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Illustration of osteoarthritis and rheumatoid arthritis in feet.
23Feb

foot arthritisThe inflammation of one or more joints causes pain and stiffness common in arthritis in foot. Many forms of arthritis that affect the foot, making it difficult to enjoy activities such as walking. The foot has more than 30 joints and 28 bones which allow movement. The joints are covered with articulate cartilage, which helps the bones to glide over each other, a thin lining surrounding the joints that produce a lubricant fluid to reduce friction. Studies have shown great connections between foot alignment, hip, and knee. Hip osteoarthritis is common among high arched feet people while knee osteoarthritis is common with flat-footed people. With proper treatment, it is possible to lead a fulfilling and active life.

Psoriatic arthritis

This is the inflammation of the tendons and ligaments attached to the bones, causing foot joint pain especially the toes. They cause sausage-like swelling. The irritation happens in the tissue that connects the heel bone and toes, which cause pain when rubbed or pressed on other bones.

Symptoms

  • Heel pain that is easily confused with the Achilles tendon.
  • Swelling of the toes.
  • Stiff ankles and feet.
  • Overextended big toe
  • Painful calluses and sore joints.
  • Bending toes looking shorter like claws.
  • The skin around the affected joints turns purplish.
  • Flattening arch which leads to rolling of the foot inward while walking or standing.
  • The tendency of joints to lock and limit the range of motion.
  • Foot swelling.
  • Difficulty and pain while walking after a long period of rest or in the morning.

Maintain mobility by taking physiotherapy or wearing shoes that do not pinch and bind areas of inflammation. Take foods rich in omega 3 fatty acids, fiber such as oatmeal, beans, and brown rice, and take green tea to reduce inflammation.

Rheumatoid arthritis feet

Joint inflammation in multiple joints of the feet and hands is a sign of rheumatoid arthritis. It is considered symmetrical because it affects the same joints on both sides of the body and it is autoimmune. This means that the immune system attacks its tissues such as the thin lining covering the joints causing them to swell. The lining, in turn, attacks cartilage, tendons, ligaments, and bones leading to disability and deformity.

Over 85% of patients report painful ankles and feet, causing instability in hindfoot causing deformation of the forefoot. Correcting the plantar stabilizes the ankle and foot, reducing foot deformities and walking disabilities.

The function of footwear in arthritis in feet

Footwear is an effective strategy to improve the function of the feet and reduce pain in arthritis. Women are at greater risk of knee and hip osteoarthritis while the use of high heels shoes has been implicated. Contrary to belief, high heeled shoes do not promote joint degeneration, though they have been associated with the development of foot pain. Arthritis in the foot is prevalent in older people and it increases with age. High heels, slippers, and sandals are poor shoes that cause foot pain in later years, it is advisable to wear average shoes. Poor shoes contribute to poor foot alignment and development.

The foot pain has a modifiable factor, especially if it affects the extremity joint alignment, though little focus is made on foot interventions. Footwear and orthotics interventions are important in foot health. Biomechanical evidence indicates that footwear plays a significant role in the treatment of osteoarthritis of the foot, knee, and hip and the treatment of rheumatoid arthritis. A running shoe-shaped toe rocker sole reduces foot joint pain by decreasing forefoot loading by promoting a normal heel-toe rolling. Custom made foot orthotics reduce pain, increase stride length and steps. Specialized footwear reduces is an effective non-surgical intervention for the feet affected by arthritis.

If you have any questions, please feel free to contact our office located in Cypress, TX. We offer the newest diagnostic and treatment technologies for all your foot care needs.

Close-up of a person receiving foot massage for plantar fasciitis relief.
17Feb

plantar fasciitis6

This is a common heel pain that is widespread in middle-aged adults, which one can wish away. The pain manifests itself when taking the first steps in the morning. The plantar fascia ligaments are the shock absorbers of your feet and when they are inflamed or damaged they can cause pain in one or both heels. Several treatment options are effective when tailored to the patient’s preferences and risk factors. Problems resulting in plantar fasciitis include hard walking/running surfaces, an increase of weight-bearing activity, worn shoes and increased intensity of activity. Early detection of the problem means a shorter course treatment with a high probability of success with conservative treatments.

Some treatment of plantar fasciitis includes

  1. Using lavender essential oil

According to a study in 2015, the lavender essential oil contains anti-inflammatory properties used in treating pain caused by inflammation. Dilute a drop of the essential oil in a oil carrier such as coconut or olive oil and massage at the bottom of your feet. Adding a few drops of the oil in a warm foot bath is also recommended.

