Are you Prepared for Winter Sports?????

For many athletes and weekend exercise warriors, winter is a time to enhance their cardiovascular health. Many partake in winter sports such as sledding, skiing, snowboarding, rough-and-tumble ice hockey or casual ice skating. Winter sports offer a fast track for fun, but expose the body to injuries, especially foot and ankle injuries.

Some common winter and snow sports injuries related to the foot and ankle include:

• Frostbite: The symptoms of frostbite include skin-color changes, from blue to whitish, and a feeling of burning or numbness.
• Blisters: Friction in winter sports footwear often causes blisters.
• Neuromas: Enlarged benign growths of nerves between the toes are caused by friction in tight footwear and can result in pain, burning, tingling, or numbness. Neuromas require professional
treatment, including an evaluation of skates and boots.
• Sprains and strains: The stress of skiing and skating can result in sprains and strains of the foot and ankle. They can be treated with rest, ice, compression, and elevation (RICE). If pain persists, seek medical attention.
• Subungual hematoma: Pressure in the toe box of a ski or skate
can cause bleeding under the toenail known as a subungual hematoma. This condition should be treated immediately to prevent the loss of a toenail.

With adequate preparation and proper equipment, you can prevent most injuries common to winter and snow sports:
• Maintain an adequate fitness level all year round. Being fit is the best way to avoid many sports-related injuries in winter.
• Find a buddy who enjoys your sport. Never participate in winter sports alone.
• Warm up thoroughly before activity. Cold muscles, tendons and ligaments are vulnerable to injury. Make sure to cool down thoroughly afterwards, as well.
• Wear several layers of light,loose, waterand-wind-resistant clothing for warmth and protection.
• Wear proper footwear that is in good condition and keeps feet warm and dry. Footwear should provide ample ankle support, as well.
• Wear appropriate protective gear, including goggles, helmets, gloves, and padding.
• Wear a blended sock that “wicks” sweat away from the skin.
• Drink plenty of water before, during, and after your sports activity.
• Move to a warm, dry environment if your feet get wet. The skin tissues of wet, cold feet are in danger of freezing (frostbite).

If you sustain any type of injury during a winter activity please contact our office, 440-946-5858, for an appointment. Happy Holidays!!!

Frostbite can lead to many problems within the winter months

As we enter the cold weather season, many of us will be skiing,sledding, and shoveling snow. Many people will get cold feet as well as wet feet. Having “Jack Frost nipping at your nose” sounds great when Nat King Cole sings it, but it’s no fun when frostbite strikes your feet. Extreme exposure of your feet to cold over a prolonged period can lead to a serious condition called frostbite. However, you do not necessarily need to be exposed to extremely cold temperatures to get frostbite. Even cool temperatures coupled with wet socks can induce frostbite.

Symptoms include pain and a burning sensation in the exposed areas, numbness in the toes or feet, and changes in skin color, from pale or red to bluish-gray or black. Children, the elderly, and people with diabetes are more prone to frostbite because of the size of their extremities or poor circulation. People who live or work outdoors also have higher likelihood of contracting frostbite because of their increased exposure to the cold.

There are various degrees of frostbite with frost nip (first degree) being the most commonly encountered by people who live in very cold climates or do a lot of outdoor activity in the winter. Skin may feel stiff to the touch, but the tissue underneath is still warm and soft.

Superficial frostbite (second degree) and deep frostbite (third degree) are serious medical conditions that must be treated by a trained medical professional. Skin will feel hard and frozen to the touch and blistering will happen. In some severe cases, doctors may have to amputate frostbitten limbs to prevent severe infection.

Mild frostbite initially can be treated by getting out of the cold and moving to a warm environment. Keep the feet dry and warm; warm the skin gradually by using warm compresses or immersing the feet in warm water (101° to 104° F) until sensation
returns. Do not use direct heat such as heating pads or fire, and do not disturb any blisters.

Frostbite is very serious, and if you suspect that you have it, please call our office, 440-946-5858, for prompt diagnosis, proper treatment and to save your toes!

Prepare for Winter Sporting Season

From the rush of downhill snow skiing to cross country skiing to ice skating, cold weather sports provide a fast track for fun and cardiovascular heath, but the colder temperatures and exhilarating speeds attained during such sports can expose your foot and ankles to debilitating injuries.

Healthy feet and ankles act as accelerators, brakes and shock absorbers in winter sports and help keep the body upright and out of the line of danger. Therefore, avoiding foot/ankle problems is key to full enjoyment during theses activities.

To ensure an injury–free winter season follow the tips provided below:

● Keep feet warm and dry - Proper footwear, insulated, waterproof boots or shoes, and thick cotton socks, to wick away moisture is as important as coats, hats and gloves during cold weather activities.

● Proper fitting footwear - Single most important factor in safe and successful skiing and ice skating. Without a snug and accurate fit, the pressure exerted from constant forward motion and lateral movement of skiing and quick turns of skating can result in discomfort and injury. Additionally, boots or skates that are too big can cause irritation in the toes due to excess motion or ones that are too small can inhibit circulation to the toes and cause cold feet.

● Stretch before and after participating in winter sports - Stretching the lower extremity prevents muscle pulls and tears and prepares the muscles for the movements required in the sports. Some simple stretches, such as a knee to chest, ankle/foot-soleus and ankle/foot-gastro with each being held for 60 seconds can aid in proper warm-up of tendons and ligaments.

Follow the tips listed above and enjoy the upcoming cold, snow-filled weather.

If you have sustained an injury during a winter sporting activity please give our office a call, 1-440-946-5858 for an appointment. Happy Holidays!

Follow These Tips to Allow for Happy Feet During the Holidays!

Don’t let sore, achy feet ruin your holiday season. Here are five tips to healthy holiday feet:

1. Chose proper shoes — When hitting the dance floor or the shopping malls during the holiday season, don’t compromise comfort and safety when picking the right shoes to wear. Narrow shoes, high-heeled shoes or shoes that aren’t worn very often, such as dress shoes, can irritate feet leading to blisters, calluses, swelling and even severe ankle injuries. To prevent problems, choose a shoe that has a low heel and fits your foot in length, width and depth while standing.

2. Don’t overindulge in holiday cheer — Did you know your feet can feel the effects of too much holiday cheer? Certain foods and beverages high in purines, such as shellfish, red meat, red wine and beer can trigger extremely painful gouty attacks. A condition where uric acid builds up and crystallizes in and around your joints, most commonly affecting the big toe.

3. Be pedicure-safety conscious — Before you head for your holiday mani/pedi, remember nail salons can be a breeding ground for bacteria, including MRSA. To reduce your risk of infection, choose a salon that follows proper sanitation practices and is licensed by the state. Consider also purchasing your own pedicure instruments to bring along to your appointment.

4. Watch for ice and snow — Holiday winter wonderlands can be beautiful but also dangerous. Use caution when traveling outdoors. Watch for ice or snow patches along your trail. Ice accelerates a fall and causes more severe trauma, because the foot can move in any direction after it slips. If you do experience a fall, take a break from activities until you can be seen by a foot and ankle surgeon. Use R.I.C.E. therapy (Rest, Ice, Compression, and Elevation) to help reduce the pain and control swelling around the injury until seen by a physician.

5. “Listen” to your feet — Don’t let foot pain ruin your holiday fun. Inspect your feet regularly for any evidence of ingrown toenails, bruising, swelling, blisters, dry skin or calluses. If you notice any pain, swelling or signs of problems, make an appointment with your foot and ankle surgeon.

If you are suffering from foot pain or have concerns about your foot health, please call our office at 440-946-5858 for an evaluation. Happy Holidays!

Got Gout?????

Thanksgiving dinner, holiday office parties, are right around the corner. Tis the season to beware of the dreaded gout!

