Foot Care in Michigan

Lions DL Nick Fairley Sidelined with Foot Injury

2011-12-05T21:41:00.000-08:00

The bye week for the Detroit Lions came exactly halfway through the NFL season, and may have been particularly beneficial for Rookie defensive lineman Nick Fairley. The Lions' first-round pick out of Auburn, Fairley, fractured his left foot during training camp and missed the first four games of the year. He played sparingly when he returned in October and missed an Oct. 30 game against the Broncos with a sore foot.

Thanks to the rest provided by the bye week, Fairley felt ready to make his presence felt in the second half of the season. Fairley was quoted saying, "I'm feeling real good. The break did a lot for me, especially just being able to sit back and rest up - get off my feet, let it heal on its own without nothing moving, without doing a lot of walking around or whatever. ... I'm all good to go, ready to go now. Second half, here we go, here we come."

Unfortunately for the Lions, Fairley’s foot injury will keep him from the top of his game for even longer. Nick Fairley was having his best game of a tough season last Sunday when he re-aggravated the foot injury that has bothered him all year. Fairley had three tackles and his first career sack in the first quarter of the Lions' 31-17 loss to the Saints, but limped off the field early in the second quarter and played sparingly the rest of the way. After going to the sideline, he pleaded with Lions trainers to go back in the game and declined a cart ride up the tunnel for X-rays, hobbling away instead.

Lions coach Jim Schwartz said the X-rays were negative, and Fairley said, "I don’t know how bad it is, I don’t know how good it is" when asked about his injury after the game. He obviously has a screw in from his broken foot this summer and it was in that area that hurt him," Schwartz said. "He was cleared to go back in the game but he wasn’t moving well enough to be real effective and it was a shame because he was playing well at the beginning of the game.”

He returned and played a handful of snaps in the second and third quarters, only to limp off again. “I felt like I was on my way to a good game,” Fairley said. “But things didn’t go the way I wanted to – it didn’t end up how I wanted. I have to go in with the trainers (on Monday) and see what’s going on, and just make it better.” How bad is the injury? “I don’t know how bad it is, I don’t know how good it is,” he said.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Keeping Your Feet Happy During the Holidays

2011-11-30T15:35:00.000-08:00

For most of us, the holidays are a time of go, go, go, and your feet bear the brunt of a lot of it.

You will likely spend hours wandering around the mall finishing holiday shopping, and when you get home, your feet hurt. Or, maybe those killer heels you wore to that party have really lived up to their reputation. When your feet hurt, it can cause your lower legs to be stiff and sore, and even cause back pain and headaches. So what can you do to reduce the nagging pain and soreness?

If you know you’re going to be walking around for an extended period of time, then wear your most comfortable pair of shoes for the day. Your best bet is a nice supportive walking or even a fitness shoe to give you adequate support during the day. Additionally, a compression stocking can keep the foot from swelling, thus decreasing the amount of restriction in the shoe. This is especially helpful for people who have high blood pressure or circulation problems.

Kyle Fiala, a podiatrist at the Missouri Orthopaedic Institute, gives a number of suggestions in an article in the Columbia Tribune for what you can do at the end of the day to keep your feet happy this holiday season. “There was a survey from the American Podiatrist Society that found moisturizing was the No. 1 way that women soothed their feet during the holiday seasons,” Fiala said.

Finally, stretching and massaging can provide some relief, especially if it is done consistently and correctly. “Point or flex the toes up and down to work out stiffness in the toes. Rotate the ankles to work out range of motion,” Fiala said. Also, stretch the calf muscles by facing a wall with arms extended, and place one foot in front of the other to feel a stretch in the back of the leg furthest from the wall. Repeat each exercise 3 times for 45 seconds. Follow these suggestions to have a holly jolly holiday season for you and your feet.

Article: http://www.columbiatribune.com/news/2011/dec/04/if-the-shoe-fits/

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Fall Prevention

2011-11-21T15:51:00.000-08:00

Fall rates are high among older people, even in the healthy population. This has led researchers to study how an aging foot may affect ambulatory function and increase the risk of falls.

The study took healthy volunteers aged 60-80 years who were independent in self-care and walking were recruited from urban Bangkok. Trained physicians evaluated health status, foot problems, and fall(s) history of all subjects. Walking performance was assessed using the 'Timed Get Up & Go' test and 6-m walking speed. Footprints were taken from the standing position. Foot dimensions and footwear were also measured by certified orthotists. Associated factors of foot disorders and falls were analyzed.

The results from the 213 subjects (108 men, 105 women with an average age of 68 years) showed that foot deformities were present in 87% of the participants and were not significantly associated with walking performance or falls. Foot pain was found in 14% with a male:female ratio of 1:4. The causes of pain were plantar fasciitis, hallux valgus, callus, metatarsalgia, and inappropriate footwear. Subjects with foot pain had slower walking speed and falls were reported in about 30% of women and 13% of men.

The analysis showed that fall risk factors were female gender, plantar fasciitis, and knee osteoarthritis. The study also showed that visual deficits were associated with falls in women, and impaired foot protective sensation was associated with falls in men.

The conclusion of the study shows that aging foot deformities were common and were mostly asymptomatic. Foot pain, especially from plantar fasciitis, increased risk of falls in healthy older persons. Podiatrists play an important role in fall prevention and can help prevent falls by proper foot assessment, foot pain management, and proper footwear.

(Reference: “Foot Disorders and Falls in Older Persons.” Chaiwanichsiri D, Janchai S, Tantisiriwat N. Gerontology. 2008 Dec 3.)

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

How Bad are High Heels?

2011-11-14T15:25:00.000-08:00

For a lot of people, one of the most common contributors to foot pain isn’t necessarily injury or fatigue; it’s shoes that don’t fit properly. Part of the problem is that most of us don’t get refitted often enough. People tend to believe they have worn one size of shoe for X number of years, but over the years, our feet widen. Your shoe size from five years ago might not be the shoe size you should be wearing now.

One way to check to see if your shoes fit properly is to trace your foot on a piece of paper and take a look at some of the shoes in your closet. If the shoe fits within the borders of the traced outline of the foot, or if that traced outline hangs over the shoe, the shoe is probably too small! Sometimes this simple visual illustration can be just what you need to admit your feet may be a different size than you think.

Still, some shoes lend themselves more to comfort than others. Anything that elevates the heel is going to put a lot of pressure on the ball of the foot. Many of the more stylish shoes are going to have a restricting toe box. The combo of extra pressure from being in heels and a narrow, constrictive shoe is one that can lead to discomfort.

Additionally, high heels can exacerbate some foot conditions, for example bunions and hammer toes. Even more common than those is metatarsalgia, or pain under the ball of the foot.

Although it’s unrealistic to expect a woman to give up her favorite heels, it is a good idea to limit their use. We recommend keeping a pair of flats in the car to drive in and to change into at work can help minimize your time in heels and prevent further pain and deformities. And if you know you’ll be spending a considerable amount of time on your feet, think comfort first.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Tiger Woods Achilles Tendon Injury

2011-11-07T20:47:00.000-08:00

You may assume non-impact sports like golf do not lead to serious foot or ankle injuries. However, golf superstar Tiger Woods recently had to drop out of the Players Championships after only playing the first nine holes of his first round due to an injured left knee and Achilles tendon. Tiger has dealt with an Achilles injury before and has undergone several knee surgeries in the past.

Serious golfers are more prone to have Achilles tendon injuries because of the amount of walking on uneven terrain, the unusual positions some golfers have to get into to hit the ball and the pivoting involved with the golf swing. Tiger injured his Achilles when he was crouching to get a shot in the rough.

An Achilles tendon injury can be frustrating and take a long time to heal. Occasionally the injury is calmed down by oral anti-inflammatory medications, but not always. Also, cortisone (steroid) injections cannot be used to treat an Achilles injury because the area where the Achilles inserts has poor blood supply and the steroid could cause it to rupture. A ruptured Achilles could mean surgery, and it takes months to heal. Treatment options for Achilles tendonitis include immobilization, physical therapy, night splints, and custom foot orthotics to address the biomechanics of the foot and less the pull on the tendon.

Tiger has also been sporting his new line of Nike golf shoes, which may be helpful in alleviating his Achilles problems. Golf shoes have long been characterized as bowling shoes with spikes coming out of the bottom. But Tiger and Nike are attempting to change that with these sleek, sneakeresque golf cleats. The shoes are similar to the Nike "Free" design and are allegedly lightweight, stable, and comfortable.

The most frustrating part of an Achilles tendon injury is the waiting. This holds true for Tiger as well, and he will only be able to return to the top of his game when he takes time off to fully rehabilitate his Achilles tendon back to full function. If you are suffering with an Achilles tendon injury, don't wait for it to go away on its own. Contact Dr. Frederick for an appointment today.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com
Allison Ippel, Student Blogger (SCPM 2013)

Interesting Nail Facts

2011-10-30T20:57:00.000-07:00

· Black/brown pigmentation (referred to as “Hutchinson’s sign”) –can be caused by malignant melanoma

· Attached free edge of nail (or attached “hyponychium”) – frequently the cause is an allergic reaction to Acrylic nails. Other causes include: scleroderma, Lupus, or it can be hereditary.

· Peeling or horizontal splitting (called “Onychoschizia”) – can be the result of excessive water exposure or the use of irritants. Treatment includes daily intake of Vitamin B, as well as Biotin.

· Ram’s horn nail (called “Onychogryphosis”) – a severely thickend, curved or twisted nail plate. It may be partially hereditary and can also occur from long-term neglect. As you would expect, these nails become difficult to cut and often remain untrimmed, which exacerbates the problem. These nails may require the use of special instruments to reduce properly, so a visit to a Podiatrist can be an easy solution.

Interesting/Odd Nail facts:

Men’s nails grow faster than women’s nails.
Fingernails grow longer than toenails.
The fastest growing nail is the middle finger. The slowest is the thumbnail.
Nails grow faster in warm climates and during daytime.
Nails grow faster on young people compared to old people.
Nails grow much faster during pregnancy.
Typing on a computer stimulates nail growth.
Nails grow at the rate of 0.1 mm per day (or 1 cm in every 100 days). So a toenail to grow out completely, it takes 12 to 18 months.

And ever wonder what the Guinness world Record is for longest nails? 8.65m for Lee Redmond, the female record-holder. But that’s not as long as Melvin Boothe, the male owner of the longest fingernails (9.05m long).

http://community.guinnessworldrecords.com/_Lee-Redmond/photo/5099452/7691.html

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Pathology of the Nail Bed

2011-10-23T20:26:00.000-07:00

The nail plate is also home to many interesting and important diseases.

Flat/spoon-shaped (“Koilonychia”) – these nails may lose their natural color and become thin and brittle. They are associated with iron-deficiency with or without anemia, thyroid dysfunction, renal disease, impaired peripheral circulation, Lupus, musculoskeletal conditions, and can be due to trauma or malnutrition.

Clubbed nail plate – this deformity is associated mostly with disease of the heart and lungs, such as: empyema.

Vertical ridges – usually the result of aging, a crush injury, or arthritis. Rarely it is associated with iron or Vitamin B deficiency.

Horizontal lines (also known as “Beau lines”) – result of chemotherapy, infection or injury.

Pitting in nail plate – may be due to psoriasis, arthritis, lichen planus, alopecia areata, eczema, trauma, or it could just be hereditary.

Onycholysis – this means loosening of an exposed portion of the nail from the nail bed, beginning at the free edge and continuing to the lunula. It is frequently associated with internal disease, trauma, infection, nail fungi, allergy to nail enhancement product, or side effects of certain medications.

Black/Blue – often due to trauma, nail fungus, or tight fitting shoes (especially in runners).

White transverse discolorations of the nail plate (known as “Leukonychia”) – caused by cirrhosis, chemotherapy, or physical injury. When it shows up on all or almost all of the nails for a months to years, it can suggest Zinc deficiency.

