A Step Ahead - Sole Foot and Ankle Specialists Blog

Posts for category: Foot Problems

By Gary N. Friedlander DPM, FACFAS and Jay C. Larson DPM
January 31, 2019
Category: Foot Problems

When asked what the most stable joint is in the leg, most would not respond with the “the ankle joint.” However, this small joint made up of only three bones coming together is extremely stable and can even support up to five times our body weight! Yet, in the United States, the number of ankle sprain injuries per year is in the hundreds of thousands. With as little as a 1 millimeter displacement of the bones, the stability of this joint may drop by 42 percent! This drastically decreases our ability to use this joint to its full-motion capabilities and potentially results in progressive damage and abnormal gait patterns. How do we protect this extremely important joint?

Proper Shoes:

While shoes may be an important fashion statement, they should also serve in protecting your foot and ankle. Finding the right pair of shoes for your daily or athletic needs can prove very challenging. Keeping the 3 rules of stability in mind can help narrow down your choices in finding the best shoe! 

Shoes should only:

■ Bend where the toes bend

■ Have a stiff back and sole 

■ Only slightly twist when you hold the shoe at the heel and at the toes

 

Stretching:

Stretching is critical to ensure muscle strength and proper alignment and functionality of our extremities. Use it or lose it!

■ Try stretching out your gastrocnemius-soleus complex. Do each of these stretches for at least 60 seconds a few times a day.

These two muscles are incredibly important, because the gastrocnemius and soleus muscles connect and become your achilles tendon; a major component of both ankle and foot integrity.  To see more stretches visit our At Home Video page here or our YouTube page here

Injuries:

Ankle injuries are common and are one of the most common problems addressed by podiatrist.  If you experience an ankle injury we recommend P.R.I.C.E. :

Protection: boot or ankle brace with limited weight bearing

Rest: Decreased activity and stress on the ankle

Ice: cold therapy helps reduce swelling and pain

Compression: Ace bandage, compression sleeve, or compression stockings help reduce swelling and decreases healing time

Elevation: Reduces pooling of fluid in the injured ankle. Reduced swelling and pain

If you experience an ankle injury or have recurrent ankle pain and/or swelling consider making an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists.  It is much better to properly evaluate and treat an ankle injury to reduce recurrence and help prevent further damage.

Have you ever experienced pain so bad you cannot even stand to put on a pair of socks without agonizing pain? Did you recently have surgery or endure a traumatic injury? If so, you may be experiencing symptoms of complex regional pain syndrome (CRPS).

About CRPS

CRPS is a debilitating condition that is characterized by having pain that is out-of-proportion, along with several other features. While it is not entirely clear why CRPS develops, it is  seen in people who have recently suffered a traumatic event prior to surgery. It is believed the pain experienced is due to an impaired processing pattern in the central nervous system (brain and spinal cord) that ultimately causes an inflammatory response, and leads to vessel spasm, swelling, and increased pain. As a result, people experience burning pain, redness, and swelling.

Signs and Symptoms to Watch For

  • Swelling and redness
  • Pain-out-of-proportion – Often experience extreme pain during something that normally would not cause pain (i.e. being brushed with a cotton swab)
  • Increased skin temperature – the foot will appear warm compared to the other foot
  • Increased or decreased sweating – this will depend on the stage of the CRPS and is due to an increase or decrease in sympathetic activity
  • Brittle or clubbed toe nails
  • Muscle changes and atrophy

 

Diagnosing CRPS is very difficult since the previously mentioned signs and symptoms are commonly seen in other conditions. It is important to rule out other possible causes before jumping to CRPS. These can include: compartment syndrome, diabetic neuropathy, gout, fibromyalgia, nerve entrapment, cellulitis, or even psychological. While there are numerous conditions that look similar to CRPS, recognizing CRPS is critical to prevent progression and improving the outcome, and a doctor should be seen right away if you suspect it.

