Trench Foot

If you’ve ever watched a movie about World War I, you’ve likely heard the term “trench foot” before. The term refers to a condition of the foot when it has been immersed in cold water for a long time, which was commonly associated with the trench warfare of World War I. The term has carried over from its historical roots into the medical books, and is considered its own diagnosis.

When the foot is exposed to a cold and wet environment, there is a change in circulation that occurs, particularly in the feet. This change is the body’s attempt to conserve heat, and move the blood out of the foot. In a shorter amount of time, this reaction allows the warm blood to stay in the core of the body, keeping the vital organs warm. However, under prolonged exposure to the elements, the change in circulation causes problems with the small arteries of the foot.

The small arteries of the foot may become permanently damaged following the inflammatory reaction that is seen in trench foot. This can lead to problems like large blisters forming on the feet and gangrene, or tissue death in the foot.

Most cases of trench foot seen today are not from trench warfare, but they are from similar circumstances involving prolonged exposure to a cold and damp environment. Hikers, hunters, and other who spend a lot of time outdoors are the most prone to the condition. If you enjoy these activities, or are often exposed to similar conditions, there are some steps you can take to keep your feet healthy.

In wet conditions, be sure to wear boots or another type of waterproofed footwear. This will help keep your feet dry, and avoid trench foot as well as other problems with your feet. Materials like Gore-Tex are good for keeping the water out of your shoes, as well as allowing your feet to breath. Look for a pair of boots with Gore-Tex or a similar material.

When the weather is cold, be sure to wear the right socks. Cotton socks have a tendency to keep moisture up against your feet, making them wet and cold for a long time. Try socks made of wool or synthetic materials that will help wick the moisture away from your feet. This will keep them dry and warmer.

You can also experiment with different thicknesses of sock. Hiking socks and other types of socks come in all different weights for different weather conditions. Trench foot can happen in water as warm as 60 degrees, so keep that in mind when you’re stomping through the muck.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Health Reform Update 10/13/09

On Tuesday, the Finance Committee passed its long anticipated bill for health care reform. The bill passed with a vote of 14-9. Of the fourteen affirmative votes, 13 were from Democrats in the committee, and one was from Sen. Olympia Snowe (R-Maine).

The Finance committee’s version of the bill is the least generous in terms of subsidies for working- and middle-class Americans, and it does not carry the public option that has been proposed by other committees in congress. Nevertheless, it is a massive step towards the final health care reform bill, a bill whose progress has been defined by stalemate and postponement.

The bill does require nearly everyone to have health insurance, and provides financial subsidies for those who cannot afford coverage. It also bans insurance companies the right to deny coverage to those with preexisting conditions. The bill is estimated to cost $829 billion over ten years, which will be paid for by taxes, fees, and reductions in Medicare costs.

Though the bill has passed through the Finance committee, it marks the non-bipartisan nature of the issue. With the exception of Sen. Snowe, the bill was passed with only Democratic support. Republicans stand strong in their position, clinging to the idea that a health reform bill only brings the government into the people’s health insurance.

Another version of the pending legislation, drafted by the Senate Health, Education, Labor and Pensions Committee was approved this summer. Now that the Finance Committee has approved its version of the bill, the final draft may be ready to be debated in front of the full Senate later this month. There, support for the legislation looks good.

What is excluded from the legislation, however, is the public option that was supported heavily by some Democrats. The bill will not include a public option when presented to the full Senate.

President Obama praised the efforts of committee members, particularly Sen. Snowe for her courage in going against Republican members in the committee. He pointed out that the bill is not perfect, but it is a start in the right direction. This seems to be a common sentiment among Democrats.

The next several weeks should be telling for the final draft of the Senate health reform bill. As the bill goes to the full Senate, it will be presented to a group of 60 Democrats and 40 Republicans. Though not all Democrats are on board with the public option, 60 votes is what it would take to add this stipulation to the final bill. Regardless of whether or not the public option is added to the bill, there is strong support for the bill in the Senate, and it is very likely that the bill will be passed.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Soda Tax for Obesity?

The obesity epidemic is raging. Roughly one in three adults have a Body Mass Index (BMI) of over 30, which is the medical definition of obesity. Obesity in children is increasing at an alarming rate. Over 17% of children ages 12-19 are obese, up from 5% in the late 1970’s. The statistics show that Americans are becoming more obese and a faster rate, which leads to an array of health problems, from high cholesterol and increased heart disease to an increased incidence of type-2 diabetes.

Many ideas have been explored to combat this trend – national health awareness programs and education is a start, though some more drastic ideas have been proposed. One of these ideas is the soda tax.

Studies have shown that the number one link between childhood obesity and diet is the consumption of sugar-sweetened beverages. These include items such as soda that have added sucrose, high-fructose corn syrup, and other artificial sweeteners.

The proposed tax of a penny-per-ounce on these beverages would be used to offset the health costs associated with obesity-related disease. Supporters of the bill claim that the tax would help deter people from drinking so much soda, and promote the consumption of water and milk among children.

