely key. The easiest way to prevent plantar warts is to wear a pair of sandals any time you visit a locker room or pool deck. HPV thrives in these moist environments.

Plantar warts can also be spread at the dance studio itself. A lot of dancers prefer to dance barefoot or with minimal-coverage thong-style shoes. Inside the studio, this should probably not be too hazardous. Wood and marley floors are not as conducive to the breeding of HPV as tile and grout. However, if your studio has a locker room or bathroom, you'll want to take extra care to wear sandals in these areas. And if you are practicing in a high school gym, you may just want to suck it up and wear full-on jazz shoes. Gym floors are generally not cleaned as often (or arguably, as well) as the floors at dance studios, and what's more, the other people using those gyms may very well be tracking in every virus or fungus in the book.

If you are one of the many competitive dancers who prefers to dance barefoot, be sure to clean off your feet when you're finished with practice. You may want to invest in some foot wipes or another product aimed at keeping feet clean and healthy. By taking this simple step, you can continue to dance barefoot without worrying about painful plantar warts.

S. Gustafson grew up in the dance studio and spent four years as a member of a nationally ranked college dance team.

Wednesday, May 2, 2012

Why Your Feet Hurt

It’s probably due to one of these ailments. Here’s how to treat them. For serious pain, see a podiatrist or a podiatric surgeon.

Published in Real Simple Magazine

1. Plantar Fasciitis

Feels like: A sharp pain in your heel (or heels), that’s at its worst when you get out of bed.
What causes it: Inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot from the heel to the toes. People with all arch types―high, medium, or low―can be prone to this type of irritation, says Carly Robbins, a podiatric surgeon in Columbus, Ohio. Wearing shoes with very flat or very high heels can worsen the problem. “If a shoe doesn’t support the arch, the fascia will be stretched, and that can cause inflammation,” says Robbins. And if your Achilles tendon often feels tight, it can exacerbate the issue.

Treatment strategies

· Wear structured shoes. Look for pairs that support the arches and enclose the heels. Avoid going barefoot or wearing ballet flats or flip-flops.

· Stretch your Achilles tendons in the morning. “The plantar fascia is in a relaxed position when you’re sleeping,” says Jacqueline Sutera, a podiatric surgeon in New York City. “Then it gets a jolt of tension when you put weight on it.” Before hopping out of bed, wrap a towel or a T-shirt around your feet and pull the toes back to stretch the tendons.

· Reduce swelling. Fill a plastic bottle with water, freeze it, and roll it under your foot for a few minutes to soothe the pain.

· Consider custom orthotics. A podiatrist can make inserts that are molded specifically for your feet, which will control their motion and decrease strain on the plantar fasciae when worn inside shoes.

2. Ingrown Toenail

Feels like: A throbbing sensation, usually on the side of a big toe. It might look red and swollen.
What causes it: This often occurs when the nail edge grows sideways into the skin of the toe. The pressure on the nail jabs into the surrounding skin, causing discomfort. Wearing shoes that are too tight or too narrow can exacerbate the problem. Cutting toenails incorrectly can also be a culprit.

Treatment strategies

· Wear pointy-toed shoes infrequently. And if you’ll be walking a lot, carry them and wear shoes with roomy toe boxes until you reach your destination.

· Keep feet well moisturized. When the skin on your toes gets inflamed, a callus can develop, causing more pressure on the ingrown nail. Keeping skin soft helps alleviate this problem.

· Cut toenails straight across. And don’t file the corners down. If you get pedicures, be sure the technician follows these rules.

· See a podiatrist if you suspect infection. Signs include significant swelling and redness. “Don’t try any bathroom surgery,” says Robbins. “Digging around the nail and trying to cut out the ingrown part can lead to more irritation.”

3. Bursitis

Feels like: A bump, usually on the back of a heel.
What causes it: “This condition can occur when you have a genetically enlarged heel bone,” says Marlene Reid, a podiatric surgeon in Naperville, Illinois. “It’s often called ‘pump bump’ because the bone can become irritated from wearing a shoe like a pump with a stiff back.” When the unforgiving shoe rubs against the bone, you can inflame the bursa, the protective sac of fluid in the tissue.

Treatment strategies

· Switch to shoes with open backs (or at least with more give) until the irritation subsides.

· Use a donut pad. Try Dr. Scholl’s Foam Ease Callus Cushions ($4.50 at drugstores). Place one over the bursa to alleviate pressure. At the end of the day, ice the area to soothe the inflammation.

