My favorite thing to see as a doctor is for a patient to get better quickly without hassling with rehab, a long post-op recovery, physical therapy, time lost from work etc. While taking a patient to the OR is often a necessary evil, I believe that it can be avoided much more often. I believe in addressing a patient's main problem and fixing that problem as efficiently as possible.
A perfect example of this is when a patient presents complaining of a painful toe or hammertoe. This pain is usually on the top, tip, or side of the toe and is usually any toe except the great toe. Sometimes there is a callus or a corn. Sometimes there is a little swelling or bursitis around one of the toe joints. As long as the toe can be manually reduced to some degree, I believe a small in-office procedure can significantly reduce or eliminate this pain. The procedure is called a flexor tenotomy. I like to utilize this procedure quite often because it gives immediate results, the dressing is 2-3 bandaids, there are no sutures, no down time or time off from work, minimal chance of complications, it eliminates a trip to the OR and therefore saves thousands of dollars. The thing it is not meant to do is be a cosmetic fix.
The procedure is performed under simple local anesthesia. The sharp beveled edge of a 16g needle is used to pierce the skin on the bottom of the toe beneath the joint where the deformity is. The tendon that keeps the toe contracted down is released with the pinpoint scalpel-like tip of the needle. The toe is then aggressively flexed up and then put through its full range of motion to ensure that the procedure has increased the flexibility in the toe. The toe is dressed and splinted with 2-3 bandaids and the patient is educated on changing these at home for a week and stretching the toe in the opposite direction of the original contracture. The toe that once only touched the ground at the tip of the toe will now be able to lay flatter and the pressure will be placed on the fleshy fat pad of the toe instead of the bony tip. This significantly reduces or eliminates the pain. This has also proven effective for those who have more pain on top of the toe because if the toe is allowed to lay flat then the top of the toe is not fighting with the inside of the shoe. Additionally, if the pain is on the side of the toe from rubbing against the toe next to it, then the increased flexibility in the toe will not so strongly contract it into the adjacent toe and therefore there will be less pressure and less pain.
The flexor tenotomy is not meant to be a cosmetic fix. When not weightbearing, the toe will still appear to be contracted, but when weightbearing it will flatten.
Conversely, the more often performed procedure on these painful toes is to take the patient to the OR, make an incision over the top of the toe, remove a small piece of bone from one or both sides of the most prominent joint, then place a wire down the length of the toe for 4-6 weeks while it heals. Common complications from this are prolonged swelling, pain, and dislocation. Also, since this is an open procedure, the risk of infection is increased.
Conclusion: If you are suffering from any pain in the toes then you should consider the flexor tenotomy in-office procedure.
The Diabetic Foot Problem
The Diabetic Foot Problem
Thousands of leg or foot amputations are performed each year due to complications of diabetes. Very often this is a result of an open sore or ulcer on the foot that goes unchecked and subsequently becomes infected. You may ask why would someone not tend to an open sore. Wouldn’t that be painful, especially on the foot? Well, surprising to most, most of the time there is no sensation in these areas at all. This is one of the most common complications of diabetes…diabetic neuropathy. Neuropathy can present with many different diseases or syndromes, but it is often closely associated with diabetes due to its prevalence.
Diabetic neuropathy can present as a burning, tingling, pins and needles sensation (like when your arm falls asleep) or a more intensified painful feeling. When diabetics get into trouble, though, is when the neuropathy presents as numbness. It creeps up on them and they often times don’t know it is happening until they notice some drainage on their sock from a sore that they were not aware of. If the foot is numb, then the patient cannot experience pain, and therefore does not stop to check out what the problem is because they don’t realize that, for example there is a toothpick stuck in their foot or they have walked so much that the callus that has developed from wear and tear has broken down underneath. Unless they have a loved one checking their feet for them on a regular basis then this may go unnoticed for a long period of time. An ulceration will then often become infected. If the infection lingers it can eventually involve the bone. When bone becomes infected, IV antibiotics and often amputation of part or all of that bone or area must be performed to rid the body of the infection. The 5-year survival rate for all lower extremity amputation patients is less than 50%! This is a staggering statistic.
