Secrets to Foot and Ankle Health

Rid Yourself of Stinky Feet

2011-08-08T15:24:00.000-04:00

All this excessive heat is bound to make you sweat. Unfortunately, we can't be at the pool all day everday cooling off. The excess heat that causes your body to sweat may be taking an extra toll on your feet! Feet have more than 250,000 sweat glands and each foot can produce up to one pint of sweat a day. However, excess sweating in the feet is a condition called, plantar hyperhidrosis. If you are suffering from excessively stinky feet during these summer months and think you should see the doctor, call our office(419-423-1888) or visit our website to request an appointment today. You can also try some of the products designed to combat foot odor in our product store, for example the SteriShoe.

The innovative SteriShoe® shoe sanitizer kills the germs that reside inside shoes with a special germicidal ultraviolet light (UVC). With the first treatment, SteriShoe destroys up to 99.9% of the microorganisms in shoes, including the bacteria and fungi that cause toenail fungus (onychomycosis), athlete’s foot (tinea pedis) and offensive foot odor. SteriShoe is also an excellent choice for those who have diabetes or are concerned about their feet's hygiene.

Don't let foot odor slow your summer down!

Arch Pain?

2011-07-28T12:01:00.000-04:00

If summer sandals have your feet aching, help is on the way. Our product store offers several products to relieve arch pain as well as stylish and supportive sandals from Aetrex. Flat worn out flip flops can cause several problems in your body, not just foot pain so think before you slip into your favorite worn out pair.
Sandals can cause heel pain, tendonitis, ankle problems, knee problems, and increase your risk for accidents.

If sandals are causing you arch pain slip into our product store. The store features several pain relieving and soothing products including the Thera-Band Foot Roller. The site also features products like Orthaheel Orthotic Sandals for beach buffs who can't kick the sandals.

The Thera-Band® Foot Roller is used to provide temporary relief from pain associated with plantar fasciitis, heel spurs and tired feet. Patients with plantar fasiciitis can use the roller as a device to stretch the plantar fascia and increase flexibility. Those experiencing soreness from tired feet will find the massaging benefits of the roller pleasant and therapeutic. In all applications, the Foot Roller can be chilled or frozen to help reduce inflammation. It also includes instructions for foot massage and stretch.

Orthaheel unisex kinetic orthotic sandals are designed to provide orthotic treatment and comfort in a stylish and sporty Flip Flop Sandal. (Stylish & Healthy Flip Flops For Men and Women). Features a soft, padded fabric toe poes. These sandals are made for walking in comfort. The sandals have built in lightweight orthotic footbeds to help reduce pain and pronation along with soft EVA orthotic midsoles. Replace your worn out sandals with these to reduce your arch pain.

If your feet are causing you pain, don't hesitate to call our office at 419-423-1888 and schedule an appointment. You can also go to our website at http://www.vailfoot.com/ to request an appointment. No one should suffer through the summer with aching feet.

Neuroma

2011-02-03T15:01:00.010-05:00

A neuroma is the swelling of nerve that is a result of a compression or trauma. They are often described as nerve tumors. However, they are not in the purest sense a tumor. They are a swelling within the nerve that may result in permanent nerve damage. The most common site for a neuroma is on the ball of the foot. The most common cause of neuroma in ball of the foot is the abnormal movement of the long bones behind the toes called metatarsal bones. A small nerve passes between the spaces of the metatarsals. At the base of the toes, the nerves split forming a "Y" and enter the toes. It is in this area the nerve gets pinched and swells, forming the neuroma. Burning pain, tingling, and numbness in one or two of the toes is a common symptom. Sometimes this pain can become so severe, it can bring tears to a patient's eyes. Removing the shoe and rubbing the ball of the foot helps to ease the pain. As the nerve swells, it can be felt as a popping sensation when walking. Pain is intermittent and is aggravated by anything that results in further pinching of the nerve. When the neuroma is present in the space between the third and fourth toes, it is called a Morton's Neuroma. This is the most common area for a neuroma to form. Another common area is between the second and third toes. Neuromas can occur in one or both of these areas and in one or both feet at the same time. Neuromas are very rare in the spaces between the big toe and second toe, and between the fourth and fifth toes. Neuromas have been identified in the heel area, resulting in heel pain.
A puncture wound or laceration that injures a nerve can cause a neuroma. These are called traumatic Neuromas. Neuromas can also result following a surgery that may result in the cutting of a nerve.

Diagnosis:

The diagnosis of Neuromas is made by a physical exam and a thorough history of the patient's complaint. Conditions that mimic the pain associated with Neuromas are stress fracture of the metatarsals, inflammation of the tendons in the bottom of the toes, arthritis of the joint between the metatarsal bone and the toe, or nerve compression or nerve damage further up on the foot, ankle, knee, hip, or back. X-rays are generally taken to rule out a possible stress fracture or arthritis. Because nerve tissue is not seen on an x-ray, the x-ray will not show the neuroma. A skilled foot specialist will be able to actually feel the neuroma on his exam of the foot. Special studies such as MRI, CT Scan, and nerve conduction studies have little value in the diagnosis of a neuroma. Additionally, these studies can be very expensive and generally the results do not alter the doctor's treatment plan. If the doctor on his exam cannot feel the neuroma, and if the patient's symptoms are not what is commonly seen, then nerve compression at another level should be suspected. In this instance, one area to be examined is the ankle.
Just below the ankle bone on the inside of the ankle, a large nerve passes into the foot. At this level, the nerve can become inflamed. This condition is called Tarsal Tunnel Syndrome. Generally, there is not pain at this site of the inflamed nerve at the inside of the ankle. Pain may instead be experienced in the bottom of the foot or in the toes. This can be a difficult diagnosis to make in certain circumstances. Neuromas, however, occur more commonly than Tarsal Tunnel Syndrome.

Treatment:

Treatment for the neuroma consists of cortisone injections, orthotics, chemical destruction of the nerve, or surgery. Cortisone injections are generally used as an initial form of treatment. Cortisone is useful when injected around the nerve, because is can shrink the swelling of the nerve. This relieves the pressure on the nerve. Up to three cortisone injections can be given over a twelve-month period. Cortisone may provide relief for many months, but is often not a cure for the condition. The abnormal movements of the metatarsal bones continue to aggravate the condition over a period of time.
To address the abnormal movement of the metatarsal bones, a functional foot orthotic can be used (pictured below is a noncustom foot orthotic). These devices are custom-made inserts for the shoes that correct abnormal function of the foot. The combination treatment of cortisone injections and orthotics can be a very successful form of treatment. If, however, there is significant damage to the nerve, then failure to this treatment can occur. When there is permanent nerve damage, the patient is left with three choices: live with the pain, chemical destruction of the nerve, or surgical removal of the nerve. So if you have having any simial symptoms if is important to see your podiatrist. Our office can be reached at 419-423-1888 or you can visit us on the web at www.vailfoot.com . Our website has a link to our online store where you can find the Powerstep foot orthotics.

Care for your feet this winter

2010-12-17T12:39:00.000-05:00

The cold weather can really take its toll on your feet and hands. Most of us tend to ignore our feet during the winter months. When it's cold outside, we tend to cover our feet with warm comfy socks and thick winter boots. The dry air in our homes and work places also tend to be hard on our skin as well. This tends to make our skin dry, itchy and flaky. Here are some tips to help keep your feet happy and healthy all winter long.

Maintain a steady temperature and don't expose your feet to any extreme heat or cold. This is very important for people who are diabetic and frequently develop neuropathy in their feet and are unable to feel pain. Even if you are just running outside to pick up the mail or to take the dog outside, you need to make sure you wear both socks and shoes.

It is also recommended that you only wear dry footwear. If your socks or shoes get wet, take them off immediately. Dry your feet completely and put clean and dry ones on. When your shoes are wet, leave them to set out and dry for a couple of days before putting them back on.

You should also get in a good routine everyday to take care of your feet. Look at it as a way to pamper yourself in these long winter months.

First, you should exfoliate your feet everyday. A good product to use for this is the Footbuffer Pro. This double sided buffer sponge effectively exfoliates and removes dry dead skin and moisturizes the underlying normal skin. Plus, it is available in two invigorating scents: Lavender tea-tree or citron-eucalyptus.

Next, choose your favorite lotion. You will want one with a kind of moisturizer in it. Apply liberally to each foot. Then put your socks on. When you put socks on your feet, this helps lock the moisture from the lotion and keeps your feet smooth and silky.

Now if you have the time, you should purchase a foot soak. Soaking your feet before you exfoliate and lotion will help keep the moisture in.

Try doing this routine every morning and night, and don't forget your hands. If you are only doing this at night and can't sleep with socks on, do your routine an hour prior to bedtime. When you are ready for bed, you can then take the socks off. This should give plenty of time to allow the lotion to soak into the skin.

Before you know it, your feet will be soft and smooth.

Should you have any questions or concerns regarding the health of your feet during the winter months, call 419-423-1888 or visit our website at http://www.vailfoot.com/ to schedule an appointment with Dr. Vail.

Protect your ankles while you walk.

2010-11-03T14:20:00.000-04:00

The ankle is actually a joint that's made up of bones and held together by ligaments, which allow motion within a certain range. When the ligaments are stretched beyond their range of motion, this is when a sprain occurs.

Sprains are relatively common and typically occur when there is a sudden change in direction or when a person is running, jumping, or steps on an uneven surface. Generally, more ankle sprains occur in the springtime when people are more engaged in physical activity, but they can occur anytime.

There are three degrees of sprains. A first degree sprain, most commonly known as a "twisted ankle", is when the ligament can be stretched or weakened but not actually torn. A second degree sprain is when the ligament is partially torn, but without significant or chronic instability. A third degree sprain is when the ligament is completely torn with significant ligament damage and chronic instability. A third degree sprain may require surgery depending on the extent of the injury.

Here are some helpful tips to keep your ankles protected from injury.

Give your body a good stretch. Stretching is one of the best ways to prevent ankle injuries. It helps to increase blood circulation, warms up the muscles and reduces tension on the tendons that connect to the ankles. The stretching exercises you should perform in order to protect your ankles include: calf and hamstring stretches as well as arm, quad and groin stretches to protect the rest of your body. Remember to drink plenty of water before you stretch as well as warm up. You should give yourself at least 5 minutes of warm-up time by doing jumping jacks, jump rope or run in place before you begin.
Wear proper footwear. Wearing the proper shoes will not only protect your feet and ankles, but your legs and back as well. Make sure your shoes are in good condition, once they start to break down you should replace them. You need shoes with the proper arch and ankle support since your feet hold the weight of your entire body. If you are prone to ankle twisting, you may want to consider a pair of high-top sports shoes. They will give you more support where you need it most.

CMO Figure of Eight Ankle Brace

A brace can be your new best friend. If you have suffered an ankle sprain or tend to have weak ankles, an ankle brace will add further support where your shoes cannot. When putting on your brace, make sure it is on tight but not too tight that it will stop or inhibit circulation. Signs that your brace is on too tight are your toes become either red in color or they become numb. If you do not feel comfortable in a brace, try using a cotton-elastic wrap for your foot and ankle.
Walk heel to toe. When you walk, make sure your steps land heel to toe and roll your foot gently to the ground. Rolling your foot as you walk ensures a stable landing and increases your body's ability to sense any obstacles you may encounter such as rocks or divots which may cause you to turn your ankle. Don't always rely on the heel to toe method for averting hazards, you also need to keep an eye on your surroundings.
R.I.C.E. This acronym stands for Rest, Ice, Compression and Elevation. If you have suffered from an ankle injury, you can protect yourself from further damage by following these techniques. When walking, take a break and apply ice for 20 minutes at a time every 2 to 3 hours. In between icing, wrap your ankle tightly with a cotton-elastic bandage and keep your foot elevated above your heart. This will ensure proper healing of the ankle tendons and prevent future sprains.

If you are encountering any ankle or foot problems that are hindering your daily walks, please contact our office at 419-423-1888 to schedule your appointment with Dr. Vail, or visit our website at www.vailfoot.com for more information.

Lederhose's Disease

2010-08-23T15:55:00.000-04:00

Did You Know?
Lederhose's disease is a condition that can cause the formation of painful bumps on the bottom of the foot. Lederhose's disease is often confused with other problems involving the sole of the foot, such as corns or benign tumors, all of which can cause nodules to form in the sole of the foot. In the case of Lederhose's disease, the layer of tissue beneath the skin forms tight nodules of tissue called fascia. No one knows exactly why the nodules form, but the condition is closely related to Dupuytren's contracture in the hand.

The Finest Quality Diabetic Sock

2010-08-18T11:54:00.002-04:00

This by far is the greatest sock invented ..Period!

I can tell you on experience, that this sock is truly worth the buy. I play in many different sports activities, but with Basketball I was always enduring blisters every sunday. I was never able to play at 100% because of the blisters that would develop by the end of my 40 minute game. Until I was told here in the office to try these comfortable, extra roomy, enjoyable Dr. Comfort diabetic socks, I had no idea the difference it would make. These diabetic socks are the finest on the market.

We do not offer these socks on our online store, however, we have an entire room full of Dr. Comfort Socks and we encourage you to come check that out at our office.

Nano Bamboo Charcoal Fibers is what this fine product is made out of. This was discovered during the Ming Dynasty in 1486 AD. Today Molecular Nano Bamboo Charcoal is made when bamboo charcoal powder is refined by temperatures over 700 degrees. Nano Bamboo Charcoal Fiber is able to release Far Infrared Rays that may promote blood circulation and increase Anion production, which is very good for physical health. This is also a natural deodorizer, has innumerable hole structures and can absorb and decompose benzene, phenol, methanol, sulfides, nitrides, etc. It helps reduce odors from NH3 gas, adjusts moisture. Another benefit is its ability to regulate skin temperature. This will keep your feet cooler in the summer and warmer during the winter, more so than traditional materials. I found that during my basketball events my feet would sweat less, and that was just one of the many reasons my blisters reduced in size and numbers. This product is great for long trips, people with Edema, and someone with oversized legs. Those are just a few of the special qualities this Dr. Comfort sock has to offer.

If you would like to view another material of socks at our online web store, click here!

6 Tips To Protect Kids in Fall Sports

2010-08-10T10:43:00.000-04:00

Back-to-school sports season linked to ankle injuries

If your children are playing sports this fall, pay attention to five tips that could protect them from serious ankle injuries.

Every fall, foot and ankle surgeon Thomas Vail, DPM, notices an increase in ankle injuries among young athletes. Football, basketball, and soccer are the sports most likely to lead to sprains, broken bones and other problems.

Our top recommendation for parents is to make sure our kids get ankle injuries treated right away.

What may seem like a sprain, is not always a sprain; in addition to cartilage injuries, your son or daughter might have injured other bones in the foot without knowing it. You should have a qualified doctor examine the injury. The sooner your rehabilitation starts, the sooner we can prevent long-term problems like instability or arthritis, and the sooner your child can get back into competition.

As parents you should also follow these additional tips from the American College of Foot and Ankle Surgeons' Website at http://www.footphysicians.com/

- Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition

- Buy the right shoe for the sport. Different sports require different shoe gear. Players shouldn't mix baseball cleats with football shoes.

- Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

* Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

* Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

Secrets to Protecting Yourself from Fungi

2010-06-14T16:17:00.002-04:00

Fungal infections on your feet are one of the most unsightly foot ailments. These infections can affect the skin of your feet as well as your nails. A fungal infection is even the cause of athlete's foot. And when it affects your nails, it can cause them to crack, break, splinter and yellow. Fungal nails are usually pretty easy to spot and look anything but healthy. So how do you protect yourself from the fungi that are responsible for these unsightly infections? Follow these tips.

1. Keep your feet dry. Fungi thrive in warm, dark, moist environments. This means your shoes are a fertile location for fungi to grow. Once your feet are exposed to the fungi, your shoes will not prevent the fungi from growing. But ensuring that your feet stays dry helps prevent fungi from ever taking hold. You should always alternate shoes every other day at the minimum to allow them the proper amount of time to air out. Don't store your shoes in your gym bag or locker if they will not get enough air to dry out. If you sweat a lot, you should consider using a foot powder to absorb excess moisture. You may also want to change your socks in the middle of the day.

2. Avoid places where fungi thrive. Fungi thrive in public showers, like the ones found in locker rooms, pools, public beaches and at camp grounds. Do not think that you should limit your activity and never visit these places, and don't sacrifice your hygiene for fear of foot fungi. Simply wear a pair of flip flops or other shower sandals in public showers and locker rooms. This will limit your contact with these fungi and help prevent their further spread. If someone in your family has foot fungi, try to keep the shower they are using clean, or ask them to use a different shower than the rest of the family. Consider a spray disinfectant that you can leave in the shower and ask them to use it after every shower.

3. Keep your feet clean. Clean feet are less susceptible to fungal infections, as you are likely to knock out the fungi before it can take hold on your feet. Wash your feet every time you take a shower or bath. Be sure to dry your feet thoroughly, especially in between your toes. This is also a good time to check your feet daily for any changes in shape or color- usual indicators of a problem.

