New Help in Office

We’d like to welcome Allison and her best friend, Trixie, to our staff. Allison will be working part-time, providing administrative support. Trixie will sit around looking adorable.

What Athletic Shoe is Best?

Anyone who has tried to figure out what "athletic shoe" is BEST for them can relate to this excellent article recently published in the N Y Times.

Some Diabetic Side Effects Can Be Prevented, Reversed.

When people hear the term “diabetic”, they normally think of a blood sugar imbalance. A shot of insulin, a better diet and things are should OK. Not so fast. What many diabetics don’t realize, there are serious side effects to this disease, which, left untreated, can be debilitating. Over the years I have dealt with dozens of patients suffering from peripheral neuropathy, a numbness in the feet and toes, which can often be traced to diabetes. A podiatric colleague, Dr. Robert Kornfeld, has written a thorough article on how to prevent and in some cases, reverse of the damage of Diabetic Neuropathy. It’s an excellent article for those seeking more information about diabetes.

http://www.huffingtonpost.com/dr-robert-a-kornfeld/diabetic-neuropathy-preve_b_527647.html

Foot News 4 U

The American Podiatric Medical Association publishes a terrific quarterly newsletter which I will post on my blog. There is wonderful information on common foot problems for women and tips for keeping feet healthy in the Spring and Summer.

Achilles Tendon Injuries Shutdown The World's BEST

In the past month Achilles tendon injuries have been prominently discussed on the sports pages. World renown soccer star, David Beckham ruptured his Achilles tendon in early March and recently Laker center, Andrew Bynum strained his Achilles. If you recall, Olympic champion volleyball player, Misty May-Treanor tore her Achilles tendon, not on the sand, but on the TV-show, "Dancing With the Stars." A word to every athlete, whether you're pro or a weekend warrior- DON'T MESS WITH YOUR ACHILLES TENDON.

The Achilles tendon is the largest tendon in the body. It can become weak two inches above the heel due to a lack of blood supply. This is where most ruptures occur. May-Treanor and Beckham both experienced this level of injury. Sports requiring jumping, pivoting, and running put strain on the tendon.

The tendon becomes weaker with age and can literally rupture or snap. Full recovery is a painfully laborious process. I've found that athletes get 80 -90 percent of their strength back in the injured leg. David Beckham starts a water physical therapy program next month, six weeks after his recent surgery. He won't be able to play soccer for 6 months and will miss the World Cup.

For Laker fans, the news is much better. Andrew Bynum's strained Achilles should only sideline him to rest and rehab for 3 weeks and he should be ready for the play-offs. This isn't an injury you want to have happen. A good prevention program includes stretching, strengthening, wearing good shoes, and orthotics. If you feel consistent pain in this area, don't push it. Come in for an exam.

Walking 4 Fitness: A Safe Aerobic Exercise for Everyone!

Everyone seems to be looking for the next great exercise, video or gadget to help burn calories, lose weight and get in better shape. Few exercises can been as effective and safe as walking. As always, it’s good to start slowly and build up the time and distance walked. Also, if you’ve been inactive for a prolonged period and have had serious health issues, please consult a physician before starting a walking program.

