Tag Archives: first coast foot and ankle clinic

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.

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.

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.

Is Your Middle School Superstar Benched with Heel Pain?

003 heel_pain_in_childrenAs summer comes to an end and fall season’s start, many parents face unexpected injuries to their favorite players.  I’m not talking about the Jacksonville Jaguars, though their O-line has its fair share of injuries, I’m referring to our middle school super-stars.  These young athletes seem to have grown a foot over summer, return to the school sports and are benched by heel pain.

A feeling of tightness throughout the foot and pain, specifically in the heel, can be caused from the bones of the foot growing faster than the muscles and ligaments.  The heel ossifies (turns into bone) later that the other foot bones, so children that play sports (most commonly soccer or basketball) and are very active are more likely to develop pain here.  The pain is caused from a repeated stress, such as running or jumping, on the growth plate in the heel, and is a sign of Sever’s disease.

Sever’s disease, medically called Calcaneal Apophysitis, is an inflammation caused by stress on the growth plate in the heel and is very common in children.  The pain is generally worse after physical activity, and commonly located on the side or back of the heel.  This is unlike another common condition, plantar fasciitis, which is worse after long periods of inactivity.  Sever’s will go away on its own in most children, but it may take a while.  There are several simple options we can offer to confirm the diagnosis, eliminate the pain and shorten recovery so kids don’t miss the fall sports season.  A fracture of the heel has very similar symptoms so if the pain is chronic, or does not subside with conservative treatments it should definitely be looked at by a podiatrist.

003 seversWe at First Coast Foot and Ankle Cliniccan offer several options for treating and preventing Sever’s disease.  Children’s arch supportsare recommended for those who have not yet experienced the severe pain, but are at risk because of their participation in sports or high activity level.  Children’s arch supports are commercially available or can be custom fitted by us and will fit into athletic shoes or cleats. It is also important to choose an athletic shoe that supports the child’s arch since it is still developing.

Heel cushions can be a good option for children already experiencing the heel pain.  Icing for 20-30 minutes after strenuous activity and stretching exercises for the calf muscles will help alleviate the pain and decrease the chance of it returning.  Temporarily decreasing the activity level, specifically activities that include jumping or running, may also be required in order to let the area heal.

Let us help heal your pain, make an appointment to get your kid back in the game.

Jacksonville Jaguars Offensive Line Suffer from Ankle Injuries

005a Jag InjuryFirst Coast Foot and Ankle Clinic could not be more excited that football season has begun! But already three of the Jacksonville Jaguars offensive line starters are wearing protective boots on their left ankles following the overtime loss to the Minnesota Vikings on Sunday.

  • Left guard Eben Britton suffered an ankle injury and was out for the remaining of the game
  • Uche Nwaneri also suffered an ankle injury
  • Right tackle Cameron Bradfield suffered a leg injury

In this one game, there have been more injuries to the lower extremities than any other and Coach Mike Mularkey is starting to wonder if it might have been a turf issue. “It’s the most foot injuries I’ve ever been around,” Mularkey said. “Foot, ankle, you think about the number of linemen we have lost with it, it’s just unheard of. I don’t know if it’s bad luck. I am putting a little research out there with some of the turf teams if they’re experiencing the same kind of issues we are with our ankles and feet. We have had an unbelievable number of injuries to that part of the body. More than I’ve ever been around.”

So what will happen this Sunday when the Jags hit Everbank Field to take on the Houston Texans?  Even with a ranking of 32nd in the NFL in total offense and all these injuries the offensive line is still showing signs of improvement.

September is National P.A.D Month: Are You At Risk?

004 PAD_picBetween the changing of seasons bringing cooler temperatures, and events such as the 2012 First Coast Heart Walk, and Northeast Florida Beer Cup approaching, September is shaping up to be an exciting month in Jacksonville.