Brown/yellow (called “Melanonychia”) – associated with psoriasis when nail plates are pitted, dry and crumbled. Melanonychia are vertical bands, described as nail ‘moles’. Sudden changes in the nail plate could signify malignant melanoma. Dark streaks are very common and normal in dark-skinned individuals.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Pathology of the Lunula

2011-10-13T20:03:00.000-07:00

The lunula is the moon-shaped part of the bed if the finger or toe nail. Its normal color is white, but in the case of injury or disease, it can be a variety of colors.

Blue – indicates circulatory problems or a lack of oxygen. Rarely it can be caused by certain medications, or Silver or Copper poisoning.

Red – is a non-specific finding in cardiovascular disease, collagen vascular diseases, congestive heart failure, rheumatoid arthritis, pulmonary disorders, and certain cancers. Less commonly it is seen in balding, Lupus, and carbon monoxide or heavy metal poisoning.

Yellow – with fluorence is a classic sign of a certain antibiotic (tetracycline) that is used for chronic lyme disease. It is also a common feature of Yellow Nail Syndrome (YNS), or from the dye contained in nail polish.

Spotted – Caused by congestion of the capillaries under the nail. It is commonly seen in psoriasis, but can also occur in certain types of balding (alopecia areata), psoriasis vulgaris, and lichen planus.

Large (or small) – is suggestive of hyperthyroidism (of hypothyroidism if it is small)

Triangular – can be the result of pushing on the cuticle of the nail from excessive manicures, or less commonly Nail-Patella Syndrome.

Obliterated – the part of the nail bed close to the cuticle can have a whitish-brownish appearance, which is seen in patients with severe renal disease.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Pathology of the Cuticle

2011-10-03T19:39:00.000-07:00

What can you learn from looking at your cuticles? The cuticle, or "eponychium", is a layer of dead skin cells that is very important as it provides a waterproof barrier against bacteria, pathogens, and irritants.

Overgrowth of the cuticle, or “Pterygium” – most commonly the result of severe trauma, such as burns, lichen planus, certain nail removal procedures.

Prominent eponychium + Hemorrhaging – often seen in a medical condition called dermatomyositis; also seen in Lupus (SLE), scleroderma, and musculoskeletal disease.

Long eponychium – mostly just a cosmetic problem.

Missing eponychium + Yellow nail plate – a strong indication for yellow nail syndrome (YNS), which is associated with lung disorders and lymphedema. Other nail features of YNS can be slow nail growth and a loose or detached nail plate.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Pathology of the Nail Fold

2011-08-30T18:14:00.000-07:00

Ever wonder what you can learn from looking at finger or toenails? You may be surprised to know that many disease processes show evidence at the nails, and can even be an early sign that a systemic problem is developing.

“Ruborous spots” – little red or purple clusters of dilated capillaries (telangiectasias) that suggest a collagen vascular disease, such as Rheumatoid arthritis, Lupus (SLE), dermatomyositis, scleroderma, psoriasis, or Raynaud’s phenomenon.

Ruborous or brown spots (also know as “Bywater Lesions”) – painless spots that may darken, become crusted and fall off, leaving a tiny pit-like depression. These spots are associated with RA and rheumatoid vasculitis.

Edema or swelling – caused by many conditions, including: nail biting, ingrown nail (onychocryptosis).

Verrucae – caused by a virus that gets under the skin fold or nail plate and deforms the nail plate. Early treatment prevents the onset of more severe nail problems.

Cysts (also called digital mucoid cysts) – commonly are benign tumors. Also myxoid cysts may be associated with osteoarthritis.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Jeremy Wariner to Miss World Championships

2011-08-14T12:51:00.000-07:00

Former Olympic and world 400m champion Jeremy Wariner will miss this month's World Championships in Daegu, South Korea because of a foot injury. The 27-year-old runner is a key member in the US Olympic and world 4x400m relay wins. Wariner tore a ligament in the second toe of his left foot while training in July. The extent of the ailment wasn't diagnosed until last week.

"Right now my focus is to get healthy, prepare for next season, and try for my second 400m Olympic gold medal in the 400," Wariner said.

Wariner, the world's top-ranked 400m runner in 2010, has been plagued by minor injuries this season. Wariner won the Olympics 400m title in Athens, in 2004, and followed that with World Championships wins in 2005 and 2007. He was runner-up to fellow American LaShawn Merritt at the 2008 Olympics and 2009 World Championships. Wariner is expected to be replaced on the US team by fourth-placed trials finisher Jamaal Torrance at the World Championships, which take place between August 27 and September 4, 2011.

Wariner’s coach described his injury as “turf toe” and said it does not allow Wariner to push off the foot the way he needs to. Doctors have advised Wariner to take a couple months off to let the injury heal completely. Wariner had already pulled out of a meet last weekend in London because of the injury, which causes him pain each time he pushes down on the foot. "He can't run on it. He just can't go," his agent Deon Minor said. The injury will not require surgery but may take 12 weeks to recover from.

"I am disappointed that I will not be able to try to regain the world title in the 400 meters in Daegu. I wish my teammates the best in Daegu," Wariner said.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

“Lawsuit Pending Against Toning Shoes”

2011-08-09T20:45:00.000-07:00

Rocker bottom or “Toning shoes” have become wildly popular in recent years and promise to give your legs and gluteal muscles a workout. But could they be more of a hazard than a help? It depends who you ask.

According to a recent news article, Rosie Jackson, 57, broke her ankle and injured her back last November after wearing the toning shoes for less than a month. She still has unpaid hospital bills and was out of work for three months – all because of a fall she says wouldn’t have taken if it weren’t for the shoes. “I was walking and all of sudden I was going down and I couldn't do anything,” she said.

Last April, house call physician Ernest Brown also suffered a broken ankle while walking down the street in a pair of toning shoes. “It almost felt like something was hitting me from behind and knocking me off my feet.” Brown said. “What I knew is I was falling down rapidly and it was excruciating pain shooting up my leg.”

Brown and Jackson are among a group of at least 40 people who plan to sue several toning shoe manufacturers. Attorney Andy Bederman says the shoes have led to a variety of serious injuries. Bederman states, “The shoes, we think, are fundamentally unsafe and the manufacturer probably knew this and didn't disclose it and should've disclosed it.” The article also quotes a podiatrist who has treated injuries resulting from the use of the shoes. Some claim the shoe’s instability can be more of a concern rather than an aid to promote muscle toning.

As with all footwear decisions, make wise choices that will best suit your fitness activity level. And if you chose to try a pair of rocker bottom shoes, carefully read the company’s instructions on how to properly break in and wear the shoes to avoid accidents or injury.

http://www.wjla.com/articles/2011/07/lawsuit-pending-against-toning-shoes-64347.html

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What’s the Deal with Rocker Bottom Shoes?

2011-08-06T20:44:00.000-07:00

Rocker bottom shoes began as a shoe modification that was prescribed to patients suffering from such maladies as arthritis, plantar fasciitis, morton's neuroma, and tendinitis. The principle behind the stiff rocker bottom is that force is distributed evenly throughout the foot with ambulation, thus decreasing stress concentration on the injured area. In addition, such a sole decreases range of motion requirements on the ankle, hindfoot, and forefoot, decreasing pain if these joints are arthritic. Also the shape of the sole allows for propulsion while walking and can challenge certain muscle groups more than they are normally. These shoes are marketed as a way to strengthen muscles, which could lead to weight loss. They are also advertized to cause a change in posture to take pressure off of achy, overused joints.

A new study, released by the American Council on Exercise (ACE), shows that toning shoes including Skechers Shape-Ups, MBT (Masai Barefoot Technology), and Reebok EasyTone don't help people exercise more intensely, burn more calories, or improve your muscle strength and tone. ACE chief science officer Cedric X. Bryant, PhD, said in a written release, “Toning shoes appear to promise a quick-and-easy fitness solution, which we realize people are always looking for. Unfortunately, these shoes do not deliver the fitness or muscle-toning benefits they claim."

In the new study performed by researchers at the University of Wisconsin-La Crosse, 12 active women aged 19-24 completed a dozen five-minute intervals on a treadmill while wearing Skechers Shape-Ups, Masai Barefoot Technology, Reebok’s EasyTone Reeinspire shoes, or traditional New Balance running shoes as researchers monitored how hard they worked. A second group of 12 women aged 21-27 performed a similar battery of five-minute treadmill tests in the various shoes while researchers measured muscle usage in their calves, quads, hamstrings, buttocks, back, and abs. The results showed that there was no significant difference in calories burned or muscle usage between the four types of shoes, the researchers reported.

Many people do feel that these shoes work because of soreness in different muscles, but Bryant says the shoe’s unstable sole design does cause wearers to use slightly different muscles to maintain balance, resulting in temporary soreness that will subside as the body adjusts to the shoe. However, he also said that "If these shoes are serving as a motivator for individuals to walk or get moving more often, that is a good thing, even if they don’t produce the dramatic toning and calorie-burning results people think they are getting.”

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Yao Ming Retires Due to Foot Injury

2011-07-29T15:51:00.000-07:00

Earlier this month, Houston Rockets center Yao Ming decided to retire after nine NBA seasons. Yao's contract had expired after this past season with the Rockets, who have missed the playoffs the last two seasons. Yao Ming spent his entire eight-year NBA career playing for the Houston Rockets, who made him their top draft pick in 2002. The league paid Yao $93 million during his nine-year career. He also has earned an estimated $25 million in endorsement deals for local products as well as global brands such as Apple, McDonald's and Visa. He averaged 19 points and 9.2 rebounds throughout his career.

At 7’6”, Yao Ming's height was one of his biggest assets and helped him rise to be a star player the NBA. But his massive stature may have been the cause of the wear and tear on his leg and ankle that forced him to retire. Yao, who turns 31 in September, missed a total of 250 regular-season games over the past six seasons due mostly to injuries to his left foot and leg. Yao broke his left foot in a postseason game against the Lakers and underwent complex surgery that sidelined him for the entire 2009-10 season. He lasted only five games at the start of the 2010-11 season before breaking his left ankle. He underwent surgery in January, and was lost for the season again.

Yao Ming says he's not leaving basketball, however, and will continue to work for his former Chinese team, the Shanghai Sharks as well as with his charity group the Yao Foundation. Yao donated $2 million and set up a foundation to rebuild schools in the wake of the 2008 earthquake in Sichuan. Speaking at a farewell news conference on Wednesday that was broadcast live on Chinese national television, Yao said the past six months have been agonizing as he thought through his decision.

"Today I have retired, but as one door closes, another door gradually opens and a brand new life is waiting for me outside that door," Yao said. "Although I have retired from the court, I will never leave basketball. The Shanghai Oriental Sharks Basketball Club will be the extension of my basketball career. I am running the club with the knowledge that I have learned over the years.”

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

When Do I Replace My Orthotics?

2011-07-23T15:29:00.000-07:00

Many factors are used to determine the useful lifetime of a pair of orthotics. The first thing to look at is the material of the shell of the orthotic. Most orthoses are fabricated using a firm plastic material, which is durable and holds its shape well. These types of devices can last for four to five years. Softer materials like cork, leather or foam may wear out more quickly and only last one to three years.

Secondly, the activity level of the wearer must be taken into account. A marathon runner is harder on their feet in general compared to a “weekend warrier.” Repetitive forces on the orthotic can cause it to lose its shape after time and no longer maintain its original function.

Finally, other factors such as pregnancy or major joint replacement surgery may alter the mechanics of the leg and foot enough to warrant a new pair of orthotics.

Keep in mind that in some cases, the topcover may wear out long before the shell material. Different materials for the topcover can be used to avoid excessive wear, especially for athletes. For example, a neoprene topcover material would be a great choice for athletic shoes that may get wet from sweat or rain. If your topcover is worn out, ask your podiatrist about having the orthotics refurbished, and hopefully they will last for a few more years.

And let’s not forget about your household pets – if your puppy chew up your orthotics then that means it’s time to get a new pair!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

“Why Do I Need to Go to a Podiatrist for Orthotics?”

2011-07-20T15:27:00.000-07:00

The study of the mechanical nature of the foot and lower extremity is called biomechanics. Biomechanics is a specialized branch of science that uses the mechanical principles of physics to study the motions and forces on the human body. During their four years of medical training, Podiatrists receive specialized, in-depth training on how the movements and forces in the foot affect the movements and forces in the rest of the lower extremity, and how the movements and forces in the lower extremity affect the movements and forces in the foot.

