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How to Keep Your Feet and Ankles Safe All Summer Long

How to Keep Your Feet and Ankles Safe All Summer LongWith Memorial Day behind you, summer may not officially be here on the calendar, but practically speaking it’s in full swing. And here in Texas, we’ve had summer-like weather for some time now.

Being active outdoors, it’s easy to forget how to care for your feet. And before you know it, you can find yourself twisting an ankle.

Make sure you follow these tips so you don’t find yourself stuck inside icing your feet and ankles instead of enjoying the outdoors:

  1. How to Choose Flip-Flops

You don’t have to get too particular when you look for flip-flops. But you do need to make sure they’re sturdy.

Test the pairs you’re considering by attempting to fold them in half. If you can do that, don’t buy that pair.

Why? Your foot fatigues faster when your sandals or flip-flops don’t provide the arch support you need. Your tendons will feel sore because you’re straining them to support the rest of your foot. This can lead to inflammation and injury to your plantar fascia, the tissue that runs from the ball of your foot to your heel.

  1. Consider Adding Support to Your Foot When You Wear Flip-Flops and Sandals

When you wear flip-flops, you naturally put downward pressure on the arch of your foot. In turn, that can lead to additional stress on your knees, hip, and lower back. And not surprisingly, this can lead to pain and inflammation in those areas of your body. Flip-flops may also lead to you taking shorter steps, which can place even more stress on your knees, ankles, hips, and back.

Consider wearing extra padding. Only wear your flip-flops or sandals for walking short distances. And maybe break them in before you wear them by stretching the material by hand.

  1. Quick Tip for Diabetics

As a diabetic, you may have reduced sensation in your feet. Or, you may have lost your sensation entirely. Some doctors have seen diabetic patients who have a rock lodged in their foot or between their toes and don’t even know it. This reduced feeling can also lead to blisters, cuts, and bruises resulting from sandal straps or flip-flop use. Your foot can also become awkwardly positioned as you walk, putting you at risk for twisting your ankle or even breaking a bone.

If you’re diabetic, make sure you examine your feet after every time you walk in sandals or flip-flops.

Have Fun This Summer

People don’t get outside as much these days. So don’t let the possible dangers of sandals or flip-flops discourage you. Have fun outside as you enjoy more quality time with your family.

Cycling Shoe Tips for Safe Summer Cycling Fun

Biking’s supposed to be fun, but injuries can quickly put an end to that. And bike injuries can be quite severe.

How do you keep your feet and ankles safe when you’re riding your bike this summer? Follow the tips below:

  1. Footwear Safety

Sandals and flip-flops just don’t offer your feet much protection. Avoid wearing them while you’re biking. They also leave the tops of your feet exposed, which can lead to sunburns. You likely won’t remember to put sunscreen on the tops of your feet (on your first few rides anyway).

You can get special sport sandals that do work for biking. But even better is special cycling shoes, or at least your running or walking shoes.

  1. General Footwear Selection Tips

Because biking’s exploded so much in popularity in recent years, you have nearly infinite choices when it comes to footwear. You can get biking shoes specifically designed for riding on the road, off-road purposes, or just for cruising around in the city.

Shoes designed for riding on the road aren’t also designed for walking. So, wear them when you’re on your bike only. Mountain biking shoes are designed for walking, so you can walk in them without causing any damage or jeopardizing the safety of your feet.

The shoes you choose should fit comfortably. Your arch should feel snug and supported, but your heel shouldn’t slip up or down. Your heel may slip a little while walking, so you’ll have to determine whether this is because of a poor fit or the stiffness of the soles.

  1. Care and Maintenance

If the cleats of your biking shoes slip off your pedals unexpectedly, they need replacement. You’ll also need to replace them if you notice they’re cracked or broken.

If you’re a frequent rider, you may need to change your cleats each year. If you’re the more casual type, your cleats can last up to 5 years. If you have to replace your cleats, you typically only have one choice designed to match your pedal type. Bring them along with you or take a picture with your phone so you can easily find the proper replacement fit.

Enjoy Riding This Summer

When you make your footwear a priority, summer cycling stays fun and safe. And you avoid any unexpected trips to the doctor or emergency room.

So have a fun summer – and remember to always examine cycling shoes before you ride.

Common Causes and Treatments for Ingrown Toenails

Keryflex Before and AfterWhat’s more painful and bothersome than an ingrown toenail? If you’re the active type, and maybe even if you’re not, they cause a significant amount of distress and irritation. It seems like all you can think about is that annoying ingrown toenail.

