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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.

Burning, tingling pain? Numbness in your feet?

Neuropathy can be moderate pain that includes burning, shooting, and stabbing pains to severe pain that includes sensory loss, reduced thermal sensation, and late complications such as ulcers. At least 60% of patients with diabetes have some degree of neuropathy. Diabetes makes your blood sugar level higher than normal. These high blood sugar levels can damage nerves in the body.

The most important thing you can do for yourself is keep your blood sugar as closely controlled as possible and get regular exercise and keep your weight under control. It is the numbness in your feet that can increase your risk for ulceration and amputation, not the pain itself.

There are options to control your neuropathy and not only diabetic are affected. Call today for a consultation on how to treat the burning, tingling and shooting pain in your feet.

Are you exercising in the wrong foot gear?

Athletic footwear should be fitted to hold the foot in the position that’s most natural to the movement involved. Athletic shoes protect your feet from stresses encountered in a given sport and to give the player more traction. The differences in design and variations in material, weight, lacing characteristics, and other factors among athletic shoes are meant to protect the areas of the feet that encounter the most stress.

 

Well-fitted athletic shoes need to be comfortable, yet well-constructed and appropriate for a given activity. A good fit will mitigate blisters and other skin irritations.

 

Sports-specific athletic shoes are a good investment for serious athletes, though perhaps a less critical consideration for non-athletes. Don’t wear any sport or other shoes beyond their useful life.

 

A running shoe is built to take impact, while a tennis shoe is made to give relatively more support, and permit sudden stops and turns. Cross training shoes are fine for a general athletic shoe, such as for physical education classes or health club exercising, such as on stair machines and weight-lifting because they provide more lateral support and less flexibility than running shoes. They also tend to be heavier than running shoes, but most people don’t need light, flexible shoes for cross-training. If a child is involved more heavily in any single sport, he or she should wear shoes specifically designed for that sport.

 

Our practice recommends sturdy, properly fitted athletic shoes of proper width with leather or canvas uppers, soles that are flexible (but only at the ball of the foot), cushioning, arch supports, and room for your toes. Try a well-cushioned sock for reinforcement, preferably one with acrylic fiber content so that some perspiration moisture is “wicked” away.

 

Athletic shoes need to be replaced after one year, whether or not they are worn, and after a certain amount of repetitive load is placed on them and wears them down. The American Academy of Podiatric Sports Medicine advises replacing running or walking shoes after 300 to 500 miles of wear, and replacing aerobic, basketball, and tennis shoes after 45 to 60 hours of wear. Athletic shoes should also be replaced if they show signs of unevenness when placed on a flat surface, display noticeable creasing, and/or when the heel counter breaks down.

Common Nail Problems

Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Sometimes, the bruise can lead to a fungal nail infection.

 

Treatment may include trimming the nail back and applying a topical antifungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied.

 

Diabetic patients should contact our office for evaluation if they experience any change in the color of toenails The pressure causing the bruised nail may lead to a small sore under the toenail, which can lead to infection.

 

Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.

In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

Ingrown toenails can be prevented by:

  • Trimming toenails straight across with no rounded corners.
  • Ensuring that shoes and socks are not too tight.
  • Keeping feet clean at all times.Many people don’t realize they have a fungal nail problem and, therefore, don’t seek treatment. Yet, fungal toenail infections are a common foot health problem and can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish. Left untreated, however, it can present serious problems.

    Also referred to as onychomycosis, fungal nails are infections underneath the surface of the nail, which may also penetrate the nail. Fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate, which ultimately can lead to difficulty and pain when walking or running. Symptoms may include discoloration, brittleness, loosening, thickening, or crumbling of the nail.

    A group of fungi, called dermophytes, easily attack the nail and thrive on keratin, the nail’s protein substance. In some cases, when these tiny organisms take hold, the nail may become thicker, yellowish-brown, or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.

    Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s Foot or excessive perspiration.

    You can prevent fungal nail infections by taking these simple precautions:

    • Exercise proper hygiene and regularly inspect your feet and toes.
    • Keep your feet clean and dry.
    • Wear shower shoes in public facilities whenever possible.
    • Clip nails straight across so that the nail does not extend beyond the tip of the toe.
    • Use a quality foot powder (talcum, not cornstarch) in conjunction with shoes that fit well and are made of materials that breathe.
    • Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active lifestyles.
    • Disinfect home pedicure tools and don’t apply polish to nails suspected of infection.

    Depending on the type of infection you have, over-the-counter liquid antifungal agents may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed, a process called debridementNote: Please consult your physician before taking any medications.

    In severe cases, surgical treatment may be required to remove the infected nail. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured and prevents the return of a deformed nail.

