Dr. Jennifer Zienkowski

Advancements in Treatment of Big Toe Arthritis

2012-01-30T10:03:00.000-08:00

There has been a great advancements in the treatment of great toe arthritis, also known as hallux limitus and/or hallux ridigus. The terms commonly used refer to the latin term for limited to no motion, which is the main complaint that patients will have when they present for this condition. There is no clear understanding of the cause of hallux limitus/rigidus, but the main understanding is it may be due to trauma or chronic mechanical overload of the joint with abnormal weight bearing. The limited motion in the great toe joint is due to bone spurring and arthritis of the joint which causes jamming and pain.

Presenting symptoms for this include, but are not limited, to stiffness/pain/swelling/limited motion and cracking and/or grinding of the great toe joint.

Patients who present initially with mild complaints are often treated with shoe modifications and orthotics or custom insoles. Patients will often state that this improves their pain because they are not placing as much weight through the great toe region. However, over time, a certain number of patients will get increasing pain as the arthritis gets worse. This diagnosis is made through examination and x-rays of the foot to see the level of arthritis and joint damage to the great toe. It is rare but in some cases of local cartilage damage of possible cartilage lesions of the great toe, an MRI may be performed.

In most cases, surgical treatment of bone spurs and great toe arthritis is necessary. As the arthritis gets worse, the surgery is more difficult and requires more invasive options.

Advancements in surgical options for hallux limitus/rigidus are growing and getting better and better, offering a multitude of treatment options based upon the patient's needs. These procedures can include cheilectomy of bone spur removal, osteotomy for realignment and joint decompression, midfoot fusion for 1st metatarsal repositioning, hemi base implant joint resurfacing and great toe fusion

In general, early cases of spurring with limited joint damage do well with cheilectomy. As the problem proceeds, less cartilage is avaliable to work with, therefore an implant or great toe fusion is required If the 1st metatarsal bone is very loose and seems to be drifting upwards resulting in jamming of the great toe joint, then a fusion of the metatarsal at the base is a good option to realign the first metatarsal and prevent the jamming at the great toe joint.

For more information or to schedule an appointment, please call our office at, 440-946-5858.

Can Your Feet be Trying to Tell You Something?

2012-01-24T08:15:00.000-08:00

Fungal Nail
Reason: Trauma or infection to the nail that makes it thickened, discolored, loose or deformed. Often caused by the spread of athlete’s foot, but may also be an indication of conditions such as diabetes or arthritis.
Response: Medications, such as Ker¬alac Gel and Lamasil tablets, have proven effective treatment.

Tendonitis
Reason: Overuse due to increase in physical activity, such as an increase in walking time or distance. May also be caused by wearing worn out or improperly-fitted shoes.
Response: Rest and ice, however in some cases, over-the-counter arch supports or anti-inflam¬matories may be indicated.

Blisters
Reason: Friction from shoes that don’t fit right or are too stiff.
Response: Instruct patients to keep feet dry and wear socks with properly-fitted shoes. Additionally, instruct them never to pop a blister and if painful, to seek medical attention.

Ingrown Toenails
Reason: Improper trimming or too much pressure on feet in tight-fitting shoes, resulting in redness, pain or swelling around the nail. Can also result from poor foot structure, heredity, trauma or foot deformities.
Response: Instruct patients to avoid tight-fitting shoes and socks and inspect nails daily. Additionally, instruct patients to trim nails straight across using toenail clipper.

Bromohydrosis (Foot Odor)
Reason: Increased perspiration from the more than 250,000 sweat glands in the foot due to increased body temperature.
Response: Instruct patients to rub corn starch or spray anti-perspirant directly onto the soles of the feet and spray Lysol into shoes daily. Additionally, instruct patients to keep shoes and socks dry and change shoes regularly.

Bunion (Hallux Abducto-Valgus Deformity)
Reason: A bump at the base of the big toe that is swollen, tender or painful when in the shoe, often caused by misalign¬ment of the joints. Ill-fitting shoes, heredity, trauma, biomedical abnormalities, neuromuscular disorders, inflammatory joint disease, congenital deformities or arthritis can also be culprits.
Response: Instruct patients to avoid pointy and narrow shoes or shoes with stitching or seams that rub bony areas of the foot. If painful, bun¬ions can be surgically removed by a podiatrist.

Plantar Fasciitis
Reason: Excessive weight gain resulting in pain on the bottom of the heel or in the arch. May also be caused by bony overgrowth on the heel, muscle imbalance, high or low arched feet, improper shoe gear, exces¬sive activity or trauma.
Response: Instruct patients to exercise, stretch their feet daily and wear strong, supportive shoes that don’t put undue stress on the ball or heel. If these measures are unsuccessful in relieving pain refer to a podiatrist for further examination and treatment.

If you are experiencing any of the above conditions, please do not hesitate to call and/or schedule an appointment at our office, 440-946-5858.

Keep Your Feet Safe at the Gym in the New Year

2012-01-09T07:59:00.000-08:00

In the New Year, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. Follow the tips provided below to ensure heatlhy feet and maintenance of your resolutions:

Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries. If you do feel you’ve sprained your ankle, be sure to seek treatment right away: Untreated or repeated ankle sprains may lead to chronic ankle instability, a condition that causes persistent pain and a ‘giving way’ of the ankle.

Wear the right shoe and sock— Wear well-fitting athletic shoes designed for the exercise or sport. Shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma, or a thickening of the nerve tissue, in the foot and may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.

Use good technique— Improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains.

Gym Safety- Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Never go barefoot while in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. “It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria. If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to call our office for an appointment.

Above all, it’s important to listen to your body. If you experience an injury or pain, call our office at 440-946-5858 for an evaluation immediately!

Snow and Ice Can be Dangerous for Many Women

2012-01-03T06:19:00.000-08:00

As a female, I too, like to wear fashionable shoes or boots, however with the onset of snow and ice after the 1st big snow storm hitting Northeastern Ohio it can be very dangerous. The treacherous snow and icy conditions we endure, can lead to falls, which are not only embarrassing but can result in a number of injuries. If your ankle rolls inward or outward, a bone can be broken or if your ankle twists, ligaments can be stretched or torn causing an ankle sprain. If this does happen to you, collect your belongings, brush off your designer duds and get somewhere where you can immediately begin “R.I.C.E.” therapy– rest, ice, compression and elevation – to help reduce swelling, pain and further injury. Then pick up your phone and call my practice in Mentor to be seen, 440-946-5858. If treatment is delayed long-term complications, such as chronic ankle instability and pain, arthritis, or deformity can develop.

Also, please do not believe the misnomer, if you can walk on it, it is not broken. If you develop pain, swelling, or bruising this is an indication of a serious injury requiring medication attention, so please don't hestiate and come into the office for evaluation.

Are you Prepared for Winter Sports?????

2011-12-28T17:08:00.000-08:00

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

2011-12-13T11:48:00.000-08:00

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

2011-12-05T09:48:00.000-08:00

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!

2011-12-02T11:04:00.000-08:00

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?????

2011-11-22T05:25:00.000-08:00

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

2011-11-16T08:52:00.000-08:00

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?

2011-10-31T06:27:00.000-07:00

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?

2011-10-27T12:59:00.000-07:00

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

2011-10-18T06:02:00.000-07:00

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

2011-10-13T09:27:00.000-07:00

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

2011-10-04T08:05:00.000-07:00

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

2011-09-26T08:52:00.001-07:00

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

2011-09-19T07:55:00.000-07:00

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.

Amputations due to Diabetes can be Prevented

2011-09-15T06:39:00.000-07:00

Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease – a foot amputation.

Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions. Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet.

Loss of sensation inhibits the body’s normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.

A variety of surgical and non-surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes.

Daily self exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected. If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing.

An estimated seven in ten diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, prevents foot loss.

In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can’t improve blood circulation and foot function, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.

Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:

■ Keep your blood sugar under control to help minimize cardiovascular and blood circulation problems
■ Lose weight, don’t smoke and adhere to prescribed dietary, medication and exercise regim
■ At least once a day, examine your feet for cuts and other small wounds you may not feel
■ Never walk barefoot, outdoors and indoors
■ Wash your feet every day in lukewarm water; dry carefully
■ Choose comfortable shoes with adequate room for the toes
■ Wear clean, dry, non-bulky socks; change daily
■ Shake pebbles or bits of gravel out of your shoes before wearing
■ Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don’t seem to be healing

If you or someone you know is a diabetic please contact our office for a diabetic foot check, 440-946-5858, it will help in preventing an amputation.

