Friday, October 28, 2011

Bunion Surgery Lecture - Toronto Podiatrist

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Bunion Surgery (Bunionectomy) - Toronto Podiatrist

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Dr. Sheldon Nadal discusses Bunion Surgery (Bunionectomy).

http://www.footcare.net

Bunions are progressive bone deformities of the foot that often cause recurring or chronic inflammation, irritation, and pain that require surgical correction. Surgical removal of a bunion is called a bunionectomy. However, there are multiple types of bunionectomies, each designed to resolve different structural changes caused by the deformity.

Bunion surgeries fall into two major categories:

  • Head procedures that treat the big toe joint. In a head procedure bunionectomy, the bone is cut just behind the joint, moved into its proper position, and fixed in place with a screw or pin. Head procedures are often used for patients who cannot be immobilized for long periods of time.
  • Base procedures concentrate on the bone near or behind the big toe joint. Different types of base procedures are conducted depending on the nature of the deformity. These range from cutting a wedge out of the bone and splitting it so that it can be moved into its proper position; making a semi-circular cut and rotating the bone into its correct position; or fusing the joint. Ligaments inside and outside the toe may also be treated during a base procedure.

There are three important factors that impact the success of bunion surgery:

  1. Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient's foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
  2. Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won't recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
  3. Bunion surgery is not a magic bullet.  Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.

What To Expect

Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.

Prior to the surgery, patients will need to make some preparatory arrangements. These include:

  • Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
  • Arranging your schedule to make sure you don't need to take any long trips for at least two to three weeks following the surgery.
  • Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
  • Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.

The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.

Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into "twilight" so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.

The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.

During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.

Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.

By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.

By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.

Visit our website: http://www.footcare.net

Senior's Foot Health and Walking Shoes - Toronto Podiatrist

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Senior’s Foot Problems and Walking Shoes - Toronto Podiatrist

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Dr. Sheldon Nadal discusses the symptoms, causes and treatments for sports injuries.

http://www.footcare.net

About 67 million adults in this country have discovered that walking is one of the most fun, natural, and inexpensive ways of keeping your health—and your feet—in top shape. Walking can be enjoyed almost anywhere, any time, and year around. It's also a good way to get exercise, particularly for people who are out-of-shape.

According to the American Podiatric Medical Association, exercise offers a host of benefits. Walking helps control weight, blood sugar, and cholesterol levels. A brisk walk can burn up to 100 calories per mile or 300 calories per hour. Walking also improves cardiovascular fitness. As an aerobic exercise, walking gets the heart beating faster to transport oxygen-rich blood from the lungs to the muscles. The heart and lungs grow more efficient with a regular walking regimen, reducing blood pressure and the resting heart rate. Walking is also a central element of medical rehabilitation for a wide array of health problems. For example, recovery from a heart attack can be facilitated by a regular walking regimen. Additionally, walking creates an overall feeling of well-being, and can relieve depression, anxiety, and stress by producing endorphins, the body's natural tranquilizer. A brisk walk will relax you and also stimulate your thinking.

To gain the most health benefit from walking, it is important to pay attention to your feet. Shoes that don't fit properly or provide adequate support, lack of stretching, and improper gait can lead to foot injuries or pain. The most common foot problems are blisters, corns, calluses, and plantar fasciitis.

Walking Shoes

The only equipment you need to enjoy walking for fitness is a good pair of shoes. But before you can shop for the best shoe for your foot, you need to identify the natural inclination of your foot and gait. There are three basic foot types:

  • Pronators are people with relatively flat feet, caused by low arches, which generally leads to overpronation, or a gait in which the ankle rolls inward excessively. People with this foot type need motion control shoes that offer support for mid-foot. Motion-control shoes are more rigid and built on a straight last. These are generally board-lasted shoes, which have a piece of cardboard running the length of the shoe for greater stability. Look for sturdy uppers for added stability and avoid shoes with a lot of cushioning or highly curved toes. Also look for a reinforced heel counter to maintain foot support and stability.
  • Supinators are people with high arches, which can lead to underpronation that places too much weight on the outsides of the feet. People with this foot type need stability shoes designed for extra shock absorption and often having a curved or semi-curved last. A slip-lasted shoe is also recommended, because the sewn seam runs the length of the shoe  giving it greater flexibility. Also look for shoes that are reinforced around the ankle and heel to stabilize the foot and extra cushioning under the ball of the foot.
  • People with normal feet can wear any type of walking shoe, although a curved last is generally preferred.

When you walk, the natural motion of your foot rolls gradually from the heel to the toe, with your foot bending at the ball on each step. That's why it is important for walking shoes to have enough flexibility in just the right places.  A good walking shoe should give a little when you twist it and bend at the ball of the foot. When you put the shoe on a flat surface and push on the toe the heel should come up off the surface. If it does, the shoe has the curvature you need to conform to your movement during walking.  Make sure the heel is low and not too wide. A slight undercut in the heel will help your foot begin its roll from the heel through the step.

Here are some other important tips for buying a good pair of walking shoes:

  • Shop at the end of the day when your feet are slightly swollen to get a good fit.
  • Try on shoes with the socks you will wear when walking. If you use an orthotic, bring that to the store when you try on shoes as well.
  • Have your feet measured standing up and fit your shoes to the larger of your two feet.
  • Be sure there is enough room in the toe box for your toes to wiggle and about a half inch between your toes and the end of the shoe.
  • Take time when shopping to try on different brands and walk around the store in each pair. Be sure to walk on a hard surface, not just on carpeting. Let your foot be the guide to the fit, not the shoe size or style.
  • Look for lightweight, breathable materials for greater comfort.
  • Run your hand all over and inside the shoes to feel for any seams or catches that might irritate your foot.
  • Choose shoes that lace for better foot stability and control.
  • Make sure your heel fits snugly and does not tend toward slipping out of the shoe.
  • Wear your walking shoes only for walking to extend their life. Consider buying two pairs and rotating your wear to give each pair time to breath between walks.
  • Replace walking shoes after every 300 to 600 miles, depending on how hard you are on your shoes.

