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Monday, 29 June 2015 21:16

Systemic Diseases of the Foot

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There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

 

Monday, 08 June 2015 17:50

Ankle Foot Orthotics For Athletes

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Ankle and foot orthotics, known as AFOs, are custom-made inserts, shaped and contoured to fit inside a shoe and used to correct an irregular walking gait or provide cushioning. Orthotics come in a variety of different models and sizes, including both over the counter and customizable variants. Customizable ones should be prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

AFOs are often used by athletes including track and field runners, cyclists, professional dancers, ice skaters, and even golfers. They benefit a lot from custom made AFOs by preventing injuries from occurring and provide cushioning to keep pain levels down to a minimum. Ankle foot orthotics allow for the correct positioning of the feet and also act as shock absorbers to help keep pressure and stress off the foot and ankle. They can also relieve back pain and hip pain while restoring balance and improving an athlete’s performance.

The way they help alleviate pain is by controlling the movement of both your feet and ankles. They are custom designed by a podiatrist or orthopedic specialist to help treat foot problems such as flat feet, spurs, arthritis of the ankle or foot, ankle sprains, weakness, and drop foot, a condition in which the patient cannot raise their foot at the ankle joint.

With custom orthotics, a patient will go through a complete examination of the foot and ankle, followed by the ankle and foot being cast and fitted for the proper orthotic. Depending upon the final result of the tests, a stretching treatment is created with specific shoe fitting in mind. After they have been fitted to the shoes, adjustments can be made in order to get the perfect fit and completely fill out the shoe. Evaluations are then usually set up to monitor the patient in the coming weeks to see how they are adjusting.

AFOs are also available over the counter and are more common than custom fit ones. Athletes that have generally low aches and pains in the foot, ankle, or lower back area can use an over the counter version of these orthotics. Weight is still distributed evenly throughout the bottom of the foot thanks to the arch support they give, but when an injury or ailment occurs, it is usually not enough to try and remedy it with an over the counter version. In either case, a podiatrist will be able to offer the best advice and treatment when it comes to foot and ankle orthotics and handle all your foot care needs.

Monday, 18 May 2015 00:00

Rheumatoid Arthritis in the Feet

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Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Monday, 11 May 2015 00:00

Keeping Children's Feet Healthy

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Having healthy feet in childhood can help prevent medical problems later in life, namely in the back and legs. As children grow, their feet require different types of care from birth to school-age.

Although babies do not walk yet, it is still very important to take care of their feet.

  • Avoid putting tight shoes or socks on his or her feet
  • Allow the baby to stretch and kick his or her feet to feel comfortable

As a toddler, kids are now on the move and begin to develop differently. At this age toddlers are getting a feel for walking, so don’t be alarmed if your toddler is unsteady or ‘walks funny’.  Be sure the child wears comfortable and protective shoes so that they can grow into their feet properly.

As your child gets older, it is important to teach them how to take care of their feet

  • Show them proper hygiene to prevent infections such as fungus
  • Be watchful of any pain or injury
  • Have all injuries checked by a doctor as soon as possible
  • Comfortable, protective shoes should always be worn, especially at play

Children of all ages are constantly developing and growing, and as a parent you want to make sure that nothing is hindering their maturation. This includes caring for their feet, as healthy feet are important in order to live a normal, fulfilling life.

Monday, 04 May 2015 00:00

What to Know About a Broken Toe

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Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma, as they will be able to diagnose the injury and recommend the appropriate treatment options. 

Monday, 27 April 2015 00:00

All About Hallux Limitus

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Hallux limitus is a medical condition which means “stiff toe”. It is actually an arthritic condition that limits movement of the big toe. The pain is usually located at the area where your large toe and foot meet. The condition is not serious, but should be treated since it can lead to hallux rigidus, in which motion of the big toe is extremely limited.

The symptoms of hallux limitus are easy to overlook. Anyone can feel a toe pain and believe that it is nothing serious. However, some of the things you will feel and see are sharp pain, development of bone growths, feelings of tightness around the joint, difficulties wearing shoes, inflammation of the joint, and even the change in the way you walk. If you experience these symptoms, you should see a podiatrist while the condition is still in the early stages.

This condition may be a result of genetics, or of simply wearing out your feet. In the first case, people can inherit hallux limitus from their parents, or even be born with a predisposition to arthritis. Injury or overuse can cause trauma to the joint which can lead to extra bone growth and the wearing a way of cartilage. These situations will lead to arthritis and thus pain and limited motion in the toe.

