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Don’t Stress the Gate River Run

The excitement of the Gate River Run is building here on the First Coast as the largest 15K race in the US will once again serve as the race where America’s top Olympic athletes will compete for $85,000 in prize money.  Many athletes can experience foot pain when they do not properly train for races or when they compete in too many and the repetitiveness of running causes an “overuse injury”.  The one overuse injury seen in many runners is the stress fracture.

Stress fractures are small, painful cracks in bones that are most commonly caused by forces that are repetitively applied to the bone overtime. It is very common for runners and track and field athletes to have stress fractures because they are running long distances every day and are therefore having these stresses occurring more at the bones in their feet.  Stress fractures are also seen in people who start a new work out program and do too much too quickly.  Another common reason in which stress fractures occur are because of osteoporotic bone, most commonly seen in the elderly and females.  Osteoporosis is a weakening of the bone, therefore making bones more susceptible to breaking.  Osteoporosis can be detected by a simple bone scan that can be done in the office.

At first, stress fractures may not be too bothersome, but they tend to get worse overtime.  Some ways to tell that you have a stress fracture include: increase in pain and swelling with activity, decreased pain and swelling with decreased activity, pain in a specific area, and pain that gets worse overtime.  After having a stress fracture for a long period of time, the pain may be chronic and/or get worse, so it is important to try and detect it early.  Many times the later you catch it the more difficult it is to treat, as well as taking longer to heal.  After a podiatric examination of the foot, the way to confirm that you have a stress fracture is to get an x-ray or MRI.  The mainstay of treatment for stress fractures is by immobilizing the foot, which is most commonly done by having the patient wear a removable CAM boot in which most cases they are still able to walk.

Here at First Coast Foot Clinic we treat stress fractures on a daily basis. Whether you’re a runner, have started a new workout program, or just have foot pain in general, make an appointment today to make sure you do not have a stress fracture.  Remember that they start out minimally painful, or sometimes even without symptoms so it is good to catch it early for the most effective treatment.

The Hand-Shake: A Sweaty Situation?

So many important moments in life are sealed with a hand-shake, and simultaneously we are judged by this same action.  The shake can initially be a stressful social necessity, due to the technique of how much strength use, and for how long, but many have an added concern…  how sweaty will it be.

Hands and feet, like the rest of your body, sweat but some feet sweat a lot more.  Extremely sweaty feet can affect any age, generally runs in families, and is called hyperhidrosis.  It is not always known why this occurs, but is the result of sweat glands secreting an excessive amount of sweat, and not just in response to increased temperatures, but also to stress and emotional situations.  This often occurs body-wide, but is more noticeable on the feet and hands due to the glands being more dense there.  Though this condition is not generally a concern to your health, it can be very embarrassing and cause social withdrawal from situations in which the feet are bare or close to other people, such as at a spa or swimming pool.

There are many options for treating and living with this condition.  Investing in good socks that will absorb the sweat away from your skin and wearing a clean pair daily is a good place to start.  Choose shoes that are well ventilated and allow the shoes to air out over night before wearing them again.  Antiperspirant can be applied directly to the foot to decreased the secretion of sweat, and if this does not affect them enough there are several creams and sprays, both over the counter and prescription, that are more powerful and can help manage the condition, but will not cure it.  Several other treatments, such as iontophoresis and oral medications have been shown to actually treat or correct the condition.  If all else fails, the possibility of a surgical treatment, called a sympathectomy, may be an option, but generally only if all other options have failed.

If excessively sweaty feet is a concern for you, First Coast Foot & Ankle Cliniccan help.  Make an appointment today.  Dr. Reddywill rule out more serious causes for the excessive sweating, discuss what treatment is best for you, and get you headed to a drier tomorrow.

