Sprain vs Fracture

Kids wait all year for summer to run outside, play sports, and go to the playground. One of the hot trends in summer birthday and graduation parties is bouncy houses. While tons of fun, they can be quite dangerous. As children jump up and down around other children, it is very easy to sprain, fracture, or break any one of the 33 bones in the foot. Accidents can happen anywhere, and there can be confusion about what constitutes a sprain, fracture, or break.

Sprains = ligaments tear, pull, or stretch
Fracture = break in the bone

If the worst happens, have your child or loved one checked by a podiatrist. The first thing that will happen will be an examination of the feet and ankles, and an X-ray of the foot. Depending upon the outcome of an initial X-ray, other tests may need to be ordered; MRI or ultrasound. The additional tests are great for finding torn ligaments and stress fractures.

Broken bones, or fractures, need to be set prior to casting. If the bones don’t line up correctly or stay in place, then surgery may be required by using pins and metal plates. Stress fractures require the R & I out of RICE; rest and immobilization. Boots, casts, or crutches can be used until healing is finished.

Sprains also require the R & I and heal faster than a broken bone. Soft casts, boots, and crutches help the patient remain mobile. Torn ligaments may also require surgery.


Image by Joe Shlabotnik. (2012). Bouncy Castle. Flickr. Retrieved from http://www.flickr.com/photos/joeshlabotnik/6984052944/

A Neuroma, so now what?

You have a neuroma, so now what? If you’re not sure if you have a neuroma or not, refer to our blog Neuroma, Oh No!

There are techniques and procedures to implement into your daily life to minimize the pain associated with a neuroma. First off, evaluate the shoes you are wearing. The tighter the shoe, the more the neuroma becomes inflamed. Wear shoes that allow for the toes to move. Shock-absorbent soles in shoes allow for the pressure to be displaced evenly which will minimize the pain associated with the neuroma. Shorter heeled shoes or flats are advised. If pain and inflammation occurs, remember RICE (rest, ice, compression, and elevation). In this case, avoid compression.

Podiatrists, like myself, diagnose and treat neuromas based on the severity of the neuroma. The ranges of treatment options fall between having the patient wear thick-soled shoes to surgery to remove the tumor. One of the first steps in the initial appointment is to take an X-ray of the foot. This will indicate the severity of the neuroma and helps to determine the best course of treatment options for minimizing the pressure on areas where the neuroma develops.

Here are a couple treatment options available for neuromas.

Padding and Taping: Padding on the ball of the foot can help to relieve the pressure and pain of the neuroma. This may also help to change the abnormal foot function.

Medication: There are many anti-inflammatory drugs and cortisone treatments available. Consult with your podiatrist on which ones are right for you.

Orthotics: Orthotics are custom shoe inserts that podiatrists use to correct a number of foot conditions. Orthotics are a step beyond purchasing over the counter shoe inserts because they are molded using your own foot for a proper fit.

Surgery: This is the last resort. All other measures should be tried first. If the neuroma progresses past the use of non-surgical treatment, surgery becomes necessary. Surgery involves removing the nerve causing the neuroma.

Contact my office if you feel you have a neuroma for a diagnosis and treatment plan.

Image by LeeLeFever. (2011). The latest in spring fashion. Flickr. Retrieved from http://www.flickr.com/photos/leelefever/5646695129/

A Neuroma, Oh No!

Let me guess, you've been wearing high heeled boots and pumps this winter and spring, but found that there were times that you experienced pain between the toes or numbness or tingling in the ball of the foot. What did you do? Chalk it up to the shoes being too tight or slightly too high? That may have been the case, but most likely your feet were telling you that you have a problem. You might have also thought that you were pinching a nerve. If you had that thought, you were probably correct. A “pinched nerve” is called a neuroma. If you have ever experienced the feeling of tingling, numbness between the third and fourth toes, and pain, you most likely have a neuroma. Not everyone has this though, so it’s time to stop and consider what is happening to your foot.

