Happy Holidays

Happy Holidays from all of us at Podiatry Care Specialists, P.C.

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Holiday Shopping

This is a busy time for everyone. Holiday shopping, running around, and being on your feet. It is important to remember, not only during the holiday season, but whenever doing long periods of walking and standing on your feet to wear the appropriate shoe gear. We generally tell our patients that anything is better then going barefoot, socks, sandals, and flip-flops. For around the house, Crocs can be very beneficial for your feet. Our office dispenses different styles of Crocs, with the most common we recommend is the Crocs Relief. They are great for heel and arch support. As for during the holiday shopping, it is not a great idea to do this while in heels, Uggs, or narrow pointy shoes. Wear comfortbale shoes or sneakers with a firm heel counter and great arch support. Happy Holidays to all and please feel free to visit our site for more info


Happy Holidays,
Chad J Friedman, DPM

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Jeremy Maclin Philadelphia Wide Receiver

It appears that another NFL player is suffering from one of the most common foot conditions we treat, plantar fasciitis. So far, Maclin, has not been limited in his activity and is still playing with the team. Expect him to play this weekend in a must win divisional game for the Philadelphia Eagles. He will most likely have a lot of physical therapy this week along with strappings, ice, and anti-inflammatory medicine to calm this down. For more information on Plantar Fasciitis, please visit out homepage listed below.

Thank you,
Chad Friedman, DPM


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Eli Manning Stress Reaction

Well it looks like Eli Manning suffered another setback with his Plantar Fasciits. Apparently he must have been compensating too much from the condition and has developed a stress reaction to the cuboid bone in his foot. Now what is a stress reaction? A stress reaction is changes that is occurring within the bone. Could be from overuse or trauma. What is important is that if left untreated, this can lead to a stress fracture in the foot. A stress fracture in the foot, and depending on the bone in the foot, can definitely put an end to a season. And with not that many weeks left in the season, it can end his. Treatment for both is to stay off the foot and offload it. This again can be done via a Camboot, cast, ice, rest, and crutches. He also has shoe gear modification as well. Will keep you posted on his progress.

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Happy Thanksgiving

We would like to wish everyone a Happy Thanksgiving!! Please keep in mind if you are doing a lot of cooking or running around this holiday season to be in good supportive shoe gear and to avoid as much as possible going barefoot or just having socks on

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SAP Health Fair

A few months ago Dr Chad Friedman was fortunate to give a lecture at the SAP health fair in Newtown Square PA. The health fair was a success as there were many people who stopped by to learn information about Podiatry and what we have to offer in our practice. If you to would like to know more about our services and what we have to offer for your foot health, please visit our website below or call to make an appointment.

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Lecture

Dr Chad Friedman recently gave a lecture at St Albans Church in Newtown Square. The lecture was presented to St Anastasia's members. The lecture presented was on general foot health and included bunion, hammertoes, neuromas, heel pain, arthritis, fractures, diabetes, and wound care. For more information please visit out site for educational videos

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Eli Manning Update Part 2

Eli Manning did not have a good game yesterday. Could it be that his plantar fasciitis is acting up again and not completely be calmed down? Sure its possible. But remember there have documented studies that show that this can be healed 90% of the time with conservative treatment options. He is still getting the continued care he needs to help this area heal. Remember this includes strappings, anti-inflammatory medicine, ice, inserts or orthotics, injections, and physical therapy. Cleats can also be a culprit because because of the quality of the cleat. These can also lead to many foot problems. This is why we recommend inserts in them.

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Eli Manning Update

Eli Manning had a great game this past weekend against the Oakland Raiders.
"I felt good," the Giants' quarterback said on a conference call with reporters Monday afternoon. "I moved around and didn't have a setback by any means. I feel like it's getting better every day and will and should feel better by the end this week and keep improving.”
He was not limited at all during the game. With plantar fasciitis, getting back to physical activity can be an achievable goal. With daily stretching, taping, orthotics, injections, and physical therapy, can get you back to your normal lifestyle. Its always important to remember, that foot pain is not normal. Plantar Fasciitis can be treated if it is treated early enough. Will keep track of Eli's progress. Please visit our website for more information on heel pain.
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Tom DeLay Dancing With The Stars Foot Injury