· Consider seeing a doctor. If the problem causes chronic pain, a podiatric surgeon can remove the bursa and the enlarged part of the heel bone.

4. Stress fracture

Feels like: A tender area, often on the front part of the foot, at the second or third metatarsal (the metatarsals are the long bones in the midfoot).
What causes it: Repetitive stress on a bone, like walking or running on hard surfaces, especially in shoes that aren’t designed to absorb shocks. “Every summer, I see fractures in women who walk the city sidewalks all day in flip-flops,” says Sutera. High heels can also make you more susceptible to stress fractures, because the heel’s tilt distributes your weight over your foot unevenly.

Treatment strategies

· See a doctor no matter what. A podiatrist will give you a surgical shoe to wear as you heal (it has a hard bottom that doesn’t allow the affected bones to bend) or advise you to wear some other kind of rigid shoes.

· Slow down. Stress fractures take four to eight weeks to heal. During that time, you’ll need to stop running and limit your walking to what’s absolutely necessary.

· Prevent recurrences. Maintain a healthy weight and wear supportive, well-cushioned shoes.

5. Bunions

Feel like: Sensitive, protruding bumps, typically at the heads of the big-toe joints.
What causes them: Bunions are thought to be hereditary, and you can develop them if you have low arches or if you overpronate (your feet roll inward). “As the bump gets bigger, it’s actually your bone moving,” says Robbins. Wearing certain shoes―such as those with narrow, pointy toes and high heels―won’t cause bunions to form, but they can speed their progression.

Treatment strategies

· Choose the right shoes. Specifically, pick pairs with a wide toe box and a low heel.

· Try gel pads. Place them over the bunions to help cushion the areas and reduce pain.

· Consider surgery. If your bunions continue to get worse, become very painful, or begin to affect your feet’s mobility, a podiatric surgeon can realign the joints and shave off the protruding bones.

6. Neuroma

Feels like: A shooting pain in the ball of the foot.
What causes it: Pressure on the nerve tissue in the underside of the foot, usually between two adjacent metatarsals. This pressure irritates the nerves, and the area swells. “Narrow, pointy shoes can put added pressure on an already irritated nerve,” says Robbins.

Treatment strategies

· Wear shoes with a wide toe box. And stick to those with low heels.

· Employ anti-inflammatories. Take ibuprofen, or if that’s not enough, see a podiatrist and ask about a cortisone injection, which should bring down the swelling of the nerve immediately.

· Consider surgery. For a stubborn Neuromas that won’t go away with less invasive treatments, a doctor can use cryotreatment, a surgical technique in which a probe is inserted to eradicate the problem nerve.

Wednesday, April 25, 2012

Must-Know Tips to Avoid a "Flip-Flop Fiasco"

Find out some easy ways to prevent injury from wearing flip-flops this summer, from the American Podiatric Medical Association (APMA). For more information on healthy flip-flops, visit www.apma.org/seal.

New Tattoo Could Be Just What the Doctor Ordered

Posted on: WWJ-TV (CBS Detroit)

Diabetics may soon be lining up for a special new tattoo that does “tricks.”

Scientists at Massachusetts Institute of Technology, and at the Texas Diabetes Institute are working on a new tattoo that is designed to change color when a person’s blood sugar drops, or when it spikes.

Oakwood Hospital podiatrist, Dr. Debbie Woody told WWJ she thinks it’s a fantastic idea.

“It’s very fascinating and amazing,” Woody says. “It’s really still a few years away. It can actually monitor a patient’s blood sugar.’

Dr. Woody said it’s not going to be a tattoo that is readily visible to the naked eye. A patient would use a “monitoring device” such as a black light to see the color changes. The tattoo is designed to go from yellow to orange to pink depending on whether a patient’s blood sugar is high or low.

“That obviously would have a lot of benefits,” says Woody. “You can decrease the amount of pin sticks you have. Certainly very helpful in children with diabetes. It also allows a diabetic to closely monitor their sugar. They’re going to know if (their sugar) is getting low or high.”

Woody doesn’t think it will ever entirely replace a glucose meter, but it will give constant monitoring which can’t be done now.

Samantha Mueller, who does body piercings at Eternal Tattoo in Eastpointe, said people are already calling her asking for the color changing tattoo.

Mueller said, “One lady just wants to get a little heart, because she’s just sick of poking herself, and her fingers hurt.”

Friday, April 13, 2012

6 in 10 Teens Have Foot Pain

Hey teens, don’t let foot pain slow you down this spring. You’re way too busy with school, sports, and prom, so find out how to ditch the pain now!

