Back to School - Prevent Foot Pain

Kids are heading back to school, with backpacks packed, lunches filled with nutritious food and heads waiting to be filled with information. However, one thing that they kids should not have as they start the school year is foot pain. Foot pain is not normal in kids or adults. Most kids have been wearing flip flops all summer long and now as they head back to school it is not uncommon for foot pain to have developed. What problems may your kids complain about?

First, flip flops do not offer support or cushion. Kids can develop arch pain from the lack of support from flip flops. This develops from the Posterior Tibial Tendon, the major supporter of the arch, can develop a tendonitis, or inflammation around the tendon. As the tendon works hard to hold up the arch the bones continue to allow the foot to roll in and cause the tendon to become inflamed and over used. Pain can be sharp or achy in the instep or around the inside of the ankle.

Another problem that can develop from long term flip flop usage is heel pain. Adults heel pain is a result of a strain or pulling of a long ligament on the bottom of the foot called the plantar fascia. However, children with heel pain is normally the result of an irritation of a growth plate. Achilles tendon, is tight and pulls on the growth plate of the heel bone or from a lack of cushion at the growth plate.  According to ACFAS, American College of Foot and Ankle Surgeons, " People often don't realize that even into your mid-teens, there's new bone growing in your heel. Flip-flops don't cushion the heel, so repetitive stress from walking can inflame that heel bone growth area and cause pain and tenderness".

Bones grow in length at a growth plate. This is an area of soft tissue between two bones where new bone is produced. If there is a tension across this area, inflammation and pain can result. Normally, tension can result if the heel cord,

Now that they are back to school and out of flip flops, make sure they are rotating their shoes. Fungus lives in everyone's shoes including children.  The fungus likes the dark moist environment. If shoes are worn daily, especially when the feet perspire, this could lead to an overgrowth of fungus in the shoes. Fungus is the cause of athlete's feet infections, a fungal skin infection, and onychomycosis, fungal toenails. By rotating the shoes and treating the shoes with an anti fungal spray you can reduce the fungus within the shoes and reduce the chance of developing fungal issues.

To make sure the kids are starting with their best foot forward this school year make sure they are starting the school year without foot pain.
Have a safe and happy school year!

 Dr. Alexandra "Sandie" Grulke
 http://www.podiatrycarespecialists.com/

For years we have been trying to educate patients on the damages improper shoewear can cause. Now, thanks to a newly developed 3-D scanner from the UK called the PedCAT, the detrimental affects of poor shoes can be clearly visualized. The PedCAT machine, the first of its kind from the UK, does a 360-degree scan of the patient's feet in just 60 seconds. Podiatrists can then view the resultant 3D image from every angle, spinning it around to view the foot from above, below and the side. It also takes 600 2D views of the foot.

The image allows the podiatrist to see 3-D scans of the foot in the position the foot normal functions.  These 3-D images allows the Podiatrist to make accurate diagnosis. X-rays can often be confusing because the image is one dimensional and there is a lot of superimposition of the bones. However, the price has made this machine a  luxury that most doctor's office cannot afford, with a price tag well over $300,000. With the advances in technology it may not be long until this becomes a cost effective reality.

Dr. Alexandra "Sandie" Grulke
Dr. Brad Jacobs

http://www.podiatrycarespecialists.com/

And the Oscar goes to....

Millions of people were glued to the TV on Sunday night to watch all the glitz and glamour of the "Red Carpet", like myself. I enjoy seeing what everyone is wearing and who they are with. I was surprised to see crutches make an appearance on the red carpet. Kristen Stewart, of Twilight fame, ambulated down the red carpet on crutches Sunday because she stepped and cut her foot on glass. Ouch! Just a good reminder of how careful you have to be with your feet, especially if you have diabetes.  If a healthy young women can cut her foot so badly on glass that she requires crutches on Oscar night reinforces what podiatrists preach, that people with health and foot issues need to be careful. The biggest health issue affecting the feet is Diabetes.