Once again another famous person has had an important injury. Tom DeLay, former Republican majority leader, has stress fractures in both feet. Stress fractures are caused by repetitive injuries. If they are not treated early enough, they can lead to a complete fracture. If this happens, this can take a lot longer to heal. Initial treatment for stress fractures include the principles of RICE- Rest, Ice, Compression, Elevation. Also this includes Immobilization. As we talked about before, CamWalkers are one of the best immobilization options we have for stress fractures. It's unfortunate that Tom DeLay had to withdraw from Dancing With The Stars, but if he did not, then he would be at risk for a complete fracture and longer healing times. This is why it is important to not continue daily activities when you have pain and discomfort. Always visit your Podiatrist if you are having foot pain. Remember, foot pain is NOT normal.

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Eli Manning Fantasy Football Outlook

It seems like another famous athlete has developed the painful condition known as Plantar Fasciitis. He also may have developed a bone bruise along with this. After the injury occurred you can see the trainer was taping up Eli's foot. One of the most common things that we do for plantar fasciitis is to tape, or strap the foot. This helps support the heel and arch area which is important in plantar fasciitis. I am sure he will also have a lot of stretching, icing, and physical therapy this week to calm the area down. It is possible he will also be wearing orthotics (shoe inserts) in his cleats as well.
Now Eli, had an MRI to help confirm the diagnosis. He may also have had a bone bruise to his heel as well. If this is the case, this may take a little longer for him to heal. Treatment is similar but he may be in a CamWalker for the bruise.
Now for people who are into Fantasy Football and have him on your team (like myself) you are probably wondering if you should start him or not. Studies show that with plantar fasciitis it is usually treated conservatively 90% of the time. Depending on which treatment he gets he should be fine for the game. I don't see him being limited too much as long as he is taped up and has inserts in his cleats. I am hoping he has a good game. We will continue to monitor his progress and will update you on his condition.

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Sweaty Feet

Sweaty feet is also known as Hyperhidrosis. This commonly occurs on the palms and soles of the feet. Some people may have more sweat glands than others. When your feet sweat, this is a breeding ground for fungus and warts to develop. Remember how we talked about that fungus and warts, love a warm moist environment? Hyperhidrosis can also lead to Bromohidrosiswhich is foot odor.

There are many different treatments that can help hyperhidrosis. One thing that we will typically recommend is to not wear 100% cotton socks. 100% cotton socks do not wick away moisture. So when your feet sweat in these cotton socks, the moisture will also stay with you all day. Socks with the synthetic material consisting of Lycra can help with this. It is also a good idea to constantly change your socks daily. We also have certain topical roll on anti-perspirants that one can roll onto their feet to help with the dryness. These products can be very effective and they range in different concentrations. There are also certain Talc's and lotions that we may dispense to help this out as well.

Please visit our page if you have more questions or call to make an appointment

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Gout

We have discussed some previous causes of heel pain such as plantar fasciitis and calcaneal apophysits. One overlooked cause of heel pain is Gout. Commonly we will see gout in the big toe joint. It can also be seen in the heel less commonly. Gout is a build up of uric acid in the body. Some people may tend to overproduce these uric crystals and then there are the people who under produce them and the body is unable to get rid of the uric acid crystals. The uric acid then tends to buildup in joints in the body. This leads to a red, hot, swollen, and inflamed joint. This can be very painful. Typically people may describe the pain so bad that the bedsheets are unable to touch the foot. There are many different causes of gout ranging from genetics, drinking too much alcohol, eating a lot of shrimp, shellfish, and red meat. Certain medications can also cause gout. Most commonly are the water pills such as Lasix and HCTZ. Certain tests can diagnose gout as well. This can be confirmed by a looking at the synovial fluid in the joint and a simple uric acid blood test. However these tests are not always positive. Sometimes in an acute gout attack, the blood test comes back normal. X-Rays sometimes can take years before seeing the erosive changes it can take on a joint.