Fortunately, you can significantly reduce your chances of getting one. And, you can speed up your recovery time in the event your toenail becomes ingrown.

First, Start with the General Causes of In-Grown Toenails

One of the most common causes is rounding the edges when you cut your toenails. It’s easily prevented. Simply cut your toenails straight across.

And believe it or not, people do bite their toenails. Yes, this is serious. As a podiatrist, I can tell you this from experience. It’s a tough habit to break if you’ve been in it for some time. Consider a “nibble inhibitor” (awful-tasting liquid) to help break you of this habit.

Some people cut their toenails too short. You should never experience pain when trimming your toenails. It likely means you’ve cut into the pulp of your toe, or the nailbed. Your toenail should come out ahead of your toe pad after trimming.

Pedicurists can make mistakes too. If they put an acrylic overlay on your toenails, this may change the shape of your nail so it grows into your toe.

Keryflex

Traumas that Cause Ingrown Toenails

Any kicking sport, like kickball or soccer, can cause ingrown toenails. Surprisingly, it’s not the kicking that causes the ingrown toenail. It’s either improper trimming or the downward force of running and quick sprinting that causes this. Allow your toenails to remain grown beyond the toe pad on both sides of the nail.

Another pedicure injury is infection of the skin around your toenails (paronychia). Bacteria and yeast can cause this type of infection.

Finally, any traumatic injury to your toes can lead to an ingrown toenail. For example, if you move heavy objects and drop one on your toe.

Fungal Causes of Ingrown Toenails

When toenail fungus takes control, it can deform your nail and lead to an ingrown toenail. A topical antifungal, oral medication, or laser nail treatment (with the painless Noveon Laser, for example) can be used to cure this. Nail avulsion (removal of the nail from its primary attachments) or chemical or surgical destruction of your nail may also be required.

A Genetic Cause of Ingrown Toenails

Pincer nail deformity is a relatively rare, genetically inherited condition. The sides of your nails curve way more than they should, which compresses the nailbed and underlying skin. It can also cause your toenails to become ingrown.

General Treatment Procedure for Ingrown Toenails

You already learned some specific procedures for taking care of ingrown toenails. The general treatment procedure in most cases will be as follows:

  • Soak your foot in warm-water Epsom salts 10 minutes daily
  • Use oral or topical antibiotics if you have an infection
  • Partial nail avulsion (removal) with chemical matrixectomy (burning your nail root with phenol)

The treatment depends on the conditions of your ingrown toenail. Regardless, you know how to avoid ingrown toenails in most cases so you don’t have to experience any unnecessary pain.

How to Keep Your Feet Safe at the Beach This Summer

Warm beach weather is coming soon. But, don’t forget the safety of your feet! Beer bottles, aluminum cans, and all sorts of other clutter routinely get left on the beach.

That can spell disaster for your feet. And it could even be worse if you already have diabetes or an immune system compromised by other health conditions.

How do you keep your feet safe at the beach so you don’t find yourself making an unexpected trip to the emergency room, or to your podiatrist? Follow the simple tips below:

This is What You Should Wear on Your Feet

You may want to wear sandals to the beach. Who wouldn’t? But, there’s a slight problem with them. First, broken glass or other trash laying around the beach can easily get between your sandal and your foot.

Second, hot sand can get under your feet. This doesn’t sound like a big deal at first. But when the temperature gets really hot, the sand can get warm enough to cause first or second degree burns.

To get the best protection, use an old or cheap pair of closed shoes (like sneakers). Yes, they may get a little damp. But you can simply remove the insole and let it dry overnight.

If you’re worried about fungus and bacteria, you can get antifungal/antibacterial spray to eliminate that threat (we carry Clarus shoe spray for this).

As an alternative, you might also wear waterproof “water sock” shoes.

Yes, Your Feet Need Sunscreen Too

Nothing’s more painful than an intense sunburn on your neck and shoulders. It makes it difficult for you to sleep at night. And it’s hard to get comfortable just about anywhere until your sunburn heals.

But don’t forget your feet! They can get sunburned too. In addition, this likely reduces your risk to get carcinoma and melanoma, according to recent research.

Make Sure Your Tetanus Shot is Up To Date

Have you had your Tetanus booster shot within the past 10 years? Simply check with your primary care physician(s) if you’re not sure.

If you do get a puncture wound when you’re at the beach, clean it immediately with soap, water, and an antiseptic. Cover the wound with a bandage, and stay out of both fresh and ocean water.

