Noticing a Neuroma?

Dr. Adam Thomas

A neuroma is the swelling and thickening of nerves in the ball of your foot. It is often referred to as a “pinched nerve.” If you feel tingling, burning, or numbness in your toes, pain or irritation in the ball of your foot, or pain between toes while walking, you could be experiencing symptoms associated with a neuroma. People who suffer from this condition also report feeling like there is something inside their foot or feeling like they have a pebble in their shoe. Many factors can lead to the formation of a neuroma whenever the nerves are compressed:

• Repeated stress on the foot from activities (like running)
• Improper footwear that squeezes the toes together (ie: High heeled shoes that force the forefoot into a narrow space) 
• Foot deformities like flat feet, hammertoes, bunions, or a high-arched foot 
• Inflammation of the nerve as a result of trauma

A majority of people who develop neuromas are women.

There are some home treatment options if you have a neuroma. You can rest the foot, massage the affected area, or apply an ice pack to lessen the pain. Or you can take anti-inflammatory medicine to reduce pain and swelling. Another alternative is to keep pressure off of the foot by using over-the-counter shoe pads or wearing shoes with thick, shock-absorbent soles. Also, as a preventative measure, wear shoes that have room for your toes and if a high heeled shoe is higher than two inches, you should probably avoid it.

The pain associated with a neuroma should not be ignored. Visit your local podiatrist for diagnosis and a treatment plan because if a neuroma is left untreated, it tends to get worse. Some treatment options include padding shoes, anti-inflammatory medicine, cortisone injections, or custom orthotics (shoe inserts). If conservative treatments fail, your podiatrist may consider surgical intervention.

I Had No Idea that I Had No Idea!

Many of us know that there are numerous complications associated with diabetes, and one of great importance is Diabetic Peripheral Neuropathy. This condition can be defined as nerve damage to the body’s lower extremities— the legs, feet, and toes. 

Your nerves carry messages between the brain and the body. If nerves are damaged, the messages will not be able to travel. This lack of communication between the brain and the body might cause you to be unable to notice or feel anything wrong with your feet: feeling hot or cold, pain or sores, the difference between ill and proper-fitting shoes. Many diabetics are shocked to learn that they are unable to detect serious injuries to their feet. 

The nerve damage may cause you to feel symptoms such as tingling, a feeling of pins and needles, burning, loss of sensation, sharp pain, or numbness. Muscle weakness and balance problems are also commonly experienced with this type of neuropathy. 

Diabetic peripheral neuropathy is a very serious matter because wound healing is slower in diabetic patients. If a wound heals too slowly, or fails to heal at all, the initial foot trauma could potentially lead to amputation. For example, if an ulcer is unable to heal, and has caused severe damage to surrounding areas (tissue and bone), the safest form of action would be to surgically remove the damaged part from the body. This means that any part of the lower extremity— a toe, foot, or leg, can be amputated.

To prevent diabetic peripheral neuropathy, diabetic patients should keep their blood sugar levels under control, carefully trim their nails, and keep feet clean and dry. They should also inspect their feet daily for blisters, burns, sores, ulcers, cuts and other puncture wounds. If you are a diabetic patient, please remember to get a diabetic foot exam at least once a year, or if you have foot issues more frequently, please see your podiatrist and primary care physician more regularly.

What's That Smell?

Did you know that each foot has more than 250,000 sweat glands? This means that your feet have the potential to sweat… A LOT! But why do they smell?

You might be surprised to learn that your sweat is not the source of the odor because sweat is only made of salt and water. The real cause of odor in stinky feet is the bacteria on your skin. The bacteria feed off of your sweat and dead skin, eventually excreting waste that has a strong odor. Bacteria love dark, warm, and damp places— sounds like your socks and shoes right? Your feet sweat and if the sweat is unable to evaporate, it comes into contact with your socks and shoes, the perfect place for bacteria to breed and thrive.

If you want to prevent smelly feet, wash and dry your feet every day! You can even use a pumice stone to help remove dead skin.  Do not wear closed toe shoes without socks. Also, try not to wear the same pair of shoes two days in a row. The rotation of shoes allows the first pair to dry out while you wear the second pair. 

Be sure to wear a fresh pair of socks (preferably made out of a material that helps keep feet dry like wool or other moisture-wicking fibers). Another quick tip is to turn your socks inside out before you toss them in the washer to make sure that they are washed more thoroughly. Still, the main goal is to keep your feet clean, dry, and cool. If you lessen the amount of moisture in socks and shoes, you also prevent the growth of bacteria.

Another way to help prevent foot odor is your diet. After foods are broken down, their compounds are absorbed in the body and released through your skin. Some of these foods have been known to cause odors like garlic and onions. At the very least, try to eat a well balanced diet.

If you are currently a victim to smelly feet, you can reduce your foot odor by using powders like talcum powder, baking soda, or corn starch. They absorb sweat and some prevent bacteria growth. Also, you could soak your feet in black tea or apple cider vinegar. You can even wipe your feet down with a Vodka-soaked washcloth!

It is important to keep in mind that there are other reasons why your feet could smell:

• Excessively sweaty feet (Hyperhidrosis )
• Poor Hygiene
• Hormone changes
• Medication
• Stress
• Alcohol and drugs

If you have more questions about this topic and your foot health, contact your local podiatrist.

Community Foot Specialists

Welcoming to Spring, Weekend Warriors!

Dr. Bridget Brondon

Spring is finally here (hopefully!) and with the weather becoming nicer (again, hopefully!), a lot of people are starting to rediscover the outdoors.  Many people take this time to become more active and begin exercise programs outside to take advantage of the nice weather. While the mind may be ready for the increase in activity after a long, cold winter spent hibernating inside our homes, sometimes it takes a little while longer for the body to get use to the higher demands we are asking of it once we become more active again.

