Foot for Thought - October 29, 2009

Foot and Ankle Injury Prevention

• Wear the correct shoes for your particular activity.
• Wear hiking shoes or boots in rough terrain.
• Don't continue to wear any sports shoe if it is worn unevenly.
• The toe box in “steel-toe” shoes should be deep enough to accommodate your toes comfortably.
• Always wear hard-top shoes when operating a lawn mower or other grass-cutting equipment.
• Don’t walk barefoot on paved streets or sidewalks.
• Watch out for slippery floors at home and at work. Clean up obviously dangerous spills immediately.
• If you get up during the night, turn on a light. Many fractured toes and other foot injuries occur while attempting to find one’s way in the dark.

If you experience a foot or ankle injury, please contact me at our website or call 309-661-9975 to schedule an appointment to diagnose the problem.

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Foot and Ankle Injuries

Immediate Treatment

Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatric physician.

This advice is universal, even though there are lots of myths about foot and ankle injuries. Some of them follow:

Myths

• "It can't be broken, because I can move it." False; this widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: Breaks in the smaller, outer bone of the lower leg, small chip fractures of either the foot or ankle bones, and the often neglected fracture of the toe.
• "If you break a toe, immediate care isn't necessary." False; a toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatric physician usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatric physician will help prevent improper or incomplete healing. Often, fractures do not show up in the initial X-ray. It may be necessary to X-ray the foot a second time, seven to ten days later. Many patients develop post-fracture deformity of a toe, which in turn results in a deformed toe with a painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.
• "If you have a foot or ankle injury, soak it in hot water immediately." False; don’t use heat or hot water on an area suspect for fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing sensation, and prevents swelling and pain. Your podiatric physician may make additional recommendations upon examination.
• "Applying an elastic bandage to a severely sprained ankle is adequate treatment." False; ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. X-ray examination, immobilization by casting or splinting, and physiotherapy to ensure a normal recovery all may be indicated. Surgery may even be necessary.
• "The terms 'fracture,' 'break,' and 'crack' are all different." False; all of those words are proper in describing a broken bone.

Before Seeing the Podiatrist

If an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatric physician are easy to remember if you can recall the word “rice.”

• Rest. Restrict your activity and get off your foot/ankle.
• Ice. Gently place a plastic bag of ice wrapped in a towel on the injured area in a 20-minute-on, 40-minute-off cycle.
• Compression. Lightly wrap an Ace bandage around the area, taking care not to pull it too tight.
• Elevation. To reduce swelling and pain, sit in a position that allows you to elevate the foot/ankle higher than your waist.
• For bleeding cuts, cleanse well, apply pressure with gauze or a towel, and cover with a clean dressing. See your podiatrist as soon as possible. It’s best not to use any medication on the cut before you see the doctor.
• Leave blisters unopened if they are not painful or in a weight-bearing area of the foot. A compression bandage placed over a blister can provide relief.
• Foreign materials in the skin—such as slivers, splinters, and sand—can be removed carefully, but a deep foreign object, such as broken glass or a needle, must be removed professionally.
• Treatment for an abrasion is similar to that of a burn, since raw skin is exposed to the air and can easily become infected. It is important to remove all foreign particles with thorough cleaning. Sterile bandages should be applied, along with an antibiotic cream or ointment.

If you experience a foot or ankle injury, please contact me at our website or call 309-661-9975 to schedule an appointment to diagnose the problem.

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Foot for Thought - October 22, 2009

Hammertoe Tips

• Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area.
• Wear a shoe with a deep toe box.
• If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling.
• Avoid heels more than two inches tall.
• A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician’s office will be necessary to repair the toe to allow for normal foot function.
• Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly.
• See your podiatric physician if pain persists.

If you think you have a hammertoe or other foot pain, please visit our website or call our office at 309-661-9975 to schedule an appointment to discuss your concerns.

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Hammertoes

What is a Hammertoe?

A hammertoe is a contracture—or bending—of the toe at the first joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down V when looked at from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammertoes are more common to females than males.

There are two different types:

Flexible Hammertoes:

These are less serious because they can be diagnosed and treated while still in the developmental stage. They are called flexible hammertoes because they are still moveable at the joint.

