March Articles 2014



All About Broken Ankles

A broken ankle is a serious injury that can inhibit your ability to function on a daily basis, including walking and causing a significant amount of pain. When referring to a broken ankle, it is actually referring to a break in one of the three bones that connect at the ankle joint, the tibia, the fibula, and the talus. The tibia and fibula are the two bones in your leg that connect from the ankle to the knee, and they both sit upon the talus bone. This is all protected by a fibrous membrane that allows for movement in the ankle. A break in any of these bones can be caused by rolling or twisting the foot too far, causing one or more of these bones to snap.

A broken ankle, which is different and more severe than an ankle sprain, is usually first noticed when you are not able to put any weight on your ankle, similar to an ankle sprain. A sprain occurs when there is a rip or tear in the ligaments of the ankle joint but a break occurs when enough pressure causes cracks in the bones themselves. If you think you have a broken ankle, the first thing you should do would be to immediately get an x-ray taken to determine the severity of the break.

Putting too much pressure on the ankle when you roll over it or twist it the wrong way, often during physical activity such as sports or exercise, is the most common way to fracture your ankle. Another way you could break your ankle is by jumping or falling from a large height. If either of these have occurred, you should seek the help of a doctor immediately to determine the severity and whether or not surgery is needed. Without medical attention, arthritis in the ankles can develop much quicker and the pain can become more sever if left untreated by a medical professional.

Broken ankles are extremely painful, but a good start to helping you overcome them would be to elevate your feet so that blood does not rush to the injured area. Also, putting ice packs to help reduce inflammation, swelling, and pain is a good idea. If surgery is required, you are probably going to need to wear a cast for several months, but even if surgery is not required, a cast is still going to be used to ensure proper healing of the ankle.

It is crucial to determine if surgery is needed right away, because the severity of a broken ankle might only be realized by a medical professional. If not treated, it can inhibit your daily routine, activities, and even just walking, so get it checked out immediately to ensure a speedy recovery.



Biomechanics in Podiatry

Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body causing an interference with the biological structure and focuses on the movement of the ankle, the foot and the forces that interact with them.

At some time in our lives we will all experience foot problems, regardless of our lifestyle or age, and we all take our mobility for granted until we are in pain. Twists or turns can cause problems and apply stress to the feet, and that pain will spread from the foot structure to the surrounding tissues. The pain will concentrate in the foot and ankle, but may eventually spread up into the knees, hips and back.

The history of biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded. Afterwards, during the first century AD, corns on feet were recorded as specifically growing on feet and toes. In 1974 biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections of conditions could be implemented to gain strength and coordination to the area. His basic principles of thermoplastic foot orthotics are still in use throughout the industry today.

Modern technology improvements are based on past theories and therapeutic processes providing a better understanding of podiatry concepts for biomechanics. Computers provide accurate determinations about the forces, movements and patterns of the foot and lower legs with the most important information captured. Today’s knowledge of detailed measurement of external and internal forces in the foot is critical to the individual’s treatment. Like most health industries, precise determinations assist the practitioner in diagnosing and prescribing the best treatment for health improving results.

Advances in materials and more awareness of biomechanics have developed enhanced corrective methods, offering further options for foot-related injuries. Shoe orthotics options have expanded to treat walking inability, helping to realign the posture deviations caused by hip or back health occurrences. Attention to posture and foot mechanics uses individual insoles to position the foot, aligning the ankle and leg. The corrected positioning comforts the pressure and helps to ease the pain. Understanding foot biomechanics can help improve and eliminate pain, stopping further stress to the foot. However, these results can only happen if one seeks a podiatrist who specializes in biomechanics.



Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

 

Hyperhidrosis of the Feet

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that is not onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

The symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the materials, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.



Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

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