All shoes Are Not Created Equal

air-jordan-2011-dominate-another-day-rocket-shoes-video-commercial-600x338The 26.2 with Donna marathon runners had some stiff competition last weekend with Tesfaye Girmafrom Ethiopia finishing the race with a record time of 2:15:40. Most of us can only dream of running a marathon in that time or opt for rocket boosters on our shoes to do so.   When running in these races it is very important to have the right type of shoe.  When buying athletic shoes, may people are more worried about getting a particular brand name, or a style that is “in” or looks “cool”, than they are about whether or not the shoe actually fits their foot and is comfortable.  The truth is that all of these can be accomplished simultaneously if the correct considerations and evaluations are taken prior to shoe shopping.  These considerations are especially important in an active person, or athlete searching for the best athletic shoes.  To many people, shoe styles and materials may look the same, but all shoes are not created equal.

The first thing that anyone shopping for shoes should consider is what size they need, in length and in width.  This can be accomplished with a Brannock foot measuring device,available at many shoe stores.   This device has different measurements for both males and females, and not only measures the overall length and width of the entire foot, but also measures the arch length, the length from the heel to the ball of the foot.  This is important because shoes are designed to flex at the ball of the foot, and properly positioning the ball of the foot in the shoe can prevent toe crowding, pressure, and the general uncomfortable nature of an ill-fitting shoe.

Feet should be measured at the end of the day, after they have endured all of the day’s stresses and impact acting on them.  A proper fitting shoe should leave around a quarter inch between your longest toe and the end of the shoe.  If one size feels too small and the next size up feels too large, either try a different brand of shoe or choose the larger size.  Shoes that are too small or constricting can cause injury to the toes such as calluses, contractures, bruising, loss of the toenail, bunions, and can predispose toenails to nail fungus, called onychomycosis.

The best way to ensure that you get an athletic shoe that fits properly and is the perfect fit for your foot is to make an appointment with a podiatrist.  Here at First Coast Foot and Ankle Clinic, Dr. Reddy can evaluate your foot type to help you pick the right shoe for your foot.  He can also dispense items that help with shoe fit and function such as orthotics that are worn in shoes. Regardless of whether you decide to make an appointment before purchasing your new shoes, or bring them with you after, we look forward to helping you find that perfect fit.

Running Pains: The Injury Report for Metatarsalgia

The Northeast is still recovering from blizzard Nemo, but in Florida February is the start to beautiful weather.  Many runners are starting the race seasonby training hard and putting many miles on their sneakers.  As with a more intense training schedule common ball of foot pain can rear its ugly head. If these pains include a sharp burning or discomfort in the ball of your foot and get worse when you stand or walk, you may be experiencing metatarsalgia.

Metatarsalgia can include a wide range of pains focusing around the area between your arch and your toes. Folks often incorrectly refer to these symptoms as a “stone bruise.”  You may have a tingling or numbness in your toes, or a pain that seems to spread from the ball of your foot into your toes.  This can be caused by a variety of factors from the wrong footwear, to putting excess stress or weight on the metatarsals, as well as either an increased or strenuous activity schedule.  This causes inflammation and pain most commonly around the ball at the base of the first and second toes although others may also be involved.  Other risk factors include high arch, hammertoe, bunion, excess body weight, stress fractures and Morton’s neuroma.

Untitled-1This condition, though it can be extremely painful, is generally not serious and easy to treat.  Untreated, the pain can negatively affect many activities due to the increased pain when walking, and can lead to more serious pains in your knees, hips, and back.  To rule out more serious reasons for the pain, you should be seen by a podiatrist who can confirm the diagnosis as well as discuss the treatment options.

Treatments vary depending on the severity and the individuals activity level and original cause of the condition.  Significant pain relief can be obtained by many by resting and icing the painful area, and ensuring a proper fitting shoe. Many continue pain free with the assistance of custom orthoticsarch supports, or insoles.  For more severe and persistent pains that are not relieved by conservative therapy, surgery may be required for resolution.

Don’t let pain keep you from crossing the finish line this weekend at the 26.2 with Donna.  Call First Coast Foot and Ankle Clinicat 904-739-9129 or go online to make an appointment today.