This is the time of year when we, as podiatrists, begin to see more of these “weekend warriors” in our offices for activity related injuries. Weekend warriors are those whose work schedules keep them busy during the week but have free time for activities on the weekend. Please be aware that the longer you have been inactive, the greater risk you have for sustaining injuries once you start increasing your activity. Examples of problems you might encounter include ankle and foot sprains, tendonitis, and plantar fasciitis.  

Now don’t get me wrong, activity is a GOOD thing.  It helps to maintain a healthy heart function, lower blood pressure, keep cholesterol and blood sugar under control, maintain a healthy weight, keep arthritic joints moving, boost your immune system, and the list goes on and on. Still, try these helpful tips to keep yourself out of trouble:

• Make sure that you have supportive shoes.  If your body doesn’t have a good supportive base to start with, increased stress put on your muscles and joints can tire them out faster making them more prone to injury.

• Also, keep in mind, shoes don’t last forever.  Over time, the cushion and support decrease. Treat yourself to a new pair if yours are starting to wear out!

• If you have overdone it one day, take a couple days to recuperate.  Your body will need time to rest and heal itself.  If you can’t sit still that long, try a lower stress workout, such as swimming or biking, which puts less stress on the body than running or other high intensity workouts.

• Elevate your legs after exercise to help with any swelling. Use ice or over-the-counter anti-inflammatory medication to help with any inflammation and soreness as needed.

• If the soreness won’t go away after doing the above for a few weeks, or the pain gets worse, call and make an appointment with your doctor.  We want to help you feel better!

The important thing is to ease your way back into the activity so your body has a chance to adjust to the change.  Start off slow and work your way up.  Don’t try and run a marathon your first day out!  Your body needs time to adjust to the increase in activity without overly fatiguing your muscles, joints, etc.  The more tired your muscles are, the higher the chance they will become injured.  Rome wasn’t built in a day.  Give your body a chance to become accustomed to its newly active lifestyle so you can continue to stay active and keep your body healthy!

You Can't Run Through a Stress Fracture!

Dr. Adam Thomas

Spring is finally here, and as more and more of you are considering outdoor running, you should familiarize yourself with the associated foot and ankle risks like stress fractures.

What is a Stress Fracture?

A stress fracture is a tiny crack on the surface of a bone or an incomplete fracture. When a muscle is overused, fatigued and no longer able to absorb the shock from impacts, it transfers stress to nearby bones, resulting in fractures.

What causes it?

If an individual is continuously striking their feet on surfaces, while either running or jumping, the risk of causing a stress fracture injury increases. Other causes include participating in athletic activities that increase physical stress, running on irregular surfaces, inappropriate footwear, and improper training.

Although stress fractures are caused by an abnormal force on a normal bone such as a young person running, they are also caused by a normal force on an abnormal bone, like an older person walking regularly. Oftentimes, stress fractures that occur from the latter are the result of bone density loss.

How does it relate to running?

Stress fractures, as a result of athletic activity, are fairly common and runners are especially susceptible to them. In many instances, the runner does not even know that an injury to the bone has occurred. If you feel pain that increases in severity, doNOT try to “run through the pain.” Continued force on the injured bone can progress the fracture, cause more damage, and worsen the pain.

Where is it common?

A majority of all stress fractures occur in weight bearing bones such as the lower leg and the foot. More specifically, stress fractures can be found in the metatarsal bones of the foot, and they are most common in the 2nd metatarsal because it is the longest.

How do you treat it?

Treatment involves rest which means no more running… until healed. Treatment also includes anti-inflammatory medication and in some cases, a splint or crutches are necessary.

How do you prevent it?

You can lessen the risk of stress fractures by changing your athletic conditioning. Start slowly, gradually increase the intensity of workouts, and avoid doing too much too soon or applying too much force too early.

You should also ensure that you have the proper shoes for the activity- cleats, running shoes, basketball sneakers, etc. They all offer different ankle and arch support, with different gripping capabilities. Try eating foods with the minerals magnesium, calcium, and potassium or foods that have vitamins D and K to improve bone health. Some foods to try are broccoli, nuts, flax seeds, salmon, spinach, bananas, and dairy products.

If you have severe pain that is not going away and believe that you have sustained a stress fracture, please contact your local podiatrist.

Welcome to Our Blog!

Left to right: Dr. Guehl, Dr. Dotter, Dr. Thomas

Hi there and welcome to our blog!  In light of Spring and Summer’s near approach, we have decided to relaunch our Community Foot Specialists blog to help address your feet concerns through these seasons (and hopefully beyond).

For those of you who are new to our blog, this is how it works: each week, one of our doctors—Adam Thomas, Belinda Dotter, Bridget Brondon or Allen Guehl—will tackle a current common and/or medical issue related to the foot. These topics could range anywhere from how custom orthotics (shoe inserts) can help with walking habits to how regular visits to your podiatrist can reduce the risk of complications associated with diabetes. All of our doctors are both progressive and current—meaning, you will receive both comprehensive and topical information through this blog. 

Ultimately, our goal is to provide relevant and important information to our patients and seekers of podiatric information, locally and nationally. To better serve you, we always encourage our users to send us topics of interest and/or concern, and we will try our best to have one of our doctors cover that topic for you. You can email your topics to cfcfeetmarketing@gmail.com . For more information on our practice, our doctors, and what we treat, visit our website: www.daytonfeet.com!

