Remember your feet when sledding!

Are you tired of the cold and snow yet? If so, then that makes at least two of us. I can't wait to drive my car without having to clear the windshield and to be able to comfortably walk around without being bundled up. Unfortunately, springtime is still a couple months away and there's more snow in the forecast.
There is, however, one thing I enjoy about snow season. Whether it's the first snow of the year or the 20th, a fresh snow always seems to awaken us from our indoor hibernation. I always see the young and the young at heart out enjoying snow right after it's fallen. In my neighborhood, that usually means that most of us are sledding. I've often seen sledders and thought to myself how unsafe they're being. I must admit that I too have done some risky sledding. The problem with this is that we see far too many preventable, snow-related injuries. If you plan on sledding in the predicted snow, please follow these tips:

1. Choose proper equipment. I've seen people use anything from laundry baskets to pizza boxes. These devices can send you down the hill going backwards which can be dangerous for everyone. Instead of using whatever you have laying around, always use a store-bought sled designed for the snow because these are less likely to spin around. Also, be sure to read and adhere to the capacity guidelines of the sled. Putting more people on it than it can hold is unsafe.
2. Dress for success. When bundling up, be sure to protect your feet. Wear moisture-wicking, wool socks and insulated, weather-proof shoes to shield your feet from the elements.
3. Use hills! We're in the mountains which means mother nature has provided us with tons of natural sledding ground - take advantage of it. The use of ATVs or even golf carts when sledding is dangerous because it makes you more likely to be thrown off of the sled. Chances are that you'll land wrong and injury your ankle.
4. Clear the area. Find a place that is both free of dangers such as trees, fences, and roads and that gives you plenty of space to stop. It is a natural instinct to stop ourselves with our feet if we're about to sled into something. Clearing the area prevents this and any foot injuries that it may cause.

I know that fresh snow is exciting and that even those who know the precautions just get caught up in the fun of it all. With that being said, I can't stress to you enough how important it is to sled carefully or not at all. Please enjoy the snow but do so safely.

Inspired by http://www.womansday.com/Articles/Lifestyle/Family-Fun/Winter-Sledding-Safety-Tips.html

Nail Disorders

Anatomy of the Nail:

Nail Plate- Is the hard and translucent portion of the nail.

Nail Bed- Is the skin underneath the nail plate.

Matrix- Is the part in which the nail rests and is responsible for the production of the cells that become the nail plate.

Hyponychium- Distal nail groove which forms a seal that protects the nail bed.

Nail Grooves- Medial and Lateral

Lunula- The whitish crescent-shaped base of the nail.



Nail disorders are more common than people know. There are a number of different nail disorders that can be treated by your podiatrist. Nail abnormalities can show problems with the color, shape, texture, or thickness of the nails. Sometimes the nails can tell the health of a patient.


Here is a group of some common nail disorders:

Anonychia- This is the absence of the nail itself.

Beau's Lines- Is a depression across the nail plate which is caused by a stressful event.

Green Nail- A disorder of the nail that may be due to an infection caused by Pseudomonas.

Hapalonychia- A pliable nail plate that is usually caused by hyperhidrosis.

Clubbed nail- When the angle of the nail plate and proximal nail fold is greater than 180 degrees. This condition may occur in cardiac, pulmonary, or gastro-intestinal disease.

Koilonychia- This is known as a spoon nail. This condition is seen in iron deficiency anemia.

Leukonychia- Is a disorder of the nail where the nail exhibits white spots.

Lindsay's Nail- A condition that shows the far half of the nail discolored pink or brown and the near half dull and white. This disorder is seen in liver disease.

Macronychia- Is an abnormally large nail.

Mee's Line- A white band across the nail that is associated with arsenic poisoning or a stressful event.

Melanonychia- A disorder that demonstrates longitudinal, pigmented bands in the nails .

Micronychia- Is an abnormally small nail.

Onychatrophia- This disorder shows atrophy of the nail.

Onychauxic Nail- This disorder shows hypertrophy (Thickening) of the nail.

Onychia- A disorder where there is inflammation of the matrix.

Onychocryptosis- This is an ingrown nail.