Visit our website: http://www.footcare.net

Thursday, October 27, 2011

Minimal Incision Foot Surgery - Toronto Podiatrist

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Minimally Invasive Foot Surgery - Toronto Podiatrist

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Dr. Sheldon Nadal discusses Minimal Incision Outpatient Foot Surgery.

http://www.footcare.net

Surgery on the foot, ankle, or lower leg is usually performed by podiatric surgeons and orthopedic surgeons specializing in the foot and ankle.

Foot and ankle surgeries address a wide variety of foot problems, including:

  • Sprains and fractures.
  • Arthritis and joint disease.
  • Benign and malignant tumors.
  • Birth deformities.
  • Bunions.
  • Calluses and warts.
  • Corns and hammertoes.
  • Flatfeet.
  • Heel or toe spurs.
  • Neuromas (nerve tumors).

Many foot and ankle surgeries today can be performed in the doctor's office or a surgical center on an outpatient basis. They frequently can be performed using local anesthesia, in some cases combined with sedation. Most foot surgeries require a period of immobilization after the procedures with protective devices, such as a bandages, splints, surgical shoes, casts, or open sandals. Limited weight bearing, elevating and icing the foot, and keeping the area dry are commonly required for the first two weeks following surgery until sutures are removed. Most surgeons will encourage post-operative exercise of the foot and legs to speed recovery. In addition, many patients need additional therapy or treatments after surgery in order to aid in the healing and recovery process. These may include physiotherapy, orthotic devices, and special footwear. After sufficient healing time, which varies from procedure to procedure, most patients can resume wearing their usual footwear.

Visit our website: http://www.footcare.net

What Causes Heel Pain? - Toronto Podiatrist

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Help for Heel Pain  - Toronto Podiatrist

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Dr. Sheldon Nadal discusses the symptoms, causes and treatments for Heel Pain (Plantar Fasciitis).

What causes heel pain?
One of the most common causes of heel pain is plantar fasciitis or heel spur syndrome.Other causes include gout, arthritis, broken heel bone, infection, foreign bodies (such as stepping on a needle). Your podiatrist can determine the exact cause of your heel pain.

What is plantar fasciitis or heel spur syndrome?
Plantar fasciitis is due to a tight tendon located under the arch and attached to the bottom of the heel. It has become strained and inflamed, often due to a lack of proper support, or due to an injury, or overuse. Over time, the tendon may begin to pull away from its attachment at the heel and a bone spur develops. Generally, the problem is not due to the heel spur, it is due to the inflamed tendon.

How do I know if I have plantar fasciitis?
Usually, you will experience pain at the bottom of the heel, particularly when getting out of bed in the morning or when starting to walk following a period of rest. It tends to feel better after a moderate amount of walking. It may not hurt during a workout but usually hurts more the next day following the workout.

What can I do at home to relieve the pain of plantar fasciitis?
Applying ice to the tender area for short periods may help. Also, try gentle calf stretches. Aspirin may relieve the inflammation. Elevating the heel by putting a soft pad in the shoe under your sore heel may help. Women may feel better in a shoe with a higher heel.

What if my heel still hurts?
It's time to see a podiatrist.

Visit our website: http://www.footcare.net

 

Laser Therapy for Fungal Toenails - Toronto Podiatrist

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Help for Fungal Toenails with Laser Therapy- Toronto Podiatrist

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Dr. Sheldon Nadal discusses laser therapy for Fungal Toenails 

http://www.footcare.net

On August 26 2010 our  Toronto podiatry office introduced in Canada, laser treatment for toenail fungus or onychomycosis using a 1320 nm YAG laser .

A preliminary study performed in Roseville California indicates that up to 75-80% of patients with mild to moderate onychomycosis or fungal toenails will experience a significant improvement following treatment.

The laser is an alternative to topical medications such as Pen Lac, which has limited efficacy, and anti-fungal pills such as Lamisil or Terbinifine, which have associated side effects.

With our laser, there is usually very little discomfort, anaesthetic is unnecessary and you may walk and resume normal activities immediately.

Currently, several lasers are being marketed to Toronto Ontario podiatrists for the treatment of fungal toenails. They include the CoolBreeze or CoolTouch Laser by NuStar lasers, the Pinpoint or Pinpointe laser by Patholase and the Genesis laser by Cutera. Other lasers for nail fungus include the Q-Clear laser and the Fotona laser

Please call our Toronto foot clinic at 416-486-9917 today to find out how we can help you with your toe nails.

Visit our website: http://www.footcare.net

Shoes and Preventing Foot Problems - Toronto Podiatrist

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How to Choose Shoes and Preventing Foot Problems - Toronto Podiatrist

Dr. Sheldon Nadal discusses How to Choose Shoes and Preventing Foot Problems http://www.footcare.net

Examining old shoes before buying new ones can help you evaluate your wear patterns and buy new shoes with a better fit and style that compensates for the stresses you place on shoes.

What are your shoes trying to tell you? Here is a translation of basic wear patterns:

  • A bulge and wear to the side of the big toe means too-narrow fit or you have a bunion.
  • Outer sole wear means you turn your foot out. Orthotics may help.
  • Toe-shaped ridges on the upper means your shoes are too small or you have hammertoes.
  • Wear on the ball of the foot means your heel tendons may be too tight.
  • Wear on the inner sole means you pronate or turn your foot inward. Inner liners or orthotics may help.
  • Wear on the upper, above the toes means the front of your shoe is too low.