4. Keep your feet healthy. Healthy feet are less susceptible to fungal infections. Not only should you keep them clean, but you should condition your skin as well, especially if you spend time barefoot. Skin that receives regular attention will be healthier, and thus less susceptible to fungal infections. Treat your calluses by trimming them. Moisturize your feet, except for in between your toes, where your feet are already moisture rich. These two steps will help prevent your skin from cracking. Cracking leads to open skin which is more susceptible to fungal and bacterial infection than healthy skin. you should use antibiotic cream on all cuts and abrasions on your feet to help them stay clean and heal faster.

If you think you are beginning to develop a fungal infection of the skin or nails of your feet please don't hesitate to contact your podiatrist. We have a number of treatment options and the sooner we start your treatment, the higher your chances of success and the less time it will take to return your skin or nails to normal. Also, try FungaSoap, a product from our online store. FungaSoap is specially formulated to help kill fungus. Using it before fungi have the chance to take hold will help prevent infections from even starting. Visit http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=504 to learn more or order this product.

Secret to Beautiful Feet

2010-06-07T16:24:00.002-04:00

Are you looking for ways to improve the look of your feet this summer? Perhaps you want your feet to look their best during trips to the beach or pool, or when you're out in sandals. Then try the Gilden Tree Terra Cotta 2-Sided Footscrubber and Callus Remover to improve the look of your feet. We recommend soaking your feet for 10-20 minutes in warm (but not hot, as this dries out your skin) water. You can add salts or soaking crystals to your foot soak. Then use the terra cotta scrubber to work away unsightly calluses and corns. Not only till this improve the look of your skin, but it helps prevent your calluses from cracking, which leaves you susceptible to bacterial and fungal infection.

This amazing Two-sided Footscrubber® leaves feet incredibly soft, smooth and touchable. Use the Footscrubber® to cleanse, exfoliate and polish feet. Used regularly, it helps remove calluses, and reduces dry, cracked heels. They are made by a women's cottage industry in Pakistan, and it's so effective that Seventeen Magazine called it "the Arnold Schwarzenegger of pumice stones." It can even be heated or chilled before use. A portion of each sale is used to help educate children in Pakistan.

We recommend that you follow your treatment with a moisturizer. This will help improve the health and look of your skin, and the warm water soak will help open up your pores to absorb more of the moisturizer.

Visit our online store at http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=632&DEPARTMENT_ID=54 for more on this product or to order.

Eccentric Exercise for Plantar Fasciitis

2010-06-01T10:19:00.002-04:00

Directions:
1. Standing on an elevated surface or a slant board, bend the left knee so that it is parallel to the floor. This knee should be bent and flexed. Drop the heel down on the right leg. Raise the right heel to neutral and then drop down. Repeat for opposite extremity. Do this with the knee extended and flexed as shown in photos.
2. This exercise should be done to 'fatigue' but not create increased pain. Gradually add weight to a backpack in .5 lb increments every 4 days as your strength and pain endurance increases.
3. It is very important to add weight slowly as it can make the difference between having success or failure.
4. Do three sets of fifteen reps two times per day for twelve weeks
5. It is very important to keep a daily log book including the number of repetitions, the amount of weight used and a pain score.

Stretching Exercises For Heel Pain

2010-05-25T08:40:00.003-04:00

Begin by standing on a step or a stool with your heel hanging off. If you are using a stool, ensure that it is stable enough to hold your weight. You may need someone to hold the stool to stabilize it. Let your heels drop off the step 20 times. Repeat this exercise twice a day.

2010-05-17T09:45:00.003-04:00

Utilize this stretch before getting out of bed, and with no shoes. Place a towel or resistance band around the bottom of your feet at the ball area. Pull on both ends of the towel or resistance band while flexing your foot. Push your foot up and back 10 times, turn your foot to the right, and flex your foot up and back 10 times in this position. The turn your foot to the left, and flex your foot up and back 10 times in this position. Repeat for the other foot.

Stretching Exercises for Heel Pain

2010-05-10T09:41:00.004-04:00

Standing up straight, lift your heels so that your body is raised onto your toes. You may use a table or the back of a chair for support. Start by doing 20 toe raises a day, then add a few more each day. You will need to work up to doing 100 toe raises, twice a day.

Stretching Exercises for Heel Pain

2010-05-03T13:54:00.004-04:00

Standing up, place one foot onto a small stool (you can use a chair or even your stairs). Keep your leg straight and your knees locked. Once in this position bring your head toward the knee of the leg that is on the stool. Hold this position for 30 seconds and then relax. Repeat 6 times for each leg. You may gradually work to a higher position by increasing the height of the stool.

A Secret to Relieving Heel Pain

2010-04-30T11:41:00.004-04:00

At our office, we are committed to helping you return to great foot health. One of the ways we do that is by offering you products that are designed to help you find relief. and we make these available through our online store for your convenience. These products can be shipped directly to your home, saving you from coming into our office.

One such product we offer is the Thera-Band® Foot Roller. It provides fast, temporary relief from pain associated with plantar fasciitis, heel spurs, achy arches, and tired feet!
The Thera-Band® Foot Roller is used to provide temporary relief from pain associated with plantar fasciitis, heel spurs and tired feet. Patients with plantar fasiciitis can use the roller as a device to stretch the plantar fascia and increase flexibility. Those experiencing soreness from tired feet will find the massaging benefits of the roller pleasant and therapeutic. In all applications, the Foot Roller can be chilled or frozen to help reduce inflammation.

Recommended Uses:
-Use chilled to reduce foot pain and inflammation.
-Massage arch pain, discomfort, and fatigue away.
-Use to exercise and stretch the plantar fascia.
-Stretch, exercise, and help straighten toes.

Visit our online store at http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=776 for more information or to order your foot roller for fast relief from plantar fasciitis.

Stretching Exercises for Heel Pain

2010-04-26T10:17:00.004-04:00

Stand up straight about three feet from a wall. Ensure that you are facing the wall. Lean forward and placy your hands on the wall; bend your arms at your elbows. Keep your legs straight, your knees locked, and your feet flat with your toes pointed inwards. Hold for 10 seconds and then relax. Repeat 6 times.

What to Do If You Are in Severe Pain

2010-04-20T10:36:00.002-04:00

Pain is our body's way of telling us that something is wrong. And it is usually true that the more severe the pain, the more severe the problem. If you are experiencing severe foot pain, seek treatment from a podiatrist immediately. Podiatrists specialize in dealing with foot problems and are experts in helping treat your symptoms. You can reach our offices at:
The Advanced Footcare Clinic
1725 Western Ave, Suite C
Findlay, OH 45840
Phone: 419-423-1888
Fax: 419-425-3668
Email: vailmedassist@sbcglobal.net
Website: www.vailfoot.com
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When to Call a Podiatrist

2010-04-12T08:58:00.002-04:00

Podiatrists are the experts on feet and ankles and should be the first doctor you call when you experience any of the symptoms or pains we explore in this blog. Remember that foot, ankle, or heel pain is never normal regardless of age or activity.

Podiatrists treat foot problems for patients of all ages. You should call a podiatrist when you have pain in your feet or in your heels. If you notice that there is any change at all to your heels or the skin on your feet and ankles, you should see the "expert" on your feet.

If you have diabetes or poor circulation and you develop any abnormal symptoms you should see us immediately. You are at much greater risk for serious complications. And if you have diabetes you should see us at least once a year whether or not you have symptoms or pain. Regular check ups are a great way to keep your feet healthy.

Most importantly, you should call us first when you have pain or any issue that affects your feet.

Happy Easter!

2010-03-31T15:32:00.002-04:00

Happy Easter from everyone at The Advanced Footcare Clinic! We hop you have a blessed holiday filled with joy, love and the presence of family.

Secrets to Footcare

2010-03-29T15:41:00.004-04:00

If you have diabetes it is especially important to check your feet very regularly and often. In fact, we recommend that you have someone else help you check your feet, because you may not be able to see or, most importantly, feel problems. Early detection and treatment may avoid potentially serious complications later.

See a podiatrist if you have any problems with your feet. Treating yourself can often cause problems or exacerbate existing problems. If you are diabetic you are at greater risk for foot problems so be sure to make an appointment to see us at least once a year. We'd love to see you. We are here to help!

Secrets to Footcare

2010-03-15T10:19:00.003-04:00

Here is some continuing information on keeping your feet healthy:

Try to develop a habit of always checking your feet. A great time to do this is right after a shower or during a bath. If you start a habit of carefully drying your feet after bathing (pay special attention to the skin between your toes) you can quickly check your feet to see if you notice any changes. If you see nails that look unusual you might be seeing a potential fungus developing. If your skin is broken, cracked or an unusual color you are noticing abnormalities. Finally, if your foot is changing shape or you observe new growth you should make an appointment to see us so we can treat these conditions before they progress and become worse.

Secrets to Footcare

2010-03-09T10:17:00.002-05:00

Here is a tip for keeping your feet healthy and functioning:

Do not ignore pain in your feet and ankles. healthy feet don't have persistent pain or skin that looks unusual. If your pain doesn't subside quickly, please contact our office right away. The sooner we can see you and examine your feet, the quicker we can begin to make the corrections needed to get your feet healthy again. So often we see people who have waited a very long time and suffered needlessly- sometimes for years.

Secrets to Your Footcare

2010-03-01T10:23:00.003-05:00

The first step in dealing with foot pain, especially heel pain, is to care for your feet. Your feet are the hardest working part of your body. They carry you wherever you need to go, whenever you need to go there and they do it for years and years. In fact, during your lifetime, you will have traveled on your feet the equivalent of three trips around the entire world. You take, on average, 15,000 steps a day and will walk or run well over 75,000 miles in your lifetime. Caring for your precious feet is the best step to avoid pain and is a critical component in eliminating it as well.

Basic Care for Diabetic Feet and Heels

2010-02-23T14:26:00.002-05:00

Here is some basic advice for the care of diabetic feet and heels:

1. Inspect your feet every day.
2. Keep your feet clean and dry.
3. Always keep your feet warm.
4. Take extra care drying your feet and toes after showering. Pay special attention to the space between your toes.
5. Be sure to exercise. Walking is one of the best exercises for diabetics unless you have complications. If you struggle with balance, use a cane.
6. Always protect your feet and legs. Never walk barefoot.
7. Avoid hot water bottles and heating pads.
8. Do not overexpose skin to the sun.
9. Never use razors blades, knives, scissors or medicated corn/wart removers.
10. Look for redness, blisters, scratches, cracks between the toes, discoloration or any other change.
11. Avoid all actions that diminish circulation such as tobacco use, sitting with legs crossed, and circular elastic garters.
12. Change your shoes and socks daily.
13. Wear soft leather shoes that conform to the shape of your overall foot.
14. Gradually "break in" new shoes and avoid blisters.
15. Call us immediately if you see any changes in your feet.

Bunions

2010-02-19T08:37:00.003-05:00

There have been some questions about bunions commented on our blog. A brief overview: Bunions are caused by your big toe joints becoming incorrectly aligned. This causes the first joint on your big toe to slant outward and the second joint then angles toward your other toes. Your joints then begin to swell. It causes a bump of bone on the foot that can become very painful if left untreated.

Keep in mind that you can also develop a callus on the bump as it rubs against your shoe, and this can become painful in itself. There a number of ways to treat bunions, both conservatively and surgically. Conservative methods include using a brace or splint to help straighten the toe, and using toe spacers to align the toes against one another. Often a bunion will cause some of your other toes to move out of alignment, and this is why toe spacers help. We recommend a shoe with adequate space to prevent your bunion from rubbing, and also to accommodate any bracing of the toe. Surgical correction of the problem is also an option.

Findlay's Day of Dance

2010-02-16T13:52:00.002-05:00

The Advanced Footcare Clinic will be at the Day of Dance for Health event sponsored by Blanchard Valley Health Systems! The event is to raise awareness for women's health issues, as well as enjoy a day to enjoy different dance styles, watch dance performance groups, take in music, eat good food, sign up for give-a-ways, receive health screenings and even win door prizes. Our office will have a booth at this event to share valuable health information about your feet. When you are exercising or dancing regularly you can really improve your over-all health. But nothing will hinder your ability to do so quicker than sore feet. So we want to give you tips on how to avoid this type of pain, as well as making you aware that we are available when you do experience foot problems. We will also have special offers and products from our office. Our display will include examples of our new therapeutic shoes. We want our patients to see that our shoes are not what they traditionally think of as therapeutic shoes, but they have been updated to offer great style as well as great footcare. And these shoes are available to all our patients, not just diabetics. We will also have an offer on a free pair of Dr. Comfort brand slippers for anyone who makes an appointment to see the podiatrist. And lastly, we will be offering free giveaways on some of our most recommended moisturizers, creams, scrubs, soaks, and other products.

The event will be held on Saturday, February 27th from 10:00am to 2:00pm. It will be in the University of Findlay's Koehler Center and the admission fee is a toothbrush and/or tube of tooth paste for charity. There is no preregistration required. Any questions can be directed to 419-423-5551. We look forward to seeing you that Saturday to enjoy yourself and learn all about women's health needs.

Secrets to Caring for Diabetic Heels

2010-02-15T10:08:00.002-05:00

Diabetes can affect many parts of the body, especially the feet and heels. According to the American Diabetes Association, about 15.7 million Americans (5.9 percent of the United States population) have diabetes. It is very important that a diabetic gives the feet very special care. A small problem in a healthy person could become a severe one to a diabetic.

Diabetes can affect the feet in a number of different ways. The first is infection, which is one of the most common complications of the diabetic foot. Because diabetes causes reduced immune response, a diabetic patient's ability to fight infection is decreased. Early treatment of infection is a critical component to success. If neglected, infection of the foot can cause gangrene, ulceration, osteomyelitis, and even amputation.

Another complication of diabetes called neuropathy causes decreased sensation to pain and temperature. This may cause a patient to underestimate a foot problem. It may also be responsible for an absence of perspiration leading to dry, cracking skin that can more easily become infected.

With a diabetic foot, a wound as small as a blister from wearing a shoe that is too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for punctures wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, and cuts. Get someone to help you, or use a mirror. Diabetic foot care can be very complicated and good podiatric care is an essential component of managing diabetes.

Secrets to Heel Pain: Foot and Ankle Surgery

2010-02-12T11:27:00.002-05:00

In a few cases, heel problems do not respond to conservative treatments. A podiatrist can best determine when surgery might be beneficial. In cases when pain or deformity persists, surgery may be needed to restore full function.

Prior to surgery a podiatric surgeon will review your medical history and perform an examination. These tests may include X-rays, blood tests, urinalysis, and blood flow studies to determine the circulatory status of your feet and legs.

The length and method of postoperative care that is needed is determined by the type of surgery performed. All postoperative care includes some degree of rest, ice, compression, and elevation. Other elements can include bandages, splints, surgical shoes, casts, crutches, and canes. Recovery can be quickened by carefully following your podiatrist's instruction.

Secrets to Treating Heel Pain: APC Injections

2010-02-09T13:40:00.002-05:00

Autologous Platelet Concentrate is a procedure that is done to stimulate healing. blood is drawn from the patient, spun in a centrifuge, and the platelets (the growth and healing factors of the blood) are drawn out afterwards. After the platelets are drawn out, they are re-injected into the damaged tissue in the plantar fascia. This stimulates healing at a rate of five times more quickly than the healing rate of normal blood vessels.

Secrets to Treating Heel Pain: ESWT

2010-02-03T13:24:00.003-05:00

Extracorporeal Shock Wave Therapy (ESWT) treatments use high-power sound waves to end chronic heel pain without painful surgery. This treatment is now being offered by our office as an alternative to heel surgery. The discovery of ESWT came about somewhat by accident. Shock wave therapy is used regularly by urologists to break up and disperse kidney stones. Urologists began reporting that patients who had kidney stones treated showed increased bone density and new tissue growth. This led to studies for using shock wave therapy for soft tissue injuries and the results were amazing: 75-80% of patients with soft tissue injuries were reported to be healed or greatly improved following ESWT!

Shock wave therapy works by purposely targeting trauma at the pain site. This stimulates the diseased tissue and activates your body's own healing process. Blood and oxygen rush to the site, activating a metabolic response that fosters healing by the growth of new connective tissue. This is what is damaged and torn when you have plantar fasciitis or heel spur pain. The most important and exciting aspects of ESWT are that it ends the pain, the procedure is not painful, there isn't a lengthy recovery period, and there are no side effects.

Secrets to Treating Heel Pain: Orthotics

2010-01-29T12:08:00.004-05:00

Custom-made heel supports are known as orthotic devices and are worn under your heel and the arch of your foot. These devices are molded to be anatomically matched to your heel and they do more than just provide support. Orthotics are designed to realign your feet and heels to a neutral or natural position to alleviate pain in your feet, legs and back, as well as restore balance, improve sports performance and relieve foot fatigue.

Research shows that the majority of heel problems can be directly connected to skeletal imbalance. More and more people tend to have some amount of either hyperpronation (flat feet) or hypersupination (high arches). The presence of these conditions can cause the heel to be unstable during normal everyday activity. This constant stress on the heel can lead to pain in the feet, ankles, legs, knees, hips and back. Orthotics can improve function in the heel by compensating for existing imbalances and in most cases can relieve or prevent the associated pains.

