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Houston
Pearland


October 2017

Monday, 30 October 2017 00:00

What Are Hammertoes?

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

Monday, 30 October 2017 00:00

What is Hammertoe and Mallet Toe?

An imbalance in either the muscles, ligaments, and tendons in the foot that keep the toes straight can cause hammertoe or mallet toe. Causes of this imbalance can stem from improperly-fitted shoes, trauma, and even foot structure. An abnormal bend in the middle joint of a toe is called hammertoe. When the joint nearest to the toenail is affected, this condition is called mallet toe. Poorly-fitted shoes can result in the toes becoming compressed which can result in the condition. Simply wearing properly-fitted footwear may cause the toes to become uncompressed and restore balance in the foot. However, surgery may be needed if the issue stems from trauma or foot structure, and if symptoms become more severe or do not go away.

Hammertoe

Hammertoes can be a painful condition to live with. For more information, contact Dr. Linda D. Nachmani from Central Foot & Ankle Associates. Our doctor will answer any of your foot- and ankle-related questions.

Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.

Symptoms

  • Pain in the affected toes
  • Development of corns or calluses due to friction
  • Inflammation
  • Redness
  • Contracture of the toes

Causes

Genetics – People who are genetically predisposed to hammertoe are often more susceptible

Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur

Trauma – Direct trauma to the toes could potentially lead to hammertoe

Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe

Treatment

Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it

Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used

Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option

If you have any questions please contact one of our offices located in Houston, and Pearland, TX. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about What Are Hammertoes?
Monday, 23 October 2017 00:00

Sports Related Foot And Ankle Injuries

Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.

Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.

Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication.  A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.

Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.

Tough break for Boston Celtics forward Gordon Hayward. Hayward badly fractured his left ankle during the Celtics and Cleveland Cavaliers game. He jumped up for a pass but collided with Lebron James and Jae Crowder. When he landed, his foot twisted and he collapsed. Hayward had signed a $128 million four year contract with the Celtics. The Celtics and Cavaliers game was his first time playing for the Celtics.

Sports related foot and ankle injuries require proper treatment before players can go back to their regular routines. For more information, contact Dr. Linda D. Nachmani of Central Foot & Ankle Associates. Our doctor can provide the care you need to keep you pain-free and on your feet.

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are a common occurrence when it comes to athletes of any sport. While many athletes dismiss the initial aches and pains, the truth is that ignoring potential foot and ankle injuries can lead to serious problems. As athletes continue to place pressure and strain the area further, a mild injury can turn into something as serious as a rupture and may lead to a permanent disability. There are many factors that contribute to sports related foot and ankle injuries, which include failure to warm up properly, not providing support or wearing bad footwear. Common injuries and conditions athletes face, including:

  • Plantar Fasciitis
  • Plantar Fasciosis
  • Achilles Tendinitis
  • Achilles Tendon Rupture
  • Ankle Sprains

Sports related injuries are commonly treated using the RICE method. This includes rest, applying ice to the injured area, compression and elevating the ankle. More serious sprains and injuries may require surgery, which could include arthroscopic and reconstructive surgery. Rehabilitation and therapy may also be required in order to get any recovering athlete to become fully functional again. Any unusual aches and pains an athlete sustains must be evaluated by a licensed, reputable medical professional.

If you have any questions please feel free to contact one of our offices located in Houston, and Pearland, TX. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Sports Related Foot And Ankle Injuries
Monday, 16 October 2017 00:00

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.

To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.

Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.

Monday, 16 October 2017 00:00

What is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a condition in which the posterior tibial nerve in the tarsal tunnel becomes pinched or compressed. This causes a number of symptoms including burning and shooting pain, a pins and needles sensation, numbness, and tightness in the foot. There are several reasons why the nerve could become compressed, which include bony prominences, bone spurs, abnormal heel position, and the swelling of tendons in the tarsal tunnel. Due to the nature of tarsal tunnel syndrome, diagnosis may be difficult because it can seem to mimic the symptoms of other conditions; heel pain and arch pain are some examples. It is best to see a podiatrist if you are experiencing any of those symptoms. Podiatrists can offer a number of treatments, such as orthotics, taping or bracing, rest, icing, anti-inflammatory medication, or even surgery if other treatments do not improve your condition.

