Foot and Ankle Doctor Blog Space

Category: Foot Care

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Athlete’s Foot

Athlete’s foot can be an embarrassing problem, despite its name anyone can contract athlete’s foot. It is caused by fungal infections and is easily contracted when wearing damp socks in tight shoes or walking barefoot in public locker rooms and shower areas.

Symptoms include cracked, scaling, itchy red skin between the toes and on the bottom on feet. In some cases blisters or ulcers may form. Athlete’s foot is contagious and it is best to avoid scratching or picking the affected areas on the feet.

Over the counter medication can be used to treat Athlete’s foot, however if your symptoms do not get better in a few weeks come see us at Foot & Ankle Doctors, Inc. If we cannot diagnose your symptoms classically as Athlete’s Foot a small shave biopsy will be taken and sent to the lab to be examined under a microscope before topical or oral anti-fungual medications will be dispensed.

  • To avoid Athlete’s Foot:
  • Keep your feet dry
  • Change your socks regularly
  • Don’t walk around barefoot in public places
  • Wear well ventilated shoes
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OATS for your Ankle Pain

Young adolescents complaining of ankle pain, joint popping or locking with decreased range of motion of the ankle and swelling and tenderness are signs of osteochondritis dissecans (OCD). OCD most often occurs in athletic males between the ages of 10 and 20. A small piece of cartilage becomes loose and can detach in some cases. If the fragment of cartilage migrates and gets stuck in the ankle joint, surgical intervention is required. OCD can increase your chances of developing osteoarthritis of the ankle joint.

Imaging

Physicians at Foot & Ankle Doctors, Inc. will take x-rays of your ankle and stage the severity of the injury from 1 to 4.

Treatment

Treat of early stages of OCD involve immobilization of the ankle joint in a non-weight bearing cast to avoid stress on the ankle. Physical therapy is important to increase range of motion and strengthen muscles that support the ankle joint. If conservative treatments fail after 3 months or a fragment of bone is caught in the ankle joint, surgery is required.Surgical intervention includes arthroscopic treatment to clean the ankle joint of debris. Osteoarticular Transfer System (OATS) surgery is another treatment that replaces damaged cartilage relieving pain and resorting movement. Small plugs of healthy cartilage are taken from another area of the ankle joint and transferred to damaged area. Patients will be on crutches for 6 to 12 weeks after surgery and long term physical therapy is necessary to restore range of motion and relieve pain.

For more information visit us at Foot & Ankle Doctors, Inc.

Dr. Nejad

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Acute Compartment Syndrome in the Foot

Compartment syndrome is a painful condition that occurs from an increase in pressure within the muscles. Increase in pressure above normal levels can decrease blood supply to the muscles and nerves in that area which can result in permanent tissue damage.

Acute compartment syndrome is a medical emergency. It is usually caused by trauma such as a crush injury, a fracture or a constricting bandage or cast.

Chronic compartment syndrome is not a medical emergency. It is usually caused by repetitive physical activity such as running.

There are 9 compartments in the foot and each compartment has a fascia covering to keep the tissues in place. This fascia does not stretch easily and following an injury, swelling or bleeding can occur, resulting in increased pressure within the compartments. If the pressure is not released, permanent tissue damage can occur.

Symptoms – The 6 P’s of Compartment Syndrome

  • Pain out of proportion and not relieved by narcotics
  • Pulselessness
  • Parasthesia
  • Paralysis
  • Pallor
  • Poikilothermia

If you experience these symptoms, seek medical advice immediately

Diagnosis
A wicker catheter is a device that is used to measure compartment pressures. Normal compartment pressure in the foot is between 0-8mmHg. A compartment pressure measuring >30mmHg or 10-30mmHg below diastolic pressure is concerning and emergent fasciotomy may be needed.

Treatment
Depending on which foot compartments are affected incisions are made over the compartments to relive pressure. Fasciotomy incisions are left open 5 days to allow edema and swelling to dissipate. After the pressure has been adequately reduced the surgical sites are closed.