Onychogryphosis (Rams horn nail) - Another disorder where there is thickening of the nail.

Onycholysis- This is a separation of the nail plate from the nail bed.

Onychomalacia- This is a softening of the nail plate.

Onychomycosis- Is a nail that is infected with a fungus.

Onychophosis- This type of nail is seen with a callus in the nail groove.

Onychopuntata- This disorder shows pitting of the nails as seen in lichen plannus, alopecia, and psoriasis.

Onychorrexia- Nails that are abnormally brittle.

Onychoschizia- This condition demonstrates splitting of the nail plate into layers.

Paronychia- Inflammation of the tissue folds around the nail. There may be infection with this type of nail.

Raquet Nail- A short and fat nail.

Subungual Hematoma- Associated with trauma. There is formation of a hematoma underneath the nail plate.

Terry's Nail- With this condition the proximal 2/3 of the nail plate is white. This disorder can be seen with hepatic cirrhosis.


So you see, there are many disorders of the nail. Some disorders may be more serious than others. If you suspect any nail disorders, make an appointment with your podiatrist to be properly evaluated.

Your legs are different lengths? No way!

You are at the tailor having your pants altered when the tailor informs you of the discrepancy in your leg length or, if you go to a bad tailor, they may measure one leg only and you notice the difference when you wear your pants for the first time. What is going on? Did the tailor make a mistake or are your legs really two different lengths?

One of the myths that seem to have become fact is that everyone has different length legs. Yes, it may not be exact to the faction of inch (or millimeter), but from a “macro” perspective your legs should be fairly equal. Most people do not ever realize that there is a discrepancy. If the length difference is causing problems, our podiatrists can help.

At Shenandoah Valley Podiatry we can measure the limbs in two different ways. We will take a measurement with our patient lying down; this measures the actual lengths of the bones, without any soft tissue involvement or input from issues such as scoliosis. It is known as the structural limb length. We will also find the functional limb length by taking a measurement while the patient is standing and with input from all structures.

Limb length difference can cause pain and injury in various ways. Most commonly, however, the pain is limited to one side. The pain can be experienced in the feet and ankles, knees, hips, or lower back. Symptoms can be felt in the upper back and neck because the difference in limb length affects the shoulders as well. Regardless of the location of pain, it is caused by the overuse of muscles and soft tissues that are forced to work harder than usual. When there is a difference in limb length, the long limb will try and shorten itself by the foot pronating, while the short limb will try to make itself functionally longer by supinating. This causes an imbalance which leads to the injury.

How can we treat your limb length discrepancy? Sometimes it is as simple as placing a lift under the short limb. Other times, physical therapy is needed to rehabilitate the soft tissue. You have tried both of those? Sometimes you need a custom molded orthotic to best control the abnormal motions. Unlike many other podiatry offices, Dr. Feeny has a personal guarantee that if you are not satisfied with the results you see within 90 days, return your orthotics and we will refund you 100% of the money you paid.

Our patients are often surprised at how quickly we can heal their lower extremity pain with these options. Schedule your appointment today with Dr. Feeny or Dr. Kate. Remember, we are here to keep you going!

A Sobering Foot Study

As a child, I remember being fascinated that one could change the color of a celery stalk or even a coffee filter simply by putting its tip in colored water. Many of us were exposed to this experiment as children because teachers often use it to show students how plants take in water and nutrients. But what's that got to do with feet?

According to a Danish urban myth, our feet can absorb alcohol in much the same way. The myth proposes that vodka can enter the blood stream through unbroken skin and cause intoxication if one stands in a puddle of it. Three Danish Ph.D. students set out to test this myth's validity by doing just that. In their comically named "PEACE ON EARTH" (Percutaneous Ethanol Absorption Could Evoke Ongoing Nationwide Euphoria And Random Tender Hugs) study, each stood in 700mL of vodka for three hours.  Their behavior and blood alcohol levels were documented every half hour to gauge their absorption. 

Aside from presumed pruning, observed changes were insignificant over the course of the study. Not surprisingly they concluded that we, unlike celery, are incapable of absorbing nutrients through the skin of our feet.