You’re wise to seek medical attention immediately after stepping on any kind of foreign material. You should be doubly concerned about doing this if you’re diabetic or have a compromised immune system. You can get a staph or strep infection from such an incident, and that can lead to loss of your limb, or even become life-threatening.

Now You Can Enjoy the Beach This Summer

Going to the beach has a few risks. Armed with this new knowledge, your afternoon of fun doesn’t have to turn into a medical nightmare.

Keep it in mind when you go to the beach. You never know when it might save the day for you or your loved one.

What To Do If You’re At Risk for Charcot Foot

How do I know if I have Charcot Foot?

Charcot neuropathic osteoarthropathy (CN) commonly referred to as the Charcot foot; is a condition affecting the bones, joints, and soft tissues of the foot and ankle, characterized by uncontrolled inflammation in the earliest phase.

This inflammation leads to increased blood flow and bone absorption that is indirectly responsible for the progressive fracture and dislocation of the foot leading to severe deformity and loss of function. The hallmark deformity associated with this condition is midfoot collapse, described as a “rocker-bottom” foot, although the condition appears in other joints and with other presentations.

The Charcot foot has been documented to occur as a consequence of various peripheral neuropathies; however, diabetic neuropathy has become the most common etiology.

Charcot foot usually only happens alongside a case of neuropathy. Due to nerve damage, you don’t feel the pain of the initial injury, so you continue to walk and make the problem worse.

Since those with severe neuropathy can’t rely on pain to identify an early case, you’ll need to carefully monitor your feet for the early warning signs, including:

  • Skin that is red or warm to touch (compared to the opposite foot).
  • Swelling of the foot despite the lack of an obvious initial injury
  • Pain and discomfort may be present, depending on your level of sensation in the lower extremities.

If you have diabetes and neuropathy and detect any or all of these warning signs, don’t take any unnecessary risks. A simple X-ray and other clinical findings by an experienced foot and ankle specialist can confirm if there has been any damage to the underlying bone. The best treatment initially is to be off-loaded in a cast while the condition takes its course. This will help preserve the integrity of the foot and prevent further complications that may result in ulceration, bone infection, surgery or loss of limb.

Cryotherapy: Healthy or Hype?

You may have heard some of the public chatter recently about “cryotherapy.” But here’s the problem: there’s absolutely zero scientific proof it works.

For what it’s worth, some celebrities, like Lindsay Lohan, believe it works. But, that doesn’t mean you should believe in it at all.

What is Cryotherapy? How Does It Theoretically Work?

Cryotherapy seems somewhat futuristic. You’ve seen it used in science fiction movies to freeze bodies so they don’t age and wake up years in the future.

This kind of cryotherapy uses localized freezing temperatures to deaden an irritated nerve. A probe gets inserted into the soft tissue next to the nerve. The probe’s temperature drops quickly to freeze the nerve. This freezing inactivates the nerve, and in theory, ends the pain. Supposedly, it helps the affected area of your body recover faster from the pain too.

Athletes use it to increase performance prior to a contest, and to aid quicker recovery afterwards. Regular people use it to alleviate the pain of soft tissue injuries, like ankle sprains.

Cryotherapy Sounds Cool, But There’s No Scientific Evidence Which Supports That It Works

One study by Tricia Hubbard and Craig Denegar was a study of studies, and it found unreliable evidence to support cryotherapy’s effectiveness (at best). They identified 55 articles claiming that cryotherapy worked for the patients involved, but only 22 were eligible for study because subjects were randomly assigned and the study’s conditions were clinically controlled. Both those criteria help assert the reliability of the study’s results.

Briefly, the PEDro scale was used to study the methodological quality of these studies. It’s been proven by researchers to be a reliable scale for doing so. If you’re interested, you can look at all the criteria the scale evaluates, and what the scale looks for in each criterion here.

You can score from 0 to 10, with 10 being the best possible score.  The study by Hubbard and Denegar found an average score of 3.4 on the 22 articles evaluated. You don’t have to be an experienced researched to understand that’s low.

Articles evaluated featured a wide range of injuries. Just five studies gave adequate information on the subjects’ baseline data. No studies kept therapists blind from the subjects they treated. Just one blinded subjects. Keeping both therapists and subjects blind (not knowing information about the study to reduce bias and increase objective measurement of results) needs to happen to have reliable study results.

Does Cryotherapy Work? At This Point, It’s Not Clear

Right now, you’ll hear celebrities and superstar athletes trumpeting the benefits of cryotherapy. But there’s no proof it works.

Who knows? They might be getting paid by the clinics who offer the services. When you think about it, cryotherapy seems cool. It’s new and different. That kind of thing sells.