How do you know if the use of orthotics is right for you? If you have an obvious imbalance that causes such symptoms as flat feet or high arches, or if you have external misalignments such as "knock knees", "bow knees", in-toeing, or out-toeing you are probably a good candidate for orthotics. If you participate in an activity that places stress on your feet or if your work requires you to be on your feet for extended periods of time, orthotics could be beneficial. The use of orthotics is just one of the conservative foot treatments used in our offices. They can be used to treat foot, heel, and arch pain and to prevent sports injuries or improve sports function. Orthotics can be used to treat children as well as adults. The best way to find out if orthotics can help you is to make an appointment with us for an exam.

Secrets to Treating Heel Pain: Conservative Care

2010-01-18T10:20:00.003-05:00

There are a number of conservative care options for patients experiencing heel pain. Also known as non-surgical treatment, conservative heel care is used to treat most heel problems with dramatic results. Any initial visit to a podiatrist's office will start with a patient history and physical examination. Diagnostic x-rays and laboratory tests can also be used to help determine the best course of treatment.

Non-surgical treatments are called for in most cases including medical conditions which preclude the option of elective surgery, time commitment constraints, and elderly patients with many medical conditions. In spite of not being able to opt for foot surgery many patients find great relief from pain and discomfort through the use of conservative heel care treatments.

There are a wide variety of non-surgical treatments being used by podiatrists today. cortisone injections, oral and topical medications, and heel taping or strapping are all examples of conservative heel care. Other options are exercise, custom-made walking shoes, physical therapy, and orthotics.

Secret for Scars

2010-01-12T14:55:00.002-05:00

Do you have unsightly scars on your feet or another part of your body. Perhaps they are large and rub against your shoes, becoming painful. Here is a product form our online to help you diminish your scars for better looking and more comfortable feet:

Blaine LightTouch Fading Solution
Helps lighten dark skin pigmentations and scars.

Description: Dr. Blaine's Light Touch is a portable, sanitary roll-on that helps improve the tone and color of darkened skin lesions and scars, delivering superior results in as little as four weeks. Suitable for all skin types.

This double-action formula uses:
-The highest level of hydroquinone available without prescription.
-Aloe vera to gently fade dark pigmented areas, scars, freckles, melasma, age spots and other concerns.

Recommended Use: Apply a small amount to the affected area until fully absorbed, twice daily. If no improvement is noticed after 2 months of treatment, discontinue use. Limit exposure to sunlight.

Please visit our website at http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=700&DEPARTMENT_ID=125 for more information or to order.

Secrets to Sizing Shoes

2010-01-06T13:16:00.002-05:00

We were met with a great question today involving the sizing of shoes. Sizing shoes is important because improperly fitted shoes can cause or worsen existing foot problems like bunions, hammertoes, plantar fasciitis, stress fractures, ingrown toenails, corns, calluses and even fungal infections. So how do you avoid causing or complicating these and other problems? Follow these tips for sizing shoes.

1. Try on all shoes. You should try on every pair of shoes you wear. Be sure to try on shoes the way you would wear them: lace and tie them completely, wear the kind of socks you would wear with those shoes, and wear any orthotics or other corrective ankle/foot braces when trying on shoes. You need to know how your shoes will fit every day, which means trying them on in real scenarios. Do not assume because you have shoes from that manufacturer already that these new shoes will fit. Even among the same manufacturer sizes vary from style to style. Your feet can also change over time, and your shoe size along with it. Shoes should leave about a half inch from your longest toe (which is the second toe and not the big toe for many people) to the end of the shoe, and they should have enough width for your toes to fit comfortably without pressure. Be sure to actually try on the shoes.

2. Measure your feet. Having a trained professional around to help you measure your feet is a great step in buying shoes. A brannock device is the name of the tool used to help indicate your shoe size. But remember, even this method is fallible, and the person reading the machine for you could make a mistake. Also, shoe size varies based on manufacturer and style. If you don't have access to a brannock device, have a friend or relative trace your feet while you stand on them with even pressure. You can compare this diagram to the sole of a shoe to get a rough idea if they will be the right size for your foot. You still need to try on any shoes before you buy them.

3. Buy shoes in the afternoon or evening. As the day progresses, your feet will swell as more of your blood flow concentrates into your lower appendages. This is natural, and how your body's fluids are distributed as you spend more of the day upright. This helps you buy shoes that are the correct size for you at all times of the day.

4. Take a walk. Walking around the store in a new pair of shoes will give you a better idea if you would like to buy them or not. Lace and tie them completely and move around the store. Pay attention to places where the shoes rub or feel uncomfortable. These may lead to blisters. You can also tell if there will be tight spots anywhere on the shoes. Do not assume that the shoes will stretch out, in most cases they won't. You should buy shoes that are already comfortable and that fit well. This will prevent blisters and other problems. Do not assume that you need to "break in" shoes, if they fit correctly you can avoid a "break in" period. Try to simulate some of the movement you will be doing in those shoes: if they are basketball shoes, do some jumping in place; for cross trainers, try some lateral motion.

5. Keep use in mind. You have different shoes for different purposes: exercising, work, casual and going out. Think about the demands an activity has on your feet and what this requires of your shoes. You would not buy high heels to go to the gym in. Making sure you are using the right shoe for an activity will keep your feet healthy in the long run. If the shoes you are looking at do not meet the needs for the activity, do not buy them. Find another pair which will meet the demands of your lifestyle. You should also rotate the kind of shoes you wear. Sure you need nice shoes for work, but give your feet support and comfort with an athletic shoe when exercising or doing house work. Remember that although high heels are fun are good looking, they should not be worn often as they can be quite bad for your feet.

6. Don't get over-committed. Just because you like a shoe's style, color, etc. is not a good reason to buy it. Buying shoes is fun and exciting, but getting carried away will not help your foot health. If you buy the shoes you love but do not fit right, you will be disappointed. They will cause pain and discomfort, and you will not want to wear them. Not only will could they damage your feet, but now you have shoes that you don't or can't wear taking up space in your closet and costing you money. Ask the clerk for a different size or even if they can order a pair in the size you want. Don't be afraid to shop around for the right size or even try to order the shoe in the right size online. You will be happier with shoes you love that also fit perfectly.

7. Ordering online. Ordering shoes online can help you save time, money and increase the selection of shoes before you. But when you order shoes online, you cannot try them on before you purchase them. When ordering off the internet, try to stick to manufacturers that your know. If you always wear a certain size with a manufacturer, you have the best chance of being close with another pair. Styles and sizes do fluctuate even within a manufacturer, so it is no guarantee that a new pair will fit or that your feet are exactly the same size and/or shape. You should also stick with a manufacturer or distributor that you are familiar with and can trust. If your shoes do not fit correctly, this will make the return/exchange process much easier. You are also entrusting the company with your credit card or other payment information. Working through an established manufacturer or distributor is the best way to ensure that you receive excellent customer service. Make sure that shoes you buy from the internet fit correctly when you receive them so you can return them promptly and before the return deadline.

8. Special interests. There are certain groups who have special interests when it comes to purchasing shoes. Anyone who needs and orthotic, brace or other supportive device needs to keep this in mind when buying shoes. The device and your foot needs to be able to fit comfortably in your shoes. Patients with conditions like bunions, corns, bad calluses and hammer toes may find shoes uncomfortable and need to buy larger or wider sizes. If you are prone to recurring ingrown toenails, you should evaluate your shoes carefully. Adequate room will help reduce the recurrence of ingrown toenails. And diabetics or others with neuropathy or reduced circulation may need to consider therapeutic shoes. These shoes are custom molded to your feet and meet a high set of standards in materials used. They leave extra depth for orthotics and other inserts and have a larger toe box to allow adequate room for your toes. This will help prevent you from getting problems like blisters and ulcers which take longer to heal in patients with poor circulation.

If you have any questions about shoe sizing or setting up an appointment for diabetic shoes, contact our office. If you would like to be added to our "Top Shoes" list- our quarterly list of shoes that we recommend to patients for various uses and activities- you can click this link to our website: http://www.vailfoot.com/top-shoes-list.html

Amazing Feats from Amazing Feet

2009-12-30T09:42:00.002-05:00

Just for fun, we wanted to give you some creative ideas with how to occupy your time and your feet. This article will explore a few world records which have been set by feet, and might even give you ideas for something to do over your Christmas and New Year's break.

Five Amazing "Feets"
Your Feet Do More Than You Think

Terence Vanderheiden, D.P.M.

Most of us walk on our feet everyday and if they are not hurting, we rarely give them a second thought. Then there are others who ask themselves, "What else could I do with my feet today?" Those are the people you will find in the Guinness World Records. You too could be a record holder if you could balance on one foot for 3 days and 5 hours. If you have trouble balancing for 30 seconds, perhaps you should keep reading and find another amazing "feet" to try.

1. Largest Feet Ever. Robert Wadlow (USA) is credited with the largest feet ever (dead or living). He wore U.S. size 37AA shoes which is equivalent to 18.5 inches long. There is not a lot of practicing you can do to try and achieve this record. You are either born with it or you would need to have many painful surgeries to try and lengthen your feet.

2. Longest Duration for Balancing on One Foot. The longest recorded time for balancing on one foot is 76 hr 40 min by Arulanantham Suresh Joachim (Sri Lanka) at Vihara Maha Devi Park Open Air Stadium, Sri Lanka, on May 22-25, 1997. Start by balancing for 10 seconds (it's harder than you think) and then increase from there. Let me know when you get close to the record.

3. Longest Time Juggling a Shuttlecock with Feet. Li Huifeng (China) juggled a badminton shuttlecock for 4 hr 40 min non-stop using only her feet. The shuttlecock never touched the ground. This was accomplished on the Guinness World Records Special in Beijing, China on December 21, 2006. Isn't it enough challenge to keep the badminton shuttlecock from touching the ground using a racket?

4. Fastest Barefoot Ice Run. The fastest time to run 100 m barefoot on ice is 17.35 sec. The record was set by Nico Surings (Netherlands) at the Ijssportcentrum in Eindhoven, Netherlands on December 8, 2006. I do not think this will be a new event at the Winter Olympics anytime soon. When was the last time you tried running on ice?

5. Fastest Time to Place Six Eggs in Eggcups Using the Feet. Leslie Tipton (USA), a contortionist, transferred six eggs into six eggcups using only her feet. She did the transfer in 57 seconds. This feat was achieved on the set of Guinness World Records in Madrid, Spain on June 11, 2006. I suspect Leslie had to eat quite a few eggs leading up to her Guinness World Record.

A Bunion Soothing Secret

2009-12-28T15:36:00.003-05:00

Bunions are not an easy problem to deal with. They can be quite painful, and sometimes require surgery to fix. This product from our online store is designed to help you find relief from the pain associated with your bunions:

Dr. Jill's Gel Bunion Guards-Bunion Shield

Features:

-Soft, flexible gel conforms and adapts to the shape of the bunion area. Shields and guards the bunion.

-Can be worn throughout the day to protect bunions from painful pressure.

-Washable and re-usable pads. Each pad can be used over-and-over again.

-For use in all styles of footwear.

-Doctor recommended.

How These Gel Pads Provide Comfort:

-Protects the bunion as if in a cradle, taking pain, pressure, and friction away from bunion area.

-Pad sits over bunion without adhesive and is held in place by hosiery.

Possible Uses:

-Bunions

-Tailor Bunions

Directions:

-Apply to clean and dry foot.

-Apply concave gel part of pad directly over tender bunion area and wear socks or hosiery as normal to hold pad in place. Re-adjust pad to make sure it is in the proper place while putting on hosiery and also after hosiery is in place.

-Remove the cushion at least 3 to 4 hours daily to allow the skin to breathe.

Recommended Care: We recommend that you hand wash the product with mild soap and water. Rinse thoroughly. Then, air dry. Once dry, lightly dust gel with talcum powder if gel becomes sticky after washing.

The life of the product is affected by its care, use, and activity level of the individual.

Warning: Do not place product on an open wound. If irritation, discomfort, or any problem results from the use of this product, discontinue use immediately, and notify your doctor immediately. Keep out of reach of children and pets.

Sizing:1 size fits all

Visit our online store at:http://www.ourdoctorstore.com/vail/store/item.asp?item_id=494 for more information or to order.

Merry Christmas

2009-12-23T09:03:00.003-05:00

Merry Christmas from Dr. Vail and the Advanced Footcare Clinic Staff. It has been our pleasure to serve you throughout the year. We get a deep satisfaction out of seeing our patients experience relief from their foot ailments, and we look forward to continuing to treat patients with the highest level of care available. This is why we continue to present educational material on our website, in blogs, in brochures, and through our free book for patients. We hope that educating you about your footcare and your general healthcare will aid you in improving your quality of life. If you ever have any questions do not hesitate to contact our office. We hope that your holiday season is enjoyable, relaxing, and fun and that you experience all the blessings that the season has to offer.

Plantar Fasciitis

2009-12-21T11:12:00.002-05:00

Do you experience pain in your feet. If this pain is a sharp, stabbing pain located on the inside of the foot where the arch and the heel meet, it may be plantar fasciitis. Often this pain will be worst at a few times: 1. when first waking up in the morning and will subside as the day continues and the plantar fascia stretches out, 2. after getting up from a long period of sitting and resting the feet or 3. after long periods of standing or walking. These patterns may be signs of plantar fasciitis, one of the most common causes of heel pain. It is an inflammation in the band of tissue (called the plantar fascia) that runs from the heel to the toes. It is often caused by poor foot structure such as overly flat feet or high arches. It can also be caused by wearing non-supportive footwear, spending long hours on your feet, working on hard surfaces (like concrete floors), or obesity.

If you feel that you may have symptoms of plantar fasciitis, you should see your podiatrist. We offer many treatments to help you find relief from the pain associated with plantar fasciitis. There is no reason for you to suffer unnecessarily when we are here to help.

Secrets to Long Lasting Shoes

2009-12-16T14:29:00.005-05:00

Shoes can be fun. They reflect your style and help you vary your outfits. And shoes have so many purposes. Some are for dancing, some for running, and some are attractive. No matter what the use your shoe may have, you want them to last so you can wear them over and over. Although you should replace shoes when they are worn out, you can get a little extra mileage out of them. Keep in mind that shoes which do not offer the appropriate support may be harmful to your foot health. But here are some tips for keeping your shoes in good shape just a little bit longer.

1. Always unlace your shoes. When you leave your shoes tied and slip them on and off, you most likely are bending the support around the ankle. The rigidity in this part of the shoe is important to support your ankle and heel. Bending it outwards when taking the shoe off, or smashing it down when sliding into shoes makes the shoes lose this support faster. This is especially important in athletic shoes which are supporting your feet during activity.

2. Add new insoles. Insoles sometimes wear out before the outside of a shoe does. When this happens, you can extend the life of your shoe by adding new ones. For some people, this is a matter of comfort as they want more padding in an already supportive shoe which has lost its original padding. For others, adding an insole is a matter of support, as they need orthotics to correct misalignments in their feet.

3. Clean your shoes. There are many products for cleaning all kinds of shoes, from leather dress shoes, to mesh athletic shoes, or even hiking or snow boots. If your shoes still have good support but are looking a little dingy, cleaning them restores that new look to your shoes. You can unlace the shoes and wash dirty shoelaces, or just replace them with new ones. If a shoestring breaks, replace it promptly. Don't just clean the outside of your shoes, but the inside as well. Spraying your shoes weekly with a disinfectant spray (like Lysol) helps kill bacteria, viruses and fungi in your shoes which cause infections (like toenail fungus and athlete's foot). You can dry your shoes with a hair dryer after spraying them.

4. Polish your shoes. Dress shoes make an impression. When your shoes are getting scuffed and worn, you can restore them to their original look with a little shoe polish. Match the polish and your shoe color and take your time to follow the instructions for the polish. Your shoes will not only have the support you require, but will start looking good again. You can even get your shoes polished by someone else as a way to relax in the middle of your day, you just need to know where to look. Machine shoe polishers are also available in certain locations.

5. Treat your shoes. There are many products available to seal shoes against weather. This will not only benefit outdoor shoes like hiking boots, but athletic, casual, and dress shoes as well. You will inevitably get caught in the rain in Italian leather dress oxfords or your favorite pair of designer pumps. Being prepared for this with a pretreatment can save your shoes from damage (and you some money if they are expensive shoes).

6. Rotate shoes. Wearing one pair of shoes every day has a lot of disadvantages. First of all, your shoes need time to air out and dry between wears. alternate shoes at least every other day. This alternation will also spread wear amongst many pairs of shoes, making them all last longer. You should also match your shoes to their activity. Your dress shoes aren't built to withstand muddy hikes or shoveling snow. Keep in mind that picking the appropriate shoe is not only good for you, but your shoes as well.

7. Store your shoes correctly. Keep them on a rack or other storage system. If your shoes get covered in heavy objects, they can lose their structure and become weakened. You should store off-season shoes in a plastic bin with a lid to avoid moisture getting to your shoes while they are in store and ruining them.

