Central Florida Foot and Ankle Center - For all the women out there

How is a Bunion Fixed?

2011-12-28T16:48:00.000-05:00

One of the most common surgical procedures that a podiatristperforms is bunion correction. Bunionsare a result of hallux abducto valgus, a deformity of the foot that leads toincreased pressure at the first metatarsophalangeal joint. Bunions can become extremely painful, and canlimit a person’s activity level and restrict them to only certain types ofshoes. Conservative therapy can help toalleviate some of the symptoms of bunions, but even the best methods ofstrapping and bracing do not correct the problem. Surgical correction of hallux abducto valgusand the bunion associated with the deformity is paramount to treatment.

A small incision is made along the medial side of themetatarsaophalangeal joint, where the bunion is. This incision site is then deepened until thejoint is reached, being careful to avoid the nerves and veins that run in thearea. Once the joint is reached, thejoint capsule can be cut to access the bone.

The surgical approach to bunions most commonly involves anosteotomy, or cutting of the bones, at the head of the first metatarsal. This is the part of the metatarsal that isclosest to the joint. By cutting themetatarsal, the operating surgeon is able to reposition the head of themetatarsal in a more functional position, thus eliminating the bunion. The bone is then fixed with one or twoscrews, which keep the two pieces of the bone in place while it can heal. Any remaining bone in the area that may beprominent or painful is also removed.

Some other approaches to bunions may involve simply removingthe painful bump, repositioning the metatarsal head to gain more motion at thejoint, or the use of joint implants. Some bone cuts may be positioned further away from the joint, whichallows for a greater correction of a more significant bunion. A number of different surgical osteotomieshave been used over the years.

A lateral release may be performed as well, which is whenthe tendons on the lateral side of the metatarsophalangeal joint are cut. The tendons that course through the foot andfunction at the first metatarsophalangeal joint often become contracted in thepresence of hallux abducto valgus. Thesestructures are cut in order to reposition the toe in a more straightenedposition.

Following all of the corrective procedures in bunionsurgery, the final step is to close everything up, layer by layer. The joint capsule is often closed using a techniqueto tighten it, as the once prominent joint has now been removed. This leaves an excess of tissue that shouldbe addressed. The skin is then closedwith suture, and stitches may be left in for two or three weeks. Some sutures are absorbable, and there is noneed to take them out.

After the surgery, the patient is usually placed in abandage and a surgical shoe, which they are allowed to walk in. Patients receiving bunion surgery areinstructed to only walk a little bit, and to keep the foot elevated most of thetime. This is done so that the body hastime to heal the surgical wounds that have been created. They are typically seen in the podiatrist’soffice following the surgery, or in some sort of follow-up clinic.

Some amount of pain and swelling is to be expected followingsurgery, as the surgery itself can be rather traumatic. This swelling should resolve after a week orso, and the pain should go away also. Painis usually addressed with oral pain medications. Elevation of the foot and ice placed behindthe knee or calf for fifteen minutes at a time will also help with pain andreducing swelling.

Typically the skin will heal after two or three weeks, atwhich time the sutures, if necessary, can be removed. Once the sutures are removed and the skin ishealed, the patient may either continue in the surgical shoe, or return to astiff-soled shoe or gym shoe. Much ofthe post-operative treatment plan is surgeon-dependent. The bones will typically heal in six to eightweeks. In the post-operative period, itis common for the surgeon to obtain x-rays to evaluate the status of thebones. This helps to determine thepost-operative course.

Bunions are sometimes corrected in conjunction with otherdeformities of the foot, such as hammertoes or tailor’s bunions. If there are other areas of pain in the footbesides the bunion, be sure to point them out to your doctor.

Talk to your podiatrist if you have painful bunions or anyother painful foot condition. Conservative therapy will generally be attempted first, but surgicalintervention should be discussed with the operating doctor. They will be able to fill you in on detailsregarding pre-operative preparation, the surgery, and the post-operative treatmentprotocol.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
863-299-4551
www.FLFootandAnkle.com

Cavus Foot

2011-11-08T11:32:00.000-05:00

The cavus foot, or pes cavus, comes in a variety offorms. Most notably, it is characterizedby a high arch. While many may thinkthat having a high arch is a good thing, having too high of an arch can lead todifficulty fitting shoes, pain in the ball of the foot (metatarsalgia), painfulhammering of the toes, and increased pressure on the lateral or outside of thefoot. This increased pressure may resultin pain and even fracture of the bones. Callus development in areas of increased pressure is typical. Advanced cases of pes cavus can often lead toa feeling of instability, particularly in the ankles.

An important aspect in the diagnosis of pes cavus is theetiology of the condition. Many timesthis foot type is associated with neurological disease and weakness of theperoneal muscles and/or the anterior muscles of the leg. These muscles insert into the foot, andcontrol the motion and function of the foot. Some neurological causes of pes cavus include Charcot-Marie-Tooth,cerebral palsy, muscular dystrophy, spina bifida, poliomyelitis, and tumors ofthe central nervous system. While these condtions can be rare, it is importantto let your doctor know of any progression of the deformity, any numbness ortingling in the feet and/or hands, and any other associated symptoms such astripping or instability.

When the etiology of the cavus foot is unknown, it isreferred to as idiopathic. Thisdiagnosis is one of exclusion, and should not be made until a throughevaluation is performed.

The next step in evaluating the cavus foot should be todetermine whether the deformity is flexible or rigid. In other words, is the foot stuck in thehigh-arched position, or is it able to be manipulated into a more normalposition? This helps determine treatmentmethods that your doctor may suggest. Italso helps determine surgical procedures that may be required in the future tocorrect the deformity, should they become necessary.

The apex of the deformity should then be determined. This is done by looking at x-rays of thefeet. The deformity may be coming fromone of three main regions of the foot; the forefoot, midfoot, or hindfoot. In forefoot deformities, it is often one ormore of the metatarsals that are malpositioned, causing the rest of the foot toalter its motion to accommodate the deformity. The apex may also be located in the midfoot, with the lesser tarsalbones such as the cuneiforms, navicular, and cuboid defining the deformity. In rearfoot pes cavus, the position of thetalus and the calcaneus determine the position of the rest of the foot. Of course, combinations of severaldeformities can exist as well.

Along with a thorough history and physical, nerve conductionstudies and/or muscle testing may be performed to help determine the cause ofthe deformity. The treating physicianshould have a high index of suspicion for a neuromuscular etiology. Family history of neurological disorder or ofpes cavus running in the family should be mentioned.

Treatment of pes cavus is initiated with conservativemeasures in the vast majority of cases. This may include things like physical therapy, custom molded orover-the-counter orthotics, shaving of painful calluses, and bracing forunstable ankles. A large percentage ofpatients will find great benefit from conservative treatment alone.

In cases of failed conservative treatment, surgicalintervention may become an option. Pescavus has been discussed in the medical literature for over one hundredyears. Much of our understanding of surgicalcorrection of the deformity comes from cases of polio, where those affected bythe disease were left with non-functional limbs. Research and technology have improved theoutcomes of surgical correction for pes cavus drastically over the years.

For those with flexible pes cavus, soft tissue proceduresmay provide adequate correction of the deformity. This can include a plantar fasciotomy and/orvarious tendon transfer procedures. Forthose with a non-progressive form of pes cavus, this may be the only correctionneeded.

For those with rigid deformity, or those with more advancedpes cavus, bone cuts may be necessary to bring the foot to a normalposition. Depending on the apex of thedeformity, this may include cuts in the metatarsals, in the calcaneus, and/orcuts in the lesser tarsal bones.

In progressive deformity, fusion of joints is usuallyrequired to establish a more normal foot. Arthrodesis, or joint fusion, can help prevent recurrence of severedeformity in those with a progressive cavus foot type.

Of course, a through evaluation is required before anydecisions can be made regarding treatment of the cavus foot. It is important to discuss with your doctorand a foot and ankle surgeon the various options for treatment. Be prepared to answer questions regarding theprogression of the deformity, any signs of neurological involvement such asnumbness, burning, or tingling in the hands and/or feet, and if there is afamily history of similar conditions. These are all important aspects of the diagnosis and treatment of thecavus foot.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.Winter Haven, FL 33881
Phone: 863-299-4551
www.FLFootandAnkle.com

2011-10-04T10:49:00.000-04:00

Rehabilitation of Foot andAnkle Injuries

One of the most important aspects of foot and ankle injuriesis the rehabilitation of those injuries, and a return to normal activity. This is often done through strengthening,stretching, and balance exercises. Whencombined, these three things can be a powerful means of rehabilitation and thereturn to previous mobility.

As an example of how these activities work, let’s look at atypical ankle fracture that was repaired surgically, and is now being treatedin a rehabilitation center by physical therapy. For a patient coming in after surgery, the first thing that must be doneis a thorough evaluation of the patient’s current level of mobility, strength,and balance.

The patient’s mobility is assessed by measuring activemovement and passive movement. Activemovement is the patient’s ability to move their ankle on their own. Passive movement will involve the physicaltherapist or the treating physician moving the ankle joint through its normalrange of motion with the patientrelaxed. The patient may experience somepain with these mtoins, and it is important to let the treating practitionerknow of this pain. If the range ofmotion is limited, this will be an area to focus during rehabilitation.

Stretching is the only way to increase the amount ofmovement at a joint such as the ankle. For ankle fractures, calf stretches are used to increase thismotion. However, stretching can bepainful at the beginning of rehabilitation. During this early period, range of motion exercises may be used insteadin order to maintain the current amount of movement available at thejoint. This may involve the patientactively moving their foot up and down slowly, in a pain free range. This is opposed to stretching, which is aprolonged hold at the end of the range of motion.

Strength will also be assessed in the rehabilitation of anankle fracture. This is done by thepractitioner applying pressure at the foot and asking the patient to hold andmaintain their foot in the correct position while the practitioner pushes inthe opposite direction. If the patientis unable to perform this activity, it is seen as a deficit in strength.

To strengthen the muscle groups involved, various exercisesmay be used. In physical therapy, thiswill often involve the use of resistance bands or manual pressure from thetherapist.

Balance is assessed by asking the patient to stand on oneleg and measuring how long they can stand like that. This may be very difficult for paitients witha history of an ankle fracture. It alsomay be assessed with the eyes closed or by having the patient stand or walk onan uneven surface. Balance is onlyassessed in the beginning in the clinic for safety reasons.

Balance training exercises include the use of a balanceboard or wobble board, which forces the patient to balance on an unevensurface. The ankle plays a critical rolein balance, so restoring this function is a priority. Increasing one’s balance after an ankleinjury can also help prevent a future ankle injury.

Later in rehab, the physical therapist will progress thepatient to their previous activity level, whether that is walking, running,climbing stairs, or returning to sports. The physical therapist, therefore, plays an important role in therehabilitation of foot and ankle injuries.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
www.FLFootandAnkle.com

Preventing Falls in the Elderly

2011-08-11T13:50:00.003-04:00

The podiatrist’s role in preventing falls in the elderly has recently got some attention at the international level. At the national meeting of the American Podiatric Medical Association, podiatrist Doug Richie Jr. presented information regarding the podiatrist’s role in preventing falls in the elderly. Some of the research that he presented was from a study by a podiatry group in Australia, who have contributed significantly to the understanding of the topic.

The Australian study led by by Dr. Martin J. Spink of La Trobe University looked at the effect of a multi-faceted podiatry intervention for older adults compared to routine podiatry care. Multi-faceted intervention was defined as the use of customized foot orthoses, advice on footwear and a subsidy for footwear, home-based foot and ankle exercises, a pamphlet of information regarding fall prevention, and routine podiatry care for a period of 12 months.

The study found that the group receiving the multi-faceted podiatry intervention suffered from 36% fewer falls than the patients randomized to the routine podiatry care group. Muscle strength, range of motion, and balance were all significantly and statistically improved in the intervention group when compared to the routine care group.

This study, in combination of what we already know about falls in the elderly, could be a very important piece of information in the way that health care is delivered. Fall prevention is a major priority in hospitals, with everyone involved in patient care also involved in the prevention of falls. Falls in the elderly can lead to disabling and even life-threatening injuries such as fractures and head injuries. It has been reported that over half of people over the age of 65 years will experience a fall each year, and that a third of these falls will lead to significant injury. The amounts to a health care cost exceeding $20 billion in the management of these injuries, which is projected to double in the next 15 years due to the aging population in the United States. Clearly, the cost associated with these serious injuries is a potential source of savings when discussing Medicare/Medicaid funding.