But just know that at this point, research doesn’t conclusively support that it works.

The 3 Most Important Things to Know About Pediatric Bunions

You normally think of bunions as something middle-aged people have. But, they affect children and teens too. Surprisingly, podiatrists see a surprising number of parents concerned with bunions their children have.

The first thing to know is that bunions are not normal in children. While they may argue they don’t want to deal with them so they can wear certain shoes or don’t look stupid in front of their friends, bunions cause a significant amount of pain in children and need to be addressed immediately. This prevents increased pain and discomfort, as well as reducing the potential for surgery.

  1. How Bunions in Children Differ From Those in Adults

By itself, a “bunion” refers to a bony prominence near your big toe. What differs between adults and children is the structural cause of the bunion.

In adults, a bunion forms because of structural misalignment in the big toe. For children, however, the bones point in too much or the big toe joint’s cartilage has shifted. Children typically have bunions as a result of genetics.

  1. Symptoms of Bunions in Children

Early on, bunions show no obvious symptoms in children. However, symptoms do progress. Eventually, you may hear your child complain about having a hard time finding shoes that fit. They may have swelling near the base of their big toe. The big toe joint may be loose or floppy, or the same may happen with their ligaments.

  1. How Bunions in Children Get Treated

In most cases, podiatrists will recommend children try non-surgical options for bunion treatment first. Toe splints may be used at night to push the big toe back into its proper position. Supportive shoe gear or orthotics may be recommended. An advantage children have is that their bones are malleable and respond to these kinds of treatments.

However, surgery may eventually become necessary if none of these treatments succeed. It may also be used if the bunion has been noticed in its later stages. Podiatrists will only recommend surgery if your child is experiencing significant pain and has no other options. They won’t suggest surgery as an alternative simply to improve the look of your child’s foot. Typically, girls’ skeletons are mature and can handle bunion surgery between 13-15, while boys can do the same at 15-17.

Unfortunately, bunions have a high rate of recurrence, even after surgery. This can be minimized when contributing factors to the bunion are controlled. And, postponing surgery until skeletal maturity happens helps to reduce the rate of recurrence.

What You Need to Know about Puncture Wounds To Your Feet

Ever step on a nail, or other sharp object? Has anyone in your family ever experienced a puncture wound to one of their feet?

Accidents happen, and sometimes they involve great pain. However, many puncture wounds are much more serious than patients believe at first. In fact, some can turn into serious conditions that threaten limb loss, or even loss of life, to patients in certain populations.

How worried should you be if you experience a puncture wound? Many patients choose to see a podiatrist because they can’t remember the last time they had a tetanus shot. If your puncture wound doesn’t appear to heal, and instead worsens, you should definitely seek treatment immediately. Not doing so risks loss of your limb due to infection, or possibly even loss of your life.

What Affects The Seriousness of a Puncture Wound?

Most puncture wounds, in and of themselves, are not of grave concern. Some cat scratches are no big deal. Even stepping on a nail, while painful, isn’t a huge problem.

But you still should have them addressed promptly to reduce your further risk of injury. Imagine, for a second, that you’re an elderly diabetic who gets scratched by a cat. Or, maybe your wound suddenly worsens because you’ve gotten cellulitis (a bacterial infection that attacks the deeper layers of your skin).

If you find yourself, or a loved one, in a situation where you have a puncture wound that’s worsening, it’s important to have this information available for your podiatrist:

  1. Original date of injury
  2. Current medications and allergies
  3. Your entire health history
  4. The type of penetrating object
  5. Type of shoes worn
  6. The area where the injury occurred
  7. Date of last tetanus vaccine

Possible Treatments for Puncture Wounds

The main concern with puncture wounds is to seek evaluation and treatment immediately. Most puncture wounds heal relatively quickly and should only include moderate pain and discomfort, with appropriate treatment. Left unattended, they can dramatically worsen, leading to severe systemic infection.

X-rays, MRIs, ultrasounds, or CT scans can be used to detect the foreign objects or materials located in the puncture area. A white blood cell count or metabolic panel may be taken to determine the presence or absence of infection.

If there’s no signs of a foreign object in your foot, and your wound is small, saline cleansing and a sterile dressing are about all that’s necessary for treatment. Incision and drainage is necessary if a wound is deep, is contaminated, or if treatment has been delayed. Antibiotics may be administered to patients at risk of developing infections, if they have delayed treatment, or if they have an obviously contaminated wound.