Rigid Hammertoes:

This variety is more developed and more serious than the flexible condition. Rigid hammertoes can be seen in patients with severe arthritis, for example, or in patients who wait too long to seek professional treatment. The tendons in a rigid hammertoe have become tight, and the joint misaligned and immobile, making surgery the usual course of treatment.

Symptoms

• Pain upon pressure at the top of the bent toe from footwear.
• The formation of corns on the top of the joint.
• Redness and swelling at the joint contracture.
• Restricted or painful motion of the toe joint.
• Pain in the ball of the foot at the base of the affected toe.

How Do You Get a Hammertoe?

A hammertoe is formed due an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can also lead to the formation of a hammertoe. Arthritis is another factor, because the balance around the toe in people with arthritis is so disrupted that a hammertoe may develop. Wearing shoes that are too tight and cause the toes to squeeze can also be a cause for a hammertoe to form.

What Will Your Podiatrist Do to Treat a Hammertoe?

The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery. Podiatric medical attention should be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option.

Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Padding and Taping:

Often this is the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain.

Medication:

Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity.

Orthotic Devices:

Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.

Surgical Options:

Several surgical procedures are available to the podiatric physician. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain.

Severe hammertoes, which are not fully reducible, may require more complex surgical procedures.

Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatric physician.

Your Feet Aren’t Supposed to Hurt

Remember that foot pain is not normal. Healthy, pain-free feet are a key to your independence. At the first sign of pain, or any noticeable changes in your feet, seek professional podiatric medical care. Your feet must last a lifetime, and most Americans log an amazing 75,000 miles on their feet by the time they reach age 50. Regular foot care can make sure your feet are up to the task. With proper detection, intervention, and care, most foot and ankle problems can be lessened or prevented. Remember that the advice provided in this pamphlet should not be used as a substitute for a consultation or evaluation by a podiatric physician.

If you think you have a hammertoe or other foot pain, please visit our website or call our office at 309-661-9975 to schedule an appointment to discuss your concerns.

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Foot for Thought - October 15, 2009

Nail Care Prevention Tips

• Proper hygiene and regular inspection of the feet and toes are the first lines of defense against fungal nails.
• Clean and dry feet resist disease.
• Washing the feet with soap and water, remembering to dry thoroughly, is the best way to prevent an infection.
• Shower shoes should be worn when possible in public areas.
• Shoes, socks, or hosiery should be changed more than once daily.
• Toenails should be clipped straight across so that the nail does not extend beyond the tip of the toe.
• Wear shoes that fit well and are made of materials that breathe.
• Avoid wearing excessively tight hosiery, which promote moisture.
• Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks.
• Disinfect instruments used to cut nails.
• Disinfect home pedicure tools.
• Don't apply polish to nails suspected of infection—those that are red, discolored, or swollen, for example.

If you have ingrown toenails or are suffering from fungal nails, please give me a call at 309-661-9975 or visit our website to make an appointment.

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Nail Problems

Barometers of Health

Toenails often serve as barometers of our health; they are diagnostic tools providing the initial signal of the presence or onset of systemic diseases. For example, the pitting of nails and increased nail thickness can be manifestations of psoriasis. Concavity—nails that are rounded inward instead of outward—can foretell iron deficiency anemia. Some nail problems can be conservatively treated with topical or oral medications while others require partial or total removal of the nail. Any discoloration or infection on or about the nail should be evaluated by a podiatric physician.

Nail Ailments

Ingrown Toenails

Ingrown nails, the most common nail impairment, are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is usually the victim of this condition but other toes can also become affected.

Ingrown toenails may be caused by:·

• Improperly trimmed nails (Trim them straight across, not longer than the tip of the toes. Do not round off corners. Use toenail clippers.)
• Heredity
• Shoe pressure; crowding of toes
• Repeated trauma to the feet from normal activities

If you suspect an infection due to an ingrown toenail, immerse the foot in a warm salt water soak, or a basin of soapy water, then apply an antiseptic and bandage the area.

People with diabetes, peripheral vascular disease, or other circulatory disorders must avoid any form of self treatment and seek podiatric medical care as soon as possible.

Other "do-it-yourself" treatments, including any attempt to remove any part of an infected nail or the use of over-the-counter medications, should be avoided. Nail problems should be evaluated and treated by your podiatrist, who can diagnose the ailment, and then prescribe medication or another appropriate treatment.