Thanks for stopping by our blog, and we look forward to seeing you here next week ☺

Community Foot Specialists 

Frostbite, Prevention and Treatment.

Dr. Belinda Dotter

This winter has been especially cold for long periods of time, quite different from our past winters that have been on the mild side. Frostbite becomes a risk every time we go out in sub-zero temperatures (and sometimes not even sub-zero temperatures). Frostbite is caused by either prolonged exposure to cold temperatures, or shorter exposures to very cold temperatures.

There are several symptoms of frostbite:  numbness, a pins and needles sensation, severe pain, itching, and burning are all common when the body part is warmed and blood starts flowing again. The skin may look white, grayish yellow, or black with severe frostbite.  Blistering is also commonly seen.

Here are some tips to avoid having frostbite on your toes and feet!

• The most important action for prevention of frostbite is: Plan Ahead! If you are planning outdoor activities, check the weather forecast frequently, and don’t ignore warnings about storms. Avoid activities, such as hiking and camping in freezing weather, if it’s beyond your experience level.
• Wear adequate clothing: Layering is key, with the inner layer being a fabric that wicks moisture from the skin. The outer layer should serve as a windbreaker. Mittens provide more protection than gloves. Wear two pairs of socks, with the outer layer being wool. Don’t forget hats and scarves!
• Increase physical activity when outside to stay warm.
• Don’t drink alcohol before or during cold weather exposure, since the alcohol may prevent you from realizing that your body is becoming too cold.
• Don’t smoke! Smoking constricts blood vessels and increases the risk for frostbite.
• Keep a cold weather emergency kit in the car: extra layers of clothing, blankets, and chemical hand warmers.

Painful Ingrowns? You Don't Have to be Stuck at Home

Dr. Belinda Dotter and Debbie

Within 5 minutes of running on the treadmill I felt a sudden sharp, stabbing pain in my toe. From past experience, I knew exactly what it was- an ingrown toenail. It was too painful to continue my workout so I headed home.

An ingrown toenail doesn't sound like much, but these can cause a lot of pain if left untreated and can affect simple tasks in your everyday life.  If yours are anything like mine, then even the smallest touch will make you cringe. An ingrown toenail is a common condition in which the corner or side of one of your toenails (usually the big toe) grows into the soft flesh of that toe. The result is pain, redness, swelling, and sometimes, an infection.

The old me would have taken matters into my own hand and tried to remove the ingrown toenail myself. You would think from past experience I would know this is a big no-no but that never stopped me before. I always made it 10x worse trying to remove the corner of the nail myself. The new me works for a podiatrist, so at this point I know better.

The following day I decided to schedule an appointment with Community Foot Specialists. I wanted to get back into a regular exercise routine, I wanted to take my children to the park, I wanted to do regular every day activities without the almost unbearable pain from the ingrown toenail.

At Community Foot Specialists, we try to get our patients in as quickly as possible so I was relieved that I was able to be seen for an evaluation the next day by Dr. Dotter at our Main Street location in Dayton, Ohio.

Based upon the doctor’s professional opinion, I was able to be seen the following day for the procedure. And I was a nervous wreck. I’m not sure why... it’s not like I didn't know what was going to happen. But the thought of my toe being numbed and my nail being clipped out had me ready to cancel my appointment.

Once I had arrived at my destination the medical assistant got me right back to a room. Within minutes, the doctor came in and talked to me about what was going to happen. She then numbed my toe. She was very gentle and to be completely honest I couldn't really feel it. I waited for my entire toe to numb before she came back to remove the nail. It only took a couple of minutes and she only took out the corner. As a woman, I was worried that the doctor would take off more toenail than necessary. I mean, it IS Summer and I love my flip flops!

Relief! That’s all I could think. I couldn't believe how easy and quick the procedure was.

If you are dealing with an ingrown toenail, or what you think may be an ingrown toe nail, I highly recommend coming in to see the doctors at Community Foot Specialists. And I’m not just saying that because I work here. At Community Foot Specialists our doctor’s mission is to provide patient centered, high-quality foot and ankle care, delivered by knowledgeable, compassionate podiatrists and a professional, caring staff… and I experienced exactly that.

The Foot of Your Foot: The Great Toe

Lately, we have had quite a few of our patient’s over the age of forty complaining of pain in the big toe joint. Typically, forty is the age when early arthritis symptoms tend to manifest and, in the foot, we see the great toe joint as the most common. This is due to the mechanical load and the important role it plays in every step we take. When we walk, our big toe joint bends up to an impressive 75 degrees just before the foot leaves the ground. But, sometimes, due to unusual wearing and tearing of the cartilage in the toe joint, the toe becomes stiff and starts to hurt. This is called Hallux Limitus.

Hallux Limitus is a progressive arthritic condition that limits the motion and function of the big toe. Symptoms of this condition come on slowly. You may only notice a mild, temporary pain when you are in motion or when you move the big toe joint. Eventually, the pain may worsen and in some cases dorsal bunions or bone spurs may develop and cause additional pain. The big toe is extremely important for proper foot/ankle/knee/hip and even low back bio-mechanics so it is important you don’t go untreated.

Symptoms of Hallux Limitus are based on the stage in which you are in. Your symptoms may or may not include: Pain while active or when you move the big toe joint, stiffness in the big toe, increased pain or aches in cold or damp temperatures, difficulty bending big toe up and down, difficulty wearing shoes, especially high heels, and development of bone growths (bunions, bone spurs).

It’s important to know that these symptoms signify the early stages of this condition. Each of these symptoms will slowly worsen until you’ve reached a point of no movement within the big toe joint. Hallux Limitus is caused by one of four things: Genetics, injury, a long first metatarsal bone (or short second metatarsal), or an elevated first metatarsal bone.