The Faster You Seek Treatment for Puncture Wounds to Your Feet, The Better

Basically, if you experience a puncture wound, see your podiatrist as soon as possible. The worst that can happen is that you get aggressive treatment so you don’t risk losing your limb – or life. The best that can happen is you learn you only need cleaning and dressing of your wound.

New Cartiva SCI Treatment Relieves Big Toe Joint Pain Without Disruption to Your Daily Routine

Hallux rigidus describes a condition where your big toe becomes painful and stiff. This is due to arthritis. For disorders that affect your big toe, it’s the second most common overall (behind bunions), while it’s the most common arthritic condition affecting your big toe.

To date, experts aren’t quite sure why the condition appears in some people and not others. In medical language, this is called the first metatarsophalangeal (MTP) joint.

Until now, joint replacements have had limited success at best. Typically, patients have gotten:

  1. Total joint replacements
  2. Hemiarthroplasties (replacement of the joint’s surface with metal or polyethylene plastics)

Generally, patients want to be able to continue to wear their favorite shoes and perform their favorite activities like normal. However, the two procedures you just learned about will loosen, wear, or lose range of motion, making wearing preferred shoe wear uncomfortable and painful. Patients also commonly lose their ability to participate in their favorite physical activities.

Cartiva SCI Provides the New Solution to Big Toe Joint Pain, Stiffness, and Arthritis

What is Cartiva SCI?

First, you need to understand that you have cartilage lining the bony surface of your big toe joint. It’s actually called “articular cartilage,” and it’s smooth and white.

Cartiva SCI is a “Synthetic Cartilage Implant.” Traditional methods remove the damaged cartilage around your toe and a combination of pins, screws, and a plate keep your big toe joint fixed in a certain position. Eventually, the bone grows back together. While it eliminates pain and arthritis, it does so at the expense of moving your big toe. You may have your favorite daily activities restricted or some of them completely eliminated altogether as a result.

With Cartiva SCI, you get an implant made from polyvinyl alcohol (PVA). PVA has actually been used in a variety of medical devices for more than two decades now. Cartiva SCI actually mimics how natural cartilage works in your big toe.

Why Use Cartiva SCI?

We currently recommend Cartiva SCI for big toe arthritis, stiffness, and pain because it:

  • Relieves the pain without restricting the mobility of your big toe joint
  • Allows you to do the daily activities and wear the shoes you want
  • Has a quick recovery period
  • Hasn’t been found to cause any additional irritation to your big toe joint
  • Has no risk of transmitting a viral or bacterial disease
  • Does not degrade

In other words, you’ll experience less pain, have a fuller and faster recovery, and you’ll be back to doing your normal daily activities that you’ve always enjoyed. In our opinion, it’s the best current treatment option for big toe joint arthritis, pain, and stiffness.

Should You Seek Surgery or Conservative Treatment for an Achilles Tendon Rupture?

Pain in achilles-tendon

You have one of the most painful injuries possible: an achilles tendon rupture. Frequently, it happens to middle-aged men who engage in inconsistent rigorous exercise. They often describe the pain as someone “kicking them.”

Regardless of how it happens, an achilles tendon rupture causes intense pain and has a months-long recovery.

But what’s the best way to get better from it? Should you have surgery done? What does the research suggest?

  1. What One Study Found

One study examined a total of 144 patients. 72 were treated operatively, and 72 non-operatively. 118 were male and 26 were female, with the average age being about 40.

2 patients in the operative group reruptured their achilles. 3 patients did so in the non-operative group. 13 patients had complications in the operative group. Just six had complications in the non-operative group. The groups did not have any significant difference in their strength or range of motion.

So in simple language, there was no huge difference in surgical versus non-surgical treatment in this study.

The study was published in 2010 by Kevin Willis and others in The Journal of Bone & Joint Surgery.

  1. Another Study Analyze 800 Patients in Other Studies, and Found This

This study was also published in The Journal of Bone & Joint Surgery, and is accurate as of 2008.

It analyzed 800 patients from 12 other studies. It found open operative treatment had a lower risk of rerupture versus nonoperative treatment. However, it did have some risks of additional complications not found with nonoperative treatment. Those risks included infection, adhesions, and disturbed skin sensibility. Various nonoperative treatments were studied, but the sample studied was so small that no definitive conclusions could be made.

The bottom line that the study found was that operative treatment done percutaneously (where the inner tissue is not exposed) greatly reduces the possibility of rerupture. However, the tradeoff is that you have a much higher risk of other complications.

You Have a Decision to Make

For now, you have a decision you have to make together with your doctor. Would you rather risk rerupture or more minor complications?

This is the best medical technology allows at this point, so every answer is up to you the individual.