Thursday, June 26, 2014

Barefoot Beach Activities

If you are up for new fitness challenges this summer, try an athletic activity such as beach soccer, beach volleyball, or barefoot beach running. There are numerous benefits to these intensive sand workouts. One important benefit to note is that beach activities are easier on your joints because the sand absorbs most of the impact every time your feet hit the ground. You should also keep in mind that the sand is a surface that is constantly changing under your feet. For this reason, running (or jumping for that matter) on the beach works the muscles differently than running on hard surfaces. For example, the ankles need to make constant adjustments with each stride in order to preserve balance. Other muscles such as the lower back, hips, core abdominals, and calves are used more because they too need to compensate to maintain balance.

Barefoot running also strengthens foot muscles by allowing your feet to move through their natural range of motion. Another benefit is that athletic beach activities burn more calories than running on hard surfaces because you have to expend more energy pulling your legs out of the sand. For instance, you use more energy to lift your knees higher than you would if you were working out on a hard surface. One of the best benefits of physical activity on the beach is the Zen feeling you can experience. You do not have to inhale any fumes or exhaust from passing cars, you get a chance to smell fresh water, hear the waves, see the beautiful ocean, and feel the spray of the ocean breeze. An added bonus is that sand is a great exfoliator so it’s like getting a natural pedicure.

If you are interested in athletic beach activities, follow these tips:

  • Take it easy. You may need to keep the length of your activity shorter than usual since you will use more energy on the sand. You don’t want to overexert yourself. 
  • Do not expect to move at your normal pace. The sand is a more difficult terrain to master, and it will surely slow you down.
  • Ease into barefoot running. If you plan on barefoot beach running, run at low tide and closer to the shore where the sand is more compact to avoid injuries. Also, you want to slowly build strength in your feet and ankles. You don’t want to start off doing too much too frequently since your feet and lower leg muscles are accustomed to support from shoes.
  • Shorten your stride. Take smaller, quicker steps instead of forcing your feet into the sand. Staying light on your feet will help you from sinking.
  • Stay hydrated. 
  • Protect your skin. Being at the beach means you will be in direct sunlight. Apply sunscreen.
  • Keep an eye out for sandcastles and beach holes!
  • Don’t forget to stretch. Take the time to thoroughly stretch to keep your muscles loose and flexible.

Now get out there and have fun!

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

Friday, June 20, 2014

Bouts of Gout

By Dr. Bridget Brondon

Gout is quickly becoming a problem we see more and more of in our office.  We all probably know someone with gout, or if we’re really lucky, we have it ourselves (not!).  There have even been dinosaur bones discovered with gout in them, so humans are not alone!  But what is gout and how big of a problem is it?

Gout is a form of arthritis, which is why it affects the joints of our feet.  It occurs when there is an excess of uric acid in our bodies.  This can happen one of two ways: we can either produce too much uric acid or we don’t get rid of it fast enough.  Most people fall into the group that does not get rid of the uric acid fast enough.  This can be due to your regular metabolism, but there are other things that can decrease the uric acid excretion, such as certain medications (aspirin and water pills especially), alcohol intake, and certain foods, especially red meat and high fructose corn syrup.  Kidney problems can also cause this because they are the filtration system that cleans out the uric acid from the body. Dehydration can also bring on a gout attack.

When uric acid builds up in our bodies, it ends up circulating through our bloodstream and one of its favorite places to get stuck in is the joints of our feet, most commonly in the big toe joint.  Other areas of the feet often affected are the middle/arch area of the foot, where lots of very small joints are present, and in our smaller toes, but gout can occur in any joint of the body.  Other body parts that can be affected are the hands, fingers, and ankles.  

The uric acid particles form crystals within the joint, under a microscope, look very similar to sewing needles.  The inflammation from these crystals is what causes the pain.  Other symptoms include redness at the joint, swelling, warmth in the area, and A LOT of pain.  Without any treatment, in time, these crystals would naturally get broken down and absorbed into the body, but who wants to suffer through all that pain when there are medications that can help?

So, how do you know if you have gout?  The symptoms above are a very good first indication.  An aspiration of the joint can also be done where some fluid from the joint is removed with a needle and sent to the lab to look for crystals in the fluid.  Your doctor can also run a blood test to determine your uric acid levels to check if it is high.  It is important to note, however, that during the first few days of an attack, very often your uric acid level in your blood is often normal, because a lot of the uric acid has made its way to the joint and is no longer in the blood stream.  Bloodwork is usually done a month or two after an attack to determine what the baseline uric acid level in your body is when you are not undergoing an attack.  If it is naturally high, you may need long term therapy to lower it.

The most common medications that are used for treatment for an acute gout attack (when the joint is super red, swollen, warm and painful) are anti-inflammatory medications and colchicine (brand name Colcrys).  Anti-inflammatories, such as Indomethacin, Aleve, Advil, Ibuprofen, Motrin, or a Medrol dose pack (steroid pack) can help to decrease the inflammation present made by the crystals and help reduce the swelling and pain.  Colchicine works to stop the inflammation from being created in the first place.  Sometimes, these two medications are prescribed at the same time to work together to get rid of the inflammation.

