Ulcers can occur in different parts of the body. Many people are familiar with stomach ulcers, or an ulcer in the mouth, but ulcers also occur on the lower limbs. This week will be the first blog of a series on different ulcers podiatrists treat. Today’s discussion is on neuropathic foot ulcers, most commonly found in Diabetic patients. Ulcers are the most common precursor to lower extremity amputations. While it is estimated that 7% of the US has Diabetes, an estimated 15% of diabetic patients will go on to develop an ulcer on their lower limbs. Neuropathy, deformity, high pressure on the feet, poor blood sugar control, duration of diabetes and the male gender are all contributory factors for foot ulcers.
So how do these occur? Many diabetics develop neuropathy, where they lose the feeling of sensation in their feet due to nerve death. Neuropathic patients can cause trauma to their feet, such as stepping on a nail, dropping an object or burning their feet, and not even realize it. These tiny wounds develop into larger, deeper, infected wounds. And since diabetes affects wound healing, what was a tiny puncture wound can progress into larger limb-threatening ones. If you do develop a neuropathic ulcer, seek medical attention immediately. Your podiatrist will want to assess the wound to determine if hospitalization is necessary. Generally if it isn’t too large or infected, rapid wound care can be started at your podiatrist’s office. However in the face of severe infection, IV antibiotics and possibly surgery have to be done. The best prevention is to stop by your podiatrist’s office and get a foot checkup. He or she will test your sensation as well as assess your current footwear choices. Also, managing your blood sugar should be priority #1 to help prevent neuropathy in the first place. For more questions and concerns on this, consult with Dr.Grimm or Dr.Pattison of Foot Associates of Central Texas.
Thursday, December 29, 2011
Wednesday, November 2, 2011
Nadal Pondered Switching to Golf After Foot Injury
Tennis star Rafael Nadal’s biography hit the US shelves recently. In it he describes a foot injury in 2005 that had the potential to end his career. He describes his thoughts of switching to golf as a career due to his pain. In the book the problem is described as a congenital (born with it) bone problem in the bridge (arch) of this left foot. Nadal more than likely had a condition called Kohler’s Disease, also known as avascular necrosis of the navicular bone. The bone is located in the middle of the foot, near the peak of the arch.
During childhood, there is an interruption of blood flow to the bone which doesn’t let it harden like it should. The causes of this aren’t known for sure, but trauma or overuse has been linked to the condition. This causes the bone to be deformed and can eventually splinter. Sometimes these effects aren’t known until later on in life, as such in Nadal’s case. And this becomes more apparent with repetitive stress to the bone, such as being a professional tennis star. Nadal’s book goes on to describe how he had pain and swelling in the area of the arch, near the top of his foot. He found this to be relatively normal since he played an intense match, but the pain became worse. The next day the swelling had increased and he couldn’t put any weight on it. His doctors couldn’t diagnose it for weeks until he saw a specialist in Spain. Nadal was forced to rest until the pain subsided. His specialist recommended insoles that would cushion the bone and try to offload the stress to that part of the foot. However there are consequences to that such as putting more stress on the knees and back.
Treatment for Kohler’s Disease is symptomatic. In Nadal’s case, his life is dependent on his ability to perform at the highest level so his treatment regimen may differ than someone else with Kohler’s. Remember that foot pain is not normal and if you are experiencing it, come by and see Dr. Grimm or Dr. Pattison of the Foot Associates of Central Texas. They have offices in Lakeway, Georgetown, Round Rock, and Taylor, Texas.
http://www.guardian.co.uk/sport/2011/aug/22/rafael-nadal-golf-injury
During childhood, there is an interruption of blood flow to the bone which doesn’t let it harden like it should. The causes of this aren’t known for sure, but trauma or overuse has been linked to the condition. This causes the bone to be deformed and can eventually splinter. Sometimes these effects aren’t known until later on in life, as such in Nadal’s case. And this becomes more apparent with repetitive stress to the bone, such as being a professional tennis star. Nadal’s book goes on to describe how he had pain and swelling in the area of the arch, near the top of his foot. He found this to be relatively normal since he played an intense match, but the pain became worse. The next day the swelling had increased and he couldn’t put any weight on it. His doctors couldn’t diagnose it for weeks until he saw a specialist in Spain. Nadal was forced to rest until the pain subsided. His specialist recommended insoles that would cushion the bone and try to offload the stress to that part of the foot. However there are consequences to that such as putting more stress on the knees and back.