However, opposition to the plan is great. Beverage companies and lobbyists are obviously not behind the idea, stating that it would unfairly hurt sales. They point out that soda is not the only thing in the American diet that causes obesity, and it would be unfair to single them out.

The proposed tax of a penny-per-ounce would increase prices, particularly in packaging of larger quantities. A 2-liter bottle of soda, which on average is priced at about $1.35, would go up $2.02 with the penny-per-ounce tax. A 12-pack of soda, with an average cost of $3.20, would go up 45% to $4.64.

This may seem like a huge increase in prices, but consider this: the average cost of a half-gallon of orange juice is still $3.50. That means that even with the tax it would still be cheaper to buy soda.

So where does that leave us? If the law was passed for a penny-per-ounce or similar tax on sugary soda, would consumers switch to another beverage? And let's not forget diet soda. Would the tax include these beverages as well?

As of now, the proposed soda tax is not included in the health reform bill, nor is it expected to be. President Obama has not pushed for this, though members of the Centers for Disease Control and Prevention have urged for it. Other health groups like the American Dietetic Association have also shown support for the idea.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Health Care Reform Update

In a speech on Wednesday night to both the Senate and House of Representatives, President Barack Obama addressed the current state of health care reform, and the bill that could very well become the President’s defining piece of legislation.

“I am not the first President to take up this cause, but I am determined to be the last” he said to a rousing applause and a standing ovation.

Obama laid out the main goals of the health care reform bill, as well as debunked some of the myths, rumors, and misrepresentations of the bill that have been circulating for the past several months. The main goals of the legislation are to increase stability and security of the coverage to those who are already indured, to provide those without health insurance coverage, and to help slow the rising costs of health care.

For those who are currently covered, nothing in the plan will force them to change their health insurance provider, or change their current health care plan. What will change is that it will be illegal for health insurance companies to deny coverage to individuals with a preexisting condition. It will also be illegal for health insurance companies to drop coverage for people when they get sick, as well as outlaw caps that are placed on coverage for a year or lifetime term. A cap will be placed, however, on the out-of-pocket expenses incurred on the behalf of the patient. As Obama puts it, “No one should go broke because they get sick”.

The second piece of the plan is to provide insurance to those who do not currently have any insurance. This is where the public option comes in to play. For a large group to seek health insurance, they have more leverage in a market when shopping for plans. It is for this reason that large companies are able to get insurance for their employees at lower rates, and the same economics can be applied to a public option.

For those who can’t afford the public option, tax credits will be available. The President also emphasized the fact that no one will be forced to take the public option – it is simply available for those who choose it.

The third aspect of the bill is to help slow the growth of health care costs. In order to make this a possibility, it will be required of all people to carry health insurance. The reason for this is that when someone gets sick and they do not have health insurance, their medical costs are paid for by those who do have insurance. In other words, the cost of the uninsured is currently built in to the costs for those with insurance. This is a vicious cycle, and it can be stopped by making everyone carry some insurance.

In order to ensure that all Americans have coverage, all employers that can afford to do so will be made to provide health insurance to their employees, or at least help them with the cost. This is more applicable to large businesses that are currently not providing their employees with coverage. Small businesses that cannot afford to provide coverage to their employees will be exempt from this law. This represents roughly 95% of all small business that will be exempt.

Circulating rumors were also addressed by President Obama, most notably the rumor that Medicare spending would be changed and benefits would be lost. This, the President said, is untrue. Not a dollar, he said, would come out of the money that is set aside for the Medicare program.

To see the full speech with a transcript, click here.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Office Exercise

Having trouble finding time in the day for exercise? Are you so busy at work that going to the gym seems impossible? Try working out in your office building!

· Taking the stairs is one easy way to burn extra calories during the workday, and it will keep you alert, too. Climbing stairs for 30 minutes can burn over 300 calories. Walking up and down stairs for 30 minutes can be pretty hard work, so keep this in mind if you plan on doing it all at once. You’ll need a good pair of shoes, too, to avoid tripping on the stairs and fatigue.

· Park far away from the door. This will give you an extra few minutes of walking every time you need to go from the door of the building to your car. If it’s an extra five minutes, this could possibly amount to twenty minutes over the course of the day (once in the morning, twice at lunch time, and once at the end of the day).

· Leave something important in your car, like a document or a briefcase. This can add another ten minutes of walking if you’ve parked five minutes away from the door.

· If you have the capability to do so, set an alarm to go off every hour. When the alarm goes off, stand up, stretch, and walk around for a couple of minutes.

· If you can, sit on an exercise ball instead of a chair. This will force you to work your core muscles all day long while you are sitting.

· If you have your own office, you can leave a few pieces of exercise equipment in the office. Try some light dumbbells, resistance bands, or ankle weights. Take a quick break, or use them while you are on the phone.

· You can also get a headset for your phone, and walk around while talking.

· Use a pedometer and track how many steps you take in a day. Aim for at least 6,000. You can set a goal for 10,000, and track your progress in a notebook.

· Use a bathroom that’s on a different floor. Take the stairs to get to the floor, and take the long way back to your desk.

· If you have a message for a co-worker, deliver it in person instead of calling or emailing.

