Aging Feet & Immobility

Aging is a real concern in today's society as the average age that people are living to is increasing. More people living longer means that there will be more people living with impairment of the lower extremities. The leading cause of limited activity in older people is the impairment of the lower extremities. Living with limited mobility then affects other areas of the body such as knee, hip, and lower back pain. According to the US National Center for Health Statistics, one-fourth of all nursing home patients can't walk and one-sixth needs assistance when walking.

Years of neglect or abuse of the lower extremities causes more problems later in life. Normal wear and tear throughout the years is also a factor in future mobility of the elderly. Prevention is important for older people for many reasons. One of the main reasons to have lower extremities checked as one gets older is to ensure future mobility. Comfort and limiting additional medical problems to reduce the chances of hospitalization are also reasons to maintain visits to a Podiatrist. Another major reason is cost. Bedridden patients cost much more than that care for an ambulatory patient.

Podiatric physicians are providing services designed to keep older people on their feet. If you or someone you know displays signs of dry skin, brittle nails, burning and tingling sensations, feelings of cold, numbness, and discoloration of the foot, seek medical attention by a Podiatrist since there are more than 300 different foot ailments.

Image by Borya. (2005). Elderly woman + her view. Flickr. 

Arthritis 101

Arthritis comes in many different forms, over 100, and occurs in men and women of all ages even though most people think that arthritis only occurs later in life. In America, about 37 million people have arthritis, which is about 1 out of every 7 people. Arthritis is an inflammation of one or more joints and results in pain, swelling, stiffness, and limited movement of the extremities.

Cartilage is what normally protects the joints of the hands and feet and it is what allows smooth movement by absorbing shock when pressure is placed on the joint. With arthritis, cartilage has been broken down to the point where bones rub together causing pain, swelling, and stiffness. This is why the major complaint by people with arthritis is joint pain.

Joint inflammation is caused by a variety of reasons and usually goes away after treatment:

• Normal wear and tear on joints
• Infection
• Broken bone
• Autoimmune disease

Some symptoms of Arthritis:

• Joint pain
• Joint swelling
• Reduced ability to move the joint
• Redness of the skin around a joint
• Stiffness
• Warmth around a joint

Contact my office when:

• Joint pain lasts longer than 3 days
• One has severe unexplained joint pain
• Joint is significantly swollen
• Difficulty in moving the joint
• Skin around the joint is red or hot

Image by bark. 40+60 Feet, Euw. (2009). 

Blood Pressure Checks

Have you ever been surprised or wondered why when visiting your Podiatrist that they took your blood pressure even though you made the appointment for a foot ailment? This is actually very commonplace since Podiatrists are concerned about all aspects of their patient's health and wellness, not just specifically their lower extremities. The reason that blood pressure is checked is to look for signs of hypertension (high blood pressure) and vascular disease (heart and circulatory problems).

By checking blood pressure, Podiatrists may be the first one to detect hypertension and/or cardiovascular disease. The reason why this concerns Podiatrists is that it decreases circulation and reduces blood flow to the lower extremities. Increased swelling in the feet and legs in some cases means that hypertension has contributed to heart disease. Hypertension can also be a cause of ulcerations on the feet or legs. Ulcerations are open sores that don't heal at all or heel very slowly.

As a patient, it is your responsibility to notify your Podiatrist of any and all medical problems you may have in order to ensure the best treatment methods. Your Podiatrist is a member of your healthcare team and should be in contact with other physicians you may be seeing for your overall health.

Image by US Army Korea. (2011). Blood pressure check. Flickr. 

Growing Pains

"Growing pains", or leg aches, are a common occurrence among children and adolescence between the ages of 3 to 12 years old. Pain tends to be centralized in the legs and can affect one or both legs at the same time. Growing pains most often occur in the evenings and at night. The pain could be so severe that the child wakes up out of sleep. The cause of the pain is unknown by it is likely due to growth factors such as muscle fatigue, overexertion, chemical imbalances and genetic factors. Some symptoms of "growing pains" include:

• Pain occurs at night
• Peaks around ages 4 to 5 but can occur up until age 12
• Normal examination – no redness, tenderness, swelling or limitation of movement
• Treatment is usually not needed
• Occurs in 15-30% of children
• Tends to occur in the popliteal fossa, which is the depression at the back of the knee

Parents can help relieve the pain of the child by applying a heating pad, massaging the lower extremities, having the child stretch prior to bed, and warm soothing baths.