The role of the podiatrist in preventing falls is likely to increase with more knowledge and awareness of the subject. This prevention hinges on early detection of potential risk factors, including existing foot and ankle pathology, diabetic neuropathy, impaired vision, and impaired mobility just to name a few. Conservative measures such as muscle strength testing, range of motion testing, gait analysis, and the use of customized orthotics and bracing can have a great impact on the health and well-being of the elderly patient, and prevent a potential fall.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

863-299-4551

www.FLFootandAnkle.com

Tightrope Fixation for Syndesmotic Injuries

2011-06-14T09:04:00.003-04:00

A newly emerging trend in foot and ankle surgery is the use of the Tightrope end-button device made by Arthrex. The device is a special type of suture material called fiberwire, attached to two small buttons at either end. A small needle is used to pass the suture through two bones, and then the suture material can be tightened to bring the bones together.

One of the uses of the device is in injuries to the tibiofibular syndesmosis. The syndesmosis is composed of several ligaments, including the anterior tibiofibular ligament, posterior tibiofibular ligament, and the interosseous tibiofibular ligament. Together this structure helps keep the fibular and tibia together, adding stability to the ankle joint.

In ankle fractures, the tibiofibular syndesmosis is often disrupted. If left unaddressed, the diastasis, or separation, between the tibia and fibula can lead to dysfunction and arthritis. A syndesmosis injury can often occur as an isolated event, sometimes referred to as a high ankle sprain.

The standard method of addressing this injury is to place a screw across the syndesmosis, sometimes referred to as a trans-syndesmotic screw. These are often placed through the bones until the ligaments can heal, and is then removed. However, complications such as broken screws and failed healing of the syndesmosis lead to research into alternatives.

The Tightrope design allows for some motion to occur at the tibiofibular syndesmosis. This allows for a more natural motion at the joint. The manufacturers state that the device never needs to be removed, so long as there aren’t any complications with the fixation, due to its allowance of micro-motion. This is in contrast to screw fixation, which necessitates another surgery.

Studies have shown good short-term results using the Tightrope for repair of syndesmotic injuries. It has been shown to be as effective as screw fixation in allowing for healing. While there are no long-term results available yet, nor are there any published studies comparing Tightrope fixation to screw fixation, the results thus far have been promising. Several studies are in development to more rigorously study this new form of fixation.

At least one study, however, has shown some complications from the use of the Tightrope device. Wilmott et al (Injury 2009) showed several soft tissue complications resulting from the use of the Tightrope. There study was small, however, and the patients involved in the study did show healing of the syndesmosis with use of the fixation device.

While it may be a new trend emerging in foot and ankle surgery, there is certainly more evidence necessary before Tightrope fixation for syndesmosis injuries can become the standard of practice. Larger, long-term studies will be necessary, comparing the device to fixation with screws.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Swanson Implants for First MTP Joint Arthritis

2011-04-25T12:50:00.005-04:00

The first metatarsophalangeal joint (MPJ, MTP Joint, or MTPJ) is highly susceptible to arthritis. This is the joint in your foot that attaches the big toe to the first metatarsal. It is a very important joint, and allows for propulsion during gait. There is a great amount of force that is put through the joint when walking, which is quickly absorbed through a number of joints in the foot. Because of this great amount of force place through the joint, it is also highly susceptible to arthritis.

Arthritis of the great toe joint, much like arthritis of any other joint, can be very difficult to treat. It is a painful condition that doesn’t always respond well to medications. There is no real cure for arthritis, and some people are affected by it at a much earlier age than others. Arthritis of the first MPJ is complicated by the fact that it is a weight-bearing joint.

Conservative treatment of first MTPJ arthritis is generally focused on preventing the advancement of arthritis by accommodating any foot deformities that may be present with orthotic devices. A foot deformity that increases pressure or force at the first MTPJ will speed up the progression of arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used, such as naproxen or ibuprofen. Icing, protective measures, heat, and a number of other non-surgical therapies are often used with varied results.

Surgical options for the treatment of first MTPJ arthritis include a number of procedures, including fusion of the joint, osteotomies (bone cuts), resection of some of the bone, and joint implants, to name a few. Joint implants come in a variety of designs.

One of the types of implants commonly used is the Swanson-type implant. This is an implant that is made of a silicone, and has two stems. One stem is placed into the metatarsal, and the other into the proximal phalanx. Some of the bone must be removed for each stem to fit into its respective end, and a small hole is reamed out to place the stem. Once the implant is placed, it creates a false joint. The first MTPJ, therefore, would have a more functional and painless range of motion. This is the goal of the surgery.

The implants have a lifespan of around 30 years, and are generally well tolerated. Occasionally the implants can breakdown at a faster rate, and cause a condition known as detritic synovitis. This is a condition caused by small particles of the silicone being sheared off within the joint, which leads to inflammation.

These double stem silicone implants are not for everyone, and are generally not used in younger patients, due to the lifespan of the implant. There are a number of different surgical methods for treating first MTPJ arthritis; this type of implant is only one.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

863-299-4551

www.FLFootandAnkle.com

Classification of Ankle Fractures

2011-03-17T09:25:00.004-04:00

Ankle fractures are one of the most common injuries to the lower extremity. The injuries are almost always due to a twisting injury, where the foot is planted flat on the ground and the leg is forced in a twisting or sliding pattern. Ankle fractures are a frequent occurrence in high impact sports, as well as from everyday-type injuries. The anatomy of the ankle helps to define this injury, and a number of structures are at risk.

The ankle joint is composed of the tibia and fibula, which are the bones of the lower leg, as well as the talus, which is a bone of the foot. The tibia and fibula join at the syndesmosis, a structure that is key in holding the ankle in place. The tibia and fibula form a groove for the talus to move through, ensuring stability through range of motion at the ankle. A number of ligaments hold these structures together, mainly the lateral ankle ligaments and the medial ankle ligaments. The medial ankle ligaments are commonly referred to as the deltoid ligament.

A series of tendons run across the joint from the leg into the foot. These tendons belong to muscles that control the movement of the foot, including plantarflexion (pointing the foot in a downward position), dorsiflexion (bringing the foot upwards), inversion, and eversion. There are also a number of arteries, veins, and nerves that run across the ankle joint that provide blood and sensation to the foot.

Injuries to the ankle, as common as they are, can be described by several different classification systems. The two most commonly used are the Lauge-Hansen and Danis-Weber systems.

The Lauge-Hansen system classifies ankle fractures based on the mechanism of injury, taking into account both the position of the foot at the time of injury as well as the movement of the leg. For example, one of the categories for the classification is supination-external rotation. The first term denotes that the foot was in a supinated position at the time of injury. The second term indicates that the leg was externally rotated in relation to the foot, causing the injury. The four categories originally described by Lauge-Hansen included supination-external rotation (the most common mechanism of ankle fracture), pronation-external rotation, supination-adduction, and pronation-abduction. Another category was later added, pronation-dorsiflexion, indicating that the force causing the injury was an axial force through the bottom of the foot that would drive the talus bone up through the tibia. This, however, is more appropriately addressed as a pilon fracture.

Within each category of Lauge-Hansen mechanism, there are different stages indicating how extensive the damage is to the ankle joint. These stages correlate with the ankle structures effected by the injury. Shown in the diagram above, starting from top left and moving clockwise, are the supination-adduction, pronation-abduction, pronation-external rotation, and supination-external rotation injuries. The stages indicate the structures involved.

Another commonly used classification system for ankle fractures is the Danis-Weber classification. This is based on the anatomy involved in the injury, particularly the tibia-fibula syndesmosis, which is the joint between the two bones. The classification is based on the level of the fibular fracture associated with the injury. If the fracture is below the level of the syndesmosis, it is considered a type A injury. Type B would be at the level of the syndesmosis, and type B would be above the level. Danis-Weber classification helps to indicate the amount of damage to the tib-fib syndesmosis. Levels B and C are associated with damage to the joint, which may lead to instability of the ankle if not addressed during the treatment of the fracture.

The classification of ankle fractures is a very academic topic, and is used primarily to communicate between physicians treating the injured patient. Other descriptors may be beneficial in describing the injury, but the classification systems are a quick and easy way to relate what is going on with the injury between doctors and those involved. Because of the reliable patterns of ankle fractures, these classification systems are fairly universal, and have a good inter- and intra-observer reliability.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

863-299-4551

www.FLFootandAnkle.com

Accessory Navicular

2011-01-11T11:07:00.003-05:00

The navicular bone, located on the medial (inside) foot, is sometimes associated with an accessory bone. This accessory bone is most commonly referred to as an accessory navicular or os tibiale externum, but may also be called navicular secundum, prehallux, bifurcate navicular, accessory tarsal scaphoid, extra scaphoid, or a divided navicular. The accessory bone may be fused (attached) to the navicular, or it may be located within the tendon of the posterior tibial muscle, which attaches to the navicualr at this point.

Accessory navicular is present from birth, and results from a secondary ossification center of the bone. This means that there is an additional area of bony growth in the growing foot, which may eventually attach to the main portion of the navicular by either a bony attachment or with cartilage.

Symptoms of an accessory navicular include pain associated with shoes rubbing against the bony prominence, or pain developing from an eversion-type twisting injury. In the event of a twisting injury, the accessory bone may become detached from the main body of the navicular, essentially acting as a fracture of the bone.

Identification of the os tibiale externum, or the accessory navicular, begins with a thorough hirtory and physical examination. Frequently the accessory bone can be felt through the skin, or even seen on gross examination. X-rays are typically required to differentiate the accessory bone from an enlarged navicular or any other type of fracture of the bone. An MRI is not always necessary, but may be ordered if the diagnosis is not definite.

Once the condition is recognized, treatment may begin with conservative therapy, often involving padding the area and preventing it from rubbing against a shoe. In the event of a fracture through the bone, or a detachment of the bone from the main body of the navicular, it may be immobilized in a hard or soft cast. A number of factors play a role in this clinical decision-making.

Eventually, surgical removal of the accessory bone may be required to alleviate the symptoms. Depending on the particular type of accessory navicular, a number of different surgical techniques may be used. This is at the discretion of the treating foot and ankle surgeon. Typically, the offending bone will be removed in order to relieve the symptoms.

Post-operative care generally consists of protection with a cast, or a soft bandage and a surgical boot. Keeping off of the foot is usually indicated in allowing the foot to heal. Some pain and swelling should be expected. Analgesics may be used to alleviate some post-op pain, and elevation, ice, and rest are typically used to remove some of the swelling associated with the surgery. Details of the surgery may be discussed with your foot and ankle surgeon, including post-operative planning and the risks associated with surgery.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Dyshidrosis

2010-11-02T15:55:00.004-04:00

Dyshidrosis is a disorder of the skin that is characterized by small blisters on the hands and/or feet. It is also known as pompholyx, podopompholyx, cheiropompholyx, acute vesiculobulbous hand eczema, and dyshidrotic eczema.

Most commonly the condition presents on the fingers and toes, in particular it may be present on the lateral sides of the digits. Dyshidrosis is a pruritic, or itchy, condition, particularly when it is located on the sides of the digits. It typically begins as a number of small, tense blisters, which are deep seated in the skin. Over time these small blisters may coalesce into larger blisters, but do not commonly rupture. However, if the vesicles do rupture, this may lead to secondary bacterial infections.

It was previously believed that dyshidrotic eczema was caused by faulty sweat glands, which led to the name “dyshidrosis”. However, this hypothesis has been refuted due to the evidence that shows that the vesicular lesions are not in fact related to the eccrine sweat glands.

It is commonly accepted now that dyshidrotic eczema is a multifactorial disorder, which is commonly related to other skin conditions and precipitating factors. In particular, atopic diathesis (such as hay fever, eczema, asthma, and allergic sinusitis) has been shown to be present in as many as 50% of patients with Dyshidrosis.