Treatment for Kohler’s Disease is symptomatic. In Nadal’s case, his life is dependent on his ability to perform at the highest level so his treatment regimen may differ than someone else with Kohler’s. Remember that foot pain is not normal and if you are experiencing it, come by and see Dr. Grimm or Dr. Pattison of the Foot Associates of Central Texas. They have offices in Lakeway, Georgetown, Round Rock, and Taylor, Texas.
http://www.guardian.co.uk/sport/2011/aug/22/rafael-nadal-golf-injury
Monday, August 29, 2011
Prince Amukamara's Foot Injury
First, the good news: The ridiculousness that is the NFL lockout is finally over. However for one player, his season will be locked out indefinitely. Prince Amukamara from Nebraska, the #1 pick of the New York Giants, fractured his 5th metatarsal bone in his left foot during the 2nd Giants practice. In the story released by ESPN, Coach Tom Coughlin goes on to say Amukamara was sore in that area beforehand but never communicated it to anyone. Amukamara states that the incident occurred when a player he was covering cut and inadvertently stepped on his foot. This type of injury can also occur with a “rolling” of the ankle.
The fifth metatarsal bone is located toward the end of the foot, on the outside border, and is a shaft-like bone that connects the 5th toe to the rest of the foot. Amukamara’s case will require surgery and a screw to heal properly. Surgery will vary on a case-by-case basis as there are numerous types of fractures that can occur to the 5th metatarsal specifically. The type of patient can also influence treatment. Your podiatrist may use a different treatment option if you are a NFL cornerback versus an elderly patient. Healing can vary greatly with this type of fracture. This is due to the lack of blood flow to some parts of this bone. This is one reason why the ESPN article is hesitant to give an exact timeline on Amukamara’s return.
The article also points out another important point. Couch Coughlin states that he had pain there before. Now there is no precise way to know if the 2 incidences are related but it does point out that if you are experiencing any type of foot pain, it is worth getting checked out before it progresses to something more serious. Remember, foot pain is not normal. If you are having any concerns about the health of your feet, remember to get them checked out by Dr.Grimm or Dr.Pattison at the Foot Associates of Central Texas.
Source: http://espn.go.com/new-york/nfl/story/_/id/6840281/prince-amukamara-new-york-giants-breaks-foot-indefinitely
The fifth metatarsal bone is located toward the end of the foot, on the outside border, and is a shaft-like bone that connects the 5th toe to the rest of the foot. Amukamara’s case will require surgery and a screw to heal properly. Surgery will vary on a case-by-case basis as there are numerous types of fractures that can occur to the 5th metatarsal specifically. The type of patient can also influence treatment. Your podiatrist may use a different treatment option if you are a NFL cornerback versus an elderly patient. Healing can vary greatly with this type of fracture. This is due to the lack of blood flow to some parts of this bone. This is one reason why the ESPN article is hesitant to give an exact timeline on Amukamara’s return.
The article also points out another important point. Couch Coughlin states that he had pain there before. Now there is no precise way to know if the 2 incidences are related but it does point out that if you are experiencing any type of foot pain, it is worth getting checked out before it progresses to something more serious. Remember, foot pain is not normal. If you are having any concerns about the health of your feet, remember to get them checked out by Dr.Grimm or Dr.Pattison at the Foot Associates of Central Texas.
Source: http://espn.go.com/new-york/nfl/story/_/id/6840281/prince-amukamara-new-york-giants-breaks-foot-indefinitely
Thursday, February 17, 2011
Rickets and Foot Disorders
There are a few deformities that can present in children that deal with the lower limbs. One of those is Rickets. This is a softening of bones in children due to either a deficiency or impaired metabolism of vitamin D, phosphorus, or calcium. The most common cause is vitamin D deficiency. Vitamin D is needed for your body to properly absorb calcium from your gut. We get vitamin D when the sunlight hits our skin and produces it. While this disease can occur in adults, the majority of cases are children suffering from very severe malnutrition. When this occurs in adults it is known as osteomalacia.
A toddler with rickets will have legs that are bowed outward, while older children will present with knock-knees. There is also bone pain or tenderness, dental problems, muscle weakness and a tendency for fractures. Lab results could show hypocalcemia, which means low levels of calcium in the blood. The symptoms of associated pain and fractures are what help your podiatrist set apart this disease from a structural deformity like genu valgum, or tibial varum, which is just the position your leg bones have grown from birth. Blood work also helps confirm the diagnosis.
More cases have been reported in Britain lately due to the inability of children to make vitamin D. But these kids weren’t starved or poor. The sunlight was not reaching their skin due to the persistent use of sunblock. This wasn’t allowing any sunlight to reach their skin, or they were spending too much time indoors with the TV, computer, etc. Treatment for rickets depends on the cause. Treatment for nutritional rickets includes vitamin D supplementation and a diet high in calcium. The earlier these children are diagnosed, the better. If the disease becomes too advanced, the bony deformities can be permanent. For questions about this or any other childhood foot deformity, come by and see Dr.Grimm or Dr.Pattison.
