New Orthotics Pictures

We have just uploaded a new set of orthotics pictures. Orthotics inserts are designed for just about any type of shoes including sports shoes and women dress shoes. Please check them out on our web site, but also at our Flickr account.





Some of our latest images will be used in the patient handouts for young athletes by the American Academy of Pediatrics.

Podiatry on YouTube

The American College of Foot and Ankle Surgeons (ACFAS) now has its own account on the popular video sharing social networking site YouTube.com. Please check it out and watch some really interesting podiatry related interviews and short clips.

http://www.youtube.com/user/FootAndAnkleSurgeons

Heel Pain - Treatment

Conservative treatment is over 90% effective and consists of:

• Oral anti-inflammatory medicine or steroid injections.


• Physical therapy


• Functional orthotics (shoe inserts that maintain proper biomechanics)

Anti-inflammatory medication and orthotics are key to long-term successful treatment.

If conservative treatment does not provide relief from heel pain, surgery may be necessary.

• The most common procedure is an endoscopic plantar fascia release, which reduces the pulling tension of the structures around the heel.


• Unless very large and projecting downward, the spur usually does not need to be removed, since the tension on the plantar fascia, not the spur, causes the symptoms.

You can download our Podiatry-at-a-Glance newsletter that talks about heel pain from out website.

Ingrown Toenails - Treatment

Treatment with over the counter products and topical or oral antibiotics is usually ineffective
since they do not address the ingrown nail itself. In order to resolve the condition the
offending nail border must be removed (Fig. 2).

• If the nail is only minimally ingrown the offending border may be removed simply by
  trimming the nail margin. This does not usually require use of a local anesthetic.
  
• If the nail is significantly ingrown or an infection is present, removal of the offending
  nail border and drainage of the infection usually requires local anasthesia and a more
  aggressive nail border resection. Any hypertrophic granulation tissue is usually resected.
  Antibiotics should be used appropriately.


• In cases of reccurrent ingrown nails a matricectomy may be performed in which the
  offending portion of the nail is permanently removed.
  
• If an abnormality of the nail, soft tissue, or bone is present a more involved surgical
  procedure may be needed to correct the condition and relieve the patient’s symptoms.

You can download our Podiatry-at-a-Glance newsletter that talks about ingrown toenails from our website.

Stress Fractures

Stress fractures are a type of injury. These fractures which may be partial or complete, result from repetitive subthreshold loading that, exceeds the bone’s intrinsic ability to repair itself. The repetitive forces of running or jumping and even benign activities such as walking, can cause these injuries. Stress fractures can occur in any bone, but most often afflict the weight-bearing bones of the lower let and foot.


SYMPTOMS

• Localized bone pain
• Pain exacarbated with weight bearing
• With or without localized edema

Stress fractures are notoriously under diagnosed and under treated. This injury carries the risk of complete fracture, displacement, nonunion, and avascular necrosis, and may result in chronic disability. R.I.C.E (Rest. Ice. Compression. Elevation.) is always a good first step.
If you think you may be having this condition, please contact your local podiatrist immediately. You can also look for futher information on our web site.

Lateral Ankle Instability

The ankle is the most commonly injured joint in sports. Ankle sprains represent about 85% of all ankle injuries in the US. While an inversion ankle injury often involves injury to the lateral collateral ankle ligaments (Figure 1), other structures in this area may also be injured. These associated injuries may not be evident until weeks or months after the initial event, and may not present themselves until the patient attempts to return to full activity but is unable to because of persistent pain. Typical associated injuries include chronic lateral ankle instability, peroneal tendon damage, nerve injury, syndesmotic sprain or tear, and intraarticular cartilage damage. Although the injury may initially seem minor, a thorough evaluation and aggressive, conservative therapy is important in improving the outcome.
SYMPTOMS

• Patients often complain that the affected ankle feels "unstable" or "gives out" frequently.
• Patients typically feel unsteady when walking on uneven ground or sloped surfaces.
• Repeated inversion injuries will occur with the slightest provocation.
• Patients commonly report twisting or spraining ankles every few months with varying levels of severity.
• Persistent swelling to the anterolateral aspect of the ankle
• Bracing or taping may not provide adequate stability.

Initial treatment involves managing symptoms and biomechanical control. Non-steroidal anti-inflammatories or steroid injections, if used alone usually do not provide long term relief. If conservative treatment fails to provide relief or the ankle is too unstable to be controlled with bracing and orthotics, surgical treatment is warranted.

For a more thorough description of this condition please visit our web site and remember to always consult your local podiatris with any foot pain condition that you may be experiencing.

Morton's Neuroma

Morton’s Neuroma is a term used to describe a benign enlargement of the third common digital branch of the medial plantar nerve located between the third and fourth metatarsal heads. Besides the third intermetatarsal space, a neuroma can develop in any area where a nerve becomes chronically irritated. A Morton’s neuroma is commonly due to specific anatomical and biomechanical relationships between the third common digital nerve, the third and fourth metatarsal heads, and the other structures in the third intermetatarsal space.

Some of the symptoms include:

• One or more numb toes (usually the 3rd and 4th toes)
• Feeling that something is between the toes or under the ball of the foot.
• Sharp pain in the foot that radiates toward the toes or up the leg.
• Early stage symptoms may be intermittent; however, late stage symptoms are constant.
• Symptoms are almost always aggravated by shoes and frequently relieved by removing them and massaging the affected area.
  

Conservative treatment is usually effective but in certain cases a surgical intervention is necessary. It's always good to have your feet checked by your local podiatrist. And if you live in the Chicagoland area, Dr. Carr from the Chicago Podiatric Surgeons will be happy to schedule your visit.