October Articles 2014

What is a Podiatrist

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podia try. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery on lower extremity fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise and referrals will be made to specialists that handle the greater health problems.

Some podiatrists have their own solo small private practices or clinics where they have a small staff and administrative personnel but many work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals or visiting patients in nursing homes. They typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Some other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that result from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

Choosing the Right Running Shoe for Your Foot Type

While running seems like a simple activity, it is actually a complicated movement that puts a lot of stress on the joints, bones and ligaments of the body. Consequently, choosing the right shoe is an important step in increasing performance and decreasing injury risk. You should select running shoes based on your foot type. While other considerations are important, such as trail versus road shoes, your foot type dictates the amount of cushioning, stability and motion control you need. The best way to determine your foot type is to visit a local specialty running shop. Professionals there can measure your arch type, stride and gait and summarize your shoe needs for future reference.

Running shoe design is based on the idea of pronation. Pronation is the natural rolling of your ankle from outside to inside during foot strike. In other words, proper running mechanics involve striking the ground on the outside of your heel and rolling toward your big toe before pushing off again. Pronation is a good thing: it helps your lower extremities absorb shock and store energy. Neutral runners who pronate correctly do not depend on their shoes to correct their form. Neutral runners can select from a large variety of shoes, even minimal or barefoot models. However, runners with problematic foot arches or incorrect form may pronate too much or too little and require specific qualities from their running shoes.

Overpronators run with excessive ankle rolling. Even when standing, severe overpronators exhibit ankles that angle inward. They also tend to have flat feet or bowed legs. Overpronation can cause a plethora of injuries, especially in the knees, ankles and Achilles tendons. If you overpronate, you should select a shoe with extra stability and motion-control. Motion-control shoes are firm and straight; they do not curve at the tip. The lack of flexibility along the midsole prevents the foot from rolling too far inward during your foot strike.

Underpronation, also called supination, is less common than overpronation. Unlike overpronators, underpronators have inflexible feet and high arches. When they land, their feet are unable to roll inward. While this places less rotational stress on the ankles and knees, it prevents any kind of shock absorptions. This additional force can result in fractures, ligament tears and muscle strains as the legs compensate for the impact. Underpronators require shoes with increased cushioning and flexibility. If you underpronate, stability or motion-control shoes may compound the problem by further preventing pronation.

Morton's Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.  Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.

There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.

If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.

Sever's Disease

Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in one or both feet of children during the period when their feet are growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14 years of age.

Sever's disease occurs when the part of the child's heel known as the growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, suffers an injury or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel, forcing the child to bear weight on their toes while walking. A toe gait develops in which the child must change the way they walk to avoid placing weight on the painful heel, a position that can lead to other developmental problems.

The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are very active athletes are among the group most susceptible to experiencing Sever's disease because of the extreme stress and tension they place on their growing feet. Improper pronation, the rolling movement of the foot during walking or running, and obesity are all additional conditions linked to causing Sever's disease.

The first step in treating Sever's disease is to rest the foot and leg and avoid sports activity which only worsens the problem. Over the counter pain medications targeted at relieving inflammation can be helpful for reducing the amount of heel pain. Combined with rest and pain medication, a child with Sever's disease should wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.

Sever's disease may affect just one heel of either foot as well as the heels of both feet. It is important to have a child experiencing heel pain get an examination by a foot doctor who can apply the squeeze test, which compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.

Exercises that help to stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling, in which the foot is pointed away from the body, then curled toward the body in order to help stretch the muscles, has also proven to be very effective at treating Sever's disease. The curling exercise should be done in sets of 10 or 20 repetitions, and repeated several times throughout the day.

Treatment methods should usually continue for at least 2 weeks and as long as 2 months before the heel pain goes completely away and the child can resume normal physical and athletic activities again. A child can continue doing daily stretching exercises for the legs and feet to prevent the heel pain of Sever's disease from returning.

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