Visit our website: http://www.footcare.net

Laser Treatment for Foot Pain – Toronto Podiatrist

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Laser Therapy for Foot Pain – Toronto Podiatrist

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Dr. Sheldon Nadal discusses laser therapy for foot pain management.

http://www.footcare.net

Laser therapy is use for pain management. The effects of Laser Treatment include but not limited to improved healing time, pain reduction, increased circulation, decreased swelling and vasodilation. Laser therapy has been widely utilized in Europe by physical therapists, nurses, and doctors as far back as the 1970s.

Visit our website: http://www.footcare.net

Foot Pain and Shoes - Toronto Podiatrist

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Choosing Shoes to Help Prevent Foot Problems - Toronto Podiatrist

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How to Choose Shoes and Preventing Foot Problems - Toronto Podiatrist

Dr. Sheldon Nadal discusses How to Choose Shoes and Preventing Foot Problems http://www.footcare.net

Examining old shoes before buying new ones can help you evaluate your wear patterns and buy new shoes with a better fit and style that compensates for the stresses you place on shoes.

What are your shoes trying to tell you? Here is a translation of basic wear patterns:

  • A bulge and wear to the side of the big toe means too-narrow fit or you have a bunion.
  • Outer sole wear means you turn your foot out. Orthotics may help.
  • Toe-shaped ridges on the upper means your shoes are too small or you have hammertoes.
  • Wear on the ball of the foot means your heel tendons may be too tight.
  • Wear on the inner sole means you pronate or turn your foot inward. Inner liners or orthotics may help.
  • Wear on the upper, above the toes means the front of your shoe is too low.

Visit our website: http://www.footcare.net

Help Prevent Sports Injuries with Stretching Exercises - Toronto Podiatrist

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Sports Injuries and Stretching Exercises - Toronto Podiatrist  

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Dr. Sheldon Nadal discusses the symptoms, causes and treatments for sports injuries.

http://www.footcare.net

Before beginning any exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

Stretching exercises should take 5 to 10 minutes and ought to be conducted in a stretch/hold/relax pattern without any bouncing or pulling. It is important to stretch the propulsion muscles in the back of the leg and thigh (posterior) as well as the anterior muscles.

Some effective stretching exercises to prepare the foot and ankle for exercise include:

  • The wall push-up. Face a wall from three feet away, with feet flat on the floor, and knees locked. Lean into the wall, keeping feet on the floor and hold for 10 seconds as the calf muscle stretches, then relax. Do not bounce. Repeat five times.
  • The hamstring stretch. Put your foot, with knee straight and locked, on a chair or table. Keep the other leg straight with knee locked. Lower your head toward the raised knee until the muscles tighten. Hold to a count of 10 then relax. Repeat five times, then switch to the other leg.
  • Lower back stretch. In a standing position, keep both legs straight, feet spread slightly. Bend over at the waist and attempt to touch the palms of your hands to the floor. Hold the stretch for 10 seconds and repeat 10 times. Do not bounce.

Excessive tightness of the calf muscles can contribute to many foot and some knee problems. A key point of injury is the Achilles tendon, which attaches the calf muscle to the back of the heel. When the calf muscle tightens up, it limits the movement of the ankle joint. 

Calf muscle stretching is very useful in the prevention and treatment of many foot problems. Two typical methods for stretching your calf muscles include the wall push-up (described above) and this technique: Standing approximately two feet from a wall. While facing the wall, turn your feet inward ("pigeon toed") and lean forward into the wall, keeping your heels on the floor and the knees extended. Keep your back straight and don't bend at the hips. Hold the stretch for 10 seconds and do the stretch 10 times in a row.

 

Visit our website: http://www.footcare.net

Choosing Children’s Shoes and Foot Health - Toronto Podiatrist

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Children’s Foot Health - Toronto Podiatrist

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Dr. Sheldon Nadal discusses children’s foot health and foot problems.

http://www.footcare.net

Choosing shoes for your children can play a critical role in their musculoskeletal development, including their posture.

In general, infants just learning to walk do not need shoes. Infants may go barefooted indoors, or wear only a pair of socks. This helps the foot grow normally and develop its muscles and strength as well as encourages the grasping ability of toes.

Once children are ready to walk as toddlers, their need for properly-fitted shoes is important. In general, a soft, pliable, roomy shoe, such as a sneaker, is ideal for all children. The toe box should provide enough space for growth and should be wide enough to allow the toes to wiggle. A finger's breadth of extra length will usually allow for about three to six months' worth of growth, though this can vary depending on your child's age and rate of growth.

Because high-top shoes tie above the ankle, they are recommended for younger children who may have trouble keeping their shoes on. Contrary to common belief, however, high-top shoes offer no advantages in terms of foot or ankle support over their low-cut counterparts.

Here are some tips when purchasing shoes for children:

  • Both feet should be measured every time you shop for new shoes since those little feet are growing. If, as is common, the feet are two different sizes, shoes should be fitted to the larger foot.
  • The child's foot should be sized while he or she is standing up with full weight-bearing.
  • There should be about one-half inch of space (or a thumb's width) between the tip of the toes and the end of the shoe. The child should be able to comfortably wiggle his or her toes in the shoe.
  • Have the child walk around the store for more than just a few minutes wearing the shoe with a normal sock. Ask the child if he or she feels any pressure spots in the shoe. Look for signs of irritation on the foot after the shoe is tested.
  • Put your hand inside the shoe and feel around for any staples or irregularities in the glue that could cause irritation. Examine where the inside stitching hits the foot.
  • Examine the shoe itself. It should have a firm heel counter (stiff material on either side of the heel), adequate cushioning of the insole, and a built-in arch. It should be flexible enough to bend where the foot bends at the ball of the foot, not in the middle of the shoe.
  • Never try to force your child's feet to fit a pair of shoes.
  • Shoes should not slip off at the heels. Children who have a tendency to sprain their ankles will do better with high-top shoes or boots.

