Achy Feet?????

It's not uncommon to experience foot pain after a long day of work or a vigorous sport activity, especially as we age. A long day of shopping or yard work can leave feet tired, heavy, swollen and achy: A problem we can all relate to at one time or another.

Some factors which contribute to achy feet, include:
-Age
-Gender
-Dehydration

Some causes which contribure to this condition include:
-Strenuous walking or standing for long periods on your fee
-Ill-fitting, poorly padded shoes
-Tight socks, stockings and/or garters
-Reduced blood circulation to the ankles and feet also causes tired aching feet.

5 Simple Ways to Relieve Tired, Aching Feet:
1. Elevate your feet to heart level for 15-20 minutes
2. Soak your feet in warm water with epsom salts if possible for 15-20 minutes
3. Massage your feet or have someone massage your feet for you
4. Exercise your feet, to tones muscles, strengthen the arches and stimulate blood circulation
5. Wear OTC and/or custom insoles in your shoes. Please see your podiatrist for their recommendation.

When foot pain persists, it's important to visit our podiatric office for a thorough examination. The cause of your foot pain may be more serious than simple stress and over work and we will work with you to determine a treatment plan that will put an end to your tired, achy feet for good!

Achilles Tendon Injuries

There are many issues relating to the Achilles tendon. It does not always result in the wince-inducing highlight reels from professional sports. While the tears and ruptures are the most notable and produce the best stories, there are other types of injuries that are just as common and not as severe. Many go undiagnosed as basic soreness and temporary injuries.

The Achilles tendon is the largest and toughest tendon in the body and it connects the heel to the calf muscles. Because it connects those two, it is responsible for moving the foot up and down, which is a motion used in just about every movement of a standing body. Because of its usage, it is very susceptible to injury, but also usually easy to diagnose and treat.

There are three basic types of Achilles tendon injuries:

Achilles Tendinosis:
There are many different words used to describe this condition. It has been referred to as tendinosis and tendinopathy. In this condition, the terminology which will be used is a degenerative tendinopathy. This term is used because it is a chronic condition, and is associated with gradual degeneration of the Achilles tendon.

There are times when the Achilles tendon does not function correctly because of multiple, minor microscopic tears of the tendon and the limited ability of the tendon to heal and repair itself. The blood circulation to the Achilles tendon in some patients is not always as good as it should be and microscopic tears begin to occur inside the tendon approximately six-centimeters from the attachment on the heel bone. Because of poor blood supply, the ability to heal these microscopic tears is limited and tearing of the tendon continues. Eventually, the tendon begins to thicken and weaken, and gets quite painful.

Achilles Tendonitis:
This injury is a result of continual stress on the tendon over time and can affect athletes and those not-so-athletic. Tight calf muscles, bone spurs, and increased physical exertion can lead to increased pain in the heel.

Achilles Tendon Rupture:
This is the Achilles injury that is often seen sidelining professional athletes. This is when the tendon tears partially or completely, and can result in inability to walk or even stand. It is often a result of Achilles tendonitis.

If you or someone you know has any questions and/or is seeking treatment for an Achilles tendon injury please give the office a call, 440-946-5858, for a consultation.

Got Heel Pain?????

Heel pain is a common presenting complaint causing patients to seek a foot and ankle surgeon or doctor. One of the most common etiologies of heel pain is mechanical and/or repetitive overuse injury causing inflammation of the plantar fascia, termed Plantar Fasciitis.

Symptoms of Plantar Fasciitis can include:
• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that is usually worse upon arising
• Pain that increases over a period of months
• Swelling around heel

Causes for Plantar Fasciitis Include:
• Repetitive loading or exercise
• Change in activity level, duration, or training surfaces
• Recent activity/long walking in un-supportive shoes or sandals
• Faulty structure of the foot.
• Recent weight gain or obesity
• Acute trauma or injury

Conservative treatment options for Plantar fasciitis include:
• Stretching of the Achilles tendon and plantar fascia complexes
• Avoid going barefoot.
• Ice.
• Limit activities.
• Custom orthotics or over-the-counter orthotics
• Supportive and comfortable shoes
• Oral anti-inflammatories
• Physical therapy modalities
• Heel injections
• Night splints

Plantar fasciitis generally resolves with conservative management, however, certain cases can fail 6 months of conservative treatment, therefore, require surgical intervention to help alleviate the symptoms. Podiatry Research has demonstrated that chronic injury and inflammation to the plantar fascia leads to micro-tears and degeneration of the plantar fascia, termed plantar fasciosis. Plantar fasciosis lacks acute inflammatory tissue, accordingly, rendering conservative options unsuccessful at times.

Surgical options for Recalcitrant Plantar Fasciitis and Plantar Fasciosis can include:
•Topaz (ArthroCare) Microdebrider
•Platelet Rich Plasma injection
•Shockwave therapy
•Open and Endoscpoic Realease

Topaz Coblation Microdebrider procedure is a minimally invasive surgical technique utilizing small holes to break up the scar tissue and attempt revascularization of the plantar fascia. By "burning holes" into the ligament, the Topaz will turn a chronic process into an acute inflammatory process to cause an influx of inflammatory healing cells directly into the ligament.