· If you go out for lunch, be sure to eat something healthy. Eating a heavy meal in the middle of the day will not only add weight, but it can make you tired and less efficient at work. Wherever you go for lunch, park far away from the door. This is yet another way to get those extra steps in.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

What Are Plantar Warts?

A plantar wart is a non-cancerous growth on the bottom surface of the foot. It is caused by the human papillomavirus (HPV), which can enter the body through tiny cuts or openings in the skin. Plantar warts can often develop at pressure points, such as the toes or the balls of the foot. While plantar warts may be painful or irritating, they are usually not a serious health concern.

Plantar warts are characterized by small, fleshy bumps that interrupt the normal skin lines of the feet. They have a well defined border, and may have a thickening of skin over the top of them. Plantar warts may also have several small black dots in them, which are clotted blood vessels.

If you think you may have plantar warts, you should see your doctor before trying to treat them yourself. Warts should be distinguished from other possible diagnoses, including cancerous tumors from carcinoma or melanoma. If the lesion has changed color recently or if you have diabetes, it is very important to show your doctor.

Once a diagnosis is made by your doctor, there are several different options in treatment. More conservative methods include using topical salicylic acid to remove the warts. Duct tape has even been used to cover the warts, preventing their spread to other parts of the foot, and to stimulate the body’s immune system. Since plantar warts are caused by a virus, it is the body’s own immune system that must fight off the virus, much like fighting off the virus of a common cold.

When conservative treatment doesn’t work, you and your doctor may opt for another method. Plantar warts are often frozen off using liquid nitrogen. This causes a blister to form around the wart, and then fall off a few days later. This sometimes takes several treatments to be completely rid of the warts, and can cause some minor pain or discomfort. Minor surgery may be performed to remove the warts from the bottom of the foot, sometimes using an electric needle or a curette. Laser surgery has also been used, effectively burning off the wart.

It is important to remember that plantar warts are caused by a virus. What this means is that treating plantar warts is a lot like treating a cold, in that a doctor is often treating the symptoms. Once a person has contracted the human papillomavirus (HPV) that causes plantar warts, it is likely that they can have recurrences of plantar warts in the future. There are literally hundreds of types of HPV, many of which only infect certain areas of the body. Plantar warts may be contagious from one area of the foot to another area, and can even spread to the hands. They may be contagious from person to person as well, but they do not spread to all areas of the body (such as the face or genitals).

The best method of treating warts is prevention. Some easy steps include wearing sandals in public bathrooms, pools, and showers, as well as keeping your feet clean and dry. Don’t pick at the warts, as this may cause them to spread more easily, and don’t touch anyone else’s warts with your bare hands. If you do touch your own warts, be sure to wash your hands thoroughly after doing so.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Health Care Reform Update

On Wednesday night, President Barack Obama hit the airwaves to discuss the idea of massive and sweeping health care reform. An unusual arrangement with ABC News allowed the president to hold a town-hall style interview, where he addressed questions directly, and drummed up support for the health care reform that is drawing much attention in the news.

There are roughly 50 million Americans without health insurance. According to Health and Human Services Secretary Kathleen Sebelius in a meeting with House Energy and Commerce Committee, lowering health care costs and providing insurance for those without insurance is “our most important domestic priority."

There have been various proposals as to how to achieve these goals, the most controversial of which is the idea of a “public option”, which goes beyond the parameters of Medicare and Medicaid. This would essentially be government provided health insurance, which would compete with the private insurance companies already in existence. President Obama is in support of this idea, as he emphasizes that this public option would keep the private insurance companies in check, and help to lower overall health care costs.

Skeptics of a public option, including current health insurance providers, claim that the public option would drive business away from private health insurance companies, and into the arms of the government. The rhetoric “socialized medicine” has been thrown around, particularly from the political right wing.

The price tag on universal coverage is estimated between $1 trillion and $1.6 trillion, and could climb as high as $2 trillion. Savings have been offered to the tune of roughly $622 billion, which leaves a remainder of at least $300 billion to come up with.

Options for obtaining that kind of money include taxing employer-sponsored health care benefits, an idea that for a long time has had many up in arms.

This proposal has gained some recent support, however, from Sen. Kent Conrad, D-N.D., and Sen. Max Baucus, D-Mont., the top two Democrats on the Senate Finance Committee. This announcement came Wednesday, with the notion that perhaps only additional benefits beyond a certain price level would be taxed.

Health care reform seems imminent, but it may take a while for the legislation to actually go through. Many special interest groups have been contacting senators and representatives this week, with each area of the health care industry wanting their voice heard.

There are loud voices on both sides of the argument of the public option, but a recent poll from CBS/New York Times shows some interesting figures. Seventy-two percent of Americans asked supported coverage for people similar to the coverage received by those qualifying for Medicaid. In the same poll, 57 percent reported that they would be willing to pay higher taxes to support the cost of that insurance.

A poll conducted by ABC/The Washington Post this month, however, found that 58 percent of Americans were “very” concerned that the quality of health care that they are currently receiving would be reduced, and another 23 percent reported that they were “somewhat” concerned about the same issue.

