News You Can Use, 2010

With the growing popularity of marathon running, we are seeing more patients with stress fractures of the foot, especially in first time marathoners. Many times new runners enter a race with little or improper long-distance training. The lack of experience along with the repetitive impact placed on the feet during the run can produce enough stress to cause hairline breaks in the bones of your foot.

If you have started running or are entering your first marathon, we recommend you follow these guidelines to help prevent injury:

• Don’t increase your mileage or change to a more intense phase of training too quickly. The increased force placed on the bones in your feet make them more susceptible to stress fractures. A general rule of thumb is to increase your mileage by no more than 10 percent each week.
• Take adequate rest time between runs to decrease your risk of injury.
• Wear properly fitting shoes that provide adequate support to your feet.

If you suffer from abnormal mechanics in the foot, such as overpronation or hypermobility, custom orthotics can also help prevent injury. Stress fractures can occur anywhere in the foot and can eventually lead to a complete break of the bone if left untreated. The signs of a stress fracture can include pain, swelling, and redness and possible bruising. Contrary to popular belief, it is possible to walk on a foot with a fracture, so just because you’re able to walk does not mean there isn’t a more serious problem. Remember, early diagnosis and treatment are important to ensure proper healing. If you suspect a break, immediately follow the RICE protocol — Rest, Ice, Compression

It’s almost time to say goodbye to your sandals, slip-on shoes and bare feet of summer and hello to socks, shoes and boots. Our patients find that the change in shoes and season can bring unwanted foot problems, including:

Ingrown toenails

Ingrown toenails can result from wearing improperly-sized shoes. Trim your toenails as straight across as possible and wear shoes that are not tight around your toe area.

Toenail fungus

Fungus thrives in dark, moist, warm environments such as your shoes. Wearing the same shoes every day can promote fungal growth. Disinfect your shoes and wear different pairs to try to avoid fungus.

Neuroma flare-ups

Neuromas, or nerve pain, may be triggered by tight-fitting, enclosed shoes. Make sure your shoes provide enough room in the toe area to avoid tight-fitting areas and irritation.

Bunion, bone spur, hammertoe irritation

Constant rubbing on your feet from shoes can irritate any existing hammertoes, bunions or bone spurs. Wear socks and properly fitting shoes. Sometimes having your shoe stretched in the areas of irritation can also provide some relief.

If you’re experiencing discomfort from your seasonal shoe switch, schedule an appointment with our office.

Runners: Stress Fractures Can Slow You Down

Sandals to Shoes: Make Sure it’s a Comfortable Switch and Elevation. If pain and swelling last longer than a few days, a visit to our office is in order. In most cases, treatment includes rest and immobilization with casting of the foot. Surgery may be required in certain instances to repair and stabilize a stress fracture that has progressed into a full fracture.

This information was developed by the American College of Foot and Ankle Surgeons www.FootHealthFacts.org.

The holiday season will soon be upon us and it will be easy to forget about taking care of our health, especially the state of our feet. This can be a particularly serious problem for those with diabetes. In the season of festivities and celebrations, it is easy to indulge in food and drink, forgetting the all important diabetic diet. It’s essential for those with diabetes to remember to pay attention to their feet, no matter the season, to detect any potential problems.

During this busy time of year, we find ourselves walking more at the mall, dancing at parties, running extra errands — many times in dress shoes that aren’t worn very often. All these added activities can cause swelling and, in turn, friction between your feet and shoes. The friction can cause blisters, calluses or abrasions on your feet and can lead to diabetic ulcers and infection. This can be especially true if your body’s defenses are down due to elevated blood sugar levels from overindulgence of holiday cheer. Infections can spread quickly and may require hospitalization and possibly amputation of the toe, foot or leg if not properly cared for early.

Even diabetics who follow recommended guidelines during the holidays can suffer from the complications of diabetes and are still at risk for wounds in the feet. For that reason, it is extremely important that all diabetics inspect their feet daily and look for the following warning signs:

• Ingrown toenails that cut into the skin and that can cause infections
• Red, purple, gray or black areas on the feet that can be due to shoes that are too small, swollen feet, or fluid retention of the legs and feet
• Blisters caused by rubbing from shoes or seams in socks
• Calluses on the toes or bottom of the feet
• Skin with signs of dryness or cracking
• Sudden swelling and heat of one foot without obvious trauma

Give yourself the greatest gift of foot health this holiday season—if you detect a wound or any other irritation, don’t delay. Make an appointment with our office as soon as possible.

