5 Podiatry Questions Answered

What’s the difference between a podiatrist, podiatric physician, and podiatric surgeon?

Nothing, they all terms used to describe doctors of podiatric medicine (DPMs) who treat foot and ankle problems.

Podiatrists are doctors, so what type of medical training do they go receive?

DPMs undergo four years of undergraduate education, four years of graduate school education at a medical college, and two to three years of residency training in hospitals and clinics.

Do podiatrists have specialty areas of focus?

Just like other doctors, podiatrists can specialize their practice and focus on areas like sports medicine, pediatrics, geriatrics, primary care, or orthopedics. Most podiatrists treat all foot and ankle problems.

Do podiatrists treat patients who have serious illnesses?

Yes, podiatrists help treat patients who have major medical issues like diabetes, obesity, arthritis, and heart disease. This is why the podiatrists as for a complete medical history upon initial consultation. Major medical conditions can have a profound effect on the feet and ankles and lead to increased problems.

What type of services do podiatrists perform?

• Arch Disorders
• Arthritis
• Bunions
• Burning Pain
• Diabetic Foot Care
• Hammertoes
• Heel Pain
• Heel Spurs
• Infections and Ulcerations
• Ingrown Toenails
• Toenail Fungus
• Neuromas
• Reconstructive Foot Surgery
• Soft Tissue Masses and Tumors
• Sports Injuries
• Tendon and Joint Pain
• Comprehensive care of foot and ankle disorders
• Surgical and non-surgical treatment of athletic injuries
• Reconstructive foot and ankle surgery
• Biomechanical analysis and functional orthotic fabrication
• Diabetic shoes and insoles
• Extracorporeal Shockwave Treatment for heel pain (ESWT)
• Alternative therapy
• Non-surgical treatment of Morton's Neuroma
• Trauma and Athletic Injuries
• Wart

Citation:
American Podiatric Medical Association. (2012). Resources for policymakers. FAQ about today's podiatrists. Retrieved from http://www.apma.org/content.cfm?ItemNumber=1598&navItemNumber=720
Image by Valerie Everett. (2008). Questions? Flickr. Retrieved from http://www.flickr.com/photos/valeriebb/3006348550/

Protect from & Check for Skin Cancer

Cancer, no matter where it is found, can be devastating. Common cancers are breast cancer, colon cancer, kidney cancer, and blood disorders, but cancer can be found in moles and on the skin on the feet and lower extremities.

The last place you might think to look for moles or skin cancer is on the feet, especially on the bottom of the foot. Skin cancer can occur anywhere on the foot and toes, even underneath toenails.

Melanoma Statistics as of 2008:

• 62,480 new cases of skin cancer due to melanoma
• 8,420 deaths associated with skin cancer
• Fastest increase of cancer in young women (ages 15 to 39) in the U.S.
• Survival rate for melanoma elsewhere on the body is 80-85%, but lower extremity melanoma has a lower than average survival rate
• 1/2 of all people diagnosed with melanoma of the foot die within 5 years of late diagnosis (American College of Foot and Ankle Surgeons)

What Can You Do?

Do a thorough foot check every time you cut your toenails:

• moles
• tops of feet
• soles of feet
• underneath toenails
• between toes

Look for changes in:

• Moles
• Freckles
• Spots
• Nail growth
• Nail discoloration
• Skin discoloration
• Sores

Protect your feet:

• Apply sunscreen EVERYWHERE: top, bottom and between toes
• Keep feet covered
• At the beach, wear water shoes to minimize sun exposure
• UV rays are strongest between 10am and 2pm, minimize sun exposure during this time

Citation:
Other health conditions. Foot Care Basics (2009), 2009, p33-37, 5p, 4 Color. Retrieved from Consumer Health Complete. 
Image by MichaelKuhn_pics. (2009). O18_365_Skin cancer. Flickr. Retrieved from http://www.flickr.com/photos/michaelkuhnphotos/3696016449/

Getting A Proper Fit

It’s almost time to start ditching the sandals and flip-flops for boots and closed toed shoes, weather permitting of course. With the change of season, evaluate the shoes currently in the closet. Throw away shoes that have wear and tear from last fall and winter because serious foot disorders can be caused by ill-fitting shoes. When shopping for new shoes this season, shy away from shoes based on how they look and focus on the following tips to help reduce the risk of foot problems.