The Road to Super Bowl XLVII

superbowl-1Unfortunately for Jacksonville football fans, the Jaguars did not make the postseason this year, however everyone should still be excited to watch the upcoming super bowl.  Throughout the long 17 week NFL regular season, and the 4 weeks of playoffs thereafter, the player’s bodies are exposed to non-stop, repetitive, strenuous activity that can put strain on muscles, tendons, ligaments and bones, the foot being no exception.  One of the most common chronic injuries to the feet of NFL players and older athletes are big toe joint injuries.  Some can be career altering such as the case with Deion Sanders when he was forced to retire from a “turf toe”injury in 2000.

Turf toe results from hyperextension of the big toe joint as the heel is raised off the ground.  An external force is place on the big toe and soft tissues that support the big toe on top are torn or ruptured.  In sports, especially football,a player whose foot is planted on the ground with the heel in the air is subjected to a force on the back of the foot thereby hyperextending the first MTP joint. The injury usually happens when a football player’s cleat is engaged with the turf and another player lands on the back of the heel.

There are also other conditions of the big toe joint that result out of abnormal wear and tear. Hallux limitus is a condition in which there is a significantly decreased amount of motion in the joint of the great toe, whereas in hallux rigidus there is no motion available at the great toe.  The diagnosis of Hallux Limitus can be made based on physical exam and x-rays that can be done here at the First Coast Foot and Ankle Clinic.

Hallux limitus can usually be treated conservatively in the office.  The first line of treatment would be functional foot orthotics that are to be worn in shoes.  These orthotics can provide a stiff surface for the inside of the foot and limit the pain associated with the decreased motion at the great toe joint.  The shoes can also be stretched so that no pressure or rubbing occurs around the joint.  In some more severe cases, surgery may be the best option to completely alleviate pain, and realign the joint.

It does not take the amount of activity or training that an NFL player has to endure to develop big toe joint problems, and is also quite common in the normal population.  If you are experience pain in that area, or want to prevent future problems, make an appointment today.

Common Exercising Injuries

images[5]It’s a couple weeks into 2013 and many people are still very dedicated to their new year’s resolution of weight loss or a healthier lifestyle.  Some of these new exercisers are filling the gyms or enjoying the jogging paths in their new, hopefully perfectly fitted, athletic shoes, while still others are starting to develop pains and injuries.  There are many common injuries associated with running and new exercise routines, many treatable at home, while others require a visit to your podiatrist.

Many new exercisers start out in a very high intensity routine, almost guaranteeing themselves an injury from overuse.  The constant repetition of contraction and release of muscles that many exercises require can lead to muscle tears or ruptures.  Injuries can occur in all body parts including the knee, shin, ankle, and foot.

Pains that occur in the knee are commonly called runners knee and are caused by the foot rolling inward too much, called excessive pronation.  This can be treated and prevented by custom orthotics which can be prescribed by a podiatrist.  Orthotics can also be an effective treatment for another common injury that presents with a painful ache on the front and medial side of the leg caused by inflamed muscles, called shin splints.

heel pain

The left image shows a foot with a healthy arch: the plantar fascia is relaxed. The right image shows a flattened arch: the plantar fascia is stretched tight with inflammation at it’s heel attachment.

The foot can experience many different injuries from overuse.  A pain in the heel of the foot, called plantar fasciitis, is often caused by stress on the bottom of the foot.  This can be caused by excessive pronation, poor fitting shoes, and overtraining.  Heel pain can also be caused from pain and tightness in the large muscles of the leg from repetitive rising up on the toes that leads to achilles tendon inflammation and pain at the back of the heel.

Another common overtraining injury is a stress fracture.  This happens because of repetitive forces from the ground and body being applied to the bones in the foot.  This temporarily weakens the bone and without proper time to recover, commonly seen with overuse, the bone will eventually fracture. This could stop your activity altogether for 4-8 weeks wiping out the work you’ve done previously.

 Make an appointment with First Coast Foot and Ankle Clinic and let us help keep your new exercise routine going strong, and your feel feeling great.