Secret to Healthy Skin

2009-12-14T13:26:00.002-05:00

Winter is a hard season on skin. Dry air around us and increased heat in our homes and workplaces takes a toll on our skin during this season. Dry skin can be painful, as anyone with chapped lips or cracked skin on their feet can tell you. Just like you need to moisturize your lips when they're chapped, you need to moisturize the skin on your feet too. Cracked skin opens your body to the bacteria, viruses and fungi which cause various infections to the skin, nails and inside the foot. You need to care for your feet to avoid these problems before they become serious medical complications. Try these tips:

1. Keep your calluses under control. It is when calluses grow that they are most likely to dry out and crack. Calluses on the bottom of your feet develop naturally and help to protect your feet. Having a callused area on your feet is not a bad thing, but you should pay attention to them and treat them as follows. Soak your feet for 10-20 minutes. This will help relax you and your feet as well as softening and moisturizing the skin on your feet. Make sure the water isn't too hot as this can actually dry out your skin worse. Dry your feet with a towel and use an emery board, pumice stone or callus file to shave down your callus. This helps remove the dead skin of the callus. Do not trim down to the fresh skin under the callus. And you do not have to completely remove the callus, only keep it manageable.

2. Moisturize the skin on your feet. Your skin is prone to drying, especially in the winter. You should moisturize the skin on your feet, especially if it is dry and cracking. The best times to moisturize are right after a shower (dry thoroughly first) and before going to bed. You may consider leaving your socks on so that the moisturizer stays on your feet longer. Do not moisturize between your toes. This will keep your skin in great shape and looking good as well.

Not sure about a moisturizer for your foot? We offer one on our online store and in our office. Try:

Pedifix Mango Magic Foot Lotion
Instantly Moisturizes Skin with Healthy Nutrients
Pamper your feet! This salon-style lotion will soothe and soften rough, dry feet and refresh your skin. It features mineral oil, aloe vera, vitamin E, lanolin and urea to nourish your skin while it stimulates your senses with the tropical-fresh scent of mangos. Also works great as an all-over body lotion.

8 oz. Bottle

Massage cream into skin as needed, particularly after bathing and just before bedtime.

Cautions on Retail Orthotics

2009-12-09T10:29:00.004-05:00

Over-the-counter orthotics and other insoles have come a long way. These items can do a great deal to help reduce pain and control foot mechanics, especially misaligned foot mechanics. Nut there are some concerns to keep in mind any time you are buying an over-the-counter orthotic.

1. Retail orthotics do not come with a diagnosis from a medical professional. Sometimes orthotics are recommended by an orthotic sales-person or are suggested based on a pressure image of your foot. The problem is that a sales-person is just that. They want you to purchase their product, but do not have the medical training necessary to actually diagnose a problem with your feet. This means that orthotics may not be right for you, or that retail orthotics cannot solve your problem as they are not customized to your feet. You should see a podiatrist if you think you need orthotics. Not only can your doctor diagnose your foot problem, they can recommend over-the-counter orthotics brands which they trust and that can provide you with the greatest relief from your foot ailments. They also can recommend a custom-molded orthotics which will offer the greatest relief and support for your foot mechanics. Also bear in mind that a scan of your feet only shows where you put the most pressure, either when standing or walking. It does not show if there is a misalignment or other foot ailment which is causing you to bear this weight in a different area of your foot than normal.

2. Some retail orthotics make such an effort to add additional support to the arch that they can cause more pressure on other areas of the foot, especially the big toe joints. Over time this pressure can lead to changes in the foot or arthritis. The orthotics can also cause you extra pain by forcing your arch higher than is normal or comfortable.

3. A retail orthotic can sometimes increase arch support without controlling the mechanics of the whole foot. This may mean that you are not getting relief from another problem which you have, and this problem could continue even with the orthotic in place.

4. Buying a retail orthotic can over-correct or under-correct your problem. Perhaps you do have problem which requires orthotics. Sometimes when an orthotic isn't customized to your foot it can over-correct or under-correct your problem, perhaps stretching your arch either too high or not high enough. Your condition may not be severe enough to warrant the use of an orthotic. Be careful not to buy an orthotic device which you do not need.

Bear these things in mind when you are considering purchasing over-the-counter orthotics. These orthotics do offer an inexpensive solution to some foot problems, but they should be recommended for use by your podiatrist. A sales-person in a store is not likely to have your footcare needs as their primary goal, and often lack to expertise to advise you on your footcare. You need to see a podiatrist who is primarily concerned with your healthcare and has the knowledge and experience to diagnose a problem. You should allow your podiatrist to recommend retail orthotics to you.

Secrets on Our Website

2009-12-07T09:56:00.003-05:00

Have you been experiencing foot or ankle pain? Have you perhaps noticed a fungal infection in your nails or athlete's foot? Maybe you have recently been diagnosed with diabetes and would like to know more about how that condition can affect your feet and your footcare. You are in luck! Our website www.vailfoot.com is a great resource for our patients to explore their footcare. We provide educational information on a wide range of topics which cover the most common footcare concerns we see in patients. We also offer information on our office, including how to find us, make appointments, and filling out new patient forms from home before coming into the office. You can even explore some of the treatments we perform for various illnesses. There is also information on the books we offer free to local residents, DVDs, the shoe brands we carry, and our online store stocked with products for your footcare needs. Explore our website at www.vailfoot.com to find many secrets to improving the condition of your feet.

A Secret to Stability

2009-12-02T14:11:00.003-05:00

Here is an ankle brace from our online store for patients who are experiencing an injury, are prone to ankle injury, or are looking for support while playing a sport or exercising.

Ossur - Exoform Ankle Brace
Advanced technology results in breakthrough performance

Exoform "Ù" Technology forms an injection molded exoskeleton directly onto soft breathable fabric, combining the compression and comfort of a soft ankle brace with the stability of a stirrup ankle brace.

Improves performance 35%. In-house testing shows that the Exoform Ankle Brace reduces ankle inversion by as much as 35% over the leading ankle stirrup. Compared to the leading stabilized soft ankle brace, the Exoform shows a 40% improvement!

Features:

-Speed laces allow the user to lace up the Exoform in seconds, a big time saver that will encourage use and drive compliance.

-Slim fit design is low profile and fits easily into all footwear.

-Injection molded exoskeleton forms a network of support zones strategically placed to minimize inversion and eversion without restricting plantar and dorsi-flexion.

-Available with a unique heel-lock strapping system.

-Nylon "figure 8" straps will not stretch during exercise. Fully adjustable even while in use.

-Breathable lightweight fabric enhances comfort by allowing heat and moisture to escape throughout the brace.

-Padded heel and tongue fabric is durable and provides added comfort. Material is 100% latex free.
-Machine washable. Air dries quickly.

-Bi-lateral design fits left or right ankle.

Visit our online store at: http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=202&DEPARTMENT_ID=48 for more information of to order this product.

Varicose Veins

2009-11-30T09:59:00.002-05:00

Varicose Veins are a comon problem, especially among people who have stood for a living for many years. They are most common in the legs. Here is an article giving a brief overview of varicose veins:

Varicose veins
Varicose veins are swollen, twisted, and sometimes painful veins that have filled with an abnormal collection of blood.

Alternative Names
Varicosity; Varicosis

Causes
In normal veins, valves in the vein keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.
This process usually occurs in the veins of the legs, although it may occur elsewhere. Varicose veins are common, affecting mostly women.

Causes include:
-Defective valves from birth (congenitally defective valves)
-Thrombophlebitis
-Pregnancy
-Standing for a long time and having increased pressure in the abdomen may make you more likely to develop varicose veins, or may make the condition worse.
-Primary varicose veins occur because of congenitally defective valves, or without a known cause. Secondary varicose veins occur because of another condition, such as when a pregnant woman develops varicose veins.

Symptoms
-Fullness, heaviness, aching, and sometimes pain in the legs
-Visible, enlarged veins
-Mild swelling of ankles
-Brown discoloration of the skin at the ankles
-Skin ulcers near the ankle (this is more often seen in severe cases)

Exams and Tests
-The diagnosis is mainly based on the appearance of the leg veins when you are standing or seated with the legs dangling.
-At times a physician may order a duplex ultrasound exam of extremity to see blood flow in the veins, and to rule out other disorders of the legs (such as a blood clot). Rarely, an angiography of the legs may be performed to rule out other disorders.

Treatment
Treatment is usually conservative. You will be asked to avoid excess standing, raise your legs when resting or sleeping, and wear elastic support hose.
You may need treatment to improve the appearance of your legs. Surgery may be recommended, such as:
-Vein stripping and removal of the varicose vein (ligation)
-Sclerotherapy of veins
-Vein stripping is usually reserved for patients who are experiencing a lot of pain or who have skin ulcers.

Outlook (Prognosis)
Varicose veins tend to get worse over time. You can ease discomfort and slow varicose vein progression with self care.

Possible Complications
-Phlebitis (chronic inflammation of the vein)
-Formation of leg ulcers
-Rupture of a varicose vein

When to Contact a Medical Professional
Call for an appointment with your health care provider if:
-Varicose veins are painful
-They get worse or do not improve with self-treatment, such as keeping the legs elevated or avoiding excessive standing
-Complications occur, including a sudden increase in pain or swelling, fever, redness of the leg, or leg ulcers

Prevention
Avoid prolonged standing if personal or family history indicates you are at risk of developing varicose veins.

Secret to Pretty Feet

2009-11-25T08:53:00.002-05:00

Many foot conditions not only cause pain and hinder your ability to walk, but many of them can render your feet rather unattractive. Conditions like toenail fungus, which causes yellowing and cracking or the toenails, often requires treatment over a period of several weeks and even months, depending on the case. But for someone who does not have any preexisting conditions, keeping your feet looking good is not hard. A small amount of time invested in your feet not only keeps them looking good, but can keep them healthy as well. Here are some tips for maintaining your pretty feet.

1. Remove any toenail polish. Once you do this you can closely inspect your toenails for signs of trauma and fungal infection. It is also a good idea to not always have toenail polish on your toes, as having them constantly polished can cause them to become discolored. Wear it for special occasions, and when it starts coming off, just remove it and allow your feet some time without polish. Non-acetone polish removers are best.

2. Enjoy a foot soak. Not only will you find this 15-20 minutes relaxing, but it helps moisturize your feet and soften skin and nails, making it easier to trim nails and calluses. Keep in mind that water which is too hot can actually dry your feet out, so don't use the hottest temperature you can stand, but rather a comfortable temperature. Aromatherapy soaks and bath salts can be added to your foot soak, but keep in mind that these may be bad for or painful on any open wounds. Consult your podiatrist about foot soaking if you have an ulcer or open wound. At then end of your soak, scrub your toenails with a toenail brush. This will help remove any excess dirt or flaking nail particles.

3. Trim your calluses and corns. The soak will have softened these hard areas of skin, making them easier to remove with a pumice stone, emery board, and/or callus file. This is important because large, hard calluses can crack, leaving a vulnerable point in your skin for bacteria, viruses, and fungi to enter and cause infection. It may take a couple of trimmings before you can remove all the hard skin. Be careful not to trim calluses down to fresh skin. Do not cause yourself pain when trimming calluses. If you think you are getting close to your skin, you can stop trimming. Calluses can be controlled without being removed.

4. Trim your toenails. They will also be softer and easier to trim after the soak. Always trim nails straight across, as cutting near the edges of your nails increases your risk of the toenail becoming ingrown as it grows back. You can round the edges slightly with an emery board. You may push your cuticles back if you choose, but do not cut them. The cuticle area can easily become infected.

5. Parafin wax treatment. Although this treatment is optional, it does have benefits for your feet. The warmth of the wax is not only relaxing, but it helps increase circulation (which increases the amount of blood traveling through your feet and thus the rate at which your body heals itself) and opens pores, which allows your feet to absorb more moisture. As the wax is cooling down, you can wrap your feet in a towel to make the warmth last a little longer.

6. Apply lotion. Since the pores are open in your feet after the wax treatment and soak, this is the best time to apply lotion so that your skin absorbs the moisturizer. Moisturizing feet is important, especially for those with dry skin which cracks. If you have dry feet you should moisturize daily. We recommend Gormel cream, which is available in our office. Just be sure never to moisturize between your toes, these areas are already pretty moist and very susceptible to fungal infections which cause athlete's foot. Put on socks after you moisturize to help keep the lotion on longer and allow your skin to absorb it. Putting on lotion is a great time to also apply foot massage. Massage benefits your feet by adding relaxation, stretching your muscles, and increasing circulation.

Some other tips for healthy and good looking feet:

1. Treat any athlete's foot. If you have athlete's foot, you should treat it. Begin treatment as soon as you notice the problem. This will reduce the amount of time it takes to clear up the problem and prevent it from getting worse. Over the counter athlete's foot products should be your first step. You should also change your socks frequently and apply foot powder to keep your feet dry. Rotating shoes gives them a chance to dry out before you wear them again and helps prevent excess moisture around your feet. If your athlete's foot problem continues, you should see your podiatrist. We have medicated powders available and the doctor can suggest treatments and prescriptions to help with your problem.

2. Treat toenail fungus. If you have yellow, discolored nails which flake or crack you most likely have a fungal infection of the toenails. See your podiatrist, as we have many treatments available for getting rid of this infection for you and returning your nails to their normal state.

3. Prevent sweating. Moisture, warmth, and darkness in your shoes makes them a prime place for bacteria and especially for fungus to grow. It also is the main contributor to foot odor. Change your shoes daily as this gives them time to dry out. Make sure you change your socks every day and wash them before you wear them again. Foot powder is also good for keeping your shoes and your feet dry. If you sweat excessively you may want to consider changing your socks and reapplying foot powder in the middle of the day. Your podiatrist can also prescribe prescription strength medications for your excessive foot sweating. You can also get antiperspirants for your feet or shoe insoles which contain charcoal.

4. Wear the right shoes. Many foot problems are actually the result of improperly fitting shoes. Shoes that are too tight, especially in the toes, do not offer enough support, or have high heels often contribute to foot deformities and foot function problems. Tight fitting shoes around your toes can also contribute to toenail fungus, ingrown toenails, the development of corns and calluses, and can irritate bunions and hammertoes. Make sure that you buy shoes that fit your properly. The best time to try on shoes in in the afternoon, when you have been on your feet for some time and the blood flow has caused them to swell.

Anatomy of the Foot

2009-11-23T10:16:00.003-05:00

Here is an article which gives an overview of your foot's anatomy. We hope it helps you to better understand your feet, their functions, and their needs.

Foot Anatomy and Physiology
By Elizabeth Quinn

The foot is an incredibly complex mechanism. This introduction to the anatomy of the foot and ankle will not be exhaustive, but rather try and highlight the structures that will be discussed in the sections below.

Foot Structure
The forefoot includes the five metatarsal bones, and the phalanges (the toes). The first metatarsal bone bears the most weight and plays the most important role in propulsion. It is the shortest and thickest. It also provides attachment for several tendons. The second, third, and fourth metatarsal bones are the most stable of the metatarsals. They are well protected and have only minor tendon attachments and are not subjected to strong pulling forces.
Near the head of the first metatarsal, on the plantar surface of the foot, are two sesamoid bones (a small, oval-shaped bone which develops inside a tendon, where the tendon passes over a bony prominence) They are held in place by their tendons, and are also supported by ligaments.
The midfoot includes five of the seven tarsal bones (the navicular, cuboid, and three cuneiform). The distal row contains the three cuneiforms and the cuboid. The midfoot meets the forefoot at the five tarsometatarsal (TMT) joints. There are multiple joints within the midfoot itself. Proximally, the three cuneiforms articulate with the navicular bone.
The talus and the calcaneus make up the hindfoot. The calcaneus is the largest tarsal bone, and forms the heel. The talus rests on top of it, and forms the pivot of the ankle.

Foot and Toe Movement
Toe movements take place at the joints. These joints are capable of motion in two directions: plantar flexion or dorsiflexion. In addition, the joints permit abduction and adduction of the toes.
The foot as a whole (excluding the toes) has two movements: invertion and evertion. All the joints of the hindfoot and midfoot from the subtalar contribute to these movements, which are complex and consist of several components. In addition, foot movements ordinarily are combined with ankle movements.

The Foot Arches
The foot has two important functions: weight bearing and propulsion. These functions require a high degree of stability. In addition, the foot must be flexible, so it can adapt to uneven surfaces. The multiple bones and joints of the foot give it flexibility, but these multiple bones must form an arch to support any weight.
The foot has three arches. The medial longitudinal arch is the highest and most important of the three arches. It is composed of the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals. The lateral longitudinal arch is lower and flatter than the medial arch. It is composed of the calcaneus, cuboid, and the fourth and fifth metatarsals. The transverse arch is composed of the cuneiforms, the cuboid, and the five metatarsal bases.
The arches of the foot are maintained not only by the shapes of the bones as well as by ligaments. In addition, muscles and tendons play an important role in supporting the arches.

Muscles of the Foot
The muscles of the foot are classified as either intrinsic or extrinsic. The intrinsic muscles are located within the foot and cause movement of the toes. These muslces are flexors (plantar flexors), extensors (dorsiflexors), abductors, and adductors of the toes. Several intrinsic muscles also help support the arches of the foot.
The extrinsic muscles are located outside the foot, in the lower leg. The powerful gastrocnemius muscle (calf) is among them. They have long tendons that cross the ankle, to attach on the bones of the foot and assist in movement. The talus, however, has no tendon attachments.

2009-11-18T10:10:00.002-05:00

Part of our commitment to patient education is to make you aware of some of the available treatments for different podiatric conditions. This article explores sports massage to help patients recover from injury and perform their best.

Sports Massage
What are the Benefits of Sports Massage?
From Terence Vanderheiden, D.P.M.

