Pain after Inactivity

WIth plantar fasciitis, some people will talk about pain first thing in the morning, after a long drive and first putting weight down on the foot, and sitting down for a while and then getting back up again.  This is termed post static dyskinesia. The reasoning behind this when at rest, the plantar fascia and your calf muscles are at rest as well. They are plantarflexed (pointing in the downward position). They are relaxed.  When you go to bear weight or take those first few steps they are now being used and this is what causes the pain. One of the goals to prevent this pain from happening can be used with such a device called a night splint. The night splints can be worn while sleeping and while sitting down. They help in stretching the plantar fascia and the calf muscles. They put your foot and your leg in the dorsiflexed position (pointing up). Also a massage of the plantar fascia and a stretch before putting any weight down on the foot after a  long period of inactivity can also help you out.
Please see our website for more details on this condition.

Chad Friedman, DPM

http://www.podiatrycarespecialists.com/

Barefoot Running Part 2

We briefly mentioned last week about the potential hazards and dangers of barefoot running. I thought that I would just add a few more interesting things about it. A study published in The Journal of Sports Medicine and Physical Fitness said that barefoot runners had less impact than runners in shoes. On the flip side to this, there has been no documented studies that show running with sneakers can cause foot problems or lead you to an injury. But if you can think about some of the stuff that I had posted last wee I will not recommmend doing it.  This is because it can lead to stepping on something, lacerations, increase in pain, and blisters just to mention a few.

Happy Running/Walking, but of course with sneakers on :)

Chad J. Friedman, DPM

http://www.podiatrycarespecialists.com/

Barefoot Running

There has been a lot of talk in the literature recently on barefoot running. In fact there was even a book written on the topic (Born to Run). Its going to be something that many people will begin to try or continue to do. For me, I will not be recommending it. Some of the reasons for this is the risk of stepping on something, contusions, sprains, strains, and possible fractures. Depending on your foot type, the foot should be constantly supported through all phases of gait. If not, it can cause other muscles to compensate for other muscles and lead to tendon problems or other stresses in the feet. The feet need good support to support the rest of the body. Think about this as well; could you imagine running on a track, concrete, or gravel barefoot? Imagine this even on a hot sunny day. Your feet would burn and increase your chance of developing blisters. And of course this would never be good in a diabetic or someone who has developed neuropathy of their feet(loss of sensation). We will continue to update you on more information that will come out with the topic, but for the time being it is something that I will not recommend.


Happy Running/Walking, but of course with sneakers on :)
Chad J Friedman, DPM

http://www.podiatrycarespecialists.com/

Happy New Year

Podiatry Care Specialists, would like to wish everyone a Happy and Healthy New year!

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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

http://www.podiatrycarespecialists.com/

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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