Children who frequently remove shoes from their feet may be signaling some discomfort. Check your child's feet periodically for signs of too-tight shoes, such as redness, calluses or blisters, which will help you know when they've outgrown their shoes.

Remember that the primary purpose of shoes is to prevent injury. Shoes seldom correct children's foot deformities or change a foot's growth pattern. Casting, bracing, or surgery may be needed if a serious deformity is present. If you notice a problem, please contact our office to have your child's feet examined.

 

Visit our website: http://www.footcare.net

Wednesday, October 26, 2011

Women’s Foot Health and Foot Problems - Toronto Podiatrist

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Women’s Foot Problems - Toronto Podiatrist

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Dr. Sheldon Nadal discusses the Women’s Foot Health and Foot Problems

http://www.footcare.net

The best shoe for women's feet is a walking shoe with laces (not a slip-on), a composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height.

Some women inflict punishment on their feet from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches).

A study conducted by the American Orthopaedic Foot and Ankle Society found that:

  • Nine out of 10 women wear shoes that are too small for their feet.
  • Eight out of 10 women say their shoes are painful.
  • More than 7 out of 10 women have developed a bunion, hammertoe, or other painful foot deformity.
  • Women are nine times more likely to develop a foot problem because of improper fitting shoes than a man.
  • Nine out of 10 women's foot deformities can be attributed to tight shoes.

High-heeled, pointed-toe shoes can cause numerous orthopedic problems, leading to discomfort or injury to the toes, ankles, knees, calves, and back. Many high-heeled-shoes also have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body's weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to discomfort, bunions, hammertoes, and other deformities.

The height of the heel makes a dramatic difference in the pressure that occurs on the bottom of the foot. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

To relieve the abusive effects of high heels, women should limit the amount of time they wear them and alternate these shoes with good quality sneakers or flats for part of the day. Look for comfortable and attractive walking pumps for work and social activities, that blend fashion appeal with athletic shoe-derived construction, reinforced heels, and wider toe room for greater comfort. Low-heeled shoes (one inch or lower) with a wide toe box are the ideal choice for women. An ample toe box that can accommodate the front part of the foot is as important as the heel in determining fit.

 

Visit our website: http://www.footcare.net

 

Laser Therapy Fungal Toenails - Toronto Podiatrist

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Laser Treatment Toenail Fungus - Toronto Podiatrist

Dr. Sheldon Nadal discusses laser therapy for Fungal Toenails

http://www.footcare.net

On August 26 2010 our  Toronto podiatry office introduced in Canada, laser treatment for toenail fungus or onychomycosis using a 1320 nm YAG laser .

A preliminary study performed in Roseville California indicates that up to 75-80% of patients with mild to moderate onychomycosis or fungal toenails will experience a significant improvement following treatment.

The laser is an alternative to topical medications such as Pen Lac, which has limited efficacy, and anti-fungal pills such as Lamisil or Terbinifine, which have associated side effects.

With our laser, there is usually very little discomfort, anaesthetic is unnecessary and you may walk and resume normal activities immediately.

Currently, several lasers are being marketed to Toronto Ontario podiatrists for the treatment of fungal toenails. They include the CoolBreeze or CoolTouch Laser by NuStar lasers, the Pinpoint or Pinpointe laser by Patholase and the Genesis laser by Cutera. Other lasers for nail fungus include the Q-Clear laser and the Fotona laser

Please call our Toronto foot clinic at 416-486-9917 today to find out how we can help you with your toe nails.

Visit our website: http://www.footcare.net

Bunion and Hammertoe Surgery - Toronto Podiatrist

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Bunion and Hammertoe Surgery - Toronto Podiatrist

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Dr. Sheldon Nadal discusses the symptoms, causes and treatments for Bunions and Hammertoes.

http://www.footcare.net

 Bunions are progressive bone deformities of the foot that often cause recurring or chronic inflammation, irritation, and pain that require surgical correction. Surgical removal of a bunion is called a bunionectomy. However, there are multiple types of bunionectomies, each designed to resolve different structural changes caused by the deformity.

Bunion surgeries fall into two major categories:

  • Head procedures that treat the big toe joint. In a head procedure bunionectomy, the bone is cut just behind the joint, moved into its proper position, and fixed in place with a screw or pin. Head procedures are often used for patients who cannot be immobilized for long periods of time.
  • Base procedures concentrate on the bone near or behind the big toe joint. Different types of base procedures are conducted depending on the nature of the deformity. These range from cutting a wedge out of the bone and splitting it so that it can be moved into its proper position; making a semi-circular cut and rotating the bone into its correct position; or fusing the joint. Ligaments inside and outside the toe may also be treated during a base procedure.

There are three important factors that impact the success of bunion surgery:

  1. Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient's foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
  2. Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won't recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
  3. Bunion surgery is not a magic bullet.  Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.

What To Expect

Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.

Prior to the surgery, patients will need to make some preparatory arrangements. These include:

  • Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
  • Arranging your schedule to make sure you don't need to take any long trips for at least two to three weeks following the surgery.
  • Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
  • Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.

The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.

Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into "twilight" so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.

The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.

During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.

Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.

By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.

By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.

