Posts for: September, 2014
Avoid these gross foot infections
Infections of the toenails and fingernails can occur at any time during the year. However, many become more concerned during the summer months when they more frequently bare their feet.
Nail fungus, or onychomycosis, is caused by dermatophytes (fungus germs) that gain entry into the nail or nail bed and then spread throughout the nail. It’s more common as we get older and is rarely seen in children. More than 15 percent of individuals will be faced with the problem at some point in their lives.
These infections can cause the nails to become discolored, thickened, and brittle. Sometimes they cause the nail to separate from the underlying nail bed. They can also change the shape of the nail as it grows. It may start as a small whitish patch within the end of the nail and then spread to involve more area of the nail.
Fungi love warm, moist and dark places to grow. This is why individuals who have sweaty feet from wearing heavy work boots or playing sports are more apt to get common fungal infections of the foot. You can also pick up fungal germs by walking around barefoot on warm wet floors, such as at the pool or in the locker room.
Though people can feel embarrassed exposing their “disfigured” toenails in public, fungal nail infections are not just a cosmetic concern. Complications can arise due to the altered growth of the nail and the infection itself. Some will experience pain in the toe, disruption of the skin around the nail, and ingrown toenails. Bacterial infections can develop if the skin has been disrupted, especially in those with altered sensation in the feet such as diabetics. The infection can also spread to other nails.
Treatment of fungal nail infections is difficult because the nails grow slowly and infected nails tend to be thicker than normal skin. Topical antifungal medications, both over the counter and prescription, are in general not very effective. It’s hard to get these medicines into the nail with enough concentration to kill the organisms.
Some oral medications can be expensive and potentially toxic to other organs, particularly the liver. Oral prescription antifungals for the treatment of nail infection must be taken daily for three to four months. Blood tests to monitor the liver need to be done at baseline and every few weeks during treatment.
There are some things you can do to take care of your nails if you have a fungal infection. Keep your nails cut short and file down any thick areas. Don’t use the same nail trimmer or file on healthy nails and infected nails. If you have your nails professionally manicured, you should bring your own nail files and trimmers from home.
Wear waterproof gloves for wet work (like washing dishes or floors). To protect your fingers, wear 100 percent cotton gloves for dry work.
Wear 100 percent cotton socks. Change your socks when they are damp from sweat or if your feet get wet. Put on clean, dry socks every day. You can put over-the-counter antifungal foot powder inside your socks to help keep your feet dry. Wear shoes with good support and a wide toe area. Don’t wear pointed shoes that press your toes together.
Avoid walking barefoot in public areas, such as in locker rooms or at swimming pools.
The content in this column is for informational purposes only. Consult your physician for appropriate individual treatment. Dr. Reynolds practices Family Medicine in Chesterfield.
Foot Health: For the love of your feet …
get help for those painful crossed toes
By Dr. Sarah Voelkel
We love our feet. They get us place to place.
But sometimes… We hate our feet. They hurt, they swell and some just aren’t pretty. The feelings we have with our feet can get pretty complicated.
Love is a battlefield, eh?
The truth is, we need to love and take care of our feet. If you have foot pain during everyday tasks or walking, that is not normal. If foot pain is the “normal” for you, you may be suffering from a condition called pre-dislocation syndrome.
This condition involves the toes, most commonly the second toe. The stabilizing tissues become inflamed and may eventually rupture causing significant deformity of the toe. Sounds pretty gruesome, right?
As this condition progresses, there is pain and swelling associated and difficulty wearing shoes, especially high heels or wedges for women. The toe can eventually begin to drift upwards and to the side eventually crossing over the big toe, especially if there is a bunion present as well… Ouch!
This condition can be caused by injuries, especially in athletic individuals, but it is usually a structural and biomechanical issue. This condition can be diagnosed in the office by clinical exam, X-Ray and possible ultrasound evaluation.
Pre-dislocation syndrome is treatable without surgery if addressed early on, but surgery may be needed if the condition worsens during conservative treatment.
Initial therapy may include:
- Offloading padding
- Anti-inflammatory medication
- Possible boot immobilization depending on pain and inflammation
- Avoiding barefoot walking and high heel shoes for women is important for healing
- Wearing a more stiff-soled shoe
If the condition continues to be painful and further progression of the deformity to the toe is present, surgical intervention will be necessary. Surgery involves stabilizing and repairing the soft tissues and addressing any other structural abnormalities that may cause the condition to return at a later date.