In some cases, certain systemic diseases such as lupus or gout can cause hallux limitus. There are different methods for diagnosis, but an x-ray is generally performed along with a test to determine the big toe's range of motion.

A limited number of treatments are available; in mild cases lifestyle and physical therapy are recommended, along with oral anti-inflammatory medications. The R.I.C.E. method stands for rest, ice, compression and elevation, and it is immensely helpful in this case. With hallux limitus it is crucial not to overuse the toe, and to be careful when it comes to exercise and other physical activities.

Too much activity can destroy the cartilage that remains in the toe joint, making the toe even stiffer.
However, if the patient does not show any improvement, surgery is the only answer. The most common surgeries are arthrodesis, to fuse the joint, and cheilectomy, in which the joint is cleaned of scar tissue so the toe can move more easily. Many patients who receive surgery are able to go back to the activities they enjoy a couple of months after the operation.

Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped and develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot. The official medical term for corns is Helomas.

Corns are often confused with a callus, but there is a difference between them. Corns can be a raised bump that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.

Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should consult their doctor immediately.

According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn a white color after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can potentially lead to infection. If your corn gets infected, and you do not respond with medication, a visit to the doctor will be necessary.

Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes, thus fixing the way you walk. This will lower your chances of getting corns, and eliminate current corns, by reducing the friction.

Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.
To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.

Monday, 13 April 2015 00:00

Hammertoe

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Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics: the person’s particular gait or the manner in which they walk, or shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time, causing the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is pertinent. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted her or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half-inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses; trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.

Monday, 06 April 2015 00:00

Flip-flops and Feet

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Flip-flops are often a popular choice of footwear for their ability to allow your feet to take in open air. As well as, for the freedom of movement they allow your toes. They are easy to slip on and can be worn with virtually any style of clothing. Flip-flops, however, despite their many benefits, can be detrimental for your foot health.

Despite their comfortableness, the frequent wearing of flip-flops can create problems in the lower body over time. Issues mainly stem from the fact that people walk differently in flip-flops compared to other footwear, such as sneakers. This is due to a change in one’s natural gait, which therefore creates stress in different parts of the body while simultaneously throwing off the body entirely.

Problems can also arise in the arches and balls of the feet, as flip-flops provide little to no support to these areas.
Aside from long-term problems, flip-fops can also create short-term issues as well, such as ankle sprains and blisters.
Weak materials that are flexible and bendable are generally used to manufacture flip-fops; these materials make a wearer prone to both trip and injure their ankles. Flip-flops can create blisters as the material rubs against the foot. People are much more at risk for infection while wearing flip-flops due to their openness; this also makes it easier to scrape and cut the foot since there is a lack of protection. If these cuts are left untreated and uncovered, the risk then becomes greater.

To prevent the aforementioned occurrences, purchase a pair of flip-flops that offer significant protection. The soles of the flip-flops should not be floppy, but sturdy and firm, and should not significantly bend or wiggle when lifted from the floor. Flip-flops made of high-quality materials will not be affected by this problem. While higher quality flip-flops may be more expensive, they will last longer and provide better protection compared to a cheaper pair.
Brand name flip-flops sold from a quality manufacturer are a dependable option.
There is no problem in wearing your favorite pair of flip-flops so as long as you do not wear them daily or for extended periods of time. Flip-flops should be replaced every 3-4 months to ensure that they provide your feet with the best protection.

Monday, 16 March 2015 00:00

Bunions

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The term bunion refers to an enlargement of the base joint of the toe, the connection to the foot. This enlargement may be formed of swollen tissue or a bony growth, and is caused by the shifting of the bones in the big toe inward, toward the other toes of the foot. The area around the base of the big toe may become inflamed, red, and painful.

Genetic factors are important in the formation of bunions – people who get bunions are usually genetically predisposed to this bone displacement, and may cause its onset by wearing improperly fitting shoes, or by running or walking in a way that causes stress to the feet. Another common cause for bunions is wearing high heeled shoes. The weight of the body in these shoes pushes the toes into an unnatural position, possibly causing bone displacement.

A podiatrist who specializes in foot structure and bio-mechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can remove the pressure on the bunion and reduce pain. High heeled shoes should be eliminated for a period of time as this type of shoe generally pushes the big toe outward toward the smaller toes. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem, but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone, or may rearrange the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that do not put undue pressure on the toe as the big toe can easily move back to its orientation toward the smaller toes.

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