Painful Ingrowns? You Don't Have to be Stuck at Home

Dr. Belinda Dotter, myself and one of the medical assistants

Within 5 minutes of running on the treadmill I felt a sudden sharp, stabbing pain in my toe. From past experience, I knew exactly what it was- an ingrown toenail. It was too painful to continue my workout so I headed home.

An ingrown toenail doesn't sound like much, but these can cause a lot of pain if left untreated and can affect simple tasks in your everyday life.  If yours are anything like mine, then even the smallest touch will make you cringe. An ingrown toenail is a common condition in which the corner or side of one of your toenails (usually the big toe) grows into the soft flesh of that toe. The result is pain, redness, swelling, and sometimes, an infection.

The old me would have taken matters into my own hand and tried to remove the ingrown toenail myself. You would think from past experience I would know this is a big no-no but that never stopped me before. I always made it 10x worse trying to remove the corner of the nail myself. The new me works for a podiatrist, so at this point I know better.

The following day I decided to schedule an appointment with Community Foot Specialists. I wanted to get back into a regular exercise routine, I wanted to take my children to the park, I wanted to do regular every day activities without the almost unbearable pain from the ingrown toenail.

At Community Foot Specialists, we try to get our patients in as quickly as possible so I was relieved that I was able to be seen for an evaluation the next day by Dr. Dotter at our Main Street location in Dayton, Ohio.

Based upon the doctor’s professional opinion, I was able to be seen the following day for the procedure. And I was a nervous wreck. I’m not sure why... it’s not like I didn't know what was going to happen. But the thought of my toe being numbed and my nail being clipped out had me ready to cancel my appointment.

Once I had arrived at my destination the medical assistant got me right back to a room. Within minutes, the doctor came in and talked to me about what was going to happen. She then numbed my toe. She was very gentle and to be completely honest I couldn't really feel it. I waited for my entire toe to numb before she came back to remove the nail. It only took a couple of minutes and she only took out the corner. As a woman, I was worried that the doctor would take off more toenail than necessary. I mean, it IS Summer and I love my flip flops!

Relief! That’s all I could think. I couldn't believe how easy and quick the procedure was.

If you are dealing with an ingrown toenail, or what you think may be an ingrown toe nail, I highly recommend coming in to see the doctors at Community Foot Specialists. And I’m not just saying that because I work here. At Community Foot Specialists our doctor’s mission is to provide patient centered, high-quality foot and ankle care, delivered by knowledgeable, compassionate podiatrists and a professional, caring staff… and I experienced exactly that.

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

The Foot of Your Foot: The Great Toe

Lately, we have had quite a few of our patient’s over the age of forty complaining of pain in the big toe joint. Typically, forty is the age when early arthritis symptoms tend to manifest and, in the foot, we see the great toe joint as the most common. This is due to the mechanical load and the important role it plays in every step we take. When we walk, our big toe joint bends up to an impressive 75 degrees just before the foot leaves the ground. But, sometimes, due to unusual wearing and tearing of the cartilage in the toe joint, the toe becomes stiff and starts to hurt. This is called Hallux Limitus.

Hallux Limitus is a progressive arthritic condition that limits the motion and function of the big toe. Symptoms of this condition come on slowly. You may only notice a mild, temporary pain when you are in motion or when you move the big toe joint. Eventually, the pain may worsen and in some cases dorsal bunions or bone spurs may develop and cause additional pain. The big toe is extremely important for proper foot/ankle/knee/hip and even low back bio-mechanics so it is important you don’t go untreated.

Symptoms of Hallux Limitus are based on the stage in which you are in. Your symptoms may or may not include: Pain while active or when you move the big toe joint, stiffness in the big toe, increased pain or aches in cold or damp temperatures, difficulty bending big toe up and down, difficulty wearing shoes, especially high heels, and development of bone growths (bunions, bone spurs).

It’s important to know that these symptoms signify the early stages of this condition. Each of these symptoms will slowly worsen until you’ve reached a point of no movement within the big toe joint. Hallux Limitus is caused by one of four things: Genetics, injury, a long first metatarsal bone (or short second metatarsal), or an elevated first metatarsal bone.

Hallux Limitus is a progressive condition that can lead to further problems, including complete loss of motion in the big toe joint. It’s best to see your podiatrist in the early stages or before bone growths develop. Your doctor will begin with a physical examination so he or she can determine the range of motion within the joint. Imaging tests such as x-rays and MRIs are often used to determine whether arthritis is present, to see how much the joint has narrowed, and to evaluate the foots overall health.

Treatment options include:

• A Morton’s extension can be used to relieve pain. These durable semi-rigid medical devices can be found in podiatry offices, and they are designed to provide support and shift weight away from the big toe to reduce pain.
• Accommodative cushions made of foam work for Hallux Limitus, since it pads the big toe joint and protects it from painful shoe pressure.
• Turf toe plates limit the range of motion of the great toe joint, which makes this product ideal for treating both Hallux Limitus and Hallux Rigidus.
• Athletic or running shoes made especially for over-pronators (flat feet) can provide support. They are less flexible than conventional running shoes, which enables them to limit the motion of the joint.