A toddler with rickets will have legs that are bowed outward, while older children will present with knock-knees. There is also bone pain or tenderness, dental problems, muscle weakness and a tendency for fractures. Lab results could show hypocalcemia, which means low levels of calcium in the blood. The symptoms of associated pain and fractures are what help your podiatrist set apart this disease from a structural deformity like genu valgum, or tibial varum, which is just the position your leg bones have grown from birth. Blood work also helps confirm the diagnosis.
More cases have been reported in Britain lately due to the inability of children to make vitamin D. But these kids weren’t starved or poor. The sunlight was not reaching their skin due to the persistent use of sunblock. This wasn’t allowing any sunlight to reach their skin, or they were spending too much time indoors with the TV, computer, etc. Treatment for rickets depends on the cause. Treatment for nutritional rickets includes vitamin D supplementation and a diet high in calcium. The earlier these children are diagnosed, the better. If the disease becomes too advanced, the bony deformities can be permanent. For questions about this or any other childhood foot deformity, come by and see Dr.Grimm or Dr.Pattison.
Tuesday, February 15, 2011
Flood Zones
For this week’s blog we look at a natural disaster less-commonly found in Texas, floods. These are still worth mentioning in light of the rain associated with the upcoming spring. This not only applies to massive flooding, but walking out to the patio or driveway where there’s standing water. Many times people in high water will walk bare foot to avoid their shoes from becoming soaked. At best, some may wear thong flip flops. This increases your risk of getting an infection or even a disease.
During a flood, damage and debris can wash as far as the water will take it. So while you may be walking on what you think is your clean driveway, there could be rusty nails from a construction site up the road. And it doesn’t just have to be a puncture wound either. Any small cuts or abrasions that were already on your legs and feet are exposed to the contaminated water. This can lead to infections such as trench foot, tinea (athlete’s foot), cellulitis, or osteomyelitis. Recently, Kevin Rudd, the former prime minister of Australia, was admitted to the hospital for such a thing. He contracted an infection while helping flood victims there.
If you think you may have an infected wound, be sure to wash it with cool water. Use soap and a clean washcloth to clean the skin around the wound. Be cautious of getting soap into the wound as this can irritate it. An antibiotic ointment can be applied to help fight infection. For a more serious wound, call your podiatrist to get it checked out. If it’s a deep wound, then it may require a few stiches. If the area becomes tender and inflamed, leaks any creamy fluid, or you start to run a temperature, call your podiatrist immediately as this could lead to more serious conditions. Your podiatrist will perform a detailed inspection and determine the best course of treatment on a case-by-case basis. For all those nicks, cuts, and foot bruises, come by and see the physicians at Foot Associates of Central Texas.
During a flood, damage and debris can wash as far as the water will take it. So while you may be walking on what you think is your clean driveway, there could be rusty nails from a construction site up the road. And it doesn’t just have to be a puncture wound either. Any small cuts or abrasions that were already on your legs and feet are exposed to the contaminated water. This can lead to infections such as trench foot, tinea (athlete’s foot), cellulitis, or osteomyelitis. Recently, Kevin Rudd, the former prime minister of Australia, was admitted to the hospital for such a thing. He contracted an infection while helping flood victims there.
If you think you may have an infected wound, be sure to wash it with cool water. Use soap and a clean washcloth to clean the skin around the wound. Be cautious of getting soap into the wound as this can irritate it. An antibiotic ointment can be applied to help fight infection. For a more serious wound, call your podiatrist to get it checked out. If it’s a deep wound, then it may require a few stiches. If the area becomes tender and inflamed, leaks any creamy fluid, or you start to run a temperature, call your podiatrist immediately as this could lead to more serious conditions. Your podiatrist will perform a detailed inspection and determine the best course of treatment on a case-by-case basis. For all those nicks, cuts, and foot bruises, come by and see the physicians at Foot Associates of Central Texas.
Friday, February 11, 2011
Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy Syndrome (RSDS), is a very debilitating disorder that podiatrists sometimes see. This disorder begins after a nerve injury. This injury can leave the nerves in a hypersensitive and painful state. This causes patients to have “out of proportion” pain. This means that an action or stimulus that would barely hurt a person without this condition causes excruciating pain to the person with CRPS.
The exact cause of CRPS is not completely understood. It is suspected that damage to the nerves causes problems in controlling blood vessels and sweat glands. These damaged nerves lose the ability to control temperature, blood flow, and sensation to the affected area. CRPS is more common between the ages of 40-60.
There are 3 stages to CRPS but they don’t necessarily represent an ordered progression. You could be in one stage indefinitely or start out at stage 2 or 3 without going through 1. Symptoms range from severe burning, aching to the lightest touch. The skin could become dry and thin. Pain may move further up the limb. This could progress to swelling, changes in bone on an x-ray, stiff muscles and joints. And severe forms could include a painful entire limb, muscle wasting, and contractions involving muscles of the limb.
