Welcome to Our Blog!

Hi there and welcome to our blog!  In light of Spring and Summer’s near approach, we have decided to relaunch our Community Foot Specialists blog to help address your feet concerns through these seasons (and hopefully beyond).

For those of you who are new to our blog, this is how it works: each week, one of our doctors—Adam Thomas, Belinda Dotter, Bridget Brondon or Allen Guehl—will tackle a current common and/or medical issue related to the foot. These topics could range anywhere from how custom orthotics (shoe inserts) can help with walking habits to how regular visits to your podiatrist can reduce the risk of complications associated with diabetes. All of our doctors are both progressive and current—meaning, you will receive both comprehensive and topical information through this blog.

Ultimately, our goal is to provide relevant and important information to our patients and seekers of podiatric information, locally and nationally. To better serve you, we always encourage our users to send us topics of interest and/or concern, and we will try our best to have one of our doctors cover that topic for you. You can email your topics to cfcfeetmarketing@gmail.com . For more information on our practice, our doctors, and what we treat, visit our website: www.daytonfeet.com!

Thanks for stopping by our blog, and we look forward to seeing you here next week ☺

Community Foot Specialists 

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

Frostbite, Prevention and Treatment.

Dr. Belinda Dotter

This winter has been especially cold for long periods of time, quite different from our past winters that have been on the mild side. Frostbite becomes a risk every time we go out in sub-zero temperatures (and sometimes not even sub-zero temperatures). Frostbite is caused by either prolonged exposure to cold temperatures, or shorter exposures to very cold temperatures.

There are several symptoms of frostbite:  numbness, a pins and needles sensation, severe pain, itching, and burning are all common when the body part is warmed and blood starts flowing again. The skin may look white, grayish yellow, or black with severe frostbite.  Blistering is also commonly seen.

Here are some tips to avoid having frostbite on your toes and feet!

• The most important action for prevention of frostbite is: Plan Ahead! If you are planning outdoor activities, check the weather forecast frequently, and don’t ignore warnings about storms. Avoid activities, such as hiking and camping in freezing weather, if it’s beyond your experience level.
• Wear adequate clothing: Layering is key, with the inner layer being a fabric that wicks moisture from the skin. The outer layer should serve as a windbreaker. Mittens provide more protection than gloves. Wear two pairs of socks, with the outer layer being wool. Don’t forget hats and scarves!
• Increase physical activity when outside to stay warm.
• Don’t drink alcohol before or during cold weather exposure, since the alcohol may prevent you from realizing that your body is becoming too cold.
• Don’t smoke! Smoking constricts blood vessels and increases the risk for frostbite.
• Keep a cold weather emergency kit in the car: extra layers of clothing, blankets, and chemical hand warmers.

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

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

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.

The Ugly Truth About Uggs!

Buyers beware - the trendy Ugg brand sheepskin boots and their generic counterparts may be hurting your feet!  While they may look soft and cuddly, studies have shown that the slipping and sliding going on inside the boots combined with the limited arch support they provide is putting unnecessary strain on muscles, tendons, ligaments, and bones.

The makers of Ugg boots maintain that their boots provide more support than the knockoff variety, but many experts see no real difference between the two. 

If you want to continue to wear the popular boot, Dr. Allen Guehl, a Dayton-area podiatrist at Community Foot Specialists recommends that you do so sparingly and when you aren’t going to be doing a lot of activity.  They aren’t the type of boots you want to be wearing if you are walking or standing all day.  You may also want to add supportive insoles to help cushion your feet and provide more support. 

Feeling the Pinch this Autumn? Bunions May Be to Blame

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With the curtain closed on summer and sandal season, fall is the season during which Community Foot Specialists sees an upswing in patients whose feet are feeling the pinch in their closed-toe footwear. This seasonal phenomenon seems to focus on women, although there are men who have this issue. The common culprit? Painful bunions that were given room to breathe during sandal season, but now face close quarters of a fall boot or shoe.

Bunions are abnormalities that form on the joint at the base of the big toe in the form of a bony bump. They occur when the big toe pushes against the other toes, which force the big toe joint in the opposite direction. As time passes, the abnormal positioning of the toe enlarges the joint. This further crowds the toes of the foot and causes pain and discomfort.

Bunions can occur for a variety of reasons. One of the most common causes is tight shoes, although they can also come about as a result of an inherited structural or mechanical defect, a stress to the foot, or a medical condition.

