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Monday, 24 April 2017 18:47

Achilles Tendon Injuries on the Rise

Many podiatrists are suspecting that Achilles tendon injuries will be on the rise especially amongst those aged 30 to 50. Every year, approximately 230,000 Achilles tendon injuries occur in the United States. While Achilles tendon injuries are typically common among young athletes, professionals suspect that the number of middle-aged and older patients sustaining Achilles tendon injuries is rising because they are staying active longer. The severity of Achilles tendon injuries can vary between mild to moderate. Injuries of this degree typically cause pain and stiffness but can heal on their own. Surgery may be necessary for more severe cases, such as the tearing or rupturing of the Achilles tendon.

Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact one of our podiatrists of PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

What is the Achilles Tendon?

The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.

What are the symptoms of an Achilles Tendon Injury?

There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.

Achilles Tendinitis Symptoms

  • Inflammation
  • Dull to severe pain
  • Increased blood flow to the tendon
  • Thickening of the tendon

Rupture Symptoms

  • Extreme pain and swelling in the foot
  • Total immobility

Treatment and Prevention

Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:

  • Thorough stretching of the tendon before and after exercise
  • Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about What are Achilles Tendon Injuries
Tuesday, 18 April 2017 16:20

Decreasing Gout Risk

Gout is one of the most painful forms of arthritis, commonly affecting those aged 60 and higher. Associated with high levels of uric acid, gout is typically characterized by pain and redness in the joints. Many health professionals agree that gout risk can be lowered by managing one’s diet, which involves reducing foods and drinks high in purine from one’s food intake. These foods include alcohol, red meat, organ meat such as liver or kidney, certain seafoods, drinks high in fructose, and processed foods. Lowering one’s uric acid levels is key in reducing gout risk.

Gout is a foot condition that requires certain treatment and care. If you are seeking treatment, contact one of our podiatrists from PA Foot & Ankle Associates. Our doctors will treat your foot and ankle needs.

What is Gout?

Gout is a type of arthritis caused by a buildup of uric acid in the bloodstream. It often develops in the foot, especially the big toe area, although it can manifest in other parts of the body as well. Gout can make walking and standing very painful and is especially common in diabetics and the obese.

People typically get gout because of a poor diet. Genetic predisposition is also a factor. The children of parents who have had gout frequently have a chance of developing it themselves.

Gout can easily be identified by redness and inflammation of the big toe and the surrounding areas of the foot. Other symptoms include extreme fatigue, joint pain, and running high fevers. Sometimes corticosteroid drugs can be prescribed to treat gout, but the best way to combat this disease is to get more exercise and eat a better diet.

If you have any questions please feel free to contact one of one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Everything You Need to Know About Gout
Monday, 10 April 2017 20:34

Different Types of Arthritis

Arthritis is a condition that many people are familiar with but that not many fully understand. Successful treatment of the condition depends on the correct diagnosis, and arthritis can take on three different types: osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. Each type of arthritis has its own various symptoms and treatments. If you are suffering from arthritis in your feet, consult with your podiatrist to determine the right diagnosis and the best treatment.

Arthritis can be a difficult condition to live with. If you are seeking treatment, contact one of our podiatrists from PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Arthritic Foot Care  

Arthritis is a joint disorder that involves the inflammation of different joints in your body, such as those in your feet. Arthritis is often caused by a degenerative joint disease and causes mild to severe pain in all affected areas. In addition to this, swelling and stiffness in the affected joints can also be a common symptom of arthritis.

In many cases, wearing ill-fitting shoes can worsen the effects and pain of arthritis. Wearing shoes that have a lower heel and extra room can help your feet feel more comfortable. In cases of rheumatoid arthritis, the arch in your foot may become problematic. Buying shoes with proper arch support that contour to your feet can help immensely.

Alleviating Arthritic Pain

  • Exercises that stretch the foot can prevent further pain and injury and increase mobility
  • Most of the pain can be alleviated with anti-inflammatory drugs, heat, and topical medications
  • Massages can help temporarily alleviate pain.

It is best to see your doctor for the treatment that is right for your needs and symptoms. Conditions vary, and a podiatrist can help you determine the right method of care for your feet.

If you have any questions, please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about Arthritic Foot Care
Tuesday, 04 April 2017 18:01

Avoiding fungal nails

Toenail fungus is a foot condition that many people can fall prey to. Symptoms of the condition include yellow or brown nails, nails that split or crumble, or nails that lift up from the nail bed. To avoid developing this uncomfortable and often unsightly condition, professionals recommend the following tips. Keep the toenails trimmed short to avoid debris from building up beneath the nails. Wear shoes that properly fit and that are breathable, as fungus thrives in warm and moist environments. Use antifungal sprays or powders when needed, avoid going barefoot in public facilities, and never share shoes or nail clippers.

