March Articles 2014

Athlete's Foot: The Sole Story
Do you suffer from itching, burning, dry, and flaking feet? It could be athlete's foot. Athlete's foot, also known as tinea pedis, can be extremely contagious, often infecting shower floors, gyms, socks and shoes, and anywhere else feet might contact. It's commonly found in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools. "Commons" areas in prisons and residential care facilities are frequently caught feeding the fungus as well. One step in the wrong direction can be enough to start the fire that can be tremendously difficult to treat.

Athlete's foot is most often caused by the same fungus that causes ringworm (tinea). It can be spread by direct contact with an infected body part, contaminated clothing, or by coming in contact with other objects or body parts that have been exposed to the fungus. Although the feet are more frequently assumed to get athlete's foot, tinea can invade other parts of the body as well so long as the proper growing conditions are met.

Tinea thrives in a dark, warm, and moist environment. Body parts that are often infected include the hands, groin, and scalp. Although many people never experience athlete's foot, around 70% of the population suffers from tinea at some point in their lifetime. Like most ailments, some people are more likely to acquire this fungal infection than others. People with a history of tinea or other skin infections are more likely to suffer from recurrent, or even additional, unrelated infections. The extent to which a person is tormented by the fungus can vary greatly as well.

While some people are never even aware that they have been infected with athlete's foot, others are pestered with mild to moderate symptoms like dry and flaking skin, itching, and redness. Still others are bothered by more severe symptoms including cracked and bleeding skin, intense itching and burning, and even pain when walking. In the worst cases, tinea can cause blistering as well.

The treatment for athlete's foot begins with prevention. Changes in the environment infected with athlete's foot can prevent spreading. Keeping the area that is infected clean and dry with the use of medicated cleansers and powders is essential. Allowing the area to breathe is important in the treatment as well. Exposure to cool air and light can make conditions undesirable for tinea. Treating the infected area with miconazole, tolnaftate, or other medicated creams, ointments, or sprays not only helps to kill the fungus, but helps prevent recurrences as well. White vinegar-based foot soaks can also be beneficial. Seeing a podiatrist is often a good idea when treating athlete's foot, since more often than not, other skin infections can develop from the initial infection, and recurrences are common.


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.


Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body causing an interference with the biological structure and focuses on the movement of the ankle, the foot and the forces that interact with them.

At some time in our lives we will all experience foot problems, regardless of our lifestyle or age, and we all take our mobility for granted until we are in pain. Twists or turns can cause problems and apply stress to the feet, and that pain will spread from the foot structure to the surrounding tissues. The pain will concentrate in the foot and ankle, but may eventually spread up into the knees, hips and back.

The history of biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded. Afterwards, during the first century AD, corns on feet were recorded as specifically growing on feet and toes. In 1974 biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections of conditions could be implemented to gain strength and coordination to the area. His basic principles of thermoplastic foot orthotics are still in use throughout the industry today.

Modern technology improvements are based on past theories and therapeutic processes providing a better understanding of podiatry concepts for biomechanics. Computers provide accurate determinations about the forces, movements and patterns of the foot and lower legs with the most important information captured. Today’s knowledge of detailed measurement of external and internal forces in the foot is critical to the individual’s treatment. Like most health industries, precise determinations assist the practitioner in diagnosing and prescribing the best treatment for health improving results.

Advances in materials and more awareness of biomechanics have developed enhanced corrective methods, offering further options for foot-related injuries. Shoe orthotics options have expanded to treat walking inability, helping to realign the posture deviations caused by hip or back health occurrences. Attention to posture and foot mechanics uses individual insoles to position the foot, aligning the ankle and leg. The corrected positioning comforts the pressure and helps to ease the pain. Understanding foot biomechanics can help improve and eliminate pain, stopping further stress to the foot. However, these results can only happen if one seeks a podiatrist who specializes in biomechanics.


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.


Playing Sports With Foot Injuries
There are many types of foot injuries common among athletes such as plantar fasciilitis, overpronation, strains, turf toe, heel spurs, and stress fractures of the foot. Plantar fasciilitis is when the thick ligament in the base of the foot becomes swollen, and causes pain. Overpronation is excessive movement of the foot during gait. Pronation would be normal movement of the gait, but when movements become excessive, it leads to a variety of areas becoming painful due to the overpronation. The most common complaint is a burning sensation or inflammation under the arch of the foot, often called strain or arch pain. Heel spurs are growths of the bone in the heel where soft tissues and tendons connect. Turf toe comes from upward bending of the big toe outside of the normal range of motion. It most commonly occurs in athletes that play on artificial surfaces because a shoe grips the surface and forces and athletes weight forward causing the upward bending of the large toe. This causes damage by stretching the ligaments under the toe. Stress fractures could be caused by overuse due to muscle fatigue in the foot, preventing the muscles and ligaments from absorbing the shock and trauma.

Many athletes continue to play with mild foot injuries. You should remember to properly stretch  before any activities, focusing on their calves to prevent injuries and reduce reoccurring pain. It is also common to wear braces to protect the areas that commonly become overstretched and use shoe inserts such as heel pads. It is important to remember to wear proper footwear and replace shoes when needed.
There are many kinds of treatments required to keep the injury from becoming serious. Most commonly an athlete should immediately ice the injury to take down swelling and inflammation. Applying a compression bandage and resting will also reduce pain and stress on the foot. Rest could include using crutches to keep weight off of the injury to allow proper healing for instance. For plantar fasciilitis, make sure calves are properly stretched and refrain from hills or speed work. One should try wearing an arch strap to add support. Those with heel spurs should also try arch straps to reduce strain and ice often. The best remedy would be heel pads. Aside from that, one would need a podiatrist or orthopedic specialist. It may require surgery. Those who are suffering from overpronation or turf toe should invest in a quality shoe to reduce motion. There are special insert and braces for the big toe, as well as shoes with firm soles to prevent bending. Stress fractures usually require rest, so an athlete may participate in lower impact activities to allow rest and healing. Most importantly, one should seek medical advice if pain does not go away or recurs frequently.

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