Morton's Neuroma
A neuroma is a thickening of nerve tissue and can develop throughout the body. In the foot, the most common neuroma is a Morton’s neuroma; this typically forms between the third and fourth toes. The thickening of the nerve is typically caused by compression and irritation of the nerve; this thickening can in turn cause enlargement and, in some cases, nerve damage.
Neuromas can be caused by anything that causes compression or irritation of the nerve. A common cause is wearing shoes with tapered toe boxes or high heels that force the toes into the toe boxes. Physical activities that involve repeated pressure to the foot, such as running or basketball, can also create neuromas. Those with foot deformities, such as bunions, hammertoes, or flatfeet, are more likely to develop the condition.
Symptoms of Morton’s neuroma include tingling, burning, numbness, pain, and the feeling that either something is inside the ball of the foot or that something in one’s shoe or sock is bunched up. Symptoms typically begin gradually and can even go away temporarily by removing one’s shoes or massaging the foot. An increase in the intensity of symptoms correlates with the increasing growth of the neuroma.
Treatment for Morton’s neuroma can vary between patients and the severity of the condition. For mild to moderate cases, padding, icing, orthotics, activity modifications, shoe modifications, medications, and injection therapy may be suggested or prescribed. Patients who have not responded successfully to less invasive treatments may require surgery to properly treat their condition. The severity of your condition will determine the procedure performed and the length of recovery afterwards.
Choosing the Right Running Shoe
Choosing the right running shoes for you is an important part of running. A good pair of running shoes will make the running experience more enjoyable for you and prevent potential injury.
Poorly-fitted shoes can increase the risk of injury in runners substantially. Common injuries from running with poor quality shoes include shin splints, sprained ankles, Achilles tendinitis, stress fractures, plantar fasciitis and more. This is due to the fact that bad shoes do not provide proper foot support, can increase pronation (how much the foot rolls when hitting the ground), have little to no cushioning, do not allow the feet to breath, and do not provide enough flex and rigidity in the right parts.
When looking for running shoes, first, determine where you will be running. If you are a trail runner, then pick trail shoes. If you run on concrete and asphalt, then regular running shoes are the best choice. When trying on shoes, its best to go at the end of the day as feet grow during the day and shrink after a night of sleep. Shoes should be more rigid towards the back of the foot while being more flexible up where the toes are. The toe box should provide enough room for the toes to move freely. The overall fit should be snug, not too tight but not too loose. A good pair of running shoes should also provide enough arch support for your foot type. If you experience overpronation or under-pronation while running, try to find a pair of shoes that will help correct this with different sole patterns. Finally, try to find a pair of shoes that allow the feet to breathe like nylon mesh or synthetic leather.
Don’t forget about the socks either. Socks that hold too much moisture can lead to athlete’s foot. Socks should be breathable so that your feet can air out and breathe. Synthetic socks wick away moisture like sweat. If you tend to run a lot, having a second pair of shoes that you can wear while you let the first pair air out is smart. Just don’t forget to replace your shoes after about every 300 to 500 miles.
Before you start running, it is advised to see a podiatrist to see if running is right for you. They can also offer good advice on how to run and what to look for in a pair of running shoes. If you have flat feet or poorly supported ones, they can also offer custom-made orthotics that will help give your feet the support they need.
Diabetic Foot Care
Diabetes affects millions of people every year. Blood vessels located all over the body are damaged due to diabetes—even the blood vessels of the feet. Neuropathy, or nerve damage, can result from slower blood flow in the legs and feet. In diabetic patients, neuropathy is very important to monitor, as diabetics are at risk for developing ulcers.
Always washing and thoroughly drying the feet are pertinent parts of diabetic foot care. There should be a focus on cleaning between the toes. Even if no pain is felt, the entire foot should be examined for redness and sores. Neuropathy can often mask the pain of sores and ulcers and can cause these conditions to be overlooked. Use a mirror to examine the underside of your feet if needed. It is recommended that diabetics wear well-fitting socks.
Patients with diabetes should have their doctor monitor their blood levels because blood sugar levels play a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised. It is very important to keep your blood sugar levels in the normal range, which can be determined by your physician. There are medications that may be prescribed to help with any neuropathy experienced by the diabetic patient. It is also advisable to visit a podiatrist if one is experiencing any conditions involving the feet, such as ingrown toenails, which in more severe cases can cause infection.