The point of all of this is that our skin is designed to keep out everything from infections to vodka. When our skin is compromised through a cut or an ulcer, it can no longer do its job. Proper foot care and visiting your podiatrist when the need arises will keep your feet healthy - and apparently sober.

If you'd like to read more about the study, visit British Medical Journal: PEACE ON EARTH.

Time Wounds All Heels - Literally

When John Lennon said, "I believe that time wounds all heels," I'm pretty sure he was referring to karmic justice and not our feet. But the literal interpretation isn't far from the truth!

Something we have seen patients complain of increasingly in our offices is heel pain - given many years, lots of walking, dancing, running, and general wear and tear, and wearing stylish-but-unsupportive shoes, it's no surprise that people's heels are hurting!

A common cause of heel pain is plantar fasciitis, meaning inflammation of the plantar fascia. The plantar fascia is a thick, broad band of fibrous tissue located at the bottom (plantar) side of the foot. It attaches to the heel as well as all five toes at the ball of the foot. The plantar fascia is not elastic like muscles are, so when we wear shoes with no arch support, our arches start to flatten and the plantar fascia pulls constantly where it is attached to the heel. This overworks the plantar fascia, causing it to become inflamed and irritated.

Given an infinite amount of time and many years of wearing unsupportive shoes, anybody could develop heel pain. If you're having heel pain, don't let your feet suffer anymore! Come see Dr. Feeny or Dr. Kate and they'll give you plenty of options to heal your hurting heels.

For more information, check out our website at http://www.blogger.com/www.shenandoahpodiatry.com.

Erythrasma

Erythrasma is a chronic superficial infection of the intertriginous areas of the skin. This is a bacterial infection and can be found between the toes. It commonly occurs between the 3rd and 4th toes.


History/Physical:

This infection usually occurs in areas of body folds that are moist. The infection can be asymptomatic or itching may be associated with the infection.

The infection consists of a well-defined area with brown-red patches commonly found. Scaling may be present, as well as fissuring and maceration. The affected area may resemble athlete's foot.


Causes:
Corynebacterium minutissimum - A bacterium found on the skin


Predisposing factors:

Excessive sweating

Obesity

Diabetes mellitus

Warm climate

Poor hygiene



Differential Diagnosis:

Candidiasis

Contact dermatitis

Psoriasis

Tinea pedis (athlete's foot)



Workup:

Wood light examination - Reveals coral red fluorescence

Gram stain - Reveals gram-positive filamentous rods



Treatment:

Antibiotics - Erythromycin is the drug of choice. Your doctor may prescribe 1-2 weeks of antibiotic therapy.

Your doctor may also prescribe a topical antibiotic to treat this infection.

New Year, New Foot Pain!

If you celebrated the new year with a night of dancing, you might now be having foot pain or simply wondering how you can take better care of your feet next time. Foot injuries caused by dancing are unfortunately common because we often pay little attention to our feet as long as they get us where we need to go. You need not worry, however, because Dr. Feeny and Dr. Kate are here to keep your feet healthy and pain free.

Injury prevention starts long before you hit the dance floor. Let your feet relax for a little while everyday by propping them up. This gives the small muscles in your feet a chance to recuperate from daily activities and will make sure they’re well-rested the next time you take them dancing. Another everyday thing you can do to protect your feet is proper skin care which can help to prevent blisters.

Shortly before dancing, take some time to stretch all the muscles in your feet. This will help to prevent you from pulling or straining your muscles. A good way to make sure that your feet are adequately stretched is to use them to spell out the alphabet in the air. It’s a simple, fun way to warm them up. You’ll also want to pick shoes that are comfortable and that have been broken in. Dancing in new shoes can cause blisters or other injuries so make sure that you walk in them a few times first to break them in. The best way to do this is to wear them for an hour or so the first time and gradually increase the amount of time you wear them.

When dancing, pay attention to your feet and take a break when they start hurting. Pain is your feet’s way of telling you when something is not right. A little bit of pain while dancing can be indicative of a more serious problem if not treated properly. This is especially true if you land on your ankle wrong or a partner with two left feet happens to step on yours.

If you have any blisters, foot, or ankle pain left over from your New Year's dancing, call us today to set up an appointment and we’ll have you back in your dancing shoes in no time.