Does Turning 30 = Foot Pain?

I'm sure by now you've seen the hit website, Buzzfeed, which displays popular social content on the web. Well, the other day I was scrolling through and an interesting title, 30 Unexpected Things You Learn in Your Thirties, caught my eye.

Working at Shenandoah Podiatry, naturally #16 jumped out at me:

I love the reference to orthotic shoe inserts as they really are an investment and they really do help with back pain (in addition to knee and foot pain!)

So our question is, when you hit the big 3-0 did you experience back and foot pain out of the blue? If you are experiencing any pain or discomfort, give our office a call! We do our best to work with your schedule and get you in quickly to see one of our doctors! We are conveniently located in Blacksburg (right off of 460) and in Troutville (North Roanoke right off 81).

Worker's Hand Attached to Foot!

A worker's hand was cut off by a machine late last month and was temporarily attached to the man's foot in order to preserve the hand! Who knew you could do that?? After doctors worked on other injuries for the man, they removed the hand from the foot to reattach to his wrist. Despite having to wait for him to recover in order to complete the reattachment, the man is doing well and will need to have several other procedures conducted once the hand is reattached.

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So basically we want to stress, if your hand gets cut off in an accident, let the docs know they can attach it to your foot to prevent it from dying (temporarily).

What Causes Gout?

"Gout is caused by an increase, or build up, of uric acid in the body.  It is usually a result of a decreased excreation of uric acid in our urine.  Initially the uric acid is found in the blood, but over time it will defuse throughout the body.  This includes the joints.  As uric acid increases in concentration in the joints it is more likely to crystallize.  These crystals can cause a lot of pain during an acute gout attack. 
 

The question can be asked: Why is gout usually seen in the feet?  Uric acid is not water soluble.  This means that it will crystallize if given the right conditions.  First, in high enough concentrations it can crystallize.  Second, as temperature decreases it is more likely to crystallize.  Gout can be found in any joint, but I believe it happens more in the feet because of the decreased temperature found in the feet.  The feet are the structures in the body that are furthest from the heart, making them the coolest. 

Symptoms of an acute gout attack include pain, edema (swelling), and erythema (redness) around the joint involved.  It is common to see a patient that was drinking alcohol or eating a steak dinner one evening to wake up the next morning with an acute gout attack.  The pain is usually 10 out of 10 and can be so painful it hurts to even let the bed sheets rest on the affected area.  An acute gout attack can mimic different arthritic conditions, including septic arthritis.  A diagnosis is made definitively through joint aspiration, which is then sent to a pathology lab."

- Dr. Marshal Gwynn

Leo DiCaprio with a Cane!

Did you recently see Leo walking around with a cane? Apparently he was showing his architect a design and wound up popping a few ligaments, spraining his ankle. Besides his upcoming premier of The Wolf of Wall Street, DiCaprio doesn't seem to be phased of his ankle injury. Luckily he looks pretty good, even with a cane!

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So how do you sprain your ankle? Well, just as DiCaprio experienced, it's caused by stretching or tearing one or more ligaments on either or both sides of the ankle. Many patients are seen in the winter with ankle sprains due to weather related injuries and of course a plethora in the spring as kids are starting up their sports and running starts up again with the warmer weather.

In order to prevent ankle sprains:
- always wear proper footwear
- warm up prior to exercise
- carefully run or walk on uneven terrain

Treat ankle sprains with RICE therapy- Rest, Ice, Compression and Elevation. If you are experiencing pain or swelling even a week after the incident, give our office a call! We are accepting new patients in both our Blacksburg and Troutville (North Roanoke) offices!

Are You Wearing the Wrong Shoes?

Tone It Up (#TIU), a website dedicated to educating people on fitness and nutrition, features a member of their "community" every Tuesday. One of the questions the TIU team asks the members on the feature is "Did you have any setbacks along the way? How did you overcome them?" A recent members response is as follows:

"I did actually have a pretty big set-back. In May 2012, I ran the 500 Festival Mini Marathon, but I ran in the wrong shoes (minimalist shoes). Shortly after finishing, my left foot began hurting badly. I went to the doctor and found out that I had two stress fractures in my foot, which forced me to stop just about all types of exercise for several months. I've just recently reintroduced running back into my routine. Even though it's been over a year, still bothers me. Now, I'm a huge advocate for making sure people wear the best shoes for their body!"