Care for Your Feet This Holiday Season

Patients with diabetes who receive medical and surgical care provided by a podiatrist are less likely to suffer hospitalization or amputation than patients who do not receive care from a podiatrist, according to a new study from Thomson Reuters. Thomson Reuters is an internationally respected research firm with expertise in the health-care market.

The study, sponsored by APMA, examined records for more than 32,000patients with Diabetes under 65 and matched health and risk factors for those who had podiatry visits to those who did not. Care by a podiatric physician, defined as at least one pre-ulcer visit, was associated with lower risk of hospitalization and amputation. James Wrobel, DPM, presented the results at the American Diabetes Association Scientific Sessions last month in Orlando, Florida.

“The dramatic results of the study demonstrate the important role of today’s podiatrist,” said APMA President Kathleen M. Stone, DPM. “As a profession, we make a significant impact on patient outcomes and health-care costs. As more diabetic patients receive high-quality medical care by podiatrists prior to developing ulcers, we will see even greater reductions in cost and improvements in patients’ quality of life.

This is the time of year that we tend to see as our recovery season. Recovery from the sedentary, over-eating, under active lifestyle that winter often demands. Now that winter with all its snow and ice, and frigid temperatures are behind us, it is time to get in shape!

Some of us will start walking, some running, some will take up tennis or get out the golf clubs. For students maybe it is track or soccer. For some it may be basketball or softball.  Whatever your sport there are some important considerations to avoid injury.

First it is important to know your individual limitations. If you are diabetic or have heart disease or hypertension, or other systemic conditions, it is extremely important to talk to your family doctor before beginning.

Second it is important to start at the right level for your current physical condition.  If you have not maintained your fitness level through the winter, as most of us are guilty of, you cannot expect to start this spring where you left off last fall.  If you used to walk 3 miles/week, for instance, you may want to start at 1/2 to 1 mile and increases each week or so by a half-mile until you reach your goal.  Runners are particularly guilty of this, eager to get out and hit the trails and roads without gradually working their way back to the desired mileage.  Injuries or overuse syndromes are common when you ask your body to do things it is not quite ready for.  Flexibility is another important part of sports that we neglect, not only when we start out, but even if we are actively exercising daily or several times each week.  It is important to stretch and maintain good range of motion, again to avoid injuries such as tendonitis and fasciitis.  It is best to warm up, stretch, then do your walk, run, etc, then do a cool-down stretch when finished.  Cold stretching, that is with no warm-up, also puts you at risk for injury.

Thirdly, use the proper shoe for the activity you intend to pursue.  If you have been in a store that sells athletic shoes recently, you may have been overwhelmed by the choices.  There are shoes for almost any exercise or sport you can imagine.  In most cases it is important to use the shoe that is labeled for your sport.  Those of us that are old enough can remember Red Ball Jets and PF Flyers.  Later came Converse, finally Nikes and all those that followed.  Until Nikes in the early 70’s most “sneakers” were pretty much the same. A little canvas with a rubber sole and little or no arch support.  How in the world did we even walk let alone run, in a shoe like that?  Now shoes are made for basketball, tennis, volleyball, soccer, walking, running, cross-training, aerobics, etc…. The big trend in shoe research started with  running shoes in the Nike era and hasn’t slowed down much since then. There are several very good quality brands of runners out there, and now there are even technical or mountain running shoes.  These are a favorite of climbers and those that run trails because of their improved traction, water resistance, lightweight, and of course their really cool looks.

When you choose your shoes for this spring’s activities go to a store where the salespersons are willing to fit you properly.  It is always helpful if you find a clerk that enjoys your sport and has knowledge of what it demands as well as how the different shoes compare.  On-line searches for the various shoe types makes it easy to do research from home or the library.  You can find articles comparing the various brands of shoes in categories such as price, durability, weight, shock absorption, cushioning, etc.  There are also many products that can enhance the shoes, such as insoles, arch supports, and custom orthotics – that are tailor made for you.

So, get out and get fit – but remember to be smart about the shoes you wear and the exercise you choose!