While excessive sweating may not cause it, dyshidrosis has historically been linked to an excessive output of sweat. However, cases reported of dyshidrosis without hyperhidrosis (excessive sweating) dispute the causation. It is possible that dyshidrosis is linked to anxiety, stress, and frustration, which may cause outbreaks or exacerbate the symptoms.

An association with nickel sensitivity has also been reported. Systemic exposure to high levels of nickel may be from foods that are high in nickel, such as cocoa, chocolate, whole grains, and nuts. Diets that restrict intake of these foods have been shown to reduce the number of outbreaks of dyshidrotic eczema.

Chemical and mechanical irritants have also been indicated as a cause of dyshidrotic eczema outbreaks. This may include things such as keeping the hands and feet damp, using strong soaps or detergents on the hands and feet, exposure to latex or other materials that cause documented allergic reactions, such as bandages, skin tapes and plasters. Dyshidrosis may also be seen in correlation with fungal and/or bacterial infections of the feet. There has also been a well-documented inheritance pattern and genetic predisposition to dyshidrotic eczema.

Dyshidrotic eczema is diagnosed by first ruling out a number of other possible diagnoses. This may include infection, allergic reaction, blistering disease such as pemphigus vulgaris, and a number of other dermatological conditions.

Treatment of dyshidrosis is largely symptom based, and many cases will clear spontaneously within several weeks. Topical steroids are often used to reduce itching, and oral steroids are occasionally used in cases of intense outbreak. When blisters are present, draining of the blisters may be appropriate, as well as using compression bandages with drying agents such as Burow solution. A number of other treatments have been used experimentally, such as Botox injections, UV-A light therapy, Nickel chelators, and a number of oral medications.

Other therapies include diet modifications to avoid exacerbating foods, as well as behavioral modifications to avoid irritating substances. Allergy testing may be indicated for patients with a known or suspected allergy to certain substances.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Nail Changes in Systemic Disease

2010-09-27T10:42:00.005-04:00

(Hutchinson’s Sign in melanoma)

An important aspect of the clinical exam for podiatrists is the careful examination of the toenails as well as the fingernails. A variety of systemic diseases can appear in both the hands and feet, and analysis can often lend itself to revealing an underlying systemic condition. The following is a brief list of some of the changes to the nail and fingers and toes, as well as the underlying conditions associated with the changes.

Nail Clubbing – This is a condition that is caused by a thickening of the soft tissue beneath the proximal portion of the nail plate (the area closest to the knuckle, or the distal interphalangeal joint). A specific finding of nail clubbing is to put the two index fingers next to each other, with the nails facing each other. If the distal interphalangeal joints of the two fingers touch, and the distal end of the nails do not come in contact with each other, it may indicate clubbing of the digits. Nail clubbing is most commonly associated with pulmonary disease, such as emphysema, cystic fibrosis, lung abscess, pulmonary fibrosis, and bronchogenic carcinoma. It is also commonly seen in inflammatory bowel disease, celiac disease, and cirrhosis of the liver.
Nail Pitting – Most commonly associated with psoriasis, nail pitting is a series of small, punctate depressions in the nail. It is caused by a defect in the layering of the nail plate as it grows out of the nail matrix. Nail pitting may also be seen in systemic diseases such as Reiter’s syndrome, connective tissue disorders, sarcoidosis, and pemphigus. A localized dermatitis may also cause nail pitting, if it disrupts the normal growth of the nail plate.
Koilonychia – Also termed “nail spooning”, koilonychia gives the nails a spoon-like appearance, with a central depression of the nail plate. It may be due to repeated chemical exposure or trauma to the nail, but is also associated with a variety of systemic conditions. Hemochromatosis and iron-deficiency are two of the conditions that the clinician should be suspicious of when koilonychia is found. Koilonychia can also be a normal variant in the infant child, which usually resolves with age.
Onycholysis – This is a separation of the nail plate from the underlying nail bed, most commonly at the distal end of the nail, and usually caused by trauma, warts, onychomycosis, or as a finding of psoriasis. However, in the absence of these explanations, it may be associated with hyperthyroidism. When onycholysis is seen in hyperthyroidism, the condition is termed “Plummer’s nails”.
Leukonychia – Any whitening of the nail in a random, non-linear pattern may be termed leukonychia. It is a very common finding in the nails of both children and adults. Many people will have several white spots on one or more nails, that grow out with time. These are benign lesions that are of no consequence, are believed to be caused by random microtrauma to the nail matrix. A whitening of one or more nails in a linear fashion that parallel the lunula (the half-moon shaped lighter portion at the proximal end of the nail) may indicate a number of systemic disease, and should be evaluated by a physician.
Longitudinal Linear Lesions – Darkened lesions that run longitudinally along the nail should always be shown to a clinician. Benign lesions must be distinguished from melanoma, which can be seen growing underneath the nail plate. Unexplained darkening in a longitudinal pattern along the nail plate should be considered malignant until proven otherwise with a biopsy.

This is simply a brief listing of some of the changes seen in the nail and surrounding tissues associated with a variety of systemic diseases. Always let your doctor know of any recent changes to your nails.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Dog Eats Toe, Saves Owner’s Life

2010-08-06T16:42:00.003-04:00

Strange news from Grand Rapids, Michigan today as a Jack Russell terrier saved its owners life after gnawing off the man’s big toe.

Yes, you read that correctly.

Forty-eight year old Jerry Douthett’s dog, Kiko, sniffed out an infection that had been growing in Jerry’s toe for several months. The wound had been the result of a small sliver that Douthett had attempted to remove himself by cutting at it with a knife. What ensued was a serious infection that would swell greatly over time, and eventually would spread to the underlying bone.

Douthett’s wife, a registered nurse, recognized the infection as possibly related to diabetes, and urged her husband to seek medical attention. After weeks of delay, Jerry would finally be forced to heed this advice.

The canine-amputation resulted in a hospital visit that would uncover Jerry’s type II diabetes, as it was undiagnosed at the time. Doctors removed what was left of the gnarled and infected toe at the hospital.

Kiko had been sniffing at the wound for quite some time, but was finally able to rid his owner of the infected toe when Jerry came home from a bar. Jerry had drank several beers and margaritas, and fell fast asleep upon arrival. Jerry would wake up later to a missing toe and pool of blood in his bed.

"The toe was gone," said Douthett. "He ate it. I mean, he must have eaten it, because we couldn't find it anywhere else in the house. I look down, there's blood all over, and my toe is gone."

What Kiko was able to sniff out is unfortunately a fairly common situation in the diabetic foot. A loss of pain sensation in diabetic peripheral neuropathy can allow someone to have a serious foot infection without much pain. This is also what would help Kiko chew off the toe without causing too much pain. Combined with the diminished immune system of the diabetic patient, this sets up a dangerous situation.

Now that Douthett is out of the hospital, he has sworn off drinking and is trying to take better care of his health. This starts with working to control his diabetes.

For diabetic patients, it is crucial that they check their feet for open wounds or areas that look like the skin is breaking down. These areas can quickly become infected. For a person with diabetes, something as simple as a hangnail could turn into a big problem. Jerry Douthett learned this in a difficult way.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Rickets

2010-07-22T09:26:00.002-04:00

Rickets is a softening of the bones in a child, sometimes referred to as childhood osteomalacia. It is caused by a decrease in calcium absorption, most commonly due to a decrease in activated vitamin D.

Vitamin D is an essential component of calcium metabolism in the body. Activated vitamin D allows for the absorption of calcium from our diet. Without it, much of the ingested calcium in our diet passes through the intestines without being absorbed and utilized by the body.

The activation of vitamin is a complex reaction that is activated by UV light, in particular UV-B from the sun’s rays. A certain amount of exposure to sunlight is required to generate activated vitamin D everyday. In an adult, it takes approximately 15-20 minutes of direct sunlight on non-protected fair skin to generate approximately 10,000 IU of vitamin D everyday.

In children, however, the amount of time required to activate an appropriate amount of vitamin D is unknown and is difficult to measure. Factors such as age, skin tone, body mass, geographical location and season will all play a role in altering the total. In children, 400 IU of vitamin D are required daily to prevent Rickets and to maintain a healthy level of calcium in the body. It has been shown that children with darker skin pigmentation may require 5-10 times as much sunlight exposure as fair skinned children to activate the daily requirement of vitamin D.

Children aged 3-18 months are at a particularly high risk for the development of rickets, because their bones are growing rapidly at this point in development. High risk groups include children that are strictly breastfed, children with darker skin pigmentation, and children with very limited exposure to sunlight.

In developed countries like the United States, the incidence of Rickets is extremely low (approximately 1 in 200,000 will develop the condition). However, in the developing world, it remains as one of the more common conditions attributable to malnutrition. A lack of vitamin D in the diet is to blame; foods rich in vitamin D include eggs, butter, fish liver oils, fortified milk, and oily fishes such as tuna, herring and salmon.

Symptoms of rickets are due to a lack of calcium, most notably the skeletal deformities that result from the softening of the bones. This includes the classic bow-legged appearance of the tibia and femur, cranial and spinal deformities, and costochondral swelling (swelling along the ribs at their attachment with the cartilage, also known as “rachitic rosary”). Other symptoms include muscle weakness, growth disturbances and failure to grow, dental problems, bone pain, and an increase risk of fractures.

The Indoor Air Quality Act of 1989 reported that Americans spent roughly 93% of their day indoors, which only further compacts the problem of limited sunlight exposure and the development of rickets. Due to the modern lifestyle of developed countries, as well as campaigns to limit sun exposure due to its influence on developing various forms of skin cancer, it is predicted that the incidence of rickets may rise in the future. This has already been observed in Western countries.

Treatment of rickets may be multi-faceted, but includes supplementation with activated vitamin D as the mainstay. Increased exposure to sunlight may be recommended in some cases, though the risk of skin cancer from over-exposure warrants a word of caution. In cases where skeletal deformity has developed, accommodative bracing, orthotics, and other devices may be used.

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.

Winter Haven, FL 33881

Phone: 863-299-4551

www.FLFootandAnkle.com

Ingrown Toenails

2010-03-16T16:28:00.003-04:00

Ingrown toenails can be an excruciating experience. They happen when the nail grows into the skin around the toe, and can lead to a tremendous amount of pain, or even infection.

The best way to avoid getting an ingrown toenail is to cut your nails straight across, without rounding off the corners. When the corners of a toenail are trimmed, they have a tendency to grow back into the skin.

If you have diabetes, nerve damage to the legs and/or arms, or are otherwise prone to infections, do NOT try treating an ingrown toenail yourself. This can lead to serious complications. If you fall into this category, you should consult with your podiatrist or primary physician immediately.

If you’ve got an ingrown toenail and it’s starting to turn red, or if there is pus coming out of the skin, it is most likely infected already. In this situation, your doctor may prescribe antibiotics, as well as trim out the offending nail border. This can be done in several different ways.

Often, a podiatrist may cut out the entire border of a nail. This is especially done in situations where an ingrown toenail is a recurring event. By removing the entire border of the nail, the chances of the nail growing back into the skin are very low.

When the entire border of the nail is to be removed, your doctor will first numb the area with a local anesthetic. This is to ensure that you have no pain during the procedure. The procedure is fairly quick, and it involves cutting into the nail and removing a small piece.

The root of the nail is often removed as well. The idea behind removing the root of the nail is that this is where the nail grows from. If the root of the nail is gone, then the nail will not be able to grow into the skin. Thus, the problem of the ingrown toenail is solved.

Many people have a problem with recurring ingrown toenails. The key is to prevent infection. Infection of an ingrown toenail is known in the medical community as a paronychia. Paronychia is usually a problem that will go away with treatment, but can evolve into a more complicated situation if left untreated. This is particular true in someone with a compromised immune system, such as a diabetic patient.

In the diabetic patient, the immune system is not functioning at full capacity. The same may be true for patients that are on oral steroids for rheumatoid arthritis or other systemic disease. For these patients it is especially important to seek treatment right away.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Varicose Veins

2010-01-07T08:33:00.001-05:00

Podiatrists are known to treat the foot and ankle and leg. To the average person, it seems like the typical problems a podiatrist is limited to are bunions and warts. The common conception is that their expertise is confined to the foot in the areas of the muscle, bone and skin.