Diabetic feet must be inspected daily. Diabetic foot care at home is possible if a patient is provided with instructions from their podiatrist. Patients can relieve dry heels with creams or ointments. Suspected wounds should warrant an immediate call to the podiatrist. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation in its worst cases. Early treatment and daily inspection of diabetic feet are keys to staying healthy.
Everything You Need to Know About Gout
Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.
The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well.
This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.
Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.
Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.
Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.
Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.
Toenail Fungus
Toenail fungus is a frustrating problem that affects many people. It can be persistent and hard to get rid of. As many different types of fungi are present throughout the environment, it is very easy to contract toenail fungus.
The feet are especially susceptible to toenail fungus because shoes and socks create the ideal dark and moist environment that fungal infections thrive in. While fungal infections of the nail plate are quite common, if left untreated they can spread beyond the toenail and into the skin and other parts of the body.
Signs of toenail fungus include a thickened nail that has become yellow or brown in color, a foul smell, and debris beneath the nail. The toe may become painful due to the pressure of a thicker nail or the buildup of debris.
Treatment for toenail fungus is most effective during the early stages of an infection. If there is an accumulation of debris beneath the nail plate, an ingrown nail or a more serious infection can occur. While each treatment varies between patients, your podiatrist may prescribe you oral medications, topical liquids and creams, or laser therapy. To determine the best treatment process for you, be sure to visit your podiatrist at the first signs of toenail fungus.
Ingrown Toenail Care
An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders, or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail. In most cases, however, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Various Causes of Ankle Pain
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
The Causes, Types, and Treatments of Achilles Tendon Injuries
Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking.
Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.
Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.
The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.
Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.
An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.
Ankle Sprains
Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.
The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.
Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over-the-counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.
Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.
The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain occurs over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.
Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate-fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.
Choosing the Right Running Shoe for Your Foot Type
Running may seem like a simple to do. However, running is actually a complex movement that puts stress on the ligaments, bones, and joints of the body. Selecting the correct running shoe is important for increasing performance and avoiding risk of injury. Running shoes should be selected based on your foot type. Considerations such as trail versus road shoes are important. Your foot type dictates the degree of cushioning, stability and motion control you require. The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes. Professionals can measure your arch type, stride and gait and help you with your shoe needs.
The design of running shoes is created around the idea of pronation. Pronation is the natural rolling movement of your ankle from the outside to inside when your foot strikes the ground. If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more. Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy. Those considered neutral runners pronate correctly and do not need running shoes that help correct their form. Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types. However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation. They may require running shoes that offer additional support.
Those who overpronate experience an over-abundance of ankle rolling. Even while standing, those who severely overpronate display ankles that are angled inward. It is not uncommon for them to have flat feet or curved legs. The tendency to overpronate may cause many injuries. Areas that tend to become injured are the knees, ankles, and Achilles tendon. If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control. Motion-control shoes are straight and firm. Shoes of this type do not curve at the tip. The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes the ground.
A less common problem is underpronation. Underpronation, also called supination, is when the feet are unable to roll inward during landing. Those who underpronate have feet that lack flexibility and high arches. This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees. This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact. Those who underpronate need shoes with more cushioning and flexibility. If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.
What is Morton's Neuroma?
Morton’s neuroma, (also referred to as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma or intermetatarsal neuroma) is a condition that is caused when the tissue around one of the nerves between your toes begins to thicken. This thickening can result in pain in the ball of the foot. Fortunately, the condition itself is not cancerous.
Morton’s neuroma affects women more often than men with a ratio of 4:1. It tends to target women between the age of 50 and 60, but it can occur in people of all ages. There are some risk factors that may put you at a slightly higher risk of developing the condition. People who often wear narrow or high-heeled shoes are often found to be linked to Morton’s neuroma. Additionally, activities such as running or jogging can put an enormous amount of pressure on the ligament and cause the nerve to thicken.
There usually aren’t any outward symptoms of this condition. A person who has Morton’s neuroma may feel as if they are standing on a pebble in their shoe. They may also feel a tingling or numbness in the toes as well as a burning pain in the ball of their foot that may radiate to their toes.
