Did a Frog Kiss My Childs Feet?
If you’ve noticed new, small areas of growth on the sole of your child’s foot recently, there’s no need to panic! They may have been kissed by a frog, but more than likely your child has been exposed to Human Papilloma Virus (HPV); a virus that can infect the skin leading to the development of plantar warts. Plantar warts are the most common infection of the skin caused by a virus and are typically seen in patients ranging in age from 12-16.
HPV is a virus that can infect several areas of the body, including the soles of the feet, and is spread via direct contact to the skin. Most often it comes in contact with the skin when patients go barefoot in public showers where the virus has been left behind by another individuals feet. It is important to keep in mind that the strain of HPV causing plantar warts cannot be spread to other areas of the body, such as the mouth or genitals.
The incubation period for HPV on the sole of the foot ranges anywhere from 1 to 20 months, thus it can be difficult to determine when and where the virus was picked-up by the patient. Once it does present itself it may go undetected, as many patients do not experience symptoms such as pain or do not notice a change in the skin on the sole of the foot. Infection is often disregarded as a callus in the early stages, due to increased thickness of the skin, overlying the area where the virus lives. One defining feature of plantar warts is the presence of small, black circular dots just visible underneath the skin. These “dots” are areas of blood, contained in capillaries that in a healthy foot are not seen, as capillaries typically do not extended into visible areas of the skin on the foot. However, as the HPV grows and comes up towards the surface of the foot, it stimulates blood supply to come with it, helping the virus thrive.
Warts can resolve on their own, as the body’s immune system attacks the virus and rids it from the body, but not all warts will resolve without treatment. Over the counter methods that can be tried include Salicylic Acid preparations (pads, liquid, gel, or ointment) and Vitamin A, in addition to keeping feet clean and dry to eliminate moisture and decrease the viruses chance to thrive. All of the above mentioned options are likely to work on new infections, but for warts that are long-standing, professional treatment from your Podiatrist is recommended.
Depending on the severity and length of infection time, there are many treatment options that can be utilized by your Podiatrist. Selection of a method will both be based on your Podiatrists opinion and evaluation of your child’s infection as well as discussion with you, the parent, to help determine which treatment methods can be tolerated by your child. Acids and ointments, similar to those available over the counter include Canthrone, Efudex and Salicylic Acids. If such treatments fail, cryotherapy (freezing of the wart with sodium nitrate) can be utilized causing the wart to turn black, and eventually fall off. This treatment is slightly more painful than some other options and often requires several applications for success. Debridement, or trimming and cutting out of the wart can be successful, but to ensure that enough of the wart is removed to prevent recurrence local anesthetic, injected with a needle, must be used. Laser treatment is a relatively new method of treating warts and is generally clean, accurate and effective in riding your child of the infection. There is minimal to no pain associated with treatment, making it a good choice! Marigold therapy (the flower), even newer than laser treatment, has shown incredible success in treating HPV infections on the plantar surface of the foot, and is great for children as it is non-invasive and induces no pain. The only downfall with Marigold therapy is its limited availability in offices across the country.
This month we will be focusing on your child and their feet! Check back next week for information on another common Podopediatric problem: ingrown toenails. You’ll learn the best way to trim your child’s nails, and other tricks for preventing an ingrown.
Friday, April 23, 2010
How to Tell if Your Child Will Suffer from Foot Abnormalities in the Future!
How to Tell if Your Child Will Suffer from
Foot Abnormalities in the Future!
Commonly, parents will present to the Podiatrists office with their 16 or 17 year old son or daughter who has been complaining of recent pains or aches in their legs and/or feet. When they find out that their child’s current foot problem was one that could have been diagnosed and corrected much earlier in life, parents become upset and wonder why their Pediatrician never said anything! It is becoming less often the case, but Pediatricians have long believed that children will “out grow” their foot problems and that it is nothing to worry about. We now know that this is not the case, and dismissing earlier indicators can lead to severe problems in a child’s early adult life and on occasion surgical interventions are required.
It is often difficult to tell before your child begins to walk if they are experiencing trouble, pains or aches, because without bearing weight on their feet it is impossible to know how those feet will feel. However, you can help catch abnormalities early on, just by using your eyes! Look at your infant’s feet: does something look abnormal? If there is something that sticks out to you, contact your Podiatrist. Many Podiatrists specialize in Pediatrics, and if they don’t they know someone who does! It never hurts to have a professional assess your child’s foot and leg position early on. If there is no abnormality present, all the better, but if there is one present, it has now been detected early on and can be monitored or corrected from the start.
Once your child does begin to walk there are a few important indicators that may signal a foot problem, and that you as parents can easily identify.
Toe Walking: Infants will commonly walk on their toes, which can be normal, but what isn’t normal is persistent toe walking. If you find that your child continually walks on their toes, it might be wise to have your child evaluated.
Pain: Children should never complain of muscle or joint pain. If your little one starts to complain of foot, knee or hip pain, it is worth have a professional investigate its source.
Family History: If you as parents have suffered from a foot problem, it is possible that you have passed on that same wonderful foot-type to your child, and they are likely to follow suite with presentation of foot problems.
In-Toeing: In-toeing is never normal in a child and can signify a rotation in your child’s foot, leg, thigh or hip! Do not let anyone tell you that your child will outgrown this problem. In-toeing can be indicative of a common but more serious abnormality in your child’s feet and with early intervention, casting and bracing can correct this deformity. If left untreated it can cause complications down the road for your child, and often they will require surgery for correction. A sign of in-toeing, to the untrained eye comes with activity by your child. Your child’s schoolteacher may inform you of frequent falling or tripping and withdrawal of your child from activities at school and these are all comments you should take seriously. Bring your child in to see a Podiatrist for evaluation.
If your child has an identified abnormality that a Podiatrist would like to initiate treatment for, first get a second opinion. It is always important to investigate all options, and hear several opinions before making a decision. Secondly, it is important that you, as the parent, take an active role in your child’s treatment plan. So many times casting and bracing regimens fail because parents do not want their child to wear a brace or leave the casting on for the specified time period. As Podiatrists, we understand that it is not an easy thing to see your child confined by their treatment modalities, but I assure you, early intervention is the key to successful treatment. Being lackadaisical with treatment leads to recurrence of their initial abnormality and again, leads to complications later in life that may require surgery.
As mentioned, if you do notice any of the signs and symptoms mentioned above, it is important that you see a Podiatrist for evaluation of your child’s feet. However, do not hesitate to contact your local Podiatrist if none of those signs or symptoms are present. It may help give you peace-of-mind to have your child evaluated for safe measures. It can assure you that everything looks as it should, and it will help you build a relationship with a Podiatrist who knows your child and can monitor them on a yearly basis to ensure their feet continue to look health and structurally normal.
Foot Abnormalities in the Future!
Commonly, parents will present to the Podiatrists office with their 16 or 17 year old son or daughter who has been complaining of recent pains or aches in their legs and/or feet. When they find out that their child’s current foot problem was one that could have been diagnosed and corrected much earlier in life, parents become upset and wonder why their Pediatrician never said anything! It is becoming less often the case, but Pediatricians have long believed that children will “out grow” their foot problems and that it is nothing to worry about. We now know that this is not the case, and dismissing earlier indicators can lead to severe problems in a child’s early adult life and on occasion surgical interventions are required.