If you believe you may have Hallux Limitus and you live in the Greater Dayton/Springfield area, give Community Foot Specialists a call. Your feet will be in good hands! 937-426-9500

Your Crooked Toes May Be Hammer Toes

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Do you have crooked toes or toes that look like little hammers or claws? You may have hammer toes. A hammer toe or contracted toe is a deformity caused by a tendon imbalance on the second, third or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe and claw toe are similar to hammer toes.

Hammer toes are most often caused from wearing ill fitted shoes that force the toe into a bent position. Wearing these shoes for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity.

The hammer toe deformity can be flexible, semi-rigid, or rigid in nature. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid or semi-rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress to the ball of the foot, and possibly causing pain and may also cause painful corns and calluses on the top of the digit (at the joint) and at the tip of the toe--due to pressure--or under the ball of the foot from retrograde pressure.

Conservative treatment starts with new shoes with soft, deep toe boxes to avoid rubbing.  Your podiatrist may also recommend padding to decrease pressure on the area.

Surgery would be the final resort. Your podiatrist can do a simple procedure done in office called Percutaneous Tenotomy, which releases the contracted tendon. For more serious hammer toes, your podiatrist can do 1 or 2 surgeries in the operating room. Arthroplasty is a surgery to relieve pain and restore range of motion by reconstructing a joint. Arthrodesis is a surgical procedure which fuses the bones that form a joint, essentially eliminating the joint.

 If you have hammer toes and live in the Dayton/Springfield area, Community Foot Specialists can help! Call today to schedule your appointment. We’re always accepting new patients! 937-426-9500

Joakim Noah and Plantar Fasciitis

Joakim Noah

How would you like to run around feeling like you have hundreds of needles underneath your feet? Doesn't sound very pleasant, does it? Well that’s what Chicago Bulls Center Joakim Noah is dealing with right now. This is called plantar fasciitis.

Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. This is more likely to happen if your feet roll inward too much when you walk, you walk, stand or run for long periods of time, especially on hard surfaces.

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. As the injury advances into later stages, the pain will begin to feel like little needles sticking you in the bottom of your heel with each step.

There is no instant cure for plantar fasciitis but immediate intervention is very important so it does not get worse. Your podiatrist will likely recommend adequate rest to take the strain off the Plantar Fascia and allow the affected tissues time to heal. There are also exercises your podiatrist may recommend, such as:

• Stretching your foot by flexing it up and down 10 times before standing.
• Do toe stretches to stretch the plantar fascia.
• Use a towel to stretch the bottom of your foot.
• Use a rolling pin or tennis ball. While seated, roll the rolling pin or ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.

Your podiatrist may also recommend custom made JM orthotics to be worn in your shoe to support your arch.

As for Joakim Noah, he’s still playing for the Bulls during the playoffs. The series is currently at 3-1, with Miami in the lead.Noah was quoted a couple of weeks ago telling reporters, "It really sucks. It feels like you have needles underneath your foot while you're playing. You need to run, you need to jump (and) you need to do a lot of things while you're playing basketball. So you don't want needles on your feet, right?”

According to the ChicagoTribune, Noah is receiving treatment for his plantar fasciitis. Aside from resting when he can, he has tried platelet rich plasma injections, sleeping in a splint and three seasons ago- shock wave therapy. He most recently received cortisone shots. Although these treatments might be beneficial, they are far from the typical prescribed treatments. For those of us who are not Joakim Noah or a pro-athlete during their mid-playoff stride, it is recommended that, first and foremost, you go and see a podiatrist. It is also recommended that you rest and stretch as much and often as you can. It is imperative that you do not put unwarranted stress on the heel of your foot. 

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Important Things to Know About Stress Fractures

With Spring here more folks are outside, including runners. Oftentimes runners complain experiencing pain in the mid foot. The first concern would be to rule out stress fractures. Stress fractures occur with either normal force on abnormal bone (example: elderly) or abnormal force on normal bone, (example: new activity or increased load on the foot).

 Symptoms include pain with walking, running or any increase in activity. Swelling may also be a problem.

A visit to the podiatrist is critical to help rule stress fractures out before they become more of a serious problem. X-rays can be taken in office to look for evidence of stress fractures. It should be noted, however, that early stress fractures may not show up on the x-ray until 2 weeks after the start of symptoms.

The most common bone in the foot to experience a stress fracture is the 2^nd metatarsal bone due to it being the longest bone in the row. The 2nd metatarsal will generate greater loads and greater stress, repetitive loads for a period of time can cause a stress fracture.

Sometimes a person may experience the same pain and symptoms of stress fractures due to a phenomenon known as over use or stress syndrome. Medical tibial stress syndrome is an irritation of the tibia (shin bone) at points where the soleus and tibialis posterior muscles attach to it. It is caused by over-use in runners, however, there are a number of factors, such as altered foot, knee and hip posture, that can predispose a person to the syndrome. This is considered as a precursor to stress fracture. An MRI can help detect this and will show increased signal in the affected bone.