Old ankle sprains come back to haunt Baby Boomers

2011-09-07T07:29:00.000-07:00

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

2011-08-29T09:18:00.000-07:00

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

2011-08-24T07:15:00.000-07:00

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

2011-08-16T07:19:00.000-07:00

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

2011-08-09T07:09:00.000-07:00

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

2011-08-02T11:19:00.000-07:00

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

2011-07-25T10:09:00.000-07:00

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

2011-07-19T07:14:00.000-07:00

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

2011-07-12T13:39:00.000-07:00

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

2011-07-05T15:45:00.000-07:00

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

2011-06-20T06:17:00.001-07:00

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

2011-06-15T06:55:00.000-07:00

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!

2011-06-06T06:09:00.000-07:00

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??????

2011-05-31T06:27:00.000-07:00

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????????

2011-05-23T10:14:00.000-07:00

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??????????

2011-05-16T06:56:00.000-07:00

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????????????

2011-05-09T09:39:00.000-07:00

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?????

2011-05-03T11:57:00.000-07:00

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

2011-04-25T10:28:00.000-07:00

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

2011-04-18T08:16:00.000-07:00

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

2011-04-12T10:16:00.000-07:00

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?

2011-04-04T10:17:00.000-07:00

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

2011-03-29T06:11:00.000-07:00

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.

Diabetic Foot Ulcers

2011-03-23T06:37:00.000-07:00

What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that occurs on the foot, most commonly on the bottom or plantar surface. Approximately 15 percent of patients with diabetes, will develop an ulcer during there lifetime, of which 6 percent will be hospitalized due to an infection or other ulcer-related complication and 14 to 24 percent will have some form of amputation.

Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, however, research has shown that the development of a foot ulcer is preventable.

Who Can Develop a Diabetic Foot Ulcer?

Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics and older men are at an increased risk in developing ulcerations. People who use insulin are also at a higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of ulcerations.

How do Diabetic Foot Ulcers Form?

Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), trauma and duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of feeling in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often occurs without pain and one may not even be aware of the problem. Your podiatric physician can test your feet for neuropathy with a simple and painless tool called a monofilament.

Vascular disease can also complicate a foot ulcer, reducing the body’s ability to heal and increasing the risk for an infection.

Elevations in blood glucose can reduce the body’s ability to fight off a potential infection and also retard or halt healing.

What Can You Do if You Develop a Diabetic Foot Ulcer?

Once an ulcer or wound is noticed, seek podiatric medical care immediately, such as our office, 440-946-5858, to reduce the risk of infection and amputation.

Warmer Weather = High Heeled Shoes

2011-03-14T06:49:00.000-07:00

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

2011-03-07T09:56:00.000-08:00

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

2011-03-01T11:42:00.000-08:00

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

2011-02-14T10:50:00.000-08:00

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.

Common Painful Foot Problem In Children

2011-02-07T08:07:00.000-08:00

Parents can help prevent a common and painful foot problem in children by following a few simple tips.

Ingrown toenails is one of the most common podiatric conditions treated in children. Tight shoes, tight socks and/or incorrect nail trimming are the main culprits. In other cases, inheritance of nails to curve in is another less common culprit.

Most kids hide their ingrown toenails from their parents, even though the condition may cause significant pain due to fear of doctors or other underlying reasons. However, over time, the nail may break the skin and lead to dangerous infections. In order to prevent this from occurring, please follow the tips provided below:

1.) Teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don't cut them too short.

2.) Ensure your child's shoes fit. 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.

3.) 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. Never try to dig the nail out or cut it off. These dangerous "bathroom surgeries" carry a high risk for infection. If your child is suffering from this condition, please contact our office, 440-946-5858, immediately for a consultation.

5 Signs Your Child May Have a Foot Problem

2011-01-31T06:59:00.000-08:00

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

The American College of Foot and Ankle Surgeons offers five warning signs parents should watch for.

1. Your Kids Can’t Keep Up with Their Peers
If children lag behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet. The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

2. Children Voluntarily Withdraw from Activities they Usually Enjoy
If they are reluctant to participate, it may be due to heel pain — a problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

3. They Don’t Want to Show You Their Feet
Children may feel pain or notice a change in the appearance of their feet or nails but don’t tell their parents because they fear a trip to the doctor’s office. Surgeons encourage parents to make a habit of inspecting their child’s feet starting at a young age. Look for any changes such as calluses, growths, skin discoloration, or redness and swelling around the toenails.

4. Your Child Often Trips and Falls
Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions.

5. The Child Complains of Pain
It is never normal for a child to have foot pain. Injuries may seem minor, but if pain or swelling last more than a few days, have your child’s foot examined.

If your child exhibits any of the above signs or symptoms please contact our office to set-up a consultation, 440-946-5858, for proper diagnosis and treatment.

Don't Play Through Pain

2011-01-24T08:04:00.000-08:00

Sometimes athletes can be their own worst enemy especially when they continue to play following an injury to a foot or ankle. Proper diagnosis and treatment are a necessity to all full healing and proper rehabilitation.

Athletes often misunderstand how serious an injury can be and try to rush back into competition without appropriate treatment and rehabilitation. Some of the most difficult cases seen are those in which athletes have continued to play after an injury. Athletes often make the mistake of ignoring what seems like a minor foot or ankle injury because they are able to walk. Serious injuries can exist even when the foot or ankle is able to accept weight or pressure.

One such injury involves the Lisfranc joint, on the top of the foot. It’s possible to walk with a Lisfranc injury, but this can lead to damage to the soft tissues of the foot or even chronic conditions such as arthritis.

Another injury that may be overlooked is a fracture of the fifth metatarsal—the bone that runs along the outer side of the foot. This can accompany an ankle sprain, or the athlete may think it’s a sprain. However, this injury is difficult to heal, and continuing to participate in sports will make it worse.

Playing with pain is never a good strategy for athletes. Prompt treatment is. Please call our office, 440-946-5858, to determine the best course of treatment for the specific injury and help you get back into the game.

Burning, Tingling or Numbness in Your Feet....Are You a Diabetic?

2011-01-19T10:02:00.000-08:00

Do you ever feel burning, tingling or numbness in your feet and toes? If so, these can be warning signs for diabetes.

The symptoms listed above may be caused by a condition called diabetic peripheral neuropathy, or nerve damage. Neuropathy in the feet can lead to permanent numbness, deformities such as bunions and hammertoes, and/or dry skin that cracks open and won't heal.

Burning, tingling and numbness in the toes can also be symptoms of thyroid problems, nutritional deficiencies, back problems and pinched nerves in the ankles. However, in the United States, diabetes is the leading cause of peripheral neuropathy and can lead to further foot complications, such as ulcerations or sores.

Out of the 23 million Americans with diabetes, one in four hasn't been diagnosed. Some people learn they have diabetes only after seeing a doctor for burning, tingling and numbness in their toes and feet. Many people already diagnosed with diabetes aren't familiar with neuropathy's symptoms.

Twenty percent of diabetes patients who develop ulcers will require an amputation. Patients who are black, Hispanic and Native American are twice as likely as whites to need a diabetes-related amputation. Half of all people with diabetes who have a toe or foot amputation die within three years. The annual cost for diabetic ulcer care in the U.S. is estimated at $5 billion.

If you or someone you know is suffering from these symptoms or has been diagnosed with diabetes and needs a foot check please call our office, 440-946-5858, to schedule an appointment.

Feet Flattening?????

2011-01-11T07:01:00.000-08:00

Treatment and prevention of adult flatfoot can reduce the incidence of additional foot problems such as bunions, hammertoes, arthritis and calluses, and improve a person’s overall health, according to research published in the recent Journal of Foot & Ankle Surgery publication.

Overweight males in white-collar jobs are most apt to suffer from adult flatfoot disorder, a progressive condition characterized by partial or total collapse of the arch, according to the research. Symptoms of adult flatfoot may include pain, swelling, flattening of the arch and an inward rolling of the ankle. Flatfoot is a progressive disorder by nature and this most recent study suggests that neglecting treatment or preventive care can lead to arthritis, loss of function of the foot and many other painful foot disorders.

Flatfoot disorder may gradually worsen to the point that many of the tendons and ligaments in the foot and ankle are simply overworking, often to the point where they tear and/or rupture. If this occurs, even simple walking and standing become increasingly painful, requiring much more energy.

In many cases, flatfoot can be treated with non-surgical approaches including orthotic devices or bracing, immobilization, physical therapy, medication and shoe modifications. In some patients whose pain is not adequately relieved by conservative treatments, there are a variety of surgical techniques available to correct flatfoot and improve foot function.

As in most progressive foot disorders, early treatment for flatfoot disorder is also the patient’s best route for optimal success in controlling symptoms and additional damage to the feet. The goal is to keep patients active, healthy and as pain free as possible and we are here to help with this goal. Please call our office at 440-946-5858 to schedule a consultation.

Keep Your Feet Safe at the Gym in the New Year

2011-01-03T06:43:00.000-08:00

It is 2011, the beginning of a New Year and new resolutions. If your resolution for the upcoming year is to get into shape, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. The American College of Foot and Ankle Surgeons offers the following tips for foot safety while at the gym.

Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries.
Wear the right shoe and sock—Wear well-fitted athletic shoes designed for exercise or sport. Shoes that do not support the arch of the foot or provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can cause a neuroma, a thickening of the nerve tissue, in the foot, which may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.

Use good technique— Improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains.

Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Therefore, never go barefoot while in public areas and cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as an entry point for bacteria.

Above all, it’s important to listen to your body. If you experience an injury or pain, please call our office, 440-946-5858, for evaluation and treatment.

New Year's Eve Foot Fixes

2010-12-30T10:40:00.000-08:00

As the ball drops and rings in another exciting New Year, many enthusiastic revelers will sport their favorite pair of sassy sling-backs and other types of fashionable high heels. However, women, myself included, often pay a hefty price for their New Year’s footwear – resulting in blisters, arch and heel pain and much more! Therefore, start the New Year off on the right foot with these sole-saving, New Year’s footwear solutions from the American Podiatric Medical Association:

Problem: Burning sensation on the balls and toes of the feet.
Solution: Heaven 4 Toes’ Alba Round Toe Cushion.
The first-ever soft cushion insert designed especially for toes. These toe cushions are made of durable polyurethane for long-lasting comfort, and are virtually invisible in any pair of haughty heels. These toe cushions help to protect against painful skin abrasions and help to quell irritation and discomfort caused by friction.

Problem: Shoe soles hard on the feet, especially the heels.
Solution: SOLE Custom Footbeds, a product designed to provide custom-fit shock absorption in footwear. SOLE Footbeds feature a deep, cushioning heel cup that help to protect tootsies on the dance floor.

Problem: Slingbacks can dig deep into heels, leaving blisters and painful abrasions.
Solution: Provide a protective barrier between the strap and your skin by using moleskin or FootPetals’ Strappy Strips to prevent blisters and strap slippage, so you can comfortably
party into another successful New Year.

Follow these tips provided by APMA and dance into the New Year with happy, healthy feet, however if foot pain persists please contact our office, 440-946-5858, for an appointment.

Can Your Stress Fracture Be a Sign of an Underlying Medical Condition?

2010-12-13T11:14:00.000-08:00

Unexplained foot fractures may be the first sign of osteoporosis, a bone thinning disease which affects over 28 million Americans and accounts for 1.5 million bone fractures a year.

Osteoporosis is frequently referred to as the “silent crippler” since it often progresses without any symptoms or isn’t diagnosed until a person experiences pain from a bone fracture. The porous nature of bones in people with osteoporosis makes them more susceptible to bone fractures, especially in the feet. Because the bones are in a weakened state, normal weight-bearing actions like walking can cause the bones in the foot to break. In fact, many patients visit their foot and ankle surgeon suffering from foot pain only to find out they actually have a stress fracture, without having experienced an injury.

Osteoporosis is most commonly seen in women over age 50, however younger people and men are also affected. Early symptoms can include increased pain with walking accompanied by redness and swelling on the top of the foot.

Diagnose of osteoporosis can be done through a bone densitometry test, which measures calcium and mineral levels in the bones through low-dose radiation x-ray or possibly through a routine x-ray.

If you are diagnosed with osteoporosis, it’s important to protect your feet from stress fractures. Wear shoes that provide support and cushioning, such as athletic running shoes, to provide extra shock absorption and protection. Custom orthotics may also be recommended to protect the foot from pressure and provide shock absorption, particularly during exercise.

If you are suffering from foot pain or suspect you may have osteoporosis, call our office at 440-946-5858 for an evaluation, or conveniently schedule your appointment online at www.drrobertrosenstein.com.

Snow and Ice Can Be Danagerous for Fashionable Boots

2010-12-06T07:58:00.000-08:00

As a female, I too, like to wear fashionable shoes or boots, however with the constant snow and ice we get in Northeastern Ohio it can be very dangerous. The treacherous snow and icy conditions we endure, can lead to falls, which are not only embarrassing but can result in a number of injuries. If your ankle rolls inward or outward, a bone can be broken or if your ankle twists, ligaments can be stretched or torn causing an ankle sprain. If this does happen to you, collect your belongings, brush off your designer duds and get somewhere where you can immediately begin “R.I.C.E.” therapy– rest, ice, compression and elevation – to help reduce swelling, pain and further injury. Then pick up your phone and call my practice in Mentor to be seen, 440-946-5858. If treatment is delayed long-term complications, such as chronic ankle instability and pain, arthritis, or deformity can develop. Also, please do not believe the misnomer, if you can walk on it, it is not broken. If you develop pain, swelling, or bruising this is an indication of a serious injury requiring medication attention.

Five Tips for Healthy Holiday Feet

2010-11-30T07:46:00.000-08:00

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.

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, or schedule an appointment.

Diabetes Awareness Month

2010-11-22T09:50:00.001-08:00

November is Diabetes Awareness Month, therefore listed below is guidelines all diabetics should abide by:

Inspect your feet daily: Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything. (If your eyesight is poor, have someone else do it for you.)

Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. But only use lukewarm water, the temperature you'd use on a newborn baby.

Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and make sure to carefully dry between the toes.

Moisturize your feet—but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON'T moisturize between the toes, this could encourage a fungal infection.

Cut nails carefully—and straight across. Also, file the edges. Don't cut them too short, since this could lead to ingrown toenails.

Never trim corns or calluses. No "bathroom surgery" let your doctor do the job.

Wear clean, dry socks. Change them daily.

Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).

Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.

Shake out your shoes and inspect the inside before wearing. Remember, you may not feel a pebble, so always shake out your shoes before putting them on.

Keep your feet warm and dry. Don't get your feet wet in snow or rain. Wear warm socks and shoes in winter.

Never walk barefoot. Not even at home! You could step on something and get a scratch or cut.

Take care of your diabetes. Keep your blood sugar levels under control.

Don't smoke. Smoking restricts blood flow in your feet.

Get periodic foot exams at Affiliated Podiatrists, Inc. 440-946-5858.

Got gout? Holiday Season Can Trigger Occurence.

2010-11-15T06:58:00.000-08:00

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, visit the ACFAS consumer Web site, FootHealthFacts.org, or contact Dr. Zienkowski's office at 440-946-5858.

Fallen Arches?????

2010-11-01T08:33:00.000-07:00

The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot.

PTTD is often called “adult acquired flatfoot” because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it isn’t treated early.

Overuse of the posterior tibial tendon is often the cause of PTTD. In fact, the symptoms usually occur after activities that involve the tendon, such as running, walking, hiking, or climbing stairs.
These symptoms include pain, swelling, flattening of the arch, and an inward rolling of the ankle. As the condition progresses, these symptoms will change. With onset of PTTD, pain is experienced on the inside of the foot and ankle (along the course of the tendon) with possible associated redness, warmth and swelling. As PTTD progresses the arch begins to flatten and the foot and toes begin to turn outward and the ankle rolls inward. As PTTD becomes more advanced, the arch flattens even more and the pain shifts to the outside of the foot, below the ankle.

Because of the progressive nature of PTTD, early treatment is advised. Early treatment includes custom orthotics and bracing to give your arch the support it needs, immobilization via short leg cast or boot to immobilize the foot and allow the tendon to heal, physical therapy to help rehabilitate the tendon and/or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to help reduce the pain and inflammation. If treated early enough, symptoms will more then likely resolve without the need for surgery and progression of the condition will be arrested.

In contrast, untreated PTTD could leave you with an extremely flat foot, painful arthritis in the foot and ankle, and increasing limitations on walking, running, or other activities which more then likely will require surgical intervention.

If you or someone you know is suffering from a condition, please do not hesitate to give our office a call to set-up a consultation, 440-946-5858.

P..R..P

2010-10-27T12:36:00.000-07:00

PRP is "platelet-rich plasma," also known as autologous platelet concentrate (APC). Platelets are a specialized type of blood cell that is involved in healing injuries. With PRP, a concentrated platelet solution is injected into an injured area, for example chronically damaged ligaments and/or tendons, to stimulate healing.

Why Does PRP Work?

Human platelets are naturally rich in connective tissue growth factors. Injecting these growth factors into damaged ligaments and/or tendons stimulates a natural repairative process.

What Conditions Benefit From PRP?

PRP treatment works best for chronic ligament and tendon sprains/strains that have failed other conservative treatment, including:

- Lateral ankle sprains & instability

- Deltoid ligament injury

- Achilles tendinosis

- Plantar fasciitis

- Sesamoiditis

- Posterior Tibial Tendonitis

- Peroneal Tendonitis

What Does the Procedure Entail?

In the office, blood is drawn, placed in a special centrifuge and spun down to isolate the needed components. The platelets are separated from the red blood cells. The red blood cells are discarded, and the isolated platelet concentrate is used for treatment. While the blood is spinning in the centrifuge, the painful area is anesthetized with local anesthetic. The resultant platelet concentrate is injected into the injured area under direct ultrasound visualization. The entire treatment takes approximately 30-45 minutes.