However, podiatrists are well-versed in many aspects of the foot, ankle and leg – nervous system disorders, musculoskeletal pathologies, dermatopathologies and vascular anomalies! Varicose veins are one such anomaly that is quite common in the population.

What are veins? Veins are a type of blood vessels that take the blood from different parts of the body TO the heart. They only function in ONE direction. The one-way direction is due to the one-way valves that are within the vessels. Varicose veins arise when the valves are malfunctioning. When a valve stops working properly, blood which was destined to the heart starts to flow back towards the legs (or other extremities). The blood is now going in the opposite direction it was supposed to be going! As a result of this backward blood flow, pressure in the veins starts to rise and causes varicose veins! Varicose veins are essentially veins that are receiving so much pressure that the start to expand and engorge. The elastic properties of the vein allow for it to expand due to pressure and it thus it protrudes out of the skin.

There are a variety of risk factors which can cause the veins to start swelling due to the pooling of blood.

A. Family history is one factor – you may genetically have valves that are incompetent;

B. Occupation – standing on your feet for greater periods of times increases venous pressure

C. Obesity

D. Pregnancy

E. Age – with increased age, vessel function starts to deteriorate

Varicose veins are not usually painful but you may feel a deep ache in the area. Swelling and discoloration may also be noted in the area of the engorged veins. The color starts out reddish and may turn to brown with time. The most common complaint is the fact that these veins just look ugly! If untreated, skin erosions can occur; this may progress to venous stasis ulcers which have a poor ability to heal! If you find that you do have varicosities, don’t hesitate to see your podiatrist! They have the knowledge and expertise to guide you to a solution and prevent this medical condition from becoming worse!

Central Florida Foot & Ankle Center, LLC

101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Small Girls and Tall Heels!!

2010-01-05T08:22:00.005-05:00

Every little girl has tossed on a pair of her mom’s high heels, doused herself in red lipstick, put on a string of pearls and topped off her ensemble with a floppy oversized hat! It is one thing to play dress up; however, it’s another thing when infants or little girls are seen wearing high heels for any period of time!

Many women are already well-aware of the damaging effects of heels on the feet. Heels themselves are a hazard for walking because they alter your center of gravity. In addition, all of your body weight which is meant to be distributed evenly across your feet is now on the ball of your foot. The ball of your foot is not designed to bear your weight and does not function well in terms of shock absorption. So the impact of the forces from the ground and the body weight from above leading to pain called metatarsalgia!

Other conditions that can occur with heels are Morton’s neuromas, corns, calluses, bunions, and hammertoes. The damaging effects of heels are not just limited to feet either! Heels affect your posture by pushing your hips and spine out of alignment! The knees are also prone to injury because heels place additional force on the inside of your knee! The calf muscles may shorten and tighten as a result of excessive contraction needed to adjust to the angle of high heels.

Many podiatrists are concerned with the advent of celebrity moms dressing their children in high heels and being seen in public. High heels are ill-advised in adults and the implications on children can be even more devastating. The bones of a child are not yet fully-formed or fully-calcified; bone formation in the foot in particular partly relies on how the forces are transmitted. The wearing of high heels alters these normal forces and can affect the normal ossification pattern of the bones! And remember, foot problems will not be the only problems that will arise from wearing high heels too early. Knee, hip and back problems can occur due to the change in the body’s center of gravity as a result of high heels. These are not problems young children should ever have! One way to AVOID these musculoskeletal problems is to delay wearing heels as long as possible! Talk to your podiatrist about the implications and possible complications of wearing high heels at any age!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Rocker-Bottom Shoes for Health

2009-10-14T10:36:00.005-04:00

The popular shoe company Skechers has recently added a new line of shoes to their repertoire. The Skechers Shape-Ups promise to help improve fitness, lose weight, and improve posture and muscle tone. They even claim to help improve circulation and reduce cellulite. But do they work?

The Skechers website offers evidence from a clinical case study that was performed to assess the effectiveness of the shoes. The study does show an increase in gluteal muscle strength, as well as weight loss and a decrease in percentage of body fat. While this study only points to one small group of wearers, a larger study is being developed to investigate the usefulness of the shoes.

The shoes work by having a contoured, rocker-bottom sole. The shape of the sole helps promote muscle use of otherwise underused muscles, such as the extensor muscles on the front of the leg. Using the muscles that are normally neglected would help to strengthen and tone, as well as burn extra calories.

The shoes also come equipped with a heavy layer of cushioning built in, which is supposed to help alleviate the stress referred up the leg and into the ankles, knees and hips. The soft landing and improved heel-to-toe motion gives a feeling of walking in sand.

Concern has been expressed, however, that the shoes limit the movement of muscles whose function is normally maximized while walking. This may throw people wearing the shoes off balance at first, something that the training video addresses on the Skechers website.

While it is innovative, the technology behind the Shape-Ups shoes is hardly new. The company MBT has been selling a similar version, which has always been heavier and much pricier than the Skechers version. Reebok also has a shoe designed with a rocker-bottom.

Podiatrists and other doctors originally used the rocker-bottom design as a therapeutic device for patients, particularly those with arthritis in the joints of their feet. The rocker-bottom helps immobilize those joints

Whether these shoes will have a great impact on your health may or may not matter. The fact that someone is willing to spend over a hundred dollars on a pair of walking shoes means that they will be more likely to use them. The extra muscle stimulation that someone gets from wearing these shoes may be minimal, but the idea that they are walking more often is a sign of good health.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

No More Heels in the Workplace!?

2009-09-23T08:44:00.000-04:00

Current events: In the United Kingdom, there is some political controversy over high-heeled shoes! British unions passed a motion stipulating that women are not confined to wearing heels at the workplace; they have the right to wear comfortable shoes! And as usual, most media outlets over-exaggerated the declaration!

The Society of Chiropodists and Podiatrists introduced a motion asking workplace employers to partner up with Health and Safety representatives and trade unions. Risk assessments of high heels should be conducted by these organizations and in where the footwear poses a health hazard, initiatives should be put into place to replace them with comfortable shoes.

The motion set forth by the Society of Chiropodists and Podiatrists just sets a standard that women should not feel that high heels are the only choice of footwear and that the prevailing medical opinion is that they should be avoided in occupations where prolonged standing is involved.

The Society has been quoted to say that, “this [high heels] is a serious issue for women in the workplace, and we at the Society of Chiropodists and Podiatrists want to ensure women workers are never forced to wear high heels which we believe can lead to foot health problems in the short, medium and long term.” In addition to the motion, members of the Society advocate the use of sensible shoes which have heels no more than one-inch high. Specifically, the safety guidelines they issued said that “heels should have a broad base and be no higher than 1.5 inches... if worn for long stretches no higher than 0.8 inches.

The motion advanced by this society was not just a random act; there is plenty of evidence that high heels are economically counterproductive and a hazard to health. Women have lost nearly 2 million days of work a year through lower extremity disorders and many of those lead to foot operations. Too high of heels end up causing long-term foot and back problems! The Society has said that “wearing high heels can cause long-term foot problems, such as blisters, corns and calluses, and also serious foot, knee and back pain. More needs to be done to raise awareness of this problem.”

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Feet: His and Hers?

2009-09-02T07:59:00.001-04:00

There are many variables that are incorporated in the study and treatment of feet such as shoe gear, activity level, and family history of foot pathologies. However, there has been increasing evidence that a fundamental variable has never been considered or often overlooked: gender.
At the microscopic level, men and women are different in terms of their chromosomes. Yet, those microscopic entities translate into enormous physiological differences ranging from hormonal influences to bone structure. Why is it that the difference between male and female feet is not taken into account when evaluating the health of feet?

What aspects of women’s feet differ from those of men’s feet?
The same basic anatomic structure of the foot holds true between the genders. All the bones, ligaments (connective tissue that links bone to bone), muscles, blood vessels, and nerves are present in the same location.
A study conducted on 300 men and 500 women of the armed forces of the United States revealed that there are inherent anatomical differences between males and females. It was found that the men had longer metatarsals, longer arch length, and a narrower forefoot. In addition, differences were noted at the ball of the foot, big toe and the length of the outer border.
As a result, these differences may also influence strength, flexibility of the ligaments, and proprioception (position sense).
Another scientific study also determined that the foot-to-body ratio is higher in males than in females. In other words, males have a longer foot length than that of a woman of the same height. That same study also used magnetic resonance imaging (MRI) to study join components such as surface area and the amount and nature of the cartilage. It was demonstrated that males had significantly increased thicker cartilage and their joints encompassed more surface area than that of women.

What do these findings mean?
These studies illustrate that women’s feet are not just smaller replicas of men’s feet and the surface of gender difference has only been scratched. The implications of these differences on locomotion and foot health can only be determined with further study!

References

Daniel M. T. Fessler, Kevin J. Haley, and Roshni D. Lal
Sexual Dimorphism in Foot Length Proportionate to Stature
Annals of Human Biology 2005 32: 44-59

Roshna E. Wunderlich and Peter R. Cavanagh.
Gender Differences in Adult Foot Shape: Implications for Shoe Design
Med and Sci in Sports and Exercise 2001 33: 605-611

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

APMA demands retraction of Arizona congressman’s statements

2009-08-31T11:36:00.004-04:00

John Shadegg, a Republican congressman from Arizona, recently referred to podiatry as an "esoteric demand that most people don't have or don't need," equating the field to such alternative medicine practices as acupuncture and aromatherapy. The American Podiatric Medical Association has fired back at the congressman, demanding a retraction of the remarks made.

In a press release issued Friday, APMA President Ronald D. Jenson, DPM, said “It is appalling to find someone who serves on the House of Republican Health Care Task Force so uninformed about the podiatry profession and the valuable role of a podiatric physician in the delivery of essential medical and surgical foot and ankle care. We are on the front lines of diabetes management. Without our services and comprehensive diabetes foot care, lower-leg amputations would soar”.

These figures that Dr. Jenson points to include the $19 billion spent in 2007 on the care of diabetic foot ulcers alone. It is estimated that up to 85% of non-traumatic lower extremity amputations could have been avoided by the early detection of such conditions by a podiatric physician.

Podiatrists are often the first to detect diseases such as peripheral vascular disease, deep vein thrombosis, and diabetes, all of which are potentially life-threatening illnesses. To equate podiatry to alternative medicine choices such as acupuncture and aromatherapy is a slap in the face to the thousands of podiatrists in this country who have completed a four-year education in addition to a residency training program. Stumbling through an interview and throwing around rhetoric like this, as Mr. Shadegg has, is a great misstep and epitomizes the misinformation that opponents of healthcare reform have been spreading in the past few months.

Beyond the press release issued on Friday, the APMA has taken further action to set the record straight. APMA president-elect Kathleen M. Stone, DPM, is demanding a personal meeting with Congressman Shadegg, and is sending letters to Arizona newspapers. The APMA will also encourage the podiatric medical school at Midwestern University in Glendale, Arizona to extend an invitation to the congressman to tour the facilities and learn more about the profession.

Healthcare reform has been making prominent headlines all summer. It is important for people following the news to know what is real, and what is not real. Facts are easily blurred by sensationalism and rhetoric. To have a true understanding of what healthcare reform means, it is important to do plenty of research on the topic. A great article was recently published in the New York Times, called “A Primer on the Details of Health Care Reform”. If you are interested in learning more about the topic, this is a good place to start.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

“Shocking” News on Electrotherapy

2009-08-07T09:45:00.004-04:00

Ever seen those late night advertisements promising you six-pack abs from sitting on the couch with an electric stimulator? Well, they don’t work. But electrotherapy is widely recognized as being a useful tool in rehabilitation. It won’t give you rock-hard muscles without the work, but it is often used in physical therapy to help alleviate pain, control inflammation, and stimulate muscles that are underdeveloped.

The American Physical Therapy Association recognizes electrotherapy as an effective method of reducing edema that is often associated with an injury. Research shows that the low-level electric current can induce blood and lymphatic flow. The stagnancy of these fluids is what is known as edema, when there is an accumulation of fluid underneath the skin. Edema is commonly seen in acute injury, or in chronic conditions such as lymphedema.