It is often difficult to tell before your child begins to walk if they are experiencing trouble, pains or aches, because without bearing weight on their feet it is impossible to know how those feet will feel. However, you can help catch abnormalities early on, just by using your eyes! Look at your infant’s feet: does something look abnormal? If there is something that sticks out to you, contact your Podiatrist. Many Podiatrists specialize in Pediatrics, and if they don’t they know someone who does! It never hurts to have a professional assess your child’s foot and leg position early on. If there is no abnormality present, all the better, but if there is one present, it has now been detected early on and can be monitored or corrected from the start.
Once your child does begin to walk there are a few important indicators that may signal a foot problem, and that you as parents can easily identify.
Toe Walking: Infants will commonly walk on their toes, which can be normal, but what isn’t normal is persistent toe walking. If you find that your child continually walks on their toes, it might be wise to have your child evaluated.
Pain: Children should never complain of muscle or joint pain. If your little one starts to complain of foot, knee or hip pain, it is worth have a professional investigate its source.
Family History: If you as parents have suffered from a foot problem, it is possible that you have passed on that same wonderful foot-type to your child, and they are likely to follow suite with presentation of foot problems.
In-Toeing: In-toeing is never normal in a child and can signify a rotation in your child’s foot, leg, thigh or hip! Do not let anyone tell you that your child will outgrown this problem. In-toeing can be indicative of a common but more serious abnormality in your child’s feet and with early intervention, casting and bracing can correct this deformity. If left untreated it can cause complications down the road for your child, and often they will require surgery for correction. A sign of in-toeing, to the untrained eye comes with activity by your child. Your child’s schoolteacher may inform you of frequent falling or tripping and withdrawal of your child from activities at school and these are all comments you should take seriously. Bring your child in to see a Podiatrist for evaluation.
If your child has an identified abnormality that a Podiatrist would like to initiate treatment for, first get a second opinion. It is always important to investigate all options, and hear several opinions before making a decision. Secondly, it is important that you, as the parent, take an active role in your child’s treatment plan. So many times casting and bracing regimens fail because parents do not want their child to wear a brace or leave the casting on for the specified time period. As Podiatrists, we understand that it is not an easy thing to see your child confined by their treatment modalities, but I assure you, early intervention is the key to successful treatment. Being lackadaisical with treatment leads to recurrence of their initial abnormality and again, leads to complications later in life that may require surgery.
As mentioned, if you do notice any of the signs and symptoms mentioned above, it is important that you see a Podiatrist for evaluation of your child’s feet. However, do not hesitate to contact your local Podiatrist if none of those signs or symptoms are present. It may help give you peace-of-mind to have your child evaluated for safe measures. It can assure you that everything looks as it should, and it will help you build a relationship with a Podiatrist who knows your child and can monitor them on a yearly basis to ensure their feet continue to look health and structurally normal.
Happy National Foot Health Awareness Month!
Happy National Foot Health Awareness Month!
The month of April is designated toward brining Foot Health to the forefront of conversation, so that will be the intention of the Blog this month. Keeping your feet in their best condition can make you feel better all over. We all know, when our feet hurt, our entire body hurts!
Did you know…
- Each foot is composed of 26 bones (together both feet contain 1/4 of the bones in the entire body), 33 joints and over 100 muscles and tendons.
- The average person, over their lifetime, will walk approximately the same distance as if they had walked around the earth 4 times.
- 1.5 times a person’s body weight is transmitted through your foot with every step!
Although your Podiatrist is the authority on everything “feet,” caring for your feet and keeping them healthy is something that you can do at home.
1. Keep feet clean and dry. In the shower make sure you scrub feet well and dry thoroughly, including between the toes. Following this simple rule will decrease your chance of infections such as athlete’s foot, plantar warts and fungal infections of the nails.
2. Trim nails straight across. This technique is the proper way to trim a nail and will prevent your risk of ingrown toenails. If you have difficulty seeing your toenails well enough to trim them, try using an emery board.
3. Wear comfortable and supportive sneakers when participating in activities. Wearing supportive sneakers decreases your risk of injury, especially ankle sprains/strains. To check your sneakers for support you can use these simple tests:
a. Holding the heel of the shoe in one hand and the toes of the shoe in the other, try to bend the shoe in half, upwards, bringing the heel and toe of the shoe together. There should be some give, but you should not be able to bend the shoe in half.
b. Holding the shoe in one hand so that the heel of the shoe is facing you and the toes of the shoe are facing away, use your other hand to squeeze the heel of the shoe from side to side. The heel should not collapse and if it does, it means there is little support for your heel and ankle in that shoe.
4. Always put on a clean pair of socks. Economically speaking it may be easier to wear a pair of socks twice, especially if you’ve only worn them for a few minutes or just around the house. However, any dirt or bacteria that was on your feet the first time you wore those socks is still in there for the second wear. It’s best to get a clean pair!
5. Never go barefoot. Not only does going barefoot decrease the support provided to your foot, but also leaves you vulnerable to injury. Stubbing a toe or stepping on a piece of glass can lead to complications that you would rather avoid and may include weeks of recovery.
6. If you’re diabetic, this is the month to make your Podiatric Check-up appointment! Your podiatrist will be able to check the blood flow to your feet as well as your “protective sensation,” which can indicate that you are at risk for ulcerations. Both sensation and blood flow, along with your ability to heal wounds decreases the longer you have been a diabetic. It’s important to get checked so you know where you stand and protective measures can be taken to prevent loss of these attributes. For uncomplicated diabetics, an appointment every 6 months is sufficient. If you do have diabetic complications, every 3 months is recommended.
7. If you’re not diabetic, you don’t necessarily need to make a Podiatrist appointment, as the advice above should help keep your feet healthy! However, if you notice any abnormalities, injuries, or signs of infection, you should schedule an appointment as soon as possible.
I hope these tips bring you “happy feet” that stay healthy and pain-free!
The month of April is designated toward brining Foot Health to the forefront of conversation, so that will be the intention of the Blog this month. Keeping your feet in their best condition can make you feel better all over. We all know, when our feet hurt, our entire body hurts!
Did you know…
- Each foot is composed of 26 bones (together both feet contain 1/4 of the bones in the entire body), 33 joints and over 100 muscles and tendons.
- The average person, over their lifetime, will walk approximately the same distance as if they had walked around the earth 4 times.
- 1.5 times a person’s body weight is transmitted through your foot with every step!
Although your Podiatrist is the authority on everything “feet,” caring for your feet and keeping them healthy is something that you can do at home.
1. Keep feet clean and dry. In the shower make sure you scrub feet well and dry thoroughly, including between the toes. Following this simple rule will decrease your chance of infections such as athlete’s foot, plantar warts and fungal infections of the nails.
2. Trim nails straight across. This technique is the proper way to trim a nail and will prevent your risk of ingrown toenails. If you have difficulty seeing your toenails well enough to trim them, try using an emery board.