How Often are Injections Given?

After the initial treatment, a follow up visit is scheduled. Some patients respond very well to just one treatment. However, typically 2-3 additional treatments are necessary at 4-6 week intervals.

Are There Risks With PRP?

The risks include infection, blood clot, skin discoloration, bleeding, and nerve damage; however, these complications are very rare.

What is the Success Rate?

Studies suggest an 80 - 85% improvement in pain and function at 6 months and 91% at 1 - 3 year follow up. Some patients experience complete relief in pain.

Additional Therapies

To get maximum benefit from the treatment, and to help prevent re-injury, a specially-designed home-based rehabilitation and exercise program is incorporated into your treatment. This helps the newly developing connective tissue mature into healthy and strong tendon or ligament fibers. Your doctor may also prescribe customized devices to correct improper biomechanics.

If you or someone you know is suffering from a condition that can benefit from this therapy, please do not hesitate to give our office a call to set-up a consultation, 440-946-5858.

Radio Personnel, Howard Stern, Fractures his Toe

2010-10-19T10:41:00.000-07:00

Howard Stern revealed that he has done what so many people do, he broke his toe. He stubbed his toe on the corner of his desk and broke his left fifth toe, a common injury seen in many podiatry offices, including our office daily.

Many people, for unspecified reasons, think there is no treatment for a broken toe. For that reason, they don’t go into the doctor to get it checked out. Howard, however, is doing everything right with his broken toe. He went to the doctor had it evaluated, x-rayed and treated. He is currently taping his 5th toe to the 4th, neighboring toe, called buddy taping. He is also wearing a fracture walker boot, which will help to stabilize the fracture and prevent the affected bones from moving, causing pain and impede healing.

Toe fractures typically take 6-8 weeks to completely heal with conservative treatment. Surgery is rarely required to treat fractures in the toes or forefoot. However, when it is necessary, it has a high degree of success.

If Howard did what most do and ignore the problem, he would be putting himself at risk for the bones to displace, resulting in chronic swelling and pain that could only be corrected with surgery. The treatment that has been prescribed is absolutely necessary to ensure he is back to full strength and activity in the shortest period of time.

If you or someone you know is suffering from this condition, please do not hesitate to give our office a call to set-up a consultation, 440-946-5858.

Seneca Wallace Suffers High Ankle Sprain

2010-10-12T07:13:00.000-07:00

Browns quarterback, Seneca Wallace, suffered a high ankle sprain injury during the next-to-last play of the first half of last Sunday’s game when Atlanta defensive end, John Abraham, sacked Wallace and fell on his ankle. A high ankle sprain is used to describe a particular type of ankle injury. Normally, when someone sprains their ankle, the ligaments that surround the ankle joint are stretched or torn. This injury causes pain and swelling around the ankle, and can be quite uncomfortable. A high ankle sprain injures the large ligament above the ankle that joins together the two bones of the lower leg. These two bones, the tibia (shin bone) and fibula, run from the knee down to the ankle. They are joined together by this ligament called the "syndesmosis" or "sydesmotic ligament."

A high ankle sprain causes symptoms similar to other ankle sprains, but patients often complain of pain when the ankle is turned to the outside or when the calf is squeezed. This later finding, the so-called "squeeze test," is the classic test for syndesmotic injuries, but it is not very reliable for diagnosis.

Syndesmotic injuries tend not to heal as well as more common ankle sprains, that is why trainers and coaches of athletes are often concerned about "high ankle sprains." If the injury is stable, then the high ankle sprain can be treated in a cast, usually for a period of 6 weeks. If the injury is unstable, then a "syndesmotic screw" can be placed between the tibia and fibula to hold the bones in proper position while the syndesmotic ligament heals.

If you or someone you know is suffering from this condition, please do not hesitate to give our office a call to set-up a consultation, 440-946-5858.

Spider Veins?

2010-10-05T11:02:00.000-07:00

Varicose veins are no longer solely a cosmetic issue, they can also lead to further complications affecting physical appearance, quality of life and time off from work

Varicose veins are more common in women, however can also affect the male population. The prevalence ranging from 25% to 33% in women versus 10% to 20% in men. Varicose veins tend to increase in frequency as one ages. The most common initial symptoms of individuals presenting with varicose veins include swelling, heaviness, fatigue or throbbing pain in the legs. These symptoms usually disappear when patients elevate their legs or get off their feet.

So if you suspect varicose veins, what might some of your treatment options be? Some treatment options include external compression devices such as compression stockings (which remain the mainstay of therapy for varicose veins), drug therapy (diuretics and horse chestnut extract), sclerotherapy (injection of a substance that obliterates the vein), laser and pulsed-light therapy (indicated for small veins) and surgery. Treatment considerations depend on the level of necessary therapy needed.

If you or someone you know is suffering from this condition, please do not hesitate to give our office a call to set-up a consultation, 440-946-5858.

Diabetes and Foot Problems

2010-10-01T06:22:00.000-07:00

Foot problems that develop in people who have diabetes (ex. ingrown toenails, calluses, corns) should be treated promptly by a podiatrist. In some diabetes cases, the body does not produce substances that are necessary to promote the healing process.

Treatment for foot sores or ulcers that do not heal properly due to poor circulation may involve a vessel bypass. Blocked blood vessels (i.e., atherosclerosis) can be bypassed with a blood vessel graft. Improved circulation promotes healing.

In some cases, a skin graft may be performed. In this procedure, a piece of skin is surgically removed from a healthy part of the body and used to cover the wound. However, skin grafts on the soles of the feet can be problematic because if the cause of the wound is not corrected, the wound can recur. For example, if the wound is caused by a bony prominence in the foot, padding the area is necessary to prevent the wound from recurring.

In patients with diabetes, an infected wound is a medical emergency. Signs of infection include the following:

Blood sugar that is difficult to control or that requires a higher than normal dosage of insulin
Discharge (pus) that oozes from the wound
Excessive sugar in the urine
Fever
Redness
Swelling

If you or someone you know is a diabetic and is experiencing foot problems, please do not hesitate to give our office a call, 440-946-5858 for an appointment.

Infection Within the Bone

2010-09-21T12:50:00.001-07:00

Osteomyelitis is an infection involving the bone caused by various microorganisms such as bacteria and/or fungus. This disorder affects about 2 out of every 10,000 people.

Osteomyelitis can affect both adults and children. The bacteria or fungus that can cause osteomyelitis, differs among age groups as does the location of infection. In adults, osteomyelitis often affects the vertebrae and the pelvis. In children, osteomyelitis usually affects the adjacent ends of long bones. Long bones are large, dense bones that provide strength, structure, and mobility. These include the femur and tibia in the legs.

Osteomyelitis does not occur more commonly in a particular race or gender. However, some people are more at risk for developing the disease. These include: Patients with diabetes, weakened immune system, sickle cell or receiving hemodialysis, IV drug drug abusers or elderly patients.

Symptoms of osteomyeltis, may include:

Pain and/or tenderness in the infected area
Swelling and warmth in the infected area
Fever
Nausea, secondarily from being ill with infection
General discomfort, uneasiness, or ill feeling
Drainage of pus through the skin

There are many ways that infecting bacteria find their way to bone, resulting in the development of osteomyelitis. These include:

An open injury to the bone or a soft tissue infection

An infection from elsewhere in the body, such as pneumonia or a urinary tract infection, that has spread to the bone through the blood stream.
Minor trauma, which can lead to a blood clot around the bone and then a secondary infection from seeding of bacteria.
Bacteria in the bloodstream, which is deposited in a localized area of the bone.

The objective of treating osteomyelitis is to eliminate the infection and prevent the development of chronic infection. Chronic osteomyelitis can lead to permanent deformity, possible loss of limb, or life and other health issues, so it is important to treat the disease as soon as possible. If you or someone you know is suffering from this condition please contact our office for consultation, 440-946-5858 to prevent the complications noted above.

Shin Pain?

2010-09-13T10:28:00.000-07:00

With the beginning of fall, means the beginning of many fall sports and possibility of new aches and pains for our athletes. One common complaint is pain to the front of the shin. Pain in this area is referred to as "shin splints."

“Shin splints” is a term used to describe pain and swelling to the front of the lower legs. The pain usually appears after and is aggravated by repetitive activities such as running or walking. Contributing causes are flat feet, calf tightness, improper training techniques, worn out or improper shoes/sneakers, as well as running or walking on uneven surfaces. The inflammation in the shin results from the repeated pull of a muscle in the leg from the shin bone (tibia).

This condition usually occurs bilaterally (both legs) and can be alleviated by rest, use of non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, icing, a change in training habits, stretching exercises, and properly fitted shoes.

