Download Summer 2008 Newsletter - Allentown Family Foot Care

ALLENTOWN
FAMILY FOOT CARE
Raymond A. Fritz, Jr., DPM, FACFAS, FACFAOM,
FAPWCA, C.Ped.
Lora Baker, DPM, FACFAS, FAPWCA
Michelle McCarron, DPM, FACFAS
Ann C. Anderson, DPM, FACFAS, FAPWCA
Randy Smargiassi, DPM, FACFAS, FAPWCA
Early diabetic
foot evaluation
to reduce risk
If you have diabetes, nerve
damage can cause you to lose feeling
in your feet. You may not feel a cut, a
blister, or a sore. Serious cases may
even lead to amputation. It may be
harder for your foot to heal if you do
get a sore or infection. Check your
feet every day.
n You may have serious foot
problems, but feel no pain. Check
your feet for cuts, sores, red spots,
swelling, and infected toenails. Find
a time (evening is best) to check your
feet each day. Make checking your
feet part of your everyday routine.
n If you have trouble bending over
to see your feet, use a plastic mirror to
help. You can also ask a family
member or caregiver to help you.
Make sure to call your doctor right
away if a cut, sore, blister, or bruise
on your foot does not begin to heal
after one day.
Randy Smargiassi, DPM,
FACFAS, FAPWCA
Dr. Smargiassi joins the practice after a
distinguished nine-year career in the U.S.
Navy, where he served as the Specialty
Consultant to the White House for six years.
The AFFC staff is excited to have him on
board and welcome him with open arms.
Five myths about bunions:
DEBUNKED!
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1 . Bunions are extra growths of bone.
A bunion is described as a "bump" or
protrusion along the inside of the foot at
the big toe joint. There can be a small
amount of extra bone that is formed,
but the protrusion is usually due to a
misalignment of the bones. There is
usually an associated deviation of the
great toe toward the second toe. When the
bump becomes large or the great toe starts
to abut or overlap the second toe, then the
condition requires treatment and possible removal.
2. Bunions are caused by tight shoe gear. Bunions are not caused by tight shoe
gear ALONE; they are caused by a combination of factors. Bunions are a result of
instability in the mechanics of the great toe joint. This instability can be due to the
way we walk, our foot type, shoe gear, etc.
3. I have inherited my bunions from my grandmother! As we have mentioned
before, bunions are due to a combination of internal and external forces working at
the great toe joint to cause instability and a bony protrusion. No, you did not inherit
your grandmother's bunions, but you may have inherited your grandmother's foot
type which predisposes you to developing bunions.
4. Bunion surgery is PAINFUL! We have all heard our grandmothers discuss
their bunion surgeries and how painful it can be to recover from a bunion procedure.
Surgery and pain medications have come a long way in the past 50 years. Modern
surgical techniques for bunion surgery include smaller incisions, hardware buried
under the skin in the bone, and plastic-surgery techniques to produce a minimal scar.
All of these new techniques in combination with local anesthesia and aggressive pain
management make the recovery much less painful and a lot smoother.
5. Everyone has the same bunion surgery. No! Every bunion is different. This is
why some people have a difficult recovery, while others are back to sneakers in two
weeks. The surgical treatment of bunions varies depending upon the severity of the
bunion and the patient's individual needs and expectations. A clinical evaluation
with a board-certified foot and ankle surgeon and radiographs are recommended
to determine which bunion procedure is performed. In addition, the patient's age,
health, medical history, activity level, and occupational requirements are taken into
consideration to determine the best bunion procedure.
If you think you have a bunion or other foot condition, it is always best to seek the
opinion of a trained foot and ankle specialist.
Ann C. Anderson, DPM, FACFAS, FAPWCA
We thank you for your referrals.
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Often, when we think of arthritis,
we picture gnarled fingers, but the
feet are one of the first places
attacked by arthritis. Generally, three
types of arthritis manifest themselves
in the feet and ankles: rheumatoid
arthritis, osteoarthritis, and gout.
Rheumatoid arthritis occurs
when a person's immune system
attacks the joints as if they were an
invading horde of bacteria. The
joints in the extremities are commonly affected. Pain, inflammation,
deformity of the joints, and morning
stiffness often result. With rheumatoid arthritis, symptoms tend to come
and go. However, problems gradually tend to get worse, and chronic
deformity of the foot can result.
Osteoarthritis causes the cartilage
to slowly deteriorate. When the
cartilage can no longer provide a
lubricating barrier between the bones
of a joint, pain, stiffness, and swelling generally occur. Injury and
trauma are often predecessors of
this disease.