Visit our website: http://www.footcare.net

Laser Therapy for Foot Pain - Podiatrist Toronto, ON

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Laser Treatment for Foot Pain - Podiatrist Toronto, ON

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Dr. Sheldon Nadal discusses laser therapy for foot pain management.

http://www.footcare.net

Laser therapy is use for pain management. The effects of Laser Treatment include but not limited to improved healing time, pain reduction, increased circulation, decreased swelling and vasodilation. Laser therapy has been widely utilized in Europe by physical therapists, nurses, and doctors as far back as the 1970s.

Visit our website: http://www.footcare.net

Laser Treatment for Fungal Toenails - Podiatrist Toronto, ON

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Laser Therapy for Fungal Toenails - Podiatrist Toronto, ON

 

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Dr. Sheldon Nadal discusses laser therapy for Fungal Toenails.

http://www.footcare.net

On August 26 2010 our  Toronto podiatry office introduced in Canada, laser treatment for toenail fungus or onychomycosis using a 1320 nm YAG laser .

A preliminary study performed in Roseville California indicates that up to 75-80% of patients with mild to moderate onychomycosis or fungal toenails will experience a significant improvement following treatment.

The laser is an alternative to topical medications such as Pen Lac, which has limited efficacy, and anti-fungal pills such as Lamisil or Terbinifine, which have associated side effects.

With our laser, there is usually very little discomfort, anaesthetic is unnecessary and you may walk and resume normal activities immediately.

Currently, several lasers are being marketed to Toronto Ontario podiatrists for the treatment of fungal toenails. They include the CoolBreeze or CoolTouch Laser by NuStar lasers, the Pinpoint or Pinpointe laser by Patholase and the Genesis laser by Cutera. Other lasers for nail fungus include the Q-Clear laser and the Fotona laser

Please call our Toronto foot clinic at 416-486-9917 today to find out how we can help you with your toe nails.

Visit our website: http://www.footcare.net

 

Tuesday, October 25, 2011

Ingrown Toenails - Podiatrist Toronto, ON

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Ingrown Toenail - Podiatry Toronto, ON

Dr. Sheldon Nadal discusses the symptoms, causes and treatments for Ingrown Toenails

http://www.footcare.net

Painless Toenail Surgery:

It is possible to get permanent relief from ingrown toenails in my Toronto podiatry office with a minor surgical procedure. The procedure is performed painlessly under local anesthetic - only your toe is frozen. Just  the painful ingowing side of the nail is removed. The part of the root that is causing the problem is treated with the carbon dioxide laseer and a special chemical. a small bandage is put on your toe. You can walk immediately. You then apply an ointment and a bandaid to the toe at home. I will see you a few days later in my office to make sure your toe is healing properly.

Ingrown toenails, also known as onychocryptosis, is usually caused by trimming toenails too short, particularly on the sides of the big toes. They may also be caused by shoe pressure (from shoes that are too tight or short), injury, fungus infection, heredity, or poor foot structure. Ingrown toenails occur when the corners or sides of the toenail dig into the skin, often causing infection. A common ailment, ingrown toenails can be painful. Ingrown toenails start out hard, swollen, and tender. Left untreated, they may become sore, red, and infected and the skin may start to grow over the ingrown toenail.

In most cases, treating ingrown toenails is simple: soak the foot in warm, soapy water several times each day. Avoid wearing tight shoes or socks. Antibiotics are sometimes prescribed if an infection is present. Note: Please consult your physician before taking any medications. In severe cases, if an acute infection occurs, surgical removal of part of the ingrown toenail may be needed. Known as partial nail plate avulsion, the procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

Ingrown toenails can be prevented by:

  • Trimming toenails straight across with no rounded corners.
  • Ensuring that shoes and socks are not too tight.
  • Keeping feet clean at all times.

 

Visit our website: http://www.footcare.net

Fungal Toenails - Podiatrist Toronto, ON

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Fungal Toenails - Podiatrist Toronto, ON

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Dr. Sheldon Nadal discusses the symptoms, causes and treatments for Fungal Toenails

http://www.footcare.net

Many people don't realize they have a fungal nail problem and, therefore, don't seek treatment. Yet, fungal toenail infections are a common foot health problem and can persist for years without ever causing pain. The disease, characterized by a change in a toenail's color, is often considered nothing more than a mere blemish. Left untreated, however, it can present serious problems.

Also referred to as onychomycosis, fungal nails are infections underneath the surface of the nail, which may also penetrate the nail. Fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate, which ultimately can lead to difficulty and pain when walking or running. Symptoms may include discoloration, brittleness, loosening, thickening, or crumbling of the nail.

A group of fungi, called dermophytes, easily attack the nail and thrive on keratin, the nail's protein substance. In some cases, when these tiny organisms take hold, the nail may become thicker, yellowish-brown, or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.

Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete's Foot or excessive perspiration.

You can prevent fungal nail infections by taking these simple precautions:

  • Exercise proper hygiene and regularly inspect your feet and toes.
  • Keep your feet clean and dry.
  • Wear shower shoes in public facilities whenever possible.
  • Clip nails straight across so that the nail does not extend beyond the tip of the toe.
  • Use a quality foot powder (talcum, not cornstarch) in conjunction with shoes that fit well and are made of materials that breathe.
  • Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to "wick" away moisture faster than cotton or wool socks, especially for those with more active lifestyles.
  • Disinfect home pedicure tools and don't apply polish to nails suspected of infection.

Depending on the type of infection you have, over-the-counter liquid antifungal agents may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed, a process called debridement. Note: Please consult your physician before taking any medications.

In severe cases, surgical treatment may be required to remove the infected nail. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured and prevents the return of a deformed nail.

