Posts for tag: dr. scott werter
Every mile you walk places a tremendous amount of stress on your feet. The good news is your feet can handle a heavy load, but, too much stress may push them past their limit. The shoes you wear or surfaces you walk on can increase the stress level. Heel pain is one of the first signs that too much stress is being placed on your feet. A sore heel will usually get better on its own with adequate rest. The problem is that many people try to ignore the early signs of heel pain and continue the activities that caused it.
It is important to see the podiatrists at Coastal Podiatry Associates right away to determine why there is foot pain and determine the proper treatment. The doctors will begin by asking where exactly the pain is located and when it began. Next, they will examine your foot, looking and feeling for signs of tenderness, swelling, and bruising. The doctors may ask you to walk, stand on one foot, or other physical tests that help determine the pain’s cause. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel.
If the pain is greatest under you heel, you may have a condition causing inflammation in that area. A stone bruise occurs after stepping on a hard object such as a rock or stone. The object can bruise the fat pad on the underside of the heel and pain gradually reduces with rest. Plantar fasciitis typically occurs after too much running, jumping, or stretching of the tissue band that connects the heel bone and the base of the toes. The pain is centered under the heel and is most intense with taking your first steps after resting. A heel spur is another cause of pain and can form from long standing plantar fasciitis. An x-ray may be used to visualize the boney projection from the heel.
Pain behind the heel is generally due to the Achilles tendon. This condition is called retrocalcaneal bursitis and is an inflammation of the insertion of the Achilles tendon into the heel bone. People often develop this by running too much or wearing shoes that rub or cut into the back of the heel. This irritation can cause a slow increase in skin thickness, redness, or swelling. A bump that is tender and warm to touch may also develop. Pain is most severe with first activity after resting. It is not uncommon for the pain to be so severe that normal shoes cannot be worn. After taking x-rays, a podiatrist will prescribe stretching exercises, anti-inflammatory medications, and icing.
Feet are just like anything else, as they are used and time passes, change is inevitable. The average person takes approximately 10,000 steps per day, which can add up to more than 3 million steps a year. Each of these steps can place a force on your feet equal to two or three times your body weight. It is easy to see that with time, this extensive repetitive use can lead to several changes related to growing older.
Normal aging is associated with gradual stretching of the ligaments that support your foot’s anatomical shape. It is normal to notice your feet becoming wider and longer. This is generally combined with a mild settling of the foot’s arch more often noticed as a flattening of the foot. Another normal change is thinning of the skin on the bottom of the heel. This is from a reduction of a fat pad as the body loses its ability to retain water. Again, normal aging is the corporate. An increase in the stiffness of joints and a loss of joint range of motion may occur. Think back to the facts of taking 10,000 steps where 2-3 times your body weight is placed on your feet, this workload on your joints will cause a natural amount of arthritis that can lead to stiffness.
Some common foot changes are abnormal or pathological. These conditions tend to occur in association with prolonged use of ill-fitting shoes and extreme stress placed on the foot. They are most commonly noticed when people are in their 30s, 40s, and 50s. These problems do not occur naturally and can be slowed or prevented with the use of proper shoes and inserts. A bunion is the most common problem and is a large bump on the inside of the big toe. Another condition is a hammer digit, which occurs when the toe becomes curled or constantly bent. Bunionette is a term used to describe a large bump found on the outside of the smallest toe in addition to the toe pointing toward the rest of the foot. Calluses or corns can occur on the toes or foot in areas of high pressure points. If you notice these changes, it is important to get your feet checked by a doctor. Podiatrists are specially trained to treat these conditions and reduce the associated discomfort or pain.
Excessive sweating from the soles of the feet, known as palmoplantar hyperhidrosis, can affect both children and adults. This condition occurs when the eccrine (sweat) glands of the soles secrete inappropriately large amounts of sweat. It typically occurs due to unknown reasons, begins in childhood, and commonly runs in families.
Eccrine glands are found on almost all parts of the body but are most dense in the palms and soles. The glands have developed and work normal in patients with palmoplantar hyperhidrosis, they just work more than needed. These glands produce sweat in response to emotion and stress. This is the reason people do not notice sweaty feet as they sleep.