For more information about treatment, contact one of our podiatrists of PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Toenail Fungus Treatment

Toenail fungus is a problem which affects many people and is hard to get rid of. Fortunately, there are several methods to go about treating toenail fungus.

Antibiotics & Treatments 

Lamisil – The most commonly effective treatment for toenail fungus. It is available as an antibiotic: Terbinafine tablet and cream. Terbinafine is a chemical component which kills fungal growth on the body. Applying regular doses will gradually kill the fungal growth. It is important to keep the area clean.

Talcum powder – Applying powder on the feet and shoes helps keep the feet free of moisture and sweat.

Sandals or open toed shoes – Wearing these will allow air movement and help keep feet dry. They also expose your feet to light, which fungus cannot tolerate. Socks with moisture wicking material also help as well.

Alternative Treatments

There are surgical procedures that are available for toenail fungus. Some people would prefer the immediate and quick removal of toenail fungus through laser surgery. Consult with yOur doctors about the best treatment options for your case of toenail fungus.  

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about Toenail Fungus
Wednesday, 29 March 2017 16:58

Managing bunions

Regardless of the season, bunions and the pain associated with them plague athletes of all fields. Skiers, hockey players, basketball players, and other athletes involved in running sports are all susceptible to developing the condition. A bunion is characterized as a painful swelling of soft tissue and bone enlargement over the inner side of the ball of the big toe joint. With progression, the condition can become arthritic and may be accompanied by pain and the inability to wear shoes and walk comfortably. Treatment for bunions depends on the severity of the condition. In many cases, orthotics and wider fitting shoes can help, whereas more severe cases may call for surgery.

If you are suffering from bunions, contact one of our podiatrists of PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

What is a Bunion?

A bunion is formed of swollen tissue or an enlargement of boney growth, usually located at the base joint of the toe that connects to the foot. The swelling occurs due to the bones in the big toe shifting inward, which impacts the other toes of the foot. This causes the area around the base of the big toe to become inflamed and painful.

Why do Bunions Form?

Genetics – susceptibility to bunions are often hereditary

Stress on the feet – poorly fitted and uncomfortable footwear that places stress on feet, such as heels, can cause bunions to form

How are Bunions Diagnosed?

Doctors often perform two tests – blood tests and x-rays – when trying to diagnose bunions, especially in the early stages of development. Blood tests help determine if the foot pain is being caused by something else, such as arthritis, while x-rays provide a clear picture of your bone structure to your doctor.

How are Bunions Treated?

  • Refrain from wearing heels or similar shoes that cause discomfort
  • Select wider shoes that can provide more comfort and reduce pain
  • Anti-inflammatory and pain management drugs
  • Orthotics or foot inserts
  • Surgery

If you have any questions, please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Bunions
Tuesday, 21 March 2017 15:41

Treatments for Ingrown Toenails

Ingrown toenails can be very painful to experience. Most common in teenagers, though fairly common in the greater population, an ingrown toenail is characterized by the toenail digging into and breaking the adjacent soft tissue. This can lead to infection if the breaks in the skin remain for too long. Treatment of ingrown toenails range from clipping the nail more appropriately to surgically removing the nail or even destroying the growth plate in the nail bed. For chronic sufferers these surgical options may be necessary. It is best to consult a podiatrist if you have ingrown toenails.

Ingrown toenails can become painful if they are not treated properly. For more information about ingrown toenails, contact one of our podiatrists of PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Ingrown Toenails

Ingrown toenails occur when a toenail grows sideways into the bed of the nail, causing pain, swelling, and possibly infection.

Causes

  • Bacterial infections
  • Improper nail cutting such as cutting it too short or not straight across
  • Trauma to the toe, such as stubbing, which causes the nail to grow back irregularly
  • Ill-fitting shoes that bunch the toes too close together
  • Genetic predisposition

Prevention

Because ingrown toenails are not something found outside of shoe-wearing cultures, going barefoot as often as possible will decrease the likeliness of developing ingrown toenails. Wearing proper fitting shoes and using proper cutting techniques will also help decrease your risk of developing ingrown toenails.

Treatment

Ingrown toenails are a very treatable foot condition. In minor cases, soaking the affected area in salt or antibacterial soaps will not only help with the ingrown nail itself, but also help prevent any infections from occurring. In more severe cases, surgery is an option. In either case, speaking to your podiatrist about this condition will help you get a better understanding of specific treatment options that are right for you.