It is possible to have only one gout attack in your lifetime, but it is far more likely that they may come and go throughout your life if your uric acid is not properly managed long term.  This is done with medication taken daily to help with the excretion of uric acid from the blood on a daily basis, so the levels do not rise high enough to cause a gout attack.  There are primarily 2 medications that do this: Allopurinol and Febuxostat (brand name Uloric).  Allopurinol is generally the first medication tried.  The dosage of this medication can be tweaked to fit your needs.  This medication does not work for everyone though and flares can continue to occur, or sometimes a patient can have a reaction to the drug.  Febuxostat is an alternative option in these cases.  It is also a safer drug for those patients with kidney problems.

Although gout may be a problem that only bothers you every once in a while at the beginning, it is important to seek long term treatment if you are prone to gout attacks.  The longer uric acid remains at a high level in your body, the more lasting damage you can have to your joints, even if you aren’t having any pain at the time.  Just like with osteoarthritis, even when you aren’t having symptoms, the damage to your joints is still occurring.  The same thing is true for gouty arthritis.  Over time, it also begins to take less to trigger a flare-up so they can happen more easily and more frequently.  With time, the uric acid crystals within the joint eat away at the cartilage which can cause problems with motion and inflammation in the future as well.  The crystals can over time deposit themselves permanently in the joints as well, which can cause stiff joints, bumps, and irritation.

So, what can you do to prevent a gout?  Well, once you have it, you have it.  But you can prevent attacks primarily by watching what you eat.  You can still eat all of your favorite foods, but moderation is the key.  Drink plenty of water to keep yourself hydrated and help flush your kidneys.  If you do get an attack, see your doctor right away. We want to help you start feeling better faster!
Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Thursday, June 12, 2014

Mowing the Lawn Barefoot?

Many people admit to mowing their lawns barefoot.  The feel of fresh cut grass is all too tempting… but don’t do it!

Please keep in mind that a lawn mower is a machine that uses a rotating blade at high speeds to cut grass. You should not mow your lawn barefoot or while wearing flip flops, sandals, or other open-toed shoes. The mower can cause flying debris, and wearing shoes helps you avoid stepping on hidden objects like twigs, rocks, mulch, broken glass, etc.

Wearing appropriate shoes also prevents your feet from turning green (caused by the chlorophyll in the grass).  Plus, if you have diabetes, going barefoot is generally a big no-no. Walking barefoot leaves you open to any number of injuries and if you suffer from neuropathy, you may not be able to feel that you are injured.

According to the US Consumer Product Safety Commission, thousands of people are injured by lawn mowers every year. Types of injuries include cuts, burns, other infection-prone lacerations, broken bones (fractures), severed tendons, and amputations. Minor injuries and superficial wounds require immediate treatment, so flush wounds with water and apply antibiotics to prevent infections. For more serious injuries, surgical intervention is usually required.

Still, many people make the decision to mow the lawn barefoot after weighing the risks: their age, slope of the lawn, type of mower they will use (riding mower vs. push mower), mowing pattern, height of the grass, etc. Nonetheless, it is best to take safety precautions to avoid any serious injury.

  • The American Podiatric Medical Association suggests that you always wear hard-top shoes when operating a lawn mower.
  • Before you start mowing, remove objects like toys and yard tools off of the lawn.
  • Do not remove safety devices such as guards or shields from your lawn mower.
  • Try to use the “grass catcher” or “clip bag” that usually comes as an attachment to help prevent projectiles from causing harm.
  • Make sure you have firm footing at all times. Pay attention to the change in slope and terrain.
  • Do not mow the lawn if it is wet. This helps prevent slipping on the grass.
  • Do not use your feet to remove debris in lawnmowers. Use a stick or broom handle instead.
  • Never touch the lawn mower blade with your hands or feet, even if the engine is off. The second you free a jammed blade, it could start to spin and cause an injury.
  • Do not let children ride on a lawn mower — not even on the lap of a parent. A majority of injuries happen to children, and many doctors see foot injuries related to children who were riding as “passengers.” Typically, children fall off of the mower and get run over, resulting in serious injury/ amputation.
  • Do not mow while heavily medicated, intoxicated, sick, or overly tired.
  • Be sure you know how to stop the mower at a moment’s notice.
  • If you have to walk backwards, be careful to avoid running over your toes (yes, it does happen).
  • Continue to maintain your lawn mower to ensure that it is working correctly.

**Remember** If you like the feel of fresh cut grass you can always walk around your lawn without shoes and socks after you finish mowing it. To cut a long story short, don’t mow the lawn barefoot. Take care of your feet because they don’t grow back!

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

Thursday, June 5, 2014

Wearing Flip Flops All Summer, Yea or Nay?

Dr. Belinda Dotter

Flip flops and sandals are increasingly the shoes of choice during the summer. The crop of new styles and funky designs have made them very common and popular.  But are they good or bad for our feet?

Flip flops can give us basic protection when out by the poolside, for example, protecting our feet from the hot floor.  They can also prevent athlete's foot or plantar warts while in public places like showers, pool areas, and locker rooms.  However, flip flop use during extensive walking is not so great because they offer no arch support, heel cushioning, or shock absorption.  We can suffer foot pain due to lack of arch support, tendinitis, and even sprained ankles if we trip. Also, don’t wear the same pair of flip flops year after year. If they are worn out, make sure you throw them out.

Many of us start out relieved at being able to come home or get to the weekend so we can ditch our work shoes and put on some comfortable flip flops, only to want to throw them away after several hours of activity.  So, wear them in moderation.  Short periods of time is acceptable, just don't overdo it!

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