As this member states, you do need to find the best shoes for YOU. A doctor or shoe salesman can't say, "this is the perfect shoe for all runners, walkers, etc." Each person needs to be evaluated in a few different ways and seeing a podiatrist is the first step in a successful exercise regimen.

Alec Baldwin's Wife with Twisted Ankle!

It looks like Mrs. Baldwin went for a run and wound up being chased by paparazzi on bikes! Crazy! One wound up getting too close to her and she twisted her ankle. Her instagram feed shows her icing her ankle (way to go!).

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Have you ever twisted you ankle? It certainly isn't a pleasant injury but completing RICE therapy (Rest, Ice, Compression and Elevation) can help you get back on your feet sooner than you think!

In addition to treating twisted ankles in our Blacksburg and Roanoke offices, we also treat patients with sprained ankles, fractures, broken bones and of course ingrown toenails, warts and much more!

If you or a loved one is in need of foot and ankle care, either

It's Turkey Day Craft Time!

Are you looking for some crafts for the kiddos while dinner is preparing this Thursday? Well look no further, below our craft is easy and you probably have most of the supplies laying around your house.

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Of course we had to pick our craft by choosing the one with a foot involved! The only supplies you need are:
- red/maroon washable paint
- yellow washable paint
- brown washable pain
- bubble/wiggly eyes
- paper
- glue
- paper plates

Instructions:
1. Press your hands into the red paint and press them onto the paper with palms next to each other to create a feather look
2. Repeat step 1 with yellow paint
3. Now press your foot into the brown paint then on the paper with your heel at the top of your paper
4. Adhere bubble eyes with glue at the top of your heel
5. Dip your finger into the yellow paint and press a dot just below the eyes
6. Dip your finger into the red paint and drag it a couple centimeters next to the nose

Ta-da! You now have fun turkey art and a fairly easy clean up :)

Did you know we treat children in both our Blacksburg and Roanoke offices? Well, we do! Everything from ingrown toenails, warts, broken bones, fractures and much more! If you your child is suffering from pain or discomfort, give us a call and we'll work with your schedule for your preferred date and time!

Metatarsalgia

Metatarsalgia translated means pain in metatarsals or ball of the foot.  In other words it is medicines junk term/diagnosis for pain in the ball of the foot.  It doesn't describe the location or cause of the pain making it more difficult to effectively treat. 

For example if a patient presented with pain in the ball of the foot (metatarsalgia) and radiographs revealed a fractured bone then I would diagnose a broken bone not metatarsalgia.  On the other hand if a patient presented with pain in the foot with no obvious diagnosis after a physical exam/radiographs then I would diagnose metatarsalgia.

If you feel you have any questions or concerns, or you have a foot or ankle concern give us a call at 808-4343!

- Dr. Marshal Gwynn

Fall Foot Blues

Do your feet hurt more than ever since summer has ended? If so, you are not alone. We see a lot of patients like you each fall. When it comes time to put the summer shoes away, these people get the shoe blues. 

In summer, sandals provide the freedom which allows your feet to feel comfortable. If you start wearing closed shoes again in autumn, the shoes can rub against bunions and hammertoes and cause you pain. Sometimes the friction of shoe against skin can cause painful corns and calluses to build up. Your first line of defense is to wear comfortable, well-fitting shoes. Pick footwear with a toe box wide enough so that your toes aren’t crowded together. If you wear shoes with heels, keep the heel height to two inches or less to avoid putting pressure on bunions. Wear socks to reduce the friction of shoes against your feet. You may also want to take your shoes to a shoe repair shop and get them stretched in the areas that are bothering you. Using the pads to shield the corns may help, but avoid medicated pads, which contain acid that can be harmful. 

If you try our tips to no avail, contact our office. There are several types of conservative treatments we can offer before we suggest surgery including:

• Trimming corns and calluses professionally- don’t attempt this yourself because you run the risk of injury or infection.
  
• Providing custom shoe inserts
  
• Injecting corticosteroids, which ease pain and inflammation or prescribing pain medication

If conservative measures like these don’t give you results, surgery may be your next alternative.