Underdeveloped muscles may be stimulated with neuromuscular electrostimulation (NMES) devices. Essentially what these devices do is send an impulse through the skin to the underlying muscles. For people that have significant muscle atrophy, or weakening of the muscles, this stimulation can help tone the muscles. NMES devices are really only effective on people who have a less than normal level of muscle tone, and they are capable of bringing those muscles up to a more normal level of tone. NMES devices are not a replacement for exercise and strength training, as some marketing companies may have you believe.

Another popular use of electrotherapy in the realm of physical therapy is for pain management. In particular, a device known as a trans-epidermal neurostimulator (TENS) device may be used. This category of equipment sends electric impulses across the skin, but not deep enough to stimulate the muscle lying deeper under the skin. The TENS device activates certain nerve fibers that are responsible for feeling vibrations and deeper impulses. When these nerve fibers are activated, they send signals to the brain that the body is experiencing this sense of vibration. This effectively masks the feeling of pain, which is sent by a different group of nerve fibers. Of course, it is important to recognize the original cause of the pain. Simply masking the pain is only a temporary relief, but it is relief nonetheless.

Another common use of electrotherapy is in the administration of pain medications. Through a process called iontophoresis, physical therapists as well as physicians are able to administer pain medication across the skin, without the use of oral medications or intravenous medications. This allows the patient to receive pain medications directly at the site of pain.

Electrotherapy is becoming more commonly used in health care. There is a lot of evidence from research that shows it is effective, and physical therapists in particular use it quite a bit.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Summer Sunburns

2009-06-22T11:10:00.004-04:00

Backyard barbecues, sitting by the pool and more fun in the sun are all signs that the summer months are here. But nothing can ruin a summer day faster than a sunburn. That painful, red, and swollen patch of skin can really put a damper on your plans, especially when your plans are to stay outside for even longer, making the burn even worse. Here are a few tips to avoiding sunburn this summer, and some remedies that may help if you do get a burn.

Sunburn is caused by too much exposure to ultraviolet light emitted by the sun. This UV light, when absorbed by the skin, causes melanin in the skin to be produced at a higher rate. Melanin is responsible for the darkening of skin, which will cause a tan. A tan is the body’s natural way of defending itself against additional UV light, but it can only do so much. Here are a few more ways to protect your self against UV light and sunburns:

§ Use sunscreen. This is perhaps the most effective way to prevent sunburn and the damage caused by UV rays. Use a sunscreen with SPF 30 or more, and apply frequently and liberally. Its best to apply sunscreen 30 minutes before going outside, and reapply every two hours, or after getting wet or sweating heavily.

§ Cover Your Skin. Throw on a hat to cover up your face. A wide brimmed hat, like a sunhat, will also protect your ears and the back of your neck, more than a baseball cap will. Wear tight-woven clothing to minimize the exposure to your skin also, especially if you will be out in the sun for an extended period of time.

§ Wear Sunglasses. It’s pretty hard to protect your eyes with sunscreen, so wear sunglasses when you’re outside. Look for a pair that blocks 99 or 100 percent of UVA and UVB rays – these are the frequencies of ultraviolet light that are most damaging to the eyes.

§ Avoid the Sun Between 10 a.m. and 4 p.m. These are the peak hours for the sun’s strength, so if you can, try to minimize your sun exposure during these hours. Schedule outdoor activities outside of these hours if at all possible.

If it’s too late, and you’re already burned, relief is possible. It’s hard to minimize the skin damage following sunburn, but some of the pain can be relieved:

§ Take anti-inflammatory medications, such as aspirin or ibuprofen. These drugs will help decrease the inflammation in the burned area, thus decreasing some of the pain.

§ Apply a cool rag to the area, or a cold compress to the area to relieve some of the pain associated with sunburn.

§ Apply aloe or moisturizing cream to the area. The skin may start peeling after a few days, so continue to use moisturizing cream as this happens. You can also use a light hydrocortisone cream, .5% or 1% concentration, to the area. This may help reduce some of the inflammation as well.

§ If blisters form, don’t pop them. Opening up the blisters will increase the risk of infection. If many blisters form, or if the blisters ooze and break on their own, apply an antibiotic cream to the area.

§ Drink plenty of fluids. Dehydration is often associated with sunburns, so drink plenty of fluids to remain properly hydrated.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Foot and Ankle News

2009-06-11T08:18:00.006-04:00

It’s been all over the blogs today, and now it’s made it to ours. You may have seen photos of Sarah Palin from an appearance she made at the Autism Speaks walk in Purchase, New York this past Sunday. What you may not have noticed were the ill-fitting high-heeled wedge style shoes she was wearing, or the paint-job she had on her big toes. Well, the Huffington Post certainly noticed this, and is currently holding a poll to see what it is that was painted on her nails. Photos show a blurry close-up of Palin’s feet, with some sort of design painted on. You can view the photos here, and cast your vote as to what you think the design is.

As a side note, there has been a vicious battle developing between Palin and late night talk show host David Letterman. On Letterman’s show this past Tuesday, he made some comments regarding Palin’s trip to New York, highlighting this in his nightly Top Ten list. Sarah Palin supporters were outraged at the jokes made, and Palin herself responded to the jokes by calling Letterman “pretty pathetic”.

In other news, recently nominated Supreme Court Justice Sonia Sotomayor broke her ankle while rushing through LaGuardia airport in New York. The incident took place on Monday. Sotomayor was on her way to Washington, D.C., and received medical attention for the small fracture in her right ankle upon landing.

Sotomayor was able to keep her six appointments in Washington with various senators. She apparently even stopped by the White House for an appointment before getting x-rays on her foot and ankle. She was treated by George Washington University Medical Faculty, who released her that day.

After receiving treatment, Sotomayor attended several meetings wearing a cast from her foot up to just below her knee, with a black boot on it as well. The meetings were part job-interview, as Sotomayor has not been confirmed as Chief Justice yet, and partly a preview of what is to come in the confirmation hearings coming up. The cast that Sotomayor was donning certainly changed the tone of the meetings.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Summer Feet

2009-06-01T16:03:00.005-04:00

The summer months are finally here, and the weather is getting warmer every day. If you’re like me, you can’t wait to enjoy every minute of it. Here are a few tips on how to keep your feet healthy and happy this summer. They’re easy to follow, and they’ll let you enjoy your summer free of pain and worry.

ü Still wearing those old flip-flops from last year? Trade them in for a new pair. Or better yet, treat yourself to a pair of sandals that are recommended by the American Podiatric Medical Association. You can check out a complete list of these sandals and shoes here. Reusing the same old flip-flops with little to no support can set your feet and ankles up for all kinds of injuries. They’re great for the pool deck or the shower, but a sturdier sandal is better for prolonged use, especially at the beach.

ü If you’re going to be doing any gardening or yard work this summer, be sure to wear appropriate footwear. Socks and closed-toe shoes are a must. These will protect your feet against rocks, debris, and general mishaps that can happen while working outside.

ü You may want to opt for socks made from synthetic fibers instead of cotton this summer. Socks with synthetic fibers are made to wick away the moisture from your feet, instead of absorbing the moisture like a cotton sock does. Moisture-wicking socks can keep your feet dry and comfortable all day long.

ü Don’t forget the sunscreen! Many people forget to cover the tops of their feet with sunscreen while sitting in the sun all day. In fact, the feet are one of the quickest and easiest areas of the body to burn, so be sure to cover them up if you’re on the beach or sitting by the pool, or any time you’ll be wearing sandals.

ü Though it can be tempting, avoid walking barefoot outside. Walking barefoot exposes your feet to injury and infection, which can lead to a not-so-pleasant addition to your summer plans.

ü Be sure to clean and dry your feet thoroughly after a day at the beach or pool. Slipping wet, dirty feet into a sock may lead to foot fungus, bacteria, and general irritation.

ü When trimming your toenails, trim them straight across to help minimize the risk of ingrown toenails. Ingrown toenails can become infected and painful, not to mention unsightly when wearing open-toe shoes.

ü If you notice any changes or pain in your feet or ankles, contact a podiatrist. Pain is never a normal thing, and should be dealt with quickly to avoid any further complication. Changes in the skin coloring, hair texture, or nail growth can be indicative of disease, and should be addressed immediately.

Keep your feet happy and healthy, and the rest of your body will be happy and healthy too! See our online store for selected sandals. Click Here!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Not-So-Sunny Summer Shoes! Part 1

2009-05-26T11:53:00.003-04:00

In order to accommodate all the diverse types of feet and personal preferences, footwear companies have developed an eclectic variation of shoes! It is probably safe to say there are more categories and styles of shoes available for women than there are for men! It probably comes as no surprise that a certain segment of the population (women, in particular are notorious for this) choose shoes based on their aesthetics first, comfort last. Personal taste should not be the only factor when it comes to purchasing footwear. Foot support, protection, and comfort should play the deciding roles! Certain styles of shoes should be avoided since they do not provide the above attributes and thus lead to foot pathologies!

The American Podiatric Medical Association conducted a survey and found that 82% of women are willing to sacrifice their foot health in the name of fashion! As much as shoes are considered art, shoes are also pieces of engineering. Each style of shoe has its own anatomy and is designed to accommodate your feet. However, not all shoes accommodate your foot properly or safely.

Some of this summer’s top fashion trends are some of the worst styles for your feet. They cause problems ranging from minor irritation to bony changes that may require surgical intervention to correct! Despite the many ailments that certain varieties of shoes cause, health professionals have found it very difficult to sway women away from their beloved shoes. Wearing shoes should not yield stress, pain and/or discomfort and place your foot in jeopardy. It is up to you to follow your healthcare provider’s advice on proper shoe gear and preservation of foot health! The best way to discourage the buying shoes that negatively impact foot health is to illustrate how a shoe can adversely affect your foot! Do not spend money on footwear that will destroy the integrity of your feet! Remember thatfeasible, fashion-forward shoes are the fad!

Take at the chart look below to see if your shoes match up with any of the styles listed! Check out the possible problems and some handy solutions that will help keep your feet in tip-top shape!

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

Not-So-Sunny Summer Shoes! Part 2

2009-05-26T11:49:00.005-04:00

Click Here for Larger Image

Gladiator-style sandals

Gladiator sandals may cause blisters because the straps are located in areas where the foot can rub against it. The repeated friction irritates the foot and leads to blister formation. In addition, foot circulation can be compromised if the straps are placed too tight upon the foot. In many shoes straps are often associated with foot stability, but with this particular style this is not the case. This false sense of security can cause ankle sprains. Many gladiator sandals do not have adequate arch support and extended wear of these shoes can lead to arch pain.

Platforms

Ankle sprains are common in shoes that do not have adequate stability. The increased height of platform shoes may lead to ankle rolling incidences and cause the wearer to lose balance and fall. Plus, these shoes do not function in shock absorption. As a result, pain may be experienced all through the lower extremity, hips, and lower back.

Wedged heels/Espadrilles

Wearing shoes that elevate the heel is another way to compromise the stability of your ankle and then sprain it. The foot wobbles as a result of the heel height and leads to the off-balance that is implicated in ankle sprain. Metatarsalgia (pain at the ball of the foot) is also associated with this type of shoe because the elevation of the heel forces all the body weight onto your forefoot. The whole foot is designed to bear body weight, not just a portion of it!

Fashion sneakers

Just because these shoes are called “sneakers” does not mean they are good for your feet! This foot wear typically has poor construction: too much flexibility and insufficient arch support. The lack of arch support is what contributes to arch pain. In addition, the materials used in the construction of these shoes typically do not allow the foot to breathe. So moisture from the foot gets trapped in the shoe leads to bromohidrosis (foot odor) and a fungus breeding ground leading to athlete’s foot.

Slingbacks

Slingbacks cause pain at the toes because the elevated nature of the shoe pushes your forefoot into the cramped front portion of the shoe. Blisters occur at the region of the strap because the foot rubs up against the material. Also, ankle twisting is a problem with slingbacks since the heel inappropriately moves from side to side during walking.

Ballet flats/Slides

These dainty shoes are not exactly the best shoes for your feet! The flat nature of ballet flats/slides and their lack of arch support places excessive pressure on the arch of the foot. Plantar fasciitis (pain from the arch to the heel) is a common result of inadequate arch support. Due to insufficient shock absorptive materials in the shoe, the heel ends up absorbing impact while walking leading to heel pain.