Clevelanders are more likely to eat and drink alcohol in excess during the upcoming holiday season. Next, thing you know your knee, ankle, or big toe starts throbbing in the middle of the night. The bed sheets touching the top of your foot feels like a hot prod. You get out of bed and your foot is red, hot, swollen and you can't place any weight on it. Got gout?

Gout attacks are extremely painful. They are caused when uric acid accumulates in the tissues or a joint and crystallizes. This most commonly occurs in the big toe joint because the big toe is the coolest part of the body and uric acid is sensitive to temperature changes.

Foods that are high in purines contribute to uric acid build-up. These foods include shellfish (shrimp, crab, etc.), organ meats (kidney, liver, etc.), red meat, red wine and beer.

Gout can be treated with medications, diet changes, increasing consumption of appropriate fluids, and immobilizing the foot. In some cases surgery is required to remove the uric acid crystals and repair the joint. For more information on gout, please contact our office at 440-946-5858. Happy Holidays!

Healthy Feet Make the Best Dancing Feet

Don’t ignore foot pain on the dance floor at your upcoming holiday parties.

Being ‘light on your feet’ when dancing is not entirely true; dancing the night away can take a toll on feet and ankles. Both professional and amateur dancers can suffer foot injuries that can stop the show.

The most common types of dance-related foot and ankle problems are overuse injuries, which occur due to the repetitive movements in dance. Over 50 percent of dance injuries occur in the foot and ankle. The severity of the damage is determined by a patient’s age, strength and flexibility and the type of shoes worn when dancing.

Other common types of injuries related to dancing can include:

■ Stress fractures (hairline breaks in the bone) from repeated jumping and landing
■ Foot neuromas (thickening/irritation of the nerves in the ball of the foot) resulting from repetitive pivoting
■ Shin splints (pain and swelling in the front of the lower legs) which can be aggravated by recurring activities
■ Tendonitis (inflammation of the tendons in the foot) from over exertion
■ Corns, calluses or blisters—all painful skin irritations resulting from repeated rubbing of the skin on the feet.

With dancing being repetitively hard on the lower extremities, how can dancers of any level protect their feet and ankles? The best defense to injury is prevention. Dancers should wear appropriate shoes to properly support their feet and ankles as well as perform dance moves with their individual skill levels in mind.

When an injury does occur, prompt medical attention by a foot and ankle surgeon can make all the difference in a proper rehabilitation. Most dance injuries can be treated with conservative care as long as they are addressed early and not ignored. Many people dispel foot pain if they can walk on the foot, but it is important to remember it is possible to walk on a seriously injured foot. Plus, common injuries, if left untreated, may require surgical intervention to ensure proper healing.

If you are suffering from foot or ankle pain, please call our office at 440-946-5858 for an assessment.

Are Fallen Arches a Real Foot Problem?

Are fallen arches a real foot problem, or just a label for chronically sore feet?

Fallen arches --or flat feet-- are a legitimate medical condition affecting five percent of Americans.

Flat feet can be present at birth, or develop over decades of walking, running and overall time spent on the feet, especially on hard surfaces in the workplace.

There are several types of flatfoot conditions that occur in adults. The most common type is adult-acquired flatfoot. It is caused by overstretching a tendon that supports the arch. Another common type is flexible flatfoot, in which the foot is flat when standing, but returns to a normal arch in non-weight-bearing positions.

Flat feet can be very painful and make people avoid walking, running and exercise, but if you seek medical attention early, a foot and ankle surgeon may be able to prevent it from becoming a more serious foot problem.

Treatments for this condition may include modification of limiting activities, stretching exercises, custom shoe inserts and non-steroidal anti-inflammatory medications. If those techniques don't work a variety of surgical procedures may be considered to relieve pain and improve foot function.

For more information about flatfoot treatment or other painful foot conditions, please call the office, 440-946-5858, for more information or a consultation.

Women: Still think high heels are worth it?

It’s not what fashion-conscious women want to hear: Another warning about high heels.

Pump-style shoes often cause significant pain by irritating a common bony deformity on the back of the heel called ‘pump bump.’ In many cases, it can lead to bursitis or Achilles tendonitis if left untreated.

'Pump bump' is common in young women who wear high heels almost every day. The rigid back of a pump-style shoe can create pressure that aggravates the heel bone when walking. The bump or bony protrusion is a hereditary deformity that can cause Achilles tendonitis or bursitis due to constant irritation from pump-style shoes. Those with high arches or tight Achilles tendons are especially vulnerable to developing pump bump if they work in high heels.

The medical term for this disorder is Haglund’s deformity. In addition to the noticeable bump, symptoms include pain where the Achilles tendon attaches to the heel, swelling in the back of the heel and redness to the area.

In most women, doctors can prescribe medications to reduce the pain and inflammation and/or dispense stretching exercises to alleviate the tension in the Achilles tendon. This does not, however, get rid of the bony protrusion. Long-term, it’s best to avoid wearing high heels, if possible.

When the dress code requires high heels, heel lifts to decrease pressure on the heel is recommended or dress shoes with soft backs or are backless would be recommended.

Women with foot pain can contact the office at 440-946-5858 for more information on "pump bump" and/or other foot and ankle conditions.

Hikers and hunters: Long, vigorous hikes take toll on feet, ankles

As brightly colored leaves dazzle the fall landscape, hikers and hunters nationwide will migrate to mountains, woods and fields, but many, unfortunately, are ill prepared for the beating their feet will take.

Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain. Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts into physician offices each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters.

Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if un-conditioned properly before hitting the trail. Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting, that well constructed hiking boots are a better choice.

Hikers and hunters must invest in top-quality hiking boots: Boots that are strong, well insulated, moisture-proof with steel or graphite shanks. The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don’t buy it.

In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Synthetic socks should be utilized as the first layer to keep the feet dry and reduce blister-causing friction. The second layer should consist of wool socks, to maintain warmth, absorb moisture away from the skin and help make the hiking boot more comfortable.

What happens if your feet or ankles hurt during a hike or hunt? Pain usually occurs from overuse, even from just walking. If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache. To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting. Pain is a warning sign that something is wrong. Serious injury risk escalates significantly if you continue hiking in pain.

Evaluation is recommended if there is persistent pain following a hiking or hunting outing, therefore please give our office a call for evaluation, 440-946-5858.

Prevent your Child from Getting this Painful Foot Problem

Parents can prevent a common childhood foot problem, ingrown toenails, by following some simple recommendations.

Ingrown toenails are one of the most frequent conditions treated in children. Many kids hide their ingrown toenails from their parents, even though the condition can cause significant pain. An ingrown nail can break the skin and lead to dangerous infections.

Tight shoes, tight socks and incorrect nail trimming are the most common causes for this condition. In others, the children may inherit the tendency for nails to curve.

Parents must teach children how to trim their toenails properly. Toenails should be trimmed in a fairly straight line and cut not too short.

Parents must also ensure their children's shoes fit well. Shoe width is more important than length. Make sure that the widest part of the shoe matches the widest part of your child's foot.

If your child develops a painful ingrown toenail, reduce the inflammation by soaking the child's foot in room-temperature water and gently massaging the side of the nail fold.

The only proper way to treat a child's ingrown toenail is with a minor surgical procedure at a doctor's office. Parents should never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection.

For more information on pediatric foot problems such as ingrown toenails, please contact my office at 440-946-5858.

Yard Cleanup Can Be Tough On Feet

Fall is the time to clear out the remains of summer gardens from the yard. Keep your feet and ankles safe from injury by following these helpful tips.

Wear appropriate shoes for the task:
No matter how warm it is, don’t wear sandals. Wear sturdy leather shoes with support to protect your feet from sharp objects, including the blades of power equipment.
Keep children away from power equipment:
Protect your kids and others from severe trauma. Leaf blowers, power lawn mowers and chain saws should not be left out where kids are playing or where other inexperienced users can have access.

