A Step Ahead - Sole Foot and Ankle Specialists Blog

Posts for tag: Podiatrst in Glendale Arizona

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 appoitment with Dr. Gary N. Friedlander and Dr. Jay C. Larson at Sole Foot and Ankle Specilaists.  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. Gary N. Friedlander or 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.

Every November the health care community at large educates the public on diabetes.  In the United States the month of November is Diabetes Awareness month.   According to the 2017 report from the CDC – Centers for Disease Control and Prevention – there are 30.3 million Americans – 9.4 percent of the U.S. population - have diabetes.  Another 84.1 million Americans have prediabetes a condition that if not treated often leads to type 2 diabetes within five years.

Diabetes can be accompanied by a handful of secondary complications that can range from mild to severe.  The most common areas that can be affected by diabetes are the feet, the eyes, kidneys and skin.  Diabetic patients can experience decreased sensation – neuropathy – in their feet.  This can lead to a decrease in the ability to recognize injury and can lead to infections, ulcers and possibly amputation.  Each year over half of all amputations in the United States, most of which involve the lower extremity, are caused by complications due to diabetes.  Thankfully, diabetes linked amputations have been on the decline. 

If you have a family history of diabetes or any of the following risk factors, take the opportunity this month to be tested.  Diabetes is diagnosed by a fasting blood glucose level.  The test is simple and pain-free.  Risk factors for diabetes include the following:  family history of diabetes, obesity, inactivity, increased age, history of gestational diabetes, polycystic ovarian syndrome, high blood pressure, and abnormal cholesterol and triglyceride levels.

While we focus on those who currently suffer from this disease, there is good news for the 84.1 million who are prediabetic.  There are ways to prevent diabetes that include healthy lifestyle modifications.  Proper diet, exercise and weight loss can bring a person on the verge of a diabetes diagnosis back to a good bill of health. 

The best outcome for handing diabetes is working as a team with your providers.  Diabetic patients are encouraged to visit a podiatrist once a year for an annual foot examination.  If any other secondary complications develop such and peripheral neuropathy or peripheral vascular disease, the visits will be more frequent.

To learn more about diabetes or find free screenings in your area go to www.diabetes.org.

If your doctor has diagnosed you having diabetes and need a podiatrist to be on your team, please call our office to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale Arizona.

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. Gary N. Friedlander or 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.

 

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. Gary N. Friedlander or 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.



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