This is why education of diabetics is so important. Prevention of infections and amputations improves quality of life for the patient and the family. Too often the diabetic patient with neuropathy and an ulceration has the mindset of "It doesn't hurt, so it must not be THAT serious." Herein lies the problem. As practitioners it is our job to relay the gravity of this situation and its very realistic potential of significantly shortening the patient's life if they don't come to grips with their problem.
If you have a friend or family member with Type 1 or Type 2 Diabetes please make sure they are properly educated on their disease state. Look for some signs that they may have neuropathy. If you are riding in the car with them and they are not so great at applying the brakes or gas smoothly it's probably because they cannot tell how much pressure they are applying to the pedal. When they walk if they have a little bit of a slap when there foot hits the ground its something they are probably doing subconsciously because they aren't able to feel their foot hit the floor, so they can at least hear it. This sounds strange to us, but it is reality for many diabetics.
Thousands of leg or foot amputations are performed each year due to complications of diabetes. Very often this is a result of an open sore or ulcer on the foot that goes unchecked and subsequently becomes infected. You may ask why would someone not tend to an open sore. Wouldn’t that be painful, especially on the foot? Well, surprising to most, most of the time there is no sensation in these areas at all. This is one of the most common complications of diabetes…diabetic neuropathy. Neuropathy can present with many different diseases or syndromes, but it is often closely associated with diabetes due to its prevalence.
Diabetic neuropathy can present as a burning, tingling, pins and needles sensation (like when your arm falls asleep) or a more intensified painful feeling. When diabetics get into trouble, though, is when the neuropathy presents as numbness. It creeps up on them and they often times don’t know it is happening until they notice some drainage on their sock from a sore that they were not aware of. If the foot is numb, then the patient cannot experience pain, and therefore does not stop to check out what the problem is because they don’t realize that, for example there is a toothpick stuck in their foot or they have walked so much that the callus that has developed from wear and tear has broken down underneath. Unless they have a loved one checking their feet for them on a regular basis then this may go unnoticed for a long period of time. An ulceration will then often become infected. If the infection lingers it can eventually involve the bone. When bone becomes infected, IV antibiotics and often amputation of part or all of that bone or area must be performed to rid the body of the infection. The 5-year survival rate for all lower extremity amputation patients is less than 50%! This is a staggering statistic.
This is why education of diabetics is so important. Prevention of infections and amputations improves quality of life for the patient and the family. Too often the diabetic patient with neuropathy and an ulceration has the mindset of "It doesn't hurt, so it must not be THAT serious." Herein lies the problem. As practitioners it is our job to relay the gravity of this situation and its very realistic potential of significantly shortening the patient's life if they don't come to grips with their problem.
If you have a friend or family member with Type 1 or Type 2 Diabetes please make sure they are properly educated on their disease state. Look for some signs that they may have neuropathy. If you are riding in the car with them and they are not so great at applying the brakes or gas smoothly it's probably because they cannot tell how much pressure they are applying to the pedal. When they walk if they have a little bit of a slap when there foot hits the ground its something they are probably doing subconsciously because they aren't able to feel their foot hit the floor, so they can at least hear it. This sounds strange to us, but it is reality for many diabetics.
The Truth About Foot Orthotics
“Do I Need Orthotics?”
What is an orthotic and why would I need one? An orthotic is a device that is worn inside of a shoe that supports the arch of the foot and helps to place it in a biomechanically balanced position. Orthotics or orthoses are used for a variety of reasons, not just for foot and ankle problems, but some practitioners will prescribe them for knee, hip, and/or back ailments. The patients that benefit the most from orthotics are the ones that have the most unstable feet. This can be someone that has a flat foot who pronates (rolls their ankle inward) excessively during gait or someone that has a high arch that cannot find a shoe that provides enough support and therefore puts excessive stress on the midfoot joints and the ball of the foot. Many of the most common diagnoses seen in a podiatry practice are treated with orthotics. These include, but are not limited to:
1. Plantar Fasciitis
2. Tendonitis
3. Arthritis
4. Apophysitis/Sever’s Disease (Growth Plate Problems)
5. Ball of Foot Pain (Neuromas, Metatarsalgia)
6. Bunions and Hammertoes
Orthotics both treat these diagnoses and help to prevent or slow the progression of the deformity or painful condition. For example, orthotics will not get rid of a bony bump, such as a bunion, but they will place the foot in a better supported, balanced position which will slow or halt the bunion’s progression.