Untreated, and long term gout can lead to arthritis in the joint. This is why it is important to see your Podiatrist (if affecting the foot) and your Primary Doctor to manage the gout. Early treatment during an acute attack most commonly involves a cortisone injection and anti-inflammatory medicine. This helps dramatically reduce the inflammation within a 12-48 hour window. Long term treatment may consist of being placed on medicine that helps control gout and prevent future flare ups. One thing that must always be done is a diet change. Avoiding alcohol, red meat, shrimp, and shellfish can help prevent future flare ups. Gout was typically called "The Disease of Kings" and "Rich Man's disease" because it was believed back in the day it was caused by an overindulgence of food and drink. But now we know more about what the causes and treatment are of gout and how to avoid it. As always if you are having the above symptoms and are suspicious for gout in your foot please contact your Podiatrist to get some relief

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Back To School Shoes

Summer is quickly ending and now many students and kids will be returning back to school. At this time, many parents will be buying their children new sneakers/shoes to also start the new year off. There are many different things to look into when buying sneakers and shoes. The American Podiatric Medical Association has listed a "1,2,3 test" to ensure a good quality shoe when purchasing new shoes.
The first thing to do it press on both back parts of the heel. this area should be firm and not compress.
(Images on the left are better quality sneakers than images on the right)
Click on picture for bigger picture.


The next step to check for is toe flexibility. The shoe/sneaker should compress at the ball of the foot and not the entire shoe. The shoe should bend with your child’s toes, but should not be too stiff or bend too much in the toe box area.




The 3rd test should be to grab the shoe/sneaker and twist it from side to side. A good quality shoe/sneaker will not easily twist in the middle.



Other important considerations is to go shoe shopping with your children. This will help promote good quality shoes early and often. Always look for the Podiatry Seal of Acceptance on the shoes. We have blogged about this earlier. Continually examine the wear pattern of the heels. Many kids will tend to wear out the heels even though their shoe size has not changed. Lastly, socks is always important when trying on shoes. Make sure to wear the correct socks when trying on shoes to ensure a proper fit.

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Flip Flops and Bacteria

There was an interesting article posted by NBC about Flip flops and bacteria that I would like to discuss. The University of Miami emergency mobile flip-flop lab found more than 18,000 bacteria on one flip flop. Now remember that's just ONE flip flop. What was even more interesting was that some of the bacteria that was found on the flip flops, were bacteria from fecal matter, respiratory germs, diaper rash, and yeast infection. Oh the places we go....the study tested different parts of NYC. The subway, parts of Coney island, Coney island public restroom at the train station, West Village, and Brooklyn's Prospect Park. Wow I couldn't even imagine wearing a pair of sandals, or flip flops in a subway. Let a lone a busy one like NYC. That one in the public restroom had about 13,900 bacteria!! Another interesting finding by Dr. Philip M. Tierno Jr., director of clinical microbiology and immunology at New York University’s Langone Medical Center, said "if such shoes were worn for three months over the course of an entire summer, 93 percent of them would have fecal bacteria on them and 20 percent of them would have E. coli."
Just think about what you are potentially walking in with those flip flops in bathroom floors, especially in a subway station. And I just don't mean human waste either. You also have small animal droppings as well.
The most important thing that one should consider is not having any open cuts, blisters, or sores. You shouldn't be wearing flip flops to begin with, with any of the above foot ailments. But with all those bacteria, this can lead to severe infections in the foot.
It is always important to take good care of your feet and to recommend checking your feet daily. For further information, please check out our website.

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What is My Foot Type?

We typically will get many questions regarding "What is my foot type?" and "What type of sneaker should I be looking for? Motion control? Stability?" Well it can be very easy to determine what your foot 'type' is. This can range from a flat foot, high arch foot, or a normal foot. It is very important to know this, so that when it comes to buying a pair of sneakers you can determine which kind to buy.

The images that you see from left to right are pictures of a High arch foot, flat foot, and a normal foot. To find out what type of foot you are you can perform the "Wet Test"

This simple test can be done at home. Basically, pour some water in a pan. Step in the pan so that the bottom of your foot is wet. Then step onto brown paper bag, shopping bag, or heavy paper. Then take a look to see which image your foot type is similar to.

Lets start off with the High Arch foot. If you don't see much of the instep, and a thin line of the outside part of your foot then you have this type of foot. You will basically be looking for a Cushioned or Flexible shoe type

Next would be the flat foot. If you see the majority of your foot than this is your foot type. You will typically be looking for a Motion Control or Stability shoe.