September is also P.A.D awareness month.  P.A.D stands for Peripheral Arterial Disease and currently affects around 8 million Americans.  People with PAD are at significantly increased risk for stroke and heart attack.  If caught early P.A.D is preventable and can be easily treated.

P.A.D occurs when arteries in the legs become clogged or blocked by fat deposits and cholesterol that stick to and accumulate on the walls of the artery. The more narrow and hard the artery is, the harder it is for blood to pass through, leading to decreased blood flow to the legs and feet that can result in a number of symptoms.

These symptoms include:  

  • Painful cramping in the legs while walking
  • Heaviness
  • Numbness and/or weakness of the lower extremity

Symptoms that occur later in the disease include: 

  • Pain or burning in the feet or toes while resting
  • Coolness and color changes of the skin
  • Loss of hair
  • Wounds of the feet or toes that do not heal

Risk factors include: 

  • Smoking
  • Hypertension
  • High cholesterol
  • Obesity
  • Sedentary lifestyle
  • Age greater than 50
  • Diabetes

Here at First Coast Foot Clinic, we use the reliable, non-invasive Ankle-Brachial Index (ABI) to test for P.A.D.  Blood pressures are taken on both the arm and the ankle, and are compared to each other.  The ankle blood pressure should be about the same as the arm blood pressure, in which normal values are 0.95-1.2.  If it is below this, a patient will be tested further for P.A.D.

Sometimes P.A.D can show no symptoms at all, so it is important to get tested if you are at risk.  So while you are enjoying the Northeast Florida Beer Cup, be aware of what puts you at risk and remember you can always walk off those extra beer calories at the First Coast Heart Walk and keep your lifestyle active.  September is going to be a great month here in Jacksonville, but try to stay aware of P.A.D and catch it early.

Don’t Hide Ugly, Thick, Discolored Toenails…. Treat Them!

002 Toe FungusIt’s hard to believe the 2012 Summer Olympics are over, the school year has started in Jacksonville, FL and Football Season is upon us. Although fall is right around the corner, we are still feeling summer temperature’s here on the First Coast, leaving many still showing off their toes in flip-flops or sandals.  For some this can be embarrassing if you have thick, yellow, cracking, brittle nails, which can be painful and hard to treat, could be fungus.  Nail polish can disguise the discoloration, but regular polish can also lock in the fungus, making it worse. Summer is more fun if you’re fungus free!

Toenail fungus, called onychomycosis, can start as a yellowing of the toenail but progress into a painful, thick nail with a foul odor.  Fungus thrives in hot, humid environments, making it an extremely common condition in Florida.  This contagious infection can be spread easily in moist environments such as public swimming pools, and gyms and can be difficult to get rid of.

It can be difficult to get rid of toenail fungus and recurrence is high, but a podiatristcan give you options that have the highest success with the particular kind of fungus you have:

  • Topical nonprescription creams
  • Oral Medications, which can have side effects
  • Surgical removal of the nail
  • Laser Therapy

First Coast Foot and Ankle Clinic makes sure to offer the most effective treatments available, from anti-fungal nail polish, to the most up-to date treatment tools.

002 rednailACurrently the Pinpointe FootLaser is one of the most effective treatments for nail fungus.  The procedure is quick, painless and does not have to be repeated.  The laser is able to go through the nail and destroy the fungus under it while leaving all other tissue unharmed.  The laser offers effective treatment without the side effects and prolonged treatments of many of the medications currently used, and without the pain and recovery associated with surgical removal of the nail.

The First Coast Foot and Ankle Clinics’ Four steps to Fabulous Fungus Free Feet:

  1. Rid yourself of any current fungus: Let us PinPointe the problem for you!
  2. Keep feet dry: Dry cotton socks and ventilated shoes are a good choice
  3. Don’t share: Tools such as nail clippers or files, and clothing can spread fungus
  4. Wear shoes in public facilities: showers, gyms and public pools

If you or someone you know may possibly be suffering from toenail fungus, request an appointment today to see what Dr. Vimal Reddy can do for you.