There are prefabricated orthotics and there are prescription custom orthotics. Both serve a purpose. A solid shell prefab device provides much more support than almost any shoe that is available and is great for someone with an average arch height and a foot that is pretty “normal”. A custom made device is made directly from imprints, casts, digital scans, etc. and is specific for that patient. These are better than prefab orthotics for this reason. Often times a patient will start in a prefab and improve, but may plateau. This is a time the fine-tuned custom devices will give that extra needed benefit. Most local insurance plans cover custom orthotics when they are deemed medically necessary.
At Westfield Foot and Ankle, LLC a digital gait scan is done of the patient's feet both in static(standing) and dynamic(walking)phases of gait. The majority of the information that is gleaned from this scanning comes from the dynamic portion, which tells us what the feet are doing during gait. The pressure distribution is clearly seen. Prior to the scan, a comprehensive examination of the feet is done to determine what modifications may be needed, such as posting to further reduce the amount of pronation or rolling in of the ankle while walking. Overpronation is the culprit in many foot and ankle pathologies. Orthotics prevent this.
To schedule an appointment with Dr. David Sullivan visit www.westfieldfoot.com or call Westfieldf Foot and Ankle at 317-896-6655.
What is an orthotic and why would I need one? An orthotic is a device that is worn inside of a shoe that supports the arch of the foot and helps to place it in a biomechanically balanced position. Orthotics or orthoses are used for a variety of reasons, not just for foot and ankle problems, but some practitioners will prescribe them for knee, hip, and/or back ailments. The patients that benefit the most from orthotics are the ones that have the most unstable feet. This can be someone that has a flat foot who pronates (rolls their ankle inward) excessively during gait or someone that has a high arch that cannot find a shoe that provides enough support and therefore puts excessive stress on the midfoot joints and the ball of the foot. Many of the most common diagnoses seen in a podiatry practice are treated with orthotics. These include, but are not limited to:
1. Plantar Fasciitis
2. Tendonitis
3. Arthritis
4. Apophysitis/Sever’s Disease (Growth Plate Problems)
5. Ball of Foot Pain (Neuromas, Metatarsalgia)
6. Bunions and Hammertoes
Orthotics both treat these diagnoses and help to prevent or slow the progression of the deformity or painful condition. For example, orthotics will not get rid of a bony bump, such as a bunion, but they will place the foot in a better supported, balanced position which will slow or halt the bunion’s progression.
There are prefabricated orthotics and there are prescription custom orthotics. Both serve a purpose. A solid shell prefab device provides much more support than almost any shoe that is available and is great for someone with an average arch height and a foot that is pretty “normal”. A custom made device is made directly from imprints, casts, digital scans, etc. and is specific for that patient. These are better than prefab orthotics for this reason. Often times a patient will start in a prefab and improve, but may plateau. This is a time the fine-tuned custom devices will give that extra needed benefit. Most local insurance plans cover custom orthotics when they are deemed medically necessary.
At Westfield Foot and Ankle, LLC a digital gait scan is done of the patient's feet both in static(standing) and dynamic(walking)phases of gait. The majority of the information that is gleaned from this scanning comes from the dynamic portion, which tells us what the feet are doing during gait. The pressure distribution is clearly seen. Prior to the scan, a comprehensive examination of the feet is done to determine what modifications may be needed, such as posting to further reduce the amount of pronation or rolling in of the ankle while walking. Overpronation is the culprit in many foot and ankle pathologies. Orthotics prevent this.
To schedule an appointment with Dr. David Sullivan visit www.westfieldfoot.com or call Westfieldf Foot and Ankle at 317-896-6655.
Skin Cancers of the Foot
Let’s shed light (but not too much) on a topic that is often overlooked. That is the topic of skin cancers and unknow skin lesions of the feet and lower legs. No one knows for sure 100% of the time what a lesion on the skin is unless it is examined under a microscope by a pathologist. That is why educating yourself on what to look for and protecting yourself from the sun are so important.