Lastly would be the normal foot type. You would most likely see half of your arch area. If so than you have a normal or neutral foot type. When buying shoes you want to typically look for a Stability type shoe.

This can help out tremendously when deciding between the differences out there between cushioned, flexible, motion control, and stability

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Athlete Update

If I come across some athletes with foot injuries I will tend to blog about them with their injuries and treatments and monitor their progress. Sometimes, their injuries are not always listed. A few weeks ago, I blogged about Carlos Quentin and his heel pain condition, plantar fasciitis.

Carlos Quentin is a baseball player for the Chicago White Sox. He plays the outfield position. His lat game played before going on the disabled list was May 25th, 2009. he did not return until July 20th, 2009. He underwent the ESWT treatment that we have discussed earlier in the blog.
Currently, he is doing very well since his treatment. He is batting .357 just in the month of August. That is up from just .190 in July with only 42 At bats. He also has had 3 HR's since his return. He still has a way to go to be where he was, but its good to know that he has not yet been limited by the plantar fasciitis.

Even after having the treatment he was still developing soreness in his heel. This is common from ESWT with everyone being different. Sometimes people do not get soreness, and some people may develop it from days, to weeks, to months. I will conitue to monitor his progress along with other athletes that we have talked about in the past.

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New Running Sneaker Style

I recently saw an interesting article from Wired magazine. Research is being done that is suggesting barefoot is the way to run. I do not agree with this at all, but we will see what kind of literature will be published in the future. Certain companies are developing models like Nike Free, the Newton All-Weather Trainer and the glove-like Vibram FiveFingers.

Could these things be the new Crocs? Only time will tell. I dont see it as a good idea due to the lack of support and cushion. By running barefoot, you increase your chances of sprain, strains, fractures, and developing cuts and bruises. The new sneakers do not seem at all supportive for the heel and arch. I will keep you posted on the new running style to see if any literature is out there. Until then, its best NOT to run barefoot, and to be in good supportive sneakers and shoes at all times.
The original article can be found at : http://www.wired.com/wiredscience/2009/07/barefoot/

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Exercising and Foot Gear

Over the past few weeks and months with the warmer weather out, I have been trying to get more and more exercising in. Usually that will be with bike riding, the elliptical machine, and running. One of the good habits that I have developed as a Podiatrist is constantly looking at ones feet or shoe gear. Its more apparent in the Summer months when people wear sandals and flip-flops.

As I talk about different shoes in this blog I would like to mention that I have no affiliations with these company's and I do not get paid for recommending their shoe gear. Its all from personal experience.

I have been amazed that when I went to the gym a few weeks ago what people are working out in. Or even cycling on trails. I have noticed a lot of sandals. They may feel fine while working out in them but it will catch up with them later. They will eventually develop foot problems. Sandals and flip flops offer no support at all. When exercising, your heel and the arches of the foot need to be constantly supported. There also needs to be some shock absorption as well. If not the knees then take a lot of that shock absorption. People will develop plantar fasciitis, arch pain, callouses, and knee pain as well.

Now i know there are a ton of different shoes and sneaker company's out there but not all have the APMA seal of acceptance. I will also post a link for them as well. As for shoes and sneakers I will recommend they are as follows:
Sneakers: New Balance, Asics, Saucony, Brooks, Mizuno, Aetrex
Shoes: Aetrex, Rockport, Ecco, Clark's, and Merrell's

And for a list of the APMA seal of acceptance for shoes and sneakers please see the following link:
http://www.apma.org/MainMenu/RecommendedProducts/SealofAcceptance/ProductsbyCategory.aspx#FOOTWEAR


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Fractures

The foot has 28 bones. Fractures can occur in any of these types of bones. There are different types of fractures that people can sustain. Recently in the sports world, Yao Ming the basketball player for the Houston Rockets, had suffered a fracture of his navicular bone. He also has a history of different foot ailments. The Dr that is treating him had mentioned that the injury he has recently sustained "could end his career'. Very scary. So what is the navicular bone and why is this a problem for him.

