“Runners Can Improve Their Performance by Keeping Their Feet in Top Condition”

Young couple run together on a sunset
Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners, according to the American College of Foot and Ankle Surgeons.

“The human foot is a biological masterpiece that amazingly endures the stresses of daily activity,” said Daniel Adamovsky, DPM, a foot and ankle surgeon in the St. Charles area.  “For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly.”

Heel pain

Adamovsky says the most common complaint from runners is heel pain caused by inflammation of the ligament that holds up the arch, a condition known as plantar fasciitis.

“In athletes, heel pain can result from faulty mechanics and overpronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft,” he explained.

At the first sign of heel pain, Adamovsky advises runners to do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory medications, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required.

Neuromas

Neuromas are another other common foot problem that affects runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective.

Tendonitis

Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition.

“There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy.” Adamovsky said. “Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon.”

Broken bones?

A common myth among athletes, according to Adamovsky, is that it’s not possible to walk or run if a bone in the foot is fractured.

“I often hear surprised patients say ‘It can’t be broken, I can walk on it,’” said Adamovsky. “That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days.”

If a fracture or sprain is suspected, Adamovsky advises runners to remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation.

RICE

“Should pain and swelling continue after following RICE for three or four days, you should see a foot and ankle surgeon for an x-ray and proper diagnosis.”

What is an Ingrown Toenail?

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

Ingrown1

Causes
Causes of ingrown toenails include:

  • Heredity. In many people, the tendency for ingrown toenails is inherited.
  • Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.
  • Improper trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.
  • Improperly sized footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.
  • Nail Conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.

Ingrown2Treatment
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected, or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot, or poor circulation.

Home care:
If you don’t have an infection or any of the above medical conditions, you can soak your foot in room-temperature water (adding Epsom’s salt may be recommended by your doctor), and gently massage the side of the nail fold to help reduce the inflammation.

Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon.

Physician care:
After examining the toe, the foot and ankle surgeon will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, the doctor removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

Preventing Ingrown Toenails
Many cases of ingrown toenails may be prevented by:

  • Proper trimming. Cut toenails in a fairly straight line, and don’t cut them too short. You should be able to get your fingernail under the sides and end of the nail.
  • Well-fitted shoes and socks. Don’t wear shoes that are short or tight in the toe area. Avoid shoes that are loose, because they too cause pressure on the toes, especially when running or walking briskly.

What You Should Know About Home Treatment 

  • Don’t cut a notch in the nail. Contrary to what some people believe, this does not reduce the tendency for the nail to curve downward.
  • Don’t repeatedly trim nail borders. Repeated trimming does not change the way the nail grows, and can make the condition worse.
  • Don’t place cotton under the nail. Not only does this not relieve the pain, it provides a place for harmful bacteria to grow, resulting in infection.
  • Over-the-counter medications are ineffective. Topical medications may mask the pain, but they don’t correct the underlying problem.

 

 

American College of Foot and Ankle Surgeons (ACFAS). “What is an Ingrown Toenal.” Ingrown Toenail.  American College of Foot and Ankle Surgeons (ACFAS), 2013. Web. 2013. <http://www.foothealthfacts.org/footankleinfo/ingrown-toenail.htm>.

Fall Back into School and Outdoor Fun

With the changing leaves and cooler weather, many adults and children will be participating in sports: football, soccer, softball, and running, to name just a few.  There is also is a flurry of activity associated with back to school prep that includes parents’ outfitting their children with new wardrobes, including new shoes.  Many important factors should be considered when purchasing new “kicks” for children returning to school.

back_to_school

Back-to-School Shoe Shopping Tips

  • Shoes that don’t fit properly can aggravate the feet.
  • Always measure a child’s feet before buying shoes and watch for signs of irritation.  Too big is just as bad too small.  Buy the shoe that fits your child now, not one to grow into!
  • Never hand down footwear.
  • Just because a shoe size fits one child comfortably doesn’t mean it will fit another the same way. Also, sharing shoes can spread germs like athlete’s foot, nail fungus and the wart virus.
  • Examine the heels.
  • Children may wear through the heels of shoes quicker than outgrowing shoes themselves.  Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.
  • Take your child shoe shopping.
  • Every shoe fits differently. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.  Also let the child take a “test drive” around the store in the shoes, better to find out before you buy if the shoe rubs somewhere.
  • Buy shoes that do not need a “break-in” period.
  • Shoes should be comfortable immediately.  Also make sure to have your child try on shoes with socks or tights, if that’s how they’ll be worn.
  • Do Your Child’s Shoes “Make the Grade?”