I started this blog by talking about high heels, because women are more prone to having neuromas. Just ask any women with condition and they will tell you that once they stop walking and take off the shoe, they start to feel relief. It’s not a condition that is experienced every day, unless one wears high heels or shoes that aggravate the neuroma.

If you or someone you know and love has suffered through or complained about this happening to them, make an appointment for a proper diagnosis. This is important because neuromas will get worse over time and can eventually lead to surgical treatment. Prior to the appointment, start adopting a few good habits and relief from the pain.

First off, stop wearing the shoes that are causing the pain and trade them for a shoe that has plenty of toe room. Look for over the counter shoe pads and shoes with shock absorbent shoes that will keep pressure off of the foot and toes. Give yourself a foot massage and apply ice afterwards to alleviate pain.

Image by VirtKitty. (2012). MRI of my left foot showing Morton's Neuroma. Flickr. Retrieved from http://www.flickr.com/photos/lalouque/6675179295/

What can the Sun do to your Feet?

We all know by now that the Sun’s UV rays can be harmful to our skin. We take many precautions to protect ourselves; limiting exposure to the sun, wear sunscreen daily, and eliminate or minimize time spent in tanning beds. If you’re like most, the part of the body that is most thought about is the face and neck. What you might be surprised by is that the Sun’s exposure on the feet and sunburns can also lead to common cancers of the lower extremity just like the skin cancer that occurs on the face.

If you’re in the habit of applying daily sunscreen to your face, take it one step further and apply it to your feet, especially if you plan on wearing flip-flops or open-toed shoes. This can help to prevent the following types of skin cancer on the feet, ankles, and legs.

Basal Cell Carcinoma: This is less common on areas of the body that are not exposed to as much sun, like feet and is one of the least aggressive cancers. This means that it rarely spreads beyond the skin.

• It looks like white bumps or patches, similar to an open sore. It may ooze or crust over.

Squamous Cell Carcinoma: This is the most common form of cancer on the skin of the feet. Like Basal Cell, it typically stays on the skin and doesn’t spread much in the beginning stages. Once the cancer becomes advanced, it becomes more aggressive and spreads throughout the body.

• It can look like a small scaly inflamed bump that may crack or bleed. Sometimes it looks like a callus-like lesion, plantar war, fungal infection, or eczema.

Malignant Melanoma: This is the most deadly skin cancer, so early detection is critical. As it spreads, the more aggressive and serious it becomes because it spreads through the lymphatics and blood vessels. It is typically found on both the sole and top of the feet. Sometimes it is found underneath a toenail.

• Often called “The Great Masquerader” because it has many different appearances. It can begin as a small brown-black spot or bump OR a pink or red bump. The tumors often look like common moles so look for irregular borders, changes in color, and a diameter greater than 6mm.

Inspect your feet every day for changes. If something appears, keep an eye on it. Document when, where, and the size of the bump or spot. Make an appointment to get it checked out.


Citations:
American Podiatric Medical Association. (2012). Skin Cancers of the Feet. Retrieved from http://www.apma.org/MainMenu/Foot-Health/Brochures/Skin-Cancers-of-the-Feet.aspx

Photo by Blondiyooper. (2004). Suspicious Mole on Foot (Before). Flickr. Retrieved from http://www.flickr.com/photos/blondieyooper/2476745069/

Don't Always "Walk It Off"

I hope people have started walking, as we’ve had beautiful weather here in the Chicagoland area.  If you’re just starting out or an avid walker, there is a potential for foot problems that occur along route and make walking difficult and uncomfortable.

Keep your feet healthy this summer and if you start to see any of the signs below, contact my office to make an appointment for treatment options to get you back on that walking trail in no time.

Problem: flaky, dry, cracked, itchy skin
Possible Condition: Athlete’s Foot
Possible Cause: The shoes you are wearing are not breathing enough and as your foot sweats, the shoes are trapping in the moisture creating fungal growth.

