June Articles 2015

Everything You Need to Know About Gout
Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the metatarsal phalangeal joint on the big toe; though it has been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers and the children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, again noted as being particularly painful, is the leftover uric acid crystallizing in the blood stream and travel to the space between joints where they rub causing agonizing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Tertiary side effects may include fatigue and fever though reports of these effects are very rare. Some patients have reported that, as the temperature drops (when you sleep for instance) the pain may intensify.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms, however there are defined tests that can be performed. A blood test to detect elevated levels of uric acid is often used as well as the use of an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms; non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation, however, diet, lifestyle changes, and preventative drugs are necessary to fully combat the most severe cases.

 Those that lead a sedentary lifestyle are at a higher risk for gout. Any amount of exercise decreases probability of repeat encounters with the condition. Also, staying away from, or reducing drastically, consumption of red meat, sea food, and fructose-sweetened drinks reduces the likelihood of chronic gout as well.

As for diet, beyond what has already been mentioned, ingesting Vitamin C, coffee, and particular dairy products help on the preventative maintenance side of healthy living. While new drugs are out on the market that inhibit the body’s production of uric acid-producing enzymes, reducing or eliminating as much as possible your overall levels of uric acid will ensure you lead a gout-free life.


Blisters on the Feet
Blisters are a common ailment of people who wear shoes that are either too tight or rubbed up against their feet in the wrong way while wearing them. In order to better understand how they are formed and what treatment should be used for them, you have to start with the basics of what a blister actually is.

A blister on the foot, or any other part of the body for that matter, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery like fluid that should not cause any concern. However, blisters can fill up with blood if they are deep enough and even pus if they have become infected with bacteria.

Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time for example, or when your shoes simply do not fit you properly. They also form faster and easier if your feet are moist, so keeping them dry and clean is a preventative step you can take to avoid getting blisters.

Preventing infection should be the number one concern when treating blisters, as well as alleviating the pain they can cause. Using a band aid to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop, or you can take a pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics might need to be taken in order to completely eliminate the bacteria inside the blister, and that needs to be prescribed by a doctor.

However, one of the best ways to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a band aid to an area you think might get a blister before one pops up is another way you can prevent them.


Hyperhidrosis of the Feet
Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that is not onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

The symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the materials, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.


Choosing the Right Running Shoe for Your Foot Type
Running may seem like a simple thing to do, but in reality it is a complex movement that puts stress on the ligaments, bones, and joints of the body.  Because of this, selecting the correct running shoe is important for increasing performance and avoiding risk of injury.  Running shoes should be selected based on your foot type.  Considerations such as trail versus road shoes are important, but your foot type dictates the degree of cushioning, stability and motion control you require.  The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes.  Professionals there can measure your arch type, stride and gait and let you know your shoe needs for future reference.

The design of running shoes is created around the idea of pronation.  Pronation is the rolling of your ankle from outside to inside when your foot strikes the ground, which is natural.  If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more.  Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy.  Those considered neutral runners pronate correctly and do not need running shoes that help correct their form.  Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types.  However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation and require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling.  Even while standing, those who severely overpronate display ankles that are angled inward.  It is not uncommon for them to have flat feet or bowed legs as well.  The tendency to overpronate may cause many injuries.  Areas that tend to become injured are the knees, ankles, and Achilles tendon.  If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control.  Motion-control shoes are straight and firm; shoes of this type do not curve at the tip.  The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes.

A less common problem is underpronation.  Underpronation, also called supination, is when the feet are unable to roll inward during landing.  Those who underpronate have feet that lack flexibility and high arches.  This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees.  This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact.  Those who underpronate need shoes with more cushioning and flexibility.  If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.


Dealing with Stress Fractures of the Foot and Ankle
Stress fractures occur in the foot and ankle when muscles in those areas are weakened from too much or too little use. When this happens, they stop cushioning the foot and ankles from the impact of hitting the ground. Because there is nothing to protect them, the bones of the foot begin to absorb the full impact of each step someone takes. The added stress causes little cracks to form in the bones that are under the most pressure. These cracks are called stress fractures.

Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Individuals who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intensive high impact work out may get stress fractures. This is because their muscles are not strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.

The pain from these fractures will occur in the general area of the fracture. It may be intermittent or constant, and will cause sharp or dull pain along with swelling and tenderness. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture. This is a much more serious problem, and will probably prevent you from applying any pressure on the foot at all.

Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.

In order to avoid getting stress fractures, make sure to get plenty of calcium and Vitamin-D. They will help to keep your bones strong, and make them less likely to break under pressure. If your new exercise regimen is running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. For example, if you plan to walk every day, you could ride a bike on some days to take the stress off of your feet. Make sure to wear supportive shoes to better protect you feet.

If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms do not go away, see an orthopedic specialist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.