Take the “1, 2, and 3 Test:”

  1. Look for a Stiff Heel.
    Press on both sides of the heel.  It shouldn’t collapse.
  2. Check Toe Flexibility.
    The shoe should bend with the child’s toes.  It shouldn’t be too stiff or too flexible in the toe box area.
  3. Select a Shoe with a Rigid Middle.
    Does the shoe twist or fold?  A shoe should never twist or fold in half in the middle.

Sports-and-exercise related injuries in both adults and children commonly seen by Feet First Podiatric Physicians are the following:

Ankle/Foot Sprains are common injuries to the ligaments, one of the bands of tough, fibrous tissue that connect the ankle and foot bones at the joint and prevent excessive movement.  Sprains that do not show improvement in three days should be seen by a podiatric physician.  Investing in five to ten minutes of stretching and warming up and wearing the right shoe for the sport in which you are participating can help prevent this common athletic injury.

Muscle Strain is either a partial or total tear of muscle fibers in the muscle itself or the origin of the muscle.  Exercisers frequently strain their lower leg and foot muscles during rapid movement sports such as football, soccer, running, and softball.  Improper or inadequate warm-up are some of the contributing factors in this type of injury.  Minor strains should heal in 1-2 weeks with rest.  If pain lingers longer, consult a Feet First podiatrist.

Tendinitis is a common type of ankle and foot problem, which is an inflammation of the tendons—the tissue that connects muscles to bones.  In sports, a tendinitis injury is usually the result of abnormal foot biomechanics, excessive foot pronation (tendency of the arch of the foot to flatten out too much), or a history of overuse in a specific sport (e.g., basketball, running, volleyball), which requires continuous high-impact, repetitive movements. Contact a Feet First podiatrist if pain does not improve or worsens after a few days of rest and ice therapy.

Stress Fractures are hairline breaks resulting from repeated stress on the bone. High-impact sports such as running, gymnastics, and volleyball can increase the risk of stress fractures.  To prevent stress fractures, wear shoes that provide sufficient padding and support when you walk, run, dance, or perform any other activities that stress the bones of the foot.  If continued pain persists, contact us at Feet First Podiatry.

Plantar Fasciitis is caused by inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts in the heel bone.   Inflammation is caused by overuse with excessive foot flattening and is aggravated by tight calf muscles.  Aerobic activities such as walking or running are usually related to this injury, but it can also result from basketball, football, or softball.  Custom orthotics (custom devices for shoes), injections or physical therapy may be recommended by your podiatrist to help alleviate pain.

 

Enjoy Pregnancy without Foot Pain

pregnant-feet-pic

“Oh my aching feet” is a phrase you hear often from pregnant women.  But, are sore feet a symptom they just must deal with during pregnancy?  According to St. Charles foot and ankle surgeons Daniel Adamovsky, DPM and Dennis Timko, DPM the answer is “no.”

There are many remedies available to help alleviate foot pain. The doctors at Feet First state that women often experience foot pain during pregnancy because of increased weight, foot instability and swelling.  “I’ve seen an increase in pregnant women with foot pain because more women than ever before are active, even running marathons, during their pregnancies,” Dr. Adamovsky says.  He recommends the following guidelines to help reduce foot pain during pregnancy.

Painful, Swollen Feet—Pregnant women often experience throbbing, swollen feet due to excess fluid build up (edema) in the feet from the weight and position of the baby.  To reduce swelling, put feet up whenever possible, stretch legs frequently, wear wide comfortable shoes and don’t cross legs when sitting.

Arch Pain—Pain in the arch can be due to both arch fatigue or over pronation (or the flattening of the arch).  Over pronation causes extreme stress to the ligament (the plantar fascia) that holds up the arch of the foot.  The best way to prevent arch pain is to stretch daily in the morning and before and after any exercise, don’t go barefoot and wear supportive low-heeled shoes.