If you or someone you know is suffering please given our office a call, 440-946-5858, to allow us to properly treat the condition, recommend proper shoe gear and evaluate whether orthotics are needed. If not treated, shin splints may eventually result in a stress fracture of the shin bone.

Broken Toes

2010-09-07T11:08:00.000-07:00

The structure of your foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in your foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones (broken toes) are common and require evaluation by a specialist.

A fracture is a break in the bone. Fractures can be divided into two categories.

Category 1 of fractures is traumatic fractures, also called acute fractures. Traumatic fractures are caused by a direct blow or impact, like seriously stubbing your toe. These types of fractures can be displaced or non-displaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated). Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required. Signs and symptoms of a traumatic fracture may include a popping sound, pin-point pain, deviation (mis-shapen or abnormal appearance of the toe) or brusing and swelling to the affected area.

Category 2 of fractures is stress fractures. Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. Or they may be caused by an abnormal foot structure, deformities, osteoporosis or improper footwear. Symptoms of stress fractures include pain with or after normal activity, pin point pain, swelling, but no bruising and pain that goes away when resting and then returns when standing or during activity.

Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options: Rest, rigid or stiff-soled shoe and splinting or "buddy" taping the affected toe. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins or screws.

Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include rest, immobilization (casting or rigid shoe) and avoidance of offending activity. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins or screws.

It is not true that if you can walk on it, it is not broken. Evaluation by a physician is recommended, therefore please call our office to schedule an appointment, 440-946-5858.

Back to School Shoe Shopping

2010-08-30T07:09:00.000-07:00

6 Tips to Protect Kids in Fall Sports

2010-08-23T11:02:00.000-07:00

If your children are playing sports this fall, pay attention to six tips that could protect them from serious ankle injuries.

--Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition.

--Buy the right shoe for the sport. Different sports require different shoe gear.

--Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

--Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

--Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

If you would like more information please visit our website at www.drrobertrosenstein.com, or call our office at 440-946-5858 to set-up a consultation.

Sporting Activities and Big Toe Pain

2010-08-17T07:10:00.000-07:00

Turf toe is a sprain of the big toe joint resulting from injury during sporting activities. This injury usually results from excessive upward bending of the big toe joint. The condition can be caused from either jamming the toe, or repetitive injury when pushing off repeatedly when running or jumping. Although this injury is most commonly reported in football players, participants in soccer, basketball, wrestling, gymnastics and dance also are at risk.

The name “turf toe” comes from the fact that this injury is especially common among athletes who play on artificial turf. When playing sports on artificial turf the foot can stick to the hard surface, resulting in jamming of the big toe joint.

The signs and symptoms of turf toe can include pain, swelling, and limited joint movement. If turf toe is caused by repetitive actions that cause injury, the signs and symptoms will usually begin slowly and gradually worsen. Turf toe can also be caused by a direct injury leading to damage of the bone beneath the cartilage. If direct injury is the cause, the signs and symptoms may begin suddenly and get worse over a 24-hour period.

Treatment of turf toe consists of controlling the inflammation of the joint capsule. The most important aspect of treatment is to rest the sore toe to allow the inflammation to subside and the joint capsule to heal. In addition to resting the toe, inflammation can be controlled by icing the area and elevating the foot, and anti-inflammatory medications.

Athletes diagnosed with turf toe should avoid their sport at least three weeks to allow the joint capsule to heal. Without doing so, the injury can progress, and can lead to an even longer recuperation. It is not uncommon for athletes to try to come back too soon, or to try to play through the injury. Unfortunately, this usually leads to a more chronic injury, and ultimately a longer recovery.

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

Surgeons Issue Warning on Dangers of Cosmetic Foot Surgery

2010-08-10T11:01:00.001-07:00

"Foot facelifts” are a growing trend around the globe, a procedure that can help to narrow the feet so that they fit better in heels or smaller shoes. However, the American Orthopedic Foot and Ankle Society has issued a warning about these procedures, indicating that this type of surgery can cause extensive nerve damage and pain, and may lead to other problems.

Cosmetic foot surgery involves shortening the second toe so that it is not longer than the big toe. This makes it easier for the foot to accommodate high heels, and can reduce pain and discomfort when wearing heels for an extensive period of time. However, the procedure can cause a significant amount of pain and nerve damage in itself, and poses many risks. Complications of foot surgery include infection, corns, and chronic pain when walking. In some cases, the bones and tendons can become inflamed or may even shift, requiring more surgery.

The procedure is also known as restorative foot surgery, because it is designed primarily to enhance the physical appearance of the foot. Some procedures involve removing fat from the heels and around the sides of the foot, so that the foot looks better in high heels. Other procedures involve the injection of fat into the balls of the feet so that the individual has a more shapelier foot and feels more comfortable in heels. Some surgeons also perform bone restructuring procedures, or administer procedures that narrow the base or tip of the feet.

Please follow the Foot and Ankle Society’s recommendation and never have surgery performed to improve the appearance of the foot.

New Study Demonstrates Dramatic Impact of Podiatric Care

2010-08-03T09:41:00.000-07:00

Patients with diabetes who receive medical and surgical care provided by a podiatrist are less likely to suffer hospitalization or amputation than patients who do not receive care from a podiatrist, according to a new study from Thomson Reuters. Thomson Reuters is an internationally respected research firm with expertise in the health-care market.

The study, sponsored by APMA (American Podiatric Medical Association), examined records for more than 32,000 patients with diabetes under 65 and matched health and risk factors for those who had podiatry visits to those who did not. Care by a podiatric physician, defined as at least one pre-ulcer visit, was associated with lower risk of hospitalization and amputation.

The dramatic results of this study demonstrate the important role of today's podiatrist. Podiatrists, make a significant impact on patient outcomes and health-care costs. As more diabetic patients receive high-quality medical care by podiatrists prior to developing ulcers, a greater reduction in cost and improvement in patients' quality of life will be seen.

If you or someone you know has diabetes and does not have a podiatrist, please contact our office for a consultation, 440-946-5858, to ensure proper quality of life.

Stiffness in Your Big Toe?

2010-07-27T12:16:00.000-07:00

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 it 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).

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

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.

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

Arches Falling???

2010-07-19T08:11:00.000-07:00

Treatment and prevention of adult flatfoot can reduce the incidences of additional foot problems such as bunions, hammertoes, arthritis and calluses, and improve a person’s overall health, according to research published in the July/August Journal of Foot & Ankle Surgery.

Overweight males in white-collar jobs are most apt to suffer from adult flatfoot disorder, a progressive condition characterized by partial or total collapse of the arch, according to the research. FootHealthFacts.org, the consumer website of the American College of Foot and Ankle Surgeons, notes that symptoms of adult flatfoot include pain, general aching or fatigue in the foot, swelling, flattening of the arch and an inward rolling of the ankle. Flatfoot is a progressive disorder by nature, therefore, the study suggests that neglecting treatment or preventive care can lead to arthritis, loss of function of the foot and other painful foot disorders.

If you are someone you know is experiencing this condition please visit our website, www.drrobertrosenstein.com, for more information or contact the office, 440-946-5858 for a consultation.

Troublesome Lump on Your Foot or Ankle?

2010-07-12T08:39:00.000-07:00

A ganglion cyst is a benign tumor, or lump that can occur anywhere on the body, but is most prevalent on the hands, but also very common on the feet. It is a sac filled with fluid that arises from either a joint (space between two bones) or from a tendon (structure that attaches a muscle into bone).

Ganglion cysts are also known as bible cysts or sometimes Gideon cysts because years ago the recommended treatment was to smash the growth with a book in order to break it up and even the poorest of families owned a bible.

Ganglion cysts vary in size and may get smaller or larger over time and may even disappear, only to possibly return later.

Ganglion cysts are more common in women with 70% of ganglion cysts occurring in people between 20-40 years of age. About 4% of all ganglion cysts occur on the feet.

Signs and symptoms associated with a ganglion cysts may include:
- A noticeable lump
- Tingling or burning, if the cyst is touching a nerve.
- Dull pain or ache, which may indicate the cyst is pressing against a tendon or
joint.

Ganglion cysts are usually caused by some type of injury. For example, a ganglion cyst might develop after something drops on the foot, if the foot was twisted while walking or after too much stress was placed on a joint or tendon.

Treatment options for a ganglion cyst include:
- Monitoring
If the cyst causes no pain and does not interfere with walking, it is best
to carefully watch the cyst over a period of time.
- Shoe modifications:
Wearing shoes that do not rub the cyst or cause irritation or placing a pad inside the shoe may
help reduce pressure against the cyst.
- Aspiration and injection.
This technique involves draining the fluid and then injecting a steroid medication into the mass.
More than one session may be needed.
- Surgery.
When other treatment options fail or are not appropriate, the cyst may need to be surgically
removed. While the recurrence rate associated with surgery is much lower than that
experienced with aspiration and injection therapy, there are nevertheless cases in which the
ganglion cyst returns.

