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.

The Vicious Cycle

There are approximately 70 million obese Americans and that number doesn’t seem to be slowing down. Many of those 70 million are caught between a rock and a hard place. Obesity can make foot problems worse. Extra weight puts stress on the joints of the body and the foot is no exception. This can lead to flat feet and heel pain, which make it harder to exercise and lose weight. Without exercise and weight loss, many of those 70 million people’s obesity leads to other problems like diabetes, heart disease, and other serious health risks.

This is where your podiatrist can save the day and your life. Obese adults should seek help for their chronic foot conditions as soon as possible so they can start a healthy exercise program. Chronic heel pain from carrying extra weight is a common cause of the lack of exercise in obese adults. Proper evaluation by your podiatrist is the very first step. And don’t let fear delay this appointment. Many causes of foot pain can be relieved without going under the knife. Stretching exercises, orthotics, and the proper athletic shoes with good shock absorption can work quite the wonder. If a condition is severe enough for surgery, you can still participate in non-weight-bearing exercises during your recovery, such as a stationary bike, swimming, or weight training.

Many diabetic patients are worried about exercising because of the risk for foot ulcers. This should not persuade you to avoid exercise. Treadmills or elliptical machines can be used to minimize the pounding stress on the feet. And losing weight can help in the control of your diabetes. For the diabetic patient, regular foot exams are also very beneficial in assessing any problematic spots before they worsen. With the right foot care and foot wear, all patients can find a workout routine that is safe and productive for them. To get back into your workout routine, come by and see Dr. Grimm or Dr. Pattison of Foot Associates of Central Texas.

Shin Splints

Continuing our segment on the World Cup, another common injury that soccer players suffer is shin splints. It shows up as pain on the front part of the lower leg during exercise, usually after a period of relative inactivity. Many other types of athletes get shin splints too, especially runners and sports that involve more running activities. So what causes it?

The exact injury is not quite known, but the pain appears to stem from inflammation due to injury to a tendon in the front of the outer leg. This is commonly described as an overuse injury. A sudden increase in distance or intensity of a workout can be associated with this inflammation. Other factors can cause shin splints, such as a tight Achilles tendon, weak ankle muscles, and a tendency to overpronate the foot. Some have even stated that athletes with worn-out footwear have shin splints due to the shoe’s inability to absorb the shock of the ground.

So how can your podiatrist help you with your shin splints? Usually this diagnosis can be made with a careful patient history on the details of their exercise routine. For an unclear diagnosis, a bone scan or x-ray could be implemented to separate this from a stress fracture. After your podiatrist properly narrows down the condition, they will decide the best treatment plan for the athlete. For shin splints the best medicine may be rest from the activity. This could also include switching to non-weight bearing activities until the condition is healed. Your podiatrist may also recommend ice or medication to reduce inflammation, an Ace bandage, and strengthening and stretching exercises. For this and any other sports injury, be sure to come by and see Dr. Grimm or Dr. Pattison.

Give Your Feet the Gold Medal

With the recent Winter Olympics, everyone gets excited about their favorite ski-resort activity. Whether you enjoy the adrendaline rush of skiing down the slopes or a more relaxed cross-country ski, it is a great way to stay active. Before you hit the slopes during your vacation, there are a few Olympic-quality tips to keep you and your feet happy.

1. Be sure to stretch thoroughly before you venture into the cold whether.
2. Wear the right shoes for your activity. Make sure ski boots are the proper size to allow good blood flow and nerve sensation to the feet. If you wear orthotics, be sure to have enough room to accomodate those as well.
3. Wear the right socks. You want to keep moisture away from your feet to prevent any blisters. This can be done with moisture-wicking socks made of smart wool, polypropylene, or acrylic fibers.

While cross-country skiing is an excellent aerobic activity there are a few foot risks to watch out for if this is a regular activity. The repeated stress of pushing off the skiis in a straight inline motion causes the big toe to stay bent at its hinge. Over a long period of time, this can lead to a condition called Hallux Rigidus, where a bone spur forms on top of the big toe joint and there is a slow destruction of the joint. Instead, change your technique by using a V-style glide and edge motion, similar to ice skates or roller blades. This puts less stress on the big toe. Hallux Limitus/Rigidus is a form of arthritis, an inflammation of the joint. This comes along with swelling and tenderness during and after skiing. If you have any foot conditions bothering you before or after, you may want to check in with Dr. Grimm or Dr. Pattison for an evaluation to get you back to going for the gold.

Treat Your Feet

It’s that time of year when you should be spreading cheer, yet all you can think about is your aching feet. Your feet may ache because you choose trendy shoes over more comfortable ones, or perhaps, because you don’t give them a little rest and relaxation every now and then. Pampering your feet is not only important for overall foot health, but it can be a great stress reliever as well. Below are some pointers for your next pedicure.

Safety at the salon. Bring your own pedicure set to the salon. There’s no way to be sure they are using proper sterilization techniques between clients. We recommend the SOS Safe Salon Pedicure Kit.

~ Schedule your pedicure first thing in the morning. Foot baths are the cleanest.

~ Don’t shave your legs prior to getting a pedicure.

Smooth calluses. Soak feet in warm water for 5 minutes. When eliminating the build-up of dead skin on the heel and ball of the foot, ensure you or the pedicurist uses a pumice stone or foot file. Do not use a razor!

Trimming toenails. Use TOEnail clippers with a straight edge. Ensure the nail is cut straight across. Using other tools can increase your chances of getting ingrown toenails.

Ingrown toenails. Attempting to remove ones that are not infected can increase your chances of infection. See your podiatrist for care.

File for style. Emery boards work best for smoothing the edges of the nails. Ensure you bring your own to the salon since emery boards are porous and can carry germs.

Clean beneath the nails. Run a wooden or rubber manicure stick underneath them to remove hidden crud.

Moisturize your soles. Apply emollient-enriched lotion to maintain the proper moisture balance of your feet, or a one-step exfoliating/moisturizing cream.

Cuticle care. Use a rubber cuticle stick to push back cuticles. Do not cut them since cuticles are barriers that protect against infection.

Polish Up. Use nail polish if toenails are healthy, and remove it regularly with a non-acetone based remover. If your nails are discolored at all, this indicates a fungal infection. Do not apply nail polish if you suspect you have a fungal infection, it will seal in moisture facilitating growth of the infection.

A good foot hygiene regimen should involve regular pedicures to prevent the build up of dry skin and painful calluses. As the holidays approach and you participate in Secret Santa exchanges, why not give someone the gift of a pedicure? Or better yet, a pedicure set to take with them the next time they treat their feet!

Information Provided by the American Podiatric Medical Association