The navicular bone has many different ligamentous attachments to it. It also has a main insertion attachment for the Posterior Tibial Tendon (PTT). One of the main functions of the PT tendon is to hold up the arch of the foot. The bone is the main corner stone of the arch of the foot. The navicular bone, also has a very poor blood supply to this area. When bones have a poor blood supply, it takes longer for them to heal. A CT scan was able to pick this tiny crack that he had in the navicular. Now, Yao's options include either conservative or surgical intervention. Conservative treatment would include casting, bone stimulator use, physical therapy, and most certianly orthotics to control his foot. Surgical intervention would consist of fixing the fracture.

So only time will tell to see how Yao's Dr's figure out a treatment plan for him. Yao's injury continued to get worse. That is why it is always important to consult your Podiatrist should you notice any foot pain.

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Numbness and Tingling in Toes?

Are you having any numbness and tingling in your toes at all? Do you feel like you are walking in a pebble or a stone? If so, this maybe an early sign of a neuroma. Neuromas are a thickening and scarring phenomena as the nerve travels in between the Metatarsals which are the bones located right behind the toes.
The nerves get pinched causing a numbness, burning type pain. Some people will even mention a feeling of a wrinkled up sock in their shoe. They can occur by having bunions, hammertoes, flat feet, high arched feet, and poor shoe gear. Anything that compresses the front part of the foot can tend to pinch the nerve. The most common location is between the 3rd and 4th toe and this is caused Morton's Neuroma.
Treatment options vary from cortisone injections, sclerosing injections, padding, and orthotics. If conservative treatment options fail, then surgical intervention is usally required to remove a portion of the nerve.

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Shock Wave

I thought it was pretty interesting to find out that one of the Chicago White Sox (baseball) players was undergoing a treatment for chronic heel pain, Extracorporeal shock wave therapy or ESWT as it is commonly called. Carlos Quentin is the player that had undergone it for his chronic plantar fasciitis. So what is so great about this ESWT treatment?

Well for one, its non-invasive. That's very important not only for athletes but for patients as well. Most people would like to have a procedure done on their feet that gets them back to their daily activities right away with out having to worry about being non-weightbearing or using crutches or a walker for support. ESWT works by sending high pressure shock waves to the tissue in the body and promotes new healing to occur from these shock waves. The tissue will then grow new blood vessels which aid in tissue healing of the plantar fascia.

Typically the procedure can be performed in the office or in a surgical center. Patients require a local anesthetic to numb the foot so it is not sensitive. The procedure lasts usually about 30 mins. Everyone is different in their response to the ESWT. Some patients may feel immediate relief and some it may take several weeks to months. Some people may feel a bone bruise to their heel after it has been completed. After the procedure one can expect to complete their normal stretching exercises they normally do with plantar fasciitis to help in the healing process.

Not only can can ESWT be used for Plantar fasciitis but it can also be for Achilles tendinitis. For more information please check out the website and consult your Podiatrist.


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Sandals and Flip Flops

Sandals and flip flops can vastly increase foot problems. If you are already having foot problems and continue to wear these, then you are at risk for more foot injuries and continued pain and discomfort. Sandals offer very little benefit to the foot and ankle. There is no support in the heel and the arch area.

Not only can you aggravate your foot, but you are also at risks for skin breakdown, cuts, bruises, and broken toes.

The only time I usually will recommend a sandal or flip flop is around hotel rooms, pools, and locker rooms. This is great to avoid other things that we have talked about such as warts, and athletes foot.

I am going to include the APMA's guide "Ten-Tips-To-Avoid-A-Flip-Flop-Fiasco" here. I think its very important to read and understand this to avoid any problems from happening. Some I will typically include are to get a sandal made of soft leather rather than plastic. Also to make sure that your feet do not hang over the edge and there is room for the baby toe, so that it is not aggravated by the edge of the sandal. Another important tip is to look for the APMA's seal of acceptance.