If you or someone you know has this condition and would like additional information, please do not hesitate to give our office a call, 440-946-5858 or visit our website at www.drrobertrosenstein.com.

Skin Cancer and Your Feet

2010-07-06T12:43:00.000-07:00

The next time you clip your toenails, take a closer look at the rest of your feet. An extra 60 seconds could save your life.

Routine self examinations of your feet are an important way to find skin cancer early, when it's easiest to cure. Half of the people who learn they have melanoma of the foot die within five years because the cancer had already spread throughout their body by the time it was diagnosed.

Nearly 60,000 people will learn they have melanoma this year. It's not known how many of those cases will involve the foot, but more than 8,100 melanoma patients will die, which is approximately one death every hour. If melanoma is detected in its earliest stages, 92 percent of patients are alive after five years.

Unlike many other types of cancer, melanoma strikes people of all age groups, even the young. Whites are 10 times more likely to develop melanoma than blacks. But studies suggest more than half of melanoma cases in blacks involve the foot, where late diagnosis leads to a higher death rate. Routine foot self exams increase the likelihood of noticing suspicious moles, freckles or other spots.

Routine foot exams should evaluate for the following ABCD findings in a mole, freckle or other lesion:

● Asymmetry – Is one half of the lesion different in shape from the other?

● Border – Does the lesion exhibit uneven or ragged borders?

● Color – Is there more than one color noted with the lesion or does the noted colors have an uneven distribution?

● Diameter – Is the lesion wider than a pencil eraser? Does the lesion exhibit signs of ulceration, craters, donut-shaped edges, bleeding or slow healing if the lesion is ulcerated?

If any of these signs are present on the foot, it is important to see a physician right away.

To help prevent melanoma please follow the general pre-cautions listed below:

● Use adequate sunscreen in areas that are unprotected by clothing or shoes. Be sure to apply sunscreen on the soles as well as the tops of feet.

● Wear water shoes or shoes and socks

● Inspect all areas of the feet daily

● If you wear nail polish, remove it occasionally so that you can inspect the skin underneath the toenails.

● Avoid UV radiation during the sun’s peak hours (10 a.m. to 4 p.m.), beginning at birth.

● Wear sunglasses that block 100% of all UV rays, both UVA and UVB.

Remember: Early detection is crucial with malignant melanoma. If you see any of the ABCD signs or if you have discoloration beneath a toenail that is unrelated to trauma be sure to visit your physician as soon as possible or given our office a call for consultation, 440-946-5858.

Bunionette

2010-06-29T08:25:00.000-07:00

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.

Burning, Tingling and Numbness in Your Feet?

2010-06-22T09:04:00.000-07:00

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 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 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 your 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, 440-946-5858.

Hammertoes

2010-06-15T12:22:00.000-07:00

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

The way in which your foot loads during walking can place increased stress on the ball of the foot and cause increased toe activity. Orthotics can help to control foot movement.

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.

Bothersome Bump to Big Toe

2010-06-08T08:54:00.000-07:00

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.

Sweaty Feet?

2010-06-01T13:03:00.000-07:00

Foot sweating is also known as pedal hyperhydrosis. Pedal hyperhydrosis is a medical condition that involves the feet and the excessive sweating of the feet. Foot sweating rarely occurs on its own. More often than not, it appears in conjunction with palmar hyperhydrosis or abnormal hand sweating. If the hands don't sweat profusely but the foot does, the condition is called solitary foot sweating. There are many causes of excessive foot sweating, therefore it is difficult to pin point the exact cause for each individual. It could be caused by an overactive nervous system, stress and anxiety, over-activity of the sweat glands themselves or heredity. It is very common to see family members with similar sweating condition.

Excessive foot sweating exists in many different degrees. Mild forms of foot sweating can be treated with absorbent foot powders, antiperspirants and more frequent changing of shoes and socks. However, more severe forms of foot sweating can lead to other diseases, such as athlete’s foot, bacterial infections, fungal toenails or other skin problems: Therefore, should be evaluated by a foot/ankle specialist for treatment, which may include medications, such as Drysol.

If you have excessive sweating to your feet, please visit the practice website at www.drrobertrosenstein.com for more information or call 440-946-5858 to schedule a consultation.

Sexy High Heels

2010-05-27T07:33:00.000-07:00

High heeled shoes create a sexier and more flattering figure. They do this 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.

Please do not hesitate to contact the Mentor Office, 440-946-5858 with questions or comments.

Spring is the Season for Ankle Sprains

2010-05-17T10:00:00.000-07:00

Spring is 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.

2010-05-10T12:23:00.000-07:00

Athlete's foot is a skin infection caused by fungus. A fungal infection may occur on any part of the body: On the foot it is called athlete’s foot or tinea pedis. Fungus commonly attacks the feet because it thrives in a dark, moist, warm environment such as a shoe.

Fungal infections are more common in warm weather when feet tend to sweat more. Fungus thrives in damp areas such as swimming pools, showers, and locker rooms. Athletes commonly have sweaty feet and use the facilities where fungus is commonly found, thus the term "athlete's foot."

Athlete's foot usually produces itchy, dry, scaling skin. It is commonly seen on the soles of the feet and in between the toes. In advanced cases, inflammation, cracks, and blisters may form. The fungus can spread to other areas of the body, including toenails.

Avoiding walking barefoot combined with good foot hygiene can help reduce the spread of the fungus. Feet should be washed every day with soap and water and thoroughly dried, including between the toes. Feet should be kept as dry as possible. If your feet sweat a lot you may need to change your socks during the day. Anti-fungal powders, sprays, and/or creams are often utilized to treat athlete's foot and our office will recommend the best treatment for you, therefore please give us a call, 440-946-5858.

Feet and Fish

2010-05-04T06:30:00.000-07:00

What do fish have to do with your feet? Well, have you heard about the latest way to get rid of rough, dead skin (callouses) on your feet? A few salons through out the US have started using tiny little fish called garra rufa or doctor fish to eat the dead skin off of your feet and toes. After the fish are done with your feet a standard pedicure is performed. It sounds like the fish do not have any teeth, so they do not eat living skin. However, with any new treatment, I would advise caution and suggest you follow the 10 tips for a safe salon pedicure provided below.

1. Bring Your Own Instruments

This will help decrease the risk of catching viruses, bacteria and fungus. Things to bring include: nail nipper, cuticle nipper, cuticle pusher and curette cleaner.

2. Ask About Instrument Cleaning

Does the salon sterilize their instruments or do they just disinfect? Sterilization of instruments by autoclaving is the better choice.

3. Ask What Type of Foot Bath is Used

Usually the whirlpool foot bath is either piped or pipe-free. It is thought that pipe-free is better because piped whirlpool foot baths have been found to contain bacteria in their pipes, jets and water filtration systems. The pipe-free whirlpool foot baths can easily be removed for cleaning. If the foot bath uses a liner, make sure that a new liner is being used each time.

4. Ask If Disposable Items Are Used Only Once

Items such as nail files, foot files, buffers and toe separators should be used only once. You may want to consider bringing your own disposable items with you.

5. Make Sure Technician's Hands Are Clean

The nail technician should wash their hands in between clients. If they do not wash their hands, request that they do or that they wear gloves. Be cautious of a technician with fake (artificial) fingernails. It is hard to clean the area between the fake fingernail and the real fingernail.

6. Ask If the Salon and Technician Are Licensed

The salon and technician should both be licensed by the state governing board.

7. Don't Shave Legs 24 Hours Before Appointment

Nicks and cuts from shaving create small openings in the skin where bacteria can enter. If you have any open sores, wait until they heal before getting a pedicure.

8. Tell Technician Your Medical Conditions and Medications

Certain medical conditions and medications can increase the risk of infection. Examples include: Diabetes, lymphedema, PVD, neuropathy, HIV and autoimmune diseases such as lupus. Examples of medications include: chemotherapy agents and blood thinners such as coumadin.

9. Check If the Salon is Clean

The salon itself should be clean and well kept. This is usually a good indicator of how well they take care of their instruments and other salon equipment.

10. You Should Have No Pain

Getting a pedicure at the salon should not be a painful experience. Just like any business, there are good salons and not so good salons. Find a pedicure salon that follows strict sterilization procedures and find a technician who does not cause pain or do you harm.

Ingrown Toenails

2010-04-27T10:22:00.000-07:00

An ingrown toenail is a nail that is curved downward and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling and warmth to the toe.
If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor.

There are many different causes for an ingrown toenail, these include but are not limited to:
•Improper trimming of your toenails: Nails should be trimmed straight across, not rounded.
•Fungal infections of the nail can cause a thickened or widened toenail to develop.
•An acute injury near the nail or anything that causes the nail to be damaged repetitively (such as playing soccer) can also cause an ingrown nail.
•If a family member has an ingrown toenail, you are more likely to develop one, too
•Tight-fitting shoes or high heels can cause the toes to be compressed together, adding pressure to the the nail, which in turn can cause the nail to grow abnormally.