Sports massage is reported to have many beneficial effects in athletes. Sports massage can be used pre-performance, post-performance, during training or for rehabilitation. Athletes of all levels may benefit from sports massage. If you are looking for a way to improve your athletic performance, then sports massage may be for you. Learn more about the possible performance enhancing effects of sports massage.

What is Sports Massage?
Sports massage is a systematic manipulation of the soft tissues of the body that focuses on muscles relevant to a particular sport. Runner Paavo Nurmi, known as the "Flying Finn," was one of the early users of sports massage. Nurmi is said to have used sports massage during the 1924 Olympics in Paris where he won five gold medals. In the United States, Jack Meagher is thought to be the father of sports massage in the United States.
Many different movements and techniques are used in sports massage. Examples of these techniques include; Swedish style massage, effleurage (stroking), petrissage (kneading), compression, friction, tapotement (rhythmic striking), vibration, gliding, stretching, percussion and trigger points. These movements and techniques are used to try to help the athlete's body achieve maximum performance and physical conditioning with a decreased chance of injury or pain and a quicker recovery.

What are the Benefits of Sports Massage?
Many benefits from sports massage have been reported based on experience and observation. Some of the benefits are to the mind (psychological) and some are to the body (physiological). Possible side effects of sports massage are tenderness or stiffness for 1 to 2 days after the sports massage. A skin reaction due to the massage oils is also possible. But for the most part, sports massage is safe. Some of the reported benefits include:
• Increased blood flow
• Increased joint range of motion (ROM)
• Increased flexibility
• Increased elimination of exercise waste products (lactic acid)
• Increased sense of well-being
• Decreased muscle tension
• Decreased neurological excitability (nerves more relaxed)
• Decreased chance of injury
• Decreased recovery time between workouts
• Decreased muscle spasms

What Does the Sports Massage Research Say?
Now that you know the reported benefits of sports massage, let's find out if the research studies support those benefits. Research studies regarding perceived fatigue and recovery showed that subjects felt they were less fatigued and felt like they recovered faster after sports massage. Decreased anxiety, improved mood and well-being were also noted. Delayed onset muscle soreness (DOMS) decreased by about 30% in one research study. Other studies support the finding that DOMS does decrease after sports massage.
Now for some benefits that are not supported by research. The ability of sports massage to help the muscles get rid of lactic acid is not supported in research studies. Many researchers feel this is linked to the fact that increased blood flow to muscles after sports massage cannot be supported either. A quicker recovery after sports massage is not yet supported by the research. Studies do support that active recovery (low-intensity exercise after work-out) is the best method of decreasing the amount of lactic acid that builds up after exercise and speeds recovery.
So what does all of this mean? It seems that the positive mind (psychological) benefits of sports massage are indeed supported by research studies. Study findings also support that sports massage does not negatively effect performance, but the positive body (physiological) benefits on performance are not quite as clear. More research is needed on the positive body effects and also on the mind/body interaction after sports massage.

Ingrown Toenails

2009-11-16T10:56:00.002-05:00

Many of our patients suffer from ingrown toenails. These can be caused by improper nail cutting, a trauma or injury, or by shoes that do not fit correctly. Ingrown toenails cane asily be removed to help the patient experience relief from the pain associated with this condition. Click on the link below to view a video with more information about ingrown toenails and their treatment.

http://www.videomd.com/IngrownToenail-fv-2172.aspx

Stretching for Plantar Fasciitis

2009-11-11T09:36:00.002-05:00

Patients who suffer from Plantar Fasciitis can often find relief from simple exercises which work to stretch the plantar fascia. These exercises are simple, can be done with minimal equipment (all of which can be found around your house), and take very little time. They are great exercises to do in the morning, when the pain from plantar fascia is usually the worst. These stretches will help loosen up your plantar fascia and prepare you for your day spent on your feet. This video link below provides an example of how to perform these stretches. You should also visit our website at http://www.vailfoot.com/ for more stretches, in depth explanations of the stretches, and products to help you receive the best relief possible from your plantar fasciitis. And of course the best way to relieve your condition is to make an appointment with the podiatrist.

http://www.videomd.com/StretchingForHeelPain-fv-3924.aspx

Lisfranc Injury

2009-11-09T09:19:00.003-05:00

Here is an article about Lisfranc Injuries, including notes on symptoms, diagnosis, and treatment of the problem.

Lisfranc Injury
History of Lisfranc Injury
by Terence Vanderheiden, D.P.M.

Lisfranc injuries are named after Jacques Lisfranc, a French surgeon in the early 1800s. In the army, a lot of the soldiers would get thrown from their horses, and their foot would get caught in the stirrup. This would cause an injury to the middle of the foot. Unfortunately, back then this injury sometimes ended up needing an amputation. Thankfully, today it is a different story, and amputation is usually not needed. Lisfranc injuries, though, can still cause a lot of problems. Learn more about Lisfranc injuries.

What is a Lisfranc Injury? Lisfranc injuries involve the midfoot area. The Lisfranc joints are between the first metatarsal, second metarsal, medial cuneiform and intermediate cuneiform. The Lisfranc complex involves all of the tarsometatarsal joints. There is also a Lisfranc ligament that runs on the bottom of the medial cuneiform to the second metatarsal base. Lisfranc injuries, to the midfoot, can include sprains, dislocations, fractures (broken bones) or all of the above. Two very serious complications can be seen with Lisfranc injuries: injuries to the dorsalis pedis artery and compartment syndrome. These are both medical emergencies and need surgery right away.

Causes. Lisfranc injuries are most often caused by some type of trauma, which can be either direct or indirect. An example of direct trauma would be dropping something on the foot. Indirect trauma usually involves a twisting of the foot after it gets caught on something. Lisfranc injuries account for about 1% of all fractures. They are not common, but sports medicine doctors tend to see the injury more frequently. Lisfranc injuries can occur in car accidents, military personnel, horse riders and in many sports (football, baseball and soccer, to name a few).

Signs and Symptoms
• Swelling of the foot and/or ankle
• Bruising of the foot and/or ankle
• Pain usually in the middle part of the foot
• Difficulty stepping on the foot (due to pain)
• Widening of the midfoot area (due to bone dislocation)
• Large bump on the top mid-foot area (due to bone dislocation)

Diagnosis. First, your doctor will do a thorough history and physical exam. He or she will be sure to check your pulse (dorsalis pedis artery) on the top of your foot, because sometimes this artery can be injured due to the trauma. Your doctor will also make sure you do not have a compartment syndrome, which is a build-up of pressure in the foot causing excruciating pain. The excessive pressure can cause damage to the soft tissues, nerves, arteries and muscles. Compartment syndrome is a medical emergency that requires surgery to relieve the pressure.
Next, you will probably get X-rays of your injured foot. The X-ray may be weight bearing (standing on the foot) or nonweight bearing. Sometimes your healthy foot is also X-rayed for comparison. Lisfranc injuries can be difficult to see on plain X-rays. If there is a question about it, your doctor may send you for a CT (computed tomography) scan. Since a CT scan has three-dimensional views, it will allow the doctor to see the bones in much better detail. An MRI (Magnetic Resonance Imaging) is also occasionally used to evaluate the soft tissues, especially the Lisfranc ligament. An MRI is not usually needed if there is dislocation or fracture, because this usually signifies that the Lisfranc ligament has already ruptured. If the dorsalis pedis artery is not felt by hand, then a Doppler ultrasound may be needed to assess the artery.

Treatment. The treatment for Lisfranc injuries varies, depending on if you had a sprain, dislocation, fracture or all of the above. Treatment also depends on when you were diagnosed with the injury. Generally speaking, if you have sustained a Lisfranc sprain, you will need to be nonweight bearing (no weight on the foot) in a cast or removable cast boot for four to six weeks. This will usually be followed by physical therapy and a gradual return to activity. Lisfranc dislocation and fracture injuries are usually treated with surgery. It is important to try and line up the bones and joints as much as possible. This is done with wires, screws or plates. After surgery you are usually nonweight bearing for six weeks and then you begin walking with a cast-walking boot for another four weeks. If the bones and joints are not lined up properly, there is an increased risk of degenerative changes, which can lead to arthritis and instability. If pain in the midfoot continues for a long time, sometimes a second surgery is needed to fuse (arthrodese) the midfoot bones together.

Shin Splints

2009-11-04T09:45:00.003-05:00

Here is an article to inform you about the condition commonly referred to as shin splints and what you can do to avoid and relieve the pain caused by this condition.

Shin Splints - Medial Tibial Stress Syndrome
Painful But Treatable
by Terence Vanderheiden, D.P.M.

What Are Shin Splints? Long ago, the term shin splints was used to describe general pain in the lower leg, because lower leg pain was all lumped together and called shin splints -- regardless of what or where the pain was located.
Today, we know that shin splints occur in a particular area and are a separate diagnosis from other problems, such as stress fractures or compartment syndromes. Researchers and doctors are now more knowledgeable and are trying to be more specific in naming causes of lower leg pain. They also are trying to base the name of the diagnosis on where the pain is located and by what is actually causing the pain. Typically, the pain associated with shin splints is felt on the medial-posterior (inside-back) tibia. Therefore, shin splints are now called medial tibial stress syndrome.
There is still much debate on what actually causes the pain. Possible causes of the pain are: periostitis (inflammation of the covering around the bone), traction periostaligia (pain of the covering around the bone due to muscle pulling on it), tendinopathy (problems with the tendons), periosteal reaction (formation of new bone due to injury) and fatigue failure of the connective tissue connecting muscle to bone.
The term "shin" is a common name for the large, lower leg bone called the tibia. If you take your hand and touch the front of your lower leg, the hard bone you feel is your tibia. Shin splints frequently affect people who run.

Causes
• Running downhill
• Running on uneven surfaces
• Weak muscles in the front of the leg (stronger muscles in the back of your leg)
• Over-pronation (when your foot rolls to the inside and your arch flattens)
• Wearing inappropriate shoes (worn-out or incorrect for your foot type)
• Training too hard too soon (not increasing your activity gradually), because muscles that fatigue quickly lose their ability to absorb shock and therefore more stress is placed on the bones

• Resuming activity (exercise) after a period of no or reduced activity

Signs and Symptoms
• Tenderness over the inside shin area (may start as a dull ache and progress to a sharp pain)
• Pain starts with activity and then seems to disappear, but may return at the end of activity, as shin splints get worse the pain may last longer
• Lower leg swelling
• May see lower leg redness (rubor)
• May feel a lump or bump on the lower leg
• Pain with toes or ankle pointed downwards

Diagnosis

The diagnosis is usually made from your history and physical examination. Pain is usually located 3-12 cm above the tip of the inside ankle bone (medial malleolus) and is "vertically oriented" (runs up and down) as opposed to pain with a stress fracture, which is horizontal (across or side to side). Your podiatrist or doctor should perform a biomechanical exam to see if your foot type is contributing to your shin splints. If the diagnosis is still unclear, your doctor may order an x-ray, MRI or bone scan. An MRI is able to show a difference between shin splints and stress fractures: A stress fracture will show a "wide signal abnormality" whereas shin splints will show a "linear signal abnormality."
However, an MRI is usually not needed if the physical exam findings are obvious. Sometimes, a bone scan may be done, which can show a linear (long line) of increased signal uptake, highlighting the difference between shin splints and stress fractures.

Treatment
• Rest (no exercise)
• Ice/ice massage
• Strengthen lower leg muscles in front of leg
• Sports massage
• Appropriate shoes
• Arch supports
• Orthoses (orthotics)
• Taping/bracing
• Anti-inflammatories (NSAIDs)
• Physical therapy
• Cross training (swimming, biking, walking)
• Train on softer surface (soft grass, smooth dirt, asphalt, concrete)
• Relative rest (lengthening the time between work-outs, decreasing the amount and intensity of the work-outs)

Other Causes of Lower leg Pain:
• Compartment syndrome
• Stress fracture
• Bone tumor
• Lipoma
• Vascular disease
• Spinal stenosis
• Cellulitis
• Infection
• Nerve entrapment

2009-11-02T09:58:00.002-05:00

Here is an article about high heeled shoes, and the effects they have on the alignment and motion of your many joints and limbs.

High-Heeled Shoes - Bad for the Body
Fashion at a High Price
by Terence Vanderheiden, D.P.M.

Wearing high heels can be fashionable and may make you feel taller, but at what price? High heels can cause foot problems while exacerbating foot problems that you already have. Leg and back pain also are common complaints from those who wear high heels.

Posture. A high heel shoe puts your foot in a plantarflexed (foot pointed downward) position, placing an increased amount of pressure on your forefoot. This causes you to adjust the rest of your body to maintain your balance. The lower part of your body leans forward and to compensate for that, the upper part of your body must lean back to keep you balanced. This is not your body's normal standing position.

Gait. When walking, your foot is in a more fixed downward position (plantarflexed) therefore you are not able to push off the ground with as much force. This causes your hip flexor muscles in your legs to work harder to move and pull your body forward. Your knees also stay more bent (flexed) and forward, causing your knee muscles to work harder.

Balance. Walking in high heel shoes is like walking on a balance beam. It takes a lot of balance and just like teetering on a beam, there is not any support in a high heel shoe to catch you if you fall. High heel shoes cause your foot and ankle to move in a supinated (turned outward) position. This position puts you at risk for losing your balance and spraining your ankles.

Back. The normal s-curve shape of the back acts as a shock absorber, reducing reduce stress on the vertebrae. Wearing high heels causes lumbar (low-back) spine flattening and a posterior (backward) displacement of the head and thoracic (mid-back) spine. High heel shoes cause you to lean forward and the body's response to that is to decrease the forward curve of your lower back to help keep you in line. Poor alignment may lead to muscle overuse and back pain.

Hips. The hip flexor muscles are located on the upper front part of your thighs. They are forced to work much harder and longer to help you walk because your feet are held in a downward position (plantarflexed) and have reduced power to move your body forward. If your hip flexor muscles are chronically overused, the muscles can shorten and a contracture can occur. If a contracture occurs, this could lead to flattening of the lumbar (low-back) spine.

Knees. Knee osteoarthritis is twice as common in women. Some of that blame may be due to high heels. The knee stays flexed (bent) and the tibia (shin bone) turns inward (varus) when wearing high heels. This position puts a compressive force on the inside of the knee (medial), a common site of osteoarthritis. If you already have osteoarthritis, it is best to avoid wearing high heel shoes. High heels increase the distance from the floor to the knee and can result in increased knee torque which can also lead to osteoarthritis.

Ankles. High heels limit the motion and power of the ankle joint. The calf muscles (gastrocnemius & soleus) are shortened because of the heel height. The shortened muscles cause them to lose power when trying to push the foot off of the ground. The position of the ankle may also cause a shortening (contraction) of the achilles tendon. This can increase the pull of the achilles tendon where it attaches on the back of your heel bone (calcaneus) and may cause a condition called insertional achilles tendonitis.

Feet. With the foot in a downward position, there is significant increase in the pressure on the bottom (plantar) of the forefoot. The pressure increases as the height of the shoe heel increases. Wearing a 3 1/4 inch heel increases the pressure on the bottom of the forefoot by 76%. The increased pressure may lead to pain or foot deformities such as hammer toes, bunions, bunionettes (tailor's bunions) and neuromas. The downward foot position (plantarflexion) also causes the foot to be more supinated (turned to the outside). This change in foot position changes the line of pull of the achilles tendon and may cause a condition called Haglund's deformity (pump bump).

Skin and Toes. The narrow, pointed toe box that is often found in high heel shoes also causes damage such as corns, callouses and blisters. If you look at a baby or toddler's foot you will see that their toes are spread apart. If you look at an adult's foot, their toes are usually squished together. A lot of times this is due to the footwear that has been worn. If you trace the footbed (part of the shoe where you put your foot) of a high heel shoe on a sheet of paper, and then stand barefoot on that tracing, you will probably have quite a bit of overlap. Does it still seem like a good idea to put your foot inside that shoe?

Save Your Feet. If your car tires are out of alignment, you can only drive so many miles before you are at risk of blowing a tire. The same is true for your body. Things need to be in alignment. It is recommended that you only wear high heels for special occasions and even then only a heel height of 1 1/2 inches. Your feet and body will thank you - and you'll save money on trips to the podiatrist's office.

A Medicine Cabinet Secret

2009-10-30T09:17:00.002-04:00

Amerigel Care Lotion is a product from our online store which has numerous benefits to your skin:

Known as “first-aid for your skin”, this all-in-one skin conditioner is a must for every medicine cabinet. It’s unique combination of Oakin™, Dimethicone and Zinc Oxide enables Amerigel® Care Lotion to address multiple skin conditions with one product, eliminating the need for numerous hand, body and facial moisturizers. The most vital ingredient, Oakin™, provides the tannins to help exfoliate dry skin, fight bacterial infections and reduce inflammation caused by irritations. Dimethicone, a well-known moisturizer and skin conditioner, is designed to re-hydrate the skin without the use of harmful chemicals and Zinc Oxide, known as a skin protectant and antiseptic, helps to provide lasting relief for damaged skin.

