Today's Podiatrist Today’s podiatrists are doctors of podiatric medicine (DPMs), also known as podiatric physicians and surgeons, qualified by their education and training to diagnose and treat conditions affecting the foot, ankle and structures of the leg.
APMA 2009 Walking Guide The Walking Guide is a great resource for you and your patients on the benefits of walking.
Aging Medicine and health awareness have progressed so rapidly since 1900 that life expectancy of the average American has increased by about 30 years.
Arthritis Arthritis is a frequent component of complex diseases that may involve more than 100 identifiable disorders. More information is available from the Arthritis Foundation.
Athlete's Foot Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes.
Bunions A bunion is an enlargement of the joint at the base of the big toe—the metatarsophalangeal (MTP) joint—that forms when the bone or tissue at the big toe joint moves out of place.
Diabetes Diabetes mellitus is a chronic disease that affects the lives of nearly 24 million people in the United States. Additional information is available from the American Diabetes Association.
Foot and Ankle Injuries Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatric physician.
Footwear Proper footwear can reduce foot problems.
Forefoot Surgery Many foot problems do not respond to "conservative" management. Your podiatric physician can determine when surgical intervention may be helpful. Often when pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot.
High Blood Pressure It's important to let your podiatrist know about high blood pressure.
Heel Pain Heel pain has many causes. it is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury, or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly constructed footwear; or being overweight.
Nail Problems Toenails often serve as barometers of our health; they are diagnostic tools providing the initial signal of the presence or onset of systemic diseases.
Neuromas A neuroma is a painful condition, also referred to as a "pinched nerve" or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot.
Orthotics Orthotics are shoe inserts that are intended to correct an abnormal, or irregular, walking pattern.
Peripheral Arterial Disease (PAD) PAD is short for peripheral arterial disease. PAD is caused by a blockage or narrowing of the arteries in the legs when fatty deposits called plaque build up.
Podiatric Medicine Podiatric medicine is the profession that strives to improve the overall health and well-being of patients by focusing on preventing, diagnosing, and treating conditions associated with the foot and ankle.
Rearfoot Surgery Many conditions can affect the back portion of the foot and ankle. Fortunately, many of these problems can be resolved through conservative treatments. However when pain persists or deformity occurs, surgical intervention can often help alleviate pain, reduce deformity, and/or restore the function of your foot or ankle.
Skin Cancers of the Feet We often view the sun's harmful rays as the primary cause of skin cancer, but this does not hold true of cancers that arise on the skin of the feet. A podiatrist's knowledge and training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.
Walking For a healthier, happier lifestyle, try walking--the most popular form of exercise.
Warts Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus, which generally invades the skin through small or invisible cuts and abrasions.
More than 11 million visits were made to physicians' offices in 2003 because of foot, toe and ankle problems, including more than 2 million visits for ankle sprains and strains and more than 800,000 visits for ankle fractures (Source: National Center for Health Statistics; Centers for Disease Control and Prevention; 2003 National Ambulatory Medical Care Survey.) Consider this:
Walking puts up to 1.5 times your bodyweight on your foot.
Your feet log approx. 1,000 miles per year.
As shock absorbers, feet cushion up to one million pounds of pressure during one hour of strenuous exercise.
How do the foot and ankle work?
Each foot has 26 bones. The ankle bone (talus) and the ends of the two lower leg bones (tibia and fibula) form the ankle joint, which is stabilized and supported by three groups of ligaments. Muscles and tendons move the foot and ankle.
What are the most prevalent foot and ankle injuries?
Ankle sprains
Sprained ankles are one of the most common injuries in sports. Because the inner ankle is more stable than the outer ankle, the foot is likely to turn inward (ankle inversion) from a fall, tackle, or jump. This stretches or tears ligaments; the result is an ankle sprain. The lateral ligament on the outer ankle is most prone to injury.
Achilles tendon injury
The strongest and largest tendon, the Achilles tendon connects muscles in the lower leg with the heel bone. Sports that tighten the calf muscles, such as basketball, running and high-jumping can overstress this tendon and cause a strain (Achilles tendinitis) or a rupture. A direct blow to the foot, ankle, or calf can also cause it.
Overuse injuries
Excessive training, such as running long distances without rest, places repeated stress on the foot and ankle. The result can be stress fractures and muscle/tendon strains.
Shin splints
Pain in front of the shin bone (tibia) usually is caused by a stress fracture, called shin splints. Overtraining, poorly fitting athletic shoes, and a change in running surface from soft to hard puts athletes at risk for this injury.
What activities make people most susceptible to foot and ankle injuries?