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Dr. Linda D. Nachmani of Central Foot & Ankle Associates. Our doctor can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

  • Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
  • Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
  • At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

  • Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
  • The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
  • If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

If you have any questions please feel free to contact one of our offices located in Houston, and Pearland, TX. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Tarsal Tunnel Syndrome
Monday, 09 October 2017 00:00

Rheumatoid Arthritis in the Feet

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.

A recent study published in the Arthritis Care and Research journal found that those who are obese and have rheumatoid arthritis may benefit greatly from bariatric, or weight-loss, surgery. While the study needs more research before conclusive results can be firmly established, early statistics note huge improvements in patients.  Out of the 53 patients who have rheumatoid arthritis (RA) and undergone bariatric surgery, only six percent were found to have moderate to severe disease activity 12 months after surgery. Six years after having the surgery, 74 percent of the patients were classified as being in remission. This contrasted with the only 24 percent achieving remission with RA medications before surgery.  While these results are excellent, there are many factors that are unknown; one such factor is whether bariatric surgery is more effective in reducing RA symptoms than diet and exercise. Furthermore, bariatric surgery may potentially lead to osteoporosis, a condition characterized by weak and brittle bones.. Ultimately, for those who have RA, are obese, and considering bariatric surgery, there are many factors that have to be taken into account. If you are overweight and suffer from arthritic pain in your feet, consulting with a podiatrist is recommended. 
 

Because RA affects more than just your joints, including the joints in your feet and ankles, it is important to seek early diagnosis from your podiatrist if you feel like the pain in your feet might be caused by RA. For more information, contact Dr. Linda D. Nachmani of Central Foot & Ankle Associates. Our doctor will assist you with all of your podiatric concerns.

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the body’s own immune system attacks the membranes surrounding the joints. Inflammation of the lining and eventually the destruction of the joint’s cartilage and bone occur, causing severe pain and immobility.

Rheumatoid Arthritis of the Feet

Although RA usually attacks multiple bones and joints throughout the entire body, almost 90 percent of cases result in pain in the foot or ankle area.

Symptoms

  • Swelling and pain in the feet
  • Stiffness in the feet
  • Pain on the ball or sole of feet
  • Joint shift and deformation

Diagnosis

Quick diagnosis of RA in the feet is important so that the podiatrist can treat the area effectively. Your doctor will ask you about your medical history, occupation, and lifestyle to determine the origin of the condition. Rheumatoid Factor tests help to determine if someone is affected by the disease.

If you have any questions please feel free to contact one of our offices located in Houston, and Pearland, TX. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Rheumatoid Arthritis in the Feet

Running may seem like a simple to do. However, running is actually a complex movement that puts stress on the ligaments, bones, and joints of the body.  Selecting the correct running shoe is important for increasing performance and avoiding risk of injury.  Running shoes should be selected based on your foot type.  Considerations such as trail versus road shoes are important. Your foot type dictates the degree of cushioning, stability and motion control you require.  The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes.  Professionals can measure your arch type, stride and gait and help you with your shoe needs.

The design of running shoes is created around the idea of pronation.  Pronation is the natural rolling movement of your ankle from the outside to inside when your foot strikes the ground.  If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more.  Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy.  Those considered neutral runners pronate correctly and do not need running shoes that help correct their form.  Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types.  However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation. They may require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling.  Even while standing, those who severely overpronate display ankles that are angled inward.  It is not uncommon for them to have flat feet or curved legs.  The tendency to overpronate may cause many injuries.  Areas that tend to become injured are the knees, ankles, and Achilles tendon.  If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control.  Motion-control shoes are straight and firm. Shoes of this type do not curve at the tip.  The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes the ground.

A less common problem is underpronation.  Underpronation, also called supination, is when the feet are unable to roll inward during landing.  Those who underpronate have feet that lack flexibility and high arches.  This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees.  This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact.  Those who underpronate need shoes with more cushioning and flexibility.  If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

Monday, 02 October 2017 00:00

Heel Pain Can Be Treated!

Do you suffer from heel pain when you get up in the morning? If so, you should seek the professional help of your podiatrist and have a proper diagnosis performed. Heel pain can be caused by several different foot-related conditions.

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