Amerigel® Care Lotion can be used from head to toe for:
Face – acne, chapped skin, Rosacea, sunburn or windburn
Elbows – dry white flaky skin, eczema, psoriasis or bruising
Hands – cuticles, calluses, bruises or blisters
Feet – fungus in-between toes, softening corns and calluses, cracked leathery heels, discolored nails, blisters and sunburns

Extremely dry skin needs a fast-acting conditioner with maximum healing power to provide lasting relief. This quick absorbing, long lasting lotion penetrates beneath the surface of dry rough spots to heal from within. If you are diabetic, you know the importance of keeping your feet moisturized and preventing a wound or ulcer from developing. Amerigel® Care Lotion is physician recommended for diabetic patients and has been reported to reduce recurrence of ulcers, when used on a daily basis.

Visit our online store at: http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=31 for more information or to order right now.

2009-10-27T14:03:00.003-04:00

Here is an article from the American Podiatric Medical Association's Website about working in a stand-up environment and the pain it can cause to your feet:

Friendly Footwear a Must for Those Who Work Standing Up

October 7, 2009 Bethesda, MD

The average American’s foot pain often gets in the way of daily activities. Perhaps no group suffers from chronic foot pain more than those who are constantly on their feet. According to the American Podiatric Medical Association's (APMA) 2009 foot ailments survey, 44 percent of respondents said they spend at least four hours standing every day. Additionally, nearly 78 percent of Americans have experienced foot problems as a result of wearing uncomfortable or ill-fitting shoes.
"The excess strain put on the legs and feet of those standing for long periods of time can take a massive toll on the body—especially for those working in the health care community," said APMA President Ronald Jensen, DPM. "Without the proper footwear that provides necessary support to the ligaments and joints of the feet, these individuals are subject to a host of ailments that can lead to chronic problems such as metatarsalgia—a pain and inflammation in the ball of the foot.”
Excessive standing and walking on hard surfaces like concrete can also increase the incidence of foot problems. However, many footwear companies create products that are specifically made for those who “work standing up.”

If you work in such an environment, you should keep an eye out for footwear which has been granted APMA’s Seal of Acceptance. The Seal of Acceptance Program recognizes products which have been found beneficial to foot health and of significant value when used in a consistently applied program of daily foot care and regular professional treatment.

Anatomy of the Foot

2009-10-21T13:46:00.001-04:00

Check out this video by clicking the link below. It will give you a brief overview of the anatomy of the foot.

http://www.videomd.com/AnatomyofTheFoot-fv-2985.aspx

A Germ Fighting Secret

2009-10-19T10:20:00.002-04:00

One of the best ways you can prevent sickness in your children is to help educate them about germs. You can explain to your children that germs called bacteria and viruses are what cause us to be sick. You can also explain to them how these germs spread from sick people to healthy people and can live in many unclean environments. Here are some tips that you can teach your children to help reduce their chance of getting sick this flu season.

-Teach your children to cover their mouths if they sneeze. Sneezing into the inside of your elbow is the best way to prevent the spread of germs. It covers your mouth and the germs coming from it, as well as prevents these germs from getting on your hands. Once these germs are on your hands, they will be transferred to everything you touch. Remind children that covering their mouths when they sneeze helps to prevent the spread of germs.

-Teach your children how to properly wash their hands. The best tip for this is to remind your children that they are not done washing their hands until they sing their ABC's. This will remind them to wash their hands for the necessary length of time. You should also remind your children that proper hand washing includes the back of their hands and between their fingers. Children should wash their hands before meals, after going to the bathroom, and whenever their hands are dirty. If you are sick, you should wash your hands more often.

-Remind your children to clean up their messes. Any mess can potentially increase germs in their environment. Depending on the ages of your children, you may want to consider making disinfecting wipes available to them. This reminds children that they are responsible for their messes, and disinfecting these messes as well.

-Keep your children away from certain foods. There is a risk of illness for anyone who handles or eats undercooked meat and other foods which may be contaminated with different viruses and bacteria (e. coli for example). Making sure your children's meals are fully cooked and promptly cleaning up preparation areas and utensils helps reduce their (and your) risk of food-related illnesses.

Secrets to Buying Shoes: The 1,2,3 Test

2009-10-14T11:57:00.003-04:00

Here is a brief test to use when buying shoes. It is from the article "Give Shoes the '1,2,3 Test' During Back-to-School Shopping" from the American Podiatric Medical Association website. The article relates to children and back-to-school shoe shopping, but the test can be utilized by anyone when they are buying shoes. It is a great way to determine if your shoes are supportive enough to protect your feet from their dialy activity. Obviously adult and child foot needs differ slightly, but simply apply this information to your own needs and you will see that it can be a beneficial secret for your foot health.

"One easy way to determine if a child’s shoe is foot-friendly is to perform the “1,2,3 Test.” First, press on both sides of the back of the shoe’s heel. Make sure that it does not collapse when pushed on. Second, check toe flexibility. The shoe should bend with your child’s toes, but should not be too stiff or bend too much in the toe box area. Third, grab the shoe by the front and back and twist gently. A foot-friendly shoe should never twist easily in the middle.

Here are several more shoe shopping tips to help start the school year off on the right foot:

Take your child shoe shopping. Letting a child have a say in the shoe buying process promotes healthy foot habits down the road.

Examine the heels. Children often wear through the heels of shoes faster than outgrowing the shoes themselves. Uneven heel wear can indicate a foot problem that should be checked by a podiatrist.

Look for the Seal of Acceptance. Certain footwear brands, such as the Reebok Classic Leather Collection and Asics’ GEL-Nimbus model, carry the APMA’s Seal of Acceptance. APMA’s Seal program recognizes products that set the benchmark for footwear and foot care industries, and have been evaluated by a team of podiatrists to guarantee proper foot function.

Remember socks when shopping. Make sure to have your child try on shoes with socks or tights, if that is how they will be worn, in order to ensure a proper fit."

A Secret to Fight Foot Odor

2009-10-12T13:32:00.004-04:00

This product from our online store can help you fight the foot odor you experience on a daily basis:

Dr. Smith's Deodorizing Foot Wash 8oz
A wonderful wash made specifically for feet. Pleasantly fresh herbal citrus & mint scent, from natural plant extracts, and essential oils that cleanse and deodorize feet....great results when treating foot odor!

Visit our online store at: http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=511&DEPARTMENT_ID=55 for more information, or to order!

2009-10-09T11:13:00.002-04:00

Here is an article on Morton's neuroma to continue our patients' footcare education.

Morton's Neuroma: Common Cause of Foot Pain
Women More Affected Than Men
by Terence Vanderheiden, D.P.M.for About.com
Updated July 21, 2008

There are many causes of foot pain, but if you are experiencing a sharp, stabbing pain that feels better when you stop walking and massage your foot, you may have what's known as Morton's neuroma. While it has a scary sounding name, this condition is benign and fortunately highly treatable.
In basic terms, a neuroma is an enlargement or thickening of a nerve in the foot in the area between the toes, usually the third interspace between the third and fourth toes, followed by the second interspace between the second and third toes. Morton's neuromas can rarely affect the fourth and first interspacesIt is also sometimes referred to as an intermetatarsal neuroma, interdigital neuroma, Morton's metatarsalgia (pain in the metatarsal area), perineural fibrosis (scar tissue around a nerve) or entrapment neuropathy (abnormal nerve due to compression).
If you have a Morton's neuroma, there is a 15% chance you will develop it in both feet. Morton's neuromas occur most commonly in women who are between 30 to 50 years old, often due to poor-fitting shoes.

Causes of Morton's Neuroma: Injury or Poor Biomechanics.

A Morton's neuroma is thought to be caused by an injury to the nerve, but scientists are still not sure about the exact cause of the injury. The injury may be caused by damage to the metatarsal heads, the deep transverse intermetatarsal ligament (holds the metatarsal heads together) or an intermetatarsal bursa (fluid-filled sac). All of these structures can cause compression and injury to the nerve, initially causing swelling and damage in the nerve. Over time, if the compression/injury continues, the nerve repairs itself with very fibrous tissue that leads to enlargement and thickening of the nerve.
Other causes of injury to the nerve may include simply having an incorrect walking style or an awkward foot structure, such as overpronation (foot rolls inward), hypermobility (too much motion), cavo varus (high arch foot) and excessive dorsiflexion (toes bend upward) of the toes.
These biomechanical (how the foot moves) factors may cause injury to the nerve with every step. If the nerve becomes irritated and enlarged, then it takes up more space and gets even more compressed and irritated. It becomes a vicious cycle.

Signs & Symptoms of Morton's Neuroma
-Pain (sharp, stabbing, throbbing, shooting)
-Numbness
-Tingling or "pins & needles"
-Burning
-Cramping
-A feeling that you are stepping on something or that something is in your shoe

Initially these symptoms may happen once in a while, but as the condition gets worse, the symptoms may happen all of the time. It usually feels better by taking off your shoe and massaging your foot.

How a Diagnosis Is Made

Your podiatrist will ask many questions about your signs and symptoms and will perform a physical exam. Some of the exams may include a web space compression test. This is done by squeezing the metatarsals (the bones just below the toes) together with one hand and using the thumb and index finger of the other hand to compress the affected area to reproduce the pain/symptoms. A palpable click (Mulder's click) is usually present. This test may also cause pain to shoot into the toes and that is called a Tinel's sign. Gauthier's test involves squeezing the metatarsals together and moving them up and down for 30 seconds. This will usually cause pain or it will bring on your other symptoms. Sullivan's sign is positive when you stand and the affected toes spread apart.
A Morton's neuroma is usually diagnosed based on the history and physical exam findings, but sometimes other tests such as an x-ray, ultrasound or an MRI are needed.

Treatment Options
-Wear shoes that are wide and deep in the toe box so they do not put pressure on your toes and metatarsals. Avoid wearing high heels because they cause increased pressure on the ball of your foot.
-Metatarsal pads: These help to lift and separate the metatarsal heads to take pressure off of the nerve. They are placed just behind where you feel the pain, not on top of the painful spot.
-Activity modification: For example, you may try swimming instead of running until your symptoms go away.
-Taping with athletic tape
-Icing
-NSAIDs (anti-inflammatory medications): Aleve, ibuprofen, etc.
-Orthotics: These help to control some of the abnormal motion in your feet. The abnormal motion can lead to extra torque and pressure on the nerve.
-Physical therapy
-Cortisone injection: Helps to decrease the size of the irritated, enlarged nerve.
-Alcohol injection: Helps to destroy the nerve chemically.
-Surgery: If conservative treatment does not help surgery may be needed. Surgery may involve cutting out the nerve or cutting the intermetatarsal ligament. Studies have shown surgery has an 80-85% success rate.

Prevention of a Morton's Neuroma
-Avoid wearing narrow, pointed toe shoes
-Avoid wearing high heel shoes

Sources:
Hughes RJ, Ali K, Jones H, Kendall S, Connell DA. Treatment of Morton's neuroma with alcohol injection under sonographic guidance: follow-up of 101 cases. AJR Am J Roentgenol. 2007 Jun;188(6):1535-9.
Kim JY, Choi JH, Park J, Wang J, Lee. An anatomical study of Morton's interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int. 2007 Sep;28(9):1007-10.
Morscher E, Ulrich J, Dick W. Morton's intermetatarsal neuroma: morphology and histological substrate. Foot Ankle Int. 2000 Jul;21(7):558-62.
Mozena JD, Clifford JT. Efficacy of chemical neurolysis for the treatment of interdigital nerve compression of the foot: a retrospective study. J Am Podiatr Med Assoc. 2007 May-Jun;97(3):203-6.
Spina R, Cameron M, Alexander R. The effect of functional fascial taping on morton's neuroma. Australas Chiropr Osteopathy. 2002 Jul;10(1):45-50.
Wu KK. Morton's interdigital neuroma: a clinical review of its etiology, treatment, and results. J Foot Ankle Surg. 1996 Mar-Apr;35(2):112-9;

Secrets for Superstars

2009-10-06T14:18:00.004-04:00

Eli Manning, the quarterback for the New York Giants football team, has been diagnosed with plantar fasciitis after injuring his right heel in the fourth quarter of the Giants' win over Kansas City. He has been reported to have pain, and inflammation/swelling around his heel.

Plantar fasciitis is the inflammation of the plantar fascia, the tendon which connects the heel to the toes along the bottom of the foot. This injury is common not only for athletes. It is often the result of overuse, acute trauma (like in Manning's case), wearing footwear without adequate supports, and working/standing/walking on hard surfaces. The condition is usually conspicuous through symptoms like pain in and around the heel and bottom of the foot, tightness in the arch of the foot, and swelling and inflammation of the heel and tendon. Often people experience the pain from this injury in the morning, and it subsides as the tendon stretches out during the course of the day. It is also common to experience pain after sitting (resting) and getting back up after being on your feet for extended periods.

There are a number of treatments for plantar fascia. Taping can help relieve the pressure on the tendon, as can wearing a night splint over night to avoid tightening of the tendon. Often a stretching program or physical therapy can help strengthen the plantar fascia. Orthotic inserts for the patient's shoes are a very common treatment as well, and they tend to be effective even in difficult cases. Cortisone shots are also recommended frequently. Our office also offers APC (autologous platelet concentration) injections and ESWT (electronic shock wave therapy) to aid in sever cases of plantar fascia. The APC injection helped Hines Ward return from a knee injury just in time to aid the Steelers in their 2009 Superbowl win. One or a combination of these treatments could help Manning return to good playing condition and reduce his pain throughout the season.

If you are experiencing pain from plantar fascia, or any foot pain, do not hesitate to contact our office. Many people delay the treatment of this condition because they think they need to just bear the pain. This is not true. There is no reason to suffer when we can help you find relief.

Peripheral Vascular Disease

2009-09-30T09:54:00.002-04:00

Peripheral Vascular Disease (PVD) is a title which can be ascribed to a number of conditions which affect circulation in the feet and legs.

Arteriosclerosis is one of the most common forms of PVD. It is characterized by a hardening of the arteries. This is a gradual process where the arterial walls that transport blood from the heart into the lower extremities thicken, harden, and loose elasticity. A build up of plaque can also occur. Your arterial insufficiency may also be caused by a blocked artery, spasms of the vessel, and a narrowing of the arteries. This condition is most common in men over 50. Look for signs of reduced circulation, like decreased sensitivity to touch and temperature. If you constantly feel cold, especially in your feet, you may be experiencing some PVD.

Diabetes is also a leading cause of PVD. Since diabetes causes the patient's body to lose control of its sugar regulation, sugar can build up in the patients' blood vessels, causing changes which reduce circulation. Other factors which increase the risk for PVD include heart disease, high blood pressure, smoking, family history of vascular disease, obesity, and elevated cholesterol levels.

If you are experiencing any lack of sensation in your lower extremities, it may be a sign of PVD or another underlying problem (like Diabetes). You should come into our office for an appointment. We are able to treat your symptoms, as well as run tests to determine the cause of your reduced circulation. With this knowledge we can better serve you and your continuing footcare needs. Reduced circulation in your feet is likely to reduce the rate at which you heal, even from minor injuries like abrasions and blisters. Often these small wounds can get infected, leading to bigger problems. This is why footcare is increasingly important with PVD patients and others with reduced circulation.

Blister Guards

2009-09-28T10:23:00.005-04:00

Here is a product from our online store to help you relieve the pain and irritation associated with blisters and shoe irritations:

Body Guard - Tender Touch Gel Pads
These thin, yet durable gel cushions comfortably protect blisters, areas of irritated skin, lacerations, and other lesions.

Features:
They are made of a space-age medical material which sticks to the skin without adhesives, and can be reused many times (remove them at night, wash with soap and water, allow to dry, and reapply to the tender area in the morning).
If rubbing, pressure, or friction are causing you problems, this product will help you.
Each sheet of Blister Guard is 2 3/8" x 3 1/2" x 1/8", and can be cut to smaller sizes to fit the painful area.
Sold by the sheet.

Visit our online store at: http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=705&DEPARTMENT_ID=256 for more information or to order.

Shoes In Our Office

2009-09-25T10:17:00.003-04:00

Our office carries a wide variety of shoes within the Medicare Diabetic Shoes Program. This program functions to get diabetic patients who are eligible for medicare benefits into shoes specially designed to serve their footcare needs. These shoes do not impede circulation and are designed to help the patient avoid blisters, abrasions, and ulcers which diabetic patients often heal slowly from. Diabetic patients can make an appointment to evaluate their feet and discuss their shoe needs. After that, we fit the shoes to your feet and order them specifically for you. Once we get your shoes in we make sure they are the right fit for you. We guarantee the fit, so if they are not right we will correct the problem. We also schedule periodic visits to ensure that your shoes are helping you, and we also take care of continuing diabetic foot needs. Under this program, the patient is eligible for one pair of shoes every year. Give our office a call if you are eligible and want to explore your shoe options.

Shoe Related Secrets

2009-09-22T11:27:00.002-04:00

Here are some tips for extending the life of your shoes:

-Untie your shoes every time you put them on and off. If you unlace your shoes so your foot can slide easily in and out of the shoe, it will save the heel counter and sides of the shoes from collapsing after repeated presure. This helps maintain the look and stbility of your shoes. Use a shoe horn when putting on shoes for extra care in not collapsing the back of your shoes. Be care ful when using slip on shoes to not push down on the heel counter, especially if you are standing and slipping on shoes.