3. Wear comfortable and supportive sneakers when participating in activities. Wearing supportive sneakers decreases your risk of injury, especially ankle sprains/strains. To check your sneakers for support you can use these simple tests:
a. Holding the heel of the shoe in one hand and the toes of the shoe in the other, try to bend the shoe in half, upwards, bringing the heel and toe of the shoe together. There should be some give, but you should not be able to bend the shoe in half.
b. Holding the shoe in one hand so that the heel of the shoe is facing you and the toes of the shoe are facing away, use your other hand to squeeze the heel of the shoe from side to side. The heel should not collapse and if it does, it means there is little support for your heel and ankle in that shoe.
4. Always put on a clean pair of socks. Economically speaking it may be easier to wear a pair of socks twice, especially if you’ve only worn them for a few minutes or just around the house. However, any dirt or bacteria that was on your feet the first time you wore those socks is still in there for the second wear. It’s best to get a clean pair!
5. Never go barefoot. Not only does going barefoot decrease the support provided to your foot, but also leaves you vulnerable to injury. Stubbing a toe or stepping on a piece of glass can lead to complications that you would rather avoid and may include weeks of recovery.
6. If you’re diabetic, this is the month to make your Podiatric Check-up appointment! Your podiatrist will be able to check the blood flow to your feet as well as your “protective sensation,” which can indicate that you are at risk for ulcerations. Both sensation and blood flow, along with your ability to heal wounds decreases the longer you have been a diabetic. It’s important to get checked so you know where you stand and protective measures can be taken to prevent loss of these attributes. For uncomplicated diabetics, an appointment every 6 months is sufficient. If you do have diabetic complications, every 3 months is recommended.
7. If you’re not diabetic, you don’t necessarily need to make a Podiatrist appointment, as the advice above should help keep your feet healthy! However, if you notice any abnormalities, injuries, or signs of infection, you should schedule an appointment as soon as possible.
I hope these tips bring you “happy feet” that stay healthy and pain-free!
Salon Smarts
Salon Smarts
It’s no secret that when the weather starts to heat up we all have a hard time facing our toenails, especially the ladies! It’s during this time of year that men and women alike head to their local nail salons to give their feet and toes the “royal treatment” ensuring they look their best for day one of “sandal weather!” Since we are focusing on foot health this month, I think it’s important for you to know how to be your own advocate in a nail salon, should you chose to get pedicures.
The most commonly seen consequence of pedicures is infection. The nail salon, with foot soaks, cuticle treatments and trimming of nails provides an excellent medium for bacteria to grab on to your toes and your nails leading to infection. Pedicures are not something that we, as Podiatrists endorse, but should you decide to get a pedicure anyway, here are some “salon smart” tips that will help you protect yourself!
1. Find a salon that is clean. Cleanliness won’t prevent infection, but it sure beats a salon that’s dirty. Make sure that your salon is cleaning out their foot basins and autoclaving their tools between clients. Look for bleach products on shelves and disposable pedicure sandals. All of these clues can indicate that your salon cares about their clients and they are committed to cutting your risk of infection following your pedicure.
2. Purchase your own pedicure tools. Most salons offer clients the option of purchasing tools that will only be used by that specific client. The salon will sterilize your tools and hold them in a box with your designated number on it. You can then rest assured knowing that only your nails and cuticles have been trimmed and cleaned using those tools.
3. Do not allow the pedicurist to push back your cuticles. Cuticles provide a barrier from infection and when cuticles are trimmed or pushed back, that barrier is broken. This increases the risk of infection, because ‘bugs’ now have an inlet. Just say no!
4. Do you have Diabetes? If so, do not get pedicures! As we’ve discussed in the past, diabetics have decreased blood flow to the parts of their body that are furthers from their heart, especially their toes. With decreased blood flow comes decreased ability to fight infection and decreased ability to heal a cut or wound on the toes. Pedicures are not worth the risk of infection.
5. Give your toes a breather! In the winter months and during weeks in the summer when you know you won’t be heading to a barbeque or to the beach, take any nail polish on your toenails off and let them have some air! It sounds silly, but nail polish acts as a sealant on your nails trapping in moisture. Moisture, as discussed before can lead fungal infections or staining of the nails, so every once in a while removing the nail polish is beneficial to your nail health.
Hopefully these tips will help you in selecting a salon for your next pedicure, but if you really don’t need one, or can give yourself an “at home pedicure,” its better to steer clear of the salon! Infection in your toes is worse than a nail or two that aren’t perfectly pedicured.
It’s no secret that when the weather starts to heat up we all have a hard time facing our toenails, especially the ladies! It’s during this time of year that men and women alike head to their local nail salons to give their feet and toes the “royal treatment” ensuring they look their best for day one of “sandal weather!” Since we are focusing on foot health this month, I think it’s important for you to know how to be your own advocate in a nail salon, should you chose to get pedicures.
The most commonly seen consequence of pedicures is infection. The nail salon, with foot soaks, cuticle treatments and trimming of nails provides an excellent medium for bacteria to grab on to your toes and your nails leading to infection. Pedicures are not something that we, as Podiatrists endorse, but should you decide to get a pedicure anyway, here are some “salon smart” tips that will help you protect yourself!
1. Find a salon that is clean. Cleanliness won’t prevent infection, but it sure beats a salon that’s dirty. Make sure that your salon is cleaning out their foot basins and autoclaving their tools between clients. Look for bleach products on shelves and disposable pedicure sandals. All of these clues can indicate that your salon cares about their clients and they are committed to cutting your risk of infection following your pedicure.
2. Purchase your own pedicure tools. Most salons offer clients the option of purchasing tools that will only be used by that specific client. The salon will sterilize your tools and hold them in a box with your designated number on it. You can then rest assured knowing that only your nails and cuticles have been trimmed and cleaned using those tools.
3. Do not allow the pedicurist to push back your cuticles. Cuticles provide a barrier from infection and when cuticles are trimmed or pushed back, that barrier is broken. This increases the risk of infection, because ‘bugs’ now have an inlet. Just say no!
4. Do you have Diabetes? If so, do not get pedicures! As we’ve discussed in the past, diabetics have decreased blood flow to the parts of their body that are furthers from their heart, especially their toes. With decreased blood flow comes decreased ability to fight infection and decreased ability to heal a cut or wound on the toes. Pedicures are not worth the risk of infection.
5. Give your toes a breather! In the winter months and during weeks in the summer when you know you won’t be heading to a barbeque or to the beach, take any nail polish on your toenails off and let them have some air! It sounds silly, but nail polish acts as a sealant on your nails trapping in moisture. Moisture, as discussed before can lead fungal infections or staining of the nails, so every once in a while removing the nail polish is beneficial to your nail health.
Hopefully these tips will help you in selecting a salon for your next pedicure, but if you really don’t need one, or can give yourself an “at home pedicure,” its better to steer clear of the salon! Infection in your toes is worse than a nail or two that aren’t perfectly pedicured.
Got Heel Pain??
Got Heel Pain??
I’m choosing to discuss heel pain during the month of April, National Foot Health Awareness Month, because it is an ailment that is seen again and again in any Podiatric practice and can usually be treated without surgery.