Treatment is tough for this condition. Your podiatrist commonly will take a team approach, possibly working with physical therapy and pain management specialists. Medications could include strong pain killers, steroids, and medications for blood pressure. Physical therapy can work with applications of hot and cold for pain relief. For the pain, nerve blocks could be utilized. For more severe cases, surgery would be pursued to cut the affected nerves. For help with this serious condition, see Dr.Grimm or Dr.Pattison to start building your treatment team.
The exact cause of CRPS is not completely understood. It is suspected that damage to the nerves causes problems in controlling blood vessels and sweat glands. These damaged nerves lose the ability to control temperature, blood flow, and sensation to the affected area. CRPS is more common between the ages of 40-60.
There are 3 stages to CRPS but they don’t necessarily represent an ordered progression. You could be in one stage indefinitely or start out at stage 2 or 3 without going through 1. Symptoms range from severe burning, aching to the lightest touch. The skin could become dry and thin. Pain may move further up the limb. This could progress to swelling, changes in bone on an x-ray, stiff muscles and joints. And severe forms could include a painful entire limb, muscle wasting, and contractions involving muscles of the limb.
Treatment is tough for this condition. Your podiatrist commonly will take a team approach, possibly working with physical therapy and pain management specialists. Medications could include strong pain killers, steroids, and medications for blood pressure. Physical therapy can work with applications of hot and cold for pain relief. For the pain, nerve blocks could be utilized. For more severe cases, surgery would be pursued to cut the affected nerves. For help with this serious condition, see Dr.Grimm or Dr.Pattison to start building your treatment team.
Monday, February 7, 2011
Pedicures
Pedicures are nothing new. People have been manicuring their nails for thousands of years, going back to the Ancient Egyptians and the Ming Dynasty. What has changed is the number of nail salons. From 2000-2010 the pedicure industry boomed from 50,000 locations nationwide, to 100,000. So what should you look out for when getting your nails treated at one of these establishments? It has been reported that 1/100 customers develop an infection from a dirty whirlpool. The germs from these can lead to more serious complications of the foot. Here are some tips to minimize the risk:
1. Are you healthy enough for a pedicure?
-Diabetes? Poor circulation? Neuropathy? Skin problems? These could increase your risk of infection so if you’re not sure, get your feet looked at by a podiatrist to be on the safe side.
2. Give your ankles and feet a look over before the pedicure.
-Any open wounds or cuts can increase the risk of infection. Also, ladies don’t shave the day before your pedicure as this can cause breaks in the skin too small for the eye, but just the right size for bacteria.
3. Inquire your pedicurist.
-Ask if they are licensed. And ask about their instruments. Do they autoclave them (a fancy sterilization machine). Or do they use hospital grade disinfectant solution? Also notice how they clean their footbath for each customer. These baths are the big source of germ breeding and should be disinfected properly
4. How’s the place look?
-Make sure your salon looks clean and presentable. This can tell you about how the business keeps their environment clean to avoid germ build up. There shouldn’t be nail clippings on the floor or tools lying out.
5. Pain?
-A pedicure should never hurt. If it does, one of two things is wrong. They either messed up or your foot has a problem that could require medical attention.
Pedicures are a great way to keep your feet maintained and inspected frequently. These are just a few tips to keep you safe so your feet can continue to be rewarded. If you have any issues from a pedicure or anything else, come by and see Dr.Grimm and Dr.Pattison at Foot Associates of Central Texas.
1. Are you healthy enough for a pedicure?
-Diabetes? Poor circulation? Neuropathy? Skin problems? These could increase your risk of infection so if you’re not sure, get your feet looked at by a podiatrist to be on the safe side.
2. Give your ankles and feet a look over before the pedicure.
-Any open wounds or cuts can increase the risk of infection. Also, ladies don’t shave the day before your pedicure as this can cause breaks in the skin too small for the eye, but just the right size for bacteria.
3. Inquire your pedicurist.
-Ask if they are licensed. And ask about their instruments. Do they autoclave them (a fancy sterilization machine). Or do they use hospital grade disinfectant solution? Also notice how they clean their footbath for each customer. These baths are the big source of germ breeding and should be disinfected properly
4. How’s the place look?
-Make sure your salon looks clean and presentable. This can tell you about how the business keeps their environment clean to avoid germ build up. There shouldn’t be nail clippings on the floor or tools lying out.
5. Pain?
-A pedicure should never hurt. If it does, one of two things is wrong. They either messed up or your foot has a problem that could require medical attention.
Pedicures are a great way to keep your feet maintained and inspected frequently. These are just a few tips to keep you safe so your feet can continue to be rewarded. If you have any issues from a pedicure or anything else, come by and see Dr.Grimm and Dr.Pattison at Foot Associates of Central Texas.
Subscribe to:
Posts (Atom)
Posts