Don’t let painful feet and toes keep you from enjoying all that fall has to offer, visit our www.ShenandoahPodiatry.com!

Foot Cream to Kill HIV?

Ciclopirox, a drug commonly used to treat foot fungus, has been suggested to kill HIV cells. "In a study performed at Rutgers New Jersey Medical School, not only does the drug Ciclopirox rid infectious HIV from cell cultures, but the virus also doesn't bounce back when the drug is withheld." - CNet.com

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However, because the drug is a topical it does not treat the whole body (a systematic treatment) meaning it only prevents HIV not actually treating it.

Luckily, since the drug is already FDA approved for human use, the process of approval for HIV use might be sped up!

To learn more about the research and interviews head to cnet.com

Foot Lifts

Nicky Hilton in Studded Christian Louboutin. (Photo credit: Wikipedia)

An excerpt from December 2012's Allure Magazine regarding different random sugeries:

Foot Lifts:
"Except in summer sandals, the foot is rarely on public display- but that doesn't mean vanity stops above the ankle. Foot surgery is available to make pointy shoes fit better and to shorten second toes that extend beyond big ones; there's lipo for the little toe in cases where it's not little enough, and injections of hyaluronic acid to add padding to the balls of the feet (dubbed the 'Loub job,' after Christian Louboutin). The complications, however, can be brutal. It took one New Yourk City socialite more than three years to recover from shots in the soles that caused nerve injury and forced her to wear sneakers. 'When patients ask to alter the architecture of a foot that has no real disabilities, I advise against it,' says Rock Positano, a New York City podiatrist and director of nonoperatvie foot and ankle service at the Hospital for Special Surgery.

Foot Exams Help Prevent Ulcerations

diabetic foot syndrome

We urge all of our patients to make sure their primary-care physicians check their feet during every office visit for signs of ulcerations that, left untreated, can lead to infection and ultimately result in lower limb amputations.

It’s a simple exam that takes two minutes to determine if you are at risk for developing a foot ulcer. Perhaps the easiest way to remember to get your feet checked is to remove your shoes and socks in the examining room. Most diabetic patients are vulnerable to foot ulcerations caused by poor blood circulation in the lower extremities and neuropathy that inhibits nerve sensation.

Ulcers are the leading cause of foot amputations among people with diabetes, but they are preventable in most cases if doctors routinely check their patient’s feet.

In a routine foot exam we check for nerve sensation, skin irregularities (corns, calluses, punctures and areas of redness), swelling, drainage, and foot deformities that cause unnatural pressure points that are prone to ulceration.

Patients with diabetes who have their feet checked regularly can prevent foot ulcers or have them treated at early stages by their podiatrist.

Patient Testimonials

We are so fortunate to have such caring patients. We're glad we're able to serve the New River Valley and Roanoke Valley communities!

What Do Podiatrists and Pedometers Have In Common?



They both involve FEET!

Health experts- myself included- say 10,000 steps a day is the magic number to get (or stay) on the healthy track. Side effects include increase in energy, weight loss and less frequent sickness (<- I’d take those side effects any day!)

One tip to obtain these “side effects” is to keep track! Make sure you record your total number of steps per day to keep yourself accountable. You might be expecting these results when you assume you’ve walked that amount each day when in reality it’s only been 7,500 or 8,000 steps. If you’re really looking for weight loss, go ahead and write down your food intake daily and you might see double digits lost on the scale sooner rather than later!

If you find any pain after your daily walks, make sure to see a podiatrist as soon as possible so you can get back on your feet!

- Dr. Kate Steklachich

Why a foot doctor?

Dr. Kate and I were talking the other day about the different types of doctors and other fields she might of considered entering other than Podiatry. After talking, I started wondering why Dr. Kate chose becoming a Doctor of Feet afterall and here's what she had to say!

What made you decide to become a foot doctor? When was this? My grandpa was Type 1 Diabetic with complications and he was the only grandparent I never met, this made me become interested in Diabetes. I also wanted to specialize in surgeries as opposed to an orthopedic doctor or doing hip surgeries, etc. Another reason is because I was an athlete in school and was exposed to injuries. So Podiatry covers all of the above- Diabetes, Surgeries and Sports Medicine! I believe I made the decision my senior year in college.