The best treatment is rest and protected weight bearing. Sometimes taking up to 6-8 weeks, something athletes never want to hear. Pain may be treated with ice and anti-inflammatory. Once improved, the goal would be to reduce chances or recurrence with slow modifications and likely functional inserts with specific design to the individual.

By: Dr. Adam M. Thomas, DPM

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Summer and Swimming and... Plantar Warts!?

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With Summer just around the corner, you and your children are at risk for picking up the painful and unsightly plantar wart, which is caused by a strain of the human papillomavirus (HPV).  The human papilloma virus enters the skin through small cuts or abrasions and may take several weeks to become visible.

The plantar wart appears on the bottom of the foot. They are similar to corns and calluses as a layer of hard skin forms over top of the lesion. Plantar warts are differentiated from corns/calluses by appearance. Plantar warts typically have small black hemorrhages under the skin giving the appearance of black dots; skin lines also diverge around warts and not through the lesion.

Plantar warts are contagious; however, the HPV strains that cause plantar warts are not easily transmitted by direct contact from one person to another. The virus thrives in warm and moist environments—such as shower floors, locker rooms and public swimming areas. When children are in swimming pools they often get small abrasions on the bottoms of their feet from the rough surface of the pool bottom. The virus enters these small abrasions, infects the basal cells resulting in plantar wart a few weeks later.

Our podiatrists, here at Community Foot Specialists, see a huge increase of patients with plantar warts in the warm Summer months. Here are a few precautions you can take this Summer to reduce your risks of plantar warts:

• Don't go barefoot in public areas. Wear sandals or flip-flops in public pools and locker rooms.
• Don’t share towels, washcloths. Even with members of your own family.
• Avoid direct contact with warts. This includes your own warts.
• Keep your feet clean and dry. Change your shoes and socks daily.
• Don't pick at warts. Picking may spread the virus.
• Don't use the same file, pumice stone or nail clipper on your warts as you use on your healthy skin and nails.
• Wash your hands carefully after touching your warts.

If you think you or your child may have a plantar wart, come in and see one of our podiatrists at Community Foot Specialists; we’re located in the Dayton/Springfield area and we can treat you with one of the following options

• Salicylic acid
• Cantharadin (blistering agent from beetle extract)
• Compounded medication that triggers an immune response against the virus
• Cryosurgery (with liquid nitrogen) freezes the internal cell structure of the wart
• Laser therapy (pulsed dye laser or CO2 laser
• Surgical excision of the verruca

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

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Reconsider Your Footwear Choice: The Truth About Flip-flops

After experiencing many glimmers of sunshine and the Groundhog's official sighting, the long awaited Spring has finally arrived. With it's arrival it graces us with many pleasures, and of the many, Spring attire might just top the list. A common and popular footwear choice for the Spring and Summer months are Flip-flops.
 However, this seemingly innocent and harmless footwear choice does not provide you with much support. Here are some dos and don’ts of flip-flops to consider this year.

Shop for high-quality, soft leather flip-flops to minimize potential blisters and other types of irritation. Don’t wear the same pair of flip-flops year after year. Inspect older pairs for wear-and-tear, and if they are in bad shape throw them out.

Look for flip-flops that will allow for the most normal foot function possible. Two good brands to look for are FitFlop and Chaco. These products are evaluated by a team of APMA podiatrists and given a Seal of Acceptance. Don’t ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections.

Gently bend the flip-flop from end to end, ensuring it bends at the ball of the foot (No shoe should ever fold in half). Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little in terms of shock absorption and arch support. Wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in a hotel room and in the locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot. Don’t do yard work while wearing flip-flops. Always wear a shoe that fully protects feet when doing outside activities such as mowing the lawn or using a weed-eater.

Ensure that your foot doesn’t hang off the edge of the flip=flop. Don’t play sports in flip-flops. This practice can lead to twisting of the foot or ankle, as well as sprains and breaks.

Follow theses Do’s and Don’ts to ensure you are fit to flip-flop this spring!

MARCH MADNESS!

