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

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

Reflexology

English: Foot reflexology is a "pressure therapy" and involves applying focused pressure to certain known reflex points located in the foot to cure or prevent disease. (Photo credit: Wikipedia)

Therapeutic reflexology, a popular therapy around the world, involves massaging the nerve endings of the feet to reduce stress and tension and promote healing in other areas of the body. The practice is based on the ideas that our body parts are reflected in the feet, with the front of the body on the sole of the feet and the back of the body on tops. For example, massaging the toes can help relieve headaches and other symptoms in the head. Massaging the ankle bone can help with hip problems. The feet have always played an important role in healing and reflexology dates back to 2500 BC. Some podiatric offices are now hiring therapeutic reflexologists as a complementary service.

It’s always a good idea to listen to your feet, as they often have lots to tell you, including giving you clues about the rest of your body’s well-being. When  your feet tell you there’s trouble somewhere, as your podiatrist, Shenandoah Podiatry will work as a team with you to keep you and your feet healthy and pain free. Feet that feel good mae the rest of you feel good, too so why not give us a call and start the process of feeling better today!

Shoe Selection

Choosing the “right” shoe for walking, or any activity for that matter, can prevent needless foot related injuries and discomfort. If the average person takes 8,000 to 10,000 steps a day, it becomes clear, selecting the “correct” shoe is paramount. Here’s how to select a walking shoe that’s right for you.

Analyze your feet

Not all feet are the same. They are complicated and intricate structure of bones, joints, ligaments, and tendons working in concert to support our body weight on varying surfaces. And they come in many different sizes and shapes. For the most part, feet fit into three categories:

• Low arched, straight foot
• Medium arched, slightly curved foot
• High arched and usually more curved foot

Know your body weight

Body weight can factor into the shoe selection process. Increased weight places more demands upon your feet. Since this is the case, consider increasing the level of protection a shoe can offer by selecting a shoe from a greater controlling category (see “select running shoe type”). For example, you may opt for a motion control shoe rather than a stability shoe or a neutral shoe. Just remember to make sure the shoe fits comfortably on your foot before you purchase it. Consider trying on shoes near the end of the day when your foot is at its largest. And use the socks or stockings that you intend to wear with those particular shoes.

Select a running shoe type

Running shoes can usually be divided into three overall functional types

• Motion Control shoes are typically based upon a straight design and are usually suited for people with low arched, straight feet
• Stability type shoes are for those individuals with a medium arched foot (typically deemed “normal”) and have a slight curve to the shape of the shoe.
• Neutral Type shoes are based upon a curved design and best fit those individuals with a high arched foot.

As you examine shoes from each of these categories, you’ll notice the motion control shoes become the most rigid and resistant to twisting and bending. Several shoe manufacturers, including Asics, Brooks, Etonic and Reebok make walking shoes are approved by the American Podiatric Medical Association’s Seal of Acceptance.

Super Bowl 47 Injuries

As the two teams lined up for their grand entrances into the Superdome last night in New Orleans, some of the players were facing questionable injuries. Let's break them down (not literally):

• Ravens: WR Tandon Doss (ankle)
• Ravens: LB Dannell Ellerbe (toe, back)
• Ravens: FB Vonta Leach (knee, ankle)
• Ravens: LB Terrell Suggs (achilles, bicep)
• 49ers: TE Garrett Celek (foot)
• 49ers: S Dashon Goldson (foot)
• 49ers: RB Frank Gore (ankle, shoulder)

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It's unfortunate it doesn't matter which sport you play, you're likely to get injured. However, in order to not keep you off your feet for too long with an injury, stop playing when it hurts. We don't like to hear, "play through the pain," it's more likely the injury will get worse if you just ignore it! Both our Blacksburg and North Roanoke offices see athletes of all levels daily. From Virginia Tech players to Hollins, our goal is to get them back on the playing field in the appropriate time frame. If you are having any kind of discomfort in your lower extremity, please take our advice and seek professional help. It may be a quick fix or a boot may be necessary- but the sooner the better!!

Why Do Diabetics Need Special Shoes?

There’s a question that we get in our Blacksburg and Roanoke offices quite frequently – and that is, “Why is it that your diabetic patients require special shoes?”

To understand the answer to this question, one must first understand the diabetic foot. One big reason why it is important for any diabetic person to carefully monitor and control blood glucose levels is that when uncontrolled, many complications can arise. Some complications that are frequently seen in our office are nerve damage, decreased blood flow, and foot and joint problems. All of these problems can and do affect the feet.

Besides the bladder, bowel and stomach issues that can arise from diabetic neuropathy, poor sensation can have devastating effects on a patient’s feet without proper care and attention. Inability to feel pain, pressure or temperature can easily allow for rubs, blisters, burns and other injuries to go unnoticed.

