Do I Have An Abnormal Gait?

Posted by on Friday, May 31st, 2013

Having an abnormal gait could be the cause of your chronic back pain, reports CBS News. Many people go through physical therapy and even spinal manipulation from a chiropractor before discovering that an abnormality in walking pattern was the culprit all along. The newspaper cites a February 2009 study published in the Journal of the American Podiatric Medical Association that found corrective shoe inserts to be an effective way to treat abnormal gait and low back pain. After being fitted for custom shoe inserts to correct their imbalanced gait, 84 percent of the test subjects experienced improvement. More than a year later, the follow-up found that pain relief lasted more than twice as long as with previous treatments.

Frequently Asked Questions About Foot Surgery

Posted by on Thursday, May 30th, 2013

Foot surgery causes a lot of anxiety for patients. They fear that they will be unable to get back to their regular routine. They fear pain. They are afraid of doing the wrong thing during their recovery. Part of our job is to soothe jangled nerves and assure patients that they are in good hands. Here are answers to some of the most common questions we field at the office.

Summer Footwear Dos & Donts

Posted by on Wednesday, May 29th, 2013

During the summer months, most people are happy to break out their favorite pair of sandals and let their feet air out after a long, chilly winter. Yet, choosing the wrong type of summer footwear can also leave us doubled over with heel pain, tendinitis, back aches, shin splints, or even broken bones due to an accidental fall. Check out our NYC podiatric medical center’s round-up of summer shoe dos and don’ts to ensure you look and feel your best all summer long.

DO choose strappy shoes.

Few incidents are more embarrassing than falling out of your shoes in public. To prevent what the American Podiatric Medical Association calls “a flip-flop fiasco,” choose sandals with a strap that wraps around the back of the foot for greater stabilization.

DON’T buy shoes with flexible soles.

Rest assured, there is zero structure in any shoe that can easily be bent in half. Instead of a shoe that bends in the middle, look for a shoe that bends closer to the ball of the foot. Flip-flops are okay for walking short distances — like a couple of feet from your lounge chair to the water — but you don’t want to overdo it. Walking around in flip-flops too often leads to arch and heel pain, according to experts.

DO look for a small platform heel.

Flats and sky-high heels are out. Small one-inch platform heels are in. “Flat shoes stress the Achilles tendon and cause extensive pronation or flattening of the feet,” says Dr. Kenneth Leavitt of the New England Baptist Hospital. On the other hand, high heels cause corns, calluses, misshapen toes and stress fractures. You can find a show with a two-inch platform and three-inch heel that will be comfortable and still look stylish, he says.

DON’T wear old shoes.

Summer shoes often don’t survive more than a season or two, according to US News & World Report. Check the sole to see if it is worn down on one side more than the other. Look for signs that the material is separating. If you have a pair of athletic shoes that has seen more than 300 to 500 miles, it won’t be long before you suffer the consequences.

DO look for the APMA Seal of Acceptance.

The American Podiatric Medical Association has a long list of summer shoes it recommends, from FitFlop and Chaco to Orthaheel and Merrell. These shoes demonstrate that they provide sufficient support for the heel and arch. Check out the list here.

 

You’ve Got A Diabetic Foot Ulcer: Now What?!

Posted by on Tuesday, May 28th, 2013

Each year, there are over 80,000 lower-limb amputations on diabetics in America. “Diabetes is what has formed this industry and keeps it afloat,” Rob Burris, an artificial limb designer for Hangar Prosthetics tells KLAS-TV News. “If you look at all the numbers, from accidents, or illness, or cancer, they are nothing compared to the number people that lose them because of diabetes-related causes.”

What Can I Do About Corns and Calluses?

Posted by on Monday, May 27th, 2013

Feet endure a lot of wear and tear over the course of a day. Corns and calluses are two of the more common foot problems seen. About 19% of the U.S. population has 1.4 foot problems each year, with 5% of the population enduring corns and calluses, reports the Illinois Podiatric Medical Association. A podiatrist will treat corns and calluses 82% of the time, with a small percentage of people speaking with a primary care physician about the matter.