  1. Plenty of rest

This has been discovered to be an effective treatment that works best. For active adults who require walking and standing long, they might have a challenge complying with this requirement. You must have an outlined rest plan and find alternative activities to avoid aggravating the pain. If possible, avoid working on hard surfaces.

  1. Wear supportive shoes

Wear shoes with a low heel that provides good arch support, especially if you are on your feet most of the time. The appropriate shoes help support the plantar fascia and prevent inflammation. If you are in sports it is important to wear the right shoe to avoid experiencing foot pain from running.

  1. Use orthotics

Most medical practitioners recommend footpads or orthotic shoe inserts, especially if you have high arches, to distribute weight evenly. You can get ready-made orthotics available in pharmacies or request custom made orthotic inserts from your podiatrist.

  1. Stretching

Stretching corrects various dysfunctional factors such as tightness of the foot muscles and improves the flexibility of the calf muscles. There are stretching techniques that help relieve plantar fasciitis. Calf stretches, toe stretches, and towel stretches are some stretches that should be done in the morning and several times a day. For towel stretches, roll the towel and pull both ends when placed under the ball of your foot.

  1. Wear night splint

Night splints relieve pain by stretching the calves and arches overnight. If you have had plantar fasciitis for more than six months, these are recommended for you. They are available in soft and hard models and can be used from one to three months.

  1. Massage

Simple massage techniques soothe pain in the heel. Use thumbs to massage the heels and arches starting from the balls of the feet towards the heel. A golf ball can be used to massage the arches. Put the foot on the golf ball and roll the golf ball under your arch. Hang on a stable support item while doing this.

  1. Use an ice pack

Ice reduces inflammation and acts as a good massage aid. With a thin towel and cloth cover your ice pack and hold over the painful area for 15 to 20minutes; repeat this for at least three-four times a day. You can also roll the foot under the ice pack like the golf ball example.

  1. Lose weight

Extra weight adds pressure on the plantar fascia and losing a few pounds relives off the pressure. Work with a doctor who can put in place a plan that focuses on regular exercise and a balanced diet.

  1. Use NSAIDs

Nonsteroidal anti-inflammatory drugs reduce inflammation such include ibuprofen; they relieve pain caused by the inflamed plantar fascia. Only use the recommended dosage and consult a doctor to understand the interactions with other medications.

  1. Apply TENS therapy

TENS (Transcutaneous Electrical Nerve Stimulation), uses low voltage electrical stimulation to relieve pain. This treatment is non-invasive and can be done at home using a TENS unit or it can be done by a professional.

If the pain does not respond to home treatments seek medical assistance from foot specialists at DeNiel Foot & Ankle Center. Additional testing and X-rays can be done to rule out other causes of foot pain such as a heel spur. A doctor can use steroid injections and physical therapy when dealing with plantar fasciitis.

Podiatrist examining a patient's foot for diabetic foot issues.
10Feb

Podiatrist examining a patient's foot for diabetic foot issues.

The importance of eating a healthy, balanced diet, monitoring blood glucose levels, staying active, and taking prescribed medications can never be emphasized enough if you are diabetic; another important thing to add is regular foot exams. Foot exams reduce the chances of developing complications as a result of conditions that were not attended to early. There are self-exams and annual professional evaluations. Diabetes presents a high risk of foot problems such as diabetic foot ulcers and peripheral vascular disease to patients. Diabetic foot care looks out for injuries, infections or bone abnormalities. The main cause of diabetic feet problem is nerve damage and poor blood flow or blood circulation.

Alarming symptoms which require attention include 

  • Burning sensation
  • Tingling
  • Pain
  • Difficulty while walking
  • Numbness
  • Swelling

Symptoms that call for the immediate attention of a podiatrist include

  • A cut or a blister that is taking longer to heal.
  • If an injury is warm to touch
  • If an injury has redness around it.
  • The presence of callus with dried blood inside.
  • And a smelly, black injury which most likely is gangrene; this is the death of body tissue and if left untreated could lead to foot amputation or death.

What to expect when a podiatrist examines you

  1. General assessment where the podiatrist asks questions about your health and any problems you have had with your feet. They also ask about your footwear to be sure your shoes do not easily cause blisters, calluses, and ulcers.
  2. Dermatological assessment where the podiatrist will look for skin problems and signs of fungal infection.
  3. Neurologic assessment that includes a series of tests which are
    1. Monofilament test which particularly tests foot sensitivity.
    2. Tuning fork and VPT (Visual Perception Tests) – to check the sensitivity of the foot and toes to vibrations.
    3. Pinprick test to determine if you can feel a pin, poke your foot.
    4. Ankle reflexes – a tap below the knee to check your reflexes.
  4. Musculoskeletal assessment to check for abnormalities in the structure and shape of your foot.
  5. Vascular assessment using the Doppler ultrasound to check how well the blood is flowing to your feet.

