Stress Fractures of the Foot and Ankle

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

Effect of High Heels on the Feet

For hundreds of years, women have been wearing various kinds of high heels for aesthetic reasons. Women who wear high heels appear to be taller and have longer and thinner legs, and the wearer’s gait and posture changes. Though high heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.

The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen. This can cause problems when shoes without heels are worn.

By putting a great deal of pressure on the ball of the foot and by forcing the toes into a small toe box, high heels can cause or may worsen many foot problems. These include corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.

Not only does wearing high heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high heels.  High heels can cause the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like in high heels. By limiting the natural motion of the foot during walking, high heels also cause an increased in stress on the knees.

Similarly, high heels can cause the back to go out of alignment. If high heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.

However, this is not to say that high heels can never be worn. If worn occasionally and not often, they will not cause serious problems. They should not be worn every day. It’s important to wear them modestly to avoid the long-term physical health problems of the feet, knees, ankles, and back mentioned above.

Neuropathy

Neuropathy is the weakness, numbness, and pain in the hands and feet due to damage to the peripheral nerves. The peripheral nerves are responsible for sending information from the brain and spinal cord to the rest of your body. Causes of Neuropathy include: traumatic injuries, infections, metabolic problems, exposure to toxins, and diabetes.

Diabetes is the most common cause, with more than half of the diabetic population developing some type of neuropathy. There are several types of neuropathy and they vary based on the damage of the nerves. Mononeuropathy is classified as only one nerve being damaged. When multiple nerves are affected, it is referred as polyneuropathy. One of the types of polyneuropathy is distal symmetric polyneuropathy. It is the most common for people with diabetes and starts when the nerves furthest away from the central nervous begin to malfunction. The symptoms begin with pain and numbness in the feet and then they travel up to the legs. A rarer form of polyneuropathy is acute symmetrical peripheral neuropathy, which is a severe type that affects nerves throughout the body and is highly associated with Guillain-Barre syndrome, an autoimmune disorder that attacks the peripheral nervous system and can be fatal. Although there are many types of neuropathy, most of them share the same symptoms such as pain, extreme sensitivity to touch, lack of coordination, muscle weakness, dizziness, and digestive problems. Since neuropathy affects the nerves, those affected should be careful of burns, infection and falling, as depleted sensations disguise such ailments.

The best way to prevent neuropathy is to manage any medical conditions such as diabetes, alcoholism, or rheumatoid arthritis. Creating and managing a healthy lifestyle can also go a long way. Having a healthy diet full of fruits, vegetables, whole grains and lean protein can keep the nerves healthy. These types of food have the nutrients to prevent neuropathy. Regularly exercising can help as well, but it is best to consult with a doctor about the right amount. In addition to diet and exercise, avoiding risk factors will also prevent neuropathy. This includes repetitive motions, cramped positions, exposure to toxic chemicals, smoking and overindulging on alcohol.

Toe Pain

Toe pain can originate from corns, calluses, hammertoes, and bunions, as well as ingrown toenails, sprains, fractures, and dislocations. Corns develop as the toe rubs against the inside of a shoe which causes the skin to thicken as a form of protection. A corn is typically cone-shaped and has a small, hardened spot that points inward. When a corn is pressed into the skin, the toe becomes painful. Corns usually form on the top or side of the toe. A callus is also a thickened patch of skin that generally forms on the bottom of the foot. Calluses are the result of friction from the toe rubbing against the inside of a shoe. They may also occur by walking barefoot or having flat feet. A hammertoe is a bump on the knuckle of the second toe that is produced by wearing shoes that are too short for your feet. The bony protrusion rubs against the top of the shoe causing pain and irritation. A bunion is a malformation of the big toe. The base of the big toe pushes away from the smaller toes, forcing the top of the big toe to press toward the other toes. Bunions can be hereditary, or they can result from injury to the toe joint or from wearing high heels with a narrow toe box. The toe becomes inflamed, and a bump may develop at the end of the misplaced bone. Ingrown toenails typically affect the big toe and its surrounding skin. The nail will dig into the skin and become painful. Wearing tight or narrow shoes that compress the big toe causes the nail to grow into the fleshy part of the toe. Cutting toenails incorrectly can also add to the development of an ingrown toenail. A toe sprain originates from a torn or stretched ligament. Strapping the injured toe to the toe next to it for stabilization is common. A broken or fractured toe usually occurs from trauma like dropping a heavy object on it or bumping into something extremely hard and rigid. Osteoporosis, a thinning of the bones, can also bring about toe fractures. 

Any of the conditions mentioned can lead to pain and irritation. While some are more serious than others, seeking an examination and diagnosis from a podiatrist is a good idea. A podiatrist can treat each ailment and get you back on your feet again without pain.


 

Foot Pain

Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place.  However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.

Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.

Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.

If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.

Laser Treatment for Fungal Nails

A new treatment for fungal nails, or onychomycosis, which has grown in popularity in recent years, is laser treatment. Laser treatment involves the use of a laser that kills fungus in the toenail with heat. Laser therapy causes no side effects and does not affect nearby healthy tissue.

Toenail fungus afflicts almost 10 percent of the U.S. population and is more common among the elderly. The most common symptom of toenail fungus is the discoloration and thickening of the nail. The nail can also become brittle and a foul smell may be produced. In rare cases, pain might be present. While it is not a serious condition, it can lead to a perception of disgust amongst those it affects. There are several different fungi that cause fungal infections. These include dermatophyte, yeast, and mold. The most common of these is dermatophyte.

Diagnosis for fungal nails involves a podiatrist utilizing microscopy and fungal cultures. This will allow the doctor to determine whether it is a fungus or another condition, such as lichen planus, psoriasis, nail damage, and onychogryphosis.