Feet are sensitive and the blood supplying oxygen to the lower extremities may be reduced without you even being aware of it. The decreased oxygen delivery to the feet from poor circulation results in slower healing and nail growth.

Uncontrolled blood glucose levels can be inherently dangerous. “Rollercoaster” blood sugar levels can damage tissues and cells. An elevated blood glucose level can cause dehydration and dryness of the skin as well as promote the growth of bacteria and fungi (since sugars are a good food source for these organisms). Because of this, bladder, gum, and skin infections are common in our diabetic patients with high sugar levels. 

So, Why Special Shoes?

-          Proper shoes are the first line of defense against injury and infection.

-          Well fitting shoes are comfortable and allow proper circulation in the feet.

-          Proper shoes will allow your feet to breathe while still protecting them.

-          Proper shoes can prevent the development of ulcers, blisters and fungus.

How are these shoes different?

-         Deeper and wider to accommodate diabetic inserts, allow more room for feet, and reduce possible pressure points.

-         These shoes provide excellent support which is recommended for anyone buying shoes.

-         Most have a breathable fabric upper to promote good air circulation within the shoe.

-         Most are custom ordered for size or even custom molded to a patient’s foot.

-         The toe boxes are roomier to prevent pinching or squeezing the toes as well as to allow for more room for foot deformities.

-         Many are easily adjustable or have elastic which makes it easier to put on without making the shoe too tight or too loose.

-         Available with Velcro to make putting on shoes easier for patients with peripheral neuropathy who can not feel their fingers well enough to lace shoes. 

 

If you are interested in a pair of these shoes for a loved one or yourself, please give our office a call at (540) 808-4343!

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.

What Does a Podiatrist Do?

A Podiatrist is a foot and ankle specialist- we offer all services listed below and more!

Dr. Kate Steklachich

Dr. Jennifer Feeny

• Surgeries- everything from removing a bunion to reconstructive surgeries 
• Bunions
• Warts
• Ingrown Toenails
• Routine/Diabetic Foot Care
• Custom Orthotics & Over the Counter Orthotics
• Heel Pain/Plantar Fasciitis
• Heel Spurs
• Bone Spurs
• Neuropathy
• Neuroma
• Corns/Calluses
• Athlete's Foot
• Nail Fungus
• Injuries

The list can really go on and on! Our Blacksburg and Roanoke offices want to stress that we specialize in feet and ankles. A lot of people may think going to a general surgeon or orthopedist for surgery is a better idea than a podiatrist for a problem they are having with their feet or ankles. However, because we specialize and are day in and day out dedicated to this specific area- we know it best! If you have a question about a condition, pain or something else you are experiencing and it isn't listed here or our website- give us a call! We are happy to answer any questions you may have. 

Foot Care & Diabetes

Q: Could I develop a Diabetic Foot Ulcer?
A: Nearly 25% of Veterans are diagnosed with diabetes. General risk factors for diabetes include obesity, high blood pressure, sedentary lifestyle, and prediabetes, to name a few. However early diabetes screening allows Veterans to make changes to their lifestlye and take advantage of annual foot screenings in our offices in Blacksburg and Troutville, VA to help manage diabetes complications such as Diabetic Foot Ulcers (DFUs).



Q: What if I develop a Diabetic Foot Ulcer?
A: People with diabetes have a 15-25% lifetime risk of developing a DFU, many of which are often associated with impaired blood flow and may not heal within an appropriate time frame. If you develop a DFU, immediately come to our office!

Q: Why should I seek treatment?
A: If left untreated, DFUs can become infected and may lead to serious complications. If detected and treated early, many of these complications can be averted. With the multitude of resources available to Veterans with diabetes, never hesitate to seek immediate medical attention when you become aware of a foot wound.

Don't put medical attention off! Always promote preventative care!

Home Remedies for Foot Cramps

Have you ever heard or tried any of these home remedies before? Well, they're worth a shot! If you are experiencing a foot cramp, or more commonly called a charlie horse, try these on for size:

• A plain, original scent, brand name bar of Dove soap placed under the sheet at the end of the bed when you go to sleep at night (Grandma Stek highly recommends this!)
• Drink 6oz of tonic water before bed (Gin isn't necessary)
• Take 3 teaspoons of yellow mustard throughout the day (can be taken by the teaspoon or with food)
• Drink one cup of gatorade right before bed
• Drink 8-10 glasses of water every day

If you want to go extra strength, combine the tonic water and gatorade and drink right before bed!




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Now these are not guaranteed to work but again, they're worth a shot!

- Dr. Kate

How Does He Do It?

Last week Dr. Feeny and I traveled to Las Vegas for a Marketing Summit and had to stop in front of Bally's to watch a performer.