Don’t work on wet surfaces:
Don’t work on wet surfaces. Ankle sprains and fractures can easily occur from slipping on wet grass or leaves, especially when carrying heavy loads across the yard.

Remember, yard work is a workout!
Before starting your yard work, warm up and perform stretching exercises, just as you would before working out at the gym. By stretching prior to activity, you can help avoid stressing muscles and tendons in the foot, ankle and calves.

If you or someone you knows suffers an injury during your labors within the yard, please give our office a call for a consultation, 440-946-5858.

Rare Diabetes Foot Complication Becoming More Common

Few people with diabetes know about the limb-threatening foot condition, or its warning signs

As diabetes rates soar nationwide, a rare diabetic foot complication is becoming more prevelant. This condition is called Charcot foot (pronounced SHAR-co). This condition involves a sudden softening of the foot’s bones which can trigger an avalanche of problems, including joint loss, fractures, collapse of the arch, massive deformity, ulcers, amputation and even death.

As the foot’s structure collapses, the bottom of the foot can become convex, bulging like the hull of a ship. But diabeteic patients frequently do not feel any pain because they have severe nerve damage in their lower extremities and do not feel these changes occurring.

Every person with diabetes should know the Charcot foot warning signs: A red, hot, swollen foot or ankle. Several other dangerous conditions, such as deep vein thrombosis and acute infections, share these symptoms. A red, hot, swollen foot or ankle requires emergency medical care.

The American College of Foot and Ankle Surgeons (ACFAS) estimates less than one percent of people with diabetes develop Charcot foot. But nationwide, the College’s 6,000 members say they’re noticing more Charcot cases as more Americans develop diabetes.

Charcot cannot be reversed, but its destructive effects can be stopped if the condition is detected early. People with diabetes play a vital role in preventing Charcot foot and its complications. Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. People with diabetes should also inspect both of their feet every day, and get regular check-ups from a foot and ankle surgeon.

For more information on Charcot foot and other diabetic foot conditions, visit the ACFAS consumer Web site, FootHealthFacts.org or contact my office at 440-946-5858.

Achilles Tendon Surgery Helps Prevent Diabetic Foot Ulcers

Diabetic patients frustrated by hard-to-heal, infection-prone ulcers on their feet could benefit from a common, minimally invasive surgical procedure to relieve tightness in their Achilles tendons.

The Achilles is the largest tendon in the human body, connecting the calf muscles to the heel bone. As we age, the tendon naturally tightens. However, diabetes exacerbates the process as increased blood sugar levels deposit glucose in the collagen of the tendon, greatly reducing its elasticity and making stretching almost impossible.

A tight Achilles inhibits ankle movement, forcing diabetic patients to place excessive pressure on the front of the foot. Pressure normally absorbed by the ankle has to go somewhere else and the forefoot gets most of it, heightening the risk for ulcer development underneath the toe joints.

Foot sores or ulcers are a common complication of diabetes. They result from sensation loss or neuropathy, which deprives diabetes patients of their ability to feel pressure or pain in the lower extremities. Therefore, even the slightest cut, blister or wound can develop into a diabetic foot ulcer. Such wounds can cause tissue and bone infections and can result in loss of a toe, a foot, a leg or even a life.

Published research has shown that surgery to lengthen the Achilles tendon in a diabetes patient can help prevent ulcer recurrence.

Lengthening occurs by making three small, pinpoint cuts to loosen and stretch the tendon. This helps restore ankle flexibility and relieves forefoot pressure. The procedure allows diabetes patients who keep their blood sugar under control to walk more normally and may lower their risk for redeveloping foot ulcers.

For further information about diabetic foot conditions, please contact our office for a consultation, 440-946-5858.

Old ankle sprains come back to haunt Baby Boomers

Many Boomers who have suffered ankle sprains in their younger years could be at risk for more serious damage as they age and try to stay active. It is estimated that one in four sports injuries involves the foot or ankle, and a majority of them occur from incomplete rehabilitation of an earlier injury.

Pain is not normal in the ankle, even if you're just getting back into shape.

Swelling is another symptom these previously-injured Boomers may experience. Both amateur and professional athletes often mis-understand how serious a sprain can be, and they rush back into action without taking time to rehabilitate the injury properly.

A sprain that happened years ago can leave residual weakness that isn’t noticed in normal daily activity, but subjecting the ankle to rigorous physical activity can further damage improperly healed ligaments, and cause persistent pain and swelling. Anyone hoping to regain past athletic fitness, it’s recommended that you have that old ankle injury checked out before becoming active once again.

Some sprains are severe enough to strain or tear the tendons on the outside of the ankle, called the peroneal tendons. Research shows that more than 85 percent of athletes who had surgery to repair a torn peroneal tendon were able to return to full sporting activity within three months after the procedure.

Peroneal tendon tears are an overlooked cause of lateral ankle pain. Although surgery for athletically active patients shouldn’t be taken lightly, surgical repair of the peroneal tendons is proving to be very successful in helping athletes with serious ankle problems return to full activity.

Persistent pain and tenderness after a sprain, especially if the individual felt a ‘pop’ on the outside of the ankle and couldn’t stand tiptoe, might be a warning sign that the tendon is torn or split. The injury is best diagnosed with an MRI exam.

If you or someone you know is in need of further information or an evaluation of the foot/ankle, plese call our office, 440-946-5858, we are here to help.

Surgical Procedure Can Correct Crossover Toe, Keep Seniors Active

Crossover toe is a common foot problem that can inhibit physical activity for older Americans, but out-patient surgery can correct the deformity and keep senior citizens active and on their feet.

Individuals with hammertoes, bunions or a second toe that extends beyond the big toe are most susceptible to developing crossover toe as they age.

It’s a common problem among older people in which the second toe gradually moves across the big toe. It can be painful and, therefore, difficult to walk comfortably or pursue an active lifestyle.

The first symptom of crossover toe is pain in the ball of the foot. A tear in the joint makes the second toe unstable. It falls out of alignment and eventually drifts.

Doctors normally check the ball of the foot for a possible plantar-plate tear when an older patient complains of pain in the area. Pre-existing forefoot problems combined with normal wear and tear or possible trauma can cause the plate to tear over time.

If the pain persists and the toe starts to drift, surgery is recommended to suture the plantar plate or replace it through a tendon-transfer.

Surgery to correct crossover toe is an outpatient procedure performed with a local anesthesia. Patients with bunions or hammertoes are advised to have those deformities corrected during the surgery. Recovery time is about six weeks.

If you're an older adult with persistent pain in the ball of your foot, it's in your best interest to see a doctor, therefore give our office a call to set-up a consultation.

Heel Pain in Youth Athletes: A Warning Sign

Indoors and outdoors, youth athletes stay active year-round in competitive sports, and for many of them heel pain has become “just another part of the game,” however heel pain, should be diagnosed promptly because it may be a warning sign of a serious foot problem.

Heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. As children become more active in sports they increase their risk for growth-plate injuries and subsequent heel pain. This is especially true at back-to-school time when surgeons see an increase in middle and high school athletes experiencing heel pain with football and soccer seasons simultaneously underway.

New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from overactivity, the heel becomes very painful.

Even though growth-plate trauma is the leading cause of heel pain in young people, this condition can be difficult to diagnose. Parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. This condition is diagnosed via a thorough examination of the child’s feet and legs and possibly medical imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and/or fractures.

In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in some instances, surgery may be necessary.

If your child is experiencing heel or foot pain, please call our office to set-up a consultation, 440-946-5858, to allow your child to play with no pain.

