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Department of Orthopaedic Surgery
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Wednesday, 24 September 2014 14:02

Flip-flops and Feet

Flip-flops are some of the most comfortable and convenient kinds of shoes there are. They let you freely move your toes, aren't constrictive, and allow your feet to breathe. They can also be worn with almost any attire, and match most clothing styles. Unfortunately, wearing flip-flops can also be very dangerous. These sorts of shoes can harm your feet in more ways than you may think.

Although they are comfortable, constant flip-flop use can lead to problems with the ankles, hips, and lower back if worn on a long-term basis. This is because people walk much differently in flip-flops than they do in other shoes like sneakers. Their natural gait is being forced to change, throwing the body off and causing stress to different parts of the body. Flip-flops can also lead to problems in the arches of your feet, and pain in the balls of your feet. There is little to no support provided by flip-flops, so some parts of the foot undergo much more stress than normal.

Flip-flops can cause more obvious short term problems as well, like ankle sprains and frequent blisters. Because these shoes are relatively weak and can easily bend while walking, wearers are far more likely to trip and hurt their ankles. Flip-flops can also cause bad blisters, because their straps are constantly rubbing up against the foot. Additionally, someone wearing flip-flops is more prone to infections, due to the openness of the shoe. It very easy to scrape and cut your foot when wearing flip-flops because they offer little protection for the foot. If left untreated and uncovered, these same cuts can get dirtied and infected as flip-flops wearers walk around.

In order to avoid this, make sure to get a pair of flip-flops that will keep your feet as safe as possible. When looking to purchase flip-flops, you should check that the actual sole is sturdy and firm. The flip-flops are too floppy if the sole droops and wiggles a great deal when lifted off the floor. These will offer very little support, and may lead to other problems like tripping.

If you only purchase flip-flops made of high quality, sturdy materials, you won't have to worry about this. Although they will cost a little more, flip-flops made of these materials will last longer, and will protect your feet more so than a cheap pair of flip-flops. Also, make sure to buy from a reliable brand name. You can often find relatively cheap shoes from these companies, and once you have bought them you know they will last.

You can still wear your favorite flip-flops, just avoid wearing them every day of the week, or for extended periods of time. It is also recommended that you replace flip-flops every three or four months, in order to be sure that they provide maximum protection to your feet.

Tuesday, 16 September 2014 21:15

What is Gout?

Gout is a form of arthritis that is unusually painful. A slight touch can send shooting pain. The most common area for gout to occur is in the metatarsal phalangeal joint of the big toe. Other areas of the body frequently affected by gout are the knees, elbows, fingers, ankles and wrists. 
Gout occurs when there are elevated levels of uric acid in the blood. This condition is called hyperuricemia. Hyperuricemia is a genetically pre-disposed condition about 90% of the time and occurs because the kidneys do not produce the correct amount of uric acid. Children of parents who have had gout will have a 20% chance of developing it themselves. The excess uric acid in the blood forms crystals that deposit in between joints causing friction with movement. 

Symptoms of gout caused by this friction include pain, redness, swelling, and inflammation. Fever and fatigue may occur as well, although these symptoms are rare. The pain can be worse during the night when the body’s temperature lowers.

Gout can be diagnosed clinically by a doctor’s observation of the redness, swelling, and pain. More definitive tests can be performed by the doctor as well. Blood tests check for elevated uric acid levels in the blood. The synovial fluid in the joint can also be withdrawn through a needle to be checked for uric acid crystals. Chronic gout can be diagnosed by X-ray.

Treatment given for acute gout diminishes the symptoms. Non-steroid anti-inflammatory drugs such as Colchicine and other corticosteroid drugs will stop the swelling, redness, and inflammation in cases of acute gout. If gout becomes chronic, there are multiple ways to combat it. Lifestyle changes and changes in diet may be necessary, as well as preventative drugs. 

Gout can be aggravated by a sedentary lifestyle. Exercise will reduce probability of future cases of gout. Certain foods cause or increase the risk of gout and their consumption should be avoided or kept at a minimum. These foods include red meat, alcohol, sea foods, and drinks sweetened with fructose. 