Common Arch Problems

Posted by on Friday, May 24th, 2013

We see all types of feet here at the The Center for Podiatric Care & Sports Medicine. About 60% of the people that come in have medium arches that are tired and aching from being always on-the-go. Often, we tell them that extra cushioning and changing shoes regularly to maintain shock absorption and support will do. Many people like the idea of getting a custom orthotic molded specifically to their feet to help the body keep proper alignment and prevent injury. Here we’ll talk about a few of the most common arch problems we see.

Flat Feet & Fallen Arches

Do you have flat feet? Get your feet wet and step on a piece of paper. Do you see a full imprint of your entire foot? If so, then you have fallen arches. According to Web MD, fallen arches occur “when tendons do not pull together properly.” Common symptoms include fatigue, aching and swelling. Some people are born with flat feet, while others may develop this condition as a part of having diabetes, arthritis, obesity or a sports injury such as torn tendons. Most patients are treated with NSAID pain relievers, shoe inserts and stretching, but surgery is also possible for cases of extreme pain.

High Arches & Supination

Using the same wet foot test, you’ll know that you have high arches if you notice a large portion of the foot imprint missing in the middle. Stiffness and pain are common symptoms. According to Beth Israel Deaconess Medical Center, “Army studies have found that recruits with the highest arches have the greatest tendency to lower limb injuries, while flat-footed recruits have the least.” Some people are born with this condition, while others may develop it due to cerebral palsy, polio, spinal cord injury or muscular dystrophy. Underpronators should wear shoes with softer midsoles. Braces are available and surgery is an option in serious cases.

Overpronation

Normally, the outside of the heel makes contact with the grand and the foot rolls inward at 15%. People whose feet roll inward more than 15% are called “overpronators.” According to Runner’s World, “This means the foot and ankle have problems stabilizing the body, and shock isn’t absorbed as efficiently.” Often people with this problem suffer pain in the arches, the shins, the knees and hips. Shoes tend to wear down quicker along the inside of the foot. Treatment includes custom orthotics for added arch support, footwear with firm heels and over-the-counter pain relief. In rare cases, surgery may be considered.

Plantar Fibromas

Plantar fibromas are noticeable bumps on the arch of the foot. These benign tumors grow deep within the plantar fascia, rather than on the skin’s surface as a plantar wart might. They may grow bigger or stay the same size — and they may or may not be painful. Usually a biopsy or MRI will be done during the diagnosis stage. From there, steroid injections and orthotic devices may be recommended. Often, patients wish to have the growth removed in surgery. However, they must be aware that recurrence is common and surgery could result in other foot problems like hammertoe or a flattening of the arch.

Are Bunions Hereditary?

Posted by on Thursday, May 23rd, 2013

A new study published in the Arthritis Care & Research journal reveals that common foot disorders — like bunions, hammertoe, and claw toe — appear to be inherited. There is increased incidence among white men and European women, the research showed. The findings are part of the Framington Foot Study, which has been looking at more than 6,000 feet over the past several years.

Are Bunions Hereditary?

Posted by on Thursday, May 23rd, 2013

A new study published in the Arthritis Care & Research journal reveals that common foot disorders — like bunions, hammertoe, and claw toe — appear to be inherited. There is increased incidence among white men and European women, the research showed. The findings are part of the Framington Foot Study, which has been looking at more than 6,000 feet over the past several years.

How Heritable Are Bunions?

According to Web MD, researchers found that:

  • Overall, 39% of women and 38% of men inherited their bunions.
  • However, 89% of bunions in younger participants (under age 60) had inherited them.
  • 68% of women and 20% of men with high-arched feet inherited the condition.
  • 99% of women and 63% of men under 60 with high-arched feet inherited it.

“These new findings highlight the importance of furthering our understanding of what causes greater susceptibility to these foot conditions, as knowing more about the pathway may ultimately lead to early prevention or early treatment,” said Harvard researcher Dr. Marian Hannan in a recent statement.

How Common Are Bunions?

One study revealed that a third of older adults experience bunions. This most recent study confirms that prevalence as well. It used to be thought that bunions were caused by wearing high heels, since they are so commonplace and strike women more than men. The 2003 High Heels Study conducted by the American Podiatric Medical Association found that 72% of women dressed in high heel shoes with heels higher than two inches. Forty percent of the women said they wear these heels daily. Twenty percent of the women wore these heels for one to four hours a day, and 10% wore them more than eight hours a day. Not surprisingly, the APMA found a wide range of foot problems associated with uncomfortable shoes — from bunions, corns and calluses, to hammertoes, neuromas and bony enlargements on the heel.