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Ingrown Toenail Care
Tuesday, 14 March 2017 14:44

Handling Heel Spurs

Heel spurs are potentially painful abnormalities that result from calcium deposits forming a protrusion on the underside of the heel bone. They are most common among athletes and people who do a lot of running. They are typically caused by stretching of the plantar fascia or tearing of the heel bone membrane. Depending on the severity of the heel spur, surgery may need to be performed in order to remove the calcium deposits. If you have pain in your heel, seeing a podiatrist is highly recommended. In the meantime, there are some remedies that may be able to help with the pain. These include: soaking your feet in an epsom salt bath, an apple cider vinegar bath, or applying an ice pack to the affected area.

Heel spurs can be incredibly painful and sometimes may make you unable to participate in physical activities. To get medical care for your heel spurs, contact one of our podiatrists from PA Foot & Ankle Associates. Our doctors will do everything possible to treat your condition.

Heels Spurs

Heel spurs are formed by calcium deposits on the back of the foot where the heel is. This can also be caused by small fragments of bone breaking off one section of the foot, attaching onto the back of the foot. Heel spurs can also be bone growth on the back of the foot. Bone may grow in the direction of the arch of the foot.

Older individuals usually suffer from heel spurs. Pain sometimes intensifies with age. Heel spurs are known to cause a substantial amount of pain. One of the main associations spurs are related to is plantar fasciitis.

Pain

The pain associated with spurs is often because of weight placed on the feet. When someone is walking, their entire weight is concentrated on the feet. Bone spurs then have the tendency to affect other bones and tissues around the foot. As the pain continues, the feet will become tender and sensitive over time.

Treatments

There are many ways to treat heel spurs. If one is suffering from heel spurs in conjunction with pain, there are several methods for healing. Medication, surgery, and herbal care are some options.

If you have any questions feel free to contact one of our offices located in Pennsylvania. We offer the latest in diagnostic and treatment technology to meet your needs.

Read more about Heel Spurs
Wednesday, 08 March 2017 15:36

Finding the Right Shoes for Women

It is recommended by the Centers for Disease Control and Prevention that “at least two and a half hours per week” of walking should be the minimum amount of aerobic activity to stay healthy. However, at least 57 percent of women fail to meet this standard. In order to get the right amount of exercise, women need the right shoes. When finding properly-fitting shoes, make sure that your shoes have a wide toe box, allowing your toes to move naturally. Look for shoes that have “seamless uppers,” or “little stitching and no rough edges to rub against your feet.” Overall, good shoes should offer protection and support.

Finding a properly-fitting shoe is important in reducing injuries and preventing foot problems. For more information about treatment, contact one of our podiatrists from PA Foot & Ankle Associates. Our doctors  will treat your foot and ankle needs.

Proper Shoe Fitting

A common concern when it comes to foot health, having properly fitted shoes can help prevent injuries to the foot. Out feet affect our posture and gait, which in turn affects the biomechanics and overall bodily structure. With 33 joints, 26 bones, and over 100 ligaments, the potential for serious injury is much greater than one realizes. Although the feet cease growth in adulthood, they still change shape as they mature. Here are some factors to consider when it comes to investing in proper fitting shoes:

  • Be sure the shoes fit correctly right away
  • Ensure the ball of your foot fits comfortably in the widest portion of the shoes
  • Even though they may look fashionable, improper fitting shoes can either create adverse conditions or exacerbate existing ones you may already have
  • Walk along a carpeted surface to ensure the shoes comfortably fit during normal activity

Keeping in mind how shoes fit the biomechanics of your body, properly-fitting shoes are vitally important. Fortunately, it is not difficult to acquire footwear that fits correctly. Be sure to wear shoes that support the overall structure of your body. Do your feet a favor and invest in several pairs of well-fitted shoes today.

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Proper Shoe Fitting
Tuesday, 07 March 2017 17:08

Causes of Plantar Fasciitis

If you are experiencing moderate to severe pain in your heel or foot, you may have Plantar Fasciitis.  Plantar Fasciitis is an inflammatory condition that affects the heel of the foot, causing in some cases, very extreme pain. There are many causes for this, one being overstretching of the plantar fascia ligament, which runs from the heel to the ball of the foot.  This ligament supports the arch and can be affected by both the feet below it, and the muscles above.  If the calf muscles are too tight, this can pull on the ligament and cause inflammation.  A similar thing happens if you have flat feet.  The foot stretches the ligament from below.  Other activities that can cause Plantar Fasciitis are standing for long periods of time, running while planting your heel instead of your toe, and constant stress on the plantar fascia ligament.  Make sure to stretch your calves, take care that your footwear is not worn out, and seek podiatric treatment if your condition is painful.