Many children see a Podiatrist for their aching legs since the pain could be caused by other conditions and growing pains should be ruled out prior to a diagnosis. Refer to the following list for symptoms of other conditions not associated with growing pains.

• Swelling or redness around the joint
• Limping
• Fever
• Fatigue
• Chronic pain
• Pain during the day
• Normal activities are interfered

Image by Anders. (2008). Waiting feet. Flickr. 

5 Foot Myths

Foot and ankle emergencies occur every day so immediate treatment from a podiatric physician is a necessity. There are myths surrounding foot care that deters people from seeking medical attention. Let's address these myths so if you or someone you know finds themselves with an ankle or foot problem, the correct medical attention is sought.

Myth 1: 

I can move my foot/ankle so it can't be broken. This is false. One can still walk or move their lower extremity and still have a fracture that needs attention by a podiatric physician.

Myth 2:

I don't need to see a Podiatric physician for a broken toe. This is false. Broken toes do need to be assessed by a physician because they can X-ray to look for a displaced or angulated break which would require realignment of the fracture. This helps prevent improper or incomplete healing.

Myth 3:

Soak your foot or ankle injury in hot water immediately. This is false. Heat promotes blood flow which causes swelling and greater pressure on the nerves causing more pain. Use ice, it has a contracting effect on blood vessels, numbness, and prevents swelling and pain.

Myth 4:

If I have a sprained ankle, all I have to do is wrap it up with an elastic bandage. This is false. Ankle sprains are torn or severely stretched ligaments and it requires an X-ray. Treatment options are usually casting or splinting. In severe cases, surgery.

Myth 5:

‘Fracture', ‘Break', and ‘Crack' mean different things. This is false. These terms all describe a broken bone.

Image by Anton Diaz. (2011). Myth of the human body. 

Shoe Wear Patterns: Translated

Before purchasing your next pair of shoes, inspect your old pair for wear patterns. By knowing what the wear patterns mean, you can look for a pair of shoes that will hold up to the wear and tear of normal use as well as extending the life of those shoes. Shoes form wear patterns from the stress the feet place on the shoe.

What wear patterns mean:

• Ever have wear or a bulge on the side of the big toe? This means you are purchasing shoes that are too narrow. Or, you could have a bunion. Look for shoes with wide width. 
• Are the outer soles of your shoes worn? If so, you have a tendency to turn your foot out. You may need to be fitted with orthotics. 
• Are there toe imprints on the upper shoe? Your shoes may be too small or you may have a hammertoe. 
• Wear on the ball of the foot? Your heel tendons may be too tight. 
• Wear on the inner sole? You turn your foot inward. You may need to be fitted with orthotics.

Image by Nick Richards. (2008). New shoes, same as the old shoes. Flickr. 

5 Shoe Components

When purchasing a shoe, one typically looks for specific styles and colors of shoes without ever considering what components make up a shoe. By knowing the components, you can use that knowledge to make an educated purchase the next time you buy shoes.

1. Toe Box. This is the tip of the shoe. Depending on how the shoe is made, it can pointed, rounded, or square tipped. 
2. Vamp. The vamp is the upper part of the shoe where the laces or velco are. 
3. Sole. There are two parts of the sole, the insole and the outsole, which you might guess that the insole is inside of the shoe and the outsole is the part of the shoe that makes contact with the ground. Buying tip: The softer the sole, the greater the shoe's ability to absorb shock. 
4. Heel. The part of the shoe that is considered the heel is the bottom part of the rear of the shoe. Sometimes the heel provides elevation to the shoe.
5. Curve. The curve is near the arch of the foot and is what gives the distinction between right and left shoes. The curve conforms to the average foot shape.

Image by velo_city. (2008). I heart shoes. Flickr.