To help avoid bunions, don’t wear pointed shoes. Choose footwear with a wide foot box to give all of your toes plenty of room. If bunions become so painful that they impede daily activities, the American College of Foot and Ankle Surgeons recommends discussing surgical options with your podiatrist. However, please note that Community Foot Specialists firmly believes in exhausting the most conservative foot care treatment options first before considering surgery.

Community Foot Specialists can be reached at 937-426-9500. Or you may visit our website to request an appointment, view common conditions we treat, or get any other info you might need.

Toenail Fungus in Dayton/Springfield, Ohio

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Thick, discolored toenails are a common complaint amongst our Dayton/Springfield, Ohio patients. Many of our patients avoid wearing sandals or swimming because they are embarrassed by their unsightly toenails. This is a problem Community Foot Specialists is happy to help you fix!

A fungal toenail (or onychomycosis) is one of the most common conditions our Dayton/Springfield podiatrist sees. People who have weak immune systems (often times diabetics, HIV patients, etc.) are more at risk for a fungal infection of the toenail.

What does an infected toenail look like? A toenail infected with fungus appears to be thickened and a yellowish color. The toenail often times will appear to crumble or become flaky.

What happens if left untreated? If you do not treat your fungal toenail, your entire toenail may become discolored and eventually begin to lift from the nail bed, often times causing your toenail to come completely off.

There are medications available that provide a complete cure, however, the process can be a little slow depending on how infected your toenail is. The more you put it off, the worse it may get so instead of worrying; call your local podiatrist at (937) 426-9500 so we assist you!

Question of the Month: I'm a diabetic, do I need diabetic shoes?

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Question of the Month!

By: Dr. Thomas

Q: "I'm a diabetic, do I need diabetic shoes?"

A: That depends. Diabetics who are well controlled with their blood sugar, do not have toe deformities such as bunions or hammertoes, intact circulation to their feet as well as intact sensation or feeling in their feet, are at low risk and do not need diabetic shoes. Diabetic shoes are considered to be a necessity for those diabetics who have an at risk foot or a foot that could be in danger of developing a wound in an otherwise normal everyday shoe. These shoes are designed with extra depth to accommodate the foam inserts which are used to reduce chances of a foot ulcer on the bottom of the foot. Some patients may be interested in these shoes for the simple fact they believe they can get free shoes and the insurance will sometimes "pay for them". This is not the purpose of diabetic shoes. To determine if the diabetic patient is eligible for shoes, the podiatric doctor will perform a comprehensive diabetic foot exam first to check to see if the feet are at high risk for developing problems such as ulcerations. If the need is determined, then your doctor will do all steps necessary to see that the patient gets those shoes and that they are fit correctly.

Common Foot Conditions and Treatments

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IngrownToenail- When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the side of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

Treatment- If an infection is present, an oral antibiotic may be prescribed. A simple procedure, often performed in the office, is commonly needed to ease the pain and remove the offending nail. Surgery may involve numbing the toe and removing a corner of the nail, a larger portion of the nail, or the entire nail. A chemical or the entire root is taken out to make sure the ingrown is permanently removed.

HeelPain- is most often caused by plantar fasciitis. Heel pain may also be due to other causes such as a stress fracture, tendonitis, arthritis, nerve irritation, or rarely a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A podiatric foot and ankle surgeon is best trained to distinguish between all the possibilities and determine the underlying source of your heel pain.

Treatment- Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery. Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia. Ice. Putting an ice pack on your heel for 10 minutes several times a day helps reduce inflammation. Limit activities. Cut down on extended physical activities to give your heel a rest. Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot. Lose weight. Extra pounds put extra stress on your plantar fascia. Padding and strapping. Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia. Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Injection therapy. In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain. Removable walking cast. A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal. Night splint. Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain.

Plantar Warts- A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. A solitary wart is a single wart. It often increases in size and may eventually multiply, forming additional “satellite” warts. Mosaic warts are a cluster of several small warts growing closely together in one area. Mosaic warts are more difficult to treat than solitary warts.

Treatment-  The foot and ankle surgeon may use topical or oral treatments, laser therapy, cryotherapy (freezing), or surgery to remove the wart. Regardless of the treatment approaches undertaken, it is important that the patient follow the surgeon’s instructions, including all home care and medication that has been prescribed, as well as follow-up visits with the surgeon. Warts may return, requiring further treatment.

If you or someone you know is experiencing any of these foot problems, contact your Dayton/Springfield podiatrist at Community Foot Specialists. 937-426-9500