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Swelling of the Feet

There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.

Blisters

Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.

The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.

The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.

If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.

What is Flexible Flat Foot?

Flatfoot is classified as having the entire sole of the foot in contact or near contact to the ground while standing. The disorder is also known as fallen arches, because those affected have no arch in their feet. Flexible flatfoot and rigid flatfoot are the two types of flatfoot.

A person has flexible flatfoot if when sitting or standing on their toes, they have an arch that disappears when they stand with the entire foot on the ground. Flexible flatfoot may also be called “pediatric flatfoot” because the condition first appears in childhood. It is common among infants because the arch does not develop until the age of 5 or 6 years. Rigid flatfoot is not as common in children as it is with adults. This type of flatfoot is developed due to the weakening of tibialis posterior muscle tendon, a major supporting structure of the foot arch. Development of this deformity is progressive and shows early signs of pain and swelling that begins at the inside arch of the foot and moves to the outside of the foot below the ankle. More severe cases can possibly lead to arthritis of the foot and ankle joints.

Although most cases of flatfoot involve people born with the condition, some less common causes are obesity, diabetes, pregnancy, and osteoporosis. In some cases, flatfoot may come with no symptoms at all and does not require any type of treatment. With other cases though, symptoms may include pain in the shin, knee, hips and lower back. If a person with flatfeet experiences such symptoms, a health care provider may suggest using orthotic devices or arch supports, which may reduce the pain. Wearing supportive shoes can also prove more comfortable with flatfeet and staying away from shoes with little support such as sandals. Other methods to relieve pain also include stretching the Achilles tendon properly and using proper form when doing any physical activity. In addition, losing weight can reduce the stress on your feet and reduce the pain.

Congenital Foot Problems

A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.

The following are specifics about a few of these conditions:

-    Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.

-    Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.

-    Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.

-    Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.

-    Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.

-    Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.


 

Diabetic Foot Conditions

Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough.  The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.

Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.

Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.

Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.

If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.

How to Treat Heel Spurs

Heel spurs are calcium deposits that cause bone protrusions on the heel bone. Heel spurs are usually associated with plantar fasciitis, which occurs when the plantar fasciitis in the foot becomes inflamed. Typically, heel spurs don’t cause any symptoms. However, they can produce chronic or intermittent heel pain. Those who have had the condition often describe the irritation as a stabbing pain.

There are risk factors that may make you more likely to develop heel spurs. People who have abnormal walking gaits, run and jog on hard surfaces, are obese, or wear poorly fitting shoes are more likely to develop heel spurs.

Fortunately, there are precautions you can take to avoid developing heel spurs. One of the best ways to do this is by wearing well-fitting shoes with shock-absorbent soles. Another preventative technique is to choose running shoes if you plan on running, and walking shoes if you plan on walking. Shoes are made for different activities and it is important to research a shoe before you purchase a pair.

The pain associated with heel spurs often decreases the more you walk. However, a recurrence of pain after an extended period of rest or walking is likely to occur with this condition. Those with severe heel spur pain may opt to go the surgical route for treatment.  However, more than 90% of those with the condition get better without surgical treatment. If you have a heel spur and want to know if surgery is right for you, you should go to your podiatrist and he or she will be able to conduct a pre-surgical test or exam to determine if you are an optimal candidate for surgery.

Systemic Diseases of the Foot

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

How to Deal with Athlete's Foot

Athlete’s foot is a type of fungal infection that affects the skin on the feet. It is caused when the tinea fungus grows on the foot. It is possible to catch the fungus through direct contact with someone who has it or by touching a surface that is contaminated with it. This type of fungus thrives in warm, moist environments such as showers, locker room floors, and swimming pools. Your risk of getting it may also increase by wearing tight-fitting, closed-toe shoes, or by having sweaty feet.

Symptoms of athlete’s foot include itching, stinging or burning sensations between the toes. You may also experience toenails that are discolored, thick, crumbly, or toenails that pull away from the nail bed.

Your podiatrist may diagnose athlete’s foot by detecting these symptoms or by doing a skin test to see if there is a fungal infection present. The most common exam used to detect Athlete’s foot is a skin lesion potassium hydroxide exam. To use this method, your doctor will scrape off a small area of the infected skin and place it into potassium hydroxide. The potassium hydroxide will destroy the normal cells and leave the fungal cells untouched so that they are visible under a microscope.

There are a variety of treatment options for athlete’s foot. Some medications are miconazole (Desenex), terbinafine (Lamisil AT), clotrimazole (Lotrimin AF), butenafine (Lotrimin Ultra), and tolnaftate (Tinactin). While these options may be able to treat your fungus, it is best that you consult with a podiatrist in order to see which treatment option may work best for you.

In some cases, Athlete’s foot may lead to complications. A severe complication would be a secondary bacterial infection which may cause your foot to become swollen, painful, and hot.

There are ways that you can prevent athlete’s foot. Washing your feet with soap and water each day and drying them thoroughly is an effective way to prevent infections. You also shouldn’t share socks, shoes, or towels with other people. It is crucial that you wear shower sandals in public showers, around swimming pools, and in other public places. Additionally, you should make sure you wear shoes that can breathe and change your socks when your feet become sweaty. If you suspect that you have Athlete’s foot, you should seek help from a podiatrist as soon as possible.

Geriatrics and Podiatry

Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.

Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.

Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.

Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.

Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.

Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.

Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.

Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.

Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

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