Treatment

The provider might recommend frequent exams to monitor the progress, but for bone deformities, surgery can be recommended while antibiotics are administered to treat foot infections.

No specific treatment is administered for nerve damage, but treatments are given, such as skin creams, medicine, and physical therapy, to improve the function of the feet and relieve pain. 

How to go about diabetic foot care?

Wear appropriate fitting shoes or ask the doctor for custom shoes.

Keep moist away from your skin by wearing socks.

Clean your feet daily and apply a fragrance-free moisturizer, avoid applying in between the toes.

Trim toenails regularly

Avoid walking barefoot

Conduct daily foot self-exams to monitor changes.

Seek professional foot evaluation at least annually.

Manage diabetes as recommended by the health professional.

Avoid abrasive foot products

Exercise daily to keep the blood flowing.

Do not smoke as this leads to foot complications due to poor blood circulation and nerve damage.

Close-up of red, sore heels indicating running injury or plantar fasciitis.
4Feb

What Causes Running Injuries?

More than fifty percent of runners suffer from an injury every year. Every elite runner knows that being sidelined for running injuries, especially heel pain, Achilles tendon pain, and the plantar fasciitis, is disappointing. People think running injuries occur because they increased the distance or intensity, or they did not stretch before and after running among other reasons. Some of these reasons aggravate an already underlying problem.

Most injuries are due to biochemical imbalance which causes the breakdown of the body due to subjective repetitive load causes. Biochemical imbalances cause muscle weakness and other imbalances that cause running injuries include

foot pain

Muscle Flexibility Imbalances

A tight muscle is a common reason for a running injury. It is very possible to do a few stretches and get back running without pain. Simple, right! No, it’s not because the stretches help you re-align a muscle or tissue and you are back running again. The main question is what was the cause of the tight muscle? First, you need to find out why the muscle is overworking or tightening because stretching is a temporal solution. A tight hamstring may be as a result of weak abdominal muscles or glute muscle. These might be forcing the hamstring to compensate and with a few stretches you do not solve the weak abs or glutes and the problem might recur.

Soft Tissue Imbalances

This is complex, but changes in muscle tension can trigger points of fascia tightness. Muscle tension affects how the body functions, but with regular massage, the muscles relax.

Structural Imbalances

The body is not perfectly symmetrical; that is the right side of the body is not the same as the left side. People who cope well have minor asymmetries of the body depending on the number of differences. Others have severe structural imbalances that need more attention to avoid overstraining causing injuries from time to time.  

Muscle Strength Imbalances

For optimal functioning of the body, a balance between the inside and outside, the right and left side, the bottom and top, and the front and back of the body should be maintained. If the muscles of the right leg are weaker the muscles of the left leg will have difficulties. Unfortunately, there is never enough exercise to strengthen your muscles as you would expect. It is important to note that every joint in your body is affected when you work on one muscle. Effective muscle exercises need to be tailored individually for running purposes.

Some common running injuries include

Plantar fasciitis

This is an irritation of the fibrous tissue at the base of the heel due to forced strain on the plantar fascia. One experiences an arch pain or heel pain and the foot hurts with every step making running very difficult. This injury is common with runners who have very low or very high arches because the plantar fascia is forced to stretch. The pain caused by plantar fasciitis can continue for months and even years before completely healing so it should be treated as soon as possible.

Achilles tendon pain

The Achilles tendon is the strongest and thickest tendon connecting the back of the heel and calf muscles. The Achilles tendon injury is the painful inflammation of the tendon. The pain is common in the morning or with activity. Avoid training amidst this injury because the pain will eventually hinder the ability to jog lightly. Runners who have tight, weak calves are vulnerable to this injury.

Choosing the right running shoe is one of the protective ways in which runners can safeguard themselves from injuries. Correct your biomechanics to decrease the probability of injuries.

Close-up of toes with hammertoe deformity on sandy surface.
20Jan

Hammertoe: Insight

Hammer toe can be defined as a condition of foot deformity meaning a painful foot condition in which the toes curl and arch up that leads to heavy pain when wearing footwear. Hammer toe usually affects the second and third toe of the feet. Hammer toe can be diagnosed by doing a set of physical examination of the feet.

Close-up of toes with hammertoe deformity on sandy surface.

Cause of Hammer Toe

Most commonly a hammer toe occurs when the middle joint of the toe becomes bent or flexed downwards.

General Causes include

  • Pressure from bunion
  • Tightened ligaments
  • Arthritis
  • Traumatic toe injury
  • Damage in the spinal cord or peripheral nerve

 

Symptoms of hammer toe

Hammer toe is bound to give an uneasy discomfort while walking. It causes unbearable pain if intended to stretch the toe.