The video of the televised special can be seen at the ABC news website.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

What is Compartment Syndrome?

Although it is not a very common condition, compartment syndrome can be a very serious complication due to a pressure build up in the muscle compartments of the body. Areas that can be affected include the muscle groups of the legs, arms, hands, and feet. Most commonly, it is the muscle compartments of the legs that are indicated in compartment syndrome. Compartment syndrome is further divided into acute compartment syndrome and chronic compartment syndrome.

Acute compartment syndrome, which is generally caused by some kind of traumatic injury, is a medical emergency, and needs to be handled promptly. The most common causes of acute compartment syndrome includes fractures to the long bones of the legs, deep bruising of the muscles, complications following surgery to the area, or a blockage of circulation to the area. The increased pressure associated with acute compartment syndrome leads to a lack of oxygen to the affected muscles. This lack of oxygen, if prolonged, can lead to nerve or muscle damage, or even paralysis of the muscles. Thus, acute compartment syndrome must be handled as an emergent situation.

Chronic compartment syndrome, while not a medical emergency, can be equally as serious. It develops over a long period of time, typically from exercise, and is associated with pain that is brought on with exercise.

Symptoms of both acute and chronic compartment syndrome are similar. Both involve pain that is localized to a particular muscle compartment. This is most commonly the anterior muscle compartment of the leg, but other muscle groups may be affected as well. Physical evidence of increased pressure is usually visible, such as swelling of the area and a hardening of the muscles when touched. Additionally there will be evidence of decreased circulation to the area (pain is recreated when the muscles are stretched) as well as evidence of nerve compression (a tingling, or a “pins and needles” sensation).

Compartment syndrome is diagnosed by a medical professional first by ruling out other possible causes. These include stress fractures of the tibia and tendonitis. If compartment syndrome is suspected, the intramuscular pressure may be evaluated at rest, one minute following exercise, and five minutes following exercise. If the muscle pressure does not decrease following exercise, compartment syndrome is suspected.

If you are concerned that you may be developing chronic compartment syndrome, see your doctor right away. This situation is much easier to deal with sooner than later.

Treatment for chronic compartment syndrome includes rest, especially from the activity that aggravates the muscle compartment. Chronic compartment syndrome is most commonly seen in runners and cyclists. Ice and anti-inflammatory medications will help to relieve some of the pressure and swelling. Elevation will also help with the swelling. Compression is not recommended, as this will increase pressure, making the problem worse.

For acute compartment syndrome, or for more serious cases of chronic compartment syndrome, surgical intervention may be recommended by your doctor. This procedure typically involves cutting some of the fascia, or the stiff connective tissue that separates muscle groups in your body. Cutting the fascia will help to relieve the pressure on the muscles.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

What is Peripheral Artery Disease?

 Peripheral Artery Disease, also called Peripheral Arterial Disease (PAD), is a fairly common condition of the arteries in the arms and legs.  The condition is characterized by a narrowing of the arteries, most commonly of the legs, which reduces blood flow to the effected area.  According to the American Heart Association, about 8 million Americans are affected by PAD, and by age 65, up to twenty percent of the population may have it. 

The most common symptom of peripheral arterial disease is pain and/or cramping of the leg muscles while walking.  This pain will go away with rest, but then returns when activity starts again.  The most commonly effected muscles are the calf muscles and the hip muscles.  Other symptoms of PAD include numbness or weakness of the leg, coldness of one leg when compared to the other leg, changes in skin coloring, hair pattern, or toenails, and sores on the toes, feet or legs that won’t heal. 

Peripheral arterial disease is most commonly caused by atherosclerosis.  Atherosclerosis is when plaques, or fatty deposits, build up on the walls of the arteries.  This causes the arteries to narrow, leading to the symptoms of PAD.  Atherosclerosis is often discussed as it relates to the heart, but peripheral arterial disease should always be brought up in the atherosclerosis conversation.  This is because plaque build up of the arteries usually does affect the arteries throughout the entire body. 

People with diabetes or those who smoke are at a particularly high risk for developing peripheral arterial disease.  Also at high risk are people with high blood pressure or high cholesterol.  Risk factors also include obesity, a family history of peripheral arterial disease or other heart/vascular disease, and increasing age.  PAD increases the risk of heart attack and stroke.

PAD may be diagnosed by your doctor using a number of methods.  Your doctor will often listen with a stethoscope to the arteries, listening for a whooshing sound (known as bruits).  This sound gives your doctor a clue that the artery is narrowed, as normal arteries do not make this sound.  One of the most commonly used tests for diagnosing PAD is the ankle-brachial index (ABI).  This is a measurement of the blood pressure in the arm compared to the blood pressure in the ankle.  Your doctor will use blood-pressure cuffs and a non-invasive Doppler sensor to measure and compare the two blood pressures.  If the blood pressure in the ankles is low compared to the blood pressure in the arms, this is a sign of peripheral arterial disease.