• Purchase durably constructed shoes.
• If your feet are two different sizes, buy shoes that fit the largest foot.
• Feet keep growing, width and length, as one gets older so measure each foot before a purchase is made.
• Shoes should conform to one’s foot. Don’t force the foot into a shoe. This is a sign that the shoe will cause discomfort and potential blisters.
• The “break-in-period” is a myth. Shoes should be comfortable from the start.
• Try on both shoes. People have a tendency to just try on the right shoe, figuring that the left shoe will fit equally well. Feet can be different shapes and sizes.
• Just because you may be a size 7 doesn’t mean you are a size 7 in every shoe. Manufacturer’s sizes may vary. Try on shoes between the 6 ½ and 7 ½ sizes. Focus on how the shoe feels, not the size.
• Rule of thumb: there needs to be a ½ inch of space from the end of the longest toe to the end of the shoe.
• Purchase shoes at the end of the day as feet swell continuously throughout the day.
• Toes should be able to wiggle in shoes.
• Don’t forget about the heel. Make sure it doesn’t slip out of the shoe.
• Limit high heel height to two inches or less to minimize the amount of pressure applied to the ball of the foot.

Citation:
Vittori Foot and Ankle Specialist. (2012). Getting a proper fit. Retrieved from http://www.vittorifootclinic.com/library/3778/GettingaProperFit.html
Image by Andrew Huff. (2007). X-ray shoe fitter. Flickr. Retrieved from http://www.flickr.com/photos/deadhorse/462921241/

6 Categories of Foot Problems

Foot pain is not normal, under any circumstances. Many blogs have been written about various ailments of the feet and ankle. Foot and ankle problems usually fall into 6 different categories.

Improper footwear causes many common and treatable problems. High heels and ill fitted shoes cause physical stress on the skin, joints, nerves, and bones of the feet. Wearing painful footwear long enough will cause small mechanical changes within the foot, making treatment more difficult. Purchase shoes that don’t need a break in period and the feet will be thankful.

The second category of foot and ankle problems is due to arthritis, which involves one or more joints, caused by many different medical illnesses. The foot has 33 joints, which makes it the most susceptible part of the body to get arthritis when the joints become inflamed by fluid. The pain can be unbearable because it bears so much weight and force throughout the day.

Some foot and ankle problems appear at birth and are genetic. These conditions are called congenital problems. Club foot, extra digits, and webbed feet are just some examples. Flexible problems correct themselves over time, but rigid congenital problems require treatment for a Podiatrist.

Who thinks of the feet or lower extremities when they hear the words tumor or cancer? Feet are just as suscible as the rest of the body. Neoplastic disorders result from abnormal growth tissue and can be either benign or malignant. Skin cancer can also appear on the feet. Don’t forget to protect the feet by applying sun screen.

Infections come in three forms; bacterial, viral, or fungal, and can cause foot problems. Athlete’s foot is an example of a fungal infection. Hand-foot-mouth disease is one of the most common viral infections. Bacterial infection such as pitted keratolysis is associated with warm damp feet. 

Last but not least are traumatic foot problems. Fractures, breaks, and sprains caused by sporting injuries or just a plain old slip and fall. Even stubbing one’s toe can be a traumatic foot problem.

Did you know there were so many ways that the feet and ankle could have so many problems?

Citation:
American Podicatric Medical Association. (2012). Foot health. Retrieved from http://www.apma.org/learn/FootHealthList.cfm?navItemNumber=498
Image by Amy the Nurse. (2011). Sunburned feet. Flickr. Retrieved from http://www.flickr.com/photos/amyashcraft/5712005292/

           

Excessively Sweaty Feet

Everyone’s feet sweat. After all, there are  250,000 glands in the feet. Most people sweat in temperatures like we had in Chicago this summer, it’s just unavoidable when it’s 100 plus degrees. When the body gets warm, it sweats. This is simply biology. The interesting thing is that everyone has their own temperature breaking point when they start to sweat. A wife could start to sweat when it’s 75 degrees outside while the husband thinks this is the ideal temperature and doesn’t start to sweat. Every person’s body has their own temperature “set point”.