-Replace footbed liners. If the padding in your shoes is wearing out, but the support is still inteact, consider replacing the foot liner for added comfort. This is true of athletic shoes, as well as dress or casual shoes. Replacing the liners can increase your comfort, and keep you in a favorite pair of shoes longer.

-Clean and polish your shoes. Keeping your shoes clean and polished allows you to keep them looking good, and this means you can wear them longer. Make sure you have the appropriate type of cleaner for the material your shoe is made of (you can even get cleaner for the mesh of athletic shoes!) and the right polish as well. This little bit of work helps maintain the look and condition of your shoes.

-Seal shoes against the elements. Sealing your shoes against water and other moisture and dirt is a great way to avoid stains and water damage to your shoes. It helps them last longer, and helps keep them looking good. It also aids in keeping your feet dry.

-Rotate your shoes. Give shoes at least a day to air out. This helps reduce the moisture the shoe absorbs, preventing materials from falling apart, and also preventing fungi which cause nail fungus and athlete's foot from growing. Rotating your shoes also means you wear them less often, and therefore they will last longer.

-Buy good quality footwear. It will last longer. Look for sturdy shoes, especially when chosing athletic shoes. Higher wuality shoes are often more comfortable as well.

-Use foot powder. This helps keep your shoes and your feet dry. It also helps prevent the spread of fungi, which like warm, dark places.

-Lysol spray your shoes to disinfect them. Although it may not make your shoes last any longer, it will help keep your feet healthy inside of them.

A Secret to Relieve Hammertoes

2009-09-16T11:38:00.002-04:00

This product from our online store is designed to help relieve the pain and deformity of a hammertoe which you may be experiencing. It is designed to help straighten the toe, approve its appearance, and help you bear weight normally on your toes.

Dr. Jill's (Budin) Hammertoe Splint
This splint is constructed of comfortable, but sturdy materials which gently extend the hammertoe, allowing it to lie straight; thus, pain is alleviated in the top and tip of the toe. It will help prevent the toe from becoming worse, allows it to bear weight normally, and prevents the unsightly bulges in footwear that hammertoes can cause. The well padded bottom part of the splint will cushion the ball of the foot, giving you extra comfort. Constructed of thin, sturdy, cushioned materials which will easily fit in any style footwear.

Visit our online store at:http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=390&DEPARTMENT_ID=52 for more information or to order.

2009-09-14T14:29:00.002-04:00

Here is an article by a fellow podiatrist, recommending many of the tips we also teach our patients:

A Podiatrist Reveals Five Secrets to Healthy, Beautiful Feet
July 13, 2009 by Michael Nirenberg

Out feet take a beating. We put in long hours, walking an average of seven to ten miles a day. We tread on artificial surfaces such as asphalt, concrete and tile, often carrying a briefcase, purse, baby or laptop—and for some of us all four! And with each step two to three times our body weight comes down on our feet, not to mention the strain of jogging, stair stepping or high impact aerobics. So what can you do to keep your feet healthy, beautiful, and strong enough to make it through the day? I hear this question often as a podiatrist and usually from female patients, which doesn't surprise me, since women experience four times more foot problems than men. Fortunately, both men and women can do simple, inexpensive things to care for their feet, and when your feet feel great, your whole body will too. Consider the following five tips to pretty, healthy feet.

1. Use a good moisturizer. The skin of your feet is increasingly prone to drying out as you age. Dry skin is not only ugly but can crack open and possibly become infected, especially in diabetics or those with poor circulation. A good moisturizer can soothe dry skin. The secret to finding a good moisturizer for your feet is not by price; more expensive doesn't mean better. Read the ingredients and avoid products with alcohol or alcohol derivatives. Generally, lotions contain alcohol to make them absorb faster, but the alcohol hinders the product's ability to moisturize your skin. The best dry skin products tend to be creams without alcohol. These are gooier and absorb slowly, so I recommend applying them just before going to bed.

2. Keep your feet dry. This may seem to contradict using moisturizer, but dampness around your feet, specifically between your toes, can be a breeding ground for bacteria. When washing your feet, be sure to dry them well, especially between the toes. Towels can pick up bacteria or fungus, especially if they are damp or dirty, so wash them often with bleach or hot water and never use the towel that dried your feet on the rest of your body or face. A good tip to keep your feet, and especially your toes, free from moisture is to use a foot powder enriched with zinc or menthol, or even both. A sprinkle a day will not only keep toes from perspiring, but also lessen odor.

3. Beware of nail polish and acrylic nails. Men can skip this tip, but women should heed it. Nail polish and acrylic nails trap moisture, increasing the chance of fungus infecting toenails, causing the nails to thicken and turn yellow or, in severe cases, black. Toenail fungus can also infect the surrounding skin and in some cases, particularly when the person is diabetic or has poor circulation, can lead to the loss of a toe or even the foot. Some women who notice their toenails beginning to darken or yellow from fungus cover the nails with polish to hide them; ironically, this only makes the problem worse. Am I saying you shouldn't wear nail polish or acrylic nails? Not at all. Nail polish or acrylic nails can cheer up the ugliest of feet, don't cost a lot and are generally among the safer pleasures for your feet. When using nail polish or acrylic nails think of them like a dieter having a scoop of ice cream: occasionally it is okay, but not every day. If you have a special event, feel free to wear nail polish or acrylic nails; just remove the polish or fake nails when you get home. The more your nails can "air out" the better.

4. Wear sensible shoes. This seems obvious, but many people choose style over comfort (one study showed that 88 percent of women have at some point knowingly squeezed their feet into shoes that were too small). Like eating that fattening scoop of ice cream, wearing Jimmy Choos or other stylish, tight-fitting shoes occasionally, for brief periods usually won't cause problems. However, wearing ill-fitting shoes too often can cause the toes to crunch up, possibly causing permanent deformities, pinched nerves, corns, calluses or other problems. People with diabetes or poor circulation need to be especially careful and should never wear tight shoes, as these medical problems can result in serious foot infections and even gangrene. The secret to making sure shoes fit properly is to shop for them late in the day when your feet are likely most swollen. When you walk in the shoes you try on, try to avoid the soft, plush carpet found in most shoe stores. If you're in a mall, leave the shoe store and walk on the mall's tile floor. Most importantly, if shoes hurt in the store they will hurt when you get them home- a shoe should never need to be "broken in."

5. Check your feet daily. The last tip to taking care of your feet is more common sense than secret. Check your feet every day. It's amazing how many people don't look at their feet; or if they do see a problem or have pain, they shove their foot into a shoe and try to forget about it. When examining your feet, watch for any blisters, redness, swelling or open sores, and be sure check between the toes as this is a common area for infections to start. A good way to see the bottom of your feet is to use a mirror. If you find a foot or ankle problem, see a podiatrist promptly. Most foot and ankle problems are easy to take care of when caught early. The biggest complaint I hear from my patients is, "I wish I had come to see you sooner."

Your feet work hard all day long, and they need a little care to remain strong. When you use these tips to take care of your feet, they can be pretty, healthy and ready to carry you anywhere.

Shoe Stretcher

2009-09-11T10:12:00.002-04:00

Try this product from our online store if you have shoes that need an area stretched. Especially helpful for patients with bunions:

Ball and Ring Shoe Stretcher
This easy to use bunion stretcher allows you to stretch the specific part of your shoe causing pain rather than stretching the entire shoe. This device can stretch problem areas without stretching the entire footbox. If you have a small spot or section on your shoe that needs to be relieved, then this is for you (great for people with bunions).

Directions:
Determine the area needed to be relieved.
Place a Zip Lock bag over the shoe to protect the exterior finish.
Place the ball inside the shoe with the ring on the outside.
Press the arms of the Stretch together over this problem area of the shoe.
You should see immediate results, with your shoe fitting more comfortably.
Can be clamped on overnight for especially difficult areas

Non-Foot Concerns

2009-09-08T14:33:00.004-04:00

We hope our blogs have you thinking about your feet and your foot care! But did you know that there are factors outside of your feet and ankles which affect the health of your feet (and your over-all health as well)? Try considering this information about foot care:

-Crossing your legs can lead to complications in your foot care. Prolonged and repeated cross-leg sitting can diminish the circulation to your feet and ankles, especially over time. Try to find other comfortable ways to sit, like feet crossed at the ankles. Any prolonged circulation restriction can lead, over time, to circulation complications of the feet. Make sure your socks or hose aren't too tight, and avoid other circulation constriction.

-Your weight affects your feet. Controlling your weight is one of the best things you can do for your over-all health. Not only does it have implications in heat and circulatory function, but your weight affects your feet. Added weight can change the way to stand and distribute your weight. It can cause biomechanical changes in your feet, which may lead to foot pain. Your feet are responsible for carrying you through life, and they will be more effective when the extra strain of extra weight is off of them.

-Your exercise habits affect your feet. This makes sense when related to weight: exercise is good for keeping your weight down, and therefore for your feet. But your feet need exercise as well. Exercise helps strengthen the bones, muscles, and ligaments in your feet. but improper exercise can harm your feet. Always warm up appropriately. And some activities have higher risks of injury (say ice skating and a high number of ankle sprains). This is to be expected, just think about your feet before exercising. Make sure your foot gear fits properly (lace up skates and shoes) and consider the gear you have available before playing (for example,many volleyball players wear ankle braces). A little preparation can help save a lot of pain. Walking is the best exercise for your feet. It strengthens and stretches them, and because it is low impact there is less risk of injury. Always wear the appropriate shoes for any activity.

-The weather can affect your feet. Think about the weather before selecting foot gear. Sunny days may inspire you to wear flip flops, but consider protection and support before selecting your foot gear. And rain, sleet, and ice can cause many surfaces to be slippery. Please wear the correct shoes for the weather. Keeping your feet dry in wet weather is important as well, especially over prolonged periods of time. Plan accordingly for camping/hiking trips, and even long days with lots of walking. Wet feet can lead to fungi and blisters.

A Product for Attractive Feet!

2009-09-02T14:13:00.002-04:00

Try using this product from our online store to help restore cracked or dry skin on your feet to healthy, attractive skin:

Gilden Tree Nourishing Foot Cream - Healing Foot Cream
A serious, but gentle foot cream that almost magically helps to heal and soften feet, Gilden Tree's Healing Foot Cream is extremely rich and gentle. Keep a jar on your bedside table and use it nightly for softer, healthier feet and legs. Made with a Certified Organic Aloe Vera base, instead of water. Thick, rich and very creamy, you'll love the way it feels and smells. It is remarkably healing - even on very dry, damaged skin, and always one of our best-selling products - try it and find out why!

Ingredients include:
Aloe Barbadensis Leaf Extract*, Aqua, Carthamus Tinctorius (Safflower) Seed Oil *, Stearyl Alcohol, Glycerin, Cetyl Alcohol, Sorbitol, Simmondsia Chinensis (Jojoba) Seed Oil *, Butyrospermum Parkii (Shea Butter)**, Stearic Acid, Isopropyl Palmitate, Citrus Medica Limonum Peel Oil*, Ascorbic Acid, Fragrance, DL-Panthenol, Phenoxyethanol, Chlorphenesin, Sorbic Acid, Symphytum Officinale (Comfrey) Leaf Extract*, Rosmarinus Officinalis Leaf Extract*. *Certified Organic **Wildcrafted

Visit our online store at http://www.ourdoctorstore.com/vail/store/item.asp?ITEM_ID=633&DEPARTMENT_ID=54 for more information or to order.

A Tip for Foot Pain

2009-08-28T11:04:00.005-04:00

The best remedy for foot pain is to call your podiatrist. Your doctor can recommend treatments, medications, and even surgeries to alleviate your pain. But if you are experiencing pain, especially pain associated with plantar fasciitis, try this exercise.

Fill a standard size (16-20oz) water bottle 3/4 full and place it in your freezer. Allow the bottle to freeze. When you experience pain, especially if it is consistently in the morning or after a long day on your feet, take out the bottle. Place the bottle on the floor and roll the bottle under your foot, from your heel up top the ball of your foot. This exercise helps to stretch the tightened plantar fascia, resulting in some relief from the pain. The cold water bottle also helps to soothe pain and reduce some swelling or inflammation. You can perform this exercise standing, or seated if you have balance issues.

This treatment is only an aid to relieving foot pain. It is not a guarantee that you will remain symptom free. Visiting your podiatrist is a better way to relieve your foot pain. The doctor can prescribe other treatments like physical therapy, night splints, and orthotics to help relieve all your symptoms. This exercise is a good way to find relief until you can schedule an appointment with your doctor.

What to Do If You Are In Severe Pain

2009-08-26T09:04:00.002-04:00

Pain is our bodies' way of telling us that something is wrong. And it is usually true that the more severe the pain, the more serious the problem. If you are experiencing severe foot pain, seek treatment from a podiatrist immediately. Podiatrists specialize in dealing with foot and ankle problems and are experts in helping treat your symptoms. You can reach our offices at:

The Advanced Footcare Clinic
1725 Western Ave., Suite C
Findlay, OH 45840
Phone: (419) 423-1888
Fax: (419) 425-3668
Email: vailmedassist@sbcglobal.net
Website: www.vailfoot.com

If you are experiencing an emergency, call 911.

When to Call a Podiatrist

2009-08-24T10:08:00.002-04:00

Podiatrists are the experts on feet and ankles and should be the first doctor you call when you experience any of the symptoms or pains described on our blogs. Remember that foot, ankle, or heel pain is never normal regardless of age or activity.

Podiatrists treat foot problems for patients of all ages. You should call a podiatrist when you have pain in your feet or in your heels. If you notice that there is any change at all to your heels or the skin on your feet and ankles, you should see the "expert" on your feet.

If you have diabetes or poor circulation and you develop any abnormal symptoms you should see us immediately. You are at much greater risk for serious complications. And if you have diabetes you should see us at least once a year whether or not you have symptoms or pain. Regular check ups are a great way to help keep your feet healthy.

Most importantly, you should call us first when you have pain or any issue that affects your feet.

What Can You Do About Foot Pain?

2009-08-21T11:31:00.003-04:00

The first step in dealing with foot pain, especially heel pain, is to care for your feet. Your feet are the hardest working part of your body. They carry you wherever you need to go, whenever you need to go there and they do it for years and years. In fact, during your lifetime you will have traveled on your feet the equivalent of three trips around the entire world. You take, on average, 15,000 steps a day and walk or run well over 75,000 miles in your lifetime. Caring for your precious feet is the best step to avoid pain and is a critical component in eliminating it as well.

Some steps you can take to keep your feet healthy and functioning:

First and foremost: do not ignore pain in your feet and ankles. Healthy feet don't have persistent pain or skin that looks unusual. If your pain doesn't subside quickly, please contact our office right away. The sooner we can see you and examine your feet, the quicker we can begin to make the corrections needed to get your feet healthy again. So often we see people who have waited a very long time and suffered needlessly- sometimes for years.

Try to develop a habit of always checking your feet. A great time to do this is right after a shower or during a bath. If you start a habit of carefully drying your feet after bathing (pay special attention to the skin between your toes) you can quickly check your feet to see if you notice any changes. If you see nails that look unusual you might be seeing a potential fungus developing. If your skin is broken, cracked or an unusual color you are noticing abnormalities. Finally, if your foot is changing shape or you observe new growth you should make an appointment to see us so we can treat these conditions before they progress and become worse.

If you have diabetes, it is especially important to check your feet very regularly and often. In fact, we recommend that you have someone else help you check your feet, because you may not be able to see or, most importantly, feel problems. Early detection and treatment may avoid potentially serious complications later.

See a podiatrist if you have a problem with your feet. Treating yourself can often cause problems or exacerbate existing problems. If you are diabetic you are at greater risk for foot problems so be sure to make an appointment to see us at least once a year. We'd love to see you. We are here to help!

Basic Advice for the Care of Diabetic Feet

2009-08-19T09:49:00.002-04:00

-Inspect your feet every day.
-Keep your feet clean and dry.
-Always keep your feet warm.
-Take extra care drying your feet and toes after showering. Pay special attention to the space between your toes.
-Be sure to exercise. Walking is one of the best exercises for diabetics unless you have complications. If you struggle with balance, use a cane.
-Always protect your feet and legs. Never walk barefoot.
-Avoid hot water bottles and heating pads.
-Do not overexpose skin to the sun.
-Never use razor blades, knives, scissors, or medicated corn/wart removers.
-Look for redness, blisters, scratches, cracks between the toes, discoloration or any other change.
-Avoid all actions that diminish circulation such as tobacco use, sitting with legs crossed, and circular elastic garters.
-Change your shoes and socks daily.
-Wear soft leather shoes that conform to the shape of your overall foot.
-Gradually "break in" new shoes and avoid blisters.
-Call us immediately if you see any changes in your feet. Our phone number

How to Care for Diabetic Heels

2009-08-17T11:52:00.002-04:00

Diabetes can affect many parts of the body, especially the feet and heels. According to the American Diabetes Association, about 15.7 million Americans (5.9 percent of the Unites States' population) have diabetes. It is very important that a diabetic gives the feet very special care. A small problem in a healthy person can become a severe one to a diabetic.

Diabetes can affect the feet in a number of different ways. The first is infection, which is one of the most common complications of the diabetic foot. Because diabetes causes reduced immune response, a diabetic patient's ability to fight infection is decreased. Early treatment of infection is a critical component to success. If neglected, infection of the foot can cause gangrene, ulceration, osteomyelitis, and even amputation.