Angiography may also be used to confirm the diagnosis of peripheral arterial disease.  This is a procedure where the doctor will inject a small amount of dye into the blood vessels, then use either an X-ray, CT scan, or MRI to view the arteries.  This method is more invasive than the others, but it allows the doctor to see exactly where the blood clot is occurring.  This makes the condition much more possible to treat. 

When treating PAD, your doctor will usually take a two-fold approach.  The first step is to treat the symptoms, such as the leg pain, so that everyday activities are manageable.  The second step is to treat the underlying causes.  This may include medications for high blood pressure or high cholesterol.  Lifestyle changes are also important, such as quitting smoking, a change in diet, or a monitored exercise program.

Catching peripheral arterial disease early is an important step in managing the disease and preventing complications from its progression.  If you have risk factors for the disease, be sure to ask your doctor about peripheral arterial disease.  If you are experiencing symptoms such as leg pain, be sure to tell your doctor about that as well.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

The foot is an extremely intricate masterpiece

It consists of 28 bones, muscles, ligaments, arteries, veins and nerves.  It is designed to absorb the forces of running, walking, and jumping, lessening the burden on the knees, hips, and back.  Our feet serve such an important purpose in our every day lives, yet we often neglect them.  We stuff them in socks and shoes, and forget about them for most of the day.  So how do we keep our feet healthy?  Here are a few tips…

·         Don’t ignore that pain.  Pain is not normal, especially when it is in your feet.  If you are having foot pains, contact a podiatric physician.

·         Take the time to inspect your feet.  Check for any recent changes in color, thickening of nails, cuts, scrapes, or anything else that may seem a little “funny” or “new”.  Many times these changes can be indicative of disease or abnormality, and it is usually much easier to treat them early rather than wait for the problem to progress.

·         Wash your feet thoroughly and regularly, especially on the soles and in between the toes.  Be sure to dry them well before putting on socks or shoes. 

·         When trimming your toenails, be careful!  Cut them straight across, but don’t dig into the sides of the nail.  This can lead to ingrown toenails and infection.  People with diabetes should have their feet cared for by a podiatric physician, as this condition makes a person much more susceptible to infection.

·         Wear shoes that fit properly.  Shoes that slide around on the foot can lead to blisters and hot spots.  As a general rule of thumb, try on new shoes later in the day, when the feet are a bit larger than in the morning.  This way, you will know if the shoe is going to be too tight.  Replace old shoes that are worn out, and always wear the appropriate shoe for any physical activity that you are doing. 

·         Avoid walking barefoot, especially outside.  Walking barefoot opens the door to injury and infection.  Walking barefoot on hard surfaces, such as a wood or tile floor, over extended periods of time can lead to heel pain or plantar fasciitis.  Try a lightweight shoe or slipper when walking around the house. 

·         If you have diabetes, make an appointment to see a podiatric physician at least once a year.  A regular check-up can avoid all kinds of complications due to diabetes.  If you need help finding a podiatric physician, you can use the American Podiatric Medical Association’s Find a Physician tool. 

Follow these tips, and help to keep your feet happy and healthy!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Big Appetite… Big Foot?

In our culture of enormous portions, endless temptations and the threat of ever-expanding waistlines bombarding us at every turn, it is easy to see that we all are fighting the battle of the bulge everyday! In addition, computers, television, video games and other technologies are not helping as they contribute to the lack of physical activity!

Obesity is an epidemic and one that adversely affects the human body in many ways. There are a slew of obesity-related diseases: hypertension (high blood pressure), congestive heart failure, sleep apnea, gallstone formation, osteoarthritis, gout and type 2 (adult-onset) diabetes! Research is uncovering more and more evidence about the detrimental effects of obesity on our vital organs and how it impedes normal body function. 

            However, did you know that obesity has now been linked to bigger foot sizes?! Apparently, the size of our feet as a population has been growing! Just 100 years ago, the typical American adult male wore a shoe size of 6.5 and the typical American female wore a size of 4.5! Today, the average male shoe size is a 9, and in the last 5 years, the size of men’s feet has increased 1 full shoe size!

What exactly is happening here?! There are several theories as to why foot size is on the rise. One guess is that the intake of highly processed and unhealthy foods during puberty may fuel growth hormone secretion in the body. Growth hormone affects all areas of the body, but may play a significant role in the waist, hands and feet. Another reason for increasing shoe size may actually be due to body weight and its effect on our feet. The increased burden due to obesity may be putting so much stress on our feet that our arches are collapsing, thus leading to the flattening of feet.

The present-day lifestyle and contemporary diet is leading to a trend of people becoming taller and larger with bigger foot sizes!

When shopping for shoes keep a few things in mind:

• 1.       Make sure to find shoes that accommodate both your foot length and foot width.
  
• 2.   Shoes that are too small will cramp your toes and lead to foot pain. Shoes that are too large will lead to a lack of stability and the formation of blisters.
  
• 3.       Never assume your shoe size is the same as it always been because with time, your foot size changes.
  
• 4.       Measure your foot size at the end of the day; your feet are at their largest then.
  
• 5.       Ensure that you are wearing your socks when sizing for athletic shoes.
  
• 6.       Always measure both feet and fit the shoes to the larger foot.
  

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Runners’ Nightmares!