What Can You Do About Hereditary Foot Problems?

The good news is that early intervention can really help patients — especially young ones — who are predisposed to foot problems like bunions or hammertoe avoid surgery later in life. Finding well-fitting shoes with roomy toe boxes and seeing a podiatrist about getting insoles for added support are good first steps if you are at-risk for hereditary foot problems. Runners can tape their feet in a normal position or wear special splints to avoid injury. There are exercises that help stretch the foot as well.

How Cryosurgery Can Help Your Plantar Fasciitis

Posted by on Wednesday, May 22nd, 2013

For Deena Hansen of Yankton, South Dakota, each step sent a shockwave of pain rippling through her body. Even worse than the pain was the shots she had to get in her foot to relieve the pain she’s suffered for a year and a half. She tried the cortisone shots in addition to physical therapy and corrective shoes, but nothing worked. “You have a strike against you in the morning before you ever get out of bed. Chronic pain rules your life,” she told KSFY News. She was the perfect candidate for cryosurgery.

What Is Cryosurgery?

Cryosurgery uses extreme cold to destroy abnormal tissue. The word comes from the Greek “cryo” (icy cold) and “cheirourgiki” (handiwork). Its applications range from killing cancerous tumors in liver and prostate, to disarming foot neuromas and destroying warts. Surgeons often prefer cryosurgery because it is “minimally invasive” — meaning that there is very minimal pain, scarring, recovery and cost. Third Age reports that cryosurgery for heel pain has been FDA-approved since 2003. The procedure costs in the ballpark of $500 and is covered by Medicare, as well as most other medical plans, they add.

How Is Cryosurgery Used To Treat Plantar Fasciitis?

When a patient comes in, a local anesthetic is used to numb the foot. A small incision is made into the heel and a cryoprobe is then inserted. The probe is positioned to the area of pain. Liquid nitrogen causes a pea-sized ice ball to form on the end of the probe, which freezes the nerve cells that cause the pain and the surrounding inflamed tissue. This intervention prompts the foot to then heal itself. The whole procedure is done within 15 to 30 minutes.

What Is Cryosurgery Recovery Like?

Many patients can resume activities immediately. Post-operative discomfort is very minimal. Deena Hansen’s doctor recommended that she stay off her feet and ice her heel for three to four days. She will also continue to use orthotics for added arch support. However, she reports that she felt immediate relief and hasn’t had any pain since her procedure. “It’s been great,” she says.

What Does The Medical Community Say About Cryosurgery For Heel Pain?

In Podiatry Today, Dr. Lawrence Fallat, DPM said he has been using cryosurgery on patients for three years. All of his patients had previously tried other therapies, including: steroid injections, pain relievers, orthotics, physical therapy, night splints, shockwave therapy, endoscopic plantar fasciotomy and percutaneous medial fascial release. “After undergoing cryosurgery, approximately 90% of the patients had complete resolution of pain or had only minor residual pain that required no treatment,” he reported.

A study conducted by RGV Footcare in Texas looked at 106 patients with plantar fasciitis who had tried other therapies to no avail. Out of the 106, 77.4% of the patients found relief through cryosurgery. The mean “pain scale” dropped from 7.6 to 1.6 at three weeks, and 1.1 after two years. Only 31 subjects did not find the treatment effective for their pain. The researchers concluded that the therapy was considered successful for immediate and long-term pain relief.

“While this treatment is relatively new for foot pain, physicians have utilized cryosurgery for pain relief for decades,” says Mark Katz DPM in Podiatry Today. He explains that other procedures like surgery and endoscopic procedures carry added risks, such as a neuroma (tumor) of the medial and lateral calcaneal nerve branches. He cites numerous case studies where cryosurgery has helped patients with severe chronic pain, inflammation, burning and nerve damage. “The procedure is cost effective and provides the patient with minimal downtime as well as a low complication rate. I encourage our profession to embrace this technology,” Dr. Katz writes.

Free Overuse Injury Consultation In NYC, Through June 4th

Posted by on Tuesday, May 21st, 2013