No other medical specialty has this in-depth training, which is necessary to understand lower extremity pathology as it relates to the biomechanics of foot function, which makes the podiatrist is the most qualified medical specialist to diagnose and treat foot pathology.

Understanding the biomechanics of the foot and lower extremity is very important to design an appropriate treatment plan for a patient. Biomechanics also plays an important part in the planning for corrective surgery of injuries, such as tendon ruptures or bone fractures, or for the surgical correction of deformities of the foot, such as hammertoes, bunions, or heel spurs.

Due to the podiatrist's training and expertise in biomechanics, either functional or accommodative orthoses are often prescribed as part of the treatment plan. In some cases an orthosis will be all that is required for the successful treatment of foot or lower extremity pathology. However more often an orthosis will be prescribed in conjunction with other therapies, such as stretching or strengthening exercises, oral or injectable medications, and specific types of shoes, in order to provide maximum healing for the patient.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

“What Type of Orthotics Do I Need?”

2011-07-14T15:24:00.000-07:00

Custom-made orthotics may be prescribed to reduce the frequency of movement-related injuries, to align the skeleton properly, to provide improved cushioning, to improve the sensory feedback, and/or to improve comfort. For common foot problems, podiatrists either prescribe functional or accommodative orthotics.

Functional orthotics are casted with the foot in its most neutral position. This is important so that the subtalar joint (joint between the talus and the calcaneus) is in a place of maximum congruity, which means the bones are arranged in a way that supports optimum function. For example, someone who over pronates (a common cause of “flat feet”) may benefit from function orthotics. Pronation is a normal part of the gait cycle that aids in shock absorption and adaptation to changing surfaces during the stance phase of the gait cycle. However, excessive pronation or pronation which occurs at the wrong time in the gait cycle may cause pain or other problems. Studies have shown that orthotic devices are effective in reducing the degree of abnormal pronation as well as clinical symptoms of the lower limb.

Accommodative orthotics are casted with the foot in its natural position instead of neutral. They are used to cushion, pad or relieve pressure from a painful or injured area on the bottom of the foot. For example, accommodative orthoses are useful in the treatment of painful calluses on the bottom of the foot, diabetic foot ulcerations, and sore bones on the bottom of the foot. Although accommodative orthoses are relatively bulky and have relatively poor durability, they are relatively soft and forgiving and are generally easy to adjust in shape after they are dispensed to the patient to improve comfort.

While over-the-counter orthotics are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription foot orthoses can since they are not custom made to fit an individual's unique foot structure.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What Are “Orthotics”?

2011-06-27T15:21:00.000-07:00

Custom-made foot orthotics are just that, custom! A pair of foot orthotics are only right for the person for whom it is made, and they are worn in a shoe instead of the sock liner. In order to make orthotics that are specific to your feet, a podiatrist first takes a mold of your foot. Podiatrists use a variety of methods to take a mold of the feet, including: plaster casting, STS fiberglass slipper socks, foam imprinting, or computer devices. It is important to get a custom orthotic from a podiatric physician, who will provide an appropriate examination.

In a complete and thorough evaluation for a custom orthotic, measurements are taken of the foot, ankle, knee, and hips during a biomechanical exam. Sometimes standing X-rays may also need to be taken to examine the bone structure in detail. Lastly a visual gait analysis is performed by watching the patient walk barefoot back and forth down a hallway. Based on the entire exam, a prescription is formulated to make orthotics to correct any deformities and allow the patient to walk as efficiently as possible.

Of course, there is a time and place to try an off-the-shelf insole. For mild foot pain, shin splints, or pain in the front of your ankle, try getting an insole from a specialty running store, which will provide some good support. An insole of this type should cost about $30-$40. If it’s more than that, just say no!!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

“Do I Need Orthotics?”

2011-06-18T15:16:00.000-07:00

Well, the simple answer is “maybe.”

First let’s start with some definitions. The insole that comes in a running shoe is called a “sock liner.” No matter what the running magazine or shoe website says, it only offers minimal support. The support and control of a running shoe comes from within the shoe itself. Anything you can buy off the shelf at a pharmacy, shoe store, or sporting goods store is an “insole.” Insoles provide generic arch support and are often a first step in solving foot issues.

Custom orthotics are used to treat many different foot deformities, such as bunions or hammertoes. A properly made orthotic will help to eliminate the forces that caused these deformities and prevent them from getting worse, which could help you avoid surgery down the road. Serious athletes at any level should consider a custom orthotic if they have pain in their feet, ankles, legs, hips, or back during the activity. Taking a chance with a generic insole may make your condition worse.

A good pair of orthotics can provide support and comfort when running and playing sports, but they are beneficial for everyday activities as well. Muscles and joints respond best to consistency, so if you suffer from foot pain it is best to wear your orthotics as much as possible. Wearing orthoses only for exercise may account for 10% of your day or less, which is not ideal for preventing deformities. To maximize the time you wear your orthotics, keep in mind that they can be made specific to fit in boots, high heels dress shoes, and even certain brands of sandals. Orthotics are used to allow the lower extremity to work more efficiently, so why not allow your body to function in its optimum position in all day long?

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Purple Toenails in Runners

2011-06-12T13:01:00.000-07:00

When a runner does not wear shoes that fit properly, the feet are able to slide around in the shoes. This can occur if running shoes are too big, allowing the foot to rub up against the front edge. However, jamming of the toes can also occur if shoes are too small. This one of many important reasons to get shoes that fit properly to avoid foot injuries! To avoid running related injuries, purchase proper fitting shoes by following the following rules of thumb:

1. If it is your first time purchasing running specific shoes, it’s a good idea to visit a specialty running store. Most running shoe stores are staffed by runners, who are knowledgeable in proper shoe fitting and full of other running tips for those who are just starting out.

2. Running shoes come in different types, for example shoes specific for those who over pronate (have flat feet), and stabilizers, for those who need more support. It is important to have someone take a good look at your feet, and possibly do some measurements and tests to see which type of shoe would work best for you. Don’t just pick the style or color you like!

3. To find the best length for each foot, you should have the approximate width of your index finger between your longest toe and the end of the shoe. If your second toe is longer, be sure to size appropriately.

4. Always size your shoes towards the middle or end of the day as feet tend to swell throughout the day. Also be sure to wear the socks you usually wear while running, and always stand when checking for proper fit of a shoe. Don’t forget to bring your orthotics or inserts with you to the store, and put them in each pair you try.

Bruised nails are a common sign of running shoes not fitting properly. If this occurs, get new running shoes! If the nail starts to become painful, see your podiatrist for a full evaluation.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Will I Lose My Bruised Toenail?

2011-06-06T12:56:00.000-07:00

Many runners may be surprised to take off their socks after a run and notice that one or more of their toenails have turned dark purple or blue. Often the bruised toenails look much worse than they are, so don’t be alarmed.

A bruised nail does not automatically mean that you will lose the toenail. If there is substantial bleeding beneath the nail, a podiatrist can relieves that pressure quickly, and the nail can reattach to the nail bed. Otherwise, prolonged trauma from the pressure can cause the nail to detach and a new nail to begin forming and growing underneath. If that occurs, the original, damaged nail will simply fall off when the new nail has progressed. As long as the nail comes off with no pain or bleeding, there should be no concern.

The color change is caused by micro lesions under the nail from tiny broken capillaries. Once you notice the discoloration, the best way to get rid of it is to stop running in the same shoes that caused the condition. More often than not, the discoloration does not cause much discomfort. But make sure to wash around the nail to prevent an infection from occurring. If there is enough bleeding under the nail, pressure can build up which can cause discomfort. The pain either signifies infection or pressure build up from bleeding under the nail, both of which can be easily treated by a podiatrist.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Stress Fractures in Ballet Dancers

2011-05-27T21:05:00.000-07:00

Classical ballet is an art form requiring extraordinary physical activity and rigorous training. The tremendous physical exertion involved in ballet dancing places participants at high risk of injuries, most of which affect the foot and ankle, unsurprisingly. Specific injuries of both bone and soft tissue have been reported. These injuries include chronic tendonitis, impingement syndromes about the ankle, and stress fractures of the foot. Overuse injuries such as stress fractures can arise from repetitive minor trauma and the base of the second metatarsal is the most common site of stress fractures in female classical dancers.

The metatarsal bones are the long bones within the foot that connect the tarsal bones to the toes and Lisfranc’s joint is the site where the second metatarsal articulates with all three of the cuneiform bones. The medial and lateral cuneiforms serve to lock the head of the second metatarsal into a relatively rigid socket, which greatly reduces its mobility. Because this joint serves as a locking mechanism for this part of the foot, a hyperflexed position, such as when dancers are en pointe, puts the foot at greater injury risk.

Classical ballet dancers spend 4-6 hours per day in pointe shoes which require the foot to remain in a snug, leather or canvas slipper. These shoes confine the feet and toes in a very small space so that the dancer can ‘feel’ the floor. Through training and performances, dancers undergo repetitive motions and executions which place large amounts of stresses on the feet. Stress fracture injuries in ballet dancers often require lengthy absence from practices, rehearsals, and performances. This is not only frustrating, but can be detrimental for a professional dancer’s career. Seeing a Podiatrist for ballet foot injuries can help dancers avoid further injury and be back on stage sooner.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What To Do If You Suspect a Stress Fracture

2011-05-20T20:36:00.000-07:00

If you think you may have a stress fracture, the first thing to do is decrease your amount of high intensity exercise. A great way to maintain your activity level is to switch to low impact sports such as cycling or swimming until the area of concern calms down. Moderate stress applied to the bone in a controlled manner can strengthen the bone and make it less susceptible to a stress fracture. An easy way to do this is to follow the runner's rule of increasing distance by no more than 10 percent per week, which allows the bones to adapt to the added stress so they are able to withstand greater stress in the future.

It is also important to see your podiatrist so they can take an x-ray of the site. Stress fractures can take up to 14 days to show up on x-rays, so most likely your injury will be treated like a fracture until the diagnosis can be confirmed. Sometimes a bone scan may also be needed to detect a stress fracture. The x-ray above shows a typical stress fracture of the second metatarsal not seen on initial radiographs. The x-ray on the right shows a callus that has formed around the bone 4 weeks later.

Although stress fractures can be frustrating to an athlete who is in training, it is important to listen to your doctor’s instructions to modify your workout routine so that you can avoid developing an even more severe injury that may require surgery and more time away from your sport.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What is a Stress Fracture?

2011-05-13T20:31:00.000-07:00

Stress fractures are tiny cracks in a bone that are due to repeated stress in an area in the body. These fractures are often the result of overuse injuries from activities that involve repeated jumping up and down or running long distances. 95% of stress fractures develop in the weight bearing bones of the lower extremity and account for 10% of all running injuries.

The symptoms of a stress fracture are tenderness over a localized area, pain when putting weight on the affected limb, and slight swelling around the area. One might also experience an earlier onset of pain with each successive workout, and continued pain at rest as the damage progresses.

For Runners in Particular:

Runners are particularly susceptible to stress fractures, especially those who run too many miles in worn out shoes, change the surface they run on, or change the intensity level of their workout. More specifically, women with amenorrhea (loss of menses), thinner athletes, and those who are not taking in adequate nutrients to replenish their bones are most prone to getting stress fractures. Careful consideration of proper nutrition can help runners have healthy bones and avoid developing stress fractures. It is recommended to take in 1000 mg of Calcium per day and 200 IU of Vitamin D per day. Also maintaining a Body Mass Index (BMI) of at least 18.5 or higher and a body fat level of at least 14% is advised.

Stress fractures may be barely noticeable at first but can lead to lengthy recovery. Proper care by a Podiatric Physician early on can prevent the stress fracture from worsening and keep you on your feet longer.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Plantar Fibromas

2011-05-03T20:41:00.000-07:00

Diagnosis:

To diagnose a plantar fibroma, a podiatrist will examine the foot and press on the affected area, which sometimes produces pain that extends down to the toes. MRI and sonography (diagnostic ultrasound) are effective in showing the extent of the lesion, but cannot reveal the tissue composition, so biopsy may be performed to further evaluate the lump and aid in diagnosis.