If you are an avid runner, chances are you have run into some kind of foot or lower extremity problems. Think about it: the action of running involves the repetitive pounding of the foot on surfaces and sends shock waves up your body.

It is important to understand that running too soon, running too fast, or running too long are the major causes of running injuries. The conditions you may experience are your body’s way of telling you to stop overworking it! 

What are some common running ailments?

Stiff Calves

Novice runners may experience tight and stiff calf muscles and is intimately associated with the Achilles tendon. This tendon comes from your calf muscles and joins the heel to your leg. If your body is not used to exercising the calf muscles and associated structures, you will definitely experience an ache on the back of your leg.

Runner’s Knee

Have you ever walked, climbed stairs, or ran and felt a grinding and grating in your knee joint accompanied by severe pain? If so, Runner’s Knee may be one cause! This ailment is caused by an unstable patella. (The patella is your kneecap).

Shin Splints

Running on hard surfaces such as asphalt or concrete may lead to the development of shin splints. Shin splints is that burning, irritating pain originating from the center of your lower leg. Without rest or treatment, shin splints may progress into stress fractures! 

What is the best way to treat running injuries?

Stiff Calves

Make sure that prior to starting your running routine that your calves experience a full, deep stretch. You can build up the area by rising on to your toes one foot at a time, holding that position for a count of five and then lowering it.

Runner’s Knee

The best way to alleviate this condition is to ease off of the physical activity for a week and work to strengthen the muscles around the knee. To improve muscle strength clench your thigh muscles as often as you can in sets of 5. It’s a simple way to work the muscles that connect to your patella.

 

Shin Splints

To reduce the occurrence of shin splints, it is advised to run on soft surfaces such as grass while wearing shoes with ample cushioning. You may have to hold off on running for an extended period of time.

Different injuries require different modes of treatment, but the tried-and-true methods always involve prevention and a good stretching regimen. Watch and pace yourself when exercising – do not overdo it! And of course, ALWAYS seek a podiatrist’s consult when evaluating the intensity of the injury and deciding on the best treatment option! 

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

What the Heel!? Pain!?

Did you know that the APMA (the American Podiatric Medical Association) recently conducted a survey of foot ailments in Americans? It was found that the most common complaint was heel pain with 16% of the population regularly experiencing it! Millions of patients visit their health professional for heel-related pain! The good news is that heel pain can be alleviated with non-invasive treatment with great results if it is detected and diagnosed early.

What are the roots of heel pain?

It is important to remember that heel pain is caused by some underlying foot deformity or by repetitive trauma. For instance, the most widespread reason for heel pain is due to plantar fasciitis. The plantar fascia is a ligament which is a tissue that connects bone to bone (from the heel bone to the base of the toes) and helps to support the arch of the foot. Plantar fasciitis is the inflammation of said connective tissue and the pain manifests itself in the center heel region. The degree of pain may fluctuate, but the overall commonality is the experience of a sudden flare up soon after becoming mobile in the morning. Excessive running or jumping may lead to this condition.

Inflammation of the Achilles tendon (known as Achilles tendinitis) is also a contributor to heel pain. This pathology has many sources for its origin: injury, increased age, bone spurs, or tight calf muscles. If medical treatment is not received early, this condition may lead to muscle tearing, formation of scar tissue, and adhesions (an adhesion is a band of scar tissue that binds two normally separate tissues together)

The degeneration of the fat pads in your foot can cause heel pain. The fat pads function as shock absorbers and if your feet strike hard surfaces it can lead to their thinning. Walking on hard surfaces with thin fat pads means your foot bones are absorbing the shock which leads to the pain.

Another reason for the development of heel pain is due to constant pounding of the foot on hard surfaces. You may irritate tissues in the foot if you participate in prolonged high-impact exercise and play sports or wear ill-fitting shoes. Most people, especially athletes try to ignore the signs of heel pain and keep on executing the action leading to their condition. As you may imagine, this ends up worsening the ailment and the heel pain could proceed into the chronic phase which leads to more problems!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Hot and Cold Treatment for Arthritis

There are many types of arthritis that can affect people.  The most common form of arthritis is osteoarthritis, or degenerative joint disease.  Osteoarthritis refers to the breaking down of the cartilage that helps cushion and support the joints.  Osteoarthritis is particularly common in people over fifty-five, and it is estimated that by age sixty-five, 60% of patients will have clinical signs of degenerative joint disease.  These signs include stiffness of the joints, inflammation of the joints, aching of the joints, and soreness of the joints especially after long periods of movement or overuse.  The joints that are most commonly affected include the small joints of the fingers and toes, as well as the weight bearing joints, such as the hip and knee 

            Some treatments that have been shown to help ease the pain of osteoarthritis include heat therapy and cold therapy.  These two methods work by stimulating the body’s natural healing powers.  Heat therapy works by dilating the blood vessels, which stimulates the body’s blood circulation.  Heat also helps alter the perception of pain.  Cold therapy works in a different manner.  The cold helps reduce swelling by constricting the blood vessels to the joints.  It also helps numb the pain of arthritis. 