Hallux Limitus is a progressive condition that can lead to further problems, including complete loss of motion in the big toe joint. It’s best to see your podiatrist in the early stages or before bone growths develop. Your doctor will begin with a physical examination so he or she can determine the range of motion within the joint. Imaging tests such as x-rays and MRIs are often used to determine whether arthritis is present, to see how much the joint has narrowed, and to evaluate the foots overall health.

Treatment options include:

• A Morton’s extension can be used to relieve pain. These durable semi-rigid medical devices can be found in podiatry offices, and they are designed to provide support and shift weight away from the big toe to reduce pain.
• Accommodative cushions made of foam work for Hallux Limitus, since it pads the big toe joint and protects it from painful shoe pressure.
• Turf toe plates limit the range of motion of the great toe joint, which makes this product ideal for treating both Hallux Limitus and Hallux Rigidus.
• Athletic or running shoes made especially for over-pronators (flat feet) can provide support. They are less flexible than conventional running shoes, which enables them to limit the motion of the joint.

If you believe you may have Hallux Limitus and you live in the Greater Dayton/Springfield area, give Community Foot Specialists a call. Your feet will be in good hands! 937-426-9500.

Your Crooked Toes May Be Hammer Toes

Do you have crooked toes or toes that look like little hammers or claws? You may have hammer toes. A hammer toe or contracted toe is a deformity caused by a tendon imbalance on the second, third or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe and claw toe are similar to hammer toes.

Hammer toes are most often caused from wearing ill fitted shoes that force the toe into a bent position. Wearing these shoes for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity.

The hammer toe deformity can be flexible, semi-rigid, or rigid in nature. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid or semi-rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress to the ball of the foot, and possibly causing pain and may also cause painful corns and calluses on the top of the digit (at the joint) and at the tip of the toe--due to pressure--or under the ball of the foot from retrograde pressure.

Conservative treatment starts with new shoes with soft, deep toe boxes to avoid rubbing.  Your podiatrist may also recommend padding to decrease pressure on the area.

Surgery would be the final resort. Your podiatrist can do a simple procedure done in office called Percutaneous Tenotomy, which releases the contracted tendon. For more serious hammer toes, your podiatrist can do 1 or 2 surgeries in the operating room. Arthroplasty is a surgery to relieve pain and restore range of motion by reconstructing a joint. Arthrodesis is a surgical procedure which fuses the bones that form a joint, essentially eliminating the joint.

 If you have hammer toes and live in the Dayton/Springfield area, Community Foot Specialists can help! Call today to schedule your appointment. We’re always accepting new patients! 937-426-9500

Joakim Noah and Plantar Fasciitis

Joakim Noah

How would you like to run around feeling like you have hundreds of needles underneath your feet? Doesn't sound very pleasant, does it? Well that’s what Chicago Bulls Center Joakim Noah is dealing with right now. This is called plantar fasciitis.

Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. This is more likely to happen if your feet roll inward too much when you walk, you walk, stand or run for long periods of time, especially on hard surfaces.

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. As the injury advances into later stages, the pain will begin to feel like little needles sticking you in the bottom of your heel with each step.

There is no instant cure for plantar fasciitis but immediate intervention is very important so it does not get worse. Your podiatrist will likely recommend adequate rest to take the strain off the Plantar Fascia and allow the affected tissues time to heal. There are also exercises your podiatrist may recommend, such as:

• Stretching your foot by flexing it up and down 10 times before standing.
• Do toe stretches to stretch the plantar fascia.
• Use a towel to stretch the bottom of your foot.
• Use a rolling pin or tennis ball. While seated, roll the rolling pin or ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.

Your podiatrist may also recommend custom made JM orthotics to be worn in your shoe to support your arch.

As for Joakim Noah, he’s still playing for the Bulls during the playoffs. The series is currently at 3-1, with Miami in the lead.Noah was quoted a couple of weeks ago telling reporters, "It really sucks. It feels like you have needles underneath your foot while you're playing. You need to run, you need to jump (and) you need to do a lot of things while you're playing basketball. So you don't want needles on your feet, right?”

According to the ChicagoTribune, Noah is receiving treatment for his plantar fasciitis. Aside from resting when he can, he has tried platelet rich plasma injections, sleeping in a splint and three seasons ago- shock wave therapy. He most recently received cortisone shots. Although these treatments might be beneficial, they are far from the typical prescribed treatments. For those of us who are not Joakim Noah or a pro-athlete during their mid-playoff stride, it is recommended that, first and foremost, you go and see a podiatrist. It is also recommended that you rest and stretch as much and often as you can. It is imperative that you do not put unwarranted stress on the heel of your foot. 

Important Things to Know About Stress Fractures

With Spring here more folks are outside, including runners. Oftentimes runners complain experiencing pain in the mid foot. The first concern would be to rule out stress fractures. Stress fractures occur with either normal force on abnormal bone (example: elderly) or abnormal force on normal bone, (example: new activity or increased load on the foot).

 Symptoms include pain with walking, running or any increase in activity. Swelling may also be a problem.

A visit to the podiatrist is critical to help rule stress fractures out before they become more of a serious problem. X-rays can be taken in office to look for evidence of stress fractures. It should be noted, however, that early stress fractures may not show up on the x-ray until 2 weeks after the start of symptoms.

The most common bone in the foot to experience a stress fracture is the 2nd metatarsal bone due to it being the longest bone in the row. The 2nd metatarsal will generate greater loads and greater stress, repetitive loads for a period of time can cause a stress fracture.