Treatment
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk for example, diabetes, nerve damage in the foot or poor circulation.

Home care includes soaking your foot in room-temperature water with one cup of vinegar. However, “bathroom surgery," involving repeated cutting of the nail is highly discourage. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon, therefore given our office a call.

The treatment our office will render will be based on the examination your toe. The treatment options include:
•Oral antibiotics
•Surgery: A simple procedure, involving numbing the toe and removing the corner of the nail, a larger portion of the nail or the entire nail.
•Permanent removal.

Please do not hesitate to give our office call, 440-946-5858. We are here to help:)

Survey Shows Nearly 40 Percent of Americans Reel from Heel Pain

2010-04-19T10:28:00.000-07:00

While foot problems such as bunions, corns and dry, cracked skin affect many Americans on a daily basis, one particular ailment—heel pain—stands out among foot disorders, according to a new survey by the American Podiatric Medical Association (APMA).

The APMA survey, which polled close to 420 Americans aged 18 and older, found that 39 percent of adults have experienced heel pain more than any other foot ailment within the last 12 months. Additionally, nearly 60 percent of respondents believed they suffered heel pain while wearing ill-fitting footwear. However, 64 percent of the respondents said they had not yet visited a medical professional—such as a podiatrist—to diagnose and treat their heel pain.
Heel pain is a detrimental foot ailment that affects millions of Americans every day, and foot pain of any kind is not normal. If detected early, most types of heel pain—including the most common, plantar fasciitis—can be treated with non-invasive treatment options including stretching, shoe modification, padding/strapping and/or orthotics. However, the longer one waits to have their heel pain evaluated, the more difficult it is to successfully treat.

If you are experiencing foot or heel pain, please schedule an appointment for evaluation and treatment to aid in finding a solution for your pain at our office. The phone number is 440-946-5858.

Bothersome Warts

2010-04-12T11:19:00.000-07:00

At this time of year, your children will soon be heading off to the local pool or beach for a refreshing swim to escape the summer heat. Unfortunately, environments such as the community pool or beach, can harbor a host of various germs and bugs. One of which can cause warts to form on both children and adults alike.
Warts are the most common infection of the skin caused by a virus. This virus, known as human papilloma virus (HPV), can invade the underside of the foot by direct contact creating plantar warts. Two main things may make a person more or less susceptible to plantar warts. These include being more genetically predisposed and/or the environment (i.e. walking barefoot in public areas or showers).
Warts often hurt and feel like a bump on the underside of the foot. This and the less than favorable appearance of the wart will often encourage patients to seek treatment. After failure of over the counter self-treatments, professional treatment options include burning the wart off with an acid (such as salicylic acid), freezing the warts (cryotherapy) and/or laser treatment. However, the best treatment for warts is prevention: This includes the avoidance of walking barefoot in public areas, keeping the feet clean and dry, changing socks daily and periodic checks of you and your child's feet (summer months especially).

Foot and Ankle Problems in Children

2010-04-05T08:44:00.000-07:00

Is your child tripping frequently, lagging behind their friends while playing or completely withdrawing from activities, if so your child might be suffering from a foot or ankle ailment.

Foot and ankle problems in children often go unnoticed. Signs and symptoms can be subtle, and sometimes children can’t explain what’s wrong. But it’s important to protect growing feet and have problems checked out early.

Below are five warning signs to watch for in your growing child:

1. Child Can’t Keep Up with Their Peers
If your child lags behind in sports or backyard play, it may be because their feet or legs are tired. Fatigue is common when children have flat feet: The muscles in the feet and legs tire easily because the feet are not functioning as well as they should.

2. Your Child Voluntarily Withdraws from Activities they Usually Enjoy
If your child is reluctant to participate, it may be due to heel pain: A problem often seen in children between the ages of 8 and 14. Repetitive stress from sports may cause muscle strain and inflammation of the growth plate, a weak area at the back of a child’s heel.

3. They Don’t Want to Show You Their Feet
Children may feel pain or notice a change in the appearance of their feet or nails but don’t want to tell mom or dad because they fear a trip to the doctor’s office. Therefore, make it a habit to inspect your child’s feet for any changes such as calluses, growths, skin discoloration or redness and swelling around the toenails.

4. Your Child Often Trips and Falls
Repeated clumsiness may be a sign of in-toeing, balance problems or neuromuscular conditions, that may warrant a trip the doctor's office.

5. Child Complains of Pain
It is never normal for a child to have foot pain.

A child with any of these signs or symptoms should be promptly examined. Please call our office for proper diagnosis and treatment of your child’s aliments, 1-440-946-5858.

What Your Feet Might Be Trying to Tell You

2010-03-31T05:56:00.000-07:00

Fungal Nail
Reason: Trauma or infection to the nail that makes it thickened, discolored, loose or deformed. Often caused by the spread of athlete’s foot, but may also be an indication of conditions such as diabetes or arthritis.

Response: Medications, such as Keralac Gel and Lamasil tablets, have proven to be effective treatment.

Tendonitis

Reason: Overuse due to increase in physical activity, such as an increase in walking time or distance. May also be caused by wearing worn out or improperly-fitted shoes.

Response: Rest and ice, however in some cases, over-the-counter arch supports or anti-inflammatories may be indicated.

Blisters

Reason: Friction from shoes that don’t fit right or are too stiff.

Response: Keep feet dry and wear socks with properly-fitted shoes. Also, never pop a blister and if painful, seek immediate medical attention.

Bromohydrosis (Foot Odor)

Reason: Increased perspiration from the more than 250,000 sweat glands in the foot due to increased body temperature.

Response: Rub corn starch or spray anti-perspirant directly onto the soles of the feet and spray Lysol into shoes daily. Keep shoes and socks dry and change shoes regularly.

Bunion (Hallux Abducto-Valgus Deformity)

Reason: A bump at the base of the big toe that is swollen, tender or painful when in the shoe, often caused by misalignment of the joints. Ill-fitting shoes, heredity, trauma, biomedical abnormalities, neuromuscular disorders, inflammatory joint disease, congenital deformities or arthritis can also be culprits.

Response: Avoid pointy and narrow shoes or shoes with stitching or seams that rub bony areas of the foot. If painful, bunions can be surgically removed.

Ingrown Toenails

Reason: Improper trimming or too much pressure on feet in tight-fitting shoes, resulting in redness, pain or swelling around the nail. Can also result from poor foot structure, heredity, trauma or foot deformities.

Response: Instruct patients to avoid tight-fitting shoes and socks and inspect nails daily. Additionally, instruct patients to trim nails straight across using toenail clipper.

Plantar Fasciitis

Reason: Excessive weight gain resulting in pain on the bottom of the heel or in the arch. May also be caused by bony overgrowth on the heel, muscle imbalance, high or low arched feet, improper shoe gear, excessive activity or trauma.

Response: Exercise, stretch feet daily and wear strong, supportive shoes that don’t put undue stress on the ball or heel. If these measures are unsuccessful in relieving pain seeking medical attention.

If you are experiencing any of the above conditions, please do not hesitate to call our office and schedule an appointment, 440-946-5858.

Fun, Interesting Foot Facts

2010-03-28T13:03:00.000-07:00

* 3 out of 4 Americans experience serious foot problems in their lifetime.

* The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.

* 1/4 of all the bones in the human body are down in your feet.
-When these bones are out of alignment, so is the rest of your body.

*Only a small percentage of the population is born with foot problems.
-It's neglect and a lack of awareness of proper care-including ill fitting
shoes that bring on problems.

* Women have about four times as many foot problems as men.
-High heels are partly to blame.

* The average person takes 8,000 to 10,000 steps a day, which adds up to
about 115,000 miles over a lifetime.
-That's enough to go around the circumference of the earth four times.

* Women on average walk 3 miles farther per day than the opposite sex.

* There are currently more websites on the Internet having to do with foot
fetishes than with foot health.

* There are 250,000 sweat glands in a pair of feet.
-Sweat glands in the feet excrete as much as a half-pint of moisture a day.

* Your two feet may be different sizes.
-Buy shoes for the larger one.

* Your feet mirror your general health.
-Conditions such as arthritis, diabetes,nerve and circulatory disorders can show
their initial symptoms in the feet. Therefore,foot ailments can be your first
sign of more serious medical problems.

* Walking is the best exercise for your feet.
-It also contributes to your general health by improving circulation,
contributing to weight control and promoting all-around well being.

David Beckham Ruptures Achilles Tendon

2010-03-15T10:58:00.000-07:00

David Beckham of the Los Angeles Galaxy ruptured his Achilles tendon Sunday, March 14 while playing for AC Milan in Italy and had surgery in Finland today to repair the tendon. This injury will likely keep Beckham from playing in the World Cup set to begin June 11 in South Africa.