If you are not a fan of college basketball, then you are probably wondering why we have a blog titled "march madness" at the beginning of April. No, it is not because this March, in terms of weather, could be considered madness, or that the word "madness" simply goes well with March (although it does). March Madness refers to the NCAA's men's basketball tournament that hosts 64 division-1 college basketball teams from around the nation. It is referred to as "March Madness" because of the chaos, excitement, and passion that it brings -- this is marked by the fact that there is no other sport, let a lone tournament, that welcomes and expects "upsets" the way that March Madness does. An upset happens when a team that is seeded lower than their opponent ends up winning the match-- the classic underdog tale. So far, there have been 23 upsets, with some standing out more than others. One of the most outstanding upsets, in my opinion, is Wichita State (No.9) putting on an electrifying performance and beating Gonzaga (No.1). FYI, Wichita State is still in the tournament. So you might be wondering how the tournament works, or, in other words, how the "madness" is structured. The tournament started with 64 teams this year (60 automatically in the tournament, and the other four playing to gain access). These 64 teams are broken down into their respective regions: Midwest, West, South, and East ( 16 teams in each region; 64 divided by 4, get it?). The number of teams that are in the tournament is cut in half with every round that passes: 64, 32,16,8, 4, and finally 2. The last four rounds are of special importance, and although they have their formal titles (Regional finals, national semi-finals...etc.), they more commonly go by their nick names: Sweet Sixteen, Elite Eight, Final Four, and, obviously, the National Championship. Currently, we are in the Final Four stage of the tournament (hence, the title picture), with the Shockers playing the Cardinals and the Wolverines playing Syracuse.

Now that you understand what March Madness is, you are probably wondering why, as a podiatrist, we care about it. Outside of the obvious reasons (the excitement, OSU, "bro time"...etc.), the game of basketball has a way of exposing the weaknesses of our feet and ankles, and, more broadly our entire lower extremity. This is highlighted in the NCAA and specifically in the March Madness tournament.

Cases-in-point:

1.


 Michael Carter Williams, the star player for Syracuse, is currently taping and recovering from a minor ankle injury amidst the teams run for the National Championship. Expected to play on Saturday against Wolverines.

2.


UC Santa Barbara's John green goes down with a foot injury that puts him out for the entire season.

3.

 

 Montana's Matthias Wards's late-February foot injury that put the entire teams chances of winning in peril.

Lastly and most notably,

4.


Kevin Ware. There hasn't been an injury this year that has shocked the sports world in such a way that Kevin Ware's broken leg did. Immediately after the injury, the video of Kevin Ware's broken leg went viral and horrified many. Fortunately, Ware promptly received proper medical attention, and is now on a steady road to recovery.


As you can see, Basketball is especially harsh on our lower extremity, with all the jumping, running, sudden stops, and the physicality of the game. Granted, it is not football, but basketball takes a different, more constant toll on the players.

Foot & Ankle Basketball Injuries:


Ankle Sprains. This is probably the most common ankle injury in the game of basketball. If you are not familiar with this injury, you probably do not play basketball. In basketball, ankle sprains happen when players come down on their foot the wrong way, suddenly and unpleasantly twist their ankle, step on an uneven part of the hardwood (say, someone's foot), or when a player exerts an unusual amount of force on the ankle.

•   Ways to avoid 
• Wear proper shoes that give you enough support on your ankles.
• Stretch and exercise your ankle before engaging in intense play (i.e., warm-up & practice)
• Be aware. When you are playing, know your surroundings and playing field. If you know that an ankle is particularly weak, have a trainer tape it beforehand.

Achilles Tendinitis. As a basketball player, you are naturally jumping quite often, whether it is to grab a rebound, shoot a jump shot, or block a shot. Constant and forceful jumping takes a toll on the Achilles. This usually results in Achilles tendinitis: the swelling of the tendon, which is associated with overuse (in this case jumping, and pushing off that tendon in general).

•  Ways to avoid
• The advice here is very similar to that of ankle sprains. You should ice and stretch your ankles and feet often. You should specifically ice your feet after playing. As for stretching, you should do it as often as you can.
• If you know that Achilles is starting to become painful, lessen the load, and, at the very least, do no over exert yourself.

Plantar Fasciitis.  Plantar Fasciitis occurs when the Plantar Fascia develops a tear, which typically results in a sharp pain that is normally described as "burning", "stabbing", or "surging". In a similar manner to ankle sprains and Achilles Tendinitis, Plantar Fasciitis is caused by overexertion. In basketball, players are often on their toes, and then their heels, and their toes again, all the while with great force and speed. This constant back and forth coupled with the typical force of a basketball play can easily cause Plantar Fasciitis. This process can be quickened and/or worsened by wearing incorrect shoes (no matter what you are doing, you should always wear shoes that fit you and support you!).

• Ways to avoid
• Wear the correct shoes. If you do not know if a shoe is supporting you properly or if you suspect that it is ill-fitting, then consult your podiatrist or your on-site medical trainer.
• Once again, stress often and extensively. Many of the injuries that occur in basketball can be prevented, and, in the case treated, with aggressive and often stretching.

The NCAA's March Madness brings us joy and excitement by watching people who love the sport that they play compete at such high levels of intensity and vigor, but it also reminds us how vulnerable we are as humans and athletes to injury. As you watch the last stages of the tournament, and as you are inspired to play the lovely game of basketball, keep in mind the safety precautions that might help you prevent injury in the future.

Fun in the sun may not be fun for your skin

 Do you have a spot on your foot that you're not too sure what it could be? This may be a sign of skin cancer. This week we will be discussing how to identify a spot as skin cancer, steps your doctor may take, how to treat it, and last but not least how to prevent it.