Sometimes a person may experience the same pain and symptoms of stress fractures due to a phenomenon known as over use or stress syndrome. Medical tibial stress syndrome is an irritation of the tibia (shin bone) at points where the soleus and tibialis posterior muscles attach to it. It is caused by over-use in runners, however, there are a number of factors, such as altered foot, knee and hip posture, that can predispose a person to the syndrome. This is considered as a precursor to stress fracture. An MRI can help detect this and will show increased signal in the affected bone.

The best treatment is rest and protected weight bearing. Sometimes taking up to 6-8 weeks, something athletes never want to hear. Pain may be treated with ice and anti-inflammatory. Once improved, the goal would be to reduce chances or recurrence with slow modifications and likely functional inserts with specific design to the individual.

By: Dr. Adam M. Thomas, DPM

Summer and Swimming and... Plantar Warts!?

With Summer just around the corner, you and your children are at risk for picking up the painful and unsightly plantar wart, which is caused by a strain of the human papillomavirus (HPV).  The human papilloma virus enters the skin through small cuts or abrasions and may take several weeks to become visible.

The plantar wart appears on the bottom of the foot. They are similar to corns and calluses as a layer of hard skin forms over top of the lesion. Plantar warts are differentiated from corns/calluses by appearance. Plantar warts typically have small black hemorrhages under the skin giving the appearance of black dots; skin lines also diverge around warts and not through the lesion.

Plantar warts are contagious; however, the HPV strains that cause plantar warts are not easily transmitted by direct contact from one person to another. The virus thrives in warm and moist environments—such as shower floors, locker rooms and public swimming areas. When children are in swimming pools they often get small abrasions on the bottoms of their feet from the rough surface of the pool bottom. The virus enters these small abrasions, infects the basal cells resulting in plantar wart a few weeks later.

Our podiatrists, here at Community Foot Specialists, see a huge increase of patients with plantar warts in the warm Summer months. Here are a few precautions you can take this Summer to reduce your risks of plantar warts:

• Don't go barefoot in public areas. Wear sandals or flip-flops in public pools and locker rooms.
• Don’t share towels, washcloths. Even with members of your own family.
• Avoid direct contact with warts. This includes your own warts.
• Keep your feet clean and dry. Change your shoes and socks daily.
• Don't pick at warts. Picking may spread the virus.
• Don't use the same file, pumice stone or nail clipper on your warts as you use on your healthy skin and nails.
• Wash your hands carefully after touching your warts.

If you think you or your child may have a plantar wart, come in and see one of our podiatrists atCommunity Foot Specialists; we’re located in the Dayton/Springfield area and we can treat you with one of the following options

• Salicylic acid
• Cantharadin (blistering agent from beetle extract)
• Compounded medication that triggers an immune response against the virus
• Cryosurgery (with liquid nitrogen) freezes the internal cell structure of the wart
• Laser therapy (pulsed dye laser or CO2 laser
• Surgical excision of the verruca

Reconsider Your Footwear Choice: The Truth About Flip-flops

After experiencing many glimmers of sunshine and the Groundhog's official sighting, the long awaited Spring has finally arrived. With it's arrival it graces us with many pleasures, and of the many, Spring attire might just top the list. A common and popular footwear choice for the Spring and Summer months are Flip-flops. 
 However, this seemingly innocent and harmless footwear choice does not provide you with much support. Here are some dos and don’ts of flip-flops to consider this year. 

Shop for high-quality, soft leather flip-flops to minimize potential blisters and other types of irritation. Don’t wear the same pair of flip-flops year after year. Inspect older pairs for wear-and-tear, and if they are in bad shape throw them out.

Look for flip-flops that will allow for the most normal foot function possible. Two good brands to look for are FitFlop and Chaco. These products are evaluated by a team of APMA podiatrists and given a Seal of Acceptance. Don’t ignore irritation between toes, where the toe thong fits. This can lead to blisters and possible infections. 

Gently bend the flip-flop from end to end, ensuring it bends at the ball of the foot (No shoe should ever fold in half). Don’t wear flip-flops while walking long distances. Even the sturdiest flip-flops offer little in terms of shock absorption and arch support. Wear a sturdy pair of flip-flops when walking around a public pool, at the beach, in a hotel room and in the locker room areas. Walking barefoot can expose foot soles to plantar warts and athlete’s foot. Don’t do yard work while wearing flip-flops. Always wear a shoe that fully protects feet when doing outside activities such as mowing the lawn or using a weed-eater.

Ensure that your foot doesn’t hang off the edge of the flip=flop. Don’t play sports in flip-flops. This practice can lead to twisting of the foot or ankle, as well as sprains and breaks. 
 

Follow theses Do’s and Don’ts to ensure you are fit to flip-flop this spring!

MARCH MADNESS!

If you are not a fan of college basketball, then you are probably wondering why we have a blog titled "march madness" at the beginning of April. No, it is not because this March, in terms of weather, could be considered madness, or that the word "madness" simply goes well with March (although it does). March Madness refers to the NCAA's men's basketball tournament that hosts 64 division-1 college basketball teams from around the nation. It is referred to as "March Madness" because of the chaos, excitement, and passion that it brings -- this is marked by the fact that there is no other sport, let a lone tournament, that welcomes and expects "upsets" the way that March Madness does. An upset happens when a team that is seeded lower than their opponent ends up winning the match-- the classic underdog tale. So far, there have been 23 upsets, with some standing out more than others. One of the most outstanding upsets, in my opinion, is Wichita State (No.9) putting on an electrifying performance and beating Gonzaga (No.1). FYI, Wichita State is still in the tournament.

