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Stephan J. LaPointe, DPM, PhD, FACFAS

Featured

Featured

Monday, 22 October 2018 00:00

Whether in practice or in the game, athletes put their bodies through great stress. Some sports demand more from the body than others. However, every sport has an element of inorganic movement or unnatural motion. For example, in softball, a pitcher winds up and flings her body with an incredible amount of dexterity in order to get the most ideal velocity out of her pitches. This motion, incredibly taxing on the body, can cause serious injury.

One of the most common issues of athletic injuries happens in the feet. If it’s a damaging fracture that leaves the athlete sidelined or just a simple turf toe, foot injuries can still be very frustrating and painful. Regardless of the sport, athletes still require use of their feet in some fashion. This is why foot therapy is extremely vital for getting athletes back on the right track to return to the field.

No matter the injury, the best way to speed up the recovery period is to receive physical therapy. Physical therapy has proven to work for millions of people. Professional physical therapists are specifically trained to help people return to proper form from any injury.

During physical therapy, you will go through organized training in order to get back into form. Sometimes training can be quite difficult, especially in the beginning when there is more pain and the foot feels awkward. To alleviate this, you will do basic twisting and stretching exercises in order to get flexibility and foot mobility back up. The therapist will also massage the injured area to activate and relax muscles. Over time you will eventually move up to strengthening exercises, designed specifically so that the injured area is exercised.

Foot therapy for sports is a modern science miracle. Unlike other treatments that may employ the use of fancy chemicals and terminology, physical therapy is an evidence-based practice that offers the same benefits. Due to huge advancements in the knowledge of muscles and joints, doctors can turn catastrophic injuries around so that athletes can return to the game once more. 

Monday, 15 October 2018 00:00

It is no secret that high heels are uncomfortable to wear for long periods of time. Although beauty is pain, you should not sacrifice the health of your feet for a stylish heel. Wearing high heels can potentially cause many different foot conditions that may be avoided by wearing proper footwear.

The structure of high heels forces weight of your body to get shifted forward toward the ball of the foot. The higher the heel you wear, the more weight and pressure get shifted forward. The pressure that your toes may experience from wearing heels may lead to hammer toes, bunions, and ingrown toenails. Extra weight and pressure resulting from wearing heels may cause stress fractures. Furthermore, heels may cause pinched nerves which may result in Morton’s neuroma.

High heels are even more dangerous for people who are clumsy. Falling or tripping while wearing heels can cause an ankle sprain or twist.

What many people don’t know is that heels can also cause back and knee problems. In order for your body to stay balanced on heels, your spine has to sway unnaturally, which adds stress to your spine muscles. This may cause you to experience a sore lower back.  

If you decide to wear high heels regardless of the risks associated with them, there are ways you can minimize their harmful effects. One way to reduce injury is to massage and stretch your legs at the end of the day. Stretching can prevent the Achilles tendons and calf muscles from becoming too tight. If you are simply looking for more height, wedges and platforms provide a better surface area to distribute the body weight across compared to thinner heels.

If you experience pain from wearing high heels, it is important to see a podiatrist before any of your symptoms become worse.

Monday, 08 October 2018 00:00

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area.  It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.

Monday, 01 October 2018 00:00

Blisters are a common ailment of people who wear shoes that are either too tight or rub against the feet in an uncomfortable way. Knowing the basics of blisters is important for understanding how they are formed and what treatments should be used for them.

A blister on the foot, or any other part of the body, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery-like fluid that usually isn’t cause for concern. However, blisters can fill up with blood if they are deep enough and pus if they have become infected with bacteria.

Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time or when your shoes do not fit you properly. Your feet are also more prone to blisters if they are moist, so keeping them dry and clean is one preventative step you can take.

Preventing infection should be the number one concern when treating blisters, as well as relieving the pain they can cause. Using a bandage to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop. You can also take a sterilized pin and try to pop it yourself.

If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics may need to be taken in order to completely eliminate the bacteria inside the blister. See a doctor to have an antibiotic prescribed.