Treatment:

Non-surgical treatment may help relieve the pain of a plantar fibroma, although it will not make the mass disappear. The foot and ankle surgeon may select one or more of the following non-surgical options:

Steroid injections. Injecting corticosteroid medication into the mass may help shrink it and thereby relieve the pain that occurs when walking. This reduction may be only temporary and the fibroma could slowly return to its original size.
Orthotic devices. If the fibroma is stable, meaning it is not changing in size, custom orthotic devices (shoe inserts) or padding may relieve the pain by distributing the patient’s weight away from the fibroma.
Physical therapy. The pain is sometimes treated through physical therapy methods that deliver anti-inflammatory medication into the fibroma without the need for injection.

If the mass increases in size or pain, the patient should be further evaluated. Surgical treatment to remove the fibroma is considered if the patient continues to experience pain following non-surgical approaches.

Surgery of this disease is difficult because tendons, nerves, and muscles are located very closely to each other. Additionally, feet have to carry heavy load, and surgery might have unpleasant side effects. Because the fibroma does not have a capsule surrounding it, clinical margins are difficult to define and portions of the diseased tissue may be left in the foot after surgery.

Surgical removal of a plantar fibroma may result in a flattening of the arch or development of hammertoes. Orthotic devices may be prescribed to provide support to the foot. Due to the high incidence of recurrence with this condition, continued follow-up with a podiatric physician is recommended.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

“I feel a knot on the bottom of my foot!”

2011-04-28T20:38:00.000-07:00

Plantar fascial fibromatosis, (aka Ledderhose's disease) is a thickening of the deep connective tissue, or fascia, on the bottom of the foot. It is relatively uncommon and non-malignant. The disease is minor at first but can be very painful. It begins with nodules or cords that start growing along tendons of the foot. Once these cords thicken, it causes the toes to stiffen and bend, and walking becomes painful. (A similar disease is Dupuytren's disease, which affects the hand and causes bent hand or fingers.)

As in most forms of fibromas, its onset varies with each patient. The nodules are typically slow growing and most often found in the central and medial portions of the plantar fascia. Occasionally, the nodules may lie dormant for months to years only to begin rapid and unexpected growth.

Plantar fibromatosis is most frequently present on the medial border of the sole, near the highest point of the arch. The lump is usually painless and the only pain experienced is when the nodule rubs on the shoe or floor. The overlying skin is freely movable, and rigid toes do not develop until later stages of the disease.

Risk Factors:

Certain risk factors have been identified and include:

A family history of the disease
Higher incidence in males
Palmar fibromatosis 10-65% of the time
Peyronie's disease
Epilepsy patients
Patients of diabetes mellitus

Although the origin of the disease is unknown, some speculate that it is an aggressive healing response to small tears in the plantar fascia, almost as if the fascia over-repairs itself following an injury.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Is Your Nail Salon Safe?

2011-04-20T14:47:00.000-07:00

According to an article from Boston News, State inspectors from the Massachusetts Division of Professional Licensure cited hundreds of nail and hair salons last year for violations. The most serious put people's health at risk.

Investigators followed state inspectors where they entered salons unannounced to go through drawers, examine equipment and check licenses. They scoured the salon -- including back rooms and basements -- looking for unsafe conditions that could harm customers. Among the violations they encountered where reusing filers and buffers, which can transmit fungal nail infections. State regulations require manicurists to throw out nail files and buffers after they've been used on a single customer.

At another salon, inspectors discovered problems with air quality.

"The fumes are very high in the salon, which means either the vent wasn't working or it wasn't on," Luc said. "It's just hazardous."

Inspectors in Massachusetts try to visit each of the state's nearly 8,000 salons once every two years.

Investigates from this news channel reviewed hundreds of inspection reports from last year and found citations for 604 salons for a range of violations, including unlicensed employees, unsanitary tools and lack of sterilization.

At some salons, staff used blades on customers. "Blades are supposed to be used by podiatrists only," an investigator said. "They not allowed in a salon at all. And they can cause infections." Fines can be up to a couple hundred dollars and serious or repeat offenders can be brought before the state board.

To avoid problems, inspectors recommend that customers ask salons how they sanitize their tools, and if they reuse nail files and buffers. Customers also should check for licenses, which indicates the salon is aware of the latest public health requirements. Be sure to be aware of these safety concerns when visiting a salon to keep your feet healthy!

Read the full article at: http://www.thebostonchannel.com/r/27295784/detail.html

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Are your shoes too small?

2011-04-12T14:33:00.000-07:00

Think of the shoe size you wear. How long have you been wearing this size? How do you know it’s the right one? Do you ever purchase shoes in a different size than you think you are based on the fit? The shoe size you wore in high school probably is not the right size!

Wearing the wrong size shoes can cause problems to your feet such as plantar fasciitis and bunions. Here’s a great way to determine your correct size and ensure that your shoes are a proper fit:

Find a Brannock device. Visit a shoe store or ask your podiatrist at your next visit to use a Brannock device. This device can be used to take multiple measurements of the feet.

Heel-to-Toe Length. As you stand on the device with your right heel against the back of the heel cup, make sure both feet are shoulder’s length apart and that your weight is equally distributed on both feet. Have an assistant press the toes flat against the base of the device and move the length piece until is rests gently against the edge of the furthest part of your longest toe.

Arch Length (Heel-to-ball). Repeat the steps above but with the “arch length pointer” piece so that it rests gently against the ball of the foot. To locate the right area, find the first metatarsophalangeal joint (see photo), which is the bony prominence where the toes bend. This is the most important step!

Measure the other foot.

Find your correct size. Compare the values for the heel-to-toe length as well as the heel-to-ball length. Use the large of the two measurements to determine your correct shoe size. Now look at the width measurement and see where your numbers line up on the Brannock device.

Width measurement. Move the width bar to rest gently against the side of your foot. Locate the shoe size (as determined in step five) on the movable width bar and view the width measurement indicated by the properly determined shoe size. If the shoe size falls between widths, choose a wider width for a thick foot, a narrower width for a thin foot.

Purchase shoes in your correct size!

For more information or clarification, visit the Brannock website at: http://www.brannock.com/cgi-bin/start.cgi/brannock/index.html

Many people have one foot that is larger than the other, so be sure to fit to the larger of the two. Your foot size changes with age, weight changes, pregnancy and other factors, so it’s a good idea to have your feet measured and fitted each time you purchase shoes. Remember, correctly fitted footwear can prevent long-term foot problems!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Foot Health Awareness Month: Keep America Moving!

2011-04-07T09:30:00.000-07:00

During April’s Foot Health Awareness Month, join the American Podiatric Medical Association (APMS) in its effort to combat the growing problem of childhood obesity through foot health education! In step with the national Let’s Move! initiative launched by First Lady Michelle Obama, the APMA will be shining the spotlight on childhood obesity and how proper foot health plays a vital role in keeping children active and healthy. Watch this video to learn more and hear from a Pediatric Podiatrist!

The Let’s Move! initiative reminds us that physical activity is an essential component of a healthy lifestyle. In combination with healthy eating, physical activity can help prevent a range of chronic diseases, including heart disease, cancer, and stroke, which are the three leading causes of death. Physical activity helps control weight, builds lean muscle, reduces fat, promotes strong bone, muscle and joint development, and decreases the risk of obesity. Children need 60 minutes of play with moderate to vigorous activity every day to grow up to a healthy weight.

If 1 hour of activity sounds like a lot, consider that 8-18 year olds spend an average of 7.5 hours a day using entertainment media including TV, computers, video games, cell phones and movies in a typical day! Plus, it’s been shown that only one-third of high school students get the recommended levels of physical activity. To increase physical activity, today’s children need safe routes to walk and bike ride to school, parks, playgrounds and community centers where they can play after school, and activities like sports, dance or fitness programs that are exciting and challenging enough to keep them engaged. The Let’s Move! campaign aims to increase opportunities for kids to be physically active, both in and out of school and to create new opportunities for families to move together.

For more information on the Lets Move! Initiative, visit the official website today!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Run to Lose Weight

2011-03-31T20:31:00.000-07:00

Many Americans trying to lose weight cringe at the thought of having to run, and, let’s face it, they do so for a good reason. Running is a hard sport. It’s no wonder that track and cross country teams proudly wear T-shirts that say, “Our sport is your sports punishment.” To some, running may come naturally, be a great way to relieve stress, and maintain a healthy weight. For others, running is plain intimidating. Training the body to be able to endure the physical requirements it takes to run requires careful consideration and planning.

One of the most popular reasons that people start to run is to lose weight. Running is one of the best physical activities you can do to shed a couple of extra pounds in a short period of time. What better time to start than in the beautiful spring weather? If you are using running as a tool to lose weight, here are some pointers to help you reach your weight lose goal in the most healthy and satisfying way:

1) You are what you eat. One of the most common misconceptions about weight loss is that one can simply lose weight by working out and not changing their diet. This is not true! The best way to lose weight is a combination of diet and exercise.

2) Don’t start off too fast. Often at the beginning of a new weight loss workout routine, people tend to be excited and driven, which puts them at risk for doing too much too fast. This causes people to tire out, give up, or get injured. Try to plan out a workout routine that starts gradually and that you can realistically follow without pushing yourself to exhaustion.

3) Be sure to have the right equipment. When starting to run for the first time ever or first time in a long while, it is important to get a new pair of shoes that will give your feet the support they need. Also make sure you get some quality socks that will be able to absorb the sweat from your new workout schedule. Many other gadgets and accessories are out there, such as fancy watches, water belts, absorbent clothing, and sweatbands. One good way to figure out what you will need for is to visit a specialty running store. The employees are often runners themselves and can offer good advice.

Who knows, maybe you’ll find out that running can actually be FUN! As you give it a whirl this spring, be sure to also change your diet, make a realistic workout routine, and have the right equipment to help you avoid injury. Check out our previous post on running shoes from 4/30/10 for more useful information!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM)

How are warts treated?

2011-03-25T20:16:00.000-07:00

The goal in getting rid of warts is to have the body’s immune system fight the wart. For this to happen, the immune response needs to be induced by irritating the area. (Diabetic patients often require alternate treatments due to risk of complications with poor circulation and healing time.) Getting rid of warts can be a long a tedious process requiring a mix of patience and creativity.

1. Chemicals: applied topically, and examples include a salicylic acid patch, 60% salicylic acid Salinicane (which includes a topical numbing agent)

2. Cold therapy (aka “cryotherapy”): for example liquid nitrogen, which causes a blood blister

3. Electrolysis: “negative galvanic” works to burn off the wart

4. Oral vitamin A: works as an adjunct to other treatments

5. 10% formalin solution: dries out the area (good option for kids)

6. Needling: puncture wart many times to intentionally cause irritation, which encourages the body’s immune response to become activated

7. Duct tape: apply for a long time to the wart

8. Manually excise: have the wart surgically removed can cause a scar and generally is bad under bony prominences

Not all people respond to certain proven therapies, which has led to a wide variety of tricks and experiments. Countless remedies have been reported to cure warts, but not all are safe. For example, taking antibiotics (such as Cimitidine or Tagamat) are not a good idea for warts, and they don’t work. What about shitake mushrooms or taping a penny to the wart? It won’t hurt, but it might not work either. Save yourself the trouble and see your podiatrist for safe and effective treatment for warts!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What are Verrucae (warts)?

2011-03-12T20:13:00.000-08:00

Warts are small, hard, benign growths on the skin and are caused by the human papilloma virus (HPV), mostly type 2 and 7. About 130 known types of HPV exist, and each type is typically only able to inject a few specific areas on the body. Therefore, the warts that are considered “high-risk” for certain types of cancers (for example, type 16 and 18 are associated cervical cancer) do not cause warts on the hands or feet.