Here are the tips below:
Visit APMA’s Seal page at
www.apma.org/seal.
Tips to Avoid a ‘Flip-Flop Fiasco’
• Do shop for a flip-flop made of high-quality, soft leather. Leather minimizes the potential
for blisters and other types of irritation.
DO’S:
• Do look for flip-flops that hold APMA’s Seal of Acceptance, such as Sole Platinum
Sandals. Evaluated by a committee of APMA podiatrists, these products are shown to
allow for the most normal foot function and promote quality health.
• Do gently bend the flip-flop from end to end, ensuring it bends at the ball of the foot.
Shoes of any kind should never fold in half.
• Do wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in
hotel rooms and in locker room areas. Walking barefoot can expose foot soles to plantar
warts and athlete’s foot.
• Do ensure that your foot doesn’t hang off of the edge of the flip-flop.
DON’TS:
• Don’t re-wear flip-flops year after year. Inspect older pairs for wear. If they show signs of
severe wear, discard them.
• Don’t ignore irritation between toes, where the toe thong fits. This can lead to blisters and
possible infections.
• Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little
in terms of shock absorption and arch support.
• Don’t do yard work while wearing flip-flops. Always wear a shoe that fully protects feet
when doing outside activities such as mowing the lawn or using a weed-eater.
• Don’t play sports in flip-flops. This practice can lead to twisting of the foot or ankle, as
well as sprains and breaks.
Donning flip-flops to enjoy warm weather? Follow these “do’s” and
“don’ts” from the American Podiatric Medical Association (APMA):

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Blood Clots

Its amazing how you can just pick up ideas on what you want to blog about in our daily travels. This weekend I take a little road trip with my friends and it got me thinking on what else we can talk about. Even though my trip was not too long, it got me thinking about longer trips. One of the things I wanted to briefly talk about are blood clots.

Now why would I be talking about blood clots in a foot blog or about trips? Blood clots or DVT (Deep Vein Thrombosis), can occur from both. There are many different risk factors for them which we will talk about.

Clots can form in vessels and break loose. If this happens its a serious condition. That clot can travel to your lungs, block flow, and even cause death. Clots can form not only form in the lower extremity's but also in the upper extremity as well.

So what can cause these blood clots? One is a long period of immobilization. If you are in the car for a long period of time or on a long flight it is very important to make sure you walk around for a few minutes. Blood can be stagnant if one is not moving for long periods of time. This increases the chances (of course with other risk factors) for a clot to form. By walking, or moving around, your calf muscles will work to pump blood flow back to the heart to be recirculated throughout the body. How about those other risk factors you say? Here is a list of other risk factors:
Abnormal blood clotting (can be in inherited), family history of clots, being overweight, cancer, any type of surgery, injury, pregnancy, age, birth control pills, smoking, varicose veins, and history or heart attack or stroke. So as you can see there are many risk factors for blood clots.

So what are the symptoms? Increase in swelling in the lower extremity, redness, increase in warmth, pain with the calf muscle,. Tests that can be done are an ultrasound, blood work, or a venography (where dye is placed in the body). Treatment ranges from medicine to either filters placed in the body.

So now that we know a little more about blood clots how can we prevent them? I already alluded to the fact that if you have a long trip planned, make sure you walk around for a few minutes. On long flights move your feet around every half hour. Others include calf and leg exercises before surgery, stop smoking, elastic stockings, and special compression devices.

As always if you have a family history of blood clots or think you may have, please consult your primary doctor right away. It is especially important to tell your Dr this before having surgery.

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Broad Street Run

Congratulations for those who participated in the Broad Street Run.
Even though it was raining there was still a great turnout for the annual event. An amazing 22,913 people were able to finish the race. Kenya's Linus Maiyo and Jane Murage were able to win the race. Both were able to do it under 50 minutes.

Things I would like to mention that can occur in such a wet environment is Tinea Pedis, or Athletes Foot. Fungus lives in a warm moist environment. If you work in conditions where your feet are constantly wet or run in a wet environment this can happen to you. Things to look out for are dry scaly skin, itching between the toes, redness, burning, and maceration between the toes (See picture). Untreated maceration between the toes can be serious. This can lead to a secondary bacterial infection which can cause a cellulitis and a serious infection in the foot. So athletes foot is no joke and should be treated when symptoms first begin.

Treatment options can range from topical anti-fungals to oral anti-fungals if its severe enough.

Blisters are also common after these runs and in wet environments. Blisters should NOT be de-roofed. The roof of the blister helps prevent infections from occurring. Treatment for blisters can include Second Skin and covering the area with moleskin. If in question with what to do, please see a Podiatrist. Preventative measures include applying Vaseline to the areas that can get blistered, not wearing 100% cotton socks, and applying moleskin to the problematic areas.

As always please check out a website for more info. Happy Running!!