Plantar fasciitis can be very painful and inconvenient. If you are experiencing heel pain or symptoms of plantar fasciitis, contact one of our podiatrists  from PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

What is Plantar Fasciitis?

Plantar fasciitis is the inflammation of the thick band of tissue that runs along the bottom of your foot, known as the plantar fascia, and causes mild to severe heel pain.

What Causes Plantar Fasciitis?

  • Excessive running
  • Non-supportive shoes
  • Overpronation
  • Repeated stretching and tearing of the plantar fascia

How Can It Be Treated?

  • Conservative measures – anti-inflammatories, ice packs, stretching exercises, physical therapy, orthotic devices
  • Shockwave therapy – sound waves are sent to the affected area to facilitate healing and are usually used for chronic cases of plantar fasciitis
  • Surgery – usually only used as a last resort when all else fails. The plantar fascia can be surgically detached from the heel

While very treatable, plantar fasciitis is definitely not something that should be ignored. Especially in severe cases, speaking to your doctor right away is highly recommended to avoid complications and severe heel pain. Your podiatrist can work with you to provide the appropriate treatment options tailored to your condition.

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Plantar Fasciitis
Tuesday, 07 March 2017 17:08

How to Avoid Peripheral Neuropathy

Peripheral neuropathy is a disorder that occurs frequently in diabetics, typically in the feet.  The symptoms include: numbness, tingling, throbbing, freezing/burning sensation, and pain.  Not all those with diabetes will get peripheral neuropathy, and not all suffering from it will have the exact same symptoms.  This neuropathy occurs when the walls of the capillaries, or tiny blood vessels, are damaged by high sugar levels in the blood.  Due to the damage they are not able to carry enough blood to the nerves, which then leads to the aforementioned symptoms.  In order to avoid peripheral neuropathy there a few things that can be done.  First, and perhaps most importantly, monitor your blood sugar level, and keep it in balance.  Exercise and diet can help keep your weight down, as well as your blood sugar.  If you are suffering from numbness in your feet, and you haven’t been diagnosed with diabetes, it is essential that you see a doctor immediately.

Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact one of our podiatrists from PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Diabetic Foot Care

Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.

The Importance of Caring for Your Feet

  • Routinely inspect your feet for bruises or sores.
  • Wear socks that fit your feet comfortably.
  • Wear comfortable shoes that provide adequate support.

Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.

It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Diabetic Foot Care

Children’s soccer has become an increasingly popular sport in the United States, making children more prone to foot and ankle injuries. The American Academy of Pediatrics states that injuries can occur when players collide and even when running, twisting or landing. Boys are more likely to incur ankle injuries especially when turning or stopping. Since children are constantly growing, some may experience irritation on the growth plate of the heel resulting in heel pain. Anti-inflammatories, ice, and stretching can help reduce this pain. However, consulting a healthcare professional is always the best bet when injuries occur. Participating in conditioning exercises, wearing proper cleats, teaching proper techniques, and maintaining field conditions can assist in preventing injury.

Making sure that your children maintain good foot health is very important as they grow. If you have any questions, contact one of our podiatrists of PA Foot & Ankle Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Keeping Children's Feet Healthy

Having healthy feet during childhood can help prevent medical problems later in life, namely in the back and legs. As children grow, their feet require different types of care.

Although babies do not walk yet, it is still very important to take care of their feet.

Avoid putting tight shoes or socks on his or her feet

Allow the baby to stretch and kick his or her feet to feel comfortable

As a toddler, kids are now on the move and begin to develop differently. At this age, toddlers are getting a feel for walking, so don’t be alarmed if your toddler is unsteady or ‘walks funny’. 

As your child gets older, it is important to teach them how to take care of their feet

Show them proper hygiene to prevent infections such as fungus

Be watchful of any pain or injury

Have all injuries checked by a doctor as soon as possible

Comfortable, protective shoes should always be worn, especially at play

If you have any questions please feel free to contact one of our offices located in Pennsylvania. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about What to Do to Keep Your Child’s Feet Healthy
Saturday, 13 February 2016 15:43

Frostbite & Frostnip - the danger is lurking

FrostnipWe’re in a Polar Vortex which is downright cold for all of us but especially dangerous for Diabetics, small children and the elderly. With the incredibly low temperatures, it’s important to be aware of Frostbite and Frostnip and how to treat it if you or a loved one is affected.

Frostbite is tissue damage caused by cold and is rated according to severity; first, second, and third degree. Skin turns white, blue or mottled and feels frozen. Frostnip is the mildest level of frostbite. Skin will look pale and feel cold, numb and stiff.

