FOOT OF THE CLASS

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

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

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

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

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

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

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

Some warning signs parents should look for are:

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

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

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

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

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

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

Flip Flop Fiasco

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

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

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


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Avoid Risks of Summer Heat to Diabetic Feet

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

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

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

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

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

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

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

Keeping Deadly Blood Clots at Bay After Foot Surgery

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

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

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

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

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

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

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

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

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

Going Barefoot. Beware!

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

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

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

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

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

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

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

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

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

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

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

--Use common sense.

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

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