You may have heard about the HPV vaccine, which young women are encouraged to receive. Unfortunately the HPV vaccine does not currently prevent the virus strain responsible for verrucas. However, keep in mind that warts are contagious and warts may regrow after they are removed.

As many as 10 varieties of warts exist and the most common are largely considered harmless. Types of warts found on the feet include:
• Verrucae vulgaris – a common wart with a raised roughed surface, located on the bottom of foot
• Verrucae plantaris/pedis – aka “plantar’s wart”, usually found on pressure points on the soles of the feet
• Juvenile warts – flat warts on found on the face and feet of children
• Mosaic wart –little warts that combine to make one large wart

How to differentiate between a wart and a callus:

HPV causes outward growth through the outer layer of skin, leading to an out-puckering of nerves and blood vessels.

-When you squeeze a wart, there is pain. Squeezing a callus does not cause pain.
-When you press a wart there is no pain. If you press a callus, there is often pain as bone is underneath the area.
-When a wart is removed, there is pinpoint bleeding (due to the out-pocketing of vessels underneath. Removing a callus does not cause bleeding unless deeper layers of healthy skin are affected.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com
Allison Ippel, Student Blogger (SCPM 2013)

What is a Podiatrist?

2011-03-06T15:39:00.000-08:00

A podiatrist is a doctor of podiatric medicine (DPM), also known as a podiatric physician or surgeon, qualified by their education and training to diagnose and treat conditions affecting the foot, ankle and related structures of the leg. Podiatrists are uniquely qualified among medical professionals to treat the foot and ankle based on their education, training and experience.

The Podiatric Medical School curriculum covers basic and clinical sciences, including, but not limited to: general anatomy, physiology, histology, biochemistry, pharmacology, pathology, general medicine, surgery, radiology, pediatric orthopedics, and ethics. Unlike MD and DO medical schools, the Podiatric Medical School curriculum also provides intensive foot and ankle “specialty” specific education beginning in the first year.

Are all podiatrists board certified?

A majority of podiatrists are board certified. Certification is considered to be an earned credential for those podiatric physicians who have achieved certain levels of skill and ability based upon completion of specific advanced training and clinical experience and examination. The American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM) is the certifying board for the specialty areas of podiatric orthopedics and primary podiatric medicine. The American Board of Podiatric Surgery (ABPS) is the certifying board for the specialty area of foot and ankle surgery.

Podiatrists must take 3 exams:

1st - test on general science courses (following Year 2 of Podiatry school)
2nd - test on clinical areas, general medicine, dermatology, radiology, orthopedics, biomechanics, surgery, anesthesia (following Year 4 of Podiatry school)
3rd - licensing exam given by state (following Residency training)

What are the qualifications of a podiatrist?

Podiatrists are defined as physicians by the federal government and in most states. DPMs receive medical education and training comparable to medical doctors, including four years of undergraduate education, four years of graduate education at one of eight accredited podiatric medical colleges and three years of hospital residency training. Within the field of podiatry, practitioners can focus on many different specialty areas, including surgery, sports medicine, biomechanics, geriatrics, pediatrics, orthopedics or primary care.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

How is gout treated?

2011-02-25T14:45:00.000-08:00

Nonsteroidal anti-inflammatory drugs (NSAIDs) may control inflammation and pain in an acute gout attack. The doctor may prescribe a higher dose to stop an acute attack, followed by a lower daily dose to prevent future attacks.  NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others), as well as more powerful prescription NSAIDs such as indomethacin (Indocin).

If you're unable to take NSAIDs, your doctor may recommend colchicine to reduce gout pain.  After an acute gout attack resolves, the doctor may prescribe a low daily dose of colchicine to prevent future attacks.

Corticosteroid medications, such as prednisone, may control gout inflammation and pain. Corticosteroids can either be taken orally or injected into the joint and help with inflammation and pain of a gout attack and are generally reserved for people who can't take either NSAIDs or colchicine.

Some drugs are used to prevent the complications associated with frequent gout attacks and include medication that blocks uric acid production (i.e. allopurinol and febuxostat). These drugs may lower your blood's uric acid level and reduce your risk of gout.

Another form of medication called Probenecid improves uric acid removal by the kidneys.

Without treatment, an acute attack of gout will usually resolve in 5 to 7 days. However, 60% of people will have a second attack within one year. Also, without treatment, episodes of acute gout may develop into chronic gout with destruction of joint surfaces, joint deformity, and painless tophi (in the earlobe, the elbow, or on the Achilles tendons). Kidney stones also affect between 10 and 40% of people with gout.

How is gout diagnosed?

Diagnosis is confirmed clinically by podiatric physicians by a joint fluid test. The podiatrist may use a needle to draw fluid from the affected joint. When the synovial joint is examined under the microscope, it will reveal characteristic urate crystals in an acute gout attack.

Also, podiatrists may recommend a blood test to measure the uric acid level in your blood. Although blood test results can be misleading, as some people have high uric acid levels but never experience gout. In other cases, some people have signs and symptoms of gout, but don't have unusual levels of uric acid in their blood.

With lifestyle changes and if necessary, certain medications, this disease can be controlled and gout attacks can be limited. As always, see your podiatrist right away if you suspect a gout attack for early treatment and relief.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Well-known Gout Suffers

2011-02-15T14:25:00.000-08:00

Gout was historically known as "the disease of kings" or "rich man's disease". Because purine rich food and drink, like red meats and wines, consumed in large quantities were only affordable to the rich, gout was seen as a disease of the affluent.

Benjamin Franklin once said that one should "eat to live, and not live to eat" he also said, "Be temperate in wine, in eating, ... or the Gout will seize you and plague you both." Benjamin Franklin also suffered from psoriasis and kidney stones, also linked to excess uric acid in the blood. Handling lead work in a print shop handling lead type when he was younger probably exposed him to mild lead poisoning and that, combined with drinking wine from lead crystal cut glass decanters (normal in the 18^th century) that leached lead into the wine, most likely made his gout worse.

The English physician Thomas Syndenham, gave his classic description of gout:

“Gouty patients are, generally, either old men, or men who have so worn themselves out in youth as to have brought on a premature old age - of such dissolute habits none being more common than the premature and excessive indulgence in venery, and the like exhausting passions. The victim goes to bed and sleeps in good health. About two o'clock in the morning he is awakened by a severe pain in the great toe; more rarely in the heel, ankle or instep. The pain is like that of a dislocation, and yet parts feel as if cold water were poured over them. The pain, which was at first moderate, becomes more intense… Now it is a violent stretching and tearing of the ligament, now it is a gnawing pain and now a pressure and tightening. Then follows chills and shivers, and a little fever... The night is passed in torture, sleeplessness, turning the part affected, and perpetual change of posture; the tossing about of body being as incessant as the pain of the tortured joint, and being worse as the fit comes on. So exquisite and lively meanwhile is the feeling of the part affected that it cannot bear the weight of bedclothes nor the jar of a person walking in the room.”

The list of famous gout sufferers is long and distinguished and includes Benjamin Franklin, Leonardo da Vinci, Martin Luther, Oliver Cromwell, Galileo, Theodore Roosevelt, Henry James, Benjamin Disraeli, Thomas Jefferson and Karl Marx.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Super Bowl Ankle Injury

2011-02-07T09:07:00.000-08:00

For a team that had overcome injury after injury on its way to Super Bowl XLV, this was altogether different.

Donald Driver, the leading receiver in Packers history, was the first to leave the game with an ankle injury. Then nickel back Sam Shields, went to the locker room with a hurt shoulder. And then, cornerback Charles Woodson, the heart of the Packers and the league’s top defensive player a year ago, was ruled out of the game with a broken left collarbone.

To lose Driver and Woodson (Shields later returned and then went out again), the emotional leaders of a team in search of that elusive Super Bowl ring, the Packers surely couldn’t overcome that.

But once again, the packers proved to be one of the most resilient teams in recent history, emerging as champions with a 31-25 victory over the Steelers last Sunday.

“We just felt like everything we went through just shaped us for this moment right here,’’ said defensive end Ryan Pickett. “It just molded us and made us the team that you saw tonight.’’

Green Bay built a 21-3 lead before the injuries took hold, and they needed that cushion to hold off the Steelers, winning 31-25.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2010)

The History of Gout

2011-01-29T14:23:00.000-08:00

Gout isn’t strictly curable, but it can be controlled relatively easily with a daily pill. Because, that pill (allopurinol) wasn’t available to the general population until the 1960s, gout has had plenty of time to develop a heritage and mythology unique unto itself. Read on for more history on gout.

· 2600 BC: The first documentation of the disease is from Egypt in a description of arthritis of the big toe.

· 400 BC: The Greek physician Hippocrates commented on gout in his Aphorisms, noting its absence in eunuchs and premenopausal women.

· 30 AD: Aulus Cornelius Celsus described the linkage with alcohol, later onset in women, and associated kidney problems:

“Again thick urine, the sediment from which is white, indicates that pain and disease are to be apprehended in the region of joints or viscera... Joint troubles in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra. These seldom attack eunuchs or boys before coition with a woman, or women except those in whom the menses have become suppressed... some have obtained lifelong security by refraining from wine, mead and venery.”

· 1200 AD: The word ‘gout’ was initially used by Randolphus of Bocking. It is derived from the Latin word gutta, meaning "a drop" (of liquid).

· 1679: The Dutch scientist Antonie van Leeuwenhoek first described the microscopic appearance of urate crystals.

· 1683: Thomas Sydenham, an English physician, describes its occurrence in the early hours of the morning and its predilection for older males.

· 1799: James Gilray caricatured gout as a black devil gnawing at the outside of the foot (see picture above).

· 1848: English physician Alfred Baring Garrod realized that this excess uric acid in the blood was the cause of gout.

· 1926: In his book “A Study of British Genius,” Havelock Ellis makes the connection between genius and gout. He writes,

“It occurs so often in such extreme forms, and in men of such pre-eminent intellectual ability, that it is impossible not to regard it as having a real association with such ability.”

Perhaps gout should be interpreted as a very unpleasant form of flattery?

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What are the Symptoms of Gout?

2011-01-27T14:19:00.000-08:00

Symptoms of gout include a sudden onset of acute arthritis. The most common joint that is affected is the big toe, or first metatarsal-phalangeal joint (contributing to over 75% of all gout attacks). In an acute “gout attack”, patients experience severe joint pain and the toe often becomes red, tender, hot and swollen (see photo above). A gout attack is often so painful that one cannot even tolerate the weight of bed sheets lying on the affected foot. Other joints, such as the heels, knees, wrists and fingers, may also be affected. Joint pain usually begins over 2–4 hours and more often during the night. At night the body temperature goes down, which is why acute attacks often occur at night. Fatigue and a high fever may also accompany the joint pain in an acute gout attack.

How common is gout?

Gout has increased in frequency in recent decades and affects approximately 1–2% of the Western population at some point in their lives. This increase is believed to be due to rise of risk factors, such as metabolic syndrome, longer life expectancy and changes in diet.

How can gout be prevented?

Both lifestyle changes and medications can decrease uric acid levels. Dietary and lifestyle choices that are effective include reducing intake of food such as meat and seafood, consuming adequate vitamin C, limiting alcohol and fructose consumption, and avoiding obesity. According to one study, a low-calorie diet in obese men decreased uric acid levels by 100 µmol/L (1.7 mg/dL). Another study showed that Vitamin C intake of 1,500 mg per day decreases the risk of gout by 45% compared to 250 mg per day. Interestingly, coffee, but not tea, consumption is associated with a lower risk of gout. Gout may be secondary to sleep apnea via the release of purines from oxygen-starved cells and treatment of apnea can lessen the occurrence of attacks.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (2013)

What is Gout?

2011-01-25T13:42:00.000-08:00

It is safe to say that several systemic diseases are often diagnosed sooner by podiatrists than a primary care physician due to the nature of how these particular diseases present. One such disease that podiatrists see and diagnose often is gout.

Gouty arthritis is a form of arthritis caused by deposits of needle-like crystals of uric acid. The uric acid precipitates to form little crystals that deposit in the joints, tendons and surrounding tissues, which can unsurprisingly be very painful.

What causes gout?

