You Can't Run Through a Stress Fracture!

Dr. Adam Thomas

Spring is finally here, and as more and more of you are considering outdoor running, you should familiarize yourself with the associated foot and ankle risks like stress fractures.

What is a Stress Fracture?

A stress fracture is a tiny crack on the surface of a bone or an incomplete fracture. When a muscle is overused, fatigued and no longer able to absorb the shock from impacts, it transfers stress to nearby bones, resulting in fractures.

What causes it?

If an individual is continuously striking their feet on surfaces, while either running or jumping, the risk of causing a stress fracture injury increases. Other causes include participating in athletic activities that increase physical stress, running on irregular surfaces, inappropriate footwear, and improper training.

Although stress fractures are caused by an abnormal force on a normal bone such as a young person running, they are also caused by a normal force on an abnormal bone, like an older person walking regularly. Oftentimes, stress fractures that occur from the latter are the result of bone density loss.

How does it relate to running?

Stress fractures, as a result of athletic activity, are fairly common and runners are especially susceptible to them. In many instances, the runner does not even know that an injury to the bone has occurred. If you feel pain that increases in severity, do NOT try to “run through the pain.” Continued force on the injured bone can progress the fracture, cause more damage, and worsen the pain.

Where is it common?

A majority of all stress fractures occur in weight bearing bones such as the lower leg and the foot. More specifically, stress fractures can be found in the metatarsal bones of the foot, and they are most common in the 2^nd metatarsal because it is the longest.

How do you treat it?

Treatment involves rest which means no more running… until healed. Treatment also includes anti-inflammatory medication and in some cases, a splint or crutches are necessary.

How do you prevent it?

You can lessen the risk of stress fractures by changing your athletic conditioning. Start slowly, gradually increase the intensity of workouts, and avoid doing too much too soon or applying too much force too early.

You should also ensure that you have the proper shoes for the activity- cleats, running shoes, basketball sneakers, etc. They all offer different ankle and arch support, with different gripping capabilities. Try eating foods with the minerals magnesium, calcium, and potassium or foods that have vitamins D and K to improve bone health. Some foods to try are broccoli, nuts, flax seeds, salmon, spinach, bananas, and dairy products.

If you have severe pain that is not going away and believe that you have sustained a stress fracture, please contact your local podiatrist.

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

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

(source)

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