Heel pain syndrome, or Plantar Fasciitis, is irritation and inflammation of the foot’s plantar fascia: a band of tissue on the bottom of the foot that begins at the heel and fans out connecting into the toes. Picture a piece of rubber band along the bottom of your foot that with each step stretches and slacks, stretches and slacks. When the length of that piece of rubber band is too short or is stretched in the wrong direction, irritation can quickly result and heel pain becomes inevitable. Microscopic tears in the plantar fascia, resulting from this improper stretching, initiate the inflammatory and healing processes within the tissue.
Heel pain is often seen in patients with a flat foot because their plantar fascia is being stretched incorrectly. It can also be associated with unsupportive shoe wear, as the foot is not positioned optimally in a high heel or a flip-flop for example, and thus the plantar fascia can not function entirely as it was intended to.
When patients present to their Podiatrist complaining of heel pain, they will likely complain that pain is greatest with their first step out of bed in the morning and that pain decreases as they become more active throughout the day. The “First-Step” pain patients experience is called “Post-static Dyskinesia:” pain after periods without movement. As we said before, the plantar fascia tears microscopically leading to pain, inflammation, and with periods of rest, healing. When you step out of bed in the morning and stretch your plantar fascia, you re-tear all those areas of fascia that have started to heal, which is why that first step is so painful! As the day goes on, you tend to do more walking and moving around, and the fascia stretches and accommodates, resulting in slightly less pain than when you first awoke. Plantar fasciitis is a progressive syndrome, in that in the early months of heel pain patients are able to tolerate, but with each month that passes the pain increases, leading them to seek professional intervention by a Podiatrist!
Often, your Podiatrist will opt to take x-rays of your feet to rule out the possibility of fracture in addition to checking for a heel spur. It is important to note that a heel spur is not the cause of the pain, but more likely the spur is a result of the plantar fascia and other musculature of the leg and foot pulling on the heel bone. Often, heel spurs are an incidental finding and are not related to a patient’s complaint.
As for treatment, a variety of options can be explored and about 95% of patients with heel pain will experience relief without the use of surgical intervention! You will first be encouraged to wear supportive shoes at all times, helping to decrease unnecessary strain on the plantar fascia. You may also be given a series of calf and fascia stretching exercises to complete. Your plantar fascia pulls the heel bone in one direction and the muscle of the calf pull the heel bone in the opposite direction, thus when calf muscles are tight there is increased strain on the fascia. It may be recommended that a steroid be injected into the plantar fascia, which will attempt to break the inflammation cycle and encourage healing of the plantar fascia by your body’s own mechanisms. Ice, oral anti-inflammatory medications and limitations to activity are all additional things that are encouraged in order to rest the fascia and allow it to heal. Keep in mind that although 95% of patients will experience relief with conservative treatments, that relief may take several weeks to be realized – so be patient with your Podiatrist!
Surgery, as mentioned, is a LAST resort for patients with heel pain and even before invasive procedures are explored, there are options that are non-invasive. Some of which we will talk about in the coming weeks, including Acoustic Shock Wave Therapy; a treatment modality only offered by Advanced Foot Care Centers LLP of Chattanooga and North Georgia. Stay tuned or contact one of our offices (http://www.advancedfootcarecenters.com/contact/index.htm) if you can’t wait it out until next week!
I’m choosing to discuss heel pain during the month of April, National Foot Health Awareness Month, because it is an ailment that is seen again and again in any Podiatric practice and can usually be treated without surgery.
Heel pain syndrome, or Plantar Fasciitis, is irritation and inflammation of the foot’s plantar fascia: a band of tissue on the bottom of the foot that begins at the heel and fans out connecting into the toes. Picture a piece of rubber band along the bottom of your foot that with each step stretches and slacks, stretches and slacks. When the length of that piece of rubber band is too short or is stretched in the wrong direction, irritation can quickly result and heel pain becomes inevitable. Microscopic tears in the plantar fascia, resulting from this improper stretching, initiate the inflammatory and healing processes within the tissue.
Heel pain is often seen in patients with a flat foot because their plantar fascia is being stretched incorrectly. It can also be associated with unsupportive shoe wear, as the foot is not positioned optimally in a high heel or a flip-flop for example, and thus the plantar fascia can not function entirely as it was intended to.
When patients present to their Podiatrist complaining of heel pain, they will likely complain that pain is greatest with their first step out of bed in the morning and that pain decreases as they become more active throughout the day. The “First-Step” pain patients experience is called “Post-static Dyskinesia:” pain after periods without movement. As we said before, the plantar fascia tears microscopically leading to pain, inflammation, and with periods of rest, healing. When you step out of bed in the morning and stretch your plantar fascia, you re-tear all those areas of fascia that have started to heal, which is why that first step is so painful! As the day goes on, you tend to do more walking and moving around, and the fascia stretches and accommodates, resulting in slightly less pain than when you first awoke. Plantar fasciitis is a progressive syndrome, in that in the early months of heel pain patients are able to tolerate, but with each month that passes the pain increases, leading them to seek professional intervention by a Podiatrist!
Often, your Podiatrist will opt to take x-rays of your feet to rule out the possibility of fracture in addition to checking for a heel spur. It is important to note that a heel spur is not the cause of the pain, but more likely the spur is a result of the plantar fascia and other musculature of the leg and foot pulling on the heel bone. Often, heel spurs are an incidental finding and are not related to a patient’s complaint.
As for treatment, a variety of options can be explored and about 95% of patients with heel pain will experience relief without the use of surgical intervention! You will first be encouraged to wear supportive shoes at all times, helping to decrease unnecessary strain on the plantar fascia. You may also be given a series of calf and fascia stretching exercises to complete. Your plantar fascia pulls the heel bone in one direction and the muscle of the calf pull the heel bone in the opposite direction, thus when calf muscles are tight there is increased strain on the fascia. It may be recommended that a steroid be injected into the plantar fascia, which will attempt to break the inflammation cycle and encourage healing of the plantar fascia by your body’s own mechanisms. Ice, oral anti-inflammatory medications and limitations to activity are all additional things that are encouraged in order to rest the fascia and allow it to heal. Keep in mind that although 95% of patients will experience relief with conservative treatments, that relief may take several weeks to be realized – so be patient with your Podiatrist!
Surgery, as mentioned, is a LAST resort for patients with heel pain and even before invasive procedures are explored, there are options that are non-invasive. Some of which we will talk about in the coming weeks, including Acoustic Shock Wave Therapy; a treatment modality only offered by Advanced Foot Care Centers LLP of Chattanooga and North Georgia. Stay tuned or contact one of our offices (http://www.advancedfootcarecenters.com/contact/index.htm) if you can’t wait it out until next week!
If The Shoe Fits, It Doesn’t Mean You Need to Buy It!
If The Shoe Fits, It Doesn’t Mean You Need to Buy It!
As the weather is beginning to warm up and spring is fast approaching, you might be off to the local department store or mall to purchase some new shoes for your little ones. There are a few guidelines you should adhere to in finding the appropriate fit for you child and selecting a style that provides support to their foot and ankle.
1. Don’t shop alone! It is important to take your children with you when heading out to purchase new shoes for them. Make sure you have your child’s foot sized; often times you may think you know what shoe size they wear, but being off by as little as half a shoe size can make a big difference in support and comfort.