            There are two ways of using heat therapy for arthritic pain – dry and wet.  Dry therapy includes things like heating blankets and microwaveable heat packs.  Wet therapy usually refers to a hot bath or shower, a washcloth soaked in hot water, or a whirl pool or sauna.  However, people with diabetes, cardiovascular disease, or high blood pressure are warned against hot tubs and saunas. 

            Cold therapy has also been shown to be effective against joint pain from osteoarthritis.  A cold pack can be used, or a bag of ice.  Some people use a spray such as flouromethane, which creates a superficial cooling on the skin.  This helps numb the pain, and can be particularly useful on areas that are hard to keep a bag of ice on, such as the backs of the knees. 

            Different people have different results with hot and cold therapy.  In face, some people have the best results with mixing the two therapies, often alternating between hot and cold.  If you suffer from arthritis, talk to your doctor about the possibility of incorporating hot and cold therapy into your arthritis treatment.  

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

"Fish Pedicure" Is It the New Fad?

 If you live in Florida, Massachusetts, Texas, Washington, or New Hampshire, you won’t be able to find the latest trend in foot care on your local salon menu.  That’s because these states have outlawed the fish pedicure, a fad that is quickly gaining press coverage throughout the country.  The trend is popular in Asia, where customers can dip their feet into a large bowl of water, inhabited by dozens of tiny fish known as garra rufa, or doctor fish.  These tiny, toothless fish nibble away at dead and dried up skin, removing it in a similar fashion as a normal pedicure might.

State legislatures have been quick to ban the practice, citing several preexisting rules, including the prohibition of pets and animals in a salon, as well as sanitation standards set in place for pedicures.  But at a Virginia salon, customers are flocking to come get their feet nibbled on by the doctor fish.  At Yvonne Salon, with locations in Alexandria and Woodbridge, VA, the practice has been all the rage, being featured on the Tyra Banks’ Show and NPR, as well as the local news.

The tiny fish don’t have any teeth, so it is more of a sucking, or “kissing” feeling for the customers.  Garra rufa originate in the river basins of Turkey, Syria, Iraq and Iran, where the fish were first used as a treatment for psoriasis.  While the fish did not cure anyone’s psoriasis, they did help treat the symptoms, nibbling away at the dead and dried flesh of the spa-goers.  Since 2006, the fish have been used in commercial day-spas, starting in Japan and China, and finally finding their way to the United States. 

While the American Podiatric Medical Association (APMA) has not officially made a statement regarding the use of fish in pedicures, there are clearly some sanitation issues that arise. The cleanliness of the fish and water that the fish live in is certainly an issue, as well as any skin conditions that the customer might have.  The effectiveness of fish pedicures has also been brought up, as it is difficult to compare this process to that of a traditional pedicure. 

For now, it remains a fad in foot care.  But if you want to try it for yourself, it may involve traveling to Virginia, or another state where fish pedicures have not yet been banned.  

Central Florida Foot and Ankle Center
101 6th St. Nw 
Winter Haven, Fl. 33881
Phone: 863-299-4551
www.FLFootandAnkle.com

Do You Have Intense Pain In Your Heels?

Has this ever happened to you?  You wake up, swing your feet out of bed, and the first few steps you take cause an intense pain in your heels?  If so, you may be one of the millions of people who suffer from plantar fasciitis every year.  It is one of the most common causes of heel pain, and it can be particularly debilitating for those who enjoy an active lifestyle. 

            Plantar fasciitis is an inflammation of the tissue on the bottom of the foot, known as the plantar fascia.  This band of tissue connects your heel bone to your toes, and helps provide the structure and support required of your feet for walking.  The inflammation is caused by a straining of the band of tissue, which can happen in a number of different ways.  One of the most common ways for the pain to occur is when a person who has been seated or lying down for an extended period of time first stands up, putting weight on their feet.  It is for this reason that plantar fasciitis often is first noticed in people getting out of bed in the morning.

            As the day goes on, the pain may temporarily goes away, only to come back later in the day or possibly the next day.  The pain is usually worsened by long periods of standing, or walking up stairs.  There are many methods of treating plantar fasciitis, including:

·         Icing the effected area

·         Stretching the plantar fascia tissue with a towel or other stretching device

·         Reducing the amount of time you stand on your feet, or cutting back on some of the activities that exacerbate the pain, such as running. 

·         Taking an over-the-counter anti-inflammatory, such as ibuprofen, naproxen, or aspirin.

·         The use of orthotics in your shoes, and getting a new pair of shoes, with arch support and a cushioned heel.  The shoes should be comfortable to wear for extended periods of time.

 These methods work better for some than for others, and it is often a combination of several factors that will ultimately alleviate the pain.  Talk to your doctor about any heel pain you may be experiencing, as it may be a sign of a potentially more serious condition, especially if that pain occurs while lying down at night.  Together with your doctor, a plan can be put in place to get you back on your feet again, pain free!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

The Price "You Pay" to Look Good

Is it just me, or has the phenomenon around Sex and the City taken the popularity of high heels and skyrocketed those to new heights? More then ever, high heels have become a fashion statement unto themselves, with each season bringing about more shocking, more vibrant, and more amazing shoes than their predecessors.