Treating CRPS

There is currently no definite treatment for CRPS since everyone responds differently to treatments. However, there are several options available to people who suffer from CRPS. These include:

  • Medication and nerve blocks
  • Nerve stimulation (TENS)
  • Physical and occupational therapy

 

If you have been experiencing excruciating pain in your feet, please do not hesitate to schedule an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona. We will explain all your treatments options to available to you to ensure you maintain healthy feet.

Did you know, according to the National Institute of Health, there are about 20 million people in the United States who have peripheral neuropathy? When hearing the words “peripheral neuropathy”, diabetes is often the first word that comes to mind. However, there are many other potential causes for peripheral neuropathy, several of which can be treated.

About Peripheral Neuropathy

Peripheral neuropathy is when nerves become damaged in the arms and legs and do not function as they should be and can present differently depending on the nerves involved. There are three different types of peripheral neuropathy named for the types of nerves affected and include:

  • Sensory Neuropathy – involves nerves that allow people to feel temperature, pain, light touch, and vibration. When these nerves are affected, a burning, tingling pain (or numbness) can occur, and disrupt a person’s quality of life.
  • Motor Neuropathy – involves nerves that allow muscle movements. When these nerves are affected, people often experience weakness and atrophy of their muscles.
  • Autonomic Neuropathy – involves nerves that control sweat glands, bladder function, and blood vessel contraction. When these nerves are affected, the skin can become dry due to lack of sweating, there is decreased bladder control, as well as the ability for the blood vessels to help regulate blood pressure.

 

Non-Diabetes Causes of Peripheral Neuropathy

Even though type-2 diabetes is the number one cause for peripheral neuropathy, there are many other conditions that can cause it, and include, but not limited to:

  • Trauma – Injuries from various traumas can cause partial or permanent damage to nerves, including surgery.
  • Infections – There are many bacteria and viruses that can cause neuropathy such as Shingles, Lyme disease, HIV, and hepatitis C.
  • Nutrition Deficiencies – Having decreased intake of certain vitamins can lead to neuropathy, such as B Vitamins (especially B1, B6, and B12). If proper nutrition is maintained, this can be easily prevented.
  • Medications – There are numerous medications that have cause neuropathy as a side-effect. Some of the most common meds are cancer chemotherapy, HIV drugs, and Isoniazid for people with tuberculosis.
  • Alcohol Consumption – Chronic alcohol consumption can lead to neuropathy by causing nutritional deficiencies in the B vitamins (especially B1 and B12).
  • Autoimmune Conditions – In autoimmune diseases, the body attacks itself, and can cause damage to nerves. These conditions include, but are not limited to: Lupus, rheumatoid arthritis, and Sjogren’s syndrome.
  • Others – Kidney diseases, cancers/tumors, small vessel disease

 

If you have been experiencing numbness, burning, tingling sensations, or weakness in your legs and feet, please do not hesitate to schedule an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona. We will explain all your treatment options to available to you to help protect and improve your foot health this upcoming summer.

 

By Gary N. Friedlander DPM, FACFAS and Jay C. Larson DPM
August 06, 2018
Category: Foot Problems

It can be distressing when the legs and feet swell. Swelling can occur in both the arms and the legs and be caused by numerous factors. This swelling is often a result of excessive fluid buildup, inflammation, or damaged joints and tissues. When this occurs in the arms and the legs, it is generally known as peripheral edema or lymphedema if it is caused by damage to the lymphatic system.