2. Make your trip a special outing after school. Not only will shopping with your child allow you an opportunity to share quality time, but going after school also provides an additional benefit; shoe fittings later in the day, when feet are at their maximum size, ensures that you are selecting a shoe size that best fits your children’s feet at their largest. Feet tend to swell during the day, thus shoe fittings in the morning may yield an inaccurate foot size and lead to discomfort in the long run.
3. Shoes should immediately be comfortable. There is no such thing as a break-in period when it comes to children. They want to wear their new shoes immediately, so making sure they are comfortable immediately is key. This will help prevent unnecessary blisters or pains during the first few weeks of wear.
4. How will the shoes be worn? If you’re purchasing sneakers, have your child try the sneakers on with sweat-socks. If you’re purchasing school shoes, make sure they are tried on with stockings or dress socks. Comfort, when it comes to shoe wear, should not be an estimate, but rather a sure bet. Make sure when trying shoes on, you try them on as they will be worn.
5. Check the heel cup. If, when you push on both sides of the heel, it should not bend, but rather hold its shape. If the heel of the shoe tends to bend inward, the ankle stability provided by the shoe is limited and may lead to ankle sprains.
6. Check toe flexibility. Looking at the shoe from the side, push up on the toe portion of the shoe and see how much the shoe can bend. If you are able fold the shoe easily without resistance, there is not enough support throughout the toe box and arch of the shoe. Place it gently back on the shelf, and look for something else!
Just because the shoe may fit, doesn’t mean, “toss the shoe-box into your shopping cart and call it a day.” Involving your children and getting their feedback on comfort, as well as having their size appropriately measured are all important aspects to ensuring an appropriate fit! Check the support provided within the shoe to help decrease your child’s risk of injury and make sure comfort, with the right pair of socks, is immediate. These quick tips should get your child into a “cool,” comfortable and supportive pair of shoes for the spring!
As the weather is beginning to warm up and spring is fast approaching, you might be off to the local department store or mall to purchase some new shoes for your little ones. There are a few guidelines you should adhere to in finding the appropriate fit for you child and selecting a style that provides support to their foot and ankle.
1. Don’t shop alone! It is important to take your children with you when heading out to purchase new shoes for them. Make sure you have your child’s foot sized; often times you may think you know what shoe size they wear, but being off by as little as half a shoe size can make a big difference in support and comfort.
2. Make your trip a special outing after school. Not only will shopping with your child allow you an opportunity to share quality time, but going after school also provides an additional benefit; shoe fittings later in the day, when feet are at their maximum size, ensures that you are selecting a shoe size that best fits your children’s feet at their largest. Feet tend to swell during the day, thus shoe fittings in the morning may yield an inaccurate foot size and lead to discomfort in the long run.
3. Shoes should immediately be comfortable. There is no such thing as a break-in period when it comes to children. They want to wear their new shoes immediately, so making sure they are comfortable immediately is key. This will help prevent unnecessary blisters or pains during the first few weeks of wear.
4. How will the shoes be worn? If you’re purchasing sneakers, have your child try the sneakers on with sweat-socks. If you’re purchasing school shoes, make sure they are tried on with stockings or dress socks. Comfort, when it comes to shoe wear, should not be an estimate, but rather a sure bet. Make sure when trying shoes on, you try them on as they will be worn.
5. Check the heel cup. If, when you push on both sides of the heel, it should not bend, but rather hold its shape. If the heel of the shoe tends to bend inward, the ankle stability provided by the shoe is limited and may lead to ankle sprains.
6. Check toe flexibility. Looking at the shoe from the side, push up on the toe portion of the shoe and see how much the shoe can bend. If you are able fold the shoe easily without resistance, there is not enough support throughout the toe box and arch of the shoe. Place it gently back on the shelf, and look for something else!
Just because the shoe may fit, doesn’t mean, “toss the shoe-box into your shopping cart and call it a day.” Involving your children and getting their feedback on comfort, as well as having their size appropriately measured are all important aspects to ensuring an appropriate fit! Check the support provided within the shoe to help decrease your child’s risk of injury and make sure comfort, with the right pair of socks, is immediate. These quick tips should get your child into a “cool,” comfortable and supportive pair of shoes for the spring!
Which is Better, Round or Square?
Which is Better, Round or Square?
The answer is square. Always square…well, at least when we’re talking about how to trim your toenails! Improper trimming of the nail can commonly lead to an ingrown, the proper technique for trimming will be covered in a few minutes, but for now, let’s talk ingrown toenails.
An ingrown toenail is caused by a sharp edge of the nail that digs into the surrounding skin creating pressure and pain. Improper trimming of the nail is the most common cause of an ingrown as a sharp edge or corner may remain, or too much nail has been removed allowing the nail to pinch the surrounding skin as it grows. Trauma to the nail, especially in adolescents who are actively involved in athletics, can also create an ingrown. Repetitive kicking, of a soccer ball for example, can cause the skin to pinch inwards towards the nail. Tight fitting shoes can cause the same sort of reaction, resulting in an ingrown nail. A hereditary component may exist, so if you have ingrown toenails, it is likely that your son or daughter will suffer from the same. It is not the toenail, per say, that is hereditary, but the structure of the bones within the toe that predisposes development.
The first sign of an ingrown will be pain. If the pain is ignored too long or if you attempt to relieve the pain on your own by cutting back the nail via “bathroom surgery,” infection is likely to occur. You will know infection is present when the area where the skin and nail come together begins to become red, hot, and swollen and when it begins to drain fluid. If you haven’t seen your Podiatrist, which if you’ve reached this point its likely that you haven’t, its time to give him or her a call and get an appointment as soon as possible. If you are experiencing chills, fevers, or night sweats, take yourself to the emergency room, as these are signs of systemic infection.
Treatment for an ingrown nail is very straightforward and most Podiatrists will follow a variation of the same protocol. A portion, or the entire nail needs to be removed to alleviate pressure and eliminate the source of the ingrown. Your Podiatrist will start by numbing the toe and cleaning the area around the nail to eliminate any bacteria living on the skin. Next he or she will free the underside of the nail from the toe, cut back the portion of the nail that is digging into the skin and remove it. Once it has been removed, they may or may not use a chemical called phenol to help prevent the nail from growing back. Your toe will be bandaged and you will be given instructions on how to care for the area at home. Depending on the severity of infection, you may or may not be given a prescription for antibiotics. You will need to follow-up with your Podiatrist within a week to ensure everything is improving. It is important that you do not try to remove the nail yourself, as the bone in your toe is situated directly under the bed of the nail and using unsterile techniques can lead to infection of the bone or abscess (basically a sac filled with infection).
Now, back to how to properly trim your toenails: A very common misconception the average person makes, in relation to trimming their toenails, is belief that the nails should be rounded off on the sides, keeping the edges smooth. The edges should be smooth, but rounding off the sides increases the risk of creating an ingrown toenail. As I said above, square is always better. You want to ensure that when trimming your nails, or your child’s nails, you trim straight across leaving the edges of the nail square. DO NOT try to round the edges down towards the skin and DO NOT trim the nail too low causing irritation at the end of the toe. If you’re not used to trimming your nails this way, it will take some getting used to, but I can assure you, you will thank yourself later when you’re not suffering from the discomfort associated with an ingrown toenail! The reason ingrown toenails are more predominant in those ages 8-12, is because it is around this age that children become responsible for trimming their own nails. If you, as their parent, haven’t taught them the proper technique, your Podiatrist will be seeing you soon!