This relationship gets serious when problems are ignored – sounds a lot like life, right? Do yourself a favor and listen to your feet. You will save time, pain and money and end the battles you have with your feet!
Dr. Sarah Voelkel is a foot and ankle surgeon atLexington Podiatry and the Kentucky Heel Pain Center.
Podiatrists and orthopedic foot surgions agree that there are 7 major habbits that should be avoided for foot health.
If you wore a pedometer from the day you started walking, you'd have logged in more then 70,000 miles by the time you hit age 50. When you walk a good portion of those miles in improperly-fitting shoes or otherwise neglect your feet, it's little wonder why they hurt.
The 38 muscles in your feet make up approximately 25 percent of the muscles in your body and absorb 1,000 pounds of force each day. Bad foot health habits can quickly add up to major problems. Below, experts discuss the most common bad habits, the consequences and ways to fix your feet so they carry you through your next 50 years:
1. You follow the barefoot running fad. The recent trend toward minimalist running shoes or barefoot running can be problematic for those who've been running in supportive shoes for many years, says Dr. Sherri Greene, a New York podiatrist. "Since most people don't train to strengthen their feet, I find many have very weak muscles and tendons. And it's not a good idea if you have biomechanically-challenged feet (e.g. flat feet) or neuropathy."
Greene recommends wearing supportive shoes or, if you're hooked on the idea of barefoot running, train to strengthen your feet where they may tolerate a minimal shoe.
2. You skip socks. Sticking your bare feet into a pair of shoes creates a field day for fungus, says Greene. Shoes such as Uggs made the news recently when the dark, cozy boot interior was found to trigger fungal infections in people who wore them sans socks.
"Fungus thrives in dark and moist environments," says Greene. Since the bug can survive long periods of time in your shoes, you also risk re-infecting yourself even if you initially clear up the problem, she adds. "Avoid the risk altogether and always wear socks."
3. You're a woman and love high heels.
Wearing heels for special occasions won't do much harm, says Dr. Andrew Gerken, foot/ankle specialist and orthopedic surgeon with Hoag Orthopedic Institute in Irvine, Calif. “As long as you don't wear them all day long at work every day. Then it's not a good idea, especially if they're pointy toe shoes," he notes.
The downward pressure on top of the scrunched toe box can cause bunions and often surgery is needed to realign the toe, says Gerken. "Heredity is also a factor for bunions. They can also recur if you continue wearing pointy toe shoes after surgery."
4. You can't remember the last time you replaced your running shoes. Your worn out, comfy running shoes may be like old friends, but old shoes lose shock absorption and support over time. "Running in them can contribute to injury (e.g. plantar fasciitis, inflammation of a tendon that runs along the bottom of the foot). But there's no good metric to figure out when it's time to replace your shoes," says Gerken.
He notes general rules of thumb include replacing shoes every 300 miles, or approximately every four months, but recommends using common sense as your guide. "Ask yourself, how do my shoes look and feel?" says Gerken.
5. You do too much too soon. Overdoing a high-impact sport, like running, can cause injuries, such as Achilles problems. "Often it's a problem of too much too soon," Gerken says. This typically happens to new runners or runners returning to the sport after an injury.
Runners who refuse to crosstrain (alternate biking or other non-impact sport along with running) are at high risk. "It's not a good idea to 'only' want to run," Gerken says. If you become injured, Gerken recommends recognizing problems early and then working with your podiatrist or trainer to develop a "game plan" to get you back on track, which may include extra stretching and a step-by-step program to get you back in the game safely.
6. You wear flip flops everywhere.
Although they've become practically the official shoe of summer, flip flops offer little support and can put you at risk for a number of foot injuries. Gripping the shoe with your toes to make sure they don't slide out when you walk can throw off your gait and increase your risk of tripping and falling.
In addition, muscle strains can result from rolling and twisting yourself off the shoe, since they do not contain an ankle strap for support. An athletic shoe or a flip flop with an orthotic foot bed make better options.
7. You're a woman who lives in ballet flats.
Many of the same problems found in flip flops pertain to ballet flats, as they offer no arch support, says Dr. Dominic J. Catanese, a podiatric surgeon at Montefiore Medical Center in New York. "They have no cushioning or support, which can lead to heel pain, plantar fasciitis and pain under the ball of the foot."