There are several things that you can look for yourself that can raise or lower your level of suspicion about this “mole”:
A - Asymmetry – normal moles are usually round or oval
B – Borders – normal moles have even borders
C – Color – normal moles are usually a consistent shade of brown
D - Diameter – normal moles are usually less than ¼” and don’t grow
E – Evolution – normal moles remain the same for years
This A-E type of description is specific for melanoma. Other skin cancers may have red patches with open or bleeding crusts or scabs that heal then re-open. They may appear wart-like or have a scar-like appearance that is white, yellow, or waxy. Also, looking for “moles” that look different from surrounding moles raises suspicion.
Squamous Cell Carcinoma and Basal Cell Carcinoma are two other prevalent skin cancers.
Basal Cell Carcinoma is the most common and if caught in early stages is almost 100% curable. Look out for an irritated or red patch, a shiny nodule or pinkish growth, or even a lesion with a crusted, indented center. In dark haired people they can even be confused with a mole. Most importantly look for white-yellow waxy appearing scar like area with abnormal borders. This can indicate that the tumor underneath is larger than it appears.
Squamous Cell Carcinoma is the second most common skin cancer. As with other skin cancers increased sun exposure increases risk of development. Many of these (40-60%) cancers begin as precancerous growths known as Actinic Keratoses or Solar Keratoses that range in size from 1mm to 1 inch and in color from brown to red. 2-10%of Actinic Keratoses progress to Squamous Cell Carcinoma. The carcinoma typically appears as persistent roughened and thick scaly occasionally bleeding patch. They can be mistaken for warts or skin ulcerations that don’t heal as expected.
To accurately diagnose a skin lesion a biopsy is taken. If it is small enough, then the entire lesion is usually excised. If it is a larger lesion, then a 2-millimeter punch biopsy is done. The lesion is then sent to the lab which reports on it in 3-5 days. This will dictate care from that point on.
This article has provided some basic information on what to look for. Do not try to be your own expert. Have a professional examine these questionable lesions.
For prevention, remember, “Slip-Slop-Slap”. Slip on a shirt, slop on sunscreen, and slap on a hat.
There are several things that you can look for yourself that can raise or lower your level of suspicion about this “mole”:
A - Asymmetry – normal moles are usually round or oval
B – Borders – normal moles have even borders
C – Color – normal moles are usually a consistent shade of brown
D - Diameter – normal moles are usually less than ¼” and don’t grow
E – Evolution – normal moles remain the same for years
This A-E type of description is specific for melanoma. Other skin cancers may have red patches with open or bleeding crusts or scabs that heal then re-open. They may appear wart-like or have a scar-like appearance that is white, yellow, or waxy. Also, looking for “moles” that look different from surrounding moles raises suspicion.
Squamous Cell Carcinoma and Basal Cell Carcinoma are two other prevalent skin cancers.
Basal Cell Carcinoma is the most common and if caught in early stages is almost 100% curable. Look out for an irritated or red patch, a shiny nodule or pinkish growth, or even a lesion with a crusted, indented center. In dark haired people they can even be confused with a mole. Most importantly look for white-yellow waxy appearing scar like area with abnormal borders. This can indicate that the tumor underneath is larger than it appears.
Squamous Cell Carcinoma is the second most common skin cancer. As with other skin cancers increased sun exposure increases risk of development. Many of these (40-60%) cancers begin as precancerous growths known as Actinic Keratoses or Solar Keratoses that range in size from 1mm to 1 inch and in color from brown to red. 2-10%of Actinic Keratoses progress to Squamous Cell Carcinoma. The carcinoma typically appears as persistent roughened and thick scaly occasionally bleeding patch. They can be mistaken for warts or skin ulcerations that don’t heal as expected.
To accurately diagnose a skin lesion a biopsy is taken. If it is small enough, then the entire lesion is usually excised. If it is a larger lesion, then a 2-millimeter punch biopsy is done. The lesion is then sent to the lab which reports on it in 3-5 days. This will dictate care from that point on.
This article has provided some basic information on what to look for. Do not try to be your own expert. Have a professional examine these questionable lesions.
For prevention, remember, “Slip-Slop-Slap”. Slip on a shirt, slop on sunscreen, and slap on a hat.