In order to properly diagnose you, the doctor will press on your foot to feel for a mass or tender spot. He may also do a series of tests such as x-rays, an ultrasound, or an MRI. X-rays are usually done to rule out any other causes for your foot pain such as a stress fracture. Ultrasounds are used to reveal soft tissue abnormalities that may exist, such as neuromas. Your podiatrist may want to use an MRI in order to visualize your soft tissues.
There are three main options for treatment of Morton’s neuroma: Injections, decompression surgery, and removal of the nerve. Injections of steroids into the painful area have been proven to help those with Morton’s neuroma. Decompression surgery has been shown to relieve pressure on the affected nerve by cutting nearby structures such as the ligaments in the foot. Another treatment option would be to surgically remove the growth to provide pain relief.
If you suspect that you have Morton’s neuroma you should make an appointment with your podiatrist right away. You shouldn’t ignore any foot pain that lasts longer than a few days, especially if the pain does not improve.
Wound Care
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
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.
Athlete's Foot
Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.
Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area. It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.
The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.
Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.
Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.
Ankle Pain
Pain experienced in the ankle can be caused by a multitude of conditions. While the most common cause is an ankle sprain, other possible problems can include arthritis, gout, ankle instability, an ankle fracture, nerve compression, or tendinitis. In more serious cases, ankle pain can be a sign of improper alignment of the foot or an infection.
Ankle pain can often be accompanied by symptoms such as redness, swelling, stiffness, and warmth in the affected area. Pain can be described differently depending on the condition: short, stabbing pain and a dull ache are some examples. If such symptoms are persistent and do not improve after time, be sure to schedule an appointment with your local podiatrist.
Depending on the condition causing your ankle pain, different treatments may be prescribed by your podiatrist. For ankle sprains, the first step in treatment involves rest, ice, elevation, and compression. Be sure to avoid placing pressure on the ankle, use an ice pack several times a day, and use a compression bandage and elevation to reduce swelling. Other, more serious conditions may require the assistance of certain drugs and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or even cortisone injections.
Depending on the severity of your ankle pain and the condition behind it, recovery from ankle pain may take some time.
Consult with your foot and ankle doctor to best determine the cause of your ankle pain and the appropriate treatment.
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Systemic Diseases of the Foot
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
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.
Hammertoe
Hammertoe is a foot deformity that occurs due to an imbalance in the tendons, muscles, or ligaments that are responsible for holding the toes in their normal position. This condition may be caused by poor footwear, foot structure, trauma, and disease. The most common solution for hammertoe is to relieve the pain by changing your footwear and wearing orthotics. In severe cases, surgery may be required.
The shoes that are most likely to cause hammertoe are high heeled shoes or shoes that are too tight in the toe box. Tight shoes will force your toes to crowd together in a curled position. This position will likely continue when you take your shoes off. Another cause is trauma. When you stub your toe, you are increasing the chance that you will develop hammertoe.
There are risk factors that may make you more likely to develop this condition. Women are more likely to have the condition compared to men, and it is also more likely to appear in those who are older in age.
Many different foot problems can be avoided by wearing shoes that have adjustability, adequate toe room, and low heels. Furthermore, if you want to buy new shoes, you should look to purchase them at the end of the day and make sure you know your correct size. The importance of buying shoes at the end of the day is that your feet swell as the day progresses. You should also ensure that you are wearing your correct size because your shoe size may change as you grow older.
To diagnose someone with hammertoe, your podiatrist will need to conduct a thorough examination of your foot. Your doctor may even order an x-ray to evaluate the bones and joints of your feet and toes.
If you have hammertoe, your podiatrist may recommend that you wear shoes that fit you better along with inserts to place inside them. Additionally, he or she may suggest special exercises for you to perform to stretch your toes. One helpful exercise it to pick up marbles with your feet or crumple a towel with your toes.
Prior to meeting with your podiatrist, it will be helpful to make a list of all the symptoms you are experiencing. You should also make a note of medications you are taking and important personal information about your medical history.
Gout
Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men.
Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.
People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.
Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.
Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.
To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks.
How to Stretch Your Feet
Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.
One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.
There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing. Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.
A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.
If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.
If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.