A podiatrist will resect the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of that piece of nail, are removed by use of a chemical, a laser, or by other methods.

Fungal Nails

Fungal infection of the nail, or onychomycosis, is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

In reality, the condition is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair one's ability to work or even walk. This happens because the resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.

Treatment of Fungal Nails

Treatments may vary, depending on the nature and severity of the infection. A daily routine of cleansing over a period of many months may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the-counter liquid antifungal agent. However, even the best over-the-counter treatments may not prevent a fungal infection from coming back.

A podiatric physician can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Newer oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Podiatrists may also prescribe a topical treatment for onychomycosis, which can be an effective treatment modality for fungal nails.

In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.

Trying to solve the infection without the qualified help of a podiatric physician can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

If you have ingrown toenails or are suffering from fungal nails, please give me a call at 309-661-9975 or visit our website to make an appointment.

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Foot for Thought - October 8, 2009

Bunion Tips

Here are some tips to help prevent/deal with painful 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 and have your feet sized each time you purchase shoes.
• Apply a commercial, nonmedicated 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 two inches tall.
• Seek professional podiatric evaluation and assistance with uncomfortable or noticeable bunions.

If you are suffering from bunions, please give me a call at 309-661-9975 or visit our website to make an appointment to discuss your options.

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Bunions

What Is a Bunion?

A bunion is an enlargement of the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place. This forces the toe to bend toward the others, causing an often painful lump of bone on the foot. Since this joint carries a lot of the body’s weight while walking, bunions can cause extreme pain if left untreated. The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. A bunion–from the Latin "bunio," meaning enlargement–can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor’s bunion."

Symptoms

• Development of a firm bump on the outside edge of the foot, at the base of the big toe.
• Redness, swelling, or pain at or near the MTP joint.
• Corns or other irritations caused by the overlap of the first and second toes.
• Restricted or painful motion of the big toe.

How Do You Get a Bunion?

Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This can lead to instability in the joint and cause the deformity. They are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk, and our inherited foot type, our shoes, or other sources.

Although bunions tend to run in families, it is the foot type that is passed down—not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.

Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.

Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women.

Conservative Treatment For Bunion Pain

Treatment options vary with the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. Podiatric medical attention should be sought at the first indication of pain or discomfort because, left untreated, bunions tend to get larger and more painful, making nonsurgical treatment less of an option.

The primary goal of most early treatment options is to relieve pressure on the bunion and halt the progression of the joint deformity. A podiatric physician may recommend these treatments:

Padding & Taping - Often the first step in a treatment plan, padding the bunion minimizes pain and allows the patient to continue a normal, active life. Taping helps keep the foot in a normal position, thus reducing stress and pain.

Medication - Anti-inflammatory drugs and cortisone injections are often prescribed to ease the acute pain and inflammations caused by joint deformities.

Physical Therapy - Often used to provide relief of the inflammation and from bunion pain. Ultrasound therapy is a popular technique for treating bunions and their associated soft tissue involvement.

Orthotics - Shoe inserts may be useful in controlling foot function and may reduce symptoms and prevent worsening of the deformity.

Surgical Options

When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatric physician. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain.

A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint.

Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatric physician.

If you are suffering from bunions, please give me a call at 309-661-9975 or visit our website to make an appointment to discuss your options.

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Foot for Thought - October 1, 2009

Wow, I can't it is already October, and I can't believe our 1st anniversary is just around the corner. Thanks to everyone for their support. Without all of you, this wouldn't have been possible.

As promised, below is the link to our feature article in the Bloomington Edition of Healthy Cells Magazine.

Link to the ARTICLE

Link to the main site with our COVER PHOTO

The link to my talk on WJBC has not been posted yet. Stay tuned. I promise to get this posted as soon as they do.

Just to remind everyone, we will be at two exciting events in the next 4 days! We will be giving away free samples, and holding a raffle for a chance to win a pair of Crocs RX footwear.

• On Saturday October 3rd, we will be part of the American Diabetes Association Step Out: Walk to Fight Diabetes. The event will be held at White Oak Park in Normal.
• On Monday October 5th, we will be participating in the McLean County Senior Expo at the Doubletree Hotel in Bloomington.

Thanks again to everyone for making HFAA a huge success. I really appreciate all your love and support.

Have a great weekend!

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