Visit our website: http://www.footcare.net

Custom Orthotics - Podiatrist Toronto, ON

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Custom Orthotics - Podiatrist Toronto, ON

Dr. Sheldon Nadal discusses Custom Orthotics for foot and ankle problems.

http://www.footcare.net

Orthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe inserts that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotic 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.

Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.

Rigid Orthotics
Rigid orthotic devices are designed to control function and are used primarily for walking or dress shoes. They are often composed of a firm material, such as plastic or carbon fiber. Rigid orthotics are made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot. Rigid orthotics control motion in the two major foot joints that lie directly below the ankle joint and may improve or eliminate strains, aches, and pains in the legs, thighs, and lower back.

Soft Orthotics
Soft orthotics are generally used to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. They are usually effective for diabetic, arthritic, and deformed feet. Soft orthotics are typically made up of soft, cushioned materials so that they can be worn against the sole of the foot, extending from the heel past the ball of the foot, including the toes. Like rigid orthotics, soft orthotics are also made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot.

Semi-Rigid Orthotics
Semi-rigid orthotics provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials. Semi-rigid orthotics are often prescribed for children to treat flatfoot and in-toeing or out-toeing disorders. These orthotics are also used to help athletes mitigate pain while they train and compete.

Visit our website: http://www.footcare.net

Friday, October 14, 2011

Arthritis Foot Care - Manhattan Podiatrist NYC and White Plains, NY

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Arthritis Foot Care - NYC Podiatrist Manhattan and White Plains, NY

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Dr. Donna M. Hartmann discusses the symptoms, causes and treatments for arthritis of the foot and ankle.

http://www.adlerfootcare.com

Arthritis is an inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. Arthritis is a disabling and occasionally crippling disease afflicting almost 40 million Americans. In some forms, it appears to be hereditary. Although the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are the primary targets.

If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints that can be afflicted, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet. Arthritic feet can result in loss of mobility and independence. However, early diagnosis and proper medical care can limit or slow the damage.

Symptoms of arthritis in the foot and ankle include:

  • Early morning stiffness.
  • Limitation in motion of joint.
  • Recurring pain or tenderness in any joint.
  • Redness or heat in a joint.
  • Skin changes, including rashes and growths.
  • Swelling in one or more joints.

Forms of Arthritis
Osteoarthritisis the most common form of arthritis. It is frequently called degenerative joint disease or wear and tear arthritis. Aging usually brings on a breakdown in cartilage, and pain gets progressively more severe. Dull, throbbing nighttime pain is characteristic, and may be accompanied by muscle weakness or deterioration. Many of these symptoms can be relieved with rest. Overweight people are particularly susceptible to osteoarthritis. The additional weight contributes to the deterioration of cartilage and the development of bone spurs.

Rheumatoid arthritisis a major crippling disorder and the most serious form of arthritis. It is a complex, chronic inflammatory group of diseases, often affecting more than a dozen smaller joints during its course. In the foot, it frequently affects both ankles and toes.

Arthritis of the foot and ankle can be treated in many ways, including:

  • Physical therapy and exercise.
  • Anti-inflammatory medication and/or steroid injections into the affected joint.  Note: Please consult your physician before taking any medications.
  • Orthotics or specially prescribed shoes.

Visit our website: http://www.adlerfootcare.com

Peripheral Neuropathy - NYC Manhattan and White Plains, NY Podiatrist

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Peripheral Neuropathy - NYC Podiatrist Manhattan and White Plains, NY

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Dr. Donna M. Hartmann discusses the symptoms, causes and treatments for Peripheral Neuropathy.

http://www.adlerfootcare.com

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here's some basic advice for taking care of your feet:

  • Always keep your feet warm.
  • Don't get your feet wet in snow or rain.
  • Don't put your feet on radiators or in front of the fireplace.
  • Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don't soak your feet.
  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

 

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

 

Visit our website: http://www.adlerfootcare.com

Diabetic Foot Care -Podiatrist Manhattan NYC and White Plains, NY

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Diabetic Foot Care - NYC Podiatrist Manhattan and White Plains, NY


Dr. Tara Blitz discusses Diabetic Foot Care.

http://www.adlerfootcare.com

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here's some basic advice for taking care of your feet:

  • Always keep your feet warm.
  • Don't get your feet wet in snow or rain.
  • Don't put your feet on radiators or in front of the fireplace.
  • Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
  • Don't soak your feet.
  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

 

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

 

Visit our website: http://www.adlerfootcare.com 

Thursday, October 13, 2011

Posterior Tibial Tendon Dysfunction - Manhattan Podiatrist NYC and White Plains, NY

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Posterior Tibial Tendon Dysfunction (PTTD) - NYC Podiatrist Manhattan and White Plains, NY

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Dr. Tara Blitz discusses the symptoms, causes and treatments for Posterior Tibial Tendon Dysfunction. http://www.adlerfootcare.com

Posterior Tibial Tendon Dysfunction (PTTD) is a painful flatfoot condition which affects adults, primarily over the age of 50. Also known as Adult Acquired Flatfoot, this pathology affects women more than men and is linked to obesity, hypertension and diabetes. Most people with PTTD have had flat feet all of their lives. Then, for reasons not fully understood, one foot starts to become painful and more deformed.

PTTD begins with a gradual stretching and loss of strength of the posterior tibial tendon which is the most important tendon supporting the arch of the human foot. Left untreated, this tendon will continue to lengthen and eventually rupture, leading to a progressive visible collapse of the arch of the foot. In the early stages, patients with PTTD will notice a pain and swelling along the inner ankle and arch. Many times, they are diagnosed with "tendonitis" of the inner ankle. If the foot and ankle are not properly supported during this early phase, the posterior tibial tendon can rupture and devastating consequences will occur to the foot and ankle structure. The progressive adult acquired flatfoot deformity will cause the heel to roll inward in a "valgus" or pronated direction while the forefoot will rotate outward causing a "duckfooted" walking pattern. Eventually, significant arthritis can occur in the joints of the foot, the ankle and even the knee.