The procedure is performed in the operating room. The anesthesia team will administer sedation medications and then a local nerve block is performed by the foot surgeon. The surgeon will then mark the area of the plantar fascia and make holes in the skin. The topaz probe is then placed through these holes into the plantar fascia. The patient is then placed into a walking boot for a period of 2 to 3weeks during the healing process.

The procedure only requires small holes compared to a larger open incision and surgery. This lends to quicker healing and less pain and scar tissue and faster recovery.

Think the Topaz procedure might help you? For help with your heel pain, please contact our office, 440-946-5858, to set-up a consultation.

Toning Shoes....Worth the Hype?

In an recently published article, Reebok International Ltd., which is owned and operated by Adidas, has been ordered to return $25 million to consumers over reported false advertising with its’ toning shoes, which include “EasyTone”, “RunTone” as well as several types of flip-flops and clothing.

These so-called “toning” shoes, which have been available for the last couple of years, have been a popular trend, and are manufactured by many of the big shoe companies such as Sketchers, New Balance, Reebok, and MBT. However, Reebok is the first company to be penalized for making advertising claims that the shoes can result in measurable changes in muscle tone and size, specifically in the buttock and upper legs. Apparently, there was a lack of scientific evidence to support these claims.

Many of my patients have tried similar toning shoes, and the overwhelming response has been negative. I recommend to my patients to refrain from wear if they have any underlying foot deformity and/or pain due to wear of shoes further exacerbating the condition.

If you or someone you know is suffering from foot pain due to wear of toning shoes please give our office a call, 440-946-5858, for evaluation and treatment.

Achilles Tendonitis

The Achilles tendon is the large tendon that attaches the powerful calf muscles to the back of the heel bone. It is important for stabilizing the foot during jumping and running and is a common area where injury occurs. Achilles tendonitis typically occurs at the tendon's weakest spot which is a few centimeters above the heel bone. This is also the area where weakening and tearing of the tendon usually occur(tendinosis).

Achilles tendonitis/tendinosis can be aggravated or caused by tight calf muscles. Calf muscle stretching on a daily basis can help prevent tendon problems. Adding heel lifts to shoes helps reduce strain on the Achilles tendon. Be sure to add heel lifts to both shoes to maintain postural stability.

Achilles tendon pain may not mean inflammation is present. Tendon pain is often caused by micro-tears and weakening of the collagen within the tendon and shows minimal (if any) inflammation at the cellular level. This gives insight as to why anti-inflammatory drugs may not alleviate the pain.

Pain at the heel bone where the tendon attaches, is more than likely not tendonitis and/or tendonosis, but bursitis. Bursitis is inflammation of a pocket of fluid (bursa) near the bone.

For more information about common types of tendonitis that affect the foot and ankle, please visit our website, www.drrobertrosenstein.com and/or give our office a call, 440-946-5858, for a consultation.

High Heels....Dangerous for Women

As a podiatrist, much of my day involves treating fellow ladies who have fallen victim to fashion with frequent wear of high heel shoes.

The human foot was once described by Leonardo Da Vinci as “a masterpiece of engineering and a work of art”, and this is evidenced by our ability to walk, run, jump, and play. However, it doesn’t take much to upset the fine balance between precision function and disaster. High heels, by their nature shift the body’s anatomy into foreign territory, causing marked postural and alignment strain.

By elevating the heel bone (calcaneus) there is an immediate change in the distribution of weight under the feet from the heel to the forefoot – the percentage of which is directly proportional to the height of the heel. With regular use, the calf muscles in the lower leg can permanently shorten, leaving you unable to comfortably wear flat shoes and further increasing pressure under the ball of the foot.

Habitual high heel wearers will invariably, at some point, suffer pain and disability because of this alteration in the way our body adapts to the ground and distributes weight.
Common complaints can include calluses, corns and blisters to more permanent deformities including bunions, hammer toes and acquired flat feet. It additionally can contribute to increased incidences of fractures of the ankle and metatarsals (forefoot), arthritis, pinched nerves, tendonitis and other soft tissue injuries and inflammation.

Before you lose faith and trust in all things fashionable, here’s some tips on how to minimise risk while wearing your heels:

• Moderation is the key: Avoid wearing heels when walking to and from work. Also, kick off the pumps in the office and replace with flats.
• Pick shoes that suit the activity for the day: Flats or shoes with only a slight heel are best for standing and walking, whereas heels may be suitable during a seated meeting or dinner date.
• Keep the heel height sensible: Anything over 5cm is hazardous and should be for only special occasions.
• Stilettos: A dangerous shoe for ankle sprains and fractures. Try broader heels with more stability and tread on the ground.
• Stretch your calf muscles regularly to improve fl exibility and reduce the likelihood of muscle contraction.

Seek immediate assistance from our office, should you experience pain, swelling or a change in shape of any part of your foot. Our office number is 440-946-5858.

March is Women's Health Month

In spirit of March being Women's Health Month, I have a created a list of 10 things all women should know before they go to pamper them self with a pedicure at their local salon.
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 their state governing board. Usually the board of cosmetology. The licenses should be clearly displayed at the salon.
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, peripheral vascular disease (PVD), neuropathy, HIV and autoimmune diseases like 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 bleeding.

Please keep the tips listed above in mind when treating yourself to a mani/pedi. However, if you fall victim to a bad experience resulting in a nail and/or toe issue, please give our office a call for consultation, 440-946-5858.