Hammertoe Surgery
Thinking About Hammertoe Surgery?
Many people develop what are referred to as hammertoes that are unsightly and often painful. They usually develop because of an imbalance with the muscles of the foot that help flex and extend the toes. The deformity and pain can be worsened with constrictive or ill-fitting shoes. The bony prominence at the joints become pronounced and become an area of increased pressure within the shoe. A bursitis (small, inflamed, fluid-filled sac) may develop over the prominence and be an added source of pain. Conservative treatment options/lifestyle changes include, but are not limited to:
-Wearing appropriate width and depth shoes
-Strapping/Padding of the affected toes
-Corticosteroid injection or Anti-Inflammatory medication for bursitis
There are surgeons who will shorten the toes strictly for cosmetic reasons, but this is not a widely accepted practice. However, surgical intervention is indicated if there is pain. There are several different methods for straightening of the toe. Many of these utilize wires, screws, or other types of implants to maintain the correction of the deformity. Sometimes additional procedures are needed on the joints and bones in the foot where the toes “attach”. A much more simple procedure can be performed in the office with only 2-3 bandaids for dressing and splinting. It requires no downtime. When the toe is contracted or hammered, but can be manually corrected during the exam, a simple procedure on the tendon that flexes the toe can be performed. This is done with local anesthesia. No stitches are needed. There is a small amount of loss of muscle strength in the toe, but this is more pronounced in the other types of surgeries mentioned and also typically not that important to the patient that is suffering pain. For the right patient it is an excellent alternative to enduring a long recovery process. It is also a fraction of the cost when comparing it to the charges associated with performing surgery in an OR setting.
For a more comprehensive explanation of what a hammertoe is, please visit www.westfieldfoot.com. This site will provide you with a library of information that will prepare you for your visit with the doctor. An overview ov anatomy, biomechanics, how hammertoes form, and what is involved with treatment are all covered comprehensively.
Dr. Sullivan performs the above mentioned procedure in his office on a regular basis with excellent results. The recovery is almost not an issue because there are no sutures and only involves a couple of bandaids for 1-2 weeks. Risks of infection and other common complications associated with hammertoe surgery that involves cutting of bone are avoided much better.
Many people develop what are referred to as hammertoes that are unsightly and often painful. They usually develop because of an imbalance with the muscles of the foot that help flex and extend the toes. The deformity and pain can be worsened with constrictive or ill-fitting shoes. The bony prominence at the joints become pronounced and become an area of increased pressure within the shoe. A bursitis (small, inflamed, fluid-filled sac) may develop over the prominence and be an added source of pain. Conservative treatment options/lifestyle changes include, but are not limited to:
-Wearing appropriate width and depth shoes
-Strapping/Padding of the affected toes
-Corticosteroid injection or Anti-Inflammatory medication for bursitis
There are surgeons who will shorten the toes strictly for cosmetic reasons, but this is not a widely accepted practice. However, surgical intervention is indicated if there is pain. There are several different methods for straightening of the toe. Many of these utilize wires, screws, or other types of implants to maintain the correction of the deformity. Sometimes additional procedures are needed on the joints and bones in the foot where the toes “attach”. A much more simple procedure can be performed in the office with only 2-3 bandaids for dressing and splinting. It requires no downtime. When the toe is contracted or hammered, but can be manually corrected during the exam, a simple procedure on the tendon that flexes the toe can be performed. This is done with local anesthesia. No stitches are needed. There is a small amount of loss of muscle strength in the toe, but this is more pronounced in the other types of surgeries mentioned and also typically not that important to the patient that is suffering pain. For the right patient it is an excellent alternative to enduring a long recovery process. It is also a fraction of the cost when comparing it to the charges associated with performing surgery in an OR setting.
For a more comprehensive explanation of what a hammertoe is, please visit www.westfieldfoot.com. This site will provide you with a library of information that will prepare you for your visit with the doctor. An overview ov anatomy, biomechanics, how hammertoes form, and what is involved with treatment are all covered comprehensively.