Follow these pieces of advice to ensure that you start your summer on the right step! No matter what the latest style trend is; happy, healthy feet are always in fashion!

Click Here to see shoe types and their adverse effects

Central Florida Foot and Ankle Center
101 6th St Nw
Winter Haven, Fl 33881
Phone: (863) 299-4551
www.FLFootandAnkle.com

The Wonders of the PedEgg!

2009-05-18T09:18:00.004-04:00

Before venturing off into describing this miracle foot care device, it may be beneficial to dive into some terminology that is associated with the PedEgg!

Callus or Hyperkeratosis – an accumulation of dead skin cells that is usually found on the bottom of feet which over time starts to toughen up into a thickened layer of skin, calluses are formed in areas of your body that are prone to constant friction

Foot File – a bidirectional instrument specifically designed to remove calluses and smooth the skin of the feet

Foot Rasp – a unidirectional device designed to smooth away the rough, hardened skin from the feet

Friction – a force that resists motion whenever the surfaces of two objects rub against each other

Exactly why do we have calluses? Calluses are formed in response to friction that may be caused by skin rubbing up against a shoe. The thick layer of skin in a callus is your body’s response to those forces and serves as a cushion against the harmful force your foot encounters. The most common places for callus formation are on the heel, ball of the foot, and/or underneath the big toe.

Now that the fundamentals of callus formation and some instruments of callus reduction have been covered, let’s talk about the PedEgg device! The PedEgg is a foot file that allows you to quickly and safely minimize that buildup of skin at the bottom of your foot; it is basically a “callus grater!”

This device is easy to use and efficiently files down callus size as well as dry skin leaving the bottoms of your feet extremely smooth. It has over 100 files that work to reduce the size of the callus! This tool also collects and retains all the skin flakes by storing them into a compartment, preventing the need to file your callus down in the bathroom or sweep up the skin shavings later. In addition, the egg-shape allows for easy gripping and the ergonomic placement of your hands so as to prevent uncomfortable positioning while filing down those calluses! Unfortunately, this device is not approved for the use by diabetic individuals and/or those who have poor circulation.

The PedEgg is a wonderful device to keep your calluses in check in between visits to your podiatrist! It’ll allow you to have beautiful, smooth beach-ready feet in no time!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Pregnancy and Your Feet Part 3

2009-05-09T16:42:00.001-04:00

Pregnancy is a wonderful phenomenon that brings about so many changes in a woman. Every major body system undergoes alterations in anticipation of the baby’s development and arrival into the world!

Pregnancy brings about certain foot changes such as edema, overpronation and increased foot size. Hormones cause almost all the changes that occur in a woman’s body due to pregnancy. Hormones are involved in almost every biological process including growth, immunity, metabolism, and reproduction. A hormone molecule acts like a little key that is secreted by a gland in the body into the blood. This key travels in the blood to link up with its matching lock elsewhere in the body to open up chemical processes like the manufacture of a certain protein, the multiplication of cell number or the stimulation of a chemical change.

Increased Foot Size

One of the key players in pregnancy is the hormone relaxin. The purpose of relaxin is to relax the tissues that bind the bones of pelvis together. By loosening up the pelvic connective tissue, the body will allow for the passage of the baby through the birth canal. However, relaxin does not just affect the pelvis.

Relaxin increases foot size because it loosens the hold of the ligaments in the foot. (Ligaments are tissues that connect bone to bone.) As a result, the arch of the foot starts to decrease in height and cause the foot to spread. Another reason that the foot grows in size is due to the increased pressure on it as a result of weight gain. The extra weight stems from the body hormones that amplify breast size and uterus size as well as the growing baby. The pressure also decrease the arch and flatten out the foot. Scores of women have reported that their foot grows by a half-size or more during pregnancy!

An array of foot problems can occur if you do not accommodate your increasing foot size! If you keep wearing tight footwear you can exhaust the muscles at the ball of your foot which play a role in keeping your toes straight! Also the jamming of your foot into tight shoes causes the development of corns, ingrown toenails, and bunions.

The effects of additional weight and slack ligaments on your foot requires well-fitting shoes with good support. Start with over-the-counter arch supports to maintain the arch and minimize problems. Furthermore, make an appointment with your podiatrist to keep your foot health in check! They may prescribe custom orthoses and advise you on other courses of treatment!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Pregnancy and Your Feet Part 2

2009-05-08T16:39:00.000-04:00

The wonder of pregnancy does not just stem from the fact that there is another human growing within you, but the considerable and diverse internal and external changes occurring throughout the body! Unfortunately, not all of these changes are favorable as they may cause discomfort or pain. Pregnancy may cause a variety of uncomfortable foot conditions stemming from edema, overpronation, and increased foot size like varicose veins, foot pain and leg cramping. To ensure that your foot health remains optimal during pregnancy, it is important to educate yourself and talk to your podiatrist

Overpronation

When the arch of an individual’s foot flattens out when weight is put on it, it is referred to as overpronation. Overpronation is seen in obese individuals, flat-footed people and in pregnant women. A person with this foot condition will find that their feet roll inwards while walking – which leads to all sorts of biomechanical effects such as ankle, knee and hip pain. All the joints in your leg work together to function in gait and balance and improper movement at the ankle will lead to the inappropriate delivery of forces up the leg and cause all sorts of problems.

Pregnant women experience overpronation and its associated symptoms because of the weight gain and the resulting added pressure on the foot. Overpronation causes your walking experience to be unpleasant and strains the muscles in the foot, leg, and back. In addition, the plantar fascia (a fibrous connective tissue connecting your heel to your forefoot) will become inflamed causing painful plantar fasciitis. Other problems that can occur if overpronation is not corrected are bunions, tibialis posterior tendonitis, metatarsalgia and heel spurs!

The good news about overpronation is that surgery is not required to correct it, however, if overpronation is not treated – it may lead to foot pathologies that will require surgery! Ready-made orthoses are available to treat overpronation. These will specifically be made to have arch support as well as rearfoot posting for the innermost surface of your foot. You can also make wise choices by selecting comfortable shoe gear that provides sufficient shock absorption and added support.

If you find that your symptoms worsen, make an appointment with your podiatrist! They will fully evaluate your foot health and make appropriate recommendations!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Pregnancy and Your Feet Part 1

2009-05-07T06:00:00.001-04:00

Pregnancy is no doubt one of the miracles of nature and is a cherished experienced for any mother-to-be! A woman’s body undergoes an amazing array of transformations to accommodate the new life developing within it! Pregnancy is a phase of life that engages the entire body and mind, resulting in a multitude of changes. Along with those changes, an abundance of precautions should be undertaken to ensure that during pregnancy and childbirth the mom and baby will both be healthy, comfortable and safe.

Every bodily system in a woman’s body experiences significant changes, and in regards to the foot, the 3 most noticeable changes due to pregnancy are swelling, overpronation, and increased foot size!

Swelling

Swelling (or edema) is a condition that a majority of women experience while childbearing. Edema usually occurs in the later stages of pregnancy and is caused by an accumulation of fluids in the lower extremity. The enlarging fetus and growing uterus put pressure on the blood vessels in the pelvis and legs. This causes a slowing in blood circulation and as a result the blood accumulates in the lower extremities. In addition, the fetus is also sitting on your lymphatic channels (vessels that drain fluid from all areas of the body) and putting pressure on them, leading to their narrowing. This constriction inhibits their ability to remove the lymphatic fluid which then keeps collecting in the area of your foot and ankle!

Edema is not EXTRA body fluid caused by pregnancy. The total amount of water in the body is exactly the same. Rather, the fluid has just has been shifted to another location due to obstruction of both blood and lymphatic vessels. Edema will cause an enlargement of the affected body area and may cause that part to tinge purple.

There are various ways to reduce the discomfort of edema. Practice the avoidance of knee-high socks and of pantyhose/socks with elastic bands. Make sure to elevate your feet, take every opportunity to sit rather than stand, and obtain plenty of rest. Although it may sound counterintuitive, it is important to increase your water intake! The extra ingestion of fluid will assist in flushing your system of waste products which may also play a role in the swelling. Also, decrease the amount of salt in your diet since it is attributed to water retention in the body.

Swelling is normal in pregnancy, but if you see that its onset is abrupt and/or that it occurs in your hands simultaneously as they are indications of preeclampsia. Preeclampsia is described as a pregnancy-related high blood pressure and is a dangerous condition!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Personal Protection from the Influenza Virus (Including Swine Flu!)

2009-05-06T16:07:00.008-04:00

Spreading the Flu Virus

The possibility of local or national influenza epidemic is a concern to all of us. While individuals cannot completely limit their exposure to the viruses that cause various types of influenza, there are things that can be done to reduce the likelihood of becoming infected. The following information is intended to help increase personal awareness and decrease the possibility of becoming exposed to the virus that causes influenza or other Type A influenzas. Additionally, it will help prevent exposing others should someone become ill.

Influenza viruses are spread when a person who has the flu coughs, sneezes, or speaks and spreads virus into the air, and other people inhale the virus. When these viruses enter the nose, throat, or lungs of a person, they begin to multiply, causing symptoms of the flu.

The viruses can also be spread when a person touches a surface with flu viruses on it (for example, a door handle) and then touches his or her nose, mouth or eyes.

A person who is sick with the flu can spread the virus (i.e., is contagious) from 1 day before developing symptoms to up to 7 days after getting sick. Children can be contagious for longer than 7 days. An individual recovering from influenza may remain contagious even while claiming to feel better.

Preventing Exposure to Flu Virus

Employees can prevent exposure to the flu by being vaccinated each Fall, but there are other common-sense ways to protect against the flu:

Avoid close contact: Avoid close contact with people who are sick. Employees who feel ill should keep their distance from others to protect them from getting sick too.

Wash hands: The best way to kill flu viruses on one’s person is by cleaning hands several times a day for at least 20 seconds with either soap or hand sanitizers. Washing hands often protects the individual from the flu virus and other germs.

Cover the mouth and nose when coughing or sneezing: Covering the mouth and nose with a tissue when coughing or sneezing is not only courteous, it is expected. This practice will help prevent those in the vicinity from getting sick.

Avoid touching the eyes, nose or mouth: The flu is often spread when a person touches something that is contaminated with the virus and then touches his or her eyes, nose, or mouth.

Stay home to prevent exposure to others: If possible, individuals with flu-like symptoms should stay home from work and not run errands in public. This will help prevent others from catching others’ illnesses.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Skip the Flip! Part 3

2009-04-28T13:59:00.001-04:00

The flip-flop excels in terms of significantly altering the biomechanics of your gait and the anatomy of your foot. The problem is that this footwear seems so innocuous! Who would have thought that such a simple shoe is the reason for so many pathologies and resultant office visits!?

This summer footwear alters your gait patterns adversely, provides zero support for your lower extremity, does not offer shock absorption (leaving your poor foot to deal with stress all on its own), yields no traction on level surfaces, and may result in strain and sprain injuries! In addition, wearing flip-flops will cause back, hip, and knee pain and overuse injuries at the level of the ankle! It is almost unbelievable that the wearing of flip-flops wreaks such havoc on your body and is responsible for so many abnormalities!

But, there’s more! Unlike other shoes, flip-flops do not hold onto the foot and so it becomes necessary to use your muscles and tendons to clutch them in place. If you have a high-arched or flat foot type, wearing flip-flops is particularly bad because you are likely to develop problems related joint stability and tendons. Depending on the length and duration of wear, you may develop chronic tendinitis!

Most flip-flops are constructed with a springy, elastic sole. As your foot hits the ground when wearing normal shoes, it rolls inwards or everts. Flip-flops actually allow the foot to roll inward even more than usual! This eversion of your foot is called pronation and too much pronation will lead to many foot problems! Your arch is supposed to lock in place in order to absorb shock every time your foot hits the ground. Pronation of the foot opens your arch and loosens its locking mechanism. If this happens, you will encounter problems in various foot areas: toes, forefoot, arch, and heel!

The open style of flip-flops also predisposes your feet to environmental factors such as friction, heat and moisture which can lead to the formation of blisters, warts and athlete’s foot!