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Foot Health Awareness Month

April is about to come to a close. The warmer weather is just around the corner. April is also known as Foot Health Awareness Month. But why should just one month be dedicated to Foot Health Awareness, when it should be all year long. We should always take care of our feet, to help us constantly go that extra distance. Everyone should always check their feet routinely for any cuts, bruises, skin lesions, and new lesions. Some of the most common areas to check are in between the toes and on the bottoms and backs if your heels. Yes, I know you are saying that this is difficult to see. If it is, grab a mirror or have someone check this for you. Check before you go to bed each night.

Foot pain is not normal and one should see a Podiatrist for care. I am also going to include a link to the American Podiatric Medical Association website that has a walking guide. It talks about the benefits of walking and exercise. It is very useful material. It will also discuss how often one should exercise per week. Its a great resource so be sure to check it out....as well as our web page for new information and updates.
http://www.apma.org/MainMenu/Foot-Health/FootHealthBrochures/Walking-guide.aspx

As always before going for that walk make sure you are in the proper shoe gear. Many people will wear that old pair of shoes, or those loafers that feel comfortable for their walks or exercise. Sure it may feel great during that time, but in the long run you are only harming your feet and preventing yourself from future activities. Invest in a good pair of shoes and it will surely pay off.

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Plantar Warts

Not only will we talk about heel pain, but we will also discuss other foot conditions as well. One of the more common things that we see are plantars warts, also known as verruca plantaris. These warts can occur at any time of the year but they are more common during the warmer months.

They are called plantar warts because they occur on the sole or plantar aspect of the foot. These warts are caused by a virus called the human papilloma virus (HPV). People can pick these up at hotels, pools, locker rooms, gym floors, mats and showers. If someone steps on one of these surfaces that has or had the virus and has a small cut in their skin, they can too pick up the HPV virus and develop the plantars wart. More people will tend to use swimming pools and walk barefoot in the summer time. That is why sometimes there is an increase in the amount of warts seen during the warmer weather. If you have sweaty feet, you also are at a risk of picking up the virus.

Plantars warts may or may not hurt. A lot of it will depend on where it is located on the foot. If it is on a weight bearing area, chances are they will hurt.

Treatment options vary depending on where the wart is located. Usually we may start off with topical acid therapy which is very effective and sometimes we may have to excise the wart.

Some ways to prevent warts is to avoid walking around barefoot, changing socks reguarly if they sweat a lot, and keeping your feet clean and dry.

As always its very important to see your Dr if you have any questions regarding warts. Its important to assess what treatment is best for you.

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Still Being Active With Heel Pain

One of the secrets to a healthy lifestyle includes being very active. Depending on your condition and the nature of your heel pain, it is still possible to be active with certain exercises when at home or going to the gym. A lot of our patients still want to go for that walk or be at the gym with their Plantar Fasciitis pain.

If the plantar fasciitis is under control the best forms of exercise include the elliptical machine, spinning (or cycling), and any type of water aerobics. The first two machines, put less stress on your plantar fascia while still being able to get a great workout.

Notice how I did not mention anything about the treadmill. Depending on the speed that you are running on the treadmill, it can have a high impact on your feet and knees. Not having the proper support in your shoes can lead to heel and knee pain while running on the treadmill. If you are noticing this type of pain after using the treadmill it is important to see your doctor. The treadmill is not going to help with the plantar fasciitis, only make it worse.

Now if you are having any type of heel pain and it simply is not getting better with some of the things we have talked about earlier in the blog, then it is strongly advised against any type of physical activity. Having pain and being on your feet is only going to make the problem worse and not any better. Arch supports, cortisone shots, a period of immobilization, or physical therapy can help you get back on your feet for a healthy lifestyle.

Dont forget, you can always view our webpage for more information

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Kids and Heel Pain

Heel pain not only affects adults, but it can also be prevalent in kids. A common condition we see in kids is called calcaneal apophysitis or Sever's disease. The age range we see this is between 10-14. The cause is an inflammation of the secondary center of growth of the heel bone called the calcaneus. The Achilles tendon which inserts into the heel bone can cause the disturbance that kids typically will feel in the bottom or the back of their heel. So what are the causes? The majority of the time its an overuse injury. Many kids will typically be very active and participate in a number of activities. The constant pulling of the Achilles tendon at this growth center leads to their pain. It also is caused by poor shoe gear, tight calf muscle, and the shape of the foot. These conditions where tendons pull on other growth centers are also common at other parts of the body including the knee and hip. The X-Ray you are looking at is the back part of the heel bone (calcaneus). The area that is separated is the secondary center of growth.