Dr. Sullivan performs the above mentioned procedure in his office on a regular basis with excellent results. The recovery is almost not an issue because there are no sutures and only involves a couple of bandaids for 1-2 weeks. Risks of infection and other common complications associated with hammertoe surgery that involves cutting of bone are avoided much better.
Mourning Morning Heel Pain?
Stabbing, aching, sharp shooting, feels like a stone bruise…these are some of the descriptions of pain that many people complain of when they have heel pain, especially on their first few steps out of bed in the morning. When people either have mechanical issues with their feet or have added stress to them, they often get symptoms similar to those just mentioned. Plantar fasciitis (planter fash-e-ite-is) is the most common heel pain diagnosis. It is caused by excessive physical stress to the plantar fascia (fasha), which is a strong, wide, fairly thick ligament that stretches from the heel to the ball of the foot. The reason that this pain is often worse on the first few steps out of bed or after any amount of rest is that the fascia tightens when at rest when that rest comes after a physically demanding activity. Then, when weight is placed on the foot it naturally wants to flatten out, but the tight fascia does not want to stretch, so it jerks on the heel bone where it attaches or sometimes along its course through the arch. This causes inflammation and pain. The physically demanding stress can be any or a combination of the following:
-poor foot mechanics
-weight gain
-prolonged stance or walking
-uneven terrain
-poor shoegear/poor support
-new exercise routine
-excessive barefoot walking
If this condition goes undiagnosed or untreated for several months, then the inflamed tissue thickens similar to scar tissue. The vast majority of patients respond very well to conservative treatment with only 3-5% requiring surgical intervention. Treatment begins with determining the actual stress, then it may include: orthotics, cortisone injections, anti-inflammatory medication, education on shoes, splinting, lifestyle changes, and physical therapy. If pain is not adequately controlled with conservative treatment then surgery is usually the next step. Call Westfield Foot and Ankle for an appointment and you will soon be thankful that you did.
Stabbing, aching, sharp shooting, feels like a stone bruise…these are some of the descriptions of pain that many people complain of when they have heel pain, especially on their first few steps out of bed in the morning. When people either have mechanical issues with their feet or have added stress to them, they often get symptoms similar to those just mentioned. Plantar fasciitis (planter fash-e-ite-is) is the most common heel pain diagnosis. It is caused by excessive physical stress to the plantar fascia (fasha), which is a strong, wide, fairly thick ligament that stretches from the heel to the ball of the foot. The reason that this pain is often worse on the first few steps out of bed or after any amount of rest is that the fascia tightens when at rest when that rest comes after a physically demanding activity. Then, when weight is placed on the foot it naturally wants to flatten out, but the tight fascia does not want to stretch, so it jerks on the heel bone where it attaches or sometimes along its course through the arch. This causes inflammation and pain. The physically demanding stress can be any or a combination of the following:
-poor foot mechanics
-weight gain
-prolonged stance or walking
-uneven terrain
-poor shoegear/poor support
-new exercise routine
-excessive barefoot walking
If this condition goes undiagnosed or untreated for several months, then the inflamed tissue thickens similar to scar tissue. The vast majority of patients respond very well to conservative treatment with only 3-5% requiring surgical intervention. Treatment begins with determining the actual stress, then it may include: orthotics, cortisone injections, anti-inflammatory medication, education on shoes, splinting, lifestyle changes, and physical therapy. If pain is not adequately controlled with conservative treatment then surgery is usually the next step. Call Westfield Foot and Ankle for an appointment and you will soon be thankful that you did.
Pregnancy and Foot Pain
Pregnant? Feet Hurt?
You don’t have to be barefoot AND pregnant to cause harm to your feet. Either one adds stress to the feet for different reasons. With pregnancy comes weight gain and typically swelling in the feet (most commonly in the 3rd trimester). The stress on the feet from added weight can result in multiple foot ailments including:
1. Plantar Fasciitis
2. Achilles Tendonitis
3. Peroneal or Posterior Tibial Tendonitis
4. Stress Fractures
5. Ingrown Toenails
There is concern when treating musculoskeletal problems during pregnancy because xrays obviously need to be avoided. A good clinician should be able to diagnose most of these problems without x-ray. MRI’s and other forms of advanced imaging are sometimes needed to confirm a diagnose, so often times the suspected diagnosis is treated without a definite diagnosis, so as not to put the fetus at risk. Supportive shoegear and orthotics will typically decrease the stress enough to either eradicate or at least lessen the pain of the first three ailments listed above. Stress fractures may be immobilized. Ingrown toenails are typically treated in the same manner as when not pregnant.