Ingrown Toenails—Excessive stress from tightly-fitting shoes causes painful ingrown toenails.  Give your feet a break: wear wider shoes during the last trimester of pregnancy to avoid ingrown toenails.  If you do experience an ingrown toenail, avoid attempting “bathroom surgery.”  Repeated cutting of the nail can cause the condition to worsen over time.  It is best to seek treatment with a foot and ankle surgeon. It is also not uncommon for women to experience a change in their foot size during pregnancy.

“A permanent growth in a women’s foot, up to half a size, can occur from the release of the same hormone, relaxin, that allows the pelvis to open to deliver the baby.  It makes the ligaments in your feet more flexible, causing feet to spread wider and longer,” Dr. Adamovsky adds.

Pregnancy and pending motherhood should be a joy.  If foot pain persists, call the office at 636-477-7300.  Our doctors can provide relief with conservative treatments such as physical therapy, foot orthotics, supportive shoes and minor toenail procedures.

Fun Foot Facts

  1. Your feet have ¼ of all the bones in your body – 52 bones!
  2. The foot is an intricate structure containing 26 bones with thirty-three joints, 107 ligaments, 19 muscles and multiple tendons that hold the structure together and allow it to move in a variety of ways.
  3. There are approximately 250,000 sweat glands in a pair of feet, and they excrete as much as half a pint of moisture each day.
  4. It is not “normal” for your feet to hurt!
  5. Seventy-five percent of Americans will experience foot health problems of varying degrees of severity at one time or another in their lives.
  6. There are times when you’re walking that the pressure on your feet exceeds your body weight, and when you’re running, it can be three or four times your weight.
  7. As a person’s income increases, the prevalence of foot problems decreases.
  8. Women have about four times as many foot problems as men; lifelong patterns of wearing high heels often are the culprit.
  9. An average, healthy person should aim to take 8,000 to 10,000 steps a day. That covers several miles and adds up to about 115,000 miles in a lifetime. By age 70, the average person will have walked the equivalent of 4 times around the globe.
  10. Walking is the best exercise for your feet. It also contributes to your general health by improving circulation, contributing to weight control and promoting all-around well being.
  11. Your feet mirror your general health. Such conditions as arthritis, diabetes, nerve and circulatory disorders can show their initial symptoms in the feet — so foot ailments can be your first sign of more serious medical problems.
  12. Only a small percentage of the population is born with foot problems. It is neglect, and a lack of awareness of proper care — including ill-fitting shoes — that bring on the problems.
  13. A lifetime of wear and tear, plus neglect, accounts for the fact that the practices of most podiatrists are made up of older Americans.

Medical Foot Facts

  • Corns and calluses are caused by friction and pressure from skin rubbing against bony areas when wearing shoes. If the first signs of soreness are ignored, corns and calluses rise up as nature’s way of protecting sensitive areas.
  • Plantar warts are caused by a virus which may invade the sole of the foot through cuts and breaks in the skin. Walking barefoot on dirty pavements or littered ground can expose feet to this sometimes painful skin infection.
  • To avoid ingrown nails, trim your toenails straight across with clippers specially designed for the purpose. Leave them slightly longer than the tips of your toes.
  • Shopping for shoes is best done in the afternoon. Your feet tend to swell a little during the day, and it’s best to buy shoes to fit them then. Have your feet measured every time you purchase shoes, and do it while you’re standing. When you try on shoes, try them on both feet; many people have one foot larger than the other, and it’s best to fit the larger one.
  • About 19% of the U.S. population has an average of 1.4 foot problems each year.  The percentages by major types of foot and ankle problems is:
Foot infections, including athlete’s foot, other fungal infections, and warts 5% of the U.S. population
Ingrown toenails or other toenail problems 5% of the U.S. population
Corns or calluses 5% of the U.S. population
Foot injuries, bunions, flat feet or fallen arches 6% of the U.S. population
  • Podiatric physicians provide treatment for 82 percent of corn and callus problems, 65 percent of toenail problems, 63 percent of bunion problems, 46 percent of flat feet or fallen arches problems, and 43 percent of toe/joint deformities.
  • Of the three major types of foot problems (infections, toenails and corns and calluses), people are less likely to receive treatment for corns and calluses and more likely to continue to have corns and calluses as a problem without treatment.
  • About 60 percent of all foot and ankle injuries, reported by the U.S. population older than 17, were sprains and strains of the ankle.
  • Podiatric physicians are four times less likely to use costly inpatient services than other physicians.