OK so how do we go about treating this? The majority of time is to reduce the amount of physical activity. Ice, anti-inflammatory, stretching, and orthotics or inserts for your shoes are all effective measures as well to help reduce the inflammation that is occurring. A change in shoe gear is important as well. In rare cases a child may need to be casted if the pain is severe enough and the above measures are not helping.

Preventative measures include orthotics and daily stretching.

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Its that time of the season....

For warmer weather to finally arrive. More and more people will be active this time of the year to be outside and play. One of the biggest concerns that we see is the Weekend Warrior Syndrome. What is that you may ask? Well that is if you have not been active and just get right into an activity that you have not prepared yourself for in years. Example, you used to play basketball as a teenager. Now you are in your 40's and want to play that pickup game again with your friends. You have not stretched or done any physical activity in years. You start that pickup game without stretching or warming up your body. You then make that run at the end of the court, as your teammate dishes off that pass to you and you pivot the wrong way and you hear a pop sound. This actually may have been your Achilles Tendon that had ruptured. And depending on the severity of that rupture, it can take you a full year time frame of recovery to get any better. So please, make sure you are not the typical Weekend Warrior and remember to stretch and slowly progress into activity if you have not done so in a while

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Stretching Exercises

Lets talk a minute on some of the stretching exercises for heel pain. This is one of the most important things that needs to be done on a consistent basis to feel better. We tell our patients that its a lifestyle change. One of our favorite stretching exercises is to take a water bottle, put it in a freezer so you have a frozen water bottle. Now, while you are sitting down, watching TV or reading a book, roll it under your heel and arch area for 10-15 minutes. Try and do this at least twice a day. Another easy exercise is to to have a towel on the floor and practice curling your toes to pick up the towel. Still have that pain first thing in the morning when getting out of bed? Try this one, the towel stretch. The key with this is to make sure that your knees are straight so that you can feel the stretch in your calf muscle. Hold this stretch for 10 seconds and repeat it 5 times. Another one to do as much as you can is the wall stretch. The key with this one is to make sure that both heels are on the ground and your toes are pointing to the wall. Hold this for 10 seconds and repeat it 5 times. Its ALWAYS a good idea to stretch out both calf muscles. What may happen with one side hurting, the other limb gets more pressure with walking and the weight shifts to your other side. This can actually cause foot pain to begin. So start with these to try and help relieve some of that heel pain. Remember, 90% of heel pain can be treated conservatively.
For more information please visit the following website:
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Camwalkers

If anyone watched Dancing with the stars they had a quick look at a Cam walker boot on one of the contestants. Cam walkers, depending on the foot and ankle condition, are taking the place of fiber glass casts. They can be used from simple strains and sprains to stable fractured bones in the foot. The pros of the Cam walker boot are that they can be easily removed during the day, not as bulky as a cast, can prevent skin irritation and breakdown, can allow for various increments for range of motion, and a rocker bottom design for easy walking. Some of the cons for the Cam walker boot are compliance with use, and limb length discrepancies. Due to the elevation of one limb, it can cause opposite limb problems such as knee, and low back. This generally can be resolved with a lift in the other shoe. Other uses of Cam Walker Boots include:
Stable fractures of the foot, Achilles Tendon problems, Peroneal tendons, acute ankle sprains, posterior tibial tendinitis, sports injuries, post op courses and more. As always please visit our website for more information
http://www.podiatrycarespecialists.com/

Dancing With the Stars

Wow 3 people were out for Dancing with the Stars. Wondering if it could be foot or ankle related. Remember, having foot pain is not normal. There are a number of different things that can be done to eliminate these problems if you are having them. Be sure to check out: http://www.podiatrycarespecialists.com/ for more info

College basketball

I bet all those Syracuse and U Conn players are dealing with a lot of heel and foot pain after their 6 overtime marathon last night. Luckily for them and other people, there are ways to get rid of their heel and foot pain.