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!

Heels, Yeah!

Extracted from Shape Magazine November 2013

After one hour and six minutes of wearing heels, most women are in pain, a new U.K. survey found. Still, more than 40% say they're willing to suffer for fashion. Sound familiar? Lessen the hurt with these tips from heel-wearing podiatrists in New York City:

1. Find the Right Fit: Narrow feet can slip around in shoes, so choose a heel with an ankle strap for added stability, Krista Archer suggests. If you have wide feet, your best bet is a wedge with a rounded toe box, which is more forgiving on joints than pointy-toed stilettos.
2. Be a Pencil Pusher: "Slip off your shoes under your desk at work, put your feet together and try to pick up a pencil with your toes to activate the 38 muscles in each foot and strengthen your arches," Suzanne Levine advises.
3. Stretch It Out: "Over time, wearing heels of the same height will cause your Achilles tendons to tighten and shrink, which can lead to pain," Jacqueline Sutera says. Do a few downward dog stretches each night to release tension in the back of your legs. 

foot with narrow flats on

foot without shoes on

If you notice deformities developing (hammertoes, bunions, taylor's bunion) or pain from your current deformities, don't hesitate to give us a call. There are plenty of conservative and surgical treatments available!

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