Another complication of diabetes called neuropathy causes decreased sensation to pain and temperature. This may cause a patient to underestimate a foot problem. It may also be responsible for an absence of perspiration leading to dry, cracking skin that can more easily become infected.

With a diabetic foot, a wound as small as a blister from wearing a shoe that is too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, and cuts. Get someone to help you, or us a mirror. Diabetic foot care can be very complicated and good podiatric care is an essential component of managing diabetes.

Foot and Ankle Surgery

2009-08-07T13:15:00.002-04:00

In a few cases heel problems do not respond to conservative treatments. A podiatrist can best determine when surgery might be beneficial. In cases when pain or deformity persists, surgery may be needed to restore normal function.

Prior to surgery a podiatric surgeon will review your medical history and perform an examination. Specific medical tests may be required before undergoing surgery. These tests may include X-rays, blood tests, urinalysis, and blood flow studies to determine the circulatory status of your feet and legs.

The length and method of postoperative care that is needed is determined by the type of surgery performed. All postoperative care includes some degree of rest, ice, compression, and elevation. Other elements can include bandages, splints, surgical shoes, casts, crutches, and canes. Recovered can be quickened by carefully following your podiatrist's instructions.

Autologous Platelet Concentrate

2009-08-05T11:45:00.002-04:00

Autologous Platelet Concentrate is a procedure that is done to stimulate healing. Blood is drawn from the patient, spun in a centrifuge, and the platelets (the growth and healing factors of the blood) are drawn out afterwards. After the platelets are drawn out, they are re-injected into the damaged tissue in the plantar fascia. This stimulates healing at a rate of five times more quickly than the healing rate of normal blood vessels.

ESWT

2009-08-03T11:10:00.002-04:00

Extracorporeal Shock Wave Therapy treatments use high-power sound waves to end chronic heel pain without painful surgery. This treatment is now being offered by our office as an alternative to heel surgery. The discovery of ESWT came about somewhat by accident. Shock wave therapy is used regularly by urologists to break p and disperse kidney stones. Urologists began reporting that patients who had kidney stones treated showed increased bone density and new tissue growth. This led to studies for using shock wave therapy for soft tissue injuries and the results were amazing: 75-80% of patients with soft tissue injuries were reported to be healed or greatly improved following ESWT.

Orthotics

2009-07-27T10:10:00.002-04:00

Custom-made heel supports are known as orthotics devices and are worn under your heel and the arch of your foot. These devices are molded to be anatomically matched to your heel and they do more than just provide support. Orthotics are designed to realign your feet and heels to a neutral or natural position to alleviate pain in your feet, legs and back, as well as to restore balance, improve sports performance, and relieve foot fatigue.

Research shows that the majority of heel problems can be directly connected to skeletal imbalance. More and more people tend to have some amount of either hyperpronation (flat feet) or hypersupination (high arches). The presence of these conditions can cause the heel to be unstable during normal everyday activity. This constant stress on the heel can lead to pain in the feet, ankles, legs, knees, hips, and back. Orthotics can improve function in the heel by compensating for existing imbalances and in most cases can relieve or prevent the associated pains.

How do you know if the use of orthotics is right for you? If you have an obvious imbalance that causes such symptoms as flat feet or high arches, or if you have external misalignments such as "knock knees", "bow knees", in-toeing, or out-toeing you are probably a good candidate for orthotics. If you participate in an activity that places stress on your feet or if your work requires you to be on your feet for extended periods, especially on hard surfaces such as concrete, orthotics could be beneficial. The use of orthotics is just one of the conservative foot treatments used in our offices. They can be used to treat foot, heel, and arch pain and to prevent sports injuries or improve sports function. Orthotics can be used to treat children as well as adults. The best way to find out if orthotics can help you is to make an appointment with us for an exam.

Conservative Heel Care

2009-07-22T10:43:00.002-04:00

Also known as non-surgical treatment, conservative heel care is used to treat most heel problems with dramatic results. Any initial visit to a podiatrist's office will start with a patient history and physical examination. Diagnostic x-rays and laboratory tests can also be used to help determine the best course of treatment.

Non-surgical treatments are called for in most cases including medical conditions which preclude the option of elective surgery, time commitment constraints, and elderly patients with many medical conditions. In spite of not being able to opt for foot surgery many patients find great relief from pain and discomfort through the use of conservative heel care treatments.

There are a wide variety of non-surgical treatments being used by podiatrists today. Cortisone injections, oral and topical medications, and heel taping or strapping are all examples of conservative heel care. Other options are exercise, custom-made walking shoe, physical therapy, and orthotics.

Podiatrists and What They Can Do About Your Heel Pain

2009-07-20T11:45:00.003-04:00

A podiatrist is a specialist who focuses on your feet and ankles. They are quite simply "The Experts" on your feet, heels, and ankles and should be the very first doctor you call when you experience pain or other problems with them.

The DPM after a podiatrist's name stands for Doctor of Podiatric Medicine. Most people know that podiatrists deal with the foot, heel, and ankle problems and work with seniors, or diabetics, or people with poor circulation; what most people don't know is that podiatrists treat patients of all ages. A podiatrist is also well-qualified to help children and young adults with the problems that they can experience with their feet, heels, and ankles.

Podiatrists are required, just like any other doctor, to be licensed by the state in which they practice. When medically necessary, podiatrists can perform surgery to correct or remedy problems. Before as podiatrist recommends surgery, he or she will explore the many conservative therapies and remedies that are available for their patients and then recommend the very best course of treatment. As medical science advances and new therapies become available to the public, podiatrists are increasingly able to offer their patients some of the most state-of-the-art care available. Pay attention to upcoming blog posts to learn more about these many different care options.

Stress Fractures and Heel Pain

2009-07-15T13:39:00.002-04:00

An incomplete break in the bone caused by overuse is known as a stress fracture. Symptoms can include pain, swelling, and redness. Up to 15% of all sports injuries are stress fractures. A podiatrist needs to perform an examination and look at X-Rays of the injury in order to diagnose a stress fracture. Treatments include immobilization of the foot with the use of a cast, medications, and in some cases orthotic devices to prevent further injury.

Sprains and Heel Pain

2009-07-13T10:15:00.002-04:00

An ankle sprain occurs by stretching or tearing one or more ligaments on either or both sides of the ankle. Ignoring a sprain won't help it heal any faster. Ankle injuries that are serious enough to cause disabling pain should be treated by a podiatrist. Further examination may even reveal a torn ligament or bone fracture. Common treatments include rest, elevation, compression, and ice. More serious sprains may call for crutches or other walking devices.

Sever's Disease and Heel Pain

2009-07-10T09:55:00.002-04:00

The most frequent source of heel pain in children between the ages of 9 and 15 is Sever's Disease. It is caused by an inflammation of growth plates in the back of the heel due to rapid bone growth and is most often seen in children who participate in athletics. With this condition pain is usually felt at the back and side of the heel bone or even the bottom of the heel. Pain usually worsens when the heel bone is squeezed or when the child is running or jumping. Podiatrists are trained to treat patients of all ages and it is important to have your child examined if they are complaining of heel pain or limping.

Heel Bumps or Haglund's Deformity

2009-07-08T09:55:00.003-04:00

Heel bumps, also known as Haglund's Deformity, are a bone enlargement on the back of the heel bone. These usually occur for athletes when the shoes they wear rub up against the heel, and they can be aggravated by the height or stitching of a heel counter of a particular shoe. The result is a painful bump or bumps on the heel that make exercising very difficult. Another term used for this condition is pump bump because it can frequently occur with the wearing of high heels as well.

Heel Bursitis and Heel Pain

2009-07-06T13:30:00.002-04:00

There are several fluid-filled sacs behind the heel bone that act as a cushion and a lubricant between muscles and tendons sliding over bone. They are known as bursae. Repetitive or over use of the ankle can cause the bursae to become inflamed or irritated leading to heel bursitis. The condition is often mistaken for Achilles Tendonitis. Symptoms include pain in the heel, especially when walking, running, or jumping or when the area is touched. The skin around the back of the heel may be red and warm to the touch, and the pain may worsen when standing on tiptoe. It is commonly seen in people who are just starting an aggressive exercise routine.

Achilles Tendonitis and Heel Pain

2009-07-01T10:18:00.002-04:00

The Achilles tendon is named for Achilles, the Greek mythology hero, who was vulnerable only at his heel. The Achilles tendon is the largest tendon (a band of tissue that connects muscle to bone) in the human body and is very strong, but is also the tendon we most often rupture. Everyone who is active can suffer from Achilles Tendonitis, a common overuse injury and inflammation of the tendon. Symptoms of Achilles tendonitis include mild pain after exercise or running that gradually worsens, a noticeable sense of sluggishness in your leg, and episodes of diffuse or localized pain, sometimes severe, along the tendon during or a few hours after activity. Symptoms also include tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. Other symptoms can be swelling, morning tenderness in the Achilles tendon, or stiffness that generally diminishes as the tendon warms up with use.

Tarsal Tunnel Syndrome and Heel Pain

2009-06-30T14:30:00.003-04:00

The tarsal tunnel is a tight space in the foot that lies between bones and tough fibrous tissue. A nerve called the posterior tibial nerve lies within the tarsal tunnel. If this nerve becomes compressed or squeezed, tarsal tunnel syndrome can result. Symptoms include numbness over the bottom of the foot and/or pain, burning and tingling over the base of the foot and heel. Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space.

Heel Spurs and Heel Pain

2009-06-29T10:20:00.002-04:00

Sometimes heel spurs are found in people with plantar fasciitis, but they are rarely the source of pain. Heel spurs are bony growths on the underside of the heel hone caused by tension from a tight plantar fascia ligament. They result from strain on the muscles and ligaments of the foot, stretching the plantar fascia, and repeated tearing away of the lining or membrane that covers the heel bone. Close to 70% of patients with plantar fasciitis have a heel spur that can be seen on an X-Ray. Plantar fasciitis and heel spurs are often confused and they are related, but they are not the same condition.

Plantar Fasciitis and Heel Pain

2009-06-26T10:30:00.003-04:00

Plantar fasciitis is the most common cause of heel pain on the bottom of the foot and is an inflammation in the band of tissue (the plantar fascia) that runs from the heel to the toes. This condition is most often caused by poor foot structure such as overly flat feet or high arches. It can also be caused by wearing non-supportive footwear on hard surfaces, spending long hours on your feet, or obesity. The pain from plantar fasciitis is usually a sharp, stabbing pain on the inside of the bottom of the heel. Pain from plantar fasciitis is usually most severe when you first stand on your feet in the morning. It will usually subside, but can return with prolonged standing or walking or getting up after long periods of sitting.

What Causes Heel Pain?

2009-06-24T10:00:00.003-04:00

Pain is the body's way of telling us that we may have suffered an injury or contracted an illness. Pain that occurs in our heels alerts us to seek medical attention. Because a variety of causes exist for heel pain, it is very important to have any type of heel pain properly diagnosed by a podiatrist.

The heel bone is the largest of the 26 bones found in the human foot. The foot also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. The heel bone is subject to a variety of outside influences that can affect its ability to function properly. Symptoms of heel pain that should be treated by a podiatrist include pain on the bottom of the heel or the back of the heel, pain that worsens upon rising, and pain that increases in severity over a period of months. The most common causes of heel pain on the bottom of the foot are plantar fasciitis, heel spurs, and tarsal tunnel syndrome. The most common causes of posterior heel pain or pain behind the heel are Achilles Tendonitis, heel bursitis, and heel bumps.

Educational Materials

2009-06-22T11:22:00.002-04:00

At the Advanced Footcare Clinic, we are committed to treating our patients as completely as possible. This includes many things, like advising on healthy habits for your whole life and not just your feet, encouraging you to live a full and healthy life, and even being involved in patient education. Members of our office visited local schools this year to make presentations to children about proper footcare, which is very important to developing feet. We make many educational materials available on our website: www.vailfoot.com. We also have a series of blogs on different subjects to further educate our patients. A list with links to these blogs can be found at: http://www.vailfoot.com/blogs.html. And we also offer free books on varying subjects to our patients as well. To receive the free book that corresponds to this blog "Secrets to Foot and Ankle Health" by Dr. Thomas F. Vail, DPM simply call 1-800-487-8951 and give the requested information. Local residents of the Findlay, OH area are eligible for a free book, and it will be mailed directly to you. We have other books available and you can view this list at: http://www.vailfoot.com/book-and-dvd.html. If you have any questions or think that you may need to see a podiatrist, please do not hesitate to contact us at:

The Advanced Footcare Clinic
1725 Western Ave., Suite C
Findlay, OH 45840
Phone: 419-423-1888
Fax: 419-425-3668
Email: vailmedassist@sbcglobal.net
Website: www.vailfoot.com

LEGOS For Your Feet

2009-06-19T11:09:00.003-04:00

When it comes to caring for your feet, remember the word "LEGOS" as the building blocks to Healthy Feet:

L- Lysol spray in your shoes daily to ward off infection and fungus!

E- Exercise is always important to stimulate blood flow and circulation to your feet.

G- Gel pads can relieve pain and reduce minor inflammations.

O- Orthotics can help everyone not just those in pain!

S- Stretching properly is important especially in helping prevent heel pain.

When To Call a Podiatrist

2009-06-17T10:11:00.002-04:00

Podiatrists are the experts on feet and ankles and should be the first doctor you call when you experience any of the symptoms or pains described in this book.

Podiatrists treat foot and ankle problems for patients of all ages. You should call a podiatrist when you have pain in your feet and ankles. If you notice that there is any change at all to your nails or the skin on your feet and ankles, you should see the "expert" on your feet.

Dr. Vail!

2009-06-15T17:41:00.001-04:00

The Advanced Footcare Clinic is the office of Dr. Thomas F. Vail, DPM, located in Findlay, Ohio. Dr. Vail is originally a native of Cleveland, Ohio. He is a cum laude graduate of Xavier University, located in Cincinnati, Ohio. Dr. Vail then went on to receive his medical degree (DPM) at the Ohio College of Podiatric Medicine in Cleveland, Ohio. He completed his surgical residency in Youngstown, Ohio, and completed an addition year specializing in minimal incision technologies in South Bend, Indiana.Dr. Vail is currently on staff at the Blanchard Valley Regional Health Center in Findlay and Bluffton, as well as the Findlay Surgery Center. He is a member of the American Podiatric Medical Association, as well as its Ohio Affiliate. He is board certified by the American Board of Podiatric Surgery (ABPS) as well as being a fellow of the American College of Foot and Ankle Surgeons.

Podiatrists and Wounds and Ulcers

2009-06-15T10:45:00.002-04:00

Foot ulcerations or open wounds are a condition where there is a breakdown in many layers of skin and tissue sometimes going all the way to the bone. They can be cause by pressure to a weight bearing point on the foot, but they can occur on top of the foot or between toes due to pressure from shoes or a bony spur. The risk of ulcer formation is higher in patients with decreased circulation or impaired blood supply to the legs and feet. Diabetics are prone to foot ulcerations, but they can be found in patients with high blood pressure, blood clots, varicose veins, and phlebitis as well.

Treatment for foot ulcerations varies according to the cause of the wound. The goal of the treatment is to close the wound from the inside out as quickly as possible. In cases where there is adequate circulation, debridement (removal of dead tissue) may be used around the edges and within the ulcer itself to promote healing. Other treatments include oral medications, compression, and bed rest. New advances have been made in wound care in recent years including the use of platelet-derived growth factor as a way to promote healing. Podiatrists are trained to diagnose and treat all forms of foot and leg ulcerations.

Podiatrists and Warts

2009-06-12T11:20:00.003-04:00

Warts are caused by a virus that generally enters the body through small nicks or abrasions in the skin. When they occur on the soles of the feet they are known as plantar warts. Due to the amount of pressure that is put on the feet in the course of a day, plantar wart can become quite painful. Teenagers between the ages of 12-16 are most commonly infected by warts but they can occur at any age. Warts are often contracted by walking barefoot on dirty surfaces or ground. The virus thrives in warm, moist environments like showers and swimming pools.

If you suspect that you or a family member has a plantar wart it is wise to see a podiatrist to get a correct diagnosis and treatment plan. Treatments may include the use of wart-removal preparation or CO2 laser cautery performed under local anesthesia to safely remove the wart.

Podiatrists and Sprains

2009-06-10T09:37:00.002-04:00

An ankle sprain occurs by stretching or tearing one or more ligaments on either or both sides of the ankle. Ignoring a sprain won't help it heal any faster. Ankle injuries that are serious enough to cause disabling pain should be treated by a podiatrist. Further examination may even reveal a torn ligament or bone fracture. Common treatments for sprains include rest, elevation, compression, and ice (think R.I.C.E. to help you remember this). More serious sprains may call for crutches or other walking devices.

Podiatrists and Stress Fractures

2009-06-08T13:37:00.003-04:00

An incomplete break in the bone caused by overuse is known as a stress fracture. Symptoms can include pain, swelling, and redness. Up to 15% of all sports injuries are stress fractures. A podiatrist needs to perform an examination and look at X-rays of the injury in order to diagnose a stress fracture. Treatments include immobilization of the foot with the use of a cast medications, and in come cases orthotic devices.