So before you rush to your closet and chuck out all your flip-flops, keep this important idea in mind: moderation! Do not wear flip-flops for long periods of time for walking and do not wear them while driving (since flip-flops are not anchored to your feet, they may get lodged under your brakes or gas pedal). This summer, just wear them to lounge by the pool or play in the sand while on the beach!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Skip the Flip! Part 2

2009-04-27T09:08:00.003-04:00

In addition to soaring stilettos and towering high-heels, the down-to-earth flip-flops are now considered to be notorious footwear! Why exactly is this the case?

The number one reason that flip-flops cause the problems that they do is due to misconception! Many people believe that flip-flops are footwear designed to relieve the stress on your feet! However, nothing could be further from the truth!

To understand how dynamic feet are, think about all their functions:

1) They are essential for our mobility

2) They help with preserving our balance

3) They bear our full body weight

As a result of trying to maintain their many roles, our feet are subjected to many stresses.

As mentioned before, wearing flip-flops will overwork your feet and lower extremity because flip-flop laden feet lead to change in gait patterns. So now along with a change in your walking, your feet have to readjust themselves to make sure they still maintain your mobility, keep your balance, and support your full body weight!

Another reason that flip-flops are no good in terms of foot health is because they provide zero support. Athletic shoes, for example, have excellent cushioning which assists the heel in shock absorption. Since flip-flops do not have shock-absorbing capabilities, the foot will take on the stress which over time can lead to pathologies like tendinitis.

Furthermore, the foot is well-confined in an athletic shoe and consequently does not deviate in different directions. A flip-flop has open sides and as a result, the foot has the ability to maneuver itself in any direction it sees fit. Excessive and improper movement of the foot diminishes its shocking-absorbing capability since the foot is now not in the proper position to take on the stress.

Additionally, many flip-flops provide poor traction on smooth surfaces. For that reason, people are more prone to falling and slipping. When you walk on a wet surface in flip-flops, your foot may slip off of the actual shoe and twist, causing a painful strain or sprain. If you step off of a sidewalk incorrectly while wearing flip-flops, there are no sides to a flip-flop available to support the foot or ankle. Now pair that with the fact that the foot has the ability to move in any direction it wants while you are in such footwear. You are setting yourself up for a potentially serious injury since flip-flops make it easy to take that wrong!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Skip the Flip! Part 1

2009-04-24T08:34:00.005-04:00

Everyone has heard that certain footwear can be damaging to your foot health, but that fact has always been associated with sky-high stilettos! However, recent research investigating flip-flops has uncovered evidence that may take away that spring in your step! Did you know that podiatrists have said flip-flops have been to blame for more health problems than any other type of shoes?! With warm weather fast approaching, you may want to rethink your choice summer footwear.

Health professionals have noticed that during the transition from summer to fall, they found an increase in patient complaints concerning lower leg pain. Incidentally, this pain seemed to coincide with a footwear change from flip-flops to athletic shoes related to the seasonal change.

The typical American walks a total of 10,000 to 20,000 steps a day! So it is no wonder that small changes in walking patterns can quickly add up to significant injury! Experimenters discovered that flip-flops actually alter the gait patterns in the individuals wearing them. It was found that this summer footwear lessens stride length and increases the ankle angle in individuals. (The ankle angle is the measurement between the top of the foot and anterior leg).The studies also showed that people wearing flip-flops exhibit a concern about hitting their toes when they swing their leg during gait.

Consider this: when walking in flip-flops you may have noticed that you try and keep the flip-flop on your foot so it does not launch into the air as leg sways forward. In addition, you also keep a watchful eye on your toes as your foot swings through so you do not stub them on the ground. In order to prevent the above two phenomena from occurring, you change the angle of your ankle during your stride in flip-flops.

Pain is not just confined to the lower leg region when you are wearing flip-flops. You may experience aches and pains in other body areas as well! The heel of your foot serves as a cushion for shock absorption. If the interface between the heel and the ground is not supported, then the heel will not absorb shock as well as it should and the foot will have to work harder! As a result of overworking your foot, knee, hip, and back problems can occur!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Do you have "Pump Bump"

2009-04-16T16:06:00.005-04:00

Haglund’s Deformity is a protrusion of bony growth off of the top of the calcaneus, or heel bone. This can often lead to a painful swelling of the bursa between the calcaneus and the Achilles tendon, also known as bursitis. The bursitis is caused by the Haglund’s Deformity rubbing up against the soft tissues of the back of the ankle, usually from a pair of poorly-fitting shoes. In fact, Haglund’s Deformity is sometimes called a “Pump Bump”, because women’s pump-style shoes will often irritate the soft tissues. Young women that wear this style of shoe make up the largest group of patients with bursitis due to Haglund’s Deformity.

Symptoms of Haglund’s Deformity include inflammation and redness of the back of the heel, swelling in the area that the Achilles tendon attaches to the calcaneus, and a noticeable bump on the back of the heel. This bump is the bursa sac between the Achilles tendon and the heel bone that has become inflamed. These symptoms can be seen on either or both heels. Your foot and ankle specialist may diagnose Haglund’s Deformity by taking x-rays of the effected area to rule out other possible causes.

Haglund’s Deformity, to a certain extent, can be attributed to heredity. A person with high arches will have a heel that is tipped backwards towards the Achilles tendon, which predisposes the person to excessive rubbing of the heel against the bursa. Other factors include the types of shoes that people wear, such as tight fitting pumps or high heels. Pain from Haglund’s Deformity is also frequently seen in runner’s, especially those with poorly-fitting running shoes that put extra pressure on the back of the heel.

Once your doctor diagnoses Haglund’s Deformity, there are several non-surgical options of treatment that may be suggested. Medication, such as a non-steroidal anti-inflammatory drug (NSAID) and ice may help in alleviating the pain and inflammation. Certain exercises that strengthen the muscles of the leg will help to alleviate some of the tension on the Achilles tendon, and physical therapy may help as well. Your foot and ankle specialist may suggest heel pads, heel lifts, or orthotics to help prevent the rubbing.

Of course, the option of surgery may be suggested if the non-surgical methods of treatment fail to relieve the pain. Surgery on Haglund’s Deformity involves removing the piece of the bone that is rubbing against the bursa sac and the Achilles tendon.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Hammertoes Affect Even the Rich and Famous!

2009-03-30T12:57:00.021-04:00

Paris Hilton, Brooke Shields, Katie Holmes

What are hammertoes?

Take a look at the toes on your feet. You will notice that your big toe only has 1 joint (1 place it can bend) while your 4 smaller toes have 2 joints (2 places they can bend). Hammertoes affect the toes with multiple joints – it is a condition where your little toes acquire a curl at the first joint which then forces the tip of your toe downward. The resulting toe looks like a hammer or hook.

What do hammertoes look like?

As mentioned before, hammertoes are the curling of the toes. In the above pictures, you can see the toes of these women do not lie parallel to the ground. However, these are feet belong to famous women! Try to identify these famous stars’ feet! The answers can be found at the end of this series (along with the full length photo of their couture)! Yes, even Hollywood superstars have foot problems!

What leads to hammertoe formation?

- High-heels

- Tight shoes

- Ill-fitting shoes

- Trauma

- Bunions

- Arthritis

Tight, ill-fitting and/or elevated shoe wear can force your middle toes to experience an overload of pressure which will then cause them to contract unnaturally. The crowding of your toes into a shoe may force your toe into the prolonged cramped position that ends up into a hammertoe condition.

A bunion is a foot deformity that involves the formation of a crooked bump on one side of the big toe. This bump is caused by the big toe moving towards your smaller toes. Overtime, the big toe will either overlap or underlay your smaller toes or crowd them and push them out position.

Hammertoes need to be evaluated because if your toes stay in their bent positions for extended periods of time, the tendons that function at those joints will become stiff (because they do not experience the full amount of stretching) causing permanent contractures. In other words, hammertoes will be evident even when walking barefoot!

What are the symptoms of hammertoes?

- Hook-like, curled toes

- Corns or calluses (thickened patches of skin created in response to friction against a surface)

- Discomfort or pain at the toes, at the ball of foot or in front of leg (when toes experience a downward stretch)

Hammertoes Affect Even the Rich and Famous!

Part 2

The passion for fashion is what leads to some very interesting foot conditions. No woman is immune to the deformities that can be caused by high heels or ill-fitting shoes – like hammertoes, for instance.

How can hammertoe formation be prevented?

Hammertoes can be avoided by following the toe-friendly recommendations listed below.

- Elect to wear shoes that are one-half inch longer than your longest toe – this allows for wiggle room for your toes

- Choose footwear with wide or box-like fronts – shoes that come to a point have very little room for your toes and may lead to deforming conditions

- Try to avoid high-heeled shoes – these types of shoe force your toes forward into the shoes where they will become cramped

Hammertoes will become permanent if you do not make the effort to take care of your toes!

How can hammertoes be treated?

Therapy for hammertoes requires stretching the toes in order to keep the tendons of the toes flexible and preventing the reoccurrence of the deforming condition.

Foot soak and stretches

- The heat from a warm water bathing of your toes will allow your toes to relax and the stretching of your toes toward the sole of your foot will keep your tendons supple

Exercises

- Simple exercises can be done to prevent tendon tightness – one such way is to place a wash cloth or small towel onto the floor and then grasp it using only your toes

- A podiatrist may recommend a proper set of toe and foot exercises to keep your toes lithe

Splints

- A store-bought or homemade splint will keep your toe straight and extend the tendons of your toes

Surgery

- A podiatrist may perform a surgical procedure on hammertoes that have reached a permanent state of contracture

Arthrodesis – this surgical technique is an option for the enduring hammertoe cases, it entails the fusion of a joint in order to flatten the toe

Arthroplasty – this hammertoe straightening procedure involves the removal of a small portion of bone from the affected joint which cause the toe to become straight

It is very important to consult your podiatrist before undertaking any course of action. Their medical expertise will help you solve your foot problems!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Spring is here, and the summer is right around the corner. Do you have your flip-flops? Should you?

2009-03-24T08:36:00.005-04:00

With warm weather just around the corner, that can only mean one thing. Ladies and Gentlemen, it’s flip-flop time! They’re all the rage – easy to throw on (and take off), usually inexpensive, and they come in thousands of colors and styles. But are they comfortable? Are they the best thing to wear all day long in the summer time? The answer is, well, probably not.

Most flip-flops and sandals provide little to no padding or arch support. For walking across the pool deck or running a quick errand, they’re okay, but walking extended distances in these types of sandals can be brutal on your feet. Heel pain, shin splints and arch pain are all common complaints of excessive flip-flop wearers. Flimsy sandals also do little to protect your toes from blunt trauma (stubbing your toe on a pool chair) or from stepping on rocks and other debris that may be on the ground.

So how do you fix the problem?

When looking for a summer sandal, it’s best to look for something that is a bit stiffer, something that will provide more arch support than the average flip-flop. You definitely don’t want to wear something for an extended period of time that you can easily fold in half. Also look for something that is well cushioned in the heel. This will lessen the impact on your foot, saving you the discomfort of some nasty heel pain. A sandal with a strap on the back will keep the sandal snug on your foot, providing added protection and support.

You can also look for sandals made by specific brands that have been awarded the American Podiatric Medical Association (APMA) Seal of Acceptance. Some of these brands include Dansko, Chaco, Wolky, Crocs, and Rockport. Check out a complete list of APMA approved footwear at the APMA website.

Flip-flops and sandals are as much a part of the summer as barbecues and baseball, but remember, they do come with a price tag. To avoid foot pain this summer, wear socks and comfortable shoes for long walks through amusement parks and malls, and save the sandals for the pool.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Feeling Callous about a Callus?

2009-03-23T08:34:00.008-04:00

Everyone who’s anyone has had a callus at some point in their lives… and has had a question or two about them. What are they? Why are they so annoying? How do they form? What do you do get rid of those little nuisances?

A callus (also called a hyperkeratosis) can be defined as a congregation of dead skin cells that is usually found on the bottom of feet. Over time that accumulation of cells starts to toughen up into a thickened layer of skin. Calluses are formed in areas of your body that are prone to constant friction. Callus formation is your body’s mode of combating the forces of excess pressure and friction. That thick layer of skin serves as a cushion for the abrasion your foot encounters. The most common places to find calluses are on the heel, ball of the foot, and/or underneath the big toe.