So you might be wondering how the tournament works, or, in other words, how the "madness" is structured. The tournament started with 64 teams this year (60 automatically in the tournament, and the other four playing to gain access). These 64 teams are broken down into their respective regions: Midwest, West, South, and East ( 16 teams in each region; 64 divided by 4, get it?). The number of teams that are in the tournament is cut in half with every round that passes: 64, 32,16,8, 4, and finally 2. The last four rounds are of special importance, and although they have their formal titles (Regional finals, national semi-finals...etc.), they more commonly go by their nick names: Sweet Sixteen, Elite Eight, Final Four, and, obviously, the National Championship. Currently, we are in the Final Four stage of the tournament (hence, the title picture), with the Shockers playing the Cardinals and the Wolverines playing Syracuse. 

Now that you understand what March Madness is, you are probably wondering why, as a podiatrist, we care about it. Outside of the obvious reasons (the excitement, OSU, "bro time"...etc.), the game of basketball has a way of exposing the weaknesses of our feet and ankles, and, more broadly our entire lower extremity. This is highlighted in the NCAA and specifically in the March Madness tournament. 

Cases-in-point: 

 Michael Carter Williams, the star player for Syracuse, is currently taping and recovering from a minor ankle injury amidst the teams run for the National Championship. Expected to play on Saturday against Wolverines. 

UC Santa Barbara's John green goes down with a foot injury that puts him out for the entire season. 

Montana's Matthias Wards's late-February foot injury that put the entire teams chances of winning in peril. 
Lastly and most notably,

Kevin Ware. There hasn't been an injury this year that has shocked the sports world in such a way that Kevin Ware's broken leg did. Immediately after the injury, the video of Kevin Ware's broken leg went viral and horrified many. Fortunately, Ware promptly received proper medical attention, and is now on a steady road to recovery. 

As you can see, Basketball is especially harsh on our lower extremity, with all the jumping, running, sudden stops, and the physicality of the game. Granted, it is not football, but basketball takes a different, more constant toll on the players. 

Foot & Ankle Basketball Injuries: 

Ankle Sprains. This is probably the most common ankle injury in the game of basketball. If you are not familiar with this injury, you probably do not play basketball. In basketball, ankle sprains happen when players come down on their foot the wrong way, suddenly and unpleasantly twist their ankle, step on an uneven part of the hardwood (say, someone's foot), or when a player exerts an unusual amount of force on the ankle. Ways to avoid: 

• Wear proper shoes that give you enough support on your ankles.
• Stretch and exercise your ankle before engaging in intense play (i.e., warm-up & practice)
• Be aware. When you are playing, know your surroundings and playing field. If you know that an ankle is particularly weak, have a trainer tape it beforehand.

Achilles Tendinitis. As a basketball player, you are naturally jumping quite often, whether it is to grab a rebound, shoot a jump shot, or block a shot. Constant and forceful jumping takes a toll on the Achilles. This usually results in Achilles tendinitis: the swelling of the tendon, which is associated with overuse (in this case jumping, and pushing off that tendon in general). Ways to avoid:

• The advice here is very similar to that of ankle sprains. You should ice and stretch your ankles and feet often. You should specifically ice your feet after playing. As for stretching, you should do it as often as you can.
• If you know that Achilles is starting to become painful, lessen the load, and, at the very least, do no over exert yourself.

Plantar Fasciitis.  Plantar Fasciitis occurs when the Plantar Fascia develops a tear, which typically results in a sharp pain that is normally described as "burning", "stabbing", or "surging". In a similar manner to ankle sprains and Achilles Tendinitis, Plantar Fasciitis is caused by overexertion. In basketball, players are often on their toes, and then their heels, and their toes again, all the while with great force and speed. This constant back and forth coupled with the typical force of a basketball play can easily cause Plantar Fasciitis. This process can be quickened and/or worsened by wearing incorrect shoes (no matter what you are doing, you should always wear shoes that fit you and support you!). Ways to avoid:

• Wear the correct shoes. If you do not know if a shoe is supporting you properly or if you suspect that it is ill-fitting, then consult your podiatrist or your on-site medical trainer.
• Once again, stress often and extensively. Many of the injuries that occur in basketball can be prevented, and, in the case treated, with aggressive and often stretching.

The NCAA's March Madness brings us joy and excitement by watching people who love the sport that they play compete at such high levels of intensity and vigor, but it also reminds us how vulnerable we are as humans and athletes to injury. As you watch the last stages of the tournament, and as you are inspired to play the lovely game of basketball, keep in mind the safety precautions that might help you prevent injury in the future. 

Fun in the Sun May not be Fun for Your Skin

Do you have a spot on your foot that you're not too sure what it could be? This may be a sign of skin cancer. This week we will be discussing how to identify a spot as skin cancer, steps your doctor may take, how to treat it, and last but not least how to prevent it.

Skin cancer develops when "mutations" of the skin's DNA grows rapidly and out of control. When it does this it begins to develop cancerous cells. There are three common skin cancers -- basal cell carcinoma, squamous cell carcinoma, and melanoma. Actinic Keratoses are referred to as "pre-cancers." The most common warning sign of skin cancer is when the skin begins to change appearance. Skin cancer is the most common type of cancer in humans. Many types of lesions, or abnormalities in the tissue of an organism, can develop on the skin and most of these lesions are benign, a mass of cells (tumor) that lacks the ability to invade neighboring tissue or metastasize, or non harmful. Some hints on inspection can help distinguish which ones are concerning and which ones are less concerning.