Fungus in the nails can be hard to get rid of with over-the-counter drugs. This is due to the nail being hard and protective, with fungus able to slip between the nail bed and plate. Furthermore the slow growth of the nail increases the difficulty of fungus going away. Laser treatment seeks to get around this by directly penetrating through the nail and killing the fungus. The laser is used on each infected nail for a couple of minutes. Patients then typically return several weeks or months later for another laser treatment. During this time the podiatrist will routinely observe the foot and infection. It is also recommended to wear clean socks and shoes and allow the feet to dry and breathe to prevent toenail fungus.

Laser treatment is still a relatively new treatment and not all podiatrists have laser machines. Ask your podiatrist if they do laser treatment for toenail fungus and if it is right for you.

What is Flexible Flat Foot?

Flatfoot is classified as having the entire sole of the foot in contact or near contact to the ground while standing. The disorder is also known as fallen arches, because those affected have no arch in their feet. Flexible flatfoot and rigid flatfoot are the two types of flatfoot.

A person has flexible flatfoot if when sitting or standing on their toes, they have an arch that disappears when they stand with the entire foot on the ground. Flexible flatfoot may also be called “pediatric flatfoot” because the condition first appears in childhood. It is common among infants because the arch does not develop until the age of 5 or 6 years. Rigid flatfoot is not as common in children as it is with adults. This type of flatfoot is developed due to the weakening of tibialis posterior muscle tendon, a major supporting structure of the foot arch. Development of this deformity is progressive and shows early signs of pain and swelling that begins at the inside arch of the foot and moves to the outside of the foot below the ankle. More severe cases can possibly lead to arthritis of the foot and ankle joints.

Although most cases of flatfoot involve people born with the condition, some less common causes are obesity, diabetes, pregnancy, and osteoporosis. In some cases, flatfoot may come with no symptoms at all and does not require any type of treatment. With other cases though, symptoms may include pain in the shin, knee, hips and lower back. If a person with flatfeet experiences such symptoms, a health care provider may suggest using orthotic devices or arch supports, which may reduce the pain. Wearing supportive shoes can also prove more comfortable with flatfeet and staying away from shoes with little support such as sandals. Other methods to relieve pain also include stretching the Achilles tendon properly and using proper form when doing any physical activity. In addition, losing weight can reduce the stress on your feet and reduce the pain.

Foot and Ankle Surgery

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

Neuropathy

Neuropathy is a condition in which the nerves in the body become damaged from a number of different illnesses. Nerves from any part of the body, including the foot, can be damaged. There are several forms of neuropathy including peripheral neuropathy, cranial neuropathy, focal neuropathy, and autonomic neuropathy. Furthermore there is also mononeuropathy and polyneuropathy. Mononeuropathies affect one nerve while polyneuropathies affect several nerves. Causes of neuropathy include physical injury, diseases, cancers, infections, diabetes, toxic substances, and disorders. It is peripheral neuropathy that affects the feet.

The symptoms of neuropathy vary greatly and can be minor such as numbness, sensation loss, prickling, and tingling sensations. More painful symptoms include throbbing, burning, freezing, and sharp pains. The most severe symptoms can be muscle weakness/paralysis, problems with coordination, and falling.

Podiatrists rely upon a full medical history and a neurological examination to diagnose peripheral neuropathy in the foot. More tests that may be used include nerve function tests to test nerve damage, blood tests to detect diabetes or vitamin deficiencies. Imaging tests, such as CT or MRI scans, might be used to look for abnormalities, and finally nerve or skin biopsies could also be taken.

Treatment depends upon the causes of neuropathy. If the neuropathy was caused by vitamin deficiency, diabetes, infection, or toxic substances, addressing those conditions can lead to the nerve healing and sensation returning to the area. However if the nerve has died, then sensation may never come back to the area. Pain medication may be prescribed for less serious symptoms. Topical creams may also be tried to bring back sensation. Electrical nerve stimulation may be used for a period of time to stimulate nerves. Physical therapy can strengthen muscle and improve movement. Finally surgery might be necessary if pressure on the nerve is causing the neuropathy.

If you are experiencing sensation loss, numbness, tingling, or burning sensations in your feet, you may be experiencing neuropathy. Be sure to talk to a podiatrist to be diagnosed right away.

Diabetic Foot Care

Diabetes can cause two problems that can potentially affect the feet: Diabetic neuropathy and Peripheral Vascular Disease. Diabetic neuropathy occurs when nerves in your legs and feet become damaged, which prevents you from feeling heat, cold, or pain. The problem with diabetic neuropathy is that a cut or sore on the foot may go unnoticed and the cut may eventually become infected. This condition is also a main cause of foot ulcers. Additionally, Peripheral vascular disease also affects blood flow in the body. Poor blood flow will cause sores and cuts to take longer to heal. Infections that don’t heal do to poor blood flow can potentially cause ulcers or gangrene.

There are certain foot problems that are more commonly found in people with diabetes such as Athlete’s foot, calluses, corns, blisters, bunions, foot ulcers, ingrown toenails, and plantar warts. These conditions can lead to infection and serious complications such as amputation. Fortunately, proper foot care can help prevent these foot problems before they progress into more serious complications.       

Each day you should wash your feet in warm water with a mild soap. When you finish washing your feet, dry them carefully especially between your toes. You should also perform daily foot inspections to ensure you don’t have any redness, blisters, or calluses. Furthermore, if you are diabetic, you should always wear closed-toed shoes or slippers to protect your feet. Practicing these tips will help ensure that your feet are kept healthy and away from infection.

If you have diabetes, contact your podiatrist if you have any of the following symptoms on your feet: changes in skin color, corns or calluses, open sores that are slow to heal, unusual and persistent odor, or changes in skin temperature. Your podiatrist will do a thorough examination of your feet to help treat these problematic conditions.