  • Bending toe
  • Calluses or corns
  • Toe looking like claw
  • Inability to flex the toe
  • Adapting difficulty in walking

 

hammer

Is surgery required for hammer toe?

Hammer toe surgery can never be the primary option. Hammer can be of different categories it may cause mild or severe. If there is severe hammer toe then hammer toe surgery is required. The best way to judge is to visit a doctor as soon as you feel uneasy.

Hammer toe surgery should be opted out in these basic following options

  • Active infection
  • Poor health condition
  • Poor blood circulation in the feet.

Doctors prescribe Hammer toe surgery in severe conditions such as joint toe fusion and joint resection or even if you have swollen toes.

Hammer toe surgery is considered to be the least choice left for any hammer toe patient. Therefore it is of utmost importance to meet a doctor as soon as possible because a mild hammer toe condition can also lead to serious mishaps. In case the doctors recommend doing a Hammer toe surgery then it may be simply out of a failure in responding to treatments.

How can hammer toe be treated?

Hammer toe can be cured by wearing appropriate footwear and wearing properly fitting shoes. Mainly the high arch toe condition is caused by wearing toe pads that do not fit better. Correct toe pads shift the toe position that relieves the toe for getting overlapped from pressure.

Hammer toe treatment can be done using over the counter cushions, bunions, corns, and medications. Applying over the counter creams provides relief to blistering infections, and an ice pack can be used as Hammer toe treatment as well.

Preventive measures for hammer toe

Hammer toe problems in most cases have found out to be either from family history or chronically using tight pointed shoes. 

Eventually, a hammer toe can be avoided by taking certain stringent changes in your daily routine.

  • Must avoid wearing shoes that are tight and narrow or don’t fit well. An especially woman who wears heels up to 6 inches must cut it down to 2 inches.
  • Choose shoes that are much wider from the tip that gives you ½ inch between the end of the longest toe and inside the tip of the show.
Detailed illustration of the Achilles tendon connecting calf muscles to the heel.
14Jan

Understanding the Achilles Tendon

The achilles tendon is known to be the largest tendon in your body that extends from calf muscles to the bones of the heel. You can feel it at the back of your ankle and above your heel. To feel the achilles tendon at work, while on your feet, point your toes to the floor and raise the tips of your toes. Injuries to this tendon are often associated with mild or moderate pain or sudden stiffness in that part of the leg. In severe cases of achilles tendon pain, it may be because the tendon is torn or possibly ruptured. 

achilles tendon

Causes of Injuries To The Achilles Tendon

The injury is common if someone is engaging in activities that require quick sprints, slow downs or pivots. Some of these activities are dancing, football, tennis, volleyball, softball, gymnastics, running, etc. Furthermore, repetitive strain of achilles tendon have been known to be a common cause of injury to the achilles tendon.

The achilles tendon connects to the achilles heel. The achilles heel bone can become tender with age and this increases the probability of an injury to the bone or tendon. This scenario is typically more severe for athletes that participate in quick movement sports.

How to prevent a foot injury to the achilles tendon?

To prevent an achilles tendon injury, some measures can be taken:

Daily stretching – It is necessary to stretch the calf muscles and achilles tendon daily to prevent injuries to this part of the leg. This will also improve your flexibility. 

  • Increase activity level slowly – With regular physical activity, the likelihood of experiencing pain from achilles tendon is very slim
  • Strengthen calf muscles – Strong muscles help the calf and achilles tendon to handle sudden stress caused by exercise or similar activities.  
  • Take it easy – Try to keep away from activities that can cause stress to your calf muscles and achilles tendon. Warm-up first before you try any strenuous activity.  
  • Choose shoes carefully – Choose the right shoes when exercising. Choose shoes that have suitable cushioning to reduce stress to your feet. Replace worn-out shoes. Finally, if the shoe is not comfortable, do not use it to exercise. 

Achilles Tendonitis Treatment

If you are dealing with Achilles tendonitis, the following steps can help alleviate the pain:

  1. Rest the injured leg as much as you can and do not put weight on the leg. 
  2. Ice it for at least twenty minutes and also do some stretches to avoid pain from the tendon.
  3. Compress your injured leg with the help of elastic bandages around the lower leg and  ankle to reduce the chances of swelling.
  4. You can take anti-inflammatory medicines which should help with pain and swelling. Take medicine only after consulting with a physician as it is necessary to use the right dosage
  5. While resting, try elevating your leg to get some relief.
  6. Try wearing heel lifts. Heel lifts in shoes give relief from achilles tendonitis pain.