Problem: Pain in the bottom of the heel or arch
Possible Condition: Plantar Fasciitis/Heel Pain
Possible Cause: tight muscles on the back of the leg; stretching and inflammation of fascia (Fascia runs from the heel to the ball of the foot); worn out shoes

Problem: Thickened, discolored, loose, or deformed nail
Possible Condition: Fungal Nail
Possible Cause: Toenail rubbing or bumping on the top of the shoe; Athlete’s foot spread to the nail; shoes and socks encourage fungal growth due to sweating

Problem: Painful, fluid-filled lesion
Possible Condition: Blister
Possible Cause: Worn out or ill-fitting shoes; socks not laying flat so they rub between the feet and shoe; sweating and moisture


Image by o5com. (2010). Walking. Flickr. Retrieved from http://www.flickr.com/photos/o5com/5081595200/

Podiatrists play a critical role in the health of elderly individuals. Fewer than 30% of patients over the age of 75 have the ability to look after the health of their lower extremities. Elderly individuals find it increasingly difficult to reach their feet, have the strength or eyesight to perform regular maintenance on the feet, and often cognitive disorders hinder the person’s awareness.

Podiatrists, like me, not only treat patients in an office, but still make house calls. We also make regular visits to long-term care facilities and assisted living centers. When I evaluate an elderly person’s lower extremities, I identify, manage, and treat those problems. Often, I perform simple tasks like trimming toenails and finding appropriate shoes.

Education is critical. The elderly patient should be informed on how to properly take care of their feet, especially if they have foot problems. Caregivers, whether at home or in long-term care facilities, should also be updated frequently on the status of the patient’s feet and how to continue providing care of the lower extremities. Pedicure treatments and general care differ if the elderly patient has a neurological or vascular disorder. Certain medication can also complicate other disorders so it is imperative that the patient and caregiver understand what complications can arise and how to minimize those complications.

The most important tip I have for the elderly population is to make an appointment for a clinical examination of the feet at least once a year.

Citation:
Imabe by myfuture.com. (2011). Checking in with a patient. Flickr. Retrieved from http://www.flickr.com/photos/myfuturedotcom/6052491503/

Vacation Essentials

When planning your summer vacation, remember to pack these essential items:

Band-aids: Scrapes and minor cuts are bound to happen in unfamiliar settings. Pack a few in the luggage instead of traveling to the store to buy an entire pack when you should be enjoying vacation.

Antibiotic cream: Neosporin or similar products are very versatile and treats an array of skin injuries.

Lotion: Keep feet and legs hydrated while spending time in the sun.

Blister pads or Moleskin: A lot of people purchase new shoes right before vacation. Don’t let a blister get you down, pack blister pads in advance to keep you walking pain free.

Ibuprofen, Motrin, Advil, etc: There are many over the counter anti-inflammatory medications that can come in handy from headaches to swollen feet.

Sunscreen: Remember to use sunscreen on the top and bottom of your foot. Feet burn just like every other part of the body. Sunscreen also helps to prevent UV rays which can cause cancer.

Aloe Vera: If you do get a sun burn on your feet, use Aloe Vera to alleviate the burn and start the healing process.

Flip Flops: Always wear flip flops or shoes in hotel rooms, never go barefoot. There is an increased chance of catching Athlete’s foot and warts. They are also good for around the pool, spa, or airport security check points.

Toenail Clippers: You never know when a toenail will break, so bring toenail clippers with you.

Emery board: After clipping your nails, use an emery board to smooth those rough edges. Sometimes toenail clippers are not needed, and the emery board can smooth a broken nail.

Pumice Stone: If while relaxing you notice that your feet’s skin is a little callused, use a Pumice Stone to soften the skin.

If the unfortunate happens, and you injure your foot or ankle when you are on vacation, contact a podiatrist right away. They will be able to help fix the problem immediately. To find the nearest podiatrist, call the American Podiatric Medical Association’s phone number (800.FOOTCARE) or visit their website at www.apma.org. Remember to contact my office when you get back for a follow up visit.

Citation:
Image by epSos.de. (2009). Lazy Feet on a Blue Ocean Beach vacation. Retrieved from http://www.flickr.com/photos/epsos/3520212719/