Lifestyle changes and diet that help prevent gout include exercise and certain foods that help decrease the chance of gout recurring. Gout preventative foods include Vitamin C, coffee and some dairy products. New drugs have been discovered that inhibit the body’s production of certain enzymes. These are the enzymes that produce uric acid. Lowering your levels of uric acid will greatly reduce the chances of developing further cases of gout.

Tuesday, 02 September 2014 00:00

Ingrown Toenail Care

An ingrown toenail is caused when a toenail grows sideways into the bed of the nail, causing pain and swelling. Sometimes this can become infected causing drainage and may become serious.

There are many risk factors that can predispose a person to this common condition. Cutting your nails too short, participating in sports, diabetes, being overweight, or having a fungal infection of the toe can all cause ingrown toe nails. Many people are genetically prone to ingrown nails and it can often be related to genetics. Often the problem can come from wearing ill-fitting shoes, or even from shoes that keep the feet slightly damp.

There are some things that you can do to prevent and treat these painful problems. Letting your toe nails grow a little longer will help prevent this condition. If you do develop an ingrown nail, soaking the toe in hot water will help prevent infection and lessen pain. You may want to add antibiotic soap or Epsom salts to the water. This will help to prevent infection.

Some experts also recommend placing small pieces of cotton under the affected part. This will help the toenail to grow up instead into in your nail bed. Resting with your feet up can reduce swelling and redness.

If your pain is so severe that it keeps you from everyday activities, it is time to see your podiatrist. Also, if you see a red streak running up your leg, or if your infection is spreading, see a podiatrist immediately. There are many quick treatments that can lessen your pain and have you walking with comfort.
One method of treating an ingrown toenail involves using a Band-Aid. Wrapping the affected toe with a Band-Aid will prevent infection and also keep the nail from growing out at painful angles.

If your podiatrist feels it is necessary, he or she may make a small incision and remove part of your toe nail. Medication will be placed in the nail bed to prevent re-growth of the problem nail parts. This will be done under local anesthesia and should lessen your discomfort in no time. You will be advised to stay off your foot for a day or so, but can then carry on normal activities.

Take care of your feet; you have many steps to take in your life. Walking in comfort should be a priority for a lifetime of healthy living.

Monday, 25 August 2014 00:00

Treating Heel Pain with Shockwave Therapy

Heel pain shockwave therapy is a treatment option that helps to treat plantar fascia, which is a type of heel and foot inflammation that causes pain to the heel area. This type of injury is often caused by overworking and overusing the feet, and normally happens to people that exercise often such as runners, athletes, obese and overweight individuals, and individuals whose profession requires them to stand for long periods of time.

Since heel pain can be caused by a number of problems including poorly fitting shoes, exercise routines, work hazards, and many more, most plantar fascia treatments include very conservative techniques. Simple things like new shoes, taking ibuprofen, doing heel and foot exercises, and resting your feet can treat the problem. However, for the worst cases, using shockwave therapy is often the best treatment option.

For patients that have tried conventional treatment options, and failed at them, and who have been having heel pains for over six months, Shockwave treatment is often the next option. The concept behind this treatment is simple; shockwaves are generated from a device that delivers shockwaves to the outside of the patients body, and the shockwaves will cause the bodies repair mechanisms to work more efficiently and effectively, and in the end, start repairing the damage done to the heel area.

The goal of shockwave therapy is to eliminate the pain in the heel area, and this should happen because shockwaves trigger the body’s natural repair mechanisms. Basically, this therapy speeds up normal tissue healing in the body, and will also lead to a reduction in pain for the patient by working the pain transmission nerves located in the heel area.

The reason this treatment is gaining popularity is because it is less invasive than surgery, and eliminates the risk factors associated with surgery, such as anesthetic usage. Since this technique also works by helping the body to improve using natural healing techniques, the recovery time should be shorter than surgical processes.

This does not mean that there are not some discomfort issues that can arise out of this treatment for patients. Short term issues normally include skin bruising, minor pain during and after treatment, swelling of the heel, and discolored tissue. These side effects of shockwave therapy should be gone in a few days, giving the patient a fast recovery time which makes it easy to return to the routines of their daily life .