Back to School Shoe Shopping

The sounds of school bells, slamming locker doors and students clammering into classrooms are being heard once again. With the start of a new school year, parents are eagerly seeking a wide array of school supplies and new fashions for their children. One of the most important purchases on a parent’s back to school shopping list is a new pair of shoes. With the numerous styles and fashions of shoes, several important factors must be considered:

-Children’s feet change with age: Shoe and sock sizes may change every few months as a child’s feet grow.
-Never hand down foot wear: Just because a shoe size fits one child comfortably does not mean it will fill another the same way. Also, sharing shoes can spread athlete’s foot and nail fungus infections.
-Examine the heels of your child’s shoe. Children may wear through the heels of shoes quicker than out-growing shoes themselves. Uneven heel wear can indicate a foot problem that should be evaluated by a foot/ankle physician.
-Shoes that do not fit properly can aggravate the feet: Always measure a child’s feet before buying shoes and watch for signs of irritation.
-Always buy for the larger foot: Feet are seldom the same size.
-Buy shoes that do not need a “break-in” period: Shoes should be comfortable immediately. Also, make sure to have your child try on shoes with socks or tights, if that’s how they will be worn.

If you do notice a problem with your child's feet, please do not hestitate to give our office a call and set-up a consultation, 440-946-5858.

Another Victim to Achilles Tendon Tear

Another well know person, falls victim to an Achilles tendon rupture. Punter Reggie Hodges of the Cleveland Browns, one of the AFC's best last season, tore his Achilles tendon last Tuesday during traning camp and will be out for the season. Team president Mike Holmgren said he will have surgery later this week.

If you or someone you know suffers from pain in the Achilles tendon area and possibly has a traumatic injury, please feel free to contact our office and set-up a consultation, 440-946-5858. We always have emergency slots!

Alex Trebek Jeopardizes his Foot/Ankle

Alex Trebek, the famous Jeopardy host, tore his Achilles tendon last week after chasing a burglar from his hotel room. He jeopardized his ability to walk due to this sudden foot injury. Alex tore his Achilles tendon, which is a severe injury that will keep him off of his feet for a while and entails a long period of recover.

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

Achilles tendon ruptures are most often seen in "weekend warriors" – typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.

Signs and symptoms of a person with a ruptured Achilles tendon may include sudden pain (which feels like a kick or a stab) in the back of the ankle or calf, a popping or snapping sensation, swelling on the back of the leg between the heel and the calf, difficulty in walking (especially upstairs or uphill) and/or difficulty rising up on the toes.

Treatment options for an Achilles tendon rupture include surgical and non-surgical approaches. The decision of whether to proceed with surgery or non-surgical treatment is based on the severity of the rupture and the patient’s health status and activity level.

Non-surgical treatment, which is generally associated with a higher rate of re-rupture, is selected for minor ruptures, less active patients, and those with medical conditions that prevent them from undergoing surgery. Non-surgical treatment involves use of a cast, walking boot or brace to restrict motion and allow the torn tendon to heal.

Surgery, which Alex underwent, offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle. Various surgical techniques are available to repair the rupture. The surgeon will select the procedure best suited to the patient.

If you or someone you know suffers from pain in the Achilles tendon area and possibly has a traumatic injury, please feel free to contact our office and set-up a consultation, 440-946-5858. We always have emergency slots!

FOOT OF THE CLASS

The sounds of back to school season include the ringing of school bells and cash registers, the slamming of locker doors, the noisy ruckus of school hallways and cafeterias, and the moans and groans of students over tests, homework, relationships, and increasingly, their aching feet.

Flip-flops are the summer footwear of choice for many students. But while these sandals are inexpensive and stylish, they don’t cushion or support the foot, leading to problems. After wearing flip-flops all summer, some students will head back to school this fall with foot pain and even injuries.

People may not realize that even into your mid-teens, there’s new bone growing in your heel. Flip-flops don’t cushion the heel, so repetitive stress from walking can inflame that heel bone growth area and cause pain and tenderness. Heel pain and arch pain rank among the most common complaints among students who wear flip-flops. Other flip-flop feet problems students can take back to school include inflammation of the Achilles tendon, painful pinched nerves, sprained ankles, broken or sprained toes, cuts and scrapes, plantar warts, Athlete’s foot, and callus build-up on the heels and toes.

Simple treatment methods can be done to reduce or eliminate students’ foot pain. These include stretching exercises, ice massage, anti-inflammatory medications and custom and/or over-the-counter shoe inserts.

Back to school season will always be painful for some students, but it doesn’t need to involve foot pain. If you or your child is suffering from foot pain please give our office a call and set-up a consultation, 440-946-5858.

Simple At-Home Checks to Aid in Underlying Foot Problems In Your Child

Back to school season is getting underway, therefore I recommend parents take five minutes to inspect their child's feet for problems that could sideline your son or daughter from sports and/or other activities.

Some warning signs parents should look for are:

•Do the bottom of the child’s shoes show uneven wear patterns?
If your child's shoe is worn on the big toe side of their foot, it could be a sign of poor arch support or flat feet.

•Does the child walk irregularly? Is one leg longer than the other or do feet turn in or out excessively?
If you find out one of your child's legs is longer than the other, heel lifts may be required to restore proper balance. Early intervention may prevent things such as scoliosis, a curvature of spine, later in life.

•Does your child often trip or stumble?
I see young adults every autumn complaining about pain from walking and/or frequency of stumbling while walking. For most students, daily stretching and proper walking shoes can solve the problem. If there are foot deformities like hammertoes and/or bunions, surgery may be advised to make walking more comfortable, if proper shoes do not relieve the symptoms.

•Does your child complain of tired legs, night pains and/or cramping?
Complaints about tired legs, heel pain or leg or foot cramps at night, can be a warning sign. Leg and foot pain can indicate flat feet or other disorders that are easier to treat the earlier they're diagnosed. Children with flat feet are at risk for arthritis later in life if the problem is left untreated.

Following the checklist listed above can uncover common problems afflicting your child, like ingrown toenails to more serious problems like flat feet, that should be addressed early in life to allow pain-free ambulation and prevent further problems later in life.

If your son or daughter are suffering from any of the conditions listed above please contact our office to set-up a consultation, 440-946-5858.

Flip Flop Fiasco

As we enter summer, more and more patients are coming into the office with new foot and leg pain. The only thing they have changed in their daily routines is a transition into flip flops and sandals with the warmer weather. Why could this type of footwear cause problems? Listed below are some of the reasons:

1.Most sandals and flip flops do not offer enough arch support. Without a well supported arch, heel pain (plantar fasciits) or pain to the inner ankle (tendonitis) can develop.
2.Sandals and flip flops also do not offer support in the region of the back of the heel and ankle. Therefore, the ankle is unstable which can also cause tendonitis and other ankle injuries.
3.Sandals and flip flops do not fit snuggly to feet. Because of this, a decrease in the length of stride is warranted which can lead to abnormal muscle usage in the lower legs, thighs and back. Also because of the loose fit, the toes/digits have to work overtime to grip the ground to stabilize the foot during gait. This can lead to the development of callus formation, ingrown toenails and/or hammer toes.

Running shoes and cross trainers would be a much better option for feet. But if you can't resist your sandals and flip flops, and pain occurs, our office is available to help. Please feel free to call our office for an appointment, 440-946-5858.


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Avoid Risks of Summer Heat to Diabetic Feet

As public health officials nationwide take precautions to help senior citizens endure the sizzling summer weather, another group vulnerable to heat related health problems is the diabetic population. The American College of Foot and Ankle Surgeons urges diabetes patients to be aware that prolonged hot and humid weather can lead to myriad foot woes -- even third-degree burns -- if they don’t protect their feet carefully.

Concerns for diabetes patients in extreme heat involve swelling, dryness and cracking from wearing sandals and problems associated with walking barefoot, such as puncture wounds and burns and blisters from hot pavement. Just a few minutes walking barefoot on a hot driveway or sidewalk to fetch the newspaper can badly burn the soles of a diabetic patient’s feet due to impaired nerve sensation from the disease. Most diabetes patients know they shouldn’t walk barefoot, but sometimes think there’s no harm if it’s just for a few minutes.