You may have heard that gout is a disorder of “purine metabolism”, but what does that mean? We take in purines from certain foods and drinks, and they become significant components in various molecules our bodies use for making energy, DNA, RNA, etc. The purine problem leading to gout is either due to our genetics or our lifestyle.

The occurrence of gout is in large part genetic, accounting for approximately 80% of cases. A few rare genetic disorders, including familial juvenile hyperuricemic nephropathy, medullary cystic kidney disease, and various deficiencies seen in Lesch-Nyhan syndrome, are complicated by gout. Secondary gout is a result of other factors such as disorders of hematological origin, certain cancers (which increase the breakdown of cellular nucleoproteins), or from the use of drugs that impair the elimination of uric acid, i.e., salicylates, alcohol, or certain diuretics.

Dietary causes account for about 20% of gout. While it’s true that the foods traditionally associated with antiquated gluttony — goose, partridge, mutton, the inner organs of beasts and fowl — are likely to bring on an attack, so too are more innocent-seeming things like fructose-sweetened drinks, sardines, anchovies and salmon, as well as a common celebratory Super Bowl-themed substance: beer. Other triggers include physical trauma and surgery. The consumption of coffee, vitamin C and dairy products as well as physical fitness appear to decrease the risk.

Gout frequently occurs in combination with other medical problems. Metabolic syndrome, a combination of abdominal obesity, hypertension, insulin resistance and abnormal lipid levels occurs in nearly 75% of cases. Other conditions which are commonly complicated by gout include: polycythemia, lead poisoning, renal failure, hemolytic anemia, psoriasis, and solid organ transplants. A body mass index (BMI) greater than or equal to 35 increases a male's risk of gout threefold!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Dance for Diabetes

2011-01-17T11:34:00.000-08:00

On January 16, 2011, the Scholl College of Podiatric Medicine (SCPM) at Rosalind Franklin University of Medicine and Science (RFUMS) hosted the 24th Annual Dance for Diabetes at the Millennium Knickerbocker Hotel in Chicago, Illinois. This annual event helps raise money to donate to the American Diabetes Association (ADA) to help fund research on preventative medicine and education on Diabetes.

Scholl College of Podiatric medicine has been dedicated to raising money for the American Diabetes Association for the past 24 years due to its close professional tie to diabetes. Most podiatrists regularly see diabetic patients and know firsthand how diabetes affects the lives of many of their patients.

Due to the fact that podiatrists see the devastating side effects of diabetes in their patients many of them become very passionate about raising awareness for Diabetes prevention and research. Undoubtedly this is why SCPM students and faculty work so hard every year to raise money through Dance for Diabetes to donate to the ADA. This year the college was pleased to announce that they donated $16,800 to the American Diabetes Association.

Thanks to all who participated and worked so hard in planning a very successful event!

For more information on diabetes research and awareness, check out the ADA website at: www.diabetes.org

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger -- SCPM 2013

What is "Lobster-Claw Syndrome?"

2011-01-09T21:17:00.000-08:00

Ectrodactyly, sometimes referred to as “Lobster-Claw Syndrome”, involves the deficiency or absence of one or more central digits of the hand or foot.

A large number of human gene defects can cause ectrodactyly, such as from deletions, translocations, and inversions in chromosome 7 (7q). These alterations in 7q can have a strong connection with growth impairment, microcephaly (abnormal smallness of the head and brain), deformities of the facial bones, hernias, hearing loss, and mental retardation. Ectrodactyly can be inherited from a parent, but many individuals are the first in their family to be affected.

Ectrodactyly is frequently seen with other congenital anomalies, or other birth defects, and may be caused by genetic factors or by exposure of the embryo to environmental factors. When two or more genes are affected by a chromosomal rearrangement, other disorders associated are with ectrodactyly, including cleft lip and/or cleft palate (Electrodactyly-Ectodermal dysplasia-Clef Syndrome, or EEC). Other abnormalities include absence of the teeth and other dental abnormalities, decreased ability to sweat, absence of tear ducts, photophobia (increased sensitivity to light), and kidney abnormalities. Most individuals with ectrodactyly have some of these abnormalities, but very few individuals have all of these abnormalities.

The cosmetic concerns of the syndrome can have a tremendous impact on the quality of life of an individual with ectrodactyly. The facial and limb differences can be socially isolating and physically challenging as many individuals erroneously assume that people with EEC syndrome have limited abilities. The overall incidence of ectodermal dysplasias in the United States is seven out of 10,000 people and the prognosis for most people with ectrodactyly is very good. In general, they have minimal and manageable serious medical problems, normal IQ, and most achieve success and have a long life, irregardless of their disabilities. The life expectancy of individuals with EEC syndrome without sweating problems is expected to be normal. EEC syndrome is usually diagnosed through a combination of clinical exam, x rays, kidney imaging tests, skin biopsy, and DNA testing.

No cure exists for EEC syndrome, but there are many treatments available to address the symptoms. These treatments include surgery, dental care, prevention of complications from hypohydrosis (abnormal sweating), and other preventative treatments. Surgery may be needed to correct cleft lips and cleft palates and is important for feeding and for speech. Podiatric physicians may perform surgery on foot abnormalities to improve the function of the lower limbs, to improve the appearance of the limbs, and to aid in shoe fit.

In 2006, the London Tate exhibition Single Shot featured a video of an unidentified person with ectrodactyly skillfully playing the piano with only four fingers: Hyewon Kwon -- Bittersweet.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What is the Treatment for Clubfoot?

2010-12-29T07:50:00.001-08:00

All cases of clubfoot must be treated, as it does not correct itself – the earlier the better. Less severe and more flexible types are casted, while the more severe and rigid types need surgery. Without treatment, persons afflicted often appear to walk on their ankles, or on the sides of their feet.

A series of plaster or fiberglass casts are applied to the foot and lower limb, with each cast progressively moving the foot towards a more corrected position. The number of times the cast needs to be replaced will be determined by the severity of the clubfoot (but several months is not unusual). The treatment should begin in the first week or two of life in order to take advantage of the favorable elasticity of the tissues forming the ligaments joint capsules and tendons.

The Ponseti Method uses full leg casts up to the groin and bent at the knee. The therapeutic component of serial casting is the manipulation between cast changes. Infants still in the neonatal unit should have the casts changed every two or three days. Discharged infants up to six weeks of age should have the casts changed twice weekly if this is practical. Infants over six weeks should have the casts changed weekly. The skin may develop breakdown from repeated casting. It is acceptable to leave the infant out of a cast until the skin heals. With the Ponseti method, the majority of clubfeet can be corrected in infancy in about six to eight weeks with the proper gentle manipulations and plaster casts. Podiatrists using the Ponseti method often have at least a 90 percent or better success rate.

On occasion, the infant will respond completely to cast therapy, however additional non-operative treatment is needed to insure that recurrence will not happen. First, there must be undisputed x-ray evidence that the deformity is corrected, and second, the foot must be held in the corrected position long enough to allow for remodeling of the abnormal cartilage. The joints must be permitted some movement, and the easiest way to accomplish this is to provide an ankle-foot orthosis custom molded to hold the foot and ankle in an acceptable position. The infant is allowed a small period of time out of the orthotic each day to permit motion. Most infants will need this for about one year form the last cast.

However, these are procedures that require experienced hands, so be sure to see a podiatric physician who is well qualified in the treatment of clubfoot.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com
Allison Ippel, Student Blogger (SCPM 2013)

What are other Causes of Clubfoot?

2010-12-22T12:56:00.000-08:00

Positional or postural talipes equinovarus can be divided into two subgroups: those caused by the position of the fetus inside the uterus, and those caused by fetal muscle dysfunction. Positional or intrauterine molding TEV can be the result of a long list of things, for example, abnormalities with the shape of the uterus, oligohydramnios (or too little amniotic fluid, caused by kidney dysfunction of the baby), a uterine leiomyoma or tumor, and more than one baby present in the womb. Breech presentation is also another known cause. Postural TEV results from abnormalities in the baby’s nerves, the skeletal muscles or where the nerves and muscles meet. Many patients classified in this class will be treated successfully with closed reduction or casting, however, many patients relapse because there is an underlying problem that results in the muscle imbalance.

Teratologic TEV have very resistant deformities in association with other skeletal deformities, such as vertebral anomalies, hip dislocations, and severe contractures. TEV occurs with some frequency in Ehlers Danlos Syndrome and some other connective tissue disorders. TEV may be associated with other birth defects such as spina bifida cystica. These deformities start in the first trimester and as a result the joints become badly misshapen and are not able to be corrected by any method.

Syndromic TEV occurs in conjunction with disorders such as facial dysmorphisms, pulmonary, cardiac, GI, renal and biochemical abnormalities. Over 50 named syndromes include TEV as an occasional or regular component. The prognosis for this class depends on the other components of the syndrome.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

Who are some Famous People who had Clubfoot?

2010-12-18T12:37:00.000-08:00

Roman emperor Claudius
Egyptian pharaoh Tutankhamun
Statesman Prince Talleyrand
Civil War politician Thaddeus Stevens
Comedian Damon Wayans
Actor Gary Burghoff
Eric The Midget from “The Howard Stern Show”

Athletes:

Soccer star Mia Hamm
Soccer players Steven Gerrard and Miguel Riffo
Sledge hockey player Matt Lloyd (Paralympian)
Figure ice-skater Kristi Yamaguchi (won a figure skating gold medal in 1992)
Baseball pitchers Larry Sherry and Jim Mecir
Former NFL quarterback Troy Aikman

Random fact:

The San Francisco Giants held the record as the team with the all-time highest number of players with clubbed feet as of July 2010, and Freddy Sanchez, one of its infielders, cites his ability to overcome the defect as a reason for his success.

Tom Dempsey of the New Orleans Saints, born with a right club foot and no toes (this was his kicking foot), kicked an NFL record 63 yard field goal. This kick became famous as the longest NFL field goal in history.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger (SCPM 2013)

What is Clubfoot?

2010-12-08T12:17:00.000-08:00

Talipes equinovarus, commonly referred to as Clubfoot, is a deformity of the whole foot that is present at birth. The term “talipes” is derived from the Latin words talis (for ankle) and pes (for foot). It is a complex of symptoms rather than a specific disease and can be caused by multiple factors.

In talipes equinovarus (TEV), the child is born with the foot pointing down and twisted inwards at the ankle. The foot and the calf muscles are usually smaller than normal. Some children with clubfoot have stiffer joints in the foot and ankle. Surprisingly, a discrepancy in the length of the entire limb is not usually seen. This means that most children with clubfoot on only one side may have a smaller limb, but it is not usually shorter.

The most common type of clubfoot, idiopathic TEV, is genetically mediated and occurs in 1.4 in 1000 births.  In half of the cases, both feet are usually affected. If a parent, siblings or cousins are born with clubfoot, the incidence rises to 1 per 20 live births. If there are two family members with the deformity, the likelihood increases even further to 1 per 5 live births. The male to female ratio is 2:1, and the deformity is usually clinically worse and the prognosis is poorer in a girl with talipes equinovarus. In this variation, an abnormality exists in the calf muscles and the vessels in the legs in about 80% of cases. The anterior tibial artery usually does not develop out past the lower one third of the leg, and in some cases it does not develop at all. Some studies suggest that some cases may be caused by neuropathy of the common peroneal nerve, which is a main nerve for the muscles on the front and side of the lower leg. Although most cases are treated with serial casting for closed reduction, surgical intervention is often required.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Diabetes Prevention:

2010-11-30T08:18:00.000-08:00

-One of every 7 dollars spend on healthcare in the USA is on diabetes.

-Males born in 2000 have 33% risk of developing diabetes; females have a 39% chance.

-From 2000 to 2050, it is estimated that diabetes will increase by 165%.

-Males diagnosed at age 40 will lose 12 years of life, and 14 years for females. The quality of life will decrease by 19 and 22 years respectively.

-Diabetes is the leading cause of blindness. 1 of 12 cases of blindness in U.S. adults is caused by diabetes.

-Diabetes accounts for 10% of all acute care hospital admissions.