Frostnip can easily be treated at home. If you think you may have the symptoms of frostnip, get out of the cold as soon as possible. Immerse the affected area in warm water (100º to 105º Fahrenheit) to thaw the frozen tissue. As an alternative, use your own body heat to warm the area. Do not use vigorous (rubbing) or high heat methods (heating pad, stove, water hotter than 105 º, etc.) to avoid burning the skin.

If the skin tingles and burns as it warms, your circulation is returning. The skin may turn red, but should not blister or swell. If the skin does not seem to warm, if it remains numb, or if it blisters or swells, seek immediate medical attention as you may be suffering from Frostbite.

Frostbite requires emergency medical care. If you think you may have frostbite, get out of the cold as soon as possible. If you cannot get medical help immediately and there's no risk that the area might be re-frozen before you get help, warm the affected area as you would for frostnip.

Protect your feet and toes by wearing two pairs of socks and choosing appropriate footwear. The first pair of socks, next to your skin, should be made of moisture-wicking fabric. Wear a pair of wool or wool-blend socks on top of those. Your boots should also provide adequate insulation. They should be waterproof and cover your ankles. Make sure that nothing feels tight, as tight clothing increases the risk of frostbite. And limit your time outdoors as an extra precaution.

Fifth Metatarsal FractureJulian Edelman is the most recent star athlete to be sidelined by a Jones fracture, but he is certainly not the first. Earlier in the NFL season, Dez Bryant underwent a single surgery to repair a similar injury and sat for 6 weeks before returning to the field.  Kevin Durant, the 2013-14 NBA MVP, missed much of the 2014-15 NBA season and underwent three surgeries to repair the injury. The difference in recovery times for Bryant and Durant highlights the complexity of treating this injury as well as the nuances each individual encounters throughout their treatment.

A Jones fracture is a fracture to the long bone on the outside of the foot, the fifth metatarsal, that is caused by a sudden inward and downward twisting of the foot or direct force to the area.  Patients experience pain to “the outside” of their foot with swelling and pain with walking.

These injuries can be diagnosed with a standard x-ray of the foot and are particularly difficult to treat as they occur in an area of the bone with limited blood supply.  Adequate blood supply is essential for healing.

While 6-8 weeks of non-weight bearing is the typical method of treatment for most patients, surgery is usually preferred for high-level athletes.  Surgery for this injury consists of introducing a single screw into the bone to hold the two fragments together so that they can heal.  Even with surgery, it is approximately 6 weeks until return to activity can be expected.  The most common complication that patients experience with this injury, as seen with Durant, is failure of the two bone fragments to heal.  When this happens, regardless of the initial method of treatment, patients require surgery to repair the non-healing bone.

Disclaimer: The author has never evaluated, treated or reviewed the medical records of the individuals mentioned in this article.  All statements and opinions are based on publicly available material released from the individual or their representatives.

We recently ran into a middle-aged friend and sometime patient who was complaining of growing aches and pains in her knees, hips and back. She wasn't an athlete, or particularly active, so the pain probably wasn't from overuse. She also didn't have a weight problem, so stress on the joints from obesity wasn't the answer. She remarked that she thought she might have Lyme Disease and had set up an appointment with her family physician to be tested. Sorry to hear that, we said, That's truly a painful condition.

back pain

And then we looked down at her shoes - the most beat-up, worn-out flats we ever saw.

"You have flat feet, don't you?"

"Yes, I do."

"Do you wear those shoes often?"

"Yes, I love them."

"Throw them away and never wear them again. Those shoes have zero support and flat feet need arch support. I bet if you wear sneakers instead your pain will go away."

"I hadn't thought of that."

Most people assume that the growing pain in their knees, hips, or back is caused by a crippling disease or an unknown injury. But in fact, the source of your pain may actually be rooted in your feet - or more specifically, heels and arches which aren't supported correctly (as in our friend's case), or feet that are out of alignment with your ankle and leg.

The older we get...

As we age we have to take better care of our feet. After forty-plus years of neglect, they gradually become painful, arthritic, misaligned, and prone to bunions and hammertoes. Our feet are designed to distribute and support our body weight evenly across the forefoot and heels, and a critical part of this is the proper alignment of the foot/ankle and the ankle/lower leg.  In the case of those who have flat feet, arch support is required for proper alignment and to avoid fatigue.

When we're out of alignment, or lack arch support, we get tired and sore, which causes us to shift our body weight to get comfortable. Then the sides of our foot, forefoot or heel carry too much weight and our ankles, knees, hips and legs compensate, which causes stress on the joints. And when the stress is continuous, the joints become irritated and painful.