Since your podiatrist is checking your feet, they are able to give a good inspection of your lower legs and ankles while sitting in the exam chair. Some characteristics to consider are: Color: Benign skin lesions are generally uniform in color, or the same color throughout. Borders/Shape: Benign lesions are generally uniform in shape and tend to be smooth  with a regular feel to the surface. Growth rate: New appearing skin lesions or rapid growth or change in size can be a concern for a more suspicious lesion. Ulcerating or bleeding skin lesions: these can be a concern for more aggressive type skin cancers.

Sometimes dark lesions under the toenail can be a concern although 90-95% of the time this will be due to dry blood or bruise from either an injury or repeated jamming of the toe in the shoes. For any type of lesion, under the nail or on the skin, your foot doctor will likely monitor and if any concern, can easily perform a biopsy in the office under local anesthetic which will help give a definitive diagnosis,and in some very rare cases, may save a limb or a life. Skin cancers of the feet are more often related to viruses, exposure to some chemicals, chronic inflammation, irritation, or inherited traits.

There are a lot of different ways to treat skin cancer. Some treatment options are freezing. Your doctor can get rid of early skin cancers by freezing them with liquid nitrogen (cryosurgery). The dead tissue sloughs off when it thaws. More known options are radiation, when surgery is not an option, and chemotherapy. Laser therapy. A precise and intense beam of light vaporizes growths with generally little damage to surrounding tissue. A doctor may use this therapy to treat superficial skin cancers.

Ways to prevent getting skin cancer on your feet is putting sunscreen on them, as directed on the bottle. Wearing protective shoes that block the harmful rays. Try to stay inside or in the shade as much as possible; from 10 a.m.- 4 p.m. when the suns rays are more harmful.

When you cannot go see a doctor you should do a regular examine especially if you spend many hours outside. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. Contact your doctor immediately if you think you may have any signs of skin cancer.

Bunions

Bunions, also called Hallux Abducto Valgus (HAV), are a deformity characterized by a lateral deviation of the great toe (hallux) with a subsequent medial prominence ("bump".) The medial prominence is from the underlying deviated prominent bone (not a growth), and sometimes can form an overlying bursitis which may add to the prominence (usually very painful and red.) Bunions form when your big toe pushes up against your other toes, forcing your big toe joint in the opposite direction. Over time, the abnormal position enlarges your big toe joint, further crowding your other toes and causing pain.

The main causes of bunions can be from genetics, tightly fitted shoes, or foot injuries. Bunions are more common in women. Bunions may be associated with various forms of arthritis, including inflammatory or degenerative forms, causing the protective cartilage that covers your big toe joint to deteriorate. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause. Bunions can not only affect the inner foot but also the outside of the foot at the base of the little toe.

Here are some treatment options for your bunions one is to have well-fitting wide enough shoes to give your feet more room. Another way is to have some padding to alleviate shoe pressure on "the bump." You can take oral or topical anti-inflammatory treatments to alleviate pain associated with the inflammation and bursitis. You can purchase orthotics to help control contributing biomechanical forces to reduce the rate of progression (especially important in kids). If none of these work you may consider surgery to correct the underlying deformity/deformities (important to also correct any contributing biomechanical forces at the time).

Bunions can be very painful and discomforting. Ways to prevent bunions are choosing footwear that fits correctly, especially low heeled shoes with plenty of space for the toes, is one of the main ways that bunions can be prevented. Getting orthotics if your prone to flat-footedness- this can prevent or delay bunions. If you think or know you have bunions get them checked out by your doctor or a specialist. 

Pregnant Feet

Today, we want to discuss the process of giving birth--namely, the nine months leading up to birth itself--and how that relates to and effects women's feet. As most mommy-to-be's know, the bulk of growth happens within the third trimester. Studies show that pregnant mothers who stand for long hours end up having smaller babies than mothers who do not stand for long. This is due to the growth cycle being stunted or slowed down.

We have many ways to treat and prevent your swollen feet. Although swelling is normal due to the weight gain from being pregnant, if the swelling is not symmetrical in both feet you should contact your doctor or a specialist--this may be signs of a vascular problem. Orthotic inserts are good for arch support and medial rear-foot postings. Remember that these should fit properly and comfortably. Also, shoes that do not fit properly can cause a cut off of the blood circulation.

Every woman loves shoes! Whether it be her high heels or her house slippers. But, pregnant mothers should put away their high heels during their pregnancy. Pregnant mothers should wear low to no heeled shoes to avoid any heel pain or falling.

Pregnant women often associate resting with being lazy or letting their pregnancy get the best of them, but in all reality, it is OK and, in fact, encouraged. A mother's feet should be elevated as much as possible. Be sure to message your feet to keep the swelling down. Some ways are going to the salon and getting a pedicure and, if possible, a massage. This not only helps keep the swelling down, but also helps pregnant women to relax and take their minds off of the (sometimes) frustrating transformation that they are going through.

Some pregnant women believe drinking less water will reduce swelling. This is not true! Drinking more water will relieve the body of any harmful toxins. Drink plenty of water; everybody should drink at least eight ounces of water daily. You should avoid any excessively warm places since high temperature climates can reduce the body's water levels. This will cause dehydration.

Soaking the feet in soothing herbs will help reduce any swelling or stress you may have. Some herbs that are good to soak in are lavender, chamomile, eucalyptus, birch, and peppermint. Also, use plenty of moisturizing lotions on your feet to prevent any painful cracking.

For many women the pregnancy can be very confusing and frustrating, we stress (aha!) the idea of relaxing and taking it easy during this during this time. It is often emphasized that you take care of yourself for the baby's sake, but don't forget that you are human, too. Do the things that you like; do not feel bad for asking for help, and enjoy the process as much as you can.