Stay in Motion

Having heel pain, Achilles tendinitis, or other common foot problems can often slow you down. There are many treatments that are effective in taking care of these aches and pains such as orthotics, physical therapy, stretching, and even cortisone injections. However, when other treatments fail to get you back on your feet there is EPAT (Extracorporeal Pulse Activation Therapy). EPAT is the most advanced and highly effective non-invasive treatment method approved by the FDA. It is performed in our office in as little as 15 minutes and generally 3 treatments are necessary at weekly intervals. The benefits include returning to your work/normal routine within 24-48 hours after the procedure, cost effective, patients are immediately fully weight bearing, and bilateral patients can be treated at the same time. The expected results are often experienced after only 3 treatments but may take up to four weeks for pain relief to begin.

Diabetes And Your Feet

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can lead to a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When a wound is not healing, is at risk for infection and infections spread quickly in diabetics.

 

When a diabetic foot becomes numb, it may be at risk for deformity. One way this happens is through ulcers. Small, unattended cuts become open sores, which may then become infected. Another way is the bone condition CharcotFoot. This is one of the most serious foot problems diabetics face. It warps the shape of the foot when bones fracture and disintegrate, and yet, because of numbness there is no pain, and the individual continues to walk on the foot. Our practice can treat diabetic foot ulcers and early phases of Charcot (pronounced “sharko”) fractures using a total contact cast and prevent more serious damage or deformity. This treatment allows the ulcer to heal by distributing weight and relieving pressure. For Charcot Foot, the cast controls foot movement and supports its contours

 

If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail discoloration. Get someone to help you, or use a mirror.

Here’s some basic advice for taking care of diabetic feet:

  • Always keep your feet warm.
  • Don’t get your feet wet in snow or rain.
  • Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
  • Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don’t soak your feet.
  • Don’t use antiseptic solutions (such as iodine or salicylic acid) or over-the-counter treatments for corns or calluses.
  • Don’t use any tape or sticky products, such as corn plasters, on your feet. They can rip your skin.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office for treatment.
  • Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a “breaking-in” period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time.
  • Don’t wear the same pair of shoes everyday. Inspect the inside of each shoe looking for foreign objects, protruding nails, or any rough spots inside before putting them on. Don’t lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day and always wear socks with shoes. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops or garters.
  • Never wear sandals or thongs (flip-flops) and never go barefoot, indoors or out.
  • In the winter, wear warm socks and protective outer footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
  • Don’t file down, remove, or shave off corns or calluses yourself.

Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.

Coming soon.

Do you need orthotics?

Your feet are the foundations of your body and then they are out of alignment, excess strain is being placed on your joints. Many of the aches, pains and injuries common to exercising can gradually be eliminated with the proper orthotic support.

Those who benefit from orthoics are many including people with plantar fasciitis, flat feet, and high arches. Plantar Fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone.

Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Flat feet are a common condition of the foot structure. Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.

Orthotics that are custom made support and realign the body to gently lift the arch into its proper position. Custom orthoics are available in our office and even some insurances cover the cost. If you are experiencing any foot pain or the above mentioned problems please call to make an appointment today.

Restore Your Natural Foot Alignment

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Understanding the basic construction of shoes will help you make more informed decisions and select shoes that fit your foot and needs.

 

Shoes are made up of five major components:

  • The toe box is the tip of the shoe that provides space for the toes. Toe boxes are generally rounded, pointed, or squared and will determine the amount of space provided for the toes.
  • The vamp is the upper middle part of the shoe where the laces are commonly placed. Sometimes Velcro is used instead of laces.
  • The sole consists of an insole and an outsole. The insole is inside the shoe; the outsole contacts the ground. The softer the sole, the greater the shoe’s ability to absorb shock.
  • The heel is the bottom part of the rear of the shoe that provides elevation. The higher the heel, the greater the pressure on the front of the foot.
  • The last is the part of the shoe that curves in slightly near the arch of the foot to conform to the average foot shape. This curve enables you to tell the right shoe from the left.

The material from which a shoe is made can affect fit and comfort. Softer materials decrease the amount of pressure the shoe places on the foot. Stiff materials can cause blisters. A counter may be used to stiffen the material around the heel and give added support to the foot.

 

The NEW Spring collection of sandals from Orthaheel are in both for Men and Women. Come in today and pick out a new pair to start off your season right!

Welcome to Our Blog!

Whether you are an existing patient or searching for a podiatrist in the Jacksonville area, we’re excited you are here. With the podiatry industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.

As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle. Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from Dr. Reddy and his/her staff.

We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.

As always, feel free to contact us with any questions or concerns.

— The First Coast Foot and Ankle Clinic Team