The answer is square. Always square…well, at least when we’re talking about how to trim your toenails! Improper trimming of the nail can commonly lead to an ingrown, the proper technique for trimming will be covered in a few minutes, but for now, let’s talk ingrown toenails.
An ingrown toenail is caused by a sharp edge of the nail that digs into the surrounding skin creating pressure and pain. Improper trimming of the nail is the most common cause of an ingrown as a sharp edge or corner may remain, or too much nail has been removed allowing the nail to pinch the surrounding skin as it grows. Trauma to the nail, especially in adolescents who are actively involved in athletics, can also create an ingrown. Repetitive kicking, of a soccer ball for example, can cause the skin to pinch inwards towards the nail. Tight fitting shoes can cause the same sort of reaction, resulting in an ingrown nail. A hereditary component may exist, so if you have ingrown toenails, it is likely that your son or daughter will suffer from the same. It is not the toenail, per say, that is hereditary, but the structure of the bones within the toe that predisposes development.
The first sign of an ingrown will be pain. If the pain is ignored too long or if you attempt to relieve the pain on your own by cutting back the nail via “bathroom surgery,” infection is likely to occur. You will know infection is present when the area where the skin and nail come together begins to become red, hot, and swollen and when it begins to drain fluid. If you haven’t seen your Podiatrist, which if you’ve reached this point its likely that you haven’t, its time to give him or her a call and get an appointment as soon as possible. If you are experiencing chills, fevers, or night sweats, take yourself to the emergency room, as these are signs of systemic infection.
Treatment for an ingrown nail is very straightforward and most Podiatrists will follow a variation of the same protocol. A portion, or the entire nail needs to be removed to alleviate pressure and eliminate the source of the ingrown. Your Podiatrist will start by numbing the toe and cleaning the area around the nail to eliminate any bacteria living on the skin. Next he or she will free the underside of the nail from the toe, cut back the portion of the nail that is digging into the skin and remove it. Once it has been removed, they may or may not use a chemical called phenol to help prevent the nail from growing back. Your toe will be bandaged and you will be given instructions on how to care for the area at home. Depending on the severity of infection, you may or may not be given a prescription for antibiotics. You will need to follow-up with your Podiatrist within a week to ensure everything is improving. It is important that you do not try to remove the nail yourself, as the bone in your toe is situated directly under the bed of the nail and using unsterile techniques can lead to infection of the bone or abscess (basically a sac filled with infection).
Now, back to how to properly trim your toenails: A very common misconception the average person makes, in relation to trimming their toenails, is belief that the nails should be rounded off on the sides, keeping the edges smooth. The edges should be smooth, but rounding off the sides increases the risk of creating an ingrown toenail. As I said above, square is always better. You want to ensure that when trimming your nails, or your child’s nails, you trim straight across leaving the edges of the nail square. DO NOT try to round the edges down towards the skin and DO NOT trim the nail too low causing irritation at the end of the toe. If you’re not used to trimming your nails this way, it will take some getting used to, but I can assure you, you will thank yourself later when you’re not suffering from the discomfort associated with an ingrown toenail! The reason ingrown toenails are more predominant in those ages 8-12, is because it is around this age that children become responsible for trimming their own nails. If you, as their parent, haven’t taught them the proper technique, your Podiatrist will be seeing you soon!
Decrease Your Risk of Diabetic Neuropathy
Decrease Your Risk of Diabetic Neuropathy
Neuropathy by definition is a disease or dysfunction of one or more peripheral nerves causing symptoms of numbness, pain, weakness or all three. In the diabetic patient neuropathy symptoms present distally (away from the heart) first, moving proximally (towards the heart) as the disease progresses. It also tends to be symmetrical, meaning symptoms are the same on both the left and right sides of the body. Diagnosis of neuropathy often comes late in its progression due to ignorance by patients. Patients are unaware of the symptoms they should be on the lookout for and they do not frequently visit a Podiatrist, who monitors neuropathy and risk factors for the disease.
In order to catch neuropathy early on, there are some risk factors you should be looking for and steps you should be taking to prevent development or slow progression:
1. Control your blood sugar – Diabetic neuropathy is directly correlated to poor sugar control. As the levels of glucose rise in the blood stream the chance of causing injury to the nerves increases, thus the chance of developing neuropathy also increases. Keeping your glucose levels controlled maintains an appropriate level of glucose in the blood stream decreasing the sugars opportunity to affect the peripheral nerves.
2. Visit your Podiatrist regularly – Typically, in diabetic patients with no complications (meaning no peripheral vascular disease or neuropathy) you should be visiting your Podiatrist every six months. They will evaluate you for changes in light and sharp touch, vibratory sensation, ulceration risk and deep tendon reflexes. Changes in any of these categories could be your first indicator for oncoming diabetic neuropathy.
3. Stop smoking – Studies have shown that in patients who are diabetic and smoke, their risk for diabetic neuropathy greatly increases. Cutting back and eliminating cigarettes from your life will decrease your risk.
4. Control your blood pressure and your cholesterol levels – Although cholesterol and blood pressure do not directly relate to diabetic neuropathy, they do enhance your diabetes which can in turn, increase your risks. Make sure that you are checking in with your primary care physician regularly and that your blood levels are within normal ranges or that you are taking medications prescribed to you in order to control these risk factors
5. Be on the lookout for – Tingling or burning sensations as well as insensitivity to pain or temperature changes that are new and equal on both sides of the body. For example if you have having tingling on the bottom surfaces of both the right and left foot, be skeptical and schedule an appointment with your podiatrist as soon as possible.
6. Protect your feet – Wearing shoes that are supportive and comfortable decrease your risk of ulceration, a complication frequently associated with neuropathy. Ulcerations in the diabetic patient are a bit trickier than those in a non-diabetic individual, in that they become more frequently infected and have increased difficulty in healing. The best option is to prevent ulceration with protective shoe wear!
If you have been diagnosed with diabetic neuropathy already, you still should adhere to the above-mentioned preventative measures. Diabetic neuropathy is one form of neuropathy that can be reversed to a certain extent, with better sugar control and a decrease in risk factors. Make sure to consult with your Primary Care Physician and your Podiatrist frequently for monitoring and take control of your own destiny! You play as much a role in decreasing your risk of neuropathy as the disease plays in affecting you.
Neuropathy by definition is a disease or dysfunction of one or more peripheral nerves causing symptoms of numbness, pain, weakness or all three. In the diabetic patient neuropathy symptoms present distally (away from the heart) first, moving proximally (towards the heart) as the disease progresses. It also tends to be symmetrical, meaning symptoms are the same on both the left and right sides of the body. Diagnosis of neuropathy often comes late in its progression due to ignorance by patients. Patients are unaware of the symptoms they should be on the lookout for and they do not frequently visit a Podiatrist, who monitors neuropathy and risk factors for the disease.