Acute compartment syndrome is a surgical emergency and if not treated immediately permanent damage and tissue death can occur. For more information on acute compartment syndrome come see one of our physicians at Foot & Ankle Doctors, Inc

Dr. Dardashti

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Melanoma of the Foot

Melanoma is a serious skin cancer that can affect people of all ages.  Exposure to UV radiation from the sun or tanning beds can increase your risk of developing melanoma. However, melanoma can occur anywhere on the body, even on less sun-exposed areas such as the soles of your feet.

Signs and Symptoms

  • Change in an existing mole

  • Development of a new pigmentation that grows over time  – predominately brown, black or blue in color and in some cases red

 

To help identify characteristics of unusual moles or spots on the body use the mnemonic ABCDE:

  • Asymmetry – Melanoma is asymmetric

  • Border – Melanoma is will have an irregular border or edge that is typically ragged

  • Color – Melanoma is typically a mix or colors rather than one solid color

  • Diameter – Melanoma grows in diameter where benign moles remain the same size. A mole larger than 5mm, the size of a pencil eraser should be seen by a physician

  • Evolving over time – change in color, size, shape or symptoms (itching tenderness or bleeding)

 

Diagnosing Melanoma

To accurately diagnose melanoma a biopsy should be taken and analyzed by a pathologist

  • Punch biopsy – a tool with a circular blade is pressed into the skin around the suspicious mole or pigmented area to remove a round piece of skin

  • Excisional biopsy – the entire mole or pigmented area is removed

  • Incisional biopsy – only parts of the irregular mole or pigmented area is taken for analysis

 

Prevention

  • Use adequate sunscreen on areas of the body not covered by clothes or shoes

  • Wear a wide brimmed hat and sunglasses

  • Wear water shoes that provide protection

  • Inspect your feet daily

  • Remove nail polish to inspect the toenails

 

Early detection of malignant melanoma is key. If you notice any changes in size of a mole on your foot or new pigmentations/discolorations come see us at Foot& Ankle Doctors, Inc.

 

Dr. Nejad

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Avoid Overuse Injuries This Spring

Spring is around the corner and many of us are ready to get back into shape and hit the pavement with the first spring thaw.  Many of us haven’t hit the gym for months and it’s important to get back into the routine of working out slowly to prevent overuse injuries.


Overuse injuries occur over time with repetitive microtrauma to tendons, bones and joints. Common overuse injuries in the lower extremities include runner’s knee, jumper’s knee, Achilles tendinitis and shin splints.


Causes of overuse injuries include

  • Training errors – over training or increasing acceleration, intensity, duration or frequency too quickly instead of gradually over time

  • Form error – improper technique or shoe gear can lead to injury overtime

  • Returning to a sport or activity too soon after injury

  • Biomechanical and individual factors – body alignment and foot structure can predispose individuals to overuse injuries


Treatment of overuse injuries can be remembered by the mnemonic RICE-AR

  • Rest – complete rest from the activity may be necessary or cross training with a different sport/activity

  • Ice – apply ice to injured area for 15 minutes a day

  • Compression – apply an ACE bandage or elastic wrap after icing to prevent further swelling

  • Elevation – elevate the injured extremity above the level of the heart when resting

  • Anti-inflammatory medication – ibuprofen or Tylenol can be taken to reduce inflammation

  • Re-condition – stretching and strength training are important steps in rehabilitation and preventing future injury


If you suspect you have an overuse injury, consult one of our doctors at Foot& Ankle Doctors, Inc.


Dr. Nejad

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Toenail Fungus

Our staff at Foot & Ankle Doctors, Inc. understand that toenail fungus is an embarrassing problem. It can lead to thickened brittle yellow discolored nails that may be painful. Fungal nails are also referred to as onychomycosis and are caused by microscopic fungi, yeasts and molds. A sample of the infected nail should be taken and sent to a lab to determine the causative agent. There are a variety of treatment options available, however fungal infections are difficult to treat and can return after treatment has finished.

The different treatment options include:

 Oral medications – required to be taken for 6-12 weeks

 Topical nail lacquer – can be used twice a day for up to 4 weeks, but is often ineffective in severe cases

Laser therapies – involve multiple sessions to achieve clearance

We will help you determine the best course of action to treat your toenail infection. It is advised during treatment to discard old shoes, which may house fungi and use antifungal spray or powder to prevent reinfection.