Solution to Heel Pain After Too Much Holiday Shopping

007 ShopperIt’s finally cooling off in Jacksonville, FL, Thanksgiving has past and the Holiday Season is officially upon us, leaving many running for Black Friday and Cyber Monday deals.  While running is great cardio, it may not be so great for your feet due to obnoxious heel pain, also known as plantar fasciitis. From the weekend recreational runner, to professional athletes, and holiday shoppers making their way through the St. John’s Town Center or The Avenues Mall, heel pain is unbiased.

  • Where does plantar fasciitis cause pain? In the arch and heel of the foot.
  • Early stages: the pain is most severe when stepping down the first time in the morning and improves with walking.
  • As the condition progresses pain becomes present throughout the day – and can be quite disabling.
  • How do I get plantar fasciitis?  Inflammation of the large ligament running from the heel across the bottom of the foot to the ball of the foot.  The inflammation is caused by “overuse” of the ligament, which causes injury and tearing of some of the ligament fibers.

007 Heel PainThe kicker to this painful problem is it doesn’t generally hurt while exercising but exercising will make it worse, and there will be no relief until you allow a period of rest. There are several treatment options for plantar fasciitis.  Conservative treatments for heel pain include:

  1. Getting rid of inflammation by icing and stretching: As with any treatment plan, stretching techniques will be suggested and can be combined with icing to alleviate some of the discomfort by rolling/stretching your foot over a frozen water bottle.
  2. Anti-inflammatory: Always consult your physician before taking any medication, and to confirm that the condition is plantar fasciitis.
  3. Correct fitting shoes paired with custom orthotics:can help keep the pain at bay

For many people with mild or moderate plantar fasciitis these methods alone will bring relief.  Unfortunately for some cases of persistent or severe plantar fasciitis, a more direct treatment plan will be needed.

If you’re currently suffering from plantar fasciitis symptoms and other treatments have not been effective, you may be a good candidate for a non-invasive procedure called Extracorporeal Pulse Activation Technology, or EPAT.  EPAT was initially used to treat kidney stones before being approved for several musculoskeletal disorders, including plantar fasciitis.

How does it work?  EPAT works through pressure waves increasing the circulation and metabolism to an area, speeding up the healing process.  It offers more intense results to persistent pain without the risk and recovery time associated with surgery.   EPAT is not needed for every patient, but those who are candidates have experienced great results.

If you or someone you know is suffering from severe heel pain come see us at First Coast Foot and Ankle Clinic to get your feet free of pain.

November: Diabetes Awareness Month

010 awareness-monthNovember is Diabetes Awareness Month, and for many people feet are the last thing they think of when they hear the word diabetes.

Diabetic patients are at a higher risk of developing foot problems than those without diabetes, due to nerve damage and poor circulation associated with the disease.  60-70% of diabetics experience damage to nerves that diminish the pain sensation, this is called neuropathy.  The idea of less pain sounds great, but without normal pain sensation we become less aware when we injure ourselves.  Injuries such as scratches, blisters or sores can lead to an infection and if gone unnoticed become very serious.

Diabetics also have a lower immune system as well as decreases blood flow, thus significantly slowing the healing process.  Therefore an infection in a diabetic patient is much more serious than that of a non-diabetic because of the body’s ability to fight off the infection is weakened.  Due to a lower immune system and decreased blood flow, this once simple skin wound can spread to underlying muscle, and even into bone.  Infection in bone is called osteomyelitis and is a very serious condition that can quickly lead to loss of the toe, foot, or possibly the limb.

Due to the serious consequences that can come from even the smallest scratch in a patient with diabetes, it is recommended diabetic patients be seen by a podiatrist at least once a year. This significantly decreases the chances of small cuts or nicks going unnoticed and progressing into more serious situations.  This can and will save you unnecessary pain as well as money.  Even a minor injury to a diabetic patient is an emergency, and it is highly recommended to visit your podiatrist immediately if you experience any injury to your foot.

Together_187_StackedList of recommendations for keeping diabetic feet healthy:

  • Wash and fully dry feet daily making sure to inspect them for any injuries or nail problems
  • Be sure to inspect between the toes
  • Wear supportive shoes that fully cover the toes as well as the heel, even when around the house
  • Do not self-treat your calluses
  • Elevate your feel while sitting to increase circulation

The key to keeping a diabetic foot healthy is prevention and early detection.  If you or someone you know is diabetic and does not have a podiatrist please contact First Coast Foot & Ankle Clinic.