But how do they do that??

I did a little research and here are the steps on how to moonwalk:

1. Get a pair of shoes with flat soles (i.e. converse or keds)
2. Get on a flat surface that won't provide much friction (i.e. wood floor) ideally you would practice at a skating rink
3. Point your left toe on the floor (but it really doesn't matter which foot you use first)
4. Place your right foot ~1 foot in front of left foot
5. Slide your right heel back so it's even with your left foot
6. As soon as you slide it back, snap your right heel up so it's pointed (like step #3)
7. Repeat!
8. You are now a Michael Jackson Moonwalker!

And here is what you can look like if you keep practicing!

Shoe Shopping Tips

Here are some tips to help reduce the risk of foot problems. Use this guide when you shop for shoes:

• Fit new shoes to your largest foot. Most people have one foot larger than the other.
• Have both feet measured every time you purchase shoes. Your foot size increases as you get older.
• If the shoes feel too tight, don`t buy them. There is no such thing as a "break-in period."
• Most high heeled-shoes have a pointed or narrow toe box that crowds the toes and forces them into an unnatural triangular shape. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.
• Shoes should be fitted carefully to your heel as well as your toes.
• Sizes vary among shoe brands and styles. Judge a shoe by how it fits on your foot - not by the marked size.
• There should be a half-inch of space from the end of your longest toe to the end of the shoe.
• Try on both shoes.
• Try on new shoes at the end of the day. Your feet normally swell and become larger after standing or sitting during the day.
• Walk around in the shoes to make sure they fit well and feel comfortable.
• When the shoe is on your foot, you should be able to freely wiggle all of your toes.
• Women should not wear a shoe with a heel higher than 2 1/4 inches.

If you have any hesitations about your shoe selections, make an appointment and we'll help identify what you should look for in a shoe with your specific foot shape (high arches, high instep, etc.)!

"He Got Cold Feet"

Ever heard the saying, "He/She got cold feet," usually referring to backing out before a wedding ceremony? Well, where did it come from? How does "cold feet" have anything to do with having apprehensions about making a commitment?

After a little research, it seems there are a couple tales of where this phrase originated, which are pretty interesting!

• The wartime usage of "cold feet" has led some to claim that the phrase originally referred to soldiers whose frost-bitten toes prevented them from entering a battle.
• Hotfoot is used for someone keen to get somewhere - perhaps cold feet are the opposite

Have you heard of any other origins of the phrase "cold feet"? Share with us below!

Why Danskos?

Red Danskos

I wear my Danskos everyday in the office, call me a loyal customer! Every once in a while I get asked why I like them so much so here's why:

1) They're deep & wide to accomodate most foot types
2) I can fit extra padding in them if necessary including my orthotics
3) No they're not the most fashionable shoes, but they're certainly not the ugliest!

One thing I do want to point out if you're researching them is while they are perfect for work, they're not great for uneven terrain so I don't recommend them for unstable ankles!

Click here if you're interested in purchasing them and if you're already a Dansko fan let us know what you like about them!

-Dr. Kate

Virginia Tech is Going Green

After VT's wide receiver, D.J. Coles, PCL ligament heeled the team had their hopes up. Soon after however, linebacker, Tariq Edwards, suffered a stress fracture in his shin which hasn't been healing well after the mishap earlier this year. The hopes for an injury-free season starter diminished even more after left guard, David Wang, sprained his left ankle.

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Wang received surgery and was placed in a green jersey (no contact) for a recent closed mini-scrimmage. Last season Wang was named most improved offensive player only to break his foot in the second game of the season!

Although Wang seems to be doing better, a number of other players were in green jerseys which several are suffering from a hamstring injury.

Good luck, Hokies! We hope your injuries heal correctly and quickly!!

Jack Daniel's Interesting Cause of Death

Did you know Jack Daniel, the famous distiller, died of a foot infection? Well, we learn something new everyday!

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Jack Daniels Logo (Photo credit: Wikipedia)



Jack Daniel had an infection that apparently started in his toe after kicking his safe (probably made of cast iron- so not a good idea!) out of anger. He often joked, "all I have to do to cure the infection is soak my toe in my own whiskey!"

The infection then lead to blood poisoning which Daniel died of in 1911.

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!

Wireless Shoe Inserts

A Canadian company is producing a wireless shoe insert which supposedly will monitor the pressure people put on their feet. This will be particularly helpful for diabetics which often receive diabetic foot ulcers and numbness leading to amputations.

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Due to the numbness, diabetics don't feel pain in their feet which this new insert will help. A watch is worn with the inserts and will trigger if people are putting too much pressure on their feet and risking numbness.

The product is currently under approval so we'll see what comes of it! Hopefully this or something like it will be available soon to prevent more and more amputations everyday.