It may be hard to believe that such acute and bothersome pain can be caused by a lack of arch support or the misalignment of your foot/ankle/lower leg. In many cases, a simple change in footwear to a quality pair of athletic shoes, worn as often as possible, is the answer. To correct your alignment and relive fatigue, your podiatrist may also recommend custom orthotics to be worn inside your shoes.

And how is our friend doing now, one month later? She reports that she's been wearing sneakers as often as possible and her back, hip and knee pain is nearly gone. Voila!

 

Put down that soda or milkshake: A recent European study has found that drinking one sugar-sweetened drink per day - just one - can raise your risk of Type 2 diabetes by up to 25%.

milkshakes, diabetes

The new British study, published in Diabetologia, the journal of the European Association for the Study of Diabetes, tracked the beverage consumption habits of more than 25,000 adults ages 40-79 over a period of 11 years, to see who was more or less likely to develop diabetes. None had diabetes at the start of the study. The research showed that those who drank unsweetened or lightly sweetened coffee, tea or water daily instead of sugar-sweetened drinks like sodas and milkshakes, were up to 25% less likely to develop diabetes.

The association of tea and coffee with diabetes has not been well-studied in the past. This is also the first study to link sweetened-milk beverages like milkshakes and flavored milks to diabetes. The authors write that the association is “unsurprising” since added sugar contributes more than half of the sugar contained in these drinks.

In a press release, the senior author of the paper, Dr. Nita Forouhi of the University of Cambridge, said, “The good news is that our study provides evidence that replacing a daily serving of a sugary soft drink or sugary milk drink with water or unsweetened tea or coffee can help to cut the risk of diabetes.”

Just one cola per day is too much sugar

Overall the study found that each 5% increase in the daily amount of calories from sweetened beverages was associated with an 18% increase in diabetes. Soft drinks like Coca Cola and Pepsi, sweetened milk beverages like milkshakes, and artificially sweetened beverages like diet sodas were all associated with approximately a 22% increase in diabetes.

Surprising findings from the study:

  • Those who consumed one artificially sweetened diet drink each day showed a 14% greater chance of developing type 2 diabetes.
  • Drinking fruit juice, which is high in naturally occurring fruit sugars, did not increase the likelihood of developing diabetes.
  • Unsweetened tea or coffee had an inverse association with diabetes (the incidence of type 2 diabetes decreased).

However, the association with artificially sweetened beverages lost statistical significance when the researchers took weight into account, suggesting that “those who are overweight or obese and at higher risk of chronic disease consume a higher amount of [artificially sweetened beverages] than those at lower risk.”

Public health experts recommend that a typical adult diet - about 2,000 calories a day - should include no more than 130 calories from added sugar. If you drink just one 12-ounce can of Coca Cola Classic, with 140 calories, you'll exceed that limit.

"Our study adds further important evidence to the recommendation from the World Health Organization to limit the intake of free sugars in our diet," states Dr. Forouhi. "Replacing soft drinks and sweetened-milk beverages with [artificially sweetened beverages] did not reduce type 2 diabetes incidence, but drinking water or unsweetened tea or coffee as alternatives to soft drinks and sweetened milk beverages lowered the incidence of type 2 diabetes significantly. These novel findings are of clinical and public health relevance,... [as] reducing consumption of sweet beverages... and promoting drinking water and unsweetened tea or coffee as alternatives may help curb the escalating diabetes epidemic."

Like clockwork, every spring we hear the same complaint in our office:

"I had pain in my feet/ankles/toes after I ran. And then I ran the next day and they hurt more. I can't understand it, because I'm running exactly the same route I did as last year."

protect your feet and ankles when running

Each spring, every athlete is anxious to jump right back in where they left off. But we forget just how quickly our bodies get out of condition, especially as we age.

Your body has de-conditioned over the winter months (assuming you're not working out regularly at the gym). Ligaments, muscles, bones, and interconnective tissue have become much weaker from lack of use. When we demand the same from them as we did when we were in peak condition at the end of last season, the disconnect between desire, endurance and strength becomes obvious. The result is soreness, stiffness, tendonitis, sprains, fractures or worse, which could sideline us for months.

Whenever we have a significant break from our training schedule, even a few weeks, it's important to build back up slowly to pre-break levels. This is especially true when we lay off all winter, or when we're recovering from an injury or an illness.

In fact, your hard-earned fitness can begin decreasing in as little as 2 weeks, especially if you're in peak condition. According to Dr. Edward Coyle, the director of the Human Performance Laboratory at the University of Texas at Austin, the maximum oxygen that an athlete can uptake and utilize (your endurance) plunges in the first month of inactivity and continues to decrease for the next 3 months of inactivity. Even the enzymes involved in metabolizing energy become less active. In fact, for the casual athlete, all the benefits derived from the previous season -  the ability to uptake and utilize oxygen - may be completely lost when they lay off their routine for 4 months or more.