Like most types of treatments, surgeries, and medications, there are certain people that should not have shockwave therapy procedures performed on them. Potential patients with heart conditions and people with pacemakers should not be considered for this technique. People on certain types of medications, usually medications affecting blood clotting, would also be ineligible for this treatment option. And lastly, children and pregnant women should avoid this as well.

Overall, shockwave therapy could be a great option for heel pain because it is less invasive than surgery, helps to trigger the natural healing mechanisms of the body, and should be considered by people who have had long bouts of heel pain, who have tried conventional treatment options that failed, and who have the money to afford such a procedure.

Monday, 18 August 2014 00:00

Keeping Children's Feet Healthy

As a parent, your most important job is taking care of your children in every possible way. You watch what they eat, you protect them from harm, but it is important to be proactive in taking care of their health, especially when it comes to their feet. Having healthy, well taken care of feet in childhood is crucial in helping eliminate problems later in life, especially in the back and legs. As children grow, their feet require different types of care. Here are some ways you can help keep your children's feet healthy, from birth to school age.

Babies require a lot of care in general, but don't forget their feet. Since babies don't walk yet, their feet can be easy to overlook, but it is still important to take care of them. In the first year of life a baby's feet grow and change very much, so it is important that you do not put any tight shoes or socks on your baby's feet. Let your baby stretch and kick her feet so he or she can feel comfortable.

When a baby turns into a toddler, they are now on the move and it is important that your toddler has comfortable and protective shoes to walk in. Now is the time you may notice different things about your child's feet, but know that children at this age are just getting the feel for walking, so don't be alarmed if they seem to walk funny. It is normal for a toddler to be unsteady on their feet.

When your child gets older and leaves the toddler stage behind, it is now important that you teach them how to take care of their own feet. Show them proper cleaning and hygiene so that their feet do not develop fungus or infection. Since children are constantly running and playing, it is also important to watch out for injury or pain. Children are still growing, and certain injuries can effect the bones growth and development so it is vital to have all injuries checked by a doctor as soon as possible. Comfortable shoes that cushion the foot and provide protection from hours of rough play are highly recommended.

Children and babies are constantly growing and developing, and it is your job as a parent to make sure that nothing is hindering their ability to mature at a normal rate. This includes properly taking care of the feet, as healthy feet are important in order to live a normal, fulfilling life.

Monday, 11 August 2014 00:00

Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.

Monday, 04 August 2014 00:00

What is a Podiatrist

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery on lower extremity fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise and referrals will be made to specialists that handle the greater health problems.

Some podiatrists have their own solo small private practices or clinics where they have a small staff and administrative personnel but many work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals or visiting patients in nursing homes. They typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Some other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that result from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

Tuesday, 29 July 2014 14:23

All About Broken Ankles

Broken ankles are a very serious injury which, if not properly treated, can lead to continuous pain and an inability to walk. An ankle is made up of at least three major bones--the tibia, fibula, and talus. The tibia and fibula are the two bones that connect to your knees. They sit directly upon the talus bone, protected by a fibrous membrane that allows slight movement in our ankle joint. When the ankle is broken, it is because the foot rolled under or twisted too far, causing one or more of these three bones to break.

An ankle sprain occurs when ligaments are ripped or torn but no bones were broken. A sprain can be very severe, causing severe bruising of the foot and an inability to hold weight. In the case of broken ankles, the bones broken in this region could be numerous. If a person cannot stand their own weight on their ankle then it is most likely a broken ankle. The best thing to do if you suspect you have a broken ankle is to get an x-ray to determine the severity of the break immediately. The longer you wait to be diagnosed, the longer the healing process will take.

The most common cause of a broken ankle is when the foot has rolled over on itself, usually while engaged in exercise, physical activity, or sports. Another common cause is from a jump of great height. It is most important to seek medical treatment if one suspects they have broken ankles. A doctor can determine if surgery is needed in order to heal correctly. Without medical assistance after such an injury, a person may suffer severe arthritis and pain later in life. In some cases, an operation may be the only option to ensure the ability to walk properly again.