Any type of skin break on a diabetic foot has the potential to get infected and ulcerate if it isn’t noticed right away. Therefore, wearing sandals all the time in the summer poses problems. Feet constantly exposed in flip-flops or strap sandals lose moisturizing oils, causing dry, rough skin prone to cracking.

Some diabetes patients experience foot swelling in hot weather, which makes their shoes fit tighter and may exert blister-causing pressure on the toes and heels. Like it or not, diabetes patients whose feet get swollen in hot weather should wear support stockings. Compression is the best way to reduce swelling and avoid complications such as poor circulation and further impaired nerve function.

Vigilant foot care is a year-round responsibility for diabetes patients, but the temptations of summer can test even the most conscientious patient’s resolve.

What’s more natural than bare feet and sandals in the summer? Unfortunately, there’s no off-season for diabetes, so patients must be very careful with their feet to avoid skin breaks and subsequent infections and ulcerations that result from this disease.

For further information about diabetic foot care and other conditions please visit our website at www.drrobertrosenstein.com and/or call our office for a consultation, 440-946-5858.

Keeping Deadly Blood Clots at Bay After Foot Surgery

Each year in the United States, pulmonary embolisms (PE) kill more people than AIDS, breast cancer and motor vehicle crashes combined. According to the American College of Foot and Ankle Surgeons, this little-known condition occurs when a blood clot in the leg travels to the lungs, blocking one or more arteries. Most recently, news that tennis star Serena Williams suffered a PE after undergoing surgery is raising awareness about the condition, its risk factors and how to prevent the potentially deadly condition from occurring.

The blood clots that cause PE often originate in the deep veins of the leg, a condition called deep vein thrombosis or DVT. Women are at the highest risk for blood clots and pulmonary embolism, as well as men and women who are overweight, smokers and those taking oral contraceptives. Surgery is also one of the leading causes of blood clots in patients, which means those at highest risk need to be diligent in speaking to their surgeon about their elevated risks so preventive measures can be taken. Patients facing surgery should take note that blood clots in the leg are relatively rare after foot and ankle surgery. In addition, the clots can be prevented with medication and exercise. Depending on a patient’s risk factors, the surgeon may decide to prescribe an anti-clotting medication to prevent DVT. The most common medications are low-molecular weight heparins, which patients inject into their arm, leg or stomach for about two to three weeks after surgery. Patients also would be advised to get up and move around after surgery — even if they are wearing a cast or using crutches.

Symptoms of pulmonary embolisms vary and can mimic those of other conditions such as a heart attack. The most common signs include sudden, unexplained shortness of breath, chest pain and a cough that produces blood-tinged mucus. Other symptoms may include wheezing, leg swelling, excessive sweating, rapid heartbeat and fainting. Pulmonary embolisms can occur quickly, and prompt medical attention is vital for recovery, so patients need to seek care if they are suffering from any of the symptoms associated with the condition.

If you would like more information please visit our website at http://www.drrobertrosenstein.com/ or contact our office, 440-946-5858.

Running in Flip Flops......Deleterious Effects

Running in flip flops....not a good idea. Running in flip flops through an airport trying to catch a flight.....even worse of an idea. This lesson learned, unfortunately came with consequences.....a fracture to the cuboid.

A cuboid bone fracture or broken cuboid bone is an uncommon foot injury. It can occur due to road accidents or any event causing a forcible twisting of the ankle or foot in an outward direction, in my case trying to pivot around fellow airline patrons in non-supportive shoes. The common mechanism for a cuboid fracture is entrapment of the calcaneus (heel bone) and the 4th and 5th metatarsals. This phenomenon resembles the cracking of a nut between the two prongs of a nutcracker, therefore a cuboid bone fracture is also called a "nutcracker’s fracture."

Once the diagnosis of a cuboid fracture is established, the course of treatment consists of immobilization of the foot and the ankle. This is achieved with a pneumatic walking boot (which I am currently using) or plaster of Paris or fiberglass cast for 4-6 weeks. This is followed by progressive physical therapy exercises, which help in regaining the foot and ankle movements and muscle strength.

If you or someone you know have suffered the same fate, please give my office a call, 440-946-5858, for a consultation.

Going Barefoot. Beware!

Parents and families can prevent cuts, puncture wounds and other injuries from going barefoot by following some simple recommendations:

--See a foot and ankle surgeon within 24 hours for a puncture wound.

Why: These injuries can embed un-sterile foreign objects deep inside the foot. A puncture wound must be cleaned properly and monitored throughout the healing process. This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles in the foot.

--Make sure you've been vaccinated against tetanus. Experts recommend teens and adults get a booster shot every 10 years.

Why: Cuts and puncture wounds from sharp objects can lead to infections and illnesses such as tetanus.

--Apply sunscreen to the tops and bottoms of your feet.

Why: Feet get sunburn too. Deadly skin cancers can develop on the feet.

--Inspect your feet and your children's feet on a routine basis for skin problems such as warts, calluses, ingrown toenails and suspicious moles, spots or freckles.

Why: The earlier a skin condition is detected, the easier it is for your foot and ankle surgeon to treat it.

--Wear flip-flops or sandals around swimming pools, locker rooms and beaches.

Why: To avoid cuts and abrasions from rough anti-slip surfaces and sharp objects hidden beneath sandy beaches, and to prevent contact with bacteria and viruses that can cause athlete's foot, plantar warts, and other problems.

--Use common sense.

Why: Every year, people lose toes while mowing the lawn barefoot. Others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Murky rivers, lakes and ponds can conceal sharp objects underwater. People with diabetes should never go barefoot, even indoors, because their nervous system may not "feel" an injury and their circulatory system will struggle to heal breaks in the skin.

If you or someone you know have any further questions regarding the topics above or need treatment for one of the conditions listed above, please feel free to contact our office, 440-946-5858, for an appointment.

Weird Sensations in the Ball of Your Foot??????

If you are experiencing burning, tingling and/or numbness to your foot, you might have a neuroma. A neuroma is thickening of nerve tissue. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an inter-metatarsal neuroma. “Inter-metatarsal” describes its location in the ball of the foot between the metatarsal bones (the long bones of the foot).

The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.

Anything that causes compression or irritation to a nerve can lead to the development of a neuroma. One of the most common offenders is wearing shoes that have a tapered toe box or high-heeled shoes that cause the toes to be forced into the toe box. Other causes include certain foot deformities, such as bunions, hammertoes, flatfeet, or more flexible feet. Other potential causes include activities that involve repetitive irritation to the ball of the foot, such as running or court sports.

Common symptoms that you might experience if you have a neuroma include:

-Tingling, burning, or numbness
-Pain
-A feeling that something is inside the ball of the foot
-A feeling that there’s something in the shoe or a sock is bunched up

Non-surgical treatment options for this condiiton may include:

-Padding: Padding techniques provide support for the metatarsal arch, thereby lessening the pressure on the nerve and decreasing the compression when walking.
-Orthotic devices: Custom orthotic devices provide the support needed to reduce pressure and compression on the nerve.
-Activity modifications: Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
-Shoe modifications: Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels.
-Medications: Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
-Injection therapy: Treatment may include injections of cortisone, local anesthetics or other agents.

Surgery may be considered if symptoms have not responded adequately to non-surgical treatments.

If you would like further information please visit our website, www.drrobertrosenstein.com or give the office a call, 440-946-5858 to schedule a consultation.

Toe Contracting????????

