Varicose Veins

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!!

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

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!?

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?

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

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

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

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

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

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