Gout is an arthritic condition that
usually involves the big toe. It is the
result of uric acid in the body that
crystallizes and builds up in the
joints. The big toe is often affected
because it is the last place the acid
arrives at within the body. Symptoms
include excruciating pain, heat,
redness, and swelling. When gout is
recurrent, gouty arthritis can occur,
causing permanent joint damage,
stiffness, and chronic discomfort.
There are treatments for all these
kinds of arthritis. Medications to
modify the effects of the disease and
control pain, orthotics to increase
mobility, and surgery when necessary can help relieve symptoms,
depending on the type of arthritis.
Patients who experience symptoms
associated with arthritis shouldn't
delay in seeking a professional
diagnosis.
The highs
and lows of arches
Some foot and ankle problems are caused by
Those with high arches don't at
deformities of the foot that are inherited, or congenital.
they walk and run. As with flat fee
High arches and flat feet are among these. Flat feet is a
knee pain; however, it can cause lc
common term, but it actually refers to pronating feet
too. Hammertoes and metatarsalgii
(walking on the inner sole). Conversely, those with high
ball of the foot) are often seen as v
arches walk on the outer edge while the toes turn in.
The good news is that both higi
Both flat feet and feet with high arches represent
can frequently be treated conserval
extremes in arch formation; both can result in numerous
orthotics. Orthotics made specifica
foot problems. Problems associated with flat feet include
normalize pronated feet or help
knee pain, having the foot turn inward during walking,
shock. In cases where orthotics car
and joint instability. Troubles such as hammertoes, arthri- surgery may be necessary.
tis, bunions, and heel pain may also present themselves.
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Pamper your feet first
Is there a special day in your future? Maybe you're a
bride-to-be...or maybe you're the attendant of one. If
that's the case, while you're thinking about all the details
of the wedding, don't forget your feet and ankles.
Pampering your feet in advance of the big day means a
lot more than just getting a pedicure.
If you have foot problems, don't hesitate to see a
podiatrist for preventive care within a couple of weeks
prior to the special day. Calluses and corns can be treated
to alleviate problems that might interfere with this
exciting event. Be cautious about your toenails as well.
Whether you have a pedicure or do your nails yourself,
be careful to cut them straight across to avoid potential
ingrown-nail problems.
If you want to be comfortable and really enjoy your day, try to choose shoes that
don't have extreme heels. Two inches or less will mean an easier day for your feet. Make
sure the shoes you wear are the right size and width. Shoes that are too short or narrow
in the store will be just as uncomfortable on the dance floor. Remember to try shoes on
in the late afternoon or early evening, when your feet are at their widest of the day.
Don't wait until the big event to take your shoes out of the box and put them on.
Wear them carefully a few times beforehand to be sure they fit comfortably and don't
rub anywhere. Taking precautions now can mean avoiding painful foot problems both on
and after your special day.
▪
s need sp ec.
rb shock well when
this can result in
er back and hip pain,
pain that strikes the
11.
rches and flat feet
ely with custom
1 for your foot can
-arched feet absorb
fix the problem,
You visit a dentist for oral
care...an optometrist for your eyes...perhaps
Vir
a dermatologist for skin care...but what about your
feet? Feet and ankles are incredible creations. Their superior
mechanical design allows them to be both strong and flexible at
the same time. Feet in particular are incredibly functional. Their
construction packs more than 25 bones, over 30 joints, and upwards of
100 muscles, ligaments, and tendons into a relatively small space.
Needless to say, such a finely crafted piece of biomechanical machinery
calls for specialized care. Think of what your feet and ankles do for you.
Daily, they bear a force equal to more than a hundred tons. In a lifetime,
they may carry you more than 100,000 miles.
It's no wonder that more than three-quarters of us have foot and ankle issues at
some point. Often, these are due to problems that accumulated over the years
as feet were exposed to overuse and poorly fitting shoes. Heredity and
systemic diseases, such as diabetes, also play significant roles in the
development of foot problems.
Podiatrists are experts in foot and ankle health. If you have
foot and ankle pain, swelling, or other abnormalities of
the feet or ankles, call us for care. We have the
training and experience to treat your
foot and ankle problems.
and
A number of patients who visit us come in because they
have suffered foot or ankle injuries. Oftentimes these injuries are sports related, but they don't have to be. It's easy
to turn an ankle just climbing the steps or when wearing
high heels.
Among the most common foot and
ankle injuries are:
• sprains to the ankle or midfoot
v fractures from overuse and
accidents
v tendonitis
v injuries to the Achilles tendon
• plantar fasciitis
v shin splints
Each of these injuries can have
a different cause. Achilles tendon
problems are often related to overuse,
as are stress fractures, shin splints,
and tendonitis. Plantar fasciitis may occur in athletes who
are beyond their teen years. Fractures and twisted ankles can
happen to anyone.
To prevent injuries, wear the appropriate shoes for
whatever you're doing. Avoid uneven or slippery surfaces.