Those without foot problems or pain may be able to wear them, but otherwise choose sandals with a contoured arch and a heel cup, suggests Catanese.
By Linda Melone from Next Avenue
Next Avenue contributor Linda Melone is a California-based freelance writer specializing in health, fitness and wellness for women over 50.
Cosmetic Foot Surgery: Fashion's Pandora's Box?
By Staff Editor
Jun 26, 2014
Foot and Ankle Surgeons Warn Against Taking Part in Growing Surgery Trend
(HealthNewsDigest.com) - CHICAGO, June 26, 2014 -- Getting excited over a snazzy pair of Jimmy Choo stilettos is one thing--having your feet surgically altered to wear them is another. As extreme and imprudent as it may sound, the cosmetic surgery craze isn't just for faces anymore--it's now moved to the feet, and it's kicking up a storm.
Today a host of women are turning to cosmetic surgery to give their feet a "face lift" and fit them into high-fashion shoes. But physician members of the American College of Foot and Ankle Surgeons, who specialize in foot surgery, are taking a stand and calling this an ill-advised trend.
Cosmetic foot surgery runs the gamut, from injectable fillers to toe shortening or lengthening and bunion and hammertoe surgery when there's no pain or dysfunction. Many of these foot-perfecting techniques are borrowed from medical procedures established years ago to relieve pain and restore function, not to alter the size or look of the foot.
"Undergoing foot surgery solely for cosmetic reasons raises serious concerns," says Michael Cornelison, DPM, FACFAS, a Cupertino, California foot and ankle surgeon and Fellow member of the American College of Foot and Ankle Surgeons. "We need our feet for walking and getting around, so breaking these bones to reconstruct them for appearance's sake is a troubling matter--it often affects function and can bring risks and complications."
In fact, the American College of Foot and Ankle Surgeons considers this fad so disturbing that it has taken an official position, asserting that cosmetic foot surgery should not be undertaken because it carries risks without medical benefit.
"I tell my patients that one of the biggest potential risks is taking a foot that doesn't hurt and in the attempt to make it look better, turning it into a foot that gives you chronic pain," says Dr. Cornelison.
Another big drawback is the likely possibility that the patient's expectations won't be entirely met, because surgery can't make an "abnormal" foot look completely normal. What's more, the incision can leave an unsightly scar.
Along with chronic pain and scarring, other potential risks of cosmetic foot surgery include infection, worsened deformity, bleeding, nerve damage, and a serious reaction to the anesthesia.
Despite these caveats, it's easy to see why many are lured into surgically changing the appearance of their feet. Marketing tactics give these procedures spa-like names that trivialize the seriousness of surgery and make each "service" seem like a rejuvenating, risk-free beauty treatment.
"Those who are compelled by these terms to pursue cosmetic surgery for their feet should be sure to ask for a description of all the possible risks and negative consequences, along with what the procedure is expected to do," urges Thomas S. Roukis, DPM, PhD, FACFAS, President of the American College of Foot and Ankle Surgeons and a foot and ankle surgeon from La Crosse, Wisconsin. "To get a full understanding of the surgery, it's important to seek the opinion of an experienced foot and ankle surgeon who has done these procedures for medical rather than cosmetic reasons."
Furthermore, as cosmetic surgery moves south on the body--from the face to the chest to the tummy to the feet--it's crucial to consider the need to function well. "We typically take our feet for granted and don't realize how much we depend on them to walk, drive, shop, and take care of family members, for example," says Dr. Roukis. "The last thing you want is to undergo all the post-op downtime and possible risks and complications for a questionable benefit."
It's important to realize, however, that foot and ankle surgery is frequently a positive life-changing event for people who have suffered from pain and/or dysfunction not adequately relieved by nonsurgical treatments, and where the risks of surgery are far outweighed by the potential benefits.
For more information on foot and ankle health, visit the American College of Foot and Ankle Surgeons' patient education website at FootHealthFacts.org. To read the full version of the College's position statement on cosmetic surgery, visit acfas.org/media.
The American College of Foot and Ankle Surgeons is a professional society of over 7,000 foot and ankle surgeons. Founded in 1942, the College's mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its patient education website, FootHealthFacts.org.