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

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

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.

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