Broken ankles will cause severe pain. It will help to elevate the feet above your head to reduce blood flow to the injured area, as well as applying ice to the ankles to help decrease swelling. If surgery is required, it usually means an ankle cast for at least three months and then rehabilitation. Rehabilitation can be painful, using atrophied muscles and building tendon strength.

It is important to determine if surgery is needed as a broken ankle can become more severe than you realize. If not professionally treated, the broken ankle bones will inhibit your ability to walk properly.

Tuesday, 22 July 2014 15:54

Every Day Foot Care

Our feet are of great importance in our everyday lives. The problem is that we tend to neglect them. When this becomes a habit, it can cause significant trouble. Ignoring foot problems can mean pain, limited mobility, and expensive doctor's visits. On the other hand, if the feet are cared for and looked after each day, they will perform without pain or complication.

Routine hygiene is the most basic way to care for the feet. Wash and dry them thoroughly everyday. Remember to get between the toes, and keep the toenails trimmed and short. If the feet feel dry or one can see visual signs of dryness or cracking, use a moisturizer designed for the feet.

When using moisturizer on the feet, try to avoid applying between the toes. If creams or lotions sit in that area, they can cause development of fungi and bacteria. When moisturizer is used between the toes, it can also cause the skin to macerate.

Shoes are also an important aspect of foot care to consider. When one is picking out shoes, make sure that they are the correct size. Shoes need to be snug, but not too tight. On the other hand, if the shoes are too loose they can cause foot problems as well. It is highly recommended that shopping for new shoes be done later in the day. The reason for this is that the feet will have settled and swelled to their full size by then. To keep your feet at their most healthy, avoid wearing high heels or flip flops too often. Instead, choose shoes that are good for your feet, and that pad the soles of your feet and support the arches and ankles.

Socks should also be worn daily with closed-toe shoes. They may feel hot during the summer months, but they absorb sweat and moisture and keep it off the feet. Without socks, the build up of sweat in a closed-toe she can cause fungi problems and athlete's foot.

The best thing to remember in every day foot care is that shoes do make a difference. If you spend much time on your feet, make sure that your shoes show no signs of wear and offer ample support for the arches and the overall foot. Additionally, try to engage in thorough foot cleaning and maintenance a part of your daily routine. If you keep these things in mind, your feet will stay healthy and safe.

Monday, 14 July 2014 00:00

About Plantar Warts

The term plantar means relating to the foot, which is why plantar warts are only found on the feet. Plantar warts are caused by the human papillomavirus (HPV) getting into open wounds on the feet. These warts are recognizable by a hard bump on the foot. They are mostly found heels or on the balls of the feet. Plantar warts are basically harmless, and may be ignored unless they cause pain or embarrassment.

If you have a plantar wart you may notice some pain when standing, or just some tenderness on the sole of your foot. You will be able to see a fleshy wart, unless it has grown into the foot behind a callus. Since plantar warts are not cancerous and not dangerous, a podiatrist only needs to be seen if there is excess pain, the warts come back often or persist for some time, or if it affects walking. It is extremely important that people suffering from compromised immune systems or diabetes seek out a physician’s care immediately upon finding a plantar wart on their foot.

Doctors can usually easily diagnose plantar warts. The doctor will scrape off a tiny bit of the rough skin to make tiny blood clots visible that make up the inside of these warts. If the doctor is unsure of a diagnosis they may do a biopsy to be certain. Though plantar warts don't often call for treatment, there are many options for combating them if need be. They can be frozen using liquid nitrogen, removed using an electric tool or burned using laser treatment. For a less invasive treatment a topical cream can be used which is available only through a prescription. Over the counter wart medications may help, given enough time and patience.

If you prefer to use home remedies an apple cider vinegar soak is believed to help remove the wart. This treatment takes time. Soak your infected foot in the vinegar for 20 minutes before using a pumice stone to remove any loose skin from the wart. Keep the wart covered for protection in between daily treatments.

The best way to avoid contracting plantar warts is to avoid walking barefoot in public areas. This includes wearing shoes in public showers also. It is also important to avoid direct contact with warts, as they can be contagious. This means not touching your own warts, as well as those on others.

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Department of Orthopaedic Surgery
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