Added stress from weight is not the only cause for discomfort in the feet during pregnancy. Many women suffer from significant swelling in the feet, especially during the third trimester. This causes much frustration when putting on shoes. It is highly advised that pregnant women have there shoe size checked throughout pregnancy. Pay attention to width and the depth of the toe box, not just the length. Swelling can be controlled with compression hose to some degree, but rest and elevation along with routine exercise to keep the fluid pumping efficiently through your system is the best way to control this common problem.
A well trained Podiatrist will know what treatment regimen is best for each patient. The biomechanics of one pregnant patient will not be the same as another. That is why custom foot orthoses provide the most benefit to patients with problems related to the positioning and balance of their feet, ankles, knees, hips, and back. These devices prevent overpronation and therefore decrease the stress during stance and gait on many structures including the plantar fascia, Achilles Tendon, multiple joints at different levels, and many other soft tissue and bony structures of the foot.
Edema control is done through disciplined use of the compression hose. These come as prefabricated and custom. If they are not worn, then they will not work. Gravity will also decrease swelling. Keep the feet elevated above the level of the heart for the quickest reduction in swelling. This will help reduce pain associated with poor fitting shoegear and general irritation.
Remember: You don’t have to live with your foot pain just because you are pregnant. There are many ways to safely treat problems of the feet and ankles without putting you or your baby at risk. Contact me at Westfield Foot and Ankle, LLC. www.westfieldfoot.com OR 317-896-6655
You don’t have to be barefoot AND pregnant to cause harm to your feet. Either one adds stress to the feet for different reasons. With pregnancy comes weight gain and typically swelling in the feet (most commonly in the 3rd trimester). The stress on the feet from added weight can result in multiple foot ailments including:
1. Plantar Fasciitis
2. Achilles Tendonitis
3. Peroneal or Posterior Tibial Tendonitis
4. Stress Fractures
5. Ingrown Toenails
There is concern when treating musculoskeletal problems during pregnancy because xrays obviously need to be avoided. A good clinician should be able to diagnose most of these problems without x-ray. MRI’s and other forms of advanced imaging are sometimes needed to confirm a diagnose, so often times the suspected diagnosis is treated without a definite diagnosis, so as not to put the fetus at risk. Supportive shoegear and orthotics will typically decrease the stress enough to either eradicate or at least lessen the pain of the first three ailments listed above. Stress fractures may be immobilized. Ingrown toenails are typically treated in the same manner as when not pregnant.
Added stress from weight is not the only cause for discomfort in the feet during pregnancy. Many women suffer from significant swelling in the feet, especially during the third trimester. This causes much frustration when putting on shoes. It is highly advised that pregnant women have there shoe size checked throughout pregnancy. Pay attention to width and the depth of the toe box, not just the length. Swelling can be controlled with compression hose to some degree, but rest and elevation along with routine exercise to keep the fluid pumping efficiently through your system is the best way to control this common problem.
A well trained Podiatrist will know what treatment regimen is best for each patient. The biomechanics of one pregnant patient will not be the same as another. That is why custom foot orthoses provide the most benefit to patients with problems related to the positioning and balance of their feet, ankles, knees, hips, and back. These devices prevent overpronation and therefore decrease the stress during stance and gait on many structures including the plantar fascia, Achilles Tendon, multiple joints at different levels, and many other soft tissue and bony structures of the foot.
Edema control is done through disciplined use of the compression hose. These come as prefabricated and custom. If they are not worn, then they will not work. Gravity will also decrease swelling. Keep the feet elevated above the level of the heart for the quickest reduction in swelling. This will help reduce pain associated with poor fitting shoegear and general irritation.
Remember: You don’t have to live with your foot pain just because you are pregnant. There are many ways to safely treat problems of the feet and ankles without putting you or your baby at risk. Contact me at Westfield Foot and Ankle, LLC. www.westfieldfoot.com OR 317-896-6655
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