Skin cancer develops when "mutations" of the skin's DNA grows rapidly and out of control. When it does this it begins to develop cancerous cells. There are three common skin cancers -- basal cell carcinoma, squamous cell carcinoma, and melanoma. Actinic Keratoses are referred to as "pre-cancers." The most common warning sign of skin cancer is when the skin begins to change appearance. Skin cancer is the most common type of cancer in humans. Many types of lesions, or abnormalities in the tissue of an organism, can develop on the skin and most of these lesions are benign, a mass of cells (tumor) that lacks the ability to invade neighboring tissue or metastasize, or non harmful. Some hints on inspection can help distinguish which ones are concerning and which ones are less concerning.

Since your podiatrist is checking your feet, they are able to give a good inspection of your lower legs and ankles while sitting in the exam chair. Some characteristics to consider are: Color: Benign skin lesions are generally uniform in color, or the same color throughout. Borders/Shape: Benign lesions are generally uniform in shape and tend to be smooth  with a regular feel to the surface. Growth rate: New appearing skin lesions or rapid growth or change in size can be a concern for a more suspicious lesion. Ulcerating or bleeding skin lesions: these can be a concern for more aggressive type skin cancers.

Sometimes dark lesions under the toenail can be a concern although 90-95% of the time this will be due to dry blood or bruise from either an injury or repeated jamming of the toe in the shoes. For any type of lesion, under the nail or on the skin, your foot doctor will likely monitor and if any concern, can easily perform a biopsy in the office under local anesthetic which will help give a definitive diagnosis,and in some very rare cases, may save a limb or a life. Skin cancers of the feet are more often related to viruses, exposure to some chemicals, chronic inflammation, irritation, or inherited traits.

There are a lot of different ways to treat skin cancer. Some treatment options are freezing. Your doctor can get rid of early skin cancers by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws. More known options are radiation, when surgery is not an option, and chemotherapy. Laser therapy. A precise and intense beam of light vaporizes growths with generally little damage to surrounding tissue. A doctor may use this therapy to treat superficial skin cancers.

Ways to prevent getting skin cancer on your feet is putting sunscreen on them, as directed on the bottle. Wearing protective shoes that block the harmful rays. Try to stay inside or in the shade as much as possible; from 10 a.m.- 4 p.m. when the suns rays are more harmful.

When you cannot go see a doctor you should do a regular examine especially if you spend many hours outside. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. Contact your doctor immediately if you think you may have any signs of skin cancer.

Bunions

 Bunions, also called Hallux Abducto Valgus (HAV), are a deformity characterized by a lateral deviation of the great toe (hallux) with a subsequent medial prominence ("bump".) The medial prominence is from the underlying deviated prominent bone (not a growth), and sometimes can form an overlying bursitis which may add to the prominence (usually very painful and red.) Bunions form when your big toe pushes up against your other toes, forcing your big toe joint in the opposite direction. Over time, the abnormal position enlarges your big toe joint, further crowding your other toes and causing pain.

The main causes of bunions can be from genetics, tightly fitted shoes, or foot injuries. Bunions are more common in women. Bunions may be associated with various forms of arthritis, including inflammatory or degenerative forms, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause. Bunions can not only affect the inner foot but also the outside of the foot at the base of the little toe.

Here are some treatment options for your bunions one is to have well-fitting wide enough shoes to give your feet more room. Another way is to have some padding to alleviate shoe pressure on "the bump." You can take oral or topical anti-inflammatory treatments to alleviate pain associated with the inflammation and bursitis. You can purchase orthotics to help control contributing biomechanical forces to reduce the rate of progression (especially important in kids). If none of these work you may consider surgery to correct the underlying deformity/deformities (important to also correct any contributing biomechanical forces at the time).

Bunions can be very painful and discomforting. Ways to prevent bunions are choosing footwear that fits correctly, especially low heeled shoes with plenty of space for the toes, is one of the main ways that bunions can be prevented. Getting orthotics if your prone to flat-footedness- this can prevent or delay bunions. If you think or know you have bunions get them checked out by your doctor or a specialist. 

Pregnant Feet

Today, we want to discuss the process of giving birth--namely, the nine months leading up to birth itself--and how that relates to and effects women's feet. As most mommy-to-be's know, the bulk of growth happens within the third trimester. Studies show that pregnant mothers who stand for long hours end up having smaller babies than mothers who do not stand for long. This is due to the growth cycle being stunted or slowed down.

We have many ways to treat and prevent your swollen feet. Although swelling is normal due to the weight gain from being pregnant, if the swelling is not symmetrical in both feet you should contact your doctor or a specialist--this may be signs of a vascular problem. Orthotic inserts are good for arch support and medial rear-foot postings. Remember that these should fit properly and comfortably. Also, shoes that do not fit properly can cause a cut off of the blood circulation.

Every woman loves shoes! Whether it be her high heels or her house slippers. But, pregnant mothers should put away their high heels during their pregnancy. Pregnant mothers should wear low to no heeled shoes to avoid any heel pain or falling.