The Achilles tendon is a fibrous band of tissue that connects the heel (calcaneus) to the calf muscles in the lower leg. It is the thickest and strongest tendon in the body and enables actions such as walking, running, jumping and standing on the toes. It was named after the ancient Greek hero of the Trojan war who was invulnerable except for one spot on his heel.

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.

A tendon rupture is usually accompanied by a popping sound, pain and a sudden loss of strength and movement. A gap or depression may also be felt and seen about 2 inches above the heel bone. Beckham was said to feel the calf muscle retract, which is also another common symptom.

A complete tear in the Achilles tendon usually requires surgery to suture the ends of the tendon back together. After surgery, there is usually a lower incidence of re-rupture. Weight bearing commonly begins at about 6 weeks with a heel support. A return to athletics is traditionally about 4 to 6 months, but with rigorous therapy, elite athletes may return as early as 3 months after injury.

Keep Your Child’s Feet in the Game

2010-03-09T11:07:00.000-08:00

Spring soccer season will soon be in full swing; don’t let your child be sidelined by toe pain. Tight or hand-me-down cleats combined with repetitive kicking can lead to painful ingrown toenails. It’s a common condition among all age groups, especially children.

A nail becomes ingrown when its corners grow into the skin of the toe, causing discomfort, redness, swelling and sometimes infection.

While tight shoes or socks and incorrect nail trimming are the usually cause of ingrown toenails, sometimes children inherit the tendency for nails to curve. You can help prevent this painful condition by following a few simple tips provided by the American College of Foot and Ankle Surgeons:

• Make sure children’s sports and day-to-day shoes fit properly. Improper shoe width
often contributes to ingrown toenails. It is important for the widest part of the
shoe to match the widest part of your child’s foot.
• Teach children how to trim their toenails properly. Toenails should be trimmed
straight across and not cut too short.
• Make it a habit to check your children’s feet starting at a young age. Oftentimes
kids hide their foot pain from their parents.

If your child develops an ingrown nail, the only permanent cure is with a minor procedure performed at our office. Don’t ever try to dig the nail out or cut it off yourself. These dangerous “bathroom surgeries” carry a high risk for infection.

As always, we are here to provide care for your entire family. If you have questions about your child’s feet, don’t hesitate to contact our office, 440-946-5858.

Diabetic Foot Ulcerations

2010-03-08T11:08:00.000-08:00

What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open sore or wound that occurs on the foot, most commonly on the bottom or plantar surface. Approximately 15 percent of patients with diabetes, will develop an ulcer during there lifetime, of which 6 percent will be hospitalized due to an infection or other ulcer-related complication and 14 to 24 percent will have some form of amputation.

6 Tips to Protect Kids in Sports

2010-02-19T05:50:00.000-08:00

If your children are playing sports this winter or will be participating in the spring, please pay attention to six simple tips provided by the American College of Foot and Ankle Surgeons that could protect them from serious ankle injuries.

--Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition.

--Buy the right shoe for the sport. Different sports require different shoe gear.

--Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

--Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

--Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

Please follow the tips provided above for an injury-free sporting season.

Can Your Feet be Trying to Tell You Something?

2010-02-10T10:22:00.000-08:00

Fungal Nail
Reason: Trauma or infection to the nail that makes it thickened, discolored, loose or deformed. Often caused by the spread of athlete’s foot, but may also be an indication of conditions such as diabetes or arthritis.
Response: Medications, such as Ker¬alac Gel and Lamasil tablets, have proven effective treatment.

Tendonitis
Reason: Overuse due to increase in physical activity, such as an increase in walking time or distance. May also be caused by wearing worn out or improperly-fitted shoes.
Response: Rest and ice, however in some cases, over-the-counter arch supports or anti-inflam¬matories may be indicated.

Blisters
Reason: Friction from shoes that don’t fit right or are too stiff.
Response: Instruct patients to keep feet dry and wear socks with properly-fitted shoes. Additionally, instruct them never to pop a blister and if pain¬ful, to seek medical attention.

Ingrown Toenails
Reason: Improper trimming or too much pressure on feet in tight-fitting shoes, resulting in redness, pain or swelling around the nail. Can also result from poor foot structure, heredity, trauma or foot deformities.
Response: Instruct patients to avoid tight-fitting shoes and socks and inspect nails daily. Additionally, instruct patients to trim nails straight across using toenail clipper.

Bromohydrosis (Foot Odor)
Reason: Increased perspiration from the more than 250,000 sweat glands in the foot due to increased body temperature.
Response: Instruct patients to rub corn starch or spray anti-perspirant directly onto the soles of the feet and spray Lysol into shoes daily. Additionally, instruct patients to keep shoes and socks dry and change shoes regularly.

Bunion (Hallux Abducto-Valgus Deformity)
Reason: A bump at the base of the big toe that is swollen, tender or painful when in the shoe, often caused by misalign¬ment of the joints. Ill-fitting shoes, heredity, trauma, biomedical abnormalities, neuromuscular disorders, inflammatory joint disease, congenital deformities or arthritis can also be culprits.
Response: Instruct patients to avoid pointy and narrow shoes or shoes with stitching or seams that rub bony areas of the foot. If painful, bun¬ions can be surgically removed by a podiatrist.

Plantar Fasciitis
Reason: Excessive weight gain resulting in pain on the bottom of the heel or in the arch. May also be caused by bony overgrowth on the heel, muscle imbalance, high or low arched feet, improper shoe gear, exces¬sive activity or trauma.
Response: Instruct patients to exercise, stretch their feet daily and wear strong, supportive shoes that don’t put undue stress on the ball or heel. If these measures are unsuccessful in relieving pain refer to a podiatrist for further examination and treatment.

If you are experiencing any of the above conditions, please do not hesitate to call and/or schedule an appointment at our office, 440-946-5858.

Health Hints: For Safer Winter Sports

2010-02-02T12:46:00.000-08:00

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 above and enjoy the cold, snow-filled weather while it lasts.

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

In the Spirit of Heart Month.....Important Information Regarding PAD

2010-01-27T13:39:00.000-08:00

Do you get pain in either leg when you walk?

Does the pain go away when your stop walking (within 10 minutes)?

According to the World Health Organization if you answered yes to both of these questions your likelihood of PAD is >95%

What is PAD you ask?

Commonly referred to as “poor circulation,” Peripheral Arterial Disease (P.A.D.) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.

The presence of P.A.D. may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke or the heart, causing a heart attack. According to The Journal of Vascular Surgery, 60-80% of patients with PAD have blockage in one coronary vessel and 21% of these patients will have a MI, stroke, cardiovascular death or hospitalization within 1 year.
Based upon the guidelines of the American Heart Association and American College of Cardiology, the following individuals would benefit from an ABI test:

- Exertional leg symptoms
- Non-healing wounds
- Asymptomatic patients at high risk:
o Adults > 70 years old
o Adults >50 years of age with diabetes or tobacco use

Testing for this condition is non-invasive: It utilizes blood pressure cuffs and is painless. If interested in being tested, please call our office to schedule an appointment.

Want to Help the Effort Relief In Haiti, We Have a Way for You to Help

2010-01-25T09:01:00.000-08:00

Looking to help the effort in Haiti? Live in Northeastern Ohio? Have gently worn shoes collecting dust in the bottom of your closet? If you answered yes to all of these questions our practice, Affiliated Podiatrists, Inc. in Mentor, Ohio has a way for you to assist in the relief effort. Through Soles 4 Soles we have joined the effort to donate more than 1 million pairs of shoes to the affected areas hit by the devastating earthquake through a collection drive in the Shoe Store of our practice for gently worn shoes. We have currently received more than 200 pairs and have a goal of 500 pairs. Please help us in providing a basic necessity for those in need.

High Heeled Boots Dangerous on Ice and Snow

2010-01-25T07:41:00.000-08:00

As a female, I too like to wear fashionable shoes or boots, however with the constant snow and ice we get in Northeastern Ohio it can be very dangerous. The treacherous snowy and icy conditions can lead to falls, which are not only embarrassing but can result in a number of injuries. If your ankle rolls inward or outward, a bone can be broken or if your ankle twists, ligaments can be stretched or torn causing an ankle sprain. If this does happen to you collect your belongings, brush off your designer duds and get to somewhere where you can immediately begin use of “R.I.C.E.” therapy– rest, ice, compression and elevation – to help reduce swelling, pain and further injury. Then pick up your phone and call my practice in Mentor to be seen. If treatment is delayed long-term complications, such as chronic ankle instability and pain, arthritis, or deformity can develop. And please do not believe if you can walk on it, nothing is broken. This is a misomer: If you develop pain, swelling, or bruising this is an indication of a serious injury.