Visit our website: http://www.adlerfootcare.com

Women’s Foot Problems - NYC Podiatrist Manhattan and White Plains, NY

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Women’s Foot Health - NYC Podiatrist Manhattan and White Plains, NY

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Dr. Tara Blitz discusses the symptoms, causes and treatments for Women’s foot problems. http://www.adlerfootcare.com

The best shoe for women's feet is a walking shoe with laces (not a slip-on), a composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height.

Some women inflict punishment on their feet from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches).

A study conducted by the American Orthopedic Foot and Ankle Society found that:

  • Nine out of 10 women wear shoes that are too small for their feet.
  • Eight out of 10 women say their shoes are painful.
  • More than 7 out of 10 women have developed a bunion, hammertoe, or other painful foot deformity.
  • Women are nine times more likely to develop a foot problem because of improper fitting shoes than a man.
  • Nine out of 10 women's foot deformities can be attributed to tight shoes.

High-heeled, pointed-toe shoes can cause numerous orthopedic problems, leading to discomfort or injury to the toes, ankles, knees, calves, and back. Many high-heeled-shoes also have a pointed, narrow toe box that crowds the toes and forces them into an unnatural triangular shape. These shoes distribute the body's weight unevenly, placing excess stress on the ball of the foot and on the forefoot. This uneven distribution of weight, coupled with the narrow toe box characteristic of most high heels, can lead to discomfort, bunions, hammertoes, and other deformities.

The height of the heel makes a dramatic difference in the pressure that occurs on the bottom of the foot. As heel height increases, the pressure under the ball of the foot may double, placing greater pressure on the forefoot as it is forced into the pointed toe box.

To relieve the abusive effects of high heels, women should limit the amount of time they wear them and alternate these shoes with good quality sneakers or flats for part of the day. Look for comfortable and attractive walking pumps for work and social activities, that blend fashion appeal with athletic shoe-derived construction, reinforced heels, and wider toe room for greater comfort. Low-heeled shoes (one inch or lower) with a wide toe box are the ideal choice for women. An ample toe box that can accommodate the front part of the foot is as important as the heel in determining fit.

 

High Heels

What should you look for to make sure your feet are healthy? Here are some general guidelines:

  • Balance. A good test for balance involves standing on one foot, with your arms out to the side and your eyes closed. If you are less than 30 years old, you should be able to balance for 15 seconds, 30 to 40 years old for 12 seconds, 40 to 50 years old for 10 seconds and over 50 years old for seven seconds. This can be improved with exercises.
  • Circulation. Look at the color of your toes. Do they look like a normal nail color or are they leaning towards red, white, purple, or blue? Press down on the nail of your big toe until the color blanches. Now let go and allow the blood flow to return to your toe. The return of normal color should take 2 to 5 seconds in a person with average circulation.
  • Flexibility. How flexible are your toes? Try to pick up a marble or a small dish towel with your toes. To test your ankle flexibility, hang your heel off of a stair. Now let the heel go below the level of the stair. If this causes pain, stop the test. If your heel goes below the level of the stair without causing strain in your calf, that is a good sign. If there is some strain, this can be improved with flexibility exercises.
  • Pain. A healthy foot does not produce any pain.
  • Sensation. Take a pencil eraser and lightly run it on the top, bottom, and both sides of your feet. The sensation should feel equal in all quadrants. It may tickle on the bottom of the feet. That is normal.
  • Skin. Check your skin for calluses, blisters, or areas of irritation. Stand next to your shoes. Are they shaped like your feet or are they causing areas of constriction that may result in irritation? Put your hand inside your shoe. Are there seams, tacks, or rough places in the shoe that correspond to calluses or blisters on your feet?

Pregnancy

Pregnant women need to observe good foot health to prevent pain and discomfort. Since the body undergoes changes and acquires a new weight-bearing stance, women should wear shoes with broad-based heels that provide support and absorb shock. Additional body weight also calls for more support, to prevent foot "breakdown."

The expectant mother often experiences more than ordinary swelling of her feet and ankles, which can aggravate existing foot conditions and promote inflammation or irritation. Pregnancy also triggers the release of hormones that enhance loose ligaments, which can contribute to foot strain. To help overcome these problems, allow time each day to stay off your feet. Elevate the feet and legs when you are sitting to help prevent and reduce swelling. Don't sit for long periods of time. If problems do develop, please contact our office.

Stockings

Women who always wear nylon pantyhose expose themselves to a host of foot problems. Nylon doesn't breathe and the heat that it generates and traps can lead to excessive perspiration. A warm, damp area is an ideal place for fungal infections such as Athlete's Foot.

Inexpensive nylon pantyhose can also cause forefoot problems, because they don't allow the normal expansion of the foot when walking, and may pull the toes backward when the pantyhose ride up. The cramping and pressure of the hose can contribute to ingrown toenails and hammertoes. If you must wear pantyhose, be sure they fit properly around the foot. Limit the length of time you wear them whenever possible and, like socks, wash them after every use.

Women Over 65

Older women have more trouble with their feet than younger ones, often because fat pads on the bottom of the feet tend to deteriorate in the aging process. Many foot problems for older women can be alleviated simply by wearing properly fitted, well-constructed shoes that provide cushioning and have a soft, flexible upper that will conform to the shape of their feet. Shoes made of leather that "breathes" can also reduce the possibility of skin irritation.

