Quell Patient Testimony only 1 week and 1/2 after using it - Dr Wellens

Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.com

12 Days Post-Op Plantar Fasciitis Surgery Patient Testimony with Dr. Wel...

Central Florida Foot and Ankle Center101 6th St Nw Winter Haven, Fl 33881Phone: (863) 299-4551www.FLFootandAnkle.com

Post Op Tarsal Tunnel Surgery Patient Testimony with Dr Wellens

Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.com

Patient Testimony after Arthritic Bone Spur Surgery with Dr Wellens

Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.com

Patient Testimony after Plantar Fasciitis Heel Pain Surgery with Dr Wel...

Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.com

Ankle Sprains

Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages, braces or even a cast (in stage 4 severe ligament injury) also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments. Chance of surgery does increase if ankle sprains are not treated correctly.

  

To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercising, stretching, and wearing well-fitted shoes. no flip flops or crocks  when running or exercising.

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.

In everyday practice at CFFA I see many examples where patients go to ER right after the injury and get Xrays and if there is no fracture present, they are told that it is just a sprain but no ankle brace and other offloading device is given therefore directly putting patient at risk for not correctly healing the injury. This incorrect treatment can cause future problems, specifically lateral ankle instability that requires surgery if early treatment is not performed.

 I always recommend that patients have ultrasound to evaluate the degree of Anterior Talo-Fibular ligament injury to determine the correct treatment protocol for them. Correct diagnosis is very important.

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

All about Bunions

What Is a Bunion?
A bunion is an enlargement of the joint at the base of the big toe -- the metatarsophalangeal (MTP) joint -- that forms when the bone or tissue at the big toe joint moves out of place. This forces the toe to bend toward the others, causing an often painful lump of bone on the foot. Since this joint carries a lot of the body's weight while walking, bunions can cause extreme pain if left untreated. The MTP joint itself may become stiff and sore, making even the wearing of shoes difficult or impossible. Bunions- from the Latin "bunio," meaning enlargement-can also occur on the outside of the foot along the little toe, where it is called a "bunionette" or "tailor's bunion."Symptoms

• Development of a firm bump on the outside edge of the foot, at the base of the big toe.
• Redness, swelling, or pain at or near the MTP joint.
• Corns or other irritations caused by the overlap of the first and second toes.
• Restricted or painful motion of the big toe.

How Do You Get a Bunion?
Bunions form when the normal balance of forces that is exerted on the joints and tendons of the foot becomes disrupted. This can lead to instability in the joint and cause the deformity. They are brought about by years of abnormal motion and pressure over the MTP joint. They are, therefore, a symptom of faulty foot development and are usually caused by the way we walk, and our inherited foot type, our shoes, or other sources.

Although bunions tend to run in families, it is the foot type that is passed down -- not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who, in turn, are also prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.

Other causes of bunions are foot injuries, neuromuscular disorders, or congenital deformities. People who suffer from flat feet or low arches are also prone to developing these problems, as are arthritic patients and those with inflammatory joint disease. Occupations that place undue stress on the feet are also a factor; ballet dancers, for instance, often develop the condition.

Wearing shoes that are too tight or cause the toes to be squeezed together is also a common factor, one that explains the high prevalence of the disorder among women. Read more here.

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

Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that is not onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

The symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the materials, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

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

Pediatric In-Toeing

In-toeing is a common complaint among parents who's children are at or near walking age.  It will frequently bring parents in with their young children, who may say that the child “walks funny” or is “pigeon-toed”.  It is most often noticed by the parents as the child begins to watch, typically around 12 months of age, but may present at anytime during childhood for various reasons. 

In-toeing, particularly in children less than 8 or 9 years old, is usually harmless.  It may represent a normal variation of anatomy and development, and will usually resolve with time.

However, what often brings parents in to the specialist’s office is that their child walks with limp, trips over their feet, is in pain, or has difficulty keeping up with their peers.  In these cases, a through evaluation of in-toeing is warranted by the specialist.