There are three things that can be affected in regards to your feet and diabetes.  Diabetes is the inability of your body to produce enough insulin or utilizing the insulin our body produces. The hormone insulin allows the sugar that is produced by the breakdown of food to be moved into organs to be used as energy. However in diabetes, the sugar remains in the blood and cannot be used as energy. Eventually the blood sugar can get absorbed into the lining of the small blood vessels such as the small arteries in your toes, fingers, eyes, etc. This causes the arteries to become calcified and limits the blood flow to the affected area, commonly called Peripheral Artery Disease or PAD.

Secondly, the blood sugar can get absorbed into nerves causing chemical nerve damage, called neuropathy. This results in numbness, burning, tingling, and pain. Often the first symptoms can be felt at night only and can be painful. Eventually, this can progress to complete numbness. This is when people are at most risk for developing problems. Because they cannot feel, they often wear shoes that are too tight, step on something, cut their feet, etc and do not realize it. Often the first sign of a problem for them  is when they see drainage or blood on their sock or on the floor, and unfortunately it may be days afterwards that this is initially noticed. For this reason it is extremely important if you are suffering from neuropathy, daily inspections of your feet must occur.

The third major complication of diabetes related to your feet is the higher your blood sugar is, the less able your body is to fight off infection. The white blood cells (that are the body's major defensive cells against bacteria) and viruses are inactive when the sugar levels in your blood is high. This can make it difficult to try and heal a problem once this process has started.

Prevention is the key with people with diabetes or other foot health issues. Don't forget to see your podiatrist at the first sign of trouble. Now we can focus on the best and worst dressed at the Oscar's. I loved Anne Hathaway's dress and did you see Jennifer Lawrence fall on the way to receiving her Oscar (another potential podiatric patient).

Dr. "Sandie" Grulke
http://www.podiatrycarespecialists.com/

Your Health and the Internet

The internet has a wealth of information on every topic. So it is not surprising that between 79-89% of internet users spend time looking up medical information, according to an article Sharing Internet Health Information With Your Doctor. So how do you determine what sites are reliable? How do you know that the information is up to date and not a self serving promotional ad?

First, look at who is sponsoring an ad.
Often drug companies will have information regarding a disease that their medication can treat. If you find only one treatment option for a particular disease then most likely this is disguised as an advertisement. You should look for websites run by respected academic, governmental, medical, and nonprofit organizations and institutions or specific websites directed to you by your doctor. A study conducted by the Pew Internet & American Life Project in 2007  found that while eight in 10 American adults have consulted the Web for health care information, 75% failed to check a source's validity or relevance. The source of the information is just as important as the content of the site.

Second, be careful.
Recent research into peoples search engine habits suggests that people are more likely to progress from benign to more serious medical inquiries, the longer they search for information. Your simple heel pain search can quickly lead to concerns of bone cancer or compartment syndrome, which are very rare causes of heel pain. Also, be specific when searching for your symptoms but also realize some conditions can only be diagnosed by your physician after a full understanding of your medical issue.

Third, consult a physician.
Seek out a physicians expertise to discuss your findings on the internet. A visit with your physician will be to address all of your questions regarding your medical issues.  Also, make a list of your questions or concerns when you see your physician so you can get as many of them answered from your appointment.

The internet can be a fantastic tool in conjunction with a visit to your healthcare provider. However, always consider your sources. Be specific with your symptoms. The internet can be a good starting point in looking up and treating your medical condition but do not hesitate to consult a physician also.

Dr. 'Sandie" Alexandra Grulke
http://www.podiatrycarespecialists.com/

APMA Seal of Acceptance

A sure sign of Spring is the Summer children's shoe catalogs are out. Yesterday in the mail I received a catalog for a local shoe store with all the summer sandals and sneakers in bright happy colors. I noticed some of the shoes brands in the catalog had a symbol located near the name.