Podiatry Facts & Statistics

  • The Podiatric Physician (Doctor of Podiatric Medicine or DPM) is the health care professional trained in the care of your feet. He or she receives conventional medical training, plus special training on the foot, ankle, and lower leg. All 50 states, the District of Columbia, and Puerto Rico require that they pass rigorous state board examinations before they are licensed, and most require continuing education programs for regular license renewal.
  • Podiatric Physicians are the major providers of foot care services, providing 39 percent of all foot care (orthopedic physicians provide 13 percent of all foot care, all other physicians provide 37 percent of all foot care, and physical therapists and others provide 11 percent of all foot care).
  • There are about 13,320 active Podiatric Physicians in the United States today. There is an average of one Podiatric Physician for every 20,408 people.
  • About 81 percent of all US hospitals have Podiatric Physicians on staff. The larger the hospital, the more likely it is to have Podiatric Physicians on its staff.
  • About 5 percent of the US population sees a Podiatric Physician each year. There were more than 55 million patient visits in 1995 from about 14 million people.
  • In 1998, the average number of yearly patient contacts with a Podiatric Physician was 4,488.
  • Over the past 10 years, an average of 592 new Podiatric Physicians graduated yearly from the 7 podiatric medical colleges.
  • In 1998, 53 percent of all active Podiatric Physicians were certified by one or more recognized podiatric medical boards.
  • On average, the Podiatric Physician in the United States is 42 years old and has been in practice 13 years.
  • Over 14 percent of Podiatric Physicians are female.
  • Podiatric Physicians are four times less likely to use costly inpatient services than other physicians.
  • Podiatric Physicians provide treatment for 82 percent of corn and callus problems, 65 percent of toenail problems, 63 percent of bunion problems, 46 percent of flat feet or fallen arches problems, and 43 percent of toe/joint deformities.
  • There are about 13,320 doctors of podiatric medicine actively in practice in the United States, and they receive more than 60 million visits a year from people with any number of foot ailments. Yet that’s probably only a fraction of the number of foot problems. Mostly, say podiatrists, that’s because many people have the erroneous notion that their feet are supposed to hurt.
  • Patients with foot problems visit Podiatric Physicians an average of 3.7 times a year, orthopedic physicians 3.4, osteopathic physicians 3.2, all other physicians 3.0, and physical therapists and others 7.1.
  • As people age, they increasingly choose Podiatric Physicians. Medicare data verifies that Podiatric Physicians are the physicians of choice for 83 percent of hammertoe surgery, 67 percent of metatarsal surgery, 77 percent of bunionectomy surgery, and 47 percent of rearfoot surgery. Medical Economics magazine reported that 56 percent of all older patients have seen a Podiatric Physician.
  • About 87 percent of Podiatric Physicians are affiliated with preferred provider organizations, 52 percent with nursing homes, 81 percent with health maintenance organizations, 21 percent with academic institutions, and 12 percent with insurance companies, utilization review firms, or peer review organizations.
  • About 58 percent of Podiatric Physicians are in solo practice. They have an average of 3 employees.
  • About 48 percent of Podiatric Physicians have a license in 1 state, 31 percent in 2, 19 percent in 3, and 2 percent in 4 states.

 

 

Sources for the data are retrieved from American Association of Colleges of Podiatric Medicine, American Hospital Association, American Podiatric Medical Association, Council on Podiatric Medical Education, Podiatry Insurance Company of America, United States Bureau of the Census, and United States Department of Health and Human Services. (2008). Podiatry Facts & Statistics[Article]. Retrieved from http://ipma.net/displaycommon.cfm?an=1&subarticlenbr=15

Preop & Postop

Preoperative Testing and Care

As with anyone preparing for any surgical procedure, those undergoing foot and ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered by your podiatrist, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulatory status of the foot and legs), and a biomechanical examination. A consultation with another medical specialist may be advised by a podiatrist, depending on your test results or a specific medical condition.

Postoperative Care

The type of foot surgery performed determines the length and kind of aftercare required to assure that your recovery from surgery is rapid and uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression, and elevation. Bandages, splints, surgical shoes, casts, crutches, or canes may be necessary to improve and ensure a safe recovery after foot surgery. Your podiatric surgeon will also determine if and when you can bear weight on your foot after the operation. A satisfactory recovery can be hastened by carefully following instructions from your podiatrist.

Patient Care with an Emphasis on Attention to Detail is Our Priority.