Of the many things that may cause a child to walk with their toes pointed inwards, there are three things that are seen most often.  These are internal rotational positions of the hip, leg, and foot. 

In the hip, femoral anteversion may cause the child to have an in-toed gait.  This is a condition whereby the femur is rotated inwards.  At the femoral head, where the bone inserts into the pelvis to create the hip joint, an increase in internal rotation can cause this to happen.  It is typically most noticeable around the time a child begins Kindergarten, at about 5 or 6 years old.  The child may “W” sit, where they sit with their legs behind them, putting pressure on the legs.  This can reinforce the malaligned position of the femur, and is typically discouraged in children with mild femoral anteversion. 

Most cases of femoral anteversion will resolve over time, reaching a normal position by the time the child is 10.  For severe cases, surgery may be necessary to cut the femur bone and rotate it into a more normal position. 

Working down from the hip, the next level that may cause pediatric in-toeing is in the leg at the tibia-fibula segmnt.  Internal tibial torsion is normal until the age of 2, where as the child walks the tibia begins to untwist.  The leg usually normalizes by the time the child is 10.  For severe cases of internal tibial torsion, resulting in significant disability or pain, surgery may be required to cut the tibia and fibula and realign them in a more normal position.

In the foot, a positional deformity called metatarsus adducutus may contribute to in-toeing.  This is commonly seen at birth, and may represent a normal variation.  In severe cases, treatment may be required to straighten out the foot.  Typically conservative measures are used first, such as straight-lasted shoes or specialized bars and braces that help to straighten out the foot.

If conservative therapy fails, surgery may be required to straighten out the foot.  However, this is reserved for severe, unrelenting and rigid cases.

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

Could Poor Circulation Indicate a Looming Heart Attack?

Do your feet and legs cramp when walking?  Do you have pain at night when laying down or when your feet are elevated?  If so, you may have a condition know as peripheral arterial disease.

Peripheral arterial disease, or PAD, is a condition where the arteries of the lower extremity become narrowed due to plaque build up and/or stenosis of the arteries. Plaque build up, or atherosclerosis, is when cholesterol and other substances in the blood cause debris to stick to the insides of the artery. Over time, this can narrow the artery, much like grime can narrow the plumbing in your home.

Symptoms of PAD include cramping upon activity in the calves, thighs, or feet. This pain is usually reproducible with a certain distance, and is relieved with rest. Other signs of PAD may include hair loss in the feet and legs, coldness in the toes, color changes in the feet with a change in position, and absence or weakness of pulses on physical exam.  Sometimes people with peripheral arterial disease will say something about having “bad circulation”. 

Left untreated, peripheral arterial disease will get progressively worse as the arteries continue to narrow.  Pain can increase in frequency, and the distance that a person will be able to walk without pain will decrease.  Poor circulation in the feet can also lead to poor wound healing and areas of gangrene development in the toes.

Risk factors for peripheral arterial disease include smoking, obesity, high blood pressure, high cholesterol, and diabetes. Advanced age can also contribute to the development of PAD, as well as inactivity.

The diagnosis of PAD is made through a detailed history and physical exam, which should include checking pulses to the feet and inspection for other signs.  Often non-invasive vascular testing is ordered in the clinical setting.  This involves putting blood pressure cuffs up and down the legs at different levels and measuring the pressure difference through the leg.  This can help isolate the area of disease.  The amount of oxygen reaching the toes can also be measured clinically, which can also help monitor the disease. 

For patients with peripheral arterial disease, screening for plaque build up in all parts of the body is essential. Atherosclerosis is a systemic disease, and the coronary arteries supplying the heart and carotid arteries supplying the brain can also show signs of disease. Unaddressed, this build-up can lead to heart attack or stroke.

It is for this reason that it is incredibly important for patients with risk factors to be screened for PAD.  The risk of heart attack and stroke associated with peripheral arterial disease has been well documented.

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