You're a young doctor, do you think its an advantage or disadvantage drawing patients to you? I 100% believe it's an advantage because Podiatry training is becoming better, you're well trained and are given good exposure to multiple aspects of Podiatry.

What do you love about your job? Helping people overcome their disease or complication and educating them on how it affects their foot health. Also, I met my current boyfriend through a patient (who is a good friend now!) and am thankful this career has led me to the person I hope to marry!

What do you do in your free time? When I can I spend time with my friends and family and try to live a healthy and active lifestyle with sporting activities.

How would you encourage others to enter this same profession? I would encourage them to shadow which is following a doctor around to educate them on what they would be taught and able to do.

Thanks Dr. Kate for taking the time out of your hectic day to inform others on what it's like to be a Podiatrist!

You're Active! So Keep Your Feet Fit!

Are you a daily walker, a hiker or a triathlete? Any level of intensity in your daily activities can create any of the serious and common injuries below.

Let's take care of your feet together, because healthy feet are happy feet!

Heel Pain- the most common complaint from runners caused by inflammation of the ligament which holds up the arc, known as Plantar Fasciitis

Causes:

• Plantar Fasciitis is classified as an overuse injury, the same as tendonitis. Sudden increase of activities such as going on vacation, starting a new exercise routine or changing jobs can contribute.
• Wearing non-supportive footwear on hard surfaces puts abnorman strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one's job requires long hours on the feet.
• During the summer months, we see an increased number of patients in our offices with plantar fasciitis due to walking barefoot or wearing flip flops. Obesity may also contribute to plantar fasciitis.

Neuromas- A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton's neuroma, which occurs at the base of the 3rd & 4th toes.

The thickening, or enlargement, of the nerve that defines a neuroma is the results of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.

What Causes a Neuroma?

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that a tapered toe box, or high-heeled shoes that cause the toes to be forced into the toe box.

Tendonitis- The Achilles tendon is the largest tendon in the human body and is very strong, but is also the tendon we rupture most often. Everyone who is active can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.

Treatment depends on the degree of injury to the tendon, but normally includes rest, which may mean a total withdrawal from running or exercise for a week, or simply switching to another exercise, such as swimming, that does not stress the Achilles tendon.

Stress Fractures:

A stress fracture usually occurs in the feet and legs. They are more common in sports like running or jumping, because this type of activity forces 2-3 times the person’s body weight onto the lower limbs. The biggest symptom with a stress fracture is pain with tenderness and swelling that worsens with weight-bearing exercise.

Make sure to see a podiatrist so we can keep you active into your late, late years!

A Common Problem: Heel Pain

Do you have heel pain? Listen up for some treatment options:

Ankle Injuries: More than just an annoyance

Though ankle injuries are painful when they first occur, the long term damage that is caused can be even more detrimental. Ankles that have suffered an injury are seven times more likely to become arthritic that ones that have seen no trauma. Injuries can very in severity and still have the same long term affects. From inconspicuous reoccurring ankle sprains to more seemingly detrimental ankle fractures or broken bones, the damage that is caused is irreversible. Ankle cartilage is quite strong and can usually withstand a life time of movement but when the cartilage gets damaged its cells are unable to be repaired. Cartilage is made to glide smoothly to create movement but when it becomes worn or frayed the movement is not fluid. This leads to swelling, inflammation, and pain in the ankle joints. If proper treatment is not attained after the injury, post-traumatic ankle arthritis could very well occur in the future.

A study taken from 1991-2004 at the University of Iowa, studying 639 patients with grade 3 or 4 arthritis concluded that ankle injury is the most common cause of ankle arthritis. Trauma was the primary cause of arthritis in 445 patients out of the 639 patients surveyed. That is about 70%. The other 30% was caused by rheumatoid disease and primary osteoarthritis.

Symptoms of ankle arthritis include: pain or tenderness, stiffness or reduced motion, swelling, difficulty walking, bone spurs, and instability. No matter what stage of arthritis is present, or if arthritis is just a possible threat in the future, professional care should be sought. Podiatrists everywhere have many surgical and non-surgical options to help cope with the pain, prevent arthritis from over running everyday life, and catch arthritis before it become a problem.

