June Articles 2014

Blisters on the Feet

Blisters are a common ailment of people who wear shoes that are either too tight or rubbed up against their feet in the wrong way while wearing them. In order to better understand how they are formed and what treatment should be used for them, you have to start with the basics of what a blister actually is.

A blister on the foot, or any other part of the body for that matter, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery like fluid that should not cause any concern. However, blisters can fill up with blood if they are deep enough and even pus if they have become infected with bacteria.

Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time for example, or when your shoes simply do not fit you properly. They also form faster and easier if your feet are moist, so keeping them dry and clean is a preventative step you can take to avoid getting blisters.

Preventing infection should be the number one concern when treating blisters, as well as alleviating the pain they can cause. Using a band aid to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop, or you can take a pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics might need to be taken in order to completely eliminate the bacteria inside the blister, and that needs to be prescribed by a doctor.

However, one of the best ways to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a band aid to an area you think might get a blister before one pops up is another way you can prevent them.

 

Barefoot Running

Barefoot running is a popular and growing trend that is taking over the running and jogging community by storm. Barefoot running is exactly what it sounds like, running without shoes. However, this doesn’t just affect whether or not you need to buy new shoes, but it also affects the motion of your feet and requires an entirely different workout.

When you run with shoes on, most of the time you land on your heels, roll over the ball of your foot, and then push off with your toes. However, in barefoot running, you actually land on the front part of your feet and not your heels. The impact shifts from the heels to the front of the feet, and barefoot runners shorten their strides to create softer landings.

Barefoot running has a lot of advantages. Landing on the front of your foot with a reduced stride lessens the stress and pressure placed on the ankles and feet, which lessens the chance of injury. It also strengthens the muscles in your feet and muscles in the ankles and lower legs that are not usually worked out. Your balance is also improved and there is a greater sensory input from your feet to the rest of the body, making your motions and posture less stressful on the body. Ironically enough, studies have shown that countries with large populations of people who do not wear shoes actually have a much lower number of those suffering from foot and ankle injuries.

Despite this, many people are still skeptical about barefoot running, and for good reason. There are some drawbacks to the unique exercise, one of the most obvious being the complete lack of protection of your feet from objects while running. Bruises, scrapes, cuts, and sometimes blisters can form on runners’ feet.  Landing on the front of the feet can also cause Achilles tendonitis, or worse yet, a rip or rupture of the Achilles tendon.

But there are a lot of ways to make barefoot running safe and enjoyable. First off, make a slow transition from your normal running routine to barefoot running, do not just dive right into it one day. Once your feet begin to adjust, slowly move from jogging to running and gradually increase the distance. It is also recommended to start out on a surface that does not contain many sharp or dangerous objects, as your feet are now unprotected. Minimalist running shoes are also another great option to get you into barefoot running and provide the perfect middle ground for those looking to get into the sport.

Nerve Disorders of the Foot and Ankle

Similar to well-known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.

Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.

Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.

Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.

If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition.  If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.

Corns: What Are They, and How Do You Get Rid of Them

Corns are areas of the skin where it has thickened to the point of being irritating and sometimes painful. Corns are circular or cone-shaped and are commonly found on the feet where there are areas of pressure or friction, such as on the little toe where it may rub against shoes or on the ball of the foot. The medical term for corns is helomas.

Corns can easily be confused with a callus, but there is a difference between the two. Corns can be a raised bump that feels hard to the touch and painful. They consist of a thick, rough area of skin that may be dry and waxy. Corns tend to be surrounded by inflamed skin and are usually smaller than calluses.

The key to treating a corn is to remove the dead skin that has built up. Salicylic acid is the most common medication used to accomplish this. Salicylic acid works by dissolving keratin, the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in the form of wart removers. It comes in medicated pads, drops or creams. People with diabetes should not use salicylic acid, but should immediately consult their doctor.

To treat corns, apply the medication directly onto the corns according to the product directions. The top layer of the corn will turn a white color. When that happens, the layers of skin can then be peeled away, making the corn smaller. It is never a good idea to try and shave off corns with razors or other pedicure equipment. This can lead to infection. If your corns get infected or do not respond to over the counter treatment, a visit to the doctor is necessary.

Orthotic inserts fitted by a podiatrist also help to treat corns and help prevent their return. Inserts fit into shoes and help to adjust the way your foot fits in your shoe, thus fixing the way you walk. This will reduce friction, lowering your chances of getting a corn and eliminating the pain for current corns.

Surgery is seldom an option for corns, but does occur on rare occasions. Surgery for corns actually deals with the underlying issue causing the corns. During surgery, the bone is shaved and any abnormalities are corrected to reduce the amount of friction that occurs during walking.

The first step to preventing corns is to reduce any possible friction. Wear well fitting shoes that don’t rub on your feet. If you notice rubbing developing, pads can be purchased to help reduce the friction. These can be purchased over the counter and are simply placed on the area that is being irritated. Friction can also be reduced by using cushioned insoles in your shoes, and making sure to wear well-fitting shoes. This will make sure your foot is not being squeezed awkwardly, and stop corns from forming in the first place.

When Foot Surgery is Necessary

When non-invasive procedures fail to help with issues pertaining to the foot, sometimes foot surgery may be necessary. Some cases that demand surgery can include foot deformities such as bunions and bone spurs, arthritic problems, and reconstruction as a result of injuries caused by accidents and congenital malformation. Regardless of age or race, foot surgery can help all individuals.

If foot surgery is necessary, the reason you will need the surgery will affect the type of surgery you need. For example, a bunionectomy may be performed to remove a growth such as a bunion. If you need to have bones realigned and fused together, you will likely undergo a surgical fusion. Surgical removal of painful nerves are used when it comes to problems dealing with nerve pain and the tissues surrounding it. Normally other, less drastic treatments are applied for most symptoms, but if those treatments are not effective, surgery is used.

Although foot surgery is considered a last resort by many physicians, there are benefits if it used to fix the problem. The first advantage is that the pain associated with the problem is normally alleviated, allowing you to resume the activities you could not do as a result of your foot problem. The second advantage is that once the surgery is complete, the problem with your foot is generally eliminated since it was addressed in a permanent fashion.

The history of podiatry shows that foot surgery techniques advance each year. For example, endoscopic surgery is one of the many advancements in the realm of foot surgery. As this technology evolves and improves, so will surgical techniques. Many procedures can now be completed with the use of a very small incision and smaller, more refined surgical instruments. Due to these better and more useful tools, surgeries are less invasive and recovery time has become a lot shorter. Shorter recovery periods allow you to be back on your feet in no time.

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