Pregnant women often associate resting with being lazy or letting their pregnancy get the best of them, but in all reality, it is OK and, in fact, encouraged. A mother's feet should be elevated as much as possible. Be sure to message your feet to keep the swelling down. Some ways are going to the salon and getting a pedicure and, if possible, a massage. This not only helps keep the swelling down, but also helps pregnant women to relax and take their minds off of the (sometimes) frustrating transformation that they are going through.

Some pregnant women believe drinking less water will reduce swelling. This is not true! Drinking more water will relieve the body of any harmful toxins. Drink plenty of water; everybody should drink at least eight ounces of water daily. You should avoid any excessively warm places since high temperature climates can reduce the body's water levels. This will cause dehydration.
   Soaking the feet in soothing herbs will help reduce any swelling or stress you may have. Some herbs that are good to soak in are lavender, chamomile, eucalyptus, birch, and peppermint. Also, use plenty of moisturizing lotions on your feet to prevent any painful cracking.

For many women the pregnancy can be very confusing and frustrating, we stress (aha!) the idea of relaxing and taking it easy during this during this time. It is often emphasized that you take care of yourself for the baby's sake, but don't forget that you are human, too. Do the things that you like; do not feel bad for asking for help, and enjoy the process as much as you can.

March, the Month of Nutrition

To many, the beginning of March signifies the sprint to St.Patty's and warm weather. The thoughts of leaning your chair back, sipping ice tea, and enjoying warm weather eases the mind and captures the heart. To add to these wonderful things that March brings us, it also brings the National Nutrition Month (NMN)! The month-long event/celebration is intended to bring more awareness to food choices that are healthier.  The primary sponsor of NMN is the Academy of Nutrition and Diabetics (AND) formally known as the American Diabetic Association. The focus of this campaign is to make "informed food choices and developing sound eating and physical activity habits." As quoted on the AND website: www.eatright.org.

The AND has had a long history of controversy, which is a natural by-product of the business of telling people how to eat. The company's membership, sponsorships, and partnerships have been consistently scrutinized. In recent news there has been controversies surrounding the AND and their partnership with "Big Food" companies such as: Coca-Cola, Hershey, PepsiCo, Mars, National Dairy Council, and many more. These "Big Food" companies, it is said, have more say in the company than most of the nutritionist do, thus creating the conflict. Furthermore, The AND receives, on average, $1 million a year from the Pharmaceutical Industry. As a form of presumed reciprocity the AND helps some of these pharmaceutical companies in their marketing and public relation efforts. Taken together, all of these facts lead some to think that the AND is securely in the pocket of big corporate companies, whose initiatives run completely counter to their own philosophies and purpose.

 Whether you agree with the critics or supporters of the AND, one thing we can all agree on is that nutrition awareness is a good thing. The significance of this notion is further increased when we considered the high rates of obesity and diabetes in America today.In the past thirty years child obesity has doubled and tripled in America alone. The rate of adulthood has doubled in the past thirty years. Twelve states currently have an adult obesity rating over thirty percent. Here are some tips to keep your body healthy:

 The Mediterranean Diet:

1.) Meats and sweets should be consumed less often in this diet.

2.) Poultry, eggs, cheese, and yogurt should be consumed in moderate portions, but should be consumed daily to weekly.

3.) Fish and seafood should be consumed often, at least two times per week.

4.) Fruits, vegetables, grains (whole), olive oil, beans, nuts, legumes, seeds, herbs and spices should be based on every meal you eat.

A proven study has shown while on the Mediterranean diet it reduces your risk of heart disease, the risk of overall and cardiovascular mortality, cancer and cancer mortality, and it reduces the incidence of Parkinson's and Alzheimer's diseases.

According to Mayoclinic.com:

"The Mediterranean diet emphasizes:

• Getting plenty of exercise
• Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
• Replacing butter with healthy fats such as olive oil and canola oil
• Using herbs and spices instead of salt to flavor foods
• Limiting red meat to no more than a few times a month
• Eating fish and poultry at least twice a week
• Drinking red wine in moderation (optional)

The diet also recognizes the importance of enjoying meals with family and friends."

The second diet is intended specifically for diabetics. Studies show that 25.8 million children and adults in the United States- 8.3% of the population-have diabetes. But here is a great diet for diabetics:

The Diabetic Diet:

1.) Healthy Carbs: Yes there is such a thing! Avoid carbs such as sugars and starches. Focus more on the healthier cards such as: fruits, vegetables, and whole grains.

2.) Fiber-rich foods: such as nuts whole bran foods, and whole flour foods.

Remember that nuts are still a "fatty" food so they should not be eaten in large amounts. Just one hand full a day should be enough. Also, try to avoid nuts that are covered in salt, and honey roasted.

3.) Fish: Try eating fish that are rich in omega-3 such as: salmon mackerel, and herring. Avoid any tilefish swordfish and king mackerel due to high levels of mercury.

