The Care You Deserve

PATIENT EDUCATION

What is a Podiatrist?

A podiatrist, also called a doctor of podiatric medicine, is a specialist who provides medical diagnosis and treatment of foot and ankle problems, such as bunions, heel pain, spurs, hammertoes, neuromas, ingrown toenails, warts, corns and calluses. A podiatrist also renders care of sprains, fractures, infections, and injuries of the foot, ankle and heel. In addition to undergraduate medical school training, podiatrists also attend graduate school for a doctorate degree in podiatry. Podiatrists are required to take state and national exams, as well as be licensed by the state in which they practice.

According to the American Podiatric Medical Association, there are an estimated 15,000 practicing podiatrists in the United States. Podiatrists are in demand more than ever today because of a rapidly aging population. In addition, according to the association, foot disorders are among the most widespread and neglected health problems affecting people in this country.

Typically, podiatrists:

• Consult with patients and other physicians on how to prevent foot problems.
   

• Diagnose and treat tumors, ulcers, fractures, skin and nail diseases, and deformities.
   

• Perform surgeries to correct or remedy such problems as bunions, clawtoes, fractures, hammertoes, infections, ruptured Achilles, and other ligaments and tendons.
   

• Prescribe therapies and perform diagnostic procedures such as ultrasound and lab tests.
   

• Prescribe or fits patients with inserts called orthotics that correct walking patterns.
   

• Treat conditions such as: bone disorders, bunions, corns, calluses, cysts, heel spurs, infections, ingrown nails, and plantar fasciitis.

When To Call a Doctor

People call a doctor of podiatry for help diagnosing and treating a wide array of foot and ankle problems. Please contact our office if you experience one of the following:

• Persistent pain in your feet or ankles.

• Changes in the nails or skin on your foot.

• Severe cracking, scaling, or peeling on the heel or foot.

• Blisters on your feet.

There are signs of bacterial infection, including:

• Increased pain, swelling, redness, tenderness, or heat.

• Red streaks extending from the affected area.

• Discharge or pus from an area on the foot.

• Foot or ankle symptoms that do not improve after two weeks of treatment with a nonprescription product.

• Spreading of an infection from one area of the foot to another, such as under the nail bed, skin under the nail, the nail itself, or the surrounding skin.

• Thickening toenails that cause discomfort.

• Heel pain accompanied by a fever, redness (sometimes warmth), or numbness.

• Tingling in the heel; persistent heel pain without putting any weight or pressure on your heel

• Pain that is not alleviated by ice or over-the-counter painkillers (such as aspirin, ibuprofen or acetaminophen).

• Diabetics with poor circulation who develop Athlete's Foot.

Foot Anatomy

The foot is made up of 26 bones, 33 joints, 107 ligaments, 19 muscles, and numerous tendons. Complex biomechanics keep all these parts in the right position and moving together. Given these intricacies, it is not surprising that most people will experience some problem with their feet at some time in their lives.

Within each foot, the essential structure can be summed up as follows:

• Seven short tarsal bones make up the heel and back of the instep.

• Five metatarsal bones spread from the back of the foot toward front and make up the structure for the ball of the foot. Each metatarsal is associated with one of the toes.

• Fourteen phalanges, small bones, form the toe structure.

• Tarsal and metatarsal bones provide the structure for the arch of the foot.

• Bands of ligaments connect and hold all the bones in place.

• A thick layer of fatty tissue under the sole helps absorb the pressure and shock that comes from walking and everyday movements.

Basic Foot Care Guidelines

1. Don't ignore foot pain. It is not normal. If you experience any type of persistent pain in the foot or ankle, please contact our office.

2. Inspect your feet regularly. Pay attention to changes in color and temperature. Look for thick or discolored nails (a sign of developing fungus), and check for cracks or cuts in the skin. Peeling or scaling on the soles of feet may indicate Athlete's Foot. Any growth on the foot is not considered normal.

3. Wash your feet regularly, especially between the toes, and be sure to dry them completely.

4. Trim toenails straight across, but not too short. Be careful not to cut nails in corners or on the sides; this can lead to ingrown toenails. Persons with diabetes, poor circulation, or heart problems should not treat their own feet, because they are more prone to infection.

5. Make sure that your shoes fit properly. Purchase new shoes later in the day when feet tend to be at their largest, and replace worn out shoes as soon as possible.

6. Select and wear the right shoe for each sport or activity that you are engaged in (e.g., running shoes for running).

7. Alternate shoes—don't wear the same pair of shoes every day.

8. Avoid walking barefooted. Your feet will be more prone to injury and infection. At the beach or when wearing sandals always use sunblock on your feet.

9. Be cautious when using home remedies for foot ailments. Self-treatment may turn a minor problem into a major one.

10. If you are a diabetic, please contact our office and schedule a check-up at least once a year.

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Diabetic Foot Care

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According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Here's some basic advice for taking care of your feet:

• Always keep your feet warm.

• Don't get your feet wet in snow or rain.

• Don't put your feet on radiators or in front of the fireplace.

• Don't smoke or sit cross-legged. Both decrease blood supply to your feet.

• Don't soak your feet.

• Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.

• Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.

• Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.

• Wash your feet every day with mild soap and warm water.

• Wear loose socks to bed.

• Wear warm socks and shoes in winter.

• When drying your feet, pat each foot with a towel and be careful between your toes.

• Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.

• Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.