Hammertoes occur when the smaller toes of the foot become bent and prominent. The four smaller toes of the foot are much like the fingers in the hand. Each has three bones (phalanges) which have joints between them (interphalangeal joints). Normally, these bones and joints are straight. A hammertoe occurs when the toes become bent at the first interphalangeal joint, making the toe prominent. This can affect any number of the lesser toes. In some cases, a bursa (rather like a deep blister) is formed over the joint and this can become inflamed (bursitis). With time, hard skin(callous) or corns (condensed areas of callous) can form over the joints or at the tip of the toe.

What Causes Hammertoes?
There are many different causes but commonly it is due to shoes or the way in which the foot works (functions) during walking. If the foot is too mobile and/or the tendons that control toe movement are over active, this causes increased pull on the toes which may result in deformity.

In some instances trauma (either direct injury or overuse from walking or sport) can predispose to hammertoes.

Patients who have other conditions such as diabetes, rheumatoid arthritis and neuromuscular conditions are more likely to develop hammertoes.

What are common symptoms?
Deformity/Prominence of toe
Pain
Redness around the joints
Swelling around the joints
Corn/Callous
Difficulty in shoes with deformity of the shoe upper
Difficulty in walking
Stiffness of the joints of the toe

What can be done to reduce symptoms?
There are several things one can do to try and relieve symptoms:

Wear proper fitting shoes with a deep toe box
Avoid high heels
Use a toe prop to straighten the toe if it is still mobile
Wear a protective pad over the toe
See a podiatrist

How can a podiatrist help?
A podiatrist can offer other options, if simple measures do not reduce symptoms. These include:

Advise on appropriate shoes
Advise on exercises if the toes are still mobile
Instruction on how to properly strap the toe in a corrected position
Providing of a splint or protection
Advise on surgery
Prescribing of custom orthotics

These are unlikely to resolve established deformity, however can help reduce discomfort to the ball of the foot.

How can I cure the deformity?
The only effective way of correcting the deformity is to have surgery.

What does surgery for this deformity entail?
There are a number of different surgeries. However, the most common procedures are:

Tendon transfer
Tendon transfers involve taking the tendon from under the toe and re-routing it to the top of the toe so that the toe is pulled down.

Digital arthroplasty/Digital arthrodesis
Digital arthroplasty and arthrodesis involve the removal of bone from the bent joint to allow correction. An arthroplasty removes half the joint and leaves some mobility whilst an arthrodesis removes the whole joint leaving the toe rigid.

In more severe cases, the tendon on the top of the toe and the joint at the ball of the foot may need to be released to allow the toe to straighten. If there is severe stiffness at this joint, the metatarsal may need to be shortened using a Weil osteotomy.

If you are suffering from hammertoes and would like more information please visit our website for more information, http://www.drrobertrosenstein.com/ or call the office, 440-946-5858, to schedule a consultation.

Stiffness in Your Big Toe??????????

Each day, with every step you take, your big toe bears a tremendous amount of stress, a force equal to about twice your body weight. Most of us don't realize how much we use our big toe. We tend to take it for granted, unless a problem develops. One problem that afflicts the big toe is called hallux rigidus, a condition where movement of the toe is restricted to varying degrees. This disorder can be very troubling and even disabling, since we use the all-important big toe whenever we walk, stoop down, climb up or even stand. If you have pain and/or stiffness in your big toe, you may have this condition.

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the big toe and with time gets increasingly harder to bend the toe. "Hallux" refers to the big toe, while "rigidus" indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis (a wearing out of the cartilage within the joint that occurs in the foot and other parts of the body).

Early signs and symptoms include pain and stiffness in the big toe during use (walking, standing, bending), difficulty with certain activities (running, squatting) and swelling and inflammation around the joint.

As the disorder gets more serious, additional symptoms may develop, including pain, even during rest, difficulty wearing shoes because bone spurs (overgrowths) develop and limping, in severe cases.

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis—the kind that results from "wear and tear"—often develops in people who have defects that change the way their foot and big toe functions. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury or an inflammatory diseases, such as rheumatoid arthritis or gout.

Treatment for mild or moderate cases of hallux rigidus may include one or more of these strategies. First, shoe modifications: Shoes that have a large toe box should be worn, because they put less pressure on the toe. Stiff or rocker-bottom soles may also be recommended. Second, orthotic devices: Custom may improve the function of your foot. Third, medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to help reduce pain and inflammation. Supplements such as glucosamine-chondroitin sulfate and some vitamins and minerals may also be helpful. Fourth, injection therapy into the affected toe can help to reduce the inflammation and pain. Lastly, physical therapy: Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery that can be undertaken to treat hallux rigidus. These surgical procedures fall into two categories. The first category of procedures consists of reconstructing and "cleaning up" the joint. The arthritic damage from the joint as well as any accompanying bone spurs are removed, preserving and restoring the normal alignment and function of the joint, as well as reducing or eliminating pain. The second category of procedures consists of more aggressive procedures. These procedures include fusing the joint or removing part or all of the joint and replacing it with an implant, such as is done for the hip or knee.

If you or someone you know is suffering from this condition please visit our website, http://www.drrobertrosenstein.com/ for more information or contact our office, 440-946-5858 to schedule a consultation.

Bump on the Side of Your Small Toe????????????

Tailor’s bunion, also called a bunionette, is a prominence of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot. The prominence that characterizes a tailor’s bunion occurs at the metatarsal “head,” located at the far end of the bone where it meets the toe. Tailor’s bunions are not as common as bunions, which occur on the inside of the foot, but they are similar in symptoms and causes.

Tailor’s bunion is most frequently caused by an inherited faulty mechanical structure of the foot resulting in the fifth metatarsal bone starting to protrude outward, while the little toe moves inward creating a bump on the outside of the foot that becomes irritated with shoe gear. Another cause for a tailor's bunion is a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head.

Symptoms associated with a tailor’s bunions can include redness, swelling, and pain to the site of the enlargement. These symptoms tend to worsen with shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation.

Treatment for tailor’s bunion typically begins with non-surgical therapies, which may include:

Shoe modifications. Shoes with a wide toe box. Avoid shoes with pointed toes or high heels.

Padding. Pads placed over the area may help reduce pain.

Oral medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.

Injection therapy. Injections of corticosteroid may be used to treat the inflamed tissue around the joint.

Orthotic devices.

Surgery is often considered when pain continues despite the above approaches. Surgery can include many different procedures or combination of procedures based upon x-ray findings, age and activity level.

If you or some one you know is suffering from a tailor's bunion, please do not hesitate to give our office a call for further information or to set-up a consultation, 1-440-946-5858.

Bothersome Bump to Your Big Toe?????

A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion’s “bump.”

Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.


Most common symptoms, which may occur at the site of a bunion, include pain or soreness, inflammation and/or redness, burning sensation or possible numbness. Symptoms most often occur when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men.

Early treatment for bunion treatment is aimed at easing the pain, not reversing the deformity itself. These treatment options include a change in shoe gear: Wearing shoes that have a wider toe box and forgoing those with pointed toes or high heels, which may only aggravate the condition. Padding over the area of the bunion can help minimize the pain associated with bunions. Medications, such as oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and icing several times a day can help to reduce pain and inflammation associated with the deformity. In some cases, custom orthotic devices may be provided to help reduce pain, control the abnormal biomechanics of your foot and prevent further progression of the deformity.If non-surgical treatments fail to relieve bunion pain and the pain of a bunion interferes with daily activities, it’s time to discuss surgical options to determine if surgery is best for you.

A variety of surgical procedures are available to treat bunions. These procedures are designed to remove the “bump,” correct the changes in the bony structure of the foot and correct soft tissue changes that may also have occurred. The goal of surgery is to reduce and/or eliminate pain.

If you are suffering from a “bump” to your big toe, please do not hesitate giving our office a call for additional information or to schedule a consultation, 440-946-5858.