And after your endurance decreases, your muscle mass and strength also take a hit. Which is when you feel ankle pain or heel pain pushing that last mile.

runner forgot somethingThe good news is, if you've been a runner or otherwise training for 10 years or more, you can maintain fitness longer than those who've been at it for less time. And highly trained athletes don't decline to the same levels as the casual athlete, even after a long layoff.

So how do you get back into condition?

  • Take it slow and don't go BIG right from the start. Begin by working below your break point and don't push
  • Warm up for longer periods before your workout. Make sure you've stretched your legs, feet and ankles sufficiently
  • Allow 1 day of rest between each run or workout. More if you have pain or soreness in your knees, shins, feet or ankles.
  • Focus on consistency and good habits, not speed
  • Progress gradually and extend your workouts by a small amount each session
  • If you feel any pain, stop immediately. Resume your training only when the pain has completely subsided
  • Wear a new pair of athletic shoes to support your feet and legs properly

Breaks are an important part of training, as they're important for your physical and mental health. They can also help you come back stronger and faster. Your best bet is to rest when injured or ill and do some cross-training in the gym during your downtime to maintain strength and endurance. That's a far better strategy than hurting yourself every spring.

If you've ever taken a yoga class, one thing was probably clear immediately: your feet and ankles weren't nearly as strong as you thought they were. In the U.S. and much of the world, we go about our daily business in shoes which protect our feet and our health. If we're athletes, we buy shoes which protect our feet from injuries and hopefully give us a little extra juice when we need it.

But on the downside, those shoes can prevent the muscles in our feet from getting the exercise they need. And as we age, it shows: bunions, hammer toes, aching arches, aching toes, poor balance, and a host of other maladies (some of these are inherited traits).

yoga strengthens feet ankles

Strong feet and ankles are essential for anyone, and especially as we age, to maintain our balance. Running, biking, weight lifting and any athletic activity is great, but they tend to develop one side of the body more than the other, due to our natural left-hand, right-hand propensity. Yoga aims to create equal strength and also loosens the joints, helping them avoid injury and maintain flexibility.

One of the first lessons in yoga is how to stand. This may seem silly at first, but our feet are our foundation, and we quickly learn that we need to unlearn some bad habits. Over the years we lean into the sides of our feet, lean back on our heels, lean forward, or shift weight from sore areas. All of these habits change the way we walk and stand, throwing our legs and ankles out of alignment and placing stress on other parts of our body. The result is pain and stiffness anywhere between the toes and neck.

Try these simple yoga-based exercises to build strength in your ankles, feet and toes. Do all exercises barefoot on a flat surface. If you have medical problems with your feet or ankles, or are obese, consult your physician before attempting.

Learn To Evenly Distribute Your Weight

The strength of your feet - and especially your arches - determines if your leg is aligned with your ankle. Strengthening your arches starts with an awareness of how you stand.

Standing upright in bare feet, sense where your weight falls in your feet. Your feet are meant to carry your body weight evenly - not back on the heels or on the balls of your feet. Press down evenly through the heels, the balls, and your toes. You'll feel the difference in your balance immediately. While standing upright and evenly balanced, spread the soles and toes as much as you can and reach the toes forward.

Stretch and Strengthen Your Feet

One of the most common yoga poses, Downward-Facing Dog, stretches the soles of your feet and strengthens your arches. In this position, gently push your heels toward the floor as much as possible. Learn how to do it here.

strengthen feet ankles

To stretch the tops of your feet and strengthen your ankles, try Hero Pose (only do this if you have no knee problems). Kneel on the floor, keeping your thighs perpendicular to the floor and touch your inner knees together. Slide your feet apart, slightly wider than your hips, but keep the tops of your feet flat on the floor. Then sit down between your feet. If your buttocks don't rest comfortably on the floor, support them with a thick book placed between your feet. Now lift your sternum, sitting as upright as possible, and try to release your shoulder blades away from your ears. Hold for 1 minute.

Raising yourself on your toes is a simple and excellent way to strengthen your feet. While this may seem easy at first, try doing it very slowly. You'll be surprised at how much effort you'll expend.

Strengthen your toes

Stand with your feet so that they're directly under your hips. Try to lift just the big toe on each foot, while keeping the other toes on the floor. Then do the opposite: lift all the toes except the big toe. Switch back and forth. You'll find that one part of that exercise will be a lot easier than the other. That's because those who pronate (roll the foot inward when they walk) typically have a hard time lifting their big toes, and those who supinate (roll the foot outward) have a hard time lifting the other toes.