Soles should be lightweight, with enough flexibility and shock-absorbing quality to provide solid footing and not be slippery. Low-heeled shoes provide greater stability, more protection for the feet, and greater comfort. Because older women often have circulatory problems, they have a special need to keep their feet warm in cold weather, to prevent frostbite or chilblains. Most importantly, keep walking and moving around every day so that all the systems in the legs and feet remain stretched and circulation stays healthy.

Visit our website: http://www.adlerfootcare.com

Flat Feet - White Plains, NY Podiatrist and Manhattan NYC

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Flat Feet - White Plains, NY Podiatrist and Manhattan NYC

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Dr. Tara Blitz discusses the symptoms, causes and treatments for Flat Feet. http://www.adlerfootcare.com

Flat feet are a common condition of the foot structure. In infants and toddlers, prior to walking, the longitudinal arch is not developed and flat feet are normal. Most feet are flexible and an arch appears when children begin standing on their toes. The arch continues to develop throughout childhood, and by adulthood most people have developed normal arches. 

Flat feet are generally associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape). 

Many people with flat feet do not experience pain or other problems. When pain in the foot, ankle, or lower leg does occur, especially in children, the feet should be evaluated. 

Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot. 

Nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, andorthotics are common treatments for painful progressive flatfoot.  Note: Please consult your physician before taking any medications.In some cases, a surgery may need to be performed to repair a torn or damaged tendon and restore normal function. In the most severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.

Visit our website: http://www.adlerfootcare.com 

 

 

Diagnostic Ultrasound - Podiatrist Manhattan NYC and White Plains, NY

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Diagnostic Ultrasound - NYC Podiatrist Manhattan and White Plains, NY

Dr. Tara Blitz discusses Diagnostic Ultrasound and Foot Problems.

http://www.adlerfootcare.com

Ultrasound is a very effective tool for diagnosing a wide variety of foot and ankle problems, particularly soft tissue problems. Ultrasound uses sound waves on the body in a way much like radar uses sound waves. The waves hit a targeted area and are bounced back to a recording device, which produces an image. Ultrasound is a completely safe, noninvasive, and painless diagnostic procedure.

Common problems for which ultrasound may be prescribed include:

  • Bursitis.
  • Heel spurs or plantar fasciitis.
  • Injuries of the ligaments, tendons, or cartilage.
  • Morton's neuroma.
  • Presence of foreign bodies.
  • Soft tissue masses.
  • Tarsal tunnel syndrome.
  • Tendonitis or tears in a tendon.

Visit our website: http://www.adlerfootcare.com

Manhattan Podiatrist NYC and White Plains, NY - Tara Blitz, DPM

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NYC Podiatrist Manhattan and White Plains, NY - Tara Blitz, DPM

http://www.adlerfootcare.com

Dr. Blitz is the latest podiatrist to become associated with the Adler Footcare team. She received her formal education at Ohio College of Podiatric Medicine in Cleveland, Ohio. She spent the following years completing her residency training at Beth Israel Deaconess Medical Center in Boston, MA, a major teaching hospital of Harvard Medical School. During this time, she held the academic appointment to the Harvard University Medical School as a clinical fellow. After completion of her residency, Dr. Blitz joined an orthopedic practice in Massachusetts where she served as the Foot and Ankle Specialist. She subsequently worked with a surgical practice in New Jersey for several years.

Dr. Blitz has extensive training in diagnosing and treating both forefoot and rear-foot deformities. She specializes in foot reconstructive surgery, bunion surgery, cosmetic techniques and sports injuries. She is a member of American Podiatric Medical Association (APMA), American College of Foot and Ankle Surgeons (ACFAS) and New Jersey Podiatric Medical Association (NJPMA). Dr. Blitz is licensed to practice podiatry in both New York and New Jersey.

 

Visit our website: http://www.adlerfootcare.com

Tuesday, October 11, 2011

Sprain Ankle – Manhattan Podiatrist NYC and White Plains, NY

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Help for Ankle SprainsPodiatry White Plains, NY and Manhattan NYC

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Dr. Donna M. Hartmann discusses the symptoms, causes and treatments for sprain ankle.

http://www.adlerfootcare.com

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.

Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising.

Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.

To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercise and stretching, and wearing well-fitted shoes.

 

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Athlete's Foot - Manhattan Podiatrist NYC and White Plains, NY

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Athlete's Foot - Manhattan Podiatrist NYC and White Plains, NY

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Dr. Donna M. Hartmann discusses the symptoms, causes and treatments for Athlete's Foot. http://www.adlerfootcare.com

Athlete's Foot, also known astinea pedis, is a skin disease caused by a fungus that usually occurs between the toes. The fungus attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth. Warm, damp areas around swimming pools, showers, and locker rooms, are also breeding grounds for fungi.

Symptoms of Athlete's Foot include drying skin, itching, scaling, inflammation, and blisters on and between the toes. Athlete's Foot can spread to the soles of the feet and to the toenails as well as other parts of the body, which is why timely treatment is so important.

You can prevent Athlete's Foot by:

  • Not walking barefoot, particularly in public pools and locker rooms.
  • Reducing foot perspiration by using talcum powder.
  • Wearing light and airy shoes.
  • Wearing socks that keep your feet dry, and changing them frequently if you perspire heavily.

While fungicidal and fungistatic chemicals are usually used to treat Athlete's Foot problems, they often fail to contact the fungi in the lower layers of the skin. For persistent Athlete's Foot, a prescription topical or oral antifungal drug may be needed. Note: Please consult your physician before taking any medications.

 

Visit our website: http://www.adlerfootcare.com