It is estimated that nearly two thirds of the annual cost for treating diabetes complications could be averted with appropriate primary care. In 2001, approximately 3.8 billion dollars was spent on in-patient hospital costs for diabetic complications such as heart disease, kidney failure, blindness, and nerve and circulatory problems. According to the Agency for Healthcare Research and Quality, 2.5 billion dollars could have been saved with preventative care.

What can you do to prevent Diabetes?

Although a genetic component is involved in the development of Type 2 diabetes, a large part of the disease reflects lifestyle choices. Of all Type 2 Diabetics, 80 to 90% are overweight or obese and roughly 80% have high blood pressure. But there is good news: you can prevent or delay the onset of Type 2 Diabetes by having a healthy lifestyle, before the disease causes nonreversible damage to your body.

By making simple but important changes in your diet, your level of physical activity, and your weight, you can stay healthier longer and reduce your risk of diabetes.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Signs and Symptoms of Diabetes:

2010-11-23T20:13:00.000-08:00

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complications.

High blood sugar is not something you see in the mirror, so it is useful to know the side effects of high blood sugar:

Some of the common 'early warning' signs of diabetes are:

-Excessive thirst (this is often the first symptom of diabetes)

-Excessive hunger (you know you've eaten "enough" but are still hungry all the time)

-Frequent urination (often noticed because you must wake up repeatedly during the night)

-Tiredness and fatigue (possibly severe enough to make you fall asleep unexpectedly after meals)

-Rapid and/or sudden weight loss

However, when diabetes goes unrecognized or is treated poorly, physical and neurological problems may arise, resulting in some of the following symptoms:

-Blurred vision (diabetes can lead to macular degeneration and eventual blindness)

-Recurrent or hard-to-treat yeast infections in women (a sign of impaired immune function)

-Dry or itchy skin (peripheral neuropathy also affects circulation and proper sweat gland function)

-Numbness and/or tingling in the hands and feet (peripheral neuropathy causes nerve damage in the extremities)

-Slow healing of minor scratches and wounds (diabetes often leads to impaired immune system function)

Ignoring (or not recognizing) the symptoms of diabetes can lead to long-term serious health risks and complications from untreated diabetes. If you find yourself experiencing many of these diabetes symptoms on a consistent, long-term basis, you should visit your primary care doctor to be tested for diabetes.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

November is American Diabetes Month!

2010-11-17T20:06:00.000-08:00

Diabetes Mellitus affects about 7% of the U.S. population (20.8 million people), and 800,000 new cases are diagnosed each year! Of the total amount, 5% of people with diabetes have Type 1, and 95% have Type 2.

What’s the difference between Type 1 and Type 2?

The most consistent symptom of diabetes mellitus (Type I and II) is elevated blood sugar levels. In Type I, known as “insulin dependent” (previously “early onset” diabetes), this is caused by the body not producing enough insulin to properly regulate blood sugar. In Type II or “non insulin dependent” (previously “adult onset”) diabetes, high blood sugar is caused by the body developing resistance to insulin, so it cannot properly use what it produces.

Effects of diabetes every 24 hours:

-4,100 new diabetes cases are diagnosed in the U.S.

-120 learn they need kidney dialysis or transplant

-55 go blind

-At least 810 people die

-230 undergo amputation

Podiatric physicians are a crucial part to a comprehensive healthcare team for people with diabetes. They not only treat diabetic complications such as neuropathy and foot ulcers, but also, and more importantly, work to reduce the number of lower extremity amputations. Diabetics account for 60% of all lower extremity amputations (excluding trauma), averaging 82,000 per year in the U.S and costing at least 35 billion dollars. Through careful monitoring and using the most up-to-date treatment methods and products, podiatrists can help prevent infections and complications.

Diabetics are more vulnerable to foot problems because the disease can damage the nerves and reduce blood flow to the feet. The American Diabetes Association has estimated that one in five people with diabetes who seek hospital care do so for foot problems. By taking proper care of your feet and seeing a podiatric physician when needed, most serious problems can be prevented.

Learn more at stopdiabetes.com.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

How Does Capsulitis Go Away?

2010-11-06T21:02:00.000-07:00

As part of the exam, the foot and ankle surgeon will examine the foot, press on it, and maneuver it to reproduce the symptoms. The surgeon will also look for potential causes and test the stability of the joint. X-rays are usually ordered, and other imaging studies are sometimes needed.

Non-surgical Treatment:

The best time to treat capsulitis of the second toe is during the early stages, before the toe starts to drift toward the big toe. At that time, non-surgical approaches can be used to stabilize the joint, reduce the symptoms, and address the underlying cause of the condition.

The foot and ankle surgeon may select one or more of the following options for early treatment of capsulitis:

-Resting the foot and avoiding excessive activity along with applying ice packs helps to reduce the swelling and pain.

-NSAIDs, such as ibuprofen, may help relieve the pain and inflammation.

-Taping/splinting may be necessary so that the toe will stay in the correct position. This helps relieve the pain and also prevents further drifting of the toe.

-Stretching exercises may be prescribed for patients who have tight calf muscles.

-Supportive shoes with stiff soles are recommended because they control the motion and lessen the amount of pressure on the ball of the foot.

-Orthotic devices or custom shoe inserts are often very beneficial. These include arch supports or a metatarsal pad that distributes the weight away from the joint.

If capsulitis is left untreated, it can eventually lead to a weakening of surrounding ligaments and can eventually cause dislocation of the toe, so be sure to have it checked out right away.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

What is Capsulitis?

2010-10-29T20:54:00.000-07:00

What is Capsulitis?

Capsulitis is inflammation of the joint capsule and can occur at any joint, but most frequently affects the foot beneath the forefoot. The most common site is beneath the second metatarsal head.

Ligaments surrounding the joint at the base of the toe form the “capsule.” Although capsulitis can also occur in the joints of the third or fourth toes, it most commonly affects the second toe. The inflammation associated with capsulitis causes considerable discomfort and if left untreated can eventually lead to a weakening of surrounding ligaments. Capsulitis can eventually cause dislocation of the toe, which is why it is also referred to as “predislocation syndrome.”

Causes:

Capsulitis of the second toe is often a result of abnormal foot mechanics, so that the ball of the foot beneath the toe joint takes an excessive amount of weight-bearing pressure.

Certain conditions or characteristics can make a person prone to experiencing excessive pressure on the ball of the foot. These most commonly include a severe bunion deformity, a second toe longer than the big toe, an arch that is structurally unstable, and a tight calf muscle.

Symptoms:

Capsulitis of the second toe is a progressive disorder and usually worsens if left untreated. Therefore early recognition and treatment are very important. Symptoms in the earlier stages may include pain, particularly on the ball of the foot. Patients often complain of the feeling that a marble is in the shoe or that a sock is bunched up. Swelling in the area is also common, including the base of the toe. Often it becomes difficult to wear certain shoes or to walk barefoot.

In more advanced stages, the supportive ligaments in the toe weaken so much that they become unable to sufficiently stabilize the toe. The unstable toe then drifts toward the big toe and eventually crosses over and lies on top of the big toe. This is called “crossover toe” and is the end stage of capsulitis.

Be sure to visit your podiatric physician as an accurate diagnosis is essential because the symptoms of capsulitis can be similar to those of a condition called Morton’s neuroma, which is treated differently from capsulitis.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

What is a DVT?

2010-10-20T10:42:00.001-07:00

Deep-vein thrombosis (DVT) is a common but serious medical condition that occurs in approximately 2 million Americans each year. DVT occurs when a thrombus (blood clot) forms in one of the large veins, usually in the lower limbs, and can partially or completely block circulation. DVT can lead to other serious health complications, such as a pulmonary embolism (PE) and even death if not diagnosed and treated effectively.

Although deaths associated with upper extremity DVT are extremely rare, untreated lower extremity DVT has a 3% PE-related mortality rate.

What are the risk factors, signs and symptoms for DVT?

Although the symptoms of DVT may be subtle and difficult to detect, there are few common signs that are red flags. In many cases, the affected extremity will be painful, swollen, red and warm.

Several factors that can increase a person's risk for DVT include:

-Surgery

-Hospitalization

-Immobilization (such as a cast, or during long-haul flights)

-Smoking

-Obesity

-Age

-Certain drugs (such as oral birth control or erythropoietin)

-Thrombophilia (for example, in carriers of factor V Leiden)

-Women have an increased risk during pregnancy and in the postnatal period.

When DVT is spotted early and properly treated, the risk of complications is greatly reduced. When left untreated, it may cause severe complications, some even fatal. One big complication from DVT, Pulmonary Embolism (a clot in the lungs), kills up to 300,000 people a year in the U.S. — which is more than AIDS and breast cancer combined!

If you experience any of the symptoms listed above, or if you have a fever or difficultly breathing after a foot or ankle surgery, be sure to inform your podiatric physician right away.

Jeffrey Frederick, DPM

Allison Ippel, Student Blogger

Heel Pain in Children

2010-10-14T10:51:00.000-07:00

Sever's disease (or calcaneal apophysitis), is the most common cause of heel pain in the growing athlete. It is due to overuse and repetitive microtrauma of growth plates of the calcaneus in the heel. The foot is one of the first body parts to grow to full size and this usually occurs in early puberty. During this time, bones often grow faster than muscles and tendons and as a result, muscles and tendons become tight.

It occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 12 years of age. Sever’s disease also relates to Osgood-Schlatter disease, which affects the knee rather than the heel/ankle. It is more common in boys, although occurs in girls as well.

Symptoms include:

-Pain or tenderness in the heel (or heels)

-Discomfort upon awaking, or when heel is squeezed

-Limping

-More severe pain after walking or exercise, and increased difficulty walking

-Pain during running or playing sports

Sever’s disease is also directly related to overuse of the bone and tendons in the heel. This can come from playing sports or anything that involves lots of heel movements. Symptoms commonly begin with starting a new sport, or at the start of a new season. In overweight children, too much weight bearing down on the heel can also cause it as can excessive traction since the bones and tendons are still developing. It occurs more commonly in children who pronate (have flat feet), and involves both heels in more than half of patients.

Treatment may consist of one or more of the following:

-Elevating the heel

-Stretching hamstring and calf muscles 2-3 times daily

-Using R.I.C.E. (Rest, Ice, Compression, Elevation)

-Foot orthotics

-Medication

Sever’s disease is self-recovering, meaning that it will go away on its own with rest and in less or when the bone is through growing. The condition rarely creates any long-term disability, and expected to subside in 2–8 weeks.

However, while the disease does subside quickly, it does recur frequently. Children commonly outgrow the condition, and recurrences happen for an average of 18 months before this occurs.

Prevention:

-Maintain good flexibility through stretching exercises

-Avoid excessive running on hard surfaces

-Use quality, well-fitting shoes with firm support and a shock-absorben

Jeffrey Frederick, DPM

Allison Ippel, Student Blogger

Too Many Toes?

2010-10-08T10:29:00.000-07:00

Polydactyly is a condition in which a person has more than five fingers or five toes on one foot, and it is the most common anomaly of the forefoot present at birth (congenital).

Having an abnormal number of digits (6 or more) can occur on its own, without any other symptoms or disease. Polydactyly may be passed down or inherited in families and can also occur with some genetic diseases.

The extra digit is usually a small piece of soft tissue that can be removed. Occasionally it contains bone without joints and rarely it may be a complete, functioning digit.

Incidence is 1.7 cases per 1000 live births. Incidence is higher in blacks (3.6-13.9 cases per 1000 live births) than in whites (0.3-1.3 cases per 1000 live births).

The doctor will diagnose the condition based on a family history, medical history, and physical examination. Questions that may be asked are:

-Have any other family members been born with extra fingers or toes?

-Is there a known family history of any of the disorders linked to polydactyly?

-Are there any other symptoms or problems?

Tests used to diagnose the condition include: Chromosome studies, Enzyme tests, X-rays, and Metabolic studies.

Surgery is indicated to improve physical appearance of the foot and to improve shoe fit. It is usually performed when the patient is aged approximately 1 year, so the effect on development and walking is minimal. Surgery should be delayed until skeletal development (ossification) has occurred within the affected rays so that accurate anatomic assessment is possible.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

How can I avoid getting toenail fungus?