• Benefits from walking – aerobic conditioning, weight control, safe exercise, low-impact sport, stress management, and social rewards.
• Aerobic conditioning- lungs use oxygen more efficiently; you strengthen your heart, and condition your muscles.
• Weight control – diets alone don’t work, walking can burn as much fat as jogging, at about 100 calories per mile. Burns fat and keeps it off!
• Safe exercise – it’s gradual, controlled excretion; it is safe if you are under medical care for heart disease, diabetes, or other conditions.
• Low-impact sport – your feet land with less impact, reducing likelihood of muscle, bone and joint injury.
• Stretching – you should gently stretch and prepare your muscles for about 5 minutes prior to walking. Stretching should be slow and easy, never bounce. Calf and quadriceps stretch 3 times for 20-30 seconds.
• Walking briskly – warm up by walking normal for about 5 minutes to increase your heart rate slowly. For 20-45 minutes walk briskly. Remain erect, taking full strides and swinging your arms easily.
• Cool down – last 5 minutes slow walk to lower our pulse safely. Remember to stretch after you walk. This prevents muscle stiffness and increases flexibility. Side reach and hamstring stretch recommended.
• Walking program – gradual increase in frequency, time and distance.Begin 15minutes 3 -4 times per week. Increase 5 minutes per week until reach your goal. Try to walk 4-5 times per week for 45 minutes to 60 minutes.
• Safe training – most injuries are caused by overuse- walking too fast and too far on hard surfaces. To protect your feet and legs, wear quality shoes, socks, and practice good walking form. Allow your body to adapt slowly. Try to walk on soft, flat, level surfaces.
• Anatomy of a good walking shoe – padded heel with good heel support, good arch support, flexible sole and plenty of toe room. Choose leather or nylon uppers. Socks should be high bulk (75-80%) Orlon, reinforced heel and toe padding, i.e. Thorlo.
• Target heart rate – maximum aerobic benefits – take a 10 second pulse 220 – age = maximum heart rate x .60 for beginner, .7 for intermediate = training rate. Note: take pulse at neck (carotid) or wrist (radial).

Not So Fast On Laser Treatment for Toe Fungus!

Patients have been asking about laser treatment for fungal nails. The laser podiatrists are using is the Pinpointe. According to this linked article (see below) it was approved for use in denistry by the FDA. So doctors using this process for toe nail fungus are using it off label. One doctor is quoted in this article says the only risk with using the laser is financial. Treatment IS expensive and NOT insurance approved. Any treatments for onychomychosis or toe nail fungus have a high reoccurance rate. Anywhere from 40-50%. Most of us who live in Southern California want to wear sandals in the summer. Fungal nails are not attractive. I assess my patients risk vs. benefit of using an oral or topical medication. I also have my patients bleach their white socks, clean their rubber sandals with lysol, put powder in their closed shoes, and clean their shower/bathtub with chlorine bleach.

http://www.nytimes.com/2009/03/20/business/20fungus.html

Be SUN SAFE This Spring and Summer!

Now that Spring is here and the weather consistently sunny, everyone must think about protecting their skin from excessive UV damage. I see patients with thin or fair skin on their arms and legs who ask what I recommend. They need protection from the sun and protection from abrasions on the arms and legs. A good sunscreen applied BEFORE you go outside is a excellent start. I recently discovered a new sports apparel line called Moeben, which helps protect the skin even more. (http://www.moeben.com -very cool website) This stylish clothing includes arm and leg sleeves that have a SPF of 50. The founder of Moeben, Shannon Farar-Griefer, is an ultra marathon runner (events of up to 100 miles) who needed to protect her skin. Even high quality sunscreen does not last long enough for distance runners and often perspiration breaks it down. Most dermatologists recommend applying fresh sunscreen every two hours you’re exposed to the sun. Another company with clothing over 30SPF is Solumbra (another excellent, website-http://www.sunprecautions.com/). It’s more common for women to get skin cancer on their legs because of wearing dresses. We all love the sun. Just takes the requisite steps to truly enjoy it !

Is Running Barefoot For You ?

There is a movement a-foot (sorry for pun ) in the fitness universe that’s picking up steam- running barefoot. Various fitness/running experts contend that running barefoot, or in most cases with minimal protection to the feet, actually creates less anatomical stress on the foot/ankle/leg/hip. The decision to run barefoot should be an educated one. Please consider things fitness level, the health of your feet and the locations where you normally run. In Southern California, we’re blessed of hundreds of beaches where thousands already run barefoot. Running in the sand is an unbelievable work-out. It’s the other areas which may cause challenges like trails and streets/sidewalks.

I’ve researched this topic and would like to pass on some helpful links: http://www.marksdailyapple.com/barefoot-running-harvard-study/#more-10569.

For specific product info, please log onto http://www.vibramfivefingers.com/

What the HEEL !!!!!!!!