Unhappy Feet

No, this is not a parody of the popular cartoon children's movie with the tap dancing penguins. It actually has more to do with the fact that fall sports are kicking off - literally, and as a former soccer player myself, we don't always listen to what are feet are telling us.

“Athletes will play through a level of pain in their feet that, if they felt it in their knees or their shoulders, they’d be hammering at a surgeon’s door,” says Glenn Pfeffer, the director of the Foot and Ankle Center at Cedars-Sinai Medical Center in Los Angeles. Aching feet are the “forgotten stepchild” of sports injuries, he adds.

He's absolutely right! When I read that, it took me way back to high school. I remember first hand how much I paid for ignoring my own foot pain.

I played an entire game in high school with an aching pain in my right foot, but I didn't even let it phase me. I was completely focused on the win. This was one of the biggest games of our season against our rival team. All I could think about as we were getting ready to take the field was my dad's favorite "motivational" (I use that description loosely) saying. "Walk if off girl, walk it off. Be a champion." So that's just what I did. Only instead of walking, I was running, pivoting, kicking, and juggling all at full speed, for about 2 hours. Probably not the best choice I had ever made, then again I was a teenager.

By the end of the game, my adrenaline was through the roof because we had one by one goal when we were not the favored team. I couldn't even feel the pain anymore. It was the best feeling in the world...until I took off my cleats and socks. My foot was swollen to twice it's normal size and there was extensive noticeable bruising. Oops!

To make a long story short, I had just played that game with a navicular fracture. A bone in the middle of my foot was broken and I had no idea. Apparently, it was due to forcing too much stress on my foot without enough recovery time. I was also told that it appeared that the fracture was severely worsened by playing in that game. Had I been responsible and listened to what my body was trying to tell me and sat that game out, I may have gotten to finish out the season only missing a few games for recovery. Since I played, I was forced to sit on the bench the rest of the season and I missed indoor tryouts for the winter season.

We really don't think too much about what are bodies are trying to tell us. Especially our feet since most of the time we attribute our discomfort to walking too much, wearing the wrong shoes, or just being plain old tired. Of course, sometimes those things are true, but if you truly enjoy being active or playing sports, do you really want to be taking that risk?

I came across an article today from the NY Times that might be of some use. It explains just how serious this lack of "listening" to our feet really is. They use Kobe Bryant as a prime example. In 2004, he had a serious struggle with plantar fasciitis, which is an extremely painful heel condition. Can you imagine being a basketball player, worth millions, and having to play the game of your career with crippling pain in your feet? I sure can't (partly because I'm a terrible basketball player and no ever paid me to play soccer - but that's beside the point.)

If you're an athlete, a parent or friend of an athlete, or even a person that just likes to got out and start pick up games I strongly encourage you to check out this article from the NY Times. And next time your feet are trying to tell you something from way down there...LISTEN UP!

Heel Pain from...Stilettos?

While us commoners might not have heel pain from Mr. Choo, Vuitton or Blahnik, we still wear our beloved 4-inch stilettos (maybe their Steve Maddens or Sam Edelmans…) When our heels, however, constrict our foot, we are bound to have increased foot pain ranging from hammertoes or “simply” bunions, corns or calluses. That’s not going to keep us from wearing those shoes on our weekend nights or working girl days, so what precautions can we take to prevent that want of taking them off 15 minutes after we put them on?

• Make sure the shoe fits- yes, you might encounter a deal that’s too good to pass up at T.J. Maxx but if you only wind up wearing them for half the night because they’re too tight, they will only take up valuable closet space!
• Where does it hurt? – If your entire foot endures pain, get a shoe length cushion insole, or if its just the balls of your feet, purchase silicone metatarsal pads
• Thicker heels- we’re in luck ladies, the thick heel is on it’s way back! This helps relieve some pressure from the foot rather than the pin needle heels
• Gradual slope- do most of your heels look like you’re going to fall face-forward when you stand in them? Try looking for cute heels that have a gradual slope instead to alleviate some pressure on the ball of the foot
• Open-toe heels- this style might not always be possible, but again panty hose with open toe heels is back (dark tights + dark heels). Open-toe heels help reduce corns and calluses which should be removed by a podiatrist