4.) 'Good' Fats: Avocado, almonds, pecans, walnuts, olives, canola, olive, and peanut oil are all considered to be 'good' fats.

Now that you have some tips to stay healthy and active try to change some the things you eat. Whether it be eating less red meats and more fish or eating out less and more with your family. Please share any facts or risks you know about obesity and diabetes with friends and family members to make National Nutritional Month a success!

Humpty Dumpt Had a Fall

To many of us the ending of February is similar to seeing the light (literally) at the end of the tunnel. Thoughts of the warm sun and beautiful sunflowers keep us trudging through the winter. Although these thoughts keep us going, reality reminds us that it will remain cold for a little while more. If you made it this far without falling or hurting yourself--due to winter conditions-- then, kudos. This week, we prepared a guide to help you survive the rest of the cold weather conditions. Here is our input on how to navigate through the wet, icy, sluggish, nasty weather:

1.  Walk like a penguin-- no, really though : On slippery, compact snow and ice, take short, careful, flat-footed little steps, spreading your body weight as evenly as possible across the entire surface of your feet.

2.  Know the snow you're walking on.  The riskiest snow to walk on is when the snow began to thaw, then ices over night.  Always be careful, even when it's above freezing and the snow is melting.

3. Choose the right shoes:  fashionable high heeled boots are just asking for trouble.  Pick snow boots with a deep, strong, rubber treat.

4. Use appliances:  poles, sticks, canes to help.

5. Or use a clamp on ice  grip or spray on snow grips on your shoes.  Inventions are nifty!

6. In the unfortunate case that you, like Humpty Dumpty, take a tumble, here is some further advice: 

           a. If you are Elderly, avoid falling on your hip and risking a fracture there.  Fall on hands--you may obtain a wrist fracture but that is better than a hip fracture.

           b. Younger folk should protect their heads and neck.  Use your non dominant hand if possible.

           c. Lastly,  Consider a bicycle helmet.  Especially if you're wearing the wrong shoes for the weather.  Yes it looks silly but better than a head injury.

February Feet: An Overview of Cold Weather Feet Conditions

Every year, the month of February brings an abundant amount of joy and celebration. Among those things are include: Valentine’s Day, where we celebrate the human desire of love & togetherness; American Black History Month, were we reflect on our nation’s history and race relations; and President’s day, where we honor our current and past Commander-in-Chiefs. Although all of these heart-warming celebrations come along with February, there is also one other thing that is coupled with this beloved month: the freezing cold weather! It is one unavoidable wrinkle in what is otherwise a perfect month. Recognizing this unfortunate condition, the folks here at Community Foot Specialist took the time out to help you understand and prevent some feet conditions related to the cold weather.

Here are some of the most common conditions related to your feet that occur in cold weather:

Frostnip & Frostbite

Frostnip and Frostbit are in close relation, so much so that some people really do not recognize the difference. This is completely understandable, given that they both signal the same symptoms, with the only true difference being the degree of severity. With frostnip, your skin still becomes pale, feels cold, uncomfortable, and stiff, but the deeper tissues are not necessarily harmed. Because these deeper tissues are not significantly affected, Frostnip typically does not lead to blisters. On the contrary, Frostbite, due to its more severe damage to the underlying tissues, does lead to blisters after the skin re-warms. Depending on the severity of the Frostbite itself, the results can be worse—possibly damaging nerves, tissues, and tendons.

Although Frostbite in the modern English colloquial is treated as a minor condition, it can lead to very serious results. It is imperative that your dress appropriately for the weather, avoid standing in snow and other extremely cold surfaces for extended periods of time, and most of all, that your recognize when you have or when you are starting to develop Frostbite. It is important that you notice the symptoms of Frostbite and that you receive medical attention as soon as possible, because untreated and unattended Frostbite can lead to extreme cases such as gangrene, which will undoubtedly require amputation—who wants their toes cut off!?  

Pernio (Chilblains)

           Although, generally, Pernio does not lead to as serious effects as Frostbite, it’s results can be extremely irritating and uncomfortable. Pernio develops when a person (more often than not, said person is already highly susceptible) is exposed to cold conditions & high humidity. This unfortunate combination results in the person having an itching, burning, and possibly sweating sensations. These symptoms can go on for weeks, even if treated, and even longer if it is not. The affected area can develop lesions that can eventually become blistered.  On the extreme side of the spectrum, pernio can, in fact, cause skin ulcers and infections, which is why it is, once again, important to know the symptoms and get it treated as soon as possible. To help prevent Pernio (chilblains), revisit the advice given for prevention of Frostbite, and in addition: Do exercises that help the flow of your blood circulation, make sure that your socks & shoes are dry at all times, and when returning from the cold avoid exposing your feet to sudden and extreme warmth.

Trench Foot

          Trench Foot, more formally known as Immersion Foot, has a couple overlaps with both Frostbite & Pernio. Trench Foot is commonly associated with people who work in cold and harsh conditions—hence the name. Often times, the most common individuals who are affected by Trench Foot are those who work on their feet in cold harsh conditions; who wear boots; and who are in these conditions for a prolonged time.  Like Frostbite, Trench Foot can exhibit blisters, sores, and, in extreme cases, gangrene and we know where that leads. . .