 But a three or four inch shoe can be daunting. And many cannot even begin to fathom the greater heights, as we push ourselves in to 4 1/2, 5, or 6 inch heels. With the pursuit of vanity (and great gams) come warnings, fears, and frights.

 DR.’S RESPONSE:  High heels are the nemesis of the astute podiatric surgeon.  Unfortunately, despite our best and well intentioned efforts to encourage the disuse of high heeled shoes, fashion conscious women continue to push the envelope.  I’ll give you an example:  Just yesterday I was at a boat show, with steps, docks, and people getting in and out of boat gunnels.  I saw a middle aged woman there with 6 inch heels, obviously in intense agony walking and hobbling along.  Why do women torture themselves?  As a physician, I recommend the use of flats with an elevated heel of 1 inch.  If heels must be worn, I encourage my patients to use heels of 2 inches or less.  Anything more severely alters the biomechanics of a normally functioning foot.  This can lead to a shortening Achilles tendon, bunions, deformed toes, formation of a bump on the back of your heel, balance problems, sprained ankles, blisters, and corns.  

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

HOW TO “HEAL” the HEEL PAIN

Heel pain is a common problem that many podiatrists see daily in their busy practices.  As foot and ankle physicians, we treat this malady quite frequently with a variety of treatment methods.  Before we concern ourselves with the actual treatment plans, let us understand a little background information about this condition.

First, what is “heel pain?”  Heel pain commonly refers to a number of conditions that can affect the heel.  For the layman, it is an umbrella term that can mean a whole host of issues.  For argument’s sake and brevity, let us focus on what is more correctly referred to as “plantar fasciitis” or inflammation of the plantar fascia.  This entity goes by many other names, such as heel spurs, heel spur syndrome, plantar fasciosis, to name a few.  

The plantar fascia is an elastic band of tissue that spans between the heel and ball of the foot.  It actually continues as the plantar part of the Achilles tendon, beginning behind your leg, around the back of your heel bone, and continuing to the bottom of the foot where it separates into 5 smaller parts to insert onto the bottom of the foot where each toe connects.  Normally, this fibrous band of tissue is able to withstand the years of punishment that we put our bodies through daily.  It actually does quite an amazing job, supporting our arches as we walk, run, jump, dance, and generally abuse this portion of our anatomy.  We don’t really think about our feet until they begin to hurt.  And nothing hurts more than a sharp, stabbing pain at the heel which is worsened with every step.  We are constantly reminded how much it hurts as we plod through our work day.  And when you rest, it feels better, right?  But then you get up off that work chair and hello that lightning like pain comes back even stronger than before.  More about that later.  

Before I continue, a small disclaimer is needed.  It is important to note that heel pain can be due to a variety of other causes.  Because of this, it is important to have heel pain properly diagnosed by a foot and ankle physician, someone who is best trained to determine the appropriate diagnosis and treatment.  

For plantar fasciitis to occur, we need to understand mechanically what is happening.  I like to tell my patients to think of a rubber band that is attached to two sides of a roman arch.  The rubber band stretches and tightens, stretches and tightens, and so on throughout the day.  To cause pain, this rubber band stretches beyond its normal length.  The tissue becomes inflamed because of the excessive stresses placed upon it.  Unlike a rubber band, it doesn’t snap, but it sure does feel like it.  In the body’s futile attempt to “bridge the gap,” sometimes extra bone is laid down where the band begins at the heel.  Thus, we arrive at the term heel spur.  Instead of alleviating the pain, this oftentimes exacerbates the pain, prompting a visit to your local podiatrist.  

Signs and symptoms that you may experiences include the classic “post static dyskinesia.”  This term really means “it hurts when I begin movement after a period of rest.”  The most common complaint I hear is “doc, my feet hurt as soon as I place them on the floor in the morning.”  Think for a moment back to the rubber band.  While you are sleeping at night, your feet are resting on your bed, and very little, if any, stress is placed upon them.  During the night, that rubber band tightens and gets smaller because the roman arch of our foot does not need to be maintained during a period of rest.  But when we wake up in the morning, bright eyes and bushy tailed, we throw our feet over the bed onto the floor and OUCH!  We have suddenly and abruptly placed a stress on that foot.  This doesn’t occur just in the morning either.  It can occur after ANY period of rest longer than two or three minutes.  Sometimes, this pain is diminished a bit after that initial first step because the fascia is being forcibly stretched.

Other symptoms include specific pin point pain at the heel, which often is easily noted.  The pain often worsens as the day continues and is very quickly alleviated with rest.  Also, the pain may progressively worsen over a period of months.  Certain shoes may aggravate the condition as well.  Obesity, shoe gear, work conditions, and foot type can all play a role in its development.  

Conservative treatment is the mainstay of eliminating heel pain.  Any number and combination of the following methods may alleviate your pain.  They are basically divided into what you can do as a patient and what we can offer as physicians. The most important component I believe is stretching which you can read more about in HOW TO “HEAL” the HEEL PAIN part 2. 

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com