Peripheral Artery Disease

Peripheral artery disease (PAD), or peripheral arterial disease, is a circulatory problem in which there is a reduction of blood flow to the limbs due to narrowed arteries. When peripheral artery disease develops, the extremities do not receive enough blood flow; this may cause symptoms to develop such as claudication, or leg pain when walking. The legs are the most common site of peripheral artery disease.

Claudication, or leg pain when walking, is one of several symptoms that can develop due to peripheral artery disease. Other symptoms caused by the disease include painful cramping in the hips, thighs, or calves after certain activities; leg numbness or weakness; coldness in the lower leg or foot; sores on the lower extremities that do not heal; hair loss on the lower extremities; and a missing or weak pulse in the lower extremities. In more severe cases, pain may even occur when the body is at rest or when lying down.

Peripheral artery disease is typically caused by atherosclerosis, a condition in which fatty deposits build up in the arterial walls and reduce blood flow. Smoking, diabetes, obesity, high blood pressure, and high cholesterol are some of the risk factors for peripheral artery disease.

If you are experiencing pain, numbness, or other symptoms in the lower extremities, see your healthcare professional immediately. Diagnosed peripheral artery disease can be treated with various medications, angioplasty and surgery, exercise programs, or alternative medicine. It is important to consult a healthcare professional to determine the best treatment for you.

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage. 

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI. 

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health. 

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health. 

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Foot and Ankle Surgery

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

What is Morton's Neuroma?

Morton’s neuroma, (also referred to as Morton’s metatarsalgia, Morton’s neuralgia, plantar neuroma or intermetatarsal neuroma) is a condition that is caused when the tissue around one of the nerves between your toes begins to thicken. This thickening can result in pain in the ball of the foot. Fortunately, the condition itself is not cancerous.

Morton’s neuroma affects women more often than men with a ratio of 4:1. It tends to target women between the age of 50 and 60, but it can occur in people of all ages. There are some risk factors that may put you at a slightly higher risk of developing the condition. People who often wear narrow or high-heeled shoes are often found to be linked to Morton’s neuroma. Additionally, activities such as running or jogging can put an enormous amount of pressure on the ligament and cause the nerve to thicken.

There usually aren’t any outward symptoms of this condition. A person who has Morton’s neuroma may feel as if they are standing on a pebble in their shoe. They may also feel a tingling or numbness in the toes as well as a burning pain in the ball of their foot that may radiate to their toes.

In order to properly diagnose you, the doctor will press on your foot to feel for a mass or tender spot. He may also do a series of tests such as x-rays, an ultrasound, or an MRI. X-rays are usually done to rule out any other causes for your foot pain such as a stress fracture. Ultrasounds are used to reveal soft tissue abnormalities that may exist, such as neuromas. Your podiatrist may want to use an MRI in order to visualize your soft tissues.

There are three main options for treatment of Morton’s neuroma: Injections, decompression surgery, and removal of the nerve. Injections of steroids into the painful area have been proven to help those with Morton’s neuroma. Decompression surgery has been shown to relieve pressure on the affected nerve by cutting nearby structures such as the ligaments in the foot. Another treatment option would be to surgically remove the growth to provide pain relief.

If you suspect that you have Morton’s neuroma you should make an appointment with your podiatrist right away. You shouldn’t ignore any foot pain that lasts longer than a few days, especially if the pain does not improve.

Exercise for Your Feet

Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.

For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.

Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.

Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works the muscles.

Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet off of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.

In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis. It’s also important to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage. This encourages circulation in the feet as well as muscle relaxation.

What Are Hammertoes?

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

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