Cracked Heels Can Turn Bothersome, Serious

Most people don’t pay much attention to “cracked heels” The skin in that area of the foot is usualy “tough” and a little lotion or cream oftens does the trick. For many patients, this is a serious issue. For more information please link to an extremely enlightening overview of the problem. http://www.epodiatry.com/cracked_heels.htm

The Bariatric Surgery Option For Type 2 Diabetes In Obese Patients

I’ve had a few patients who have undergone this surgery. Recovery is difficult, both physically and mentally. Unfortunately, it doesn’t take foot pain away. Foot pain may decrease after losing weight, but many times there is a biomechanical problem causing foot pain. This specific problem must be addressed to stop foot pain. If you or a loved one is considering bariatric surgery, please be sure to have a strong support network of friends and family for a successful outcome. The below link covers the various options more thoroughly.

http://www.podiatrytoday.com/can-bariatric-surgery-be-a-cure-for-type-2-diabetes-in-obese-patients

One More Way to Help

In the wake of the Haitian earthquake people nationwide have answered the call to help. Everything from money, food, medical supplies and much more. A supremely worthy cause we promote is Souls4souls, a philanthropic organization dedicated to putting shoes on the millions of shoeless worldwide. When going to your closet today please see if there are any shoes, in useable condition, you don’t wear and donate them to this wonderful cause. For more information please log onto http://www.soles4souls.org/. This informative website lists local donation centers.

Try Walking Poles To Your Fitness Regimen

Balance has become a new buzz word in the fitness industry. There are shoes on the market that can help you improve balance and burn more calories. Many older patients are challenged with less than ideal balance, which often leads them to avoid walking altogether. We KNOW that’s not good. The below link features equipment that can make exercise safe and fun.

http://balancewalking.com/equipment-needed/

Healthy Feet Make the Best Dancing Feet Don’t Ignore Foot Pain on the Dance Floor

You can’t channel surf for more than a couple minutes before coming across a “dancing” reality show. Classical, ballroom, hip hop and more. It looks like so much much fun ! Being ‘light on your feet’ when dancing is not entirely true; dancing the night away can take a toll on feet and ankles. If you enjoy social dancing or have gotten serious enough to take a class, don’t let foot injuries stop the show, be sure to protect your feet and ankles. The most common types of dance-related foot and ankle problems are overuse injuries, which occur due to the repetitive movements in dance. Over 50 percent of dance injuries occur in the foot and ankle. The severity of the damage is often determined by a dancer’s age, strength and flexibility and the type of shoes worn when dancing. Other common types of injuries related to dancing can include:

• stress fractures (hairline breaks in the bone) from repeated jumping and landing
• foot neuromas (thickening/irritation of the nerves in the ball of the foot) resulting from repetitive pivoting
• shin splints (pain and swelling in the front of the lower legs) which can be aggravated by recurring activities
• tendonitis (inflammation of the tendons in the foot) from over exertion
• corns, calluses or blisters—all painful skin irritations resulting from repeated rubbing of the skin on the feet. What’s the best defense to protect your feet and ankles?
• Wear appropriate shoes to properly support your feet and ankles
• Perform dance moves that best fit your skill level

If you do suffer an injury, it is important to make an appointment with our office as soon as possible. Prompt medical attention by a foot and ankle surgeon can make all the different in a proper rehabilitation. Most dance injuries can be treated with conservative care as long as they are not ignored. Don’t dispel foot pain even if you can walk on it; remember it is possible to walk on a seriously injured foot. Common injuries, if left untreated, may require surgical intervention to ensure proper healing.

New Year; New Healthier You

Let 2010 be the year of a healthier you. If you’ve been putting off having foot surgery to correct bunions or hammertoes, make a commitment to yourself for fit feet this year. Something simple as having healthier, pain-free feet can make a huge difference in your overall health and well-being. Many patients don’t realize, in most cases, advances in surgical techniques have made bunion and hammertoes correctable with outpatient surgery and patients return home the same day. I can’t tell how many times I’ve heard, “If I knew it was this simple I wouldn’t have put it off so long.” Don’t let painful foot conditions slow you down another year. Call our office to schedule an examination to determine the best treatment approach and make this your year of healthy feet!