March, the Month of Nutrition

To many, the beginning of March signifies the sprint to St.Patty's and warm weather. The thoughts of leaning your chair back, sipping ice tea, and enjoying warm weather eases the mind and captures the heart. To add to these wonderful things that March brings us, it also brings the National Nutrition Month (NMN)! The month-long event/celebration is intended to bring more awareness to food choices that are healthier.  The primary sponsor of NMN is the Academy of Nutrition and Diabetics (AND) formally known as the American Diabetic Association. The focus of this campaign is to make "informed food choices and developing sound eating and physical activity habits." As quoted on the AND website: www.eatright.org.

The AND has had a long history of controversy, which is a natural by-product of the business of telling people how to eat. The company's membership, sponsorships, and partnerships have been consistently scrutinized. In recent news there has been controversies surrounding the AND and their partnership with "Big Food" companies such as: Coca-Cola, Hershey, PepsiCo, Mars, National Dairy Council, and many more. These "Big Food" companies, it is said, have more say in the company than most of the nutritionist do, thus creating the conflict. Furthermore, The AND receives, on average, $1 million a year from the Pharmaceutical Industry. As a form of presumed reciprocity the AND helps some of these pharmaceutical companies in their marketing and public relation efforts. Taken together, all of these facts lead some to think that the AND is securely in the pocket of big corporate companies, whose initiatives run completely counter to their own philosophies and purpose.

 Whether you agree with the critics or supporters of the AND, one thing we can all agree on is that nutrition awareness is a good thing. The significance of this notion is further increased when we considered the high rates of obesity and diabetes in America today.In the past thirty years child obesity has doubled and tripled in America alone. The rate of adulthood has doubled in the past thirty years. Twelve states currently have an adult obesity rating over thirty percent. Here are some tips to keep your body healthy:

The Mediterranean Diet:

1.) Meats and sweets should be consumed less often in this diet.

2.) Poultry, eggs, cheese, and yogurt should be consumed in moderate portions, but should be consumed daily to weekly.

3.) Fish and seafood should be consumed often, at least two times per week.

4.) Fruits, vegetables, grains (whole), olive oil, beans, nuts, legumes, seeds, herbs and spices should be based on every meal you eat.

A proven study has shown while on the Mediterranean diet it reduces your risk of heart disease, the risk of overall and cardiovascular mortality, cancer and cancer mortality, and it reduces the incidence of Parkinson's and Alzheimer's diseases.

According to Mayoclinic.com:

"The Mediterranean diet emphasizes:

• Getting plenty of exercise
• Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
• Replacing butter with healthy fats such as olive oil and canola oil
• Using herbs and spices instead of salt to flavor foods
• Limiting red meat to no more than a few times a month
• Eating fish and poultry at least twice a week
• Drinking red wine in moderation (optional)
• The diet also recognizes the importance of enjoying meals with family and friends."

The second diet is intended specifically for diabetics. Studies show that 25.8 million children and adults in the United States- 8.3% of the population-have diabetes. But here is a great diet for diabetics:

The Diabetic Diet:

1.) Healthy Carbs: Yes there is such a thing! Avoid carbs such as sugars and starches. Focus more on the healthier cards such as: fruits, vegetables, and whole grains.

2.) Fiber-rich foods: such as nuts whole bran foods, and whole flour foods.
Remember that nuts are still a "fatty" food so they should not be eaten in large amounts. Just one hand full a day should be enough. Also, try to avoid nuts that are covered in salt, and honey roasted.

3.) Fish: Try eating fish that are rich in omega-3 such as: salmon mackerel, and herring. Avoid any tilefish swordfish and king mackerel due to high levels of mercury.

4.) 'Good' Fats: Avocado, almonds, pecans, walnuts, olives, canola, olive, and peanut oil are all considered to be 'good' fats.

Now that you have some tips to stay healthy and active try to change some the things you eat. Whether it be eating less red meats and more fish or eating out less and more with your family. Please share any facts or risks you know about obesity and diabetes with friends and family members to make National Nutritional Month a success!

Humpty Dumpty Had a Fall

To many of us the ending of February is similar to seeing the light (literally) at the end of the tunnel. Thoughts of the warm sun and beautiful sunflowers keep us trudging through the winter. Although these thoughts keep us going, reality reminds us that it will remain cold for a little while more. If you made it this far without falling or hurting yourself--due to winter conditions-- then, kudos. This week, we prepared a guide to help you survive the rest of the cold weather conditions. Here is our input on how to navigate through the wet, icy, sluggish, nasty weather:

1. Walk like a penguin-- no, really though : On slippery, compact snow and ice, take short, careful, flat-footed little steps, spreading your body weight as evenly as possible across the entire surface of your feet.

2. Know the snow you're walking on.  The riskiest snow to walk on is when the snow began to thaw, then ices over night.  Always be careful, even when it's above freezing and the snow is melting.

3. Choose the right shoes:  fashionable high heeled boots are just asking for trouble.  Pick snow boots with a deep, strong, rubber treat.

4.  Use appliances:  poles, sticks, canes to help.

5. Or use a clamp on ice  grip or spray on snow grips on your shoes.  Inventions are nifty!

6. In the unfortunate case that you, like Humpty Dumpty, take a tumble, here is some further advice: 

a. If you are Elderly, avoid falling on your hip and risking a fracture there.  Fall on hands--you may obtain a wrist fracture but that is better than a hip fracture.

b. Younger folk should protect their heads and neck.  Use your non dominant hand if possible.

c. Lastly,  Consider a bicycle helmet.  Especially if you're wearing the wrong shoes for the weather.  Yes it looks silly but better than a head injury.