In order to catch neuropathy early on, there are some risk factors you should be looking for and steps you should be taking to prevent development or slow progression:
1. Control your blood sugar – Diabetic neuropathy is directly correlated to poor sugar control. As the levels of glucose rise in the blood stream the chance of causing injury to the nerves increases, thus the chance of developing neuropathy also increases. Keeping your glucose levels controlled maintains an appropriate level of glucose in the blood stream decreasing the sugars opportunity to affect the peripheral nerves.
2. Visit your Podiatrist regularly – Typically, in diabetic patients with no complications (meaning no peripheral vascular disease or neuropathy) you should be visiting your Podiatrist every six months. They will evaluate you for changes in light and sharp touch, vibratory sensation, ulceration risk and deep tendon reflexes. Changes in any of these categories could be your first indicator for oncoming diabetic neuropathy.
3. Stop smoking – Studies have shown that in patients who are diabetic and smoke, their risk for diabetic neuropathy greatly increases. Cutting back and eliminating cigarettes from your life will decrease your risk.
4. Control your blood pressure and your cholesterol levels – Although cholesterol and blood pressure do not directly relate to diabetic neuropathy, they do enhance your diabetes which can in turn, increase your risks. Make sure that you are checking in with your primary care physician regularly and that your blood levels are within normal ranges or that you are taking medications prescribed to you in order to control these risk factors
5. Be on the lookout for – Tingling or burning sensations as well as insensitivity to pain or temperature changes that are new and equal on both sides of the body. For example if you have having tingling on the bottom surfaces of both the right and left foot, be skeptical and schedule an appointment with your podiatrist as soon as possible.
6. Protect your feet – Wearing shoes that are supportive and comfortable decrease your risk of ulceration, a complication frequently associated with neuropathy. Ulcerations in the diabetic patient are a bit trickier than those in a non-diabetic individual, in that they become more frequently infected and have increased difficulty in healing. The best option is to prevent ulceration with protective shoe wear!
If you have been diagnosed with diabetic neuropathy already, you still should adhere to the above-mentioned preventative measures. Diabetic neuropathy is one form of neuropathy that can be reversed to a certain extent, with better sugar control and a decrease in risk factors. Make sure to consult with your Primary Care Physician and your Podiatrist frequently for monitoring and take control of your own destiny! You play as much a role in decreasing your risk of neuropathy as the disease plays in affecting you.
The Triad That Leads to P.A.D.
The Triad That Leads to P.A.D.
P.A.D. or Peripheral Arterial Disease is a disease of the circulatory system where blood flow to the periphery of the body, mainly the legs, is compromised or blocked. The blood vessels flowing towards the legs become compromised when plaque builds up within their walls. Plaque is a thick material, which can be made of fat, calcium or cholesterol and deposition within the blood vessels is a result of Atherosclerosis (hardening of the arteries). It builds up over a series of years going unnoticed by the patient and unfortunately when symptoms do arise, the degree of blockage is usually greater than 50%.
Due to the nature of the disease and the compromised blood flow to the legs, the tissues within the leg and foot do not receive adequate oxygen needed for optimum function. Therefore, they are forced to function without their appropriate requirements and the patient begins to experience symptoms. Symptoms take the form of “intermittent claudication:” pain in the calves after periods of walking. The only relief for intermittent claudication pain is rest. After a short period of rest, the pain subsides and the patient can begin walking once again. As the amount of disease increases, the pain becomes greater and the distance a patient can walk before pain ensues decreases. In severe cases of P.A.D. patients will experience ischemic type pain, or rest pain: pain in the legs, feet or toes without periods of activity that can be so severe that it keeps patients awake at night. Eventually, if the blood flow is extremely compromised or discontinued all together, tissue loss can result meaning that ulcerations on the toes will not heal, will become infected, and will likely need to be amputated.
The risk factors that increase a patient’s chances of developing Atherosclerosis and subsequent Peripheral Arterial Disease and are three: High Blood Pressure, High Cholesterol, and Smoking. Diabetes can also contribute to the disease, but keep in mind that although Peripheral Arterial Disease is commonly seen in the diabetic patient, it is not limited to that patient population alone.
If you are experiencing pain in your legs with walking/exercise that wasn’t there before and/or have any of the risk factors for P.A.D., see your Podiatrist at your earliest convenience! They will check the blood flow to your legs by doing a pulse exam; seeing if they can feel flow through the arteries traveling from your abdomen down into your legs. If they are unable to feel the flow, they will likely send you for additional tests at a Vascular Laboratory, where the level of blood flow in the legs can be determined. These tests are typically non-invasive and will take less than a half-hour to complete.
Once your symptoms have been confirmed and you are diagnosed with P.A.D. treatment options can be discussed with your Podiatrist or a Vascular Surgeon. It is likely that no treatment methods will be implemented if you can tolerate the symptoms, but once symptoms become intolerable, both non-surgical and surgical options can be discussed including oral medications, endovascular procedures or bypass procedures.
The most important thing patients can do to help themselves is to QUIT SMOKING. After that, it is important that you work with your Primary Care Physician to control your high cholesterol and high blood pressure. As was discussed, diabetes can also play an important role in development and progression of P.A.D., so, if you are diabetic it is imperative that you manage your blood glucose levels to control the disease and the associated risks that come along with diabetes itself.
P.A.D. or Peripheral Arterial Disease is a disease of the circulatory system where blood flow to the periphery of the body, mainly the legs, is compromised or blocked. The blood vessels flowing towards the legs become compromised when plaque builds up within their walls. Plaque is a thick material, which can be made of fat, calcium or cholesterol and deposition within the blood vessels is a result of Atherosclerosis (hardening of the arteries). It builds up over a series of years going unnoticed by the patient and unfortunately when symptoms do arise, the degree of blockage is usually greater than 50%.
Due to the nature of the disease and the compromised blood flow to the legs, the tissues within the leg and foot do not receive adequate oxygen needed for optimum function. Therefore, they are forced to function without their appropriate requirements and the patient begins to experience symptoms. Symptoms take the form of “intermittent claudication:” pain in the calves after periods of walking. The only relief for intermittent claudication pain is rest. After a short period of rest, the pain subsides and the patient can begin walking once again. As the amount of disease increases, the pain becomes greater and the distance a patient can walk before pain ensues decreases. In severe cases of P.A.D. patients will experience ischemic type pain, or rest pain: pain in the legs, feet or toes without periods of activity that can be so severe that it keeps patients awake at night. Eventually, if the blood flow is extremely compromised or discontinued all together, tissue loss can result meaning that ulcerations on the toes will not heal, will become infected, and will likely need to be amputated.
The risk factors that increase a patient’s chances of developing Atherosclerosis and subsequent Peripheral Arterial Disease and are three: High Blood Pressure, High Cholesterol, and Smoking. Diabetes can also contribute to the disease, but keep in mind that although Peripheral Arterial Disease is commonly seen in the diabetic patient, it is not limited to that patient population alone.