Leaning is Exercise

Leaning teaches us how to balance our weight across our feet. Those who shift their weight to their heels leave the front of their foot without much to do, and the foot weakens.

Stand with your feet a comfortable distance apart and put a soft bend in your knees. Lean forward at the ankle as if you were about to ski down a slope. Do not lean from the waist or hips - keep the lean in your ankles. This exercise wakes up the muscles in your toes and the soles of your feet.

If your feet feel tired after these exercises, that's good - it means that the muscles are being worked. If your feet are sore, that's not good - back off a little next time around.

Flat feet (flatfoot, pes planus, fallen arches) occur when the arch in your foot drops, causing the bottom of your foot to flatten. This is easy to note, as the entire sole of your foot will contact the floor when you stand. In many cases, flat feet are hereditary and cause no pain.

flat foot, flat feet, flatfootBut for those who once had arches, Flatfoot slowly develops from wear and tear (aging) or trauma, causing pain in the arches, heels, ankles, knees or hips, as the leg and foot fall out of alignment. The culprit is usually damage to the posterior tibial tendon which runs along the inside of your ankle - when it weakens, it can no longer support the arch.

Why you need your arches

We all start with zero arch. We're born with flat feet and slowly our arches develop during childhood, becoming fully developed in adulthood.

The arches and the biomechanics of the lower leg are intimately linked - our arches literally put a "spring" in our step, determine how we walk and distribute our body weight proportionally across our feet and legs. Arches also need to be sturdy and flexible to adapt to various surfaces. When the strength or flexibility of the arch fails, the alignment and balance of the foot and leg suffers.

What causes flat feet?

The most common cause of Adult Acquired Flat Foot Deformity (AAFFD) is damage to the posterior tibial tendon, one of the most important tendons in your leg. Starting at the calf, the posterior tibial tendon travels down the inside of your leg and heel, and attaches to the bones on the inside of your foot. The main function of the tendon is to support your arch and foot. If the tendon suffers chronic damage such as persistent inflammation, it may lose its ability to support your arch, and the arch will slowly collapse. Pain and discomfort from AAFFD can be substantial, occurring anywhere in the foot, heel, ankle, knee, back, or hip.

Inflammatory arthritis, especially rheumatoid arthritis, attacks the cartilage in the joints as well as the ligaments that support the foot. The inflammation causes not only pain, but also may change the shape of the foot and cause the arch to drop.

Ligament injury causes the joints to fall out of alignment. The job of the ligaments is to hold the bones in place and prevent them from moving. When the ligaments are damaged, the bones fall, flattening the arch.

Fractures or dislocations of the bones in the midfoot can lead to Flatfoot deformity.

Charcot Foot Disorder, a complication of diabetes, results from a nerve condition (diabetic peripheral neuropathy) which causes a loss of sensation in the feet. An infection in the foot, unknown to the patient, causes weakness in the ligaments and bones, leading to collapse of the arch and other complications. Complicated surgery is required to correct the problem.

Other reasons for developing Flatfoot include

  • Obesity
  • Muscle diseases
  • Pregnancy
  • Aging
  • Trauma

Symptoms of Flatfoot depend on the cause of the condition, but may include :

  • Difficulty standing or walking for long periods, and pain that gets worse with activity. High intensity activities such as running can be especially difficult.
  • Pain or achiness occurring anywhere from the mid foot, heel and arch to the hip and back.
  • Pain along the inside of the foot or ankle (path of the posterior tibial tendon). May be accompanied by swelling.
  • Stiffness in the feet
  • Feet tire easily
  • Standing on toes is difficult
  • Pain on the outside of the ankle, caused by a shifting heel bone which puts pressure on the fibula (ankle bone)
  • In the presence of diabetes, patients may discover a lump on the bottom of their foot. This may develop into an ulcer and consequently Charcot foot disorder. Any difference in the top or bottom surface of the foot should immediately be brought to the attention of a podiatrist

Treatment for flat feet

  • Custom orthotics may be prescribed to support your feet correctly and reduce pain
  • A change in footwear: Your podiatrist may suggest you buy a pair of high quality, supportive shoes to reduce stress on your feet and support them correctly
  • Physical therapy to stretch the Achilles tendon. A short Achilles can contribute to Flatfoot, and stretching it will improve flexibility in the foot
  • Surgery may be recommended to repair the arch and improve flexibility

Watch the story of how we alleviated the pain of Flatfoot (and other conditions) for one of our patients.

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