 

Dr. Dardashti

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Choosing a Top Quality Nail Salon

We all want to look our best and do a little self pampering and what better way to pamper ourselves than with a manicure and pedicure.

Nail salons provide services to hundreds of people and it’s important to choose a high quality salon with adequate hygiene to avoid accidental exposure to fungus, bacteria and viruses. To avoid a nail salon nightmare follow this guide:

1. Licensing – Make sure the salon is licensed and the staff has proper training. Podiatrist commonly see infected ingrown toe nails as a result of nail technicians that were too aggressive with their nail trimming.

2. Open cuts – avoid the salon if you have any open cuts or wounds on your feet or legs. Exposing any open wound to an environment like a salon that has a high volume of customers sharing the same chairs and whirlpools may lead to.

3. Whirlpools – avoid soaking your feet in whirlpools or the water basin connected to the chair. These are often difficult to clean and harbor bacteria. You can ask to have your feet soaked in a separate tub or use a disposable liner in the whirlpool.

4. Tools – ask the salon if the tools used are autoclaved or if disposable instruments are used. You can bring your own tools with you and clean them yourself to avoid the spread of warts.

5. Bring your own nail polish – salons use the same polish brush for each of their customers and this can result in the spread of nail fungus. Bringing your own polish will avoid any cross contamination and reduce your risks of developing a fungal infection.

Podiatrists commonly see infected ingrown toenails, plantar warts and fungal infection as a consequence from nail salons. If you think you have any of these infections come see one of our doctors at Foot & Ankle Doctors, Inc.

 

Dr. Farshid Nejad

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Podiatrists Preventing Falls

Fall related injuries are a serious burden on the public health system. More than a third of older adults fall each year and injuries can result in fractures, head traumas, decreased function and loss of independence in the elderly. Podiatrists can help reduce fall related injuries by evaluating your gait (the way you walk), your strength and your balance.

 

Dr. Dardashti stresses the importance of finding the right shoes. When selecting shoes he evaluates the heel height, sole slip resistance, sole flexion point (does the shoe bend in the correct area), sole hardness and sole thickness. Finding the right shoe increases support when walking thus boosting confidence and decreasing the fear of falling. Custom orthotics can also improve balance and support by evenly distributing pressure and forces, realigning the body in a more anatomically correct position that improves stability and reduces the likelihood of falling.

 

Muscle weakness can reduce flexibility and balance contributing the falls. For these patients Dr. Dardashti recommends braces and AFO’s (ankle foot orthotics). It’s crucial to stretch the muscles of the leg, foot and toes to improve strength, balance and proprioception. The specialists at the Foot & Ankle Doctors, Inc can provide you with simple stretches you can perform at home to improve your strength and balance.

 

Certain foot problems are risk factors for falls that can be addressed by podiatrists such as lower extremity muscle weakness, limited ankle motion, foot deformities like bunions, toe deformities such as hammertoes and calluses. It’s important to see your podiatrist regularly to address any of these risk factors.

Dr. David Dardashti

 

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What are custom orthotics?

Custom orthotics are devices that are custom molded to your feet. They fit comfortably inside your shoes and are designed to reduce stress and strain on the feet, knees legs hips and back. Orthotics will help improve your gait making walking and running more comfortable. Orthotics will help to correct your body’s misalignments also known as “biomechanical or structural deformities.” Most people that have biomechanical deformities will develop symptoms that usually present as pain in the joints, muscles or tendons.

Think of wearing orthotics as similar to wearing eyeglasses. When you wear your glasses they help correct your sight by placing corrective lenses in front of the eyes. This helps your eyes function as close to 20/20 vision. Orthotics help the body function in a similar way by helping to restore normal biomechanical function in your feet and legs.

There are a variety of types of custom orthotics, the two main types are: functional orthotics and accommodative orthotics. Functional orthotics help re-align the feet and legs. They reduce, or control abnormal motion that may be causing pain in the foot, leg and back. Accommodative orthotics are made out of softer material and they are designed to absorb shock and reduce pressure. They are less effective in controlling abnormal motion, they simply cushion and pad ulcers, painful calluses, bony prominences and other pathologies of the foot.

If you have pain or discomfort and think you can benefit from orthotics come see Dr. Nejad or Dr. Dardashti at Foot & Ankle Doctors, Inc.

 

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