But for some, their feet sweat excessively all of the time. By excessive I mean when one’s foot slips and slides around in one’s shoe. The technical term is called hyperhidrosis. The foot may appear whitish in color and look wet. Excessive wetness of the feet can cause foot infections. Skin is durable, but still sensitive. The wetness can cause the skin to break down, causing small tears where infection can take place. Bacteria grow in dark damp conditions and can be a real concern.

Sweaty feet are commonly found:

Men > Women
Young Adults > Older Adults

What does one do for sweaty feet?

1. Wear shoes that breathe.
2. Wear wicking socks.
3. Wear synthetic sock blends vs. cotton socks.
4. Change socks multiple times a day.
5. Wash feet with antibacterial soap.
6. Make appointment for a proper diagnosis & further medical treatment options.

American Podiatric Medical Associaton. (2012). Sweaty feet. Retrieved from http://www.apma.org/learn/FootHealth.cfm?ItemNumber=1951

Image by Brave Heart. (2008). Wet foot prints. Flickr. Retrieved from http://www.flickr.com/photos/brraveheart/2607936114/

Dry Skin - When to Make an Appointment

Dry skin, we’ve all had it at one point or another in our lives. It seems like we’re constantly battling outside forces to keep our skin fresh and smooth. Soap, swimming, hot weather, cold weather, bodily hormones, the socks and shoes we wear, medications, and certain medical conditions can minimize the naturally protective oils on the skin. These oils keep the skin on our feet moist and soft. When the oils are reduced, the skin becomes dry and cracked. Most people turn to lotions as their first line of defense against dry skin, which works the majority of the time.

But how do you know when you need to make an appointment to have your dry skin evaluated by a Podiatrist?

Try this test: Use lotions and moisturizers for two weeks and wash with mild soup during the test phase. If dry skin persists, make an appointment.

Aside from the test, diabetics should be checked at first sign of dry skin. If skin becomes cracked, swollen, red, bleeding, or oozing, make an appointment immediately. Severe and persistent itchiness of the feet or toes can be a number of skin related conditions such as Athlete’s foot, psoriasis, or eczema.

Each skin condition has different treatment options so a diagnosis is imperative to stop the dry and itchy skin. Treatment options can be as simple as using milder soaps, using topical antihistamines or creams. Some conditions require antibiotics and treatments to control the underlying medical condition causing the dry skin.


Image by Lotus Carroll. (2008). Dry patch. Flickr. Retrieved from http://www.flickr.com/photos/thelotuscarroll/2204691159/
Gardner, Stephanie. (2011). WebMd. Ultra dry skin? when to call a doctor. Retrieved from http://www.webmd.com/healthy-beauty/dry-skin-10/medical-treatment

Treacherous Toes

In the grand scheme of limbs, toes are awfully small compared to other limbs on the body. Even though they are small, they provide vital support, balance, and strength for the rest of the foot. If the structure of the toe is compromised, pain and discomfort occurs. It’s interesting to note that toe deformities can result from a problem stemming in another part of the foot or even farther up the leg.

A quick symptom guide of various structure deformities can help pinpoint problems of treacherous toes. For a diagnosis and treatment plan, make an appointment with my office.

Symptoms of Bunions & Bunionettes:

• Bump appears at the base of the big (for bunion) or fifth toe (for bunionette)
• Pain, especially when wearing shoes that press or rub against the bump
• Big toe points toward the second toe

Symptoms of Hammertoe:

• Bending and curling of the second toe, but it can be found on any of the three middle toes
• It’s given its name for a reason… the shape resembles a hammer. The end part of the toe bends down into a claw-like deformity.
• Over time, pain persists on the top of the toe and one will not be able to move the toe.

Symptoms of Osteoarthritis (joint disorder):

• Morning pain that diminishes as the day goes on
• Resting the joints minimizes pain
• Stiffness in the affected joint
• Increased pain after exercising

Symptoms of Gout (joint disorder):

• Jolts of pain in the affected joint
• Possible inflammation in the joint
• Increase in symptoms after eating certain foods
• Pain often starts during the night & is described as throbbing
• Joint becomes red, warm, and tender

Symptoms of Sesamoid:

• Pain in the ball of the foot, beneath the big toe
• Swelling in the ball of the foot
• Loss of range of motion in the big toe & difficulty walking

Image by Janine. (2009). toe family. Flickr. Retrieved from http://www.flickr.com/photos/pinkcotton/3301572765/