Athletes who jump risk ankle sprains because they can accidentally land on the side of their foot. Extensive running, exercise, or training also can overstress the ligaments, leading to injury. Contact and kicking sports expose the foot and ankle to potential trauma-direct blows, crushing, displacement, etc. Especially prevalent in football, hockey, and soccer-trauma can dislocate a joint, fracture a bone, stretch or tear ligaments, or strain muscles and tendons.
What other factors make people susceptible to foot and ankle injuries?
Improperly fitting shoes or improper footwear for a particular sport can damage your feet. Training errors, i.e., running up hills, or running on bumpy roads, predispose you to serious sprains and strains. If you start a new sport without proper conditioning, you are at risk.
How are foot and ankle injuries treated?
Most sprains and strains are initially treated with rest, ice, compression, and elevation. Moderate and severe sprains and strains are often immobilized with a cast or splint. Severe fractures often require surgical repair.
How do I reduce the risk of injury?
No one is immune from these injuries, but the American Academy of Orthopaedic Surgeons developed these tips to help reduce your injury risk:
Warm up before any sports activity, including practice
Participate in a conditioning program to build muscle strength
Do stretching exercises daily
Listen to your body: never run if you experience pain in the foot or ankle.
Wear protective equipment appropriate for that sport
Replace athletic shoes as soon as the tread or heel wears out
Wear properly fitting athletic, dress, and casual shoes
Foot and Ankle Injuries
Immediate Treatment
Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time. Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatric physician.
This advice is universal, even though there are lots of myths about foot and ankle injuries. Some of them follow:
Myths
"It can't be broken, because I can move it."False; this widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: Breaks in the smaller, outer bone of the lower leg, small chip fractures of either the foot or ankle bones, and the often neglected fracture of the toe.
"If you break a toe, immediate care isn't necessary." False; a toe fracture needs prompt attention. If X-rays reveal it to be a simple, displaced fracture, care by your podiatric physician usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture by your podiatric physician will help prevent improper or incomplete healing. Often, fractures do not show up in the initial X-ray. It may be necessary to X-ray the foot a second time, seven to ten days later. Many patients develop post-fracture deformity of a toe, which in turn results in a deformed toe with a painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.
"If you have a foot or ankle injury, soak it in hot water immediately." False; don’t use heat or hot water on an area suspect for fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain. An ice bag wrapped in a towel has a contracting effect on blood vessels, produces a numbing sensation, and prevents swelling and pain. Your podiatric physician may make additional recommendations upon examination.
"Applying an elastic bandage to a severely sprained ankle is adequate treatment." False; ankle sprains often mean torn or severely overstretched ligaments, and they should receive immediate care. X-ray examination, immobilization by casting or splinting, and physiotherapy to ensure a normal recovery all may be indicated. Surgery may even be necessary.
"The terms 'fracture,' 'break,' and 'crack' are all different." False; all of those words are proper in describing a broken bone.
Before Seeing the Podiatrist
If an injury or accident does occur, the steps you can take to help yourself until you can reach your podiatric physician are easy to remember if you can recall the word “rice.”
Rest. Restrict your activity and get off your foot/ankle.
Ice. Gently place a plastic bag of ice wrapped in a towel on the injured area in a 20-minute-on, 40-minute-off cycle.
Compression. Lightly wrap an Ace bandage around the area, taking care not to pull it too tight.
Elevation. To reduce swelling and pain, sit in a position that allows you to elevate the foot/ankle higher than your waist.
For bleeding cuts, cleanse well, apply pressure with gauze or a towel, and cover with a clean dressing. See your podiatrist as soon as possible. It’s best not to use any medication on the cut before you see the doctor.
Leave blisters unopened if they are not painful or in a weight-bearing area of the foot. A compression bandage placed over a blister can provide relief.
Foreign materials in the skin—such as slivers, splinters, and sand—can be removed carefully, but a deep foreign object, such as broken glass or a needle, must be removed professionally.
Treatment for an abrasion is similar to that of a burn, since raw skin is exposed to the air and can easily become infected. It is important to remove all foreign particles with thorough cleaning. Sterile bandages should be applied, along with an antibiotic cream or ointment.
Prevention
Wear the correct shoes for your particular activity.
Wear hiking shoes or boots in rough terrain.
Don't continue to wear any sports shoe if it is worn unevenly.
The toe box in “steel-toe” shoes should be deep enough to accommodate your toes comfortably.
Always wear hard-top shoes when operating a lawn mower or other grass-cutting equipment.
Don’t walk barefoot on paved streets or sidewalks.
Watch out for slippery floors at home and at work. Clean up obviously dangerous spills immediately.
If you get up during the night, turn on a light. Many fractured toes and other foot injuries occur while attempting to find one’s way in the dark.