So what does this mean. Are these shoes better than other shoes listed in the catalog? What advantage do these shoes have for your children's feet that other shoes do not have?
I went to the APMA website to see what this symbol meant and what these shoes companies had to do to get this seal of acceptance. The Seal of Acceptance is given to footwear, insoles, hosiery or equipment. The Seal is given to the companies that have proven the footwear or equipment allows normal foot function or promotes foot health. The companies must provide the Podiatric Seals Committee with research documentation of the benefits of the products, as well as, composition and quality control procedures. It is important to note that the Seals Committee does not evaluate footwear companies that have not applied for the seal, nor does it evaluate one footwear brand versus another. The companies that have been approved with a Seal of Acceptance are required to re-qualify every 3 years .

The Seal of Acceptance should be used as a guide when shopping for shoes. However, everyone's foot is different and therefore this should not be the only reason to buy a shoe.

For more shoe buying tips see an earlier blog we posted http://howtotreatfootproblems.blogspot.com/2012/01/first-question-out-of-most-peoples.html.

Dr. Alexandra "Sandie" Grulke

http://www.podiatrycarespecialists.com/

How far would you go to wear Stilettos?

As young girls we have heard the phrase "Beauty hurts." This definitely includes the trend of wearing stilettos. As a result of wearing these high heels, women are developing a host of foot problems including corns, calluses, hammertoes, bunions and ball of foot pain. Some have even gone as far as to surgically alter their feet to allow them to wear stilettos. Procedures such as toe shortening or even removal of the 5th toe to allow a more comfortable fit of these high heel shoes have been performed. When is it appropriate for these surgical procedures and what else other than surgery can you do to wear shoes comfortably?

Stiletto

According to Fox News Garrett Tenney, Eighty-seven percent of women have had foot problems from wearing uncomfortable or ill-fitting shoes such as high heels, according to the American Podiatric Medical Association. So to avoid surgery, a more practical solution is sensible shoes. Nowadays, a sensible shoe does not necessarily mean an ugly one, so here are some tips as to what to look for in a sensible shoe.  Firstoff, a squared toe box in the front of shoes allows much more room  than a pointed toe box. The toes will not rub in the shoes or be cramped and therefore, will reduce pain and pressure. The pressure from the toes rubbing on the shoes can cause the corns and calluses to develop. Then shopping for a lower heel causes less pressure on the forefoot  and lessens potential ball of foot pain. A stiletto heel can be anywhere from 1 inch heel to believe it or not, a 10 inch heel! When you are walking, the entire body weight is supported by your foot. When you are wearing a shoe with a high heel, 8 times your body weight is being supported by your forefoot, according to a study from Indiana University. So it is not too surprising that you instantly can develop pain under the ball of the foot after wearing stiletto heels.



More sensible Aetrex shoe

The thought of doing surgical procedures for purely aesthetic reasons reminds me of the handouts that come with your prescription medications. This states your doctor has decided the benefits of the medication out weigh the risks. In terms of anesthetic surgery, the risks seem to out weigh the benefits. Typically we recommend surgery when the pain is preventing a patient from doing their normal daily activities and maintain their quality of life. In these cases the surgical benefits far out weigh the risks. But to perform surgery when pain is associated only to accomodate a certain style of shoes is not in their best interests. In fact both the APMA and American College of Foot and Ankle Surgeons do not recommend cosmetic foot surgery. According to Fox News Garret Tenney's article, "surgical procedures of the foot and ankle are generally performed for relief of pain, restoration of function, and reconstruction of deformities". Patients considering surgery of the foot or ankle, whether for medical or aesthetic reasons, are advised to consult a member of the American Podiatric Medical Association. "Surgery performed solely for the purpose of improving the appearance or size of the foot or ankle carries risks without a medical benefit, and therefore should not be undertaken,” according to the American College of Foot and Ankle Surgeons.

Is this what we are heading to?

 

 Dr. Alexandra "Sandie" Grulke
http://www.podiatrycarespecialists.com/

Scott Hartnell Fractured Foot

Scott Hartnell from the Philadelphia Flyers has suffered a fracture of his first metatarsal. While he was playing, he took a puck shot to the foot that broke the bone.  He had successful surgery the other day to have this repaired and will be out for up to 6-8 weeks. If you have suffered from a foot or ankle injury it is always important to have this evaluated.

http://www.podiatrycarespecialists.com/