If you're a runner or involved in a
sport, be sure to warm up and stretch.
Also choose shoes with adequate support
and stable heels, and replace worn-out
shoes regularly.
We always enjoy seeing you in our
office, but it pains us when you come in
with an injury. Take steps to lessen your
chances of hurting yourself. If you do
suffer a foot or ankle injury, either on the
court or on the sidewalk, contact us right
away.
We offer...
• Diagnostic ultrasound
• Extracorporeal shockwave therapy for heel pain
• Vascular Doppler testing to evaluate blood flow
• State-of-the-art digital x-ray system
a
• Therapy with ultrasound, E-stim, and Anodyne
to help decrease inflammation and pain
• State-of-the-art custom orthotic devices
and bracing
• F-scan gait analysis system to monitor/measure
plantar pressures on diabetics
• Shoes for all needs
• Conservative and surgical treatments performed
in-office and at area hospitals
Dr. Baker
Dr. Smargiassi
Dr. Fritz
Dr. McCarroll
Dr. Anderson
Copyright 2008. Newsletters, Ink. Corp. Printed in the U.S.A. www.newslettersink.com
From the office of
Allentown Family Foot Care
(610) 434-7000
1 633 North 26th Street
Allentown, PA 18104
Ingrown toenails
When a toenail is ingrown, the nail curves downward into the skin at the nail borders
(the sides of the nail). Usually, the side of the nail penetrates deep, and it is difficult to see the
ingrowing portion of the nail. This acts like a small spike that penetrates the skin, like a knife.
This can result in an infection in which the toe appears red, inflamed, and painful. Many people
610-828-1100
say, "My toe hurts when the bedsheets touch it!" This is a cardinal sign of an ingrown nail.
Route 145 Spruce Street
Ingrown toenails can develop for various reasons. In many people, the tendency to have this
Walnutport, PA 18088
common disorder is inherited. However, the most common cause is improper trimming. Avoid
"bathroom surgery." Do not cut the toenail halfway and rip it off the rest of the way. Do not cut
Hours expanding; call for days and times.
down the side of the toenail. Other causes of ingrown toenails include trauma, tight shoes, or
Evening & weekend hours available.
fungal infections.
Web site:
www.affc.com
The mainstay of treatment for an ingrown toenail is to remove the portion of toenail that is
ingrown.
It is a myth that a "V" should be cut in the end of the nail to treat an ingrown toenail.
Hospital Affiliations
The
shape
of a nail is determined by growth at the base of the toe, not the tip. Your podiatrist can
• Lehigh Valley Hospital, Allentown, PA
determine
which
treatment is best for you.
• Sacred Heart Hospital, Allentown, PA
• Saint Luke's—Allentown Campus, Allentown, PA
Treatment: If an infection is present, an oral antibiotic may be prescribed. Your podiatrist can
• Good Shepherd Rehabilitation Hospital,
remove the ingrown toenail with relatively little discomfort. A cold spray or local anesthesia is
Allentown, PA
often used to numb the area.
Don't forget that unless the
offending piece of nail that is
cp COMM,OftfilOtfraterft
ingrown is removed, the
Does it feel like you are walking on a pebble or as if your sock is constantly bunched up under your
infection is likely to persist.
foot? Well, you may be suffering from a common foot condition called a neuroma. A neuroma is a
Permanent correction of the
swollen nerve, usually occurring in the ball of your foot, that causes abnormal sensations in the area.
ingrown toenail (removing the
These sensations include burning, pain, numbness, and even cramping.
nail root) is an option if the
Neuromas are caused by a bone or outside entity irritating the nerve. Once the nerve swells, it can take
problem becomes a chronic one.
some time for it to calm down. Conservative treatments include wide-toe shoes, avoidance of high heels,
This procedure is done right in
steroid injections, orthotics for your shoes, physical therapy, and anti-inflammatories. In chronic cases,
the office. Talk to your
surgical excision of the nerve is indicated. Early diagnosis and treatment can increase the success rate of
podiatrist about which
conservative care, thus avoiding surgery.
procedure is right for you!
Other causes of forefoot pain can include stress fractures, metatarsalgia, diabetic neuropathy,
Michelle McCarroll, DPM,
and arthritis. The exact cause of your pain needs careful examination and testing by your podiatrist.
Diagnostic tests can be used to help confirm the diagnosis, including x-rays and diagnostic ultrasound
FACFAS
pictures. Some patients may need further testing, such as an EMG nerve conduction study or an MRI.
Most of the commonly needed tests can be performed right in our office. Visit us for examination and
diagnosis of your foot problems.
2100 Hanover Avenue
Allentown, PA 18104
N euromas:
Lora Baker, DPM, FACFAS, FAPWCA