2010-09-29T16:34:00.000-07:00

Toenail and athlete's foot fungi like to grow in warm, moist areas, which include public areas such as spas, swimming pools, locker rooms, or showers. The fungus can remain alive or short periods of time in warm puddles on tile floors, just waiting for someone to walk along and pick up the spores. Sandals help keep your feet from touching the floor directly, but remember to always wash your feet thoroughly and dry them well after going to the pool or other public area.

Prevention tips:

-When drying feet that have a fungal infection, only use your towel once, then wash it.

-Use a paper towel or toilet paper to dry your affected area, and throw away when finished.

-Do not share your towels or washcloths with others as you may spread or collect spores.

-Wear breathable shoes that allow plenty of air and moisture exchange. Look for air-breather holes on the sides, natural materials (plastic shoes do not allow air and moisture to pass through).

-Pure 100% wool, cotton, or silk socks are best because they absorb moisture from your feet (i.e. sweat) and provide good ventilation. When your socks are damp, take them off and dry your feet before putting on a fresh pair of clean, dry, cotton socks. Synthetic socks such as nylon are not advised because they don't allow the moisture to pass through away from your skin.

-Do not use nail polish until the disease is gone. (The fungus is sealed beneath the toenails in a dark, moist, warm environment – just where it loves to grow!)

-Are you eating a lot of sugar in your food? Some people suggest reducing sugar consumption will make your body less capable of hosting fungi.

Remember, prevention is the best cure!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

How do I get rid of toenail fungus?

2010-09-24T20:42:00.000-07:00

Treatment of onychomycosis is challenging because the infection is embedded within the nail and is difficult to reach. Most treatments are either systemic antifungal medications such as terbinafine and itraconazole, or topical such as nail paints containing ciclopirox or amorolfine. There is also evidence for combining systemic and topical treatments.

The most common oral medications are: Itraconazole (Sporanox), Fluconazole (Diflucan), Griseofulvin (Fulvicin), or Terbinafine (Lamisil). These medications work to fight off the fungal infection and permit new healthy nail growth to gradually replace the infected part the nail. These medications must be consumed for six to twelve weeks, but will not see the final result until the nail fully grows out. However, it may take four months or longer to eliminate an infection, depending on the severity of the infection, as well as the rate at which one’s nails grow. Future infections are likely to occur, especially if one continues to expose the nails to warm and/or moist conditions. Drawbacks of system meds include side effects such as: headache, upset stomach, skin rashes, or allergic reactions to ingredients in the medication.

Nail lacquer (with consistent application) may be used as a method of removing the fungus in mild to moderately infected nails only. The lacquer must be coated onto the infected nail(s) and surrounding skin daily for seven days. Following the seven-day coating period, the layered lacquer must be wiped off the nail(s), and the process must be repeated again. This procedure must be consistently repeated for at least one year until the nail infection(s) has cleared up. Research has down that the using these types of lacquer lacks effectiveness and it cures less than 10 percent of the infections.

Self treatment options include soaking the feet in Epsom salts or a mixture of apple cider vinegar and tea tree oil in a twenty-minute foot bath.

Keep in mind, full removal of symptoms is very slow and may take a year or more, so be patient! Be sure to visit your podiatrist for the best treatment, as the most effective medications are available with prescription only.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

What is "Onychomycosis"?

2010-09-19T20:39:00.000-07:00

So your nail plate is thickened, yellow, and has a cloudy appearance. And the nails can are rough and crumbly, and are starting to separate from the nail bed…what is going on?

Onychomycosis is a fungal infection of the nail plate and nail bed, and is also known as "Dermatophytic onychomycosis”, “Ringworm of the nail”, or "Tinea unguium.” It is the most common disease of the nails and constitutes about a half of all nail abnormalities. This condition may affect toenails or fingernails, but toenail infections are particularly common.

A nail fungal infection may begin as a white or yellow spot under the tip of your fingernail or toenail. As the nail fungus spreads deeper into your nail, it may cause your nail to discolor, thicken and develop crumbling edges, which is an unsightly and potentially painful problem.

The bugs that cause onychomycosis include dermatophytes, Candida, and non-dermatophytic molds. Dermatophytes are the fungi most commonly responsible for onychomycosis in the temperate western countries; meanwhile, Candida and non-dermatophytic molds are more frequently involved in the tropics and subtropics with a hot and humid climate.

Risk factors for onychomycosis include family history, increasing age, poor health, prior trauma, warm climate, participation in fitness activities, immunosuppression (e.g., HIV, drug induced), communal bathing, and occlusive footwear.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Nail Polish: take a break!

2010-09-06T11:06:00.000-07:00

Most men can sit this one out, but now that sandal season is on its way out, it’s a good time to talk about nail polish.

Even in Michigan when women wear closed shoes and boots, their nails are still being polished!

Most nail polishes contain formaldehyde, a carcinogenic chemical best known for preserving cadavers. On a toenail, the formaldehyde dries and damages the nail. Polish remover has acetone, which is popular for removing adhesives and paint, and it is also damaging for the nail. This damage can leave the toenail susceptible to fungus infections.

The dry, white, flaky condition of the nail when the polish comes of is often presumed to be a fungus when in fact, it is damage from the polish.

Perhaps it’s time to take a vacation. While the closed shoes season is here, give your nails a chance to recover by not wearing polish. That’s right…no polish. What about just wearing a base coat? Clear polish is still just as damaging. It’s not the color that does it – it’s the polish itself.

So, is there any good polish? The answer is yes.

There is no nail polish that is totally natural, but the best thing to look for in nail polish is one that is "Three-Free," meaning free of toluene, dibutyl phthalate (DHB) and formaldehyde — all known carcinogenic ingredients. Some brands that are “Three-Free” are: Priti, Zoya,  Aquarella, Butter London, and Sante.

By some reports, they are inferior, but your health should probably trump the prettiness of your toenails. There are also “healthy” polishes that contain vitamins, tea tree oil, and wheat protein. These are better for the nails and have antifungal properties. Even so, no polish is still better than these.

So if you’re on vacation, go crazy, wear polish for a week if you’re wearing shoes that will show your toes. But otherwise, treat the nails right and get them ready for next sandal season.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Twisted foot? Might be…

2010-08-26T17:16:00.000-07:00

If it’s painful mostly across the whole foot, you may have sprained the ligaments that hold the bones of the midfoot together.

Diagnosis: A person with a midfoot sprain will have sustained a twisting or pivoting injury to his or her foot. They will develop immediate pain and later swelling in the central region of their foot. The swelling often can lead to bruising on either the top or bottom or the foot. How much swelling and subsequent bruising occurs is related to how severe the injury is. The patient will also complain of pain with bearing weight. In milder injuries they will be able to walk without too much pain, but the higher demands on the foot in athletics will be painful. On the other end of the spectrum, in more severe injuries, the injured athlete may not be able to bear any weight even to walk.

On physical examination, the injured foot will look swollen and be tender over the injured joints. It’s important that the examining physician localize the injury to the specific joints involved. The tendons of the foot should remain intact in a midfoot sprain, however their motion may produce pain in the foot if they place stress on the injured joints with motion.

Treatment: A mild, grade 1, midfoot sprain can be managed with a short period of immobilization in a hard-soled shoe or a removable boot. A short period of limited weight-bearing may be necessary to allow the ligament to heal and therefore the swelling and pain to subside. Regular icing, elevation and non-steroidal anti-inflammatory medications (NSAIDS) are both important to treat the swelling along with the pain. In most of these cases, the athlete will be able to return to participating in their sport in anywhere from a week to a few months.

Again, be sure to see your Podiatrist to be sure that you are back to normal and pain free as soon as possible!

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Twisted foot? Might be…

2010-08-20T17:14:00.000-07:00

A common issue to worry about with twisting the foot and having pain on the side of the foot is a fracture of the fifth metatarsal bone:

Diagnosis: In many cases, the patient may not relate a specific traumatic event during the history portion of the exam. In the acute setting, the patient may present with symptoms of localized pain on the outside or bottom of the midfoot. These symptoms can be exacerbated by weightbearing. The physical exam may reveal ecchymosis (redness), edema (swelling), point tenderness and/or pain against resistance.

X-rays with multiple views are invaluable in the diagnosis. One should also obtain radiographs after the patient’s affected extremity has been immobilized for two to three weeks. Fracture healing is dependent on location of the fracture and the specific blood supply to that area of violation.

Shaft fractures: Fractures along the shaft of the metatarsal tend to be the result of direct violence or impact. Comminuted fractures (fragments) are the most common result and one may occasionally see a concurrent open wound and a segmental defect. Alternatively, indirect forces, such as a twisting fall, will result in a spiral fracture of the metatarsal shaft. In either case, in the absence of considerable displacement, both types of fractures tend to heal quite well with conservative non-weightbearing care (i.e. NOT SURGERY!).

Tuberosity fracture: the tendon of a muscle on the side of your leg inserts onto a side part of the 5^th metatarsal bone. A common injury to this area involves the tendon pulling off a small piece of the bone, which is called an avulsion fracture.

If you twist your foot and aren’t sure what the problem may be, be sure to check with your podiatrist right away to make sure it is treated properly.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

Do Barefoot Shoes perform lake a Running Shoe?

2010-08-14T13:38:00.000-07:00

This type of shoe is not to be used an everyday trainer, especially if you run on hard surfaces. It does offer basic cushioning and support but it is recommended to ease yourself into Nike Free running progressively. It will not replace your high-mileage training shoe but it should be worn once weekly (according to your training schedule) in relatively short runs, maybe just starting with a mile or two and increasing week by week. Your foot muscles will get a specific workout, but as every with every workout, overtraining is worse than no training. 

The flexibility index of a Nike Free (3.0, 5.0 etc.) does not only refer to the sole unit, but also to the upper which has to have the same ration between support and freedom as the midsole. As to which model to chose (3.0, 5.0 or everyday), they suggest over-pronators to wear the 5.0, while neutral runners can approach the 3.0. Check out this video below for more information on the structure of the Nike Free.

So, should you try them out or not? It’s up to you. If you experience foot pain while running, barefoot shoes are probably not for you. Running with no shoes at all puts you at risk of injury from stepping on sharp objects from unfamiliar surfaces. If you are looking to add variety to your workouts or want to see what the barefoot fad is all about, I would recommend trying out the Free or similar shoes before you go to full barefoot running. Be sure to ask your podiatrist if any injuries occur, and see previous posts for more tips on running in general.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger

What are Barefoot Running Shoes?

2010-08-08T13:33:00.000-07:00

With the increasing popularity of coaches and athletes suggesting that runners include barefoot runs to their running schedule, shoe companies have designed a type of shoe for those who don’t have the luxury of running on a pristine beach or a soft, grass field.

Running on concrete is not what our legs and feet were designed for, thus we do need the protection offered by a shoe. But with the use of cushioned and supported modern running shoes, some propose that our feet are becoming lazy. We don’t use our foot’s intrinsic muscles very efficiently because the shoes do it for us. Barefoot proponents say that while running barefoot you are forced to naturally improve your running gait and at the same time strengthen foot and legs muscles.

In 2005 Nike introduced the Free concept as a way of conjugating the principles and advantages of running barefoot to strengthen the feet and legs with the protection and traction of a training shoe. The lightweight mid-sole provides enough durability to double as an outsole, dramatically reducing the weight. The upper of the Nike Free is engineered specifically to achieve the barefoot sensation as well. The laces are positioned asymmetrically, which relieves pressure on the top of your foot, and the grooves in the sole are deeper and wider, which forces you to use your toes more.

Nike+ has been incorporated into the Free, meaning you can insert Nike's iPod-compatible sensor into a special groove in the sole to track your progress, count calories and gauge your workout.If you are looking to get more serious about your running regime and want to keep more detailed records of your workouts, adding this type of shoe and tracking system might be beneficial to you.

Jeffrey Frederick, DPMhttp://www.michiganfootcare.com

Allison Ippel, Student Blogger