Healthy Feet Make the Best Dancing Feet

Don’t ignore foot pain on the dance floor. Being ‘light on your feet’ when dancing is not entirely true; dancing the night away can take a toll on feet and ankles. Both professional and amateur dancers can suffer foot injuries that can stop the show, as witnessed this season on the popular reality-television show, Dancing with the Stars.

The most common types of dance-related foot and ankle problems are overuse injuries, which occur due to the repetitive movements in dance. Over 50 percent of dance injuries occur in the foot and ankle. The severity of the damage is determined by a patient’s age, strength and flexibility and the type of shoes worn when dancing.

Other common types of injuries related to dancing can include:

- Stress fractures (hairline breaks in the bone) from repeated jumping and landing.

- Foot neuromas (thickening/irritation of the nerves in the ball of the foot) resulting from repetitive pivoting.

- Shin splints (pain and swelling in the front of the lower legs) which can be aggravated by recurring activities.

- Tendonitis (inflammation of the tendons in the foot) from over exertion.

- Corns, calluses or blisters—all painful skin irritations resulting from repeated rubbing of the skin on the feet.

With dancing being repetitively hard on the lower extremities, how can dancers of any level protect their feet and ankles? The best defense to injury is prevention. Dancers should wear appropriate shoes to properly support their feet and ankles as well as perform dance moves with their individual skill levels in mind.

If you are suffering from foot or ankle pain, call our office at 440-946-5858 or visit our website for additional information, http://www.drrobertrosenstein.com/.

Diabetes and Your Feet

An estimated 23.6 million Americans have diabetes and some 750,000 new cases are diagnosed every year, according to the American Diabetes Association (ADA). The most common form of the disease, Type 2 diabetes, accounts for 90 to 95 percent of the cases and is caused by the body’s resistance to insulin at the cellular level and a relative insulin deficiency. Also known as adult-onset diabetes, the disease is nearing epidemic proportions due to an increased number of older Americans and a greater prevalence of obesity and sedentary lifestyles.

A number of systemic disorders occur from diabetes, including sensory neuropathy, a common complication of the disease in which patients lose nerve sensation. As a result, they lose feeling at the bottom of the feet and are unable to react to pain, pressure and heat. Another complication of diabetes affecting the foot is compromised circulation. Poor circulation to the feet can cause foot ulcers and prevent timely healing of wounds and injuries in the patient with diabetes.

According to published studies, 15 percent of Americans afflicted with diabetes, will develop a serious foot ulcer during their lifetime. Repetitive trauma or pressure that goes unnoticed due to sensory neuropathy can produce calluses that, without proper attention, eventually progress to ulcers. Chronic ulcers can become seriously infected if they are unnoticed or untreated. As a result, some 80,000 foot amputations are performed every year in the U.S. on patients with diabetes.

Early detection of risk factors associated with ulcer formation, therefore, is essential in the overall management of diabetic patients and can significantly reduce the incidence of ulcers and eventual amputation. Prompt and aggressive treatment of foot ulcers can prevent worsening and help accelerate healing. Diligent self care also is a key component for early detection. Diabetic patients should inspect their feet every day, wear shoes that fit properly and minimize pressure, and maintain their blood glucose levels within the desired range. Regular visits to a foot and ankle surgeon for removal of calluses and ingrown toenails provide an opportunity to reinforce self-care behavior and detect new or impending foot problems. Diabetic patients should not try to remove calluses by themselves.

Patients with a long patient history of diabetes may experience change to their foot such as limited joint mobility, muscle atrophy and diminished fat padding that contribute to foot deformities and foot ulcers. For example, diabetes-induced atrophy of the muscles in the foot increases pressure at the tips of the toes and can cause a hammertoe deformity. The resulting constant pressure on the toes makes them susceptible to ulcers.

Off-loading techniques using orthotics and special shoes can help minimize pressure and prevent calluses. The pressure reduction approach also can prevent or minimize the risk of the foot ulcers that result from the abnormal, repetitive pressures caused by the foot deformities that are a complication of diabetes.

Optimal care of chronic foot ulcers also requires supportive home and work environments that allow patients to be compliant with an off-loading treatment regimen. This must be combined with appropriate glucose control through diet and medication, aggressive wound care, adequate treatment of infection, and use of custom-fitted shoe gear and orthotics to prevent reoccurrence of these ulcers.

If you or someone you know has diabetes, please contact our office, 440-946-5858, for consultation.

5 Myths About Foot Care

From bunions to broken toes, I have heard it all.

“Don’t cross your eyes, they’ll stay that way!”Old wives’ tales and myths like that example are fun to laugh at. We believed them as children. “Step on a crack and you’ll break your mother’s back.” But there are other myths that are no laughing matter, especially when they involve your health.

Below are the five most common myths about foot care and the realities behind them:

Myth: Cutting a notch (a “V”) in a toenail will relieve the pain of ingrown toenails.

Reality: When a toenail is ingrown, the nail curves downward and grows into the skin. Cutting a “V” in the toenail does not affect its growth. New nail growth will continue to curve downward. Cutting a “V” may actually cause more problems and is painful in many cases.

Myth: My foot or ankle can’t be broken if I can walk on it.

Reality: It’s entirely possible to walk on a foot or ankle with a broken bone. It depends on your threshold for pain, as well as the severity of the injury. But it’s not a smart idea. Walking with a broken bone can cause further damage. It is crucial to stay off an injured foot until diagnosis by a foot and ankle surgeon. Until then, apply ice and elevate the foot to reduce pain.

Myth: Shoes cause bunions.

Reality: Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types make a person prone to developing a bunion. While wearing shoes that crowd the toes together can, over time, make bunions more painful, shoes themselves do not cause bunions. Although some treatments can ease the pain of bunions, only surgery can correct the deformity.

Myth: A doctor can’t fix a broken toe.

Reality: Nineteen of the 26 bones in the foot are toe bones. There are things that can be done to make a broken toe heal better and prevent problems later on, such as arthritis or toe deformities. Broken toes that aren’t treated correctly can also make walking and wearing shoes difficult.

Myth: Corns have roots.

Reality: A corn is a small build-up of skin caused by friction. Many corns result from a hammertoe deformity, where the toe knuckle rubs against the shoe. The only way to eliminate these corns is to surgically correct the hammertoe condition. Unlike a callus, a corn has a central core of hard material. But corns do not have roots. Attempting to cut off a corn or applying medicated corn pads can lead to serious infection or even amputation.

If you are someone you know is suffering from one of the conditions listed above please call our office, 440-946-5858, for consultation or visit our website, http://www.drrobertrosenstein.com/, for further information.

Foot Pain Ruining Your Gulf Swing?

The barrier to a perfect golf swing could lie in your big toe, your heel or on the ball of your foot. These are the three most common areas of your foot likely causing pain that can ruin your golf swing. Behind these pain-prone spots can lie stiff joints, stretched-out tissues and even nerve damage. But pain relief is possible and frequently does not require surgery.

Arthritis can cause pain in the joint of your big toe that makes it difficult to follow-through on your golf swing.

Heel pain typically results from an inflammation of the band of tissue that extends from your heel to the ball of your foot. People with this condition compare the pain to someone jabbing a knife in their heel. Heel pain can make it uncomfortable for golfers to maintain a solid stance during crucial portions of their golf swing.

Neuromas are nerves that become thickened, enlarged and painful because they’ve been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other in a golf swing.

Several other painful conditions can also cause instability during your swing. Some athletes and former athletes develop chronic ankle instability from previous ankle sprains that failed to heal properly. Motion-limiting arthritis and Achilles tendonitis can also affect your balance. Ill-fitting golf shoes may cause corns and calluses that make standing uncomfortable. For the majority of golfers and other patients simple treatments such as custom orthotic devices (shoe inserts), stretching exercises, changes to your shoes, medications, braces or steroid injections and physical therapy help to alleviate or eliminate symptoms. However, if these conservative measures fail to provide adequate relief, surgery may be required. Foot pain is not normal. With the treatment options available, a pain-free golf swing is clearly in view. When your feet aren’t in top condition, your golf swing won’t be either. For more information please visit our website, ww.drrobertrosenstein.com and/or call our office, 440-946-5858 to set-up a consultation.