The best way to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a bandage to an area where you think a blister is about to form is another way you can prevent them.

Monday, 24 September 2018 00:00

Although rheumatoid arthritis attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA, such as a rheumatoid factor test. There is, however, no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.

Monday, 17 September 2018 00:00

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Monday, 10 September 2018 00:00

Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.

Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.

It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.

There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.

Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes. 

Tuesday, 04 September 2018 00:00

Extracorporeal Shockwave Therapy (ESWT) is an alternative treatment method that is used for bone and soft tissue disorders in the foot and ankle. EWST is a noninvasive option for pain relief and it was originally created to help dissolve kidney stones. This therapy works by focusing impulses to target the area in pain. This method has been proven to show a reduction in the amount of nerve fibers that transmit painful impulses, which leads to a reduction in pain. Shockwave therapy can also expedite the tissue which would, in turn, increase the amount of new blood vessels that are formed.

Conditions that can be treated with shockwave therapy include Achilles pain and heel pain. People with plantar fasciitis may opt for this therapy and the results are usually great after 18 months. Additionally, this method can also be used to treat fractures that have failed to heal correctly. Anesthesia is not required to perform this treatment. It usually is not painful, but it can be uncomfortable.

The duration of treatment sessions usually lasts 5-15 minutes each. This procedure is safe since there is no risk of infection from wound complications, if you are looking to try shockwave therapy to heal plantar fasciitis, it may take 3-4 sessions to start working. After treatment, patients typically notice a dull pain in the area which was treated. However, this pain rarely lasts more than 24 hours.

Nevertheless, there are pros and cons that come along with Shockwave Therapy. The most obvious pro is that this treatment is noninvasive, meaning surgery will not be required. Another upside is that there have been very little complications that have been found with this procedure. On the other hand, those who opt for surgery are at risk for continued pain, wound problems, and infections. The biggest con for ESWT is that it is very expensive; it typically costs around $1,000 before insurance. Another con is that the effectiveness of the treatment is questionable. Usually, if this treatment is helpful, the difference is small.

If you are curious about Shockwave Therapy, you should talk to your podiatrist to see if this treatment method is right for you. At times, patients will find that there are other treatment options that are more efficient for their individual cases.

Monday, 27 August 2018 00:00

The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three phalanges except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.

Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.

Another type of toe fractures is a stress fracture. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity instead of a single injury. Stress fractures occur when the muscles in the bone become too weak to absorb impact. Consequently, the toe bone becomes vulnerable to any pressure and impact it endures. Symptoms for a stress fracture in the toe include swelling without bruising, tenderness to the touch, pain that goes away with rest, and pain after walking or running.

If you suspect that you have a broken toe, you should make an appointment with your podiatrist. He or she will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more. 

Monday, 20 August 2018 00:00

Cracked heels may make you want to think twice about showing off your feet in warmer weather. However, cracked heels may be harmful to more than just the appearance of your feet. If deep fissures and cracks develop in your heels, they may make walking and standing painful for you. Additionally, these openings make way for germs to enter through your skin and cause infection.

There are several different causes of cracked heels. One of the most common reasons for this ailment is dry skin. This problem may make your keeps feel rough tight and itchy. Dry skin may be caused by cold air, extremely hot water, harsh soaps, and aging. Skin disorders such as eczema and psoriasis may eventually lead to dry skin. In some cases, complications may arise from cracked heels. Some of these complications are a loss of feeling in the heel, cellulitis, or a diabetic foot ulcer.

There are ways you can try to prevent getting cracked heels. One of the best ways to do so is to avoid wearing flip flops and sandals because these shoes increase your risk of drying out your feet. You should also avoid wearing shoes with a tall skinny heel, because these shoes cause your heel to expand sideways. At night, you should slather on a thick moisturizing cream on your feet and then cover them in socks to keep your feet moisturized overnight. Drinking water to stay hydrated is also a good way to ensure that your skin doesn’t become dry.

If you suffer from a severe case of cracked feet, you should make an appointment with your podiatrist to see what treatment methods are best for you.

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