Photo credit: Hemera/Thinkstock

Posted on: Care2

A lot of adults suffer from foot pain and discomfort for a variety of reasons, but did you know that six out of 10 teens have foot pain, too? A survey conducted by the American Podiatric Medical Association (APMA) shows that

sports are the number one cause of foot pain among teens;
two out of 10 teens suffer from pain due to wearing high heels and other uncomfortable footwear; and
less than two out of 10 teens have ever seen a podiatrist to treat foot problems.

“Foot health is incredibly important to a person’s overall health and wellbeing — especially in the teen years when feet are still growing,” said Joseph M. Caporusso, DPM, APMA president. “Our survey found that only about half of teens see feet as important to their overall health, but many are living with foot pain. It’s vital that we educate teens on how to properly care for their feet and when to visit today’s podiatrist, the foot and ankle expert.”

APMA’s survey collected the opinions of 1,000 teenagers on their attitudes toward foot health, foot care, and their knowledge of and experience with podiatrists. Among the key findings:

Almost half reported that playing a sport was the cause of their foot pain. Seventy-five percent of high school students play a school or recreational sport, and nearly 40 percent of that group has injured their feet while participating in sports.
Not surprisingly, gender differences were also found to play a role in how teens care for their feet. Two out of every 10 teens suffer from pain from uncomfortable shoes — girls more than boys. It’s all about the type of shoes — high heels are the most painful, reported by 64 percent of girls who took the survey.

Helpful advice from the APMA includes:

How to Choose Good Shoes

Activity: Sports-specific shoes help protect against injury.
Size: Teen feet are still changing and shoe sizes can vary from one brand to another.
Support: Make sure your shoes support your feet when you walk. Well-made backless shoes and flip flops are fine, but shouldn’t be worn all the time, and high heels should be reserved for special occasions. Stilettos can be a problem due to lack of stability.
Maintenance: Check the cushioning, tread, and midsole, and replace shoes that are showing signs of wear and tear.

Basic Foot Care

Give ‘em a good washing: You’d think this would go without saying, but it is tempting to just swish your feet around in the shower. Podiatrists say it’s important to use soap to remove germs and grime, and it’s important to get in between your toes.
And a thorough drying: Fungus, like the kind that causes athlete’s foot, grows in moist, damp environments. After your shower, dry your feet thoroughly, especially in between your toes. If your socks get wet during the day, change socks. (Keep an extra pair in your locker or gym bag.)
Give toenails a little TLC: Toenails that are too long can harbor bacteria. Use a pair of toenail clippers to cut your toenails to just above or at the edge of your toe. Some docs will tell you to cut straight across the nail, but a slight curve is OK too.

Common Foot Problems…and what to do about them

Warts: Common warts, which can appear anywhere on the body, are rough little bumps. Plantar warts, which occur on the bottom of the feet, are typically hard, flat, and rough. All warts are caused by a virus. Warts aren’t harmful, but they can be uncomfortable and unsightly. If you have warts on your feet, keep your feet clean and dry because viruses flourish in dark, wet environments.
Sweaty, smelly feet: You can cut down on odors by keeping your feet clean and dry at all times. Rubbing powder on the bottom of your feet before putting on your socks and shoes can help too. If possible, let shoes air out for 24 hours before wearing them again. Podiatrists can help with this embarrassing problem.
Ingrown toenails: Symptoms of an ingrown toenail include redness, swelling, and tenderness around the nail. Sometimes you can even see the nail digging directly into the toe. Try soaking the affected foot in lukewarm water and Epsom salts for 20 minutes three or four times a day. If the redness and pain doesn’t improve after a couple days, a podiatrist can easily treat ingrown toenails.
Athlete’s foot: Athlete’s foot, an itchy foot condition that causes the skin to flake and peel, is caused by a fungus. Keeping your feet clean and dry can help. So can over-the-counter athlete’s foot medication. Just be sure to use the medication until the fungus is completely gone. With current medications, two to three weeks of treatment may be enough to treat athlete’s foot fungus. Stubborn cases of athlete’s foot may require a doctor’s care.

APMA has launched the myFEET campaign visit www.apma.org/myfeet during April’s Foot Health Awareness Month to emphasize the importance of foot health to teens. To see the full results of the survey, visit www.apma.org/teen-feet-survey

It doesn’t hurt to point out that people of all ages should take care of their feet.

Source: American Podiatric Medical Association

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!