Power Mowers Pose Danger to Feet

Lawn care season is back, therefore homeowners need to protect their feet and the feet of those around them when using rotary-blade lawnmowers.

Each year, some 25,000 Americans sustain injuries from power mowers, according to reports issued by the U.S. Consumer Products Safety Commission. “The blades whirl at 3,000 revolutions per minute and produce three times the kinetic energy of a .357 handgun. Yet, each year we continue to see patients who have been hurt while operating a lawnmower barefoot.

Children under the age of 14 and adults over the age of 44 are more likely to be injured from mowers than others. Anyone who operates a power mower needs to take the few simple precautions listed below:

• Don’t mow a wet lawn. Losing control from slipping on rain-soaked grass is the leading cause of foot injuries caused by power mowers.
• Wear heavy shoes or work boots when mowing – no sneakers or sandals.
• Don’t allow small children to ride on the lap of an adult on a lawn tractor. Children can be severely injured by the blades when getting on or off the machine.
• Mow across slopes, never go up or down.
• Never pull a running mower backwards.
• Keep children away from the lawn when mowing.
• Keep the clip bag attached when operating a power mower to prevent projectile injuries.
• Use a mower with a release mechanism on the handle that automatically shuts it off when the hands let go.

If a mower accident occurs, immediate treatment is necessary to flush the wound thoroughly and apply antibiotics to prevent infection. Superficial wounds can be treated on an outpatient basis, but more serious injuries usually require surgical intervention to repair tendon damage, deep clean the wound and suture it. Tendons severed in lawnmower accidents generally can be surgically reattached unless toes have been amputated.

If you or someone you know has fallen victim to a lawnmower, please contact our office immediately for an appointment, 440-946-5858.

Warmer Weather = High Heeled Shoes

With warmer weather approaching, women are starting to put their winter boots away and take out their sexy high heeled shoes. High heeled shoes can create a sexier, more flattering figure by tilting the hips, accentuating the bust-line and making the legs look longer. However, high heels can cause a great deal of discomfort: High heels can cause calf pain, heel pain, bunions, corns, calluses, ankle sprains, neuromas, hammertoes, pump bumps and pain to the ball of foot.

How do I encourage women to wear more sensible shoes? It's almost impossible. I do tell my well-heeled patients to limit their time spent in heels-never all day, just for a few hours. I also instruct them to buy shoes at the end of the day that fit comfortably across the widest part of the foot and wear gel or silicone insoles for a comfortable cushioning effect as well.

If you have any questions or concerns please do not hesitate to contact the Mentor Office, 440-946-5858.

Kelly Osbourne is Having Foot Surgery

Kelly Osbourne is to undergo bunion surgery. A bunion (also referred to as hallux valgus or hallux abducto valgus) is often described as a bump on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion’s “bump.”

Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to developing a bunion.

Most common symptoms, which may occur at the site of a bunion, include pain or soreness, inflammation and/or redness, burning sensation or possible numbness. Symptoms most often occur when wearing shoes that crowd the toes, such as shoes with a tight toe box or high heels. This may explain why women are more likely to have symptoms than men.

Early treatment for bunion treatment is aimed at easing the pain, not reversing the deformity itself. These treatment options include a change in shoe gear: Wearing shoes that have a wider toe box and forgoing those with pointed toes or high heels, which may only aggravate the condition. Padding over the area of the bunion can help minimize the pain associated with bunions. Medications, such as oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and icing several times a day can help to reduce pain and inflammation associated with the deformity. In some cases, custom orthotic devices may be provided to help reduce pain, control the abnormal biomechanics of your foot and prevent further progression of the deformity.

If non-surgical treatments fail to relieve bunion pain and the pain of a bunion interferes with daily activities, it’s time to discuss surgical options to determine if surgery is best for you.

A variety of surgical procedures are available to treat bunions. These procedures are designed to remove the “bump,” correct the changes in the bony structure of the foot and correct soft tissue changes that may also have occurred. The goal of surgery is to reduce and/or eliminate pain.

If you are suffering from a “bump” to your big toe, as Kelly Osbourne, please do not hesitate giving our office a call for additional information or to schedule a consultation, 440-946-5858.

Spring Tis the Season for Ankle Sprains

Spring is approximately 3 weeks away and the beginning of sports season for many amateur athletes and weekend warriors in the Cleveland area. It's also ankle sprain season. Ankle sprains are one of the most common sports injuries treated at this time of year due to people emerging from their winter hibernation and getting active again, through playing sports such as basketball, baseball, tennis and/or soccer.

If you injury your ankle prompt medical treatment is required, whether it's your first sprain or fifth. Rest, ice, compression and elevation (R.I.C.E.) can reduce swelling and pain until the ankle can be evaluated and treated. A sprain may not always be a sprain; the ankle could be fractured.

To prevent injury or sprain to your ankle follow the following tips to ensure safe play. First, perform warm-up stretches and exercises before playing sports. Second, wear the right shoes for the sport. For example, don't wear running shoes for sports that involve a lot of side-to-side movement, such as tennis and basketball. Lastly, wear an ankle brace if you're recovering from an injury or have repeatedly sprained your ankle. Follow these tips and enjoy the spring season. However, if you do sustain an injury please contact our office, 440-946-5858 for evaluation and treatment.

Common Foot/Ankle Myths

Old wives’ tales and myths, a like, are fun to laugh at. We believed them growing up. “Step on a crack and you’ll break your mother’s back.” But there are other myths that are no laughing matter, especially when they involve your foot health.

From bunions to broken toes, as doctors we have heard it all. Here are five myths about foot care and the realities behind them.

Myth: Cutting a notch (a “V”) in a toenail will relieve the pain of ingrown toenails.
Reality: When a toenail is ingrown, the nail curves downward and grows into the skin. Cutting a “V” does not affect the growth of the toenail. New nail growth will continue to curve downward. Cutting a “V” may actually cause more problems and is painful in many cases.

Myth: My foot or ankle can’t be broken if I can walk on it.
Reality: It’s entirely possible to walk on a foot or ankle with a broken bone. It depends on your threshold for pain, as well as the severity of the injury. Walking with a broken bone can cause further damage. It is crucial to stay off an injured foot until diagnosis by your foot/ankle physician. Until then, apply ice and elevate the foot to reduce pain.

Myth: Shoes cause bunions.
Reality: Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types make a person prone to developing a bunion. While wearing shoes that crowd the toes together can, over time, make bunions more painful, shoes themselves do not cause bunions.

Although some treatments can ease the pain of bunions, only surgery can correct the deformity.

Myth: A doctor can’t fix a broken toe.
Reality: Nineteen of the 26 bones in the foot are toe bones. There are things that can be done to make a broken toe heal better and prevent problems later on, like arthritis or toe deformities.

Broken toes that aren’t treated correctly can also make walking and wearing shoes difficult.

Myth: Corns have roots.
Reality: A corn is a small build-up of skin caused by friction. Many corns result from a hammertoe deformity, where the toe knuckle rubs against the shoe. The only way to eliminate these corns is to surgically correct the hammertoe condition.

Unlike a callus, a corn has a central core of hard material. But corns do not have roots. Attempting to cut off a corn or applying medicated corn pads can lead to serious infection or even amputation. A foot and ankle surgeon can safely evaluate and treat corns and the conditions contributing to them.

If you or someone you know are suffering from any of the above conditions, please contact our office, 440-946-5858, for consultation.