         To prevent Trench Foot, it is important to heed all the advice that has been aforementioned. Try your best to stay warm and dry. If you are a person who works on your feet often and extendedly, it is important that you take care of your feet outside of work—see a podiatrist and get your foot examined  frequently (we have six locations! J ).

Although some of these conditions seem daunting if you know about them know, you can prevent them in the future—what is that old saying, “the best defense is a good offense”?  We hope that this guide can help you so that you may enjoy all of the wonderful celebrations that February has to offer.

Watch GOUT, they'll get ya!

Gout is a condition that is unknown to many, especially those of the younger generations. But, for those of us who do know what Gout is, we definitely know that it is, by no means, pleasant or enjoyable. Gout is a form of arthritis that typically develops when a substantial amount of uric acid builds up in the blood. Uric acid releases shard-like objects into your joints, thus cause them to inflame.  Gout most frequently “attacks” the big toe, often showing redness and swelling in the joints associated with that toe.  Although the big toe is the most likely victim of Gout, this condition can also affect the ankle and knee. 

                How can I tell if it is Gout? Although you should see a doctor to be certain, these are symptoms that are associated with Gout:

• Redness
• Swelling
• Tenderness of joints
• The pain is acute and develops rapidly
• Typically the pain increases exponentially overnight

What can I do to prevent Gout Attacks?

There is a plethora of things that you can do to help prevent Gout. One of the most prominent ways of stopping gout attacks before they develop is by maintaining a well-regulated diet. As we mentioned before, Gout is caused by the buildup of uric acid, so you should stay away from food that increases this acid, and instead look to eat foods that decreases uric acid. Foods that increase uric acid are, but not limited to : Meats, that is meat with high purines such as beef kidneys, liver, lamb, bacon (pork in general) and veal;  Fish, that includes, cod, sardines, shrimp, and scallops; Vegetables  such as asparagus, cauliflower, spinach and mushrooms (I know what you’re thinking, “now you’re going to tell me that vegetables are bad!?” but the truth is some vegetables, like the other categories mentioned, can trigger gout attacks).

Gout attacks are the most common among men that are over the age of forty. With this in mind, we know turn the conversation to Alcohol. God forbid that we do a regression (correlation) between American men over the age of forty and alcohol consumption—you get where the discussion is going now? The truth is, alcoholic beverages increase uric acid, which can cause gout attacks, so we urge you to keep your consumption low or avoid it completely—especially if you are over the age of forty.

Whether you have or have not experienced a gout attack, we hope that this information can help you. Although maintaining a well-regulated diet can help decrease your chances of having a gout attack, there are plenty of other ways; you should consult your doctor. For more information on Gout, check out these websites:

1. http://www.gout.com
2. http://www.livestrong.com/article/279756-foods-that-increase-uric-acid/
3. http://www.arthritistoday.org/conditions/gout/all-about-gout/what-is-gout.php
4. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gout.asp

Hearts & Heels: The Complete Guide For Shoes On Valentine's Day



As Valentine's Day quickly approaches, the mere image of wearing high heels is giving some women a spliting headache. On the other side of the tolken, this image is excitng happines and celebration, as women across the United States are going shopping for that one pair of high heels that will make them look like million bucks (maybe even two, who knows). Here at Community Foot Specialist, we understand that this can be a very nerve-racking or exciting time, so we preparared a mini guide for all women when it comes to Valentine's Day and wearing high heels. Here are some key points to keep in mind this holiday season:


1.)  High heels,as pretty as they may look, inevitably increase stress on the ball of your feet. Specifically for high heels that are two (2) inches or higher, every inch increases the stress on the ball of the foot by 50 percent!

2.) Buy the best fitting shoes (a sound idea for any kind of shoe). Try the shoe on and walk around for 15 minutes in the shoe store or at home to determine any friction or extra pressure.

3.) Invest on appliances such as metatarsal pads to provide better cushioning on the balls of your feet.

4.)   Wear open toed heel if possible. If you have any deformities such as hammer toes, this will prevent any pain due to the tightness around the toebox.

 

5.) Consider wearing comfortable shoes until you get to the event. Change into the sexy but possibly painful shoes once you arrive.

6.)  Wear a shoe with a thicker heel. The thinner the heel the less stability there is. You may look more elegant but much more clumsy!

 

7.)  Pay attention to the slope of the heel. They may be 4 or 5 inch heels but the higher or steeper the slope, the more painful the shoes may be. Pick a shoe with a more gradual slope from heel to toe.

8.) Buy shoes with square or rounded toes rather than pointy.

 

 

We hope that this guide can help you look AND feel the way that you want. For infomation regarding this blog or feet, in general, feel free to contact one of our doctors in any of our locations!

 

Information provided by: Dr.Belinda Dotter.