The overload of these forces on your feet can be caused by a variety of factors: high-arched or low-arched feet, loss of the fat pad of your foot, obesity, high-heeled shoes, gait abnormalities, foot friction while wearing socks and/or shoes, ill-fitting or narrow shoes, and prolonged standing. A callus is usually painless, but in some instances you may experience significant discomfort because your callus may have a deep knot-like center called a nucleation. This type of callus is called an intractable plantar keratosis.

Calluses can be treated by using rasps, files, or another callus remover product to minimize the callus. You may also try applying a moisturizer or cream to soften the callus. The best way to treat calluses is to wear proper fitting shoes that eliminate the focused irritation or friction on your feet. You can purchase shoe inserts, insoles or orthoses to provide padding and reduce the pressure points in your shoe. It is best to find shoe wear that has shock absorbing capabilities. Whatever you do make sure not to cut or trim your calluses with a razor, knife or scissors. This is a dangerous method to eliminate calluses and may worsen the problem.

According to the American Podiatric Medical Association, painful calluses affect 5% of the U.S. population. Calluses are not a serious health risk, but as mentioned before, they may be irritating and/or painful. Make sure to secure an appointment with your podiatrist if you experience pain with your calluses. They may perform in-office procedures and devise a treatment plan to help you fight off those pesky little problems!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Nail Polish: a Health Hazard?

2009-03-23T08:26:00.007-04:00

The immense variety of nail lacquers and polishes make it hard to choose the perfect product! Whether you want to strengthen brittle nails, lengthen short nails, or just add a little color to your fingers and toes – there is a vast arsenal of products in an infinite palate of hues to satisfy every fancy. However, do not be fooled by the seemingly innocent contents of that small, brightly colored bottle. Did you know that the chemicals in nail polish are potentially hazardous for your health?

The dangers of nail polish are directly correlated with the chemicals used in their manufacture. Most nail polishes are chock full of a variety of harmful substances. The major toxic compounds that you need to watch out for are toluene and dibutyl phthalate.

Toluene is a clear fluid that is a component of many products: gasoline, paints, shoe polish, and even explosives! This compound allows t the nail polish to stay in its liquid form in the bottle and is responsible for the rapid drying of the nail polish when on your nails. Toluene is bad for your health because it affects your nervous system causing nausea, headaches, and depression. In addition, toluene induces kidney and liver damage as well as eye, nose and throat irritation. It has even been implicated in the development of cancer!

Dibutyl phthalate (DBP) is a chemical that is used as a binder to improve the endurance of nail polish when applied to your nails. This is th substance that allows plastic ware its flexible properties. Women of child-bearing age are being asked to avoid DBP because it has been linked to cancer in laboratory rats and the disruption of hormone levels in humans. In addition, this compound may play a role in childhood asthma, lasting fertility problems in newborn boys, and liver toxicity.

Besides toluene and DBP, compounds such as ethyl alcohol, formaldehyde, and glycol ethers are potential toxins found in nail polish as well! Why are these chemicals so bad?

Ethyl alcohol – irritant of mucous membranes and suppresses the activity of the central nervous system

Formaldehyde – neurotoxin that has produced cancer in certain laboratory rats

Glycol ethers – substance that has been associated with birth defects in animals, lower sperm counts in human males whose mothers were exposed to low levels, and higher than normal rates of miscarriage with increased exposure

Take the time to find a product that is DBP and toluene-free! There’s no point in taking an unnecessary risk just to keep those toes colorful!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Barefoot Running

2009-03-16T13:04:00.005-04:00

The barefoot lifestyle and barefoot running is a trend gaining popularity in the running community. Opinions on barefoot running vary greatly, from “Absolutely Not” to “Absolutely No Other Way”.

The barefoot community claims that running barefoot improves the runner’s form, and eliminates problems like knee and hip pain. This is due to a change in form. When wearing running shoes, which typically have a thick padded cushion in the heel, striking the ground with the heel first sends shock all the way up the leg. This force is largely absorbed by the knee, as well as the hip and back, which can be transferred to chronic pain. Barefoot running eliminates the option of heel striking, forcing the barefooter to land on the balls of the feet, with the feet lined up directly underneath the hips. This allows the force to be displaced more evenly, avoiding common running injuries.

Many claim that the barefoot lifestyle is the only way to go. Advocates of a barefoot lifestyle claim that it is the only true way to feel the ground, and that keeping your foot in a shoe all day is bad for the mind and the spirit. Barefoot running expands into barefoot walking, even barefoot driving!

But is the barefoot lifestyle a wise decision? The opinion on the other side of the spectrum is that barefoot running and walking can lead to serious health problems. Imagine walking around barefoot all day with an “improper” form, striking with your heel. This would lead to some serious heel pain. Also, a barefoot lifestyle offers no protection against the elements, and no protection against debris that may be on the ground. Puncture wounds on the foot can lead to serious infections.

Still, even with the obvious thought that a barefoot runner’s feet would get chewed up by the elements and terrain, barefoot running has a significant following. In fact, many bare footers prefer a rough terrain like asphalt to a soft terrain like grass or sand! There has been much reporting on the barefoot lifestyle, including this article found in New York Magazine, which discusses the idea of shoes wrecking our feet by wearing shoes. There are websites devoted to a barefoot lifestyle, like the Society for Barefoot Living and RunningBarefoot.org.

While many may shudder at the thought of walking to the store with no shoes on, or running on a city sidewalk barefoot, there are those who would have it no other way. Which side of the fence are you on?

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

Warning: DANGEROUS Pedicures Ahead! Part 1

2009-03-16T09:35:00.005-04:00

In anticipation of sandal-wearing season a trip to the salon to pamper your feet and to beautify your toenails is definitely on your to-do list. Soaking your feet in a warm bubbling foot spa followed by a massage is definitely an indulgence. However, you might be getting more out of a pedicure treatment than you might expect!

It may not be a surprise that the root of all evil is bacteria. However, what might be shocking is that these organisms just love the temperate water of the swirling foot spas. These bacteria are just teeming in the water that you place in your feet in! The danger lies in the fact that these bacteria will find places in the pipes and plumbing of foot spas to adhere to. No matter how clean the basin is – the bacteria never actually disappears because they will be flushed out of the tubing with the circulating water and they will still find their way to your feet.

What exactly happens?

For bacteria to grow, they need to be in an environment that provides them with nutrition and optimal temperature. The filters of a foot spa are perfect havens for bacterial growth because they provide a food supply as well as a warm environment for the organisms. Filters trap particles and debris while allowing for the passage of water and the bacteria make their home where this organic and inorganic material has collected and feed off the filtered matter. Once the bacteria have found a place to nest they will multiply and rejoin the water stream with every cycle of water circulation. Now this is the water you are soaking your feet in.

How will the bacteria enter the body?

If you have any cuts or open wounds you should not enter a salon until the skin has been allowed to heal itself. If you have a pedicure appointment, make sure that it is at least 24 hours after you have shaved or waxed your skin because those procedures will have left tiny openings in your skin. These holes are portals of entry for bacteria – so do not give them the chance to get into your body! If you are a diabetic, HIV patient, and/or elderly – you are prone to bacterial infections that may lead to serious complications including death.

Not such a relaxing experience now, is it?

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

Warning: DANGEROUS Pedicures Ahead! Part 2

2009-03-16T09:34:00.004-04:00

You may just come home with more than pretty feet after a pedicure!

Who are the culprits?

Bacteria such as Mycobacterium fortuitum and Methicillin-Resistant Staphylcoccus Aureus(MRSA) are two such organisms that can cause a variety of health problems that can range from being a nuisance to life-threatening illness.

What kind of problems will these bacteria cause?

Mycobacterium fortuitum is often found in pedicure facilities and if it finds its way into your body, you may be dealing with some irritating problems. The bacteria will produce lesions that bear a resemblance to insect bites. These lesions will eventually enlarge to produce pus. When the boils finally heal they will leave scars on your skin!

Methicillin-Resistant Staphylcoccus Aureus or MRSA is another organism that could cause problems. This is a particularly dangerous bacterium because it is very aggressive and hard to treat because it easily develops resistance to many antibiotics. MRSA will cause the most the serious problems in individuals with weak immune systems such as diabetic patients. Signs of a MRSA infection include small red bumps that look like spider bites that may be associated with fever and rashes. With the passage of a couple of days the bumps will swell into painful pus-filled lesions that could turn into abscesses! To treat an abscess, an incision and drainage procedure is required.

MRSA is especially scary when it spreads to other parts of the body. In 75% of all cases, the bacteria will journey to other areas of the skin and soft tissue – so it remains superficial. Unfortunately, there have been cases where MRSA dives into the body and proliferates into bones, joints, and inner organs! This organism may also cause sepsis which is the presence of various pus-forming organisms or their toxins in the blood or tissue. The sepsis can be considered a total body inflammation to the infection! There have also been incidents where MRSA infections from a pedicure treatment have lead to limb amputation and death!

Always be careful and make sure that your salon follows the highest standards of safety and hygiene. Contracting Mycobacterium fortuitum or MRSA during a pedicure session is probably not your idea of a peaceful spa experience. Who knew that a day at the salon to pamper your feet might jeopardize your life!?

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

The "Price" You Pay to Look Good

2009-03-16T09:32:00.004-04:00

Is it just me, or has the phenomenon around Sex and the City taken the popularity of high heels and skyrocketed those to new heights? More then ever, high heels have become a fashion statement unto themselves, with each season bringing about more shocking, more vibrant, and more amazing shoes than their predecessors.

But a three or four inch shoe can be daunting. And many cannot even begin to fathom the greater heights, as we push ourselves in to 4 1/2, 5, or 6 inch heels. With the pursuit of vanity (and great gams) come warnings, fears, and frights.

DR.’S RESPONSE: High heels are the nemesis of the astute podiatric surgeon. Unfortunately, despite our best and well intentioned efforts to encourage the disuse of high heeled shoes, fashion conscious women continue to push the envelope. I’ll give you an example: Just yesterday I was at a boat show, with steps, docks, and people getting in and out of boat gunnels. I saw a middle aged woman there with 6 inch heels, obviously in intense agony walking and hobbling along. Why do women torture themselves? As a physician, I recommend the use of flats with an elevated heel of 1 inch. If heels must be worn, I encourage my patients to use heels of 2 inches or less. Anything more severely alters the biomechanics of a normally functioning foot. This can lead to a shortening Achilles tendon, bunions, deformed toes, formation of a bump on the back of your heel, balance problems, sprained ankles, blisters, and corns.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

HIgh Heels

2009-03-16T09:30:00.004-04:00

High Heels

Did you know the average woman will wear high heels for 51 years of her life? It’s no wonder that foot problems will develop! Just what features of high heels make them so bad for your feet? It is not the color or the material of high heels that are leading to the foot problems! Rather, all the problems that stem from high heels center on their incompatibility with human anatomy!

Stress 1: The angled nature of a high heel means that your forefoot becomes the focus of pressure when walking, climbing stairs, jumping, or running! The excess force on a particular section of your foot can lead to stress fractures which are small breaks in your bones that can lead to pain and swelling!

Stress 2: When you slip on high heels you are actually elevating your foot which drastically off-balances the forces that act upon your feet. By altering the force that acts upon your big toe, you might destabilize that joint and it could lead to the formation of a bunion. That bunion can lead to discomfort and swelling which can then push the other toes out of line!

Stress 3: Wearing high heels means that your foot is slanted instead of parallel to the ground and now gravity has more of a reason to pull you down! If you have worn high heels you know that your foot slides forward into the shoe due to the gravity and this phenomenon leads to a shift in your weight. The sliding motion results in friction and in an effort to protect itself, your foot will develop thickened areas of skin called corns (top of your foot) and calluses (bottom of your foot).

Stress 4: The sliding action of your foot in a high heel forces your toes into the narrow portion of the shoe. Over time, your toes will start to deform by curling at their middle joint in order to accommodate in the cramped space. The bending at the middle joint of your toes leads tohammertoe formation and leads to the increased incidence of corns and calluses. Your joints could even dislocate and may require surgical correction!

Ladies, think about how a high heel looks and how your feet feel in them while reading this and it might help you fathom all the different stresses you are subjecting your feet to!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com