If you are experiencing pain in your legs with walking/exercise that wasn’t there before and/or have any of the risk factors for P.A.D., see your Podiatrist at your earliest convenience! They will check the blood flow to your legs by doing a pulse exam; seeing if they can feel flow through the arteries traveling from your abdomen down into your legs. If they are unable to feel the flow, they will likely send you for additional tests at a Vascular Laboratory, where the level of blood flow in the legs can be determined. These tests are typically non-invasive and will take less than a half-hour to complete.
Once your symptoms have been confirmed and you are diagnosed with P.A.D. treatment options can be discussed with your Podiatrist or a Vascular Surgeon. It is likely that no treatment methods will be implemented if you can tolerate the symptoms, but once symptoms become intolerable, both non-surgical and surgical options can be discussed including oral medications, endovascular procedures or bypass procedures.
The most important thing patients can do to help themselves is to QUIT SMOKING. After that, it is important that you work with your Primary Care Physician to control your high cholesterol and high blood pressure. As was discussed, diabetes can also play an important role in development and progression of P.A.D., so, if you are diabetic it is imperative that you manage your blood glucose levels to control the disease and the associated risks that come along with diabetes itself.
Is Your Child Suffering from Sever’s?
Is Your Child Suffering from Sever’s?
As we mentioned last week, your children should not be complaining of foot pain. If they are you should take them seriously and contact your local Podiatrist for evaluation as soon as possible. Foot pain in children is hardly normal. Sever’s Disease (Calcaneal Apophysitis) is localized to the heel and is the most common cause of heel pain in children, seen in individuals 10-14 years of age. If your child is suffering from Sever’s Disease, they will complain of pain in the heel, difficulty partaking in athletic activities and they may even begin to walk with a limp. These should signal red flags to you that there is injury present and immediate evaluation becomes important!
Sever’s Disease is described as a painful inflammation of the growth plate within your child’s heel. Unlike the other bones in the foot, the heel has two “centers of ossification,” or areas where the heel bone grows from. As your child ages, those two areas of growth meet one another, creating one heel bone and solidifying completely by the age of 14. With two areas of growth, any abnormal forces or repetitive injury to the heel can slow the process of their coming together and create inflammation in that area, leading to the diagnosis of Sever’s Disease.
Inflammation of the growth plate is commonly seen in children who are involved in athletic activities. Due to the repetitive trauma placed on to the heel bone with running, jumping and pounding on unforgiving surfaces such as blacktop, inflammation can easily find its way to the area in and around the heel. The muscles being used to support both the heel and the foot place undue stress on the two areas of the heel bone; combined with the inflammation, pain results! Children involved in activities such as soccer, basketball and track are the most vulnerable. With that said, fear of Sever’s Disease is no reason to keep your children from engaging in activities. Let them have fun and be kids! There is a small percentage of individuals that suffer from this injury, and it is can easily be corrected so that your child will not suffer any long-term difficulties. Other things that may lead to Sever’s Disease, but less commonly so than repetitive trauma include obesity, congenital structural problems in your child’s foot and tight musculature surrounding the heel bone.
Once your child has been diagnosed with Sever’s Disease, it is first important to remember that although it is a “disease,” Sever’s is free from systemic (whole body) effects, and is treatable and curable. Your Podiatrist is likely to suggest a reduction in activity by your child and possibly immobilization with a cast that may be removable or non-removable, depending on Doctor’s preference. Both of these treatment methods attempt to reduce stresses on the heel and allow the body to decrease inflammation in the area, while giving the heel time to grow without abnormal forces from activity or musculature pull. It is possible that they will suggest your child take over the counter anti-inflammatory medications to help the healing process by decreasing inflammation as well as decrease the level of pain your child is experiencing. Finally, in more complicated or painful cases, your Podiatrist may recommend your child undergo several weeks of Physical Therapy. The goal of therapy is to increase flexibility in the musculature surrounding and attaching to the heel, helping to decrease any abnormal forces those muscles may be exerting.
It may be difficult to prevent Sever’s Disease, but certainly wearing comfortable athletic shoes that are also supportive may help. It is good to keep in mind that your child is young and things are still growing. Certainly you should not withhold them from activities they love, but encourage them regardless of their abilities, rather than pushing them to the limit and creating undue stress on the heel, or any parts of their fragile bodies for that matter!
As we mentioned last week, your children should not be complaining of foot pain. If they are you should take them seriously and contact your local Podiatrist for evaluation as soon as possible. Foot pain in children is hardly normal. Sever’s Disease (Calcaneal Apophysitis) is localized to the heel and is the most common cause of heel pain in children, seen in individuals 10-14 years of age. If your child is suffering from Sever’s Disease, they will complain of pain in the heel, difficulty partaking in athletic activities and they may even begin to walk with a limp. These should signal red flags to you that there is injury present and immediate evaluation becomes important!
Sever’s Disease is described as a painful inflammation of the growth plate within your child’s heel. Unlike the other bones in the foot, the heel has two “centers of ossification,” or areas where the heel bone grows from. As your child ages, those two areas of growth meet one another, creating one heel bone and solidifying completely by the age of 14. With two areas of growth, any abnormal forces or repetitive injury to the heel can slow the process of their coming together and create inflammation in that area, leading to the diagnosis of Sever’s Disease.
Inflammation of the growth plate is commonly seen in children who are involved in athletic activities. Due to the repetitive trauma placed on to the heel bone with running, jumping and pounding on unforgiving surfaces such as blacktop, inflammation can easily find its way to the area in and around the heel. The muscles being used to support both the heel and the foot place undue stress on the two areas of the heel bone; combined with the inflammation, pain results! Children involved in activities such as soccer, basketball and track are the most vulnerable. With that said, fear of Sever’s Disease is no reason to keep your children from engaging in activities. Let them have fun and be kids! There is a small percentage of individuals that suffer from this injury, and it is can easily be corrected so that your child will not suffer any long-term difficulties. Other things that may lead to Sever’s Disease, but less commonly so than repetitive trauma include obesity, congenital structural problems in your child’s foot and tight musculature surrounding the heel bone.
Once your child has been diagnosed with Sever’s Disease, it is first important to remember that although it is a “disease,” Sever’s is free from systemic (whole body) effects, and is treatable and curable. Your Podiatrist is likely to suggest a reduction in activity by your child and possibly immobilization with a cast that may be removable or non-removable, depending on Doctor’s preference. Both of these treatment methods attempt to reduce stresses on the heel and allow the body to decrease inflammation in the area, while giving the heel time to grow without abnormal forces from activity or musculature pull. It is possible that they will suggest your child take over the counter anti-inflammatory medications to help the healing process by decreasing inflammation as well as decrease the level of pain your child is experiencing. Finally, in more complicated or painful cases, your Podiatrist may recommend your child undergo several weeks of Physical Therapy. The goal of therapy is to increase flexibility in the musculature surrounding and attaching to the heel, helping to decrease any abnormal forces those muscles may be exerting.
It may be difficult to prevent Sever’s Disease, but certainly wearing comfortable athletic shoes that are also supportive may help. It is good to keep in mind that your child is young and things are still growing. Certainly you should not withhold them from activities they love, but encourage them regardless of their abilities, rather than pushing them to the limit and creating undue stress on the heel, or any parts of their fragile bodies for that matter!
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