Flat Feet Forever?

Lots has happen this month on the First Coast; The successful 2012 Southern Women’s Show, Zac Brown Band performing at Veterans Memorial, The Jacksonville Beach Sea and Sky Spectacular, Florida vs. Georgia and lets not forget Halloween 2012!  With all the different events that happened in Jacksonville this October, parents had enough to worry about, but there children’s flat feet does not have to be one of them.

Many parents express concern about the appearance of their children’s feet at a young age.  Children under three years old have many bones that are not fully formed.  This lack of support can give the appearance of a flat foot.  Children may also appear pigeon-toed or walk on the inside of their foot; both can be normal in the very young.

Flat feet, also called pes plannus, can be flexible or rigid.

  • Flexible flatfoot: The foot is flat when the child is weight-bearing, but appears normal when child is non-weight-bearing.
  • Rigid flatfoot: The foot will appear flat, regardless of the child’s position, whether weight-bearing or not.

 

Sometimes flat foot can cause pain in areas other than the feet.  The child may have pain in their ankle, knee, or even hip by changing the way they walk because of their flat feet. Due to the pain and weakness parents may see a decrease in the activity of their child. If you suspect this is happening your child should be evaluated by a podiatrist.  However, with young children, the flexible flatfoot is much more common and generally not something to be too concerned with if it is not bothering them.

If an older child that is closer to skeletal maturity still has a flat foot, then you may want to consider having them wear an orthotic in their shoes.Professionally fitted Orthotics that are placed in the shoe help control the foot’s motion and place it in its proper alignment.  The orthotics also help with common symptoms and deformitiesseen with flat foot including:

  • Pain
  • Weakness
  • Bunions
  • Toe deformities

Getting the foot in correct alignment now can help avoid more serious conditions later on in life. Custom orthotics are the easiest way to prevent problems associated with flat foot and increase walking comfort.

Addressing flat feet today can prevent more serious complications, as the child gets older.  For more information on what’s normal, and what’s not or if you have questions about how First Coast Foot and Ankle Clinic can custom fit you or your child’s feet for orthotics, visit our website or contact us today.

Retired Jacksonville Jaguar Fred Taylor Inducted into the Pride of the Jaguars

Despite the Jacksonville Jaguars losing to the Cincinnati Bengals at last Sunday’s game there was a silver lining for First Coast fans.  The official NFL referees are back and Fred Taylor was inducted into the Pride of Jaguars during halftime!  But the last thing any football fan, team, or coach needs at this point in the season is their star football players being injured.  Steve Smith, the veteran wide receiver for the Carolina Panthers missed practice earlier in the season due to an infection in his left foot.  Fortunately Smith was able to play in the season opener against the Tampa Bay Buccaneers.

How the foot infection came about still remains a mystery, but there are numerous ways for a foot to become infected, from bacterial to fungal.  Anytime you have an open lesion or a possible opening to the skin such as a blister, or even a bug bite, the wound can become swarmed with bacteria and cause an infection.  Ingrown toenails can also commonly become infected.  Signs of infection include:

  • Redness
  • Swelling
  • Pain
  • Drainage
  • Warmth
  • Foul odor

This is especially important for diabetic patients due to the fact that diabetes is a systemic disease which predisposes these patients to infection.  It is crucial that the diabetic patient perform daily foot checks to make sure that they do not have a new wound.  Something of equal importance is to make sure the web-spaces between the toes is dry, since wet, web-spaces can also be a portal of entry to infection.

At First Coast Foot and Ankle Clinic, we see many diabetic patients for routine foot checks every three months, as well as treat a multitude of painful ingrown toenails that can potentially lead to infection.  Not only do we prevent the infection, but we can also treat it by prescribing antibiotics to rid your body of those pesky bacteria.

If you or someone you know may be suffering from a possible infection request an appointment today to see what Dr. Vimal Reddy can do for you.