March Articles 2015

What are Achilles Tendon Injuries
The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. Since this tendon provides an enormous amount of mobility to an individual, any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries and can be recognized by the following symptoms: inflammation, dull to severe pain, an increased flow of blood to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.

Many problems arise among athletes and people who overexert themselves while exercising or who do not properly warm up before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat, as this will relieve pressure on the heels. As always, a healthy diet will also increase tendon health.

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region, because further damage could result in severe complications that would make being mobile difficult, if not impossible.


Ankle Sprains
Ankle sprains can be quite the painful experience. Often times the injured person will experience limited mobility, swelling, and, depending on the severity, discoloration of the skin. This type of injury takes place when the ligaments are torn or stretched beyond their limits. Although this can occur in various areas of the body, the ankle is the most common site for a sprain.

There are multiple ways that the ankle can become injured like this. However, the simple act of walking may cause a sprain. If footing is lost or the person is walking on uneven terrain, local damage may occur. This may be especially so for athletes that continually push their limits, or for the person who has suffered from a previous accident involving the lower extremities.

In the majority of cases, medical attention is not required for a sprained ankle. Remedies for self-care at home include propping the ankle up, applying ice packs as needed, and remaining off your feet. Some may also find that wrapping with an ACE bandage and taking over-the-counter pain relievers are helpful. One of the most important things is to avoid further stress to the affected area.

Although rare, complications may arise and obtaining medical treatment may become necessary. A severe sprain can actually tear the ligament and even damage the muscle. When this occurs, the person may have to be off their feet for a prolonged period of time. Depending on the severity and nature of the damage, surgery and physical therapy may be required. Seeking out a podiatrist will help in making these decisions.

Sprained ankles are painful in nature, but those with severe unrelenting pain may have sustained a worse injury than previously though. If walking becomes too painful for the person to take more than a few steps, swelling becomes too severe, or if numbness or tingling is present, immediate medical attention should be sought. Mild to moderate bruising is common with a sprain but redness of the skin or worsening of the discoloration should not persist either.

One of the best treatments for an ankle sprain is to prevent it in the first place. Wearing appropriate shoes for the occasion, stretching before exercises and sports, and knowing your limits can aid in prevention. Those that have suffered from a previous sprain may want to consider additional support, such as a brace and regular exercises to strengthen the ankle.


What Are Ankle/Foot Orthotics?
Orthotics is a medical field concerned with the design, manufacture and use of aids used to support weak limbs or direct the proper function of limbs, in this case the foot and ankle. Ankle-foot orthotics, or AFOs, are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require AFOs to strengthen the muscles or train in the proper direction. Tight muscles that need to be lengthened and loosened also benefit from AFOs.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature or that there are some who "toe in". But whatever trauma affects that musculature, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walk, correct deformities and manage pain load. A podiatrist would be consulted for those who "toe in", for instance, or an arthritis sufferer whose ankles suffer through walking on the job or perhaps a victim of stroke whose musculature is wasting away and requires strength.

Before the advent of modern orthotic devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children who "toed in" wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthotics are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or AFO would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthotic is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. As present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.


Corns: What Are They, and How Do You Get Rid of Them
Corns are areas of the skin where it has thickened to the point of being irritating and sometimes painful. Corns are circular or cone-shaped and are commonly found on the feet where there are areas of pressure or friction, such as on the little toe where it may rub against shoes or on the ball of the foot. The medical term for corns is helomas.

Corns can easily be confused with a callus, but there is a difference between the two. Corns can be a raised bump that feels hard to the touch and painful. They consist of a thick, rough area of skin that may be dry and waxy. Corns tend to be surrounded by inflamed skin and are usually smaller than calluses.

The key to treating a corn is to remove the dead skin that has built up. Salicylic acid is the most common medication used to accomplish this. Salicylic acid works by dissolving keratin, the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in the form of wart removers. It comes in medicated pads, drops or creams. People with diabetes should not use salicylic acid, but should immediately consult their doctor.

To treat corns, apply the medication directly onto the corns according to the product directions. The top layer of the corn will turn a white color. When that happens, the layers of skin can then be peeled away, making the corn smaller. It is never a good idea to try and shave off corns with razors or other pedicure equipment. This can lead to infection. If your corns get infected or do not respond to over the counter treatment, a visit to the doctor is necessary.

Orthotic inserts fitted by a podiatrist also help to treat corns and help prevent their return. Inserts fit into shoes and help to adjust the way your foot fits in your shoe, thus fixing the way you walk. This will reduce friction, lowering your chances of getting a corn and eliminating the pain for current corns.

Surgery is seldom an option for corns, but does occur on rare occasions. Surgery for corns actually deals with the underlying issue causing the corns. During surgery, the bone is shaved and any abnormalities are corrected to reduce the amount of friction that occurs during walking.

The first step to preventing corns is to reduce any possible friction. Wear well fitting shoes that don’t rub on your feet. If you notice rubbing developing, pads can be purchased to help reduce the friction. These can be purchased over the counter and are simply placed on the area that is being irritated. Friction can also be reduced by using cushioned insoles in your shoes, and making sure to wear well-fitting shoes. This will make sure your foot is not being squeezed awkwardly, and stop corns from forming in the first place.


Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet
Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others