Diagnosis is obvious because the sweating is easily noticed. Various treatment options are available but each has limitations. Creams and sprays are a great way to limit the severity of sweat but do not cure the condition. These are time-consuming therapies because the cream must be applied nightly. Iontophoresis is the passage of an electrical current onto to the skin, and has long been used to treat hyperhidrosis. Iontophoresis consists of 30 min sessions for ten consecutive days followed by one or two maintenance sessions per week. Oral pills will achieve desired results but must be taken for long periods of time and have numerous side effects. Surgical treatment is an option to treat hyperhidrosis. Sympathectomy involves the surgical destruction of nerves in the soles. Although the procedure is effective, it is permanent and should be considered only after all other therapeutic options have been explored. It is important to visit a podiatrist for treatment of palmoplantar hyperhidrosis, as there are many treatment methods. Coastal Podiatry Associates can help determine which treatment method is best to restore normal function of the sweat glands.
Contrary to common knowledge, shin splints are not a specific diagnosis but a feeling of pain over the front of the shin. The pain referred to as shin splints arise from problems in the muscle, bone, or attachment of muscle to bone. To provide a specific location, the pain is felt where the tibialis anterior muscle inserts into the tibia bone (just below the knee to ½ way down the leg). When people speak of shin splints, they most commonly refer to an overuse injury and irritation of the tibialis anterior tendon and the attachment to bone. Medically, the condition is termed medial tibial stress syndrome. Pain over the front of the shin can also be caused by stress fractures or exercised induced compartment syndrome. All of these injuries are typically due to overuse injury.
Ordinary, the tibialis anterior muscle is overused because the foot overpronates. Pronation occurs when the foot flattens as weight is applied. This is a normal event in walking but during overpronation the foot becomes so flat that it rolls inward. The increased movement in the foot increases the demand on the tibailis anterior muscle and its connection to the tibial bone.
People with shin splints typically complain of tenderness along the bone and may have some swelling in the area. This pain is most commonly increased when pushing the foot into the ground, like what is done during running. In addition to taking a detailed medical history and physical, a doctor may order an x-ray or bone scan. While not all shin splints are the same, basic treatments are. Applying ice packs or ice massage the area for 20 min three times a day with anti-inflammatory medication will help reduce the pain. This should be done in addition to making sure shoes are in good condition and the foot does not excessively pronate (a good shoe insert or orthotic should prevent overpronation). As always, it is important to be evaluated by a doctor if pain is not temporary.
By Dr Scott Werter of Coastal Podiatry Associates, Myrtle Beach SC.
Running is an excellent form of exercise. However, without proper precaution, foot and ankle injuries can limit the ability to run or walk. The following is a list of the most common running injuries, tips for treatment, and ways to prevent them from occurring. The treatment tips are just a starting point and if pain continues consult a podiatrist for an evaluation.
Plantar Fasciitis This is an inflammation of the fibrous band of tissue in the bottom of the foot. This band extends from the heel to the toes, helping to form the arch in the foot by supporting the bones and muscles. The tissue can become irritated for many reasons; most commonly from placing too much stress on the bottom of the foot. Plantar fasciitis can be prevented by stretching before and after every run. Wearing supportive running shoes equipped with shoe inserts can also provide relief. It is important not to over-train and gradually increase running distance and time. The recommendation to reduce plantar fasciitis pain is icing, ibuprofin, and rest.
Achilles Tendonitis Achilles tendonitis is an inflammation of the Achilles tendon. This tendon connects the calf muscles to the back of the heel. Lack of flexibility and too much movement of the foot’s bones often cause this condition. Regular stretching and shoe inserts prevent Achilles tendonitis. Ice, ibuprofin, and rest are important methods to reduce pain.
Shin Splints Also known as tibial stress syndrome, shin splints are experienced as a shooting pain felt near the front or sides of the shin. Toe raises and shin stretches are excellent prevention exercises. Replacing worn running footwear is also a key for preventing shin splints. It can be treated with ice and ibuprofin. A podiatrist may also recommend a physical therapy program.
Stress Fracture Stress fractures are caused by repetitive force to a bone. This starts as a localized pain and swelling that grows worse over time. Stress fractures are prevented by modifying running equipment or training regimens with emphasis placed on replacing running shoes on a regular basis. A stress fracture is a break in the bone and requires 8-10 weeks to heal completely. Treatments consist of rest, icing and if needed immobilization casts.
Morton’s Neuroma Morton’s neuroma is felt as a burning, stinging pain between the third and fourth toe. It may also be felt as a pain in the ball of the foot or a feeling of pins and needles or numbness in the toes. Wearing proper fitting shoes with adequate cushioning is a great way to prevent a neuroma. Shoes should also have a roomy toe box and not laced too tightly. Treatment for a neuroma is a cortisone injection and shoe inserts.
By Dr. Scott Werter of Coastal Podiatry Associates, Myrtle Beach SC.