Causes of Edema

The swelling can be common after injuries and often goes away over time. However, edema that does not resolve can be an indication of more serious conditions, such as heart, kidney, or lymphatic disorders. The following are several causes for peripheral edema:

  • Lymphatic damage – this is known as lymphedema and generally occurs after cancer treatments or damage during a surgical procedure. Unfortunately, there is no cure for lymphedema due to damaged vessels, and inability to properly drain the fluid.
  • Trauma or injury – This is a very common occurrence due an inflammatory response, especially after spraining an ankle, or after having surgery for bunions and hammertoes.
  • Infections – This is commonly seen in cellulitis infections caused by staph or another bacterium.
  • Insufficient Veins or venous blood clots – When veins have damaged valves, poor drainage back to the heart can result in fluid leaking into the tissues, and cause swelling. You may see varicosed veins on the legs before seeing swelling. If your leg is swollen, painful, and you are having difficulty breathing, this is a medical emergency, and you should see a doctor right away.
  • Medications – there are numerous types of medications that can cause swelling in the legs and arms. These include, but are not limited to: diabetes medications, beta blockers and calcium channel blockers for high blood pressure and heart disease, some anti-depressants, hormones in replacement therapy, and steroidal medications.
  • Heart Disease/Congestive Heart Failure – If an individual has coronary artery disease, history of heart attacks, or high blood pressure, edema can occur because of decreased heart function.
  • Diabetes – Individuals with diabetes often have edema because of the high blood sugar levels, combined with medications they might be taking for it, as well as blood pressure.
  • Kidney Disease – If the kidneys are not functioning properly, they can cause proteins to be lost from the body. Proteins help draw in fluid from the tissues and prevent edema from occurring.

 

Treatments for Peripheral and Lymphedema

Depending on the cause of the edema, it can be treated, or even cured. For most cases, the swelling is not permanent, and can be alleviated. Elevating the feet is one of the best starting treatments since this will help use gravity to pull fluid away from the legs. Compression socks are another great way to help relieve edema and work by applying pressure to the leg and squeezing the fluid back into the lymph vessels for recirculation. Your doctor may also temporarily prescribe diuretic medications to help the body relieve excess fluid.

Peripheral edema can be stressful, painful to deal with, and be an indicator of additional underlying health problem. If you have concerns about your swelling, please do not hesitate to schedule an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona. We will explain all your treatment options to available to you to help improve your health, function, and overall quality of life.

Summer is here in Arizona and there are numerous chances to enjoy the sun and  have fun. However, summer can also impose health risks on the feet, and it is important to make sure you properly take care of your feet this summer. The following are several tips for you to be aware about for the summer:

  • Minimize how much you go barefoot – Since the weather is nice and sunny, it can be tempting to go barefoot or wear flip-flops most of time. However, when you are barefoot, your feet are vulnerable to injuries, including trauma to the toes, and sunburns.
  • Always wear appropriate shoes – Even though flip-flops are nice and convenient, they are not meant to be worn for long-term, but can be okay for short-term wear. However, if you have excessively sweaty feet, flip-flops can be a great way to minimize fungal infections by ensuring your feet have exposure to air and drying. Wearing properly fitted and supported shoes will remain vital to the health of your feet this summer to minimize injury. For more information on flip-flops, check out the link to our blog for Flip-Flops – How they can affect your foot health.
  • Whenever you are barefoot, apply sunscreen to your feet – even though getting proper sun exposure is important for vitamin D intake, it is also a risk for developing burns on your feet.
  • Ensure you keep yourself and your feet hydrated – with continual heat exposure, it is easy to become dehydrated. Staying hydrated helps tremendously with circulation, swelling, and preventing cracking of the skin. The heels and in between the toes are especially susceptible to dehydration and cracking.
  • Properly clean your feet and nails daily, especially if you have diabetes – When outside enjoying the weather, if your feet are not properly protected, they are susceptible to injury. For people with diabetes, it is important to properly inspect and clean your feet daily since many commonly have a loss of sensation and can be unaware if they have an injury.
  • Watch out for fungal infections – If some individual sweats excessively, they are more prone to developing fungal infections on your feet. Ensure the footwear worn allows the feet to breath, such as mesh lined shoes, or flip-flops if they are worn short-term. Having at least two pairs of shoes to rotate through will allow the other shoes to air dry and minimize excessive moisture in the shoes.

If you have concerns about your foot health this summer, do not hesitate to schedule an appointment with Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona. We will explain all your treatment options to available to you to help improve your foot health this upcoming summer.



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