Many patients come to our office with swollen and tender feet and legs. Commonly these patients will complain of leg pain while standing or tightness around the legs. Often times if the swelling gets severe enough patients may have a hard time wearing shoes.
Typically chronic swelling that occurs in the foot and leg is due to fluid buildup. There are muscles within the veins of the leg that push blood back to the heart. As we age those muscles get tired and cannot push blood up to the heart as effectively as they should. Blood then becomes sluggish in the vein walls and swelling occurs. Swelling that is due to an inefficiency of foot and leg musculature of the veins is called venous insufficiency.
Venous insufficiency is a common problem that needs to be evaluated by a foot specialist or your primary care physician. If left untreated this could lead to clot in the leg called a deep vein thrombosis or a clot in the leg. A multitude of other problems can occur from a clot.
There are many simple treatments that can be performed within a podiatrist's office to diagnose this problem. There is a vein test that actually tests the muscles of the veins.
Once a diagnosis has been established treatment options are multiple depending on the diagnosis. There are oral medications to decrease fluid in the blood. There are also stockings that compress the foot and the leg and cause a constant pressure on the leg to keep swelling down at all times. There are even shoes which we stock in our office that accommodate daily swelling issues of the foot and ankle.
Many people develop fungal infections between their toes. There is typically is a lot of moisture between the toes and the webbed space of the toes becomes moist. What many people will see is a moist area that is reddened with a white discoloration. Sometimes the fungal infection will advance to a point where patients will develop a cheese like substance and have redness due to chronic inflammation of the site. Fungus loves to grow in warm, dark and moist locations. In between toes and on the webbed spaces is a safe haven for these funguses.
There are a multitude of ways to prevent fungal infections and the spread of the disease. Most importantly is moisture control by always wearing socks and changing them throughout the day when they become moist. Secondly spraying antifungal powder between the toes and on the top and bottom of the foot is quite important. Unfortunately while you wear a shoe there is usually a sweaty buildup and a fungal infection will occur in your shoes causing a chronic cycle of fungal infections in your foot. Antifungal powder should be sprayed or poured into your shoes after each wearing. There are many advanced treatments for fungal infections. These include prescription topical medications, oral medications, and even ultraviolet ray treatments of the inside of your shoe. If you have tried many of the methods of treatment outlined in this blog and you still have problems with this I would recommend following up with a foot specialist.
Have you ever gone for a long run and felt a rush of energy? This is commonly referred to as "runners high". People often turn to soda, coffee, and energy drinks for this energy boost, but it can easily be acquired through running. Along with this increased energy you can accomplish more in a day in a healthy way.
"Runners high" is caused by the increased production of endorphins in the brain. Endorphins are chemicals released in the brain that give you a feeling of well-being and diminishes senses of pain. This feeling doesn't only result from running; it can also be achieved through other types of exercise. "Runners high" can be an immediate result of physical activity resulting in more productivity, more restful sleep at night, and an overall happier existence.
With a decreased sense of pain during a run, the runner may often push themselves past their bodies limit without knowing at the time. Injuries can occur due to overexertion. Aches and pains are one of the less painful injuries that can occur from pushing yourself too hard. Often times, regardless of how careful you are, you will experience soreness the day after a run.
Patellofemoral Pain syndrome, also known as Runners Knee, is a common problem occurring from overexerting yourself during a run. A symptom of this is pain under and surrounding the knee cap. This can occur from rolling in or down on the foot while running. One way to decrease this knee pain is to take a break from running. Give yourself a day or two of rest, and then gradually increase the amount of time you are running. If you start to feel pain again take another break and start again with a slow run after a few days.
Icing your knees is also a good way to decrease pain and to speed up the healing process. After a run ice the knee for 10-15 minutes with a towel wrapped around the ice pack. Ibuprofen can also help to temporarily relieve discomfort.
Often times these methods of relieving the pain are only temporary. Talking to a podiatrist about running shoes can help your pains. Cheap running shoes are good for your wallet but are not helping your body to cope with the stress running puts on it. Talk with a podiatrist about running shoes that they recommend.
Orthotics are also very helpful to give your feet the support that they need during running. It's important to build a strong foundation for your body, especially during physical activity. If you don't have that strong foundation you may develop knee, hip, back, and shoulder pain, just from not having the proper support. An orthotic is a shoe insert that helps to give your body support and correct the way you walk or run. There are custom made orthotics that are molded to your feet and over the counter orthotics that are matched to your foot type as close as possible.
Running is a great way to stay in shape and be a happier more productive individual. It is so important to keep a close watch on what is stressing your body. Many of the problems that arise from running begin with your feet. It's crucial to see a podiatrist to discuss the type of shoe gear you need so you can run pain free.
A corn is a development of thickened dead tissue on a toe due to irritation. Corns can quite painful. It is typically due to mechanical irritation of the toe up against the shoe. The reason hammertoes are painful is either due to a corn or bursitis, which is an inflammation of the toe. Swelling sometimes occurs under the toe where the pressure is. It is important to be evaluated if you have a corn because the corn can become quite thick and can also cause an infection or ulceration (breakdown in the skin). Infections and ulcers can be dangerous with risk of bone infection and/or gangrene.
We commonly see this in diabetic patients who do not pay attention to their feet and present to the doctor's office with a swollen toe after weeks of bleeding and swelling. Most importantly we recommend being evaluated for this problem by a podiatrist. Multiple treatment options are available. Simple peeling of the corn can usually provide relief and a shoe gear change. Accommodative shoe gear is one way of conservatively treating the problem with an extra depth shoe or very wide sneaker. Many times the shoe is more the offending factor. If the toe is still swollen and painful after debridement we recommend possible cortisone injection. Lastly if conservative treatment fails we recommend a surgical procedure where we remove a small piece of bone and straighten the toe with very little post-op course.
People with high arches come into my office with a multitude of foot and ankle problems. A high arch is when the foot is shaped like a "c". This shape of the foot can cause various problems in the foot and the ankle. The mere shape of the foot causes many patients to land on- the heel and foot in an unstable manner. High arch, also called cavus foot, causes rigidity in the foot and the body's natural ability to absorb shock is hampered. Several other problems typically occur due to high arches, such a heel pain, Achilles tendinitis, painful bumps on the back of the heel called bone spurs and arch pain. The way the foot is shaped and high arched feet can be surgically corrected to change the way that it lands. The arch is typically stretched in a weird way and arch tissue gets inflamed and painful. Due to the instability bunions, or knob like structures on the side of the foot, occur and can get larger. Tendons on top of the foot and ankle typically will get strained because of the structure of the foot.
Treatment varies from patient to patient. It is important to have x-rays to see if there is what we call spurring, or bony growths (also called degenerative joint damage), that occurs due to this foot type. Caves or high arched feet can be surgically corrected, but we usually try a conservative treatment, which is usually is the treatment of choice. Typically custom orthotics, which are custom casted to your feet, will provide relief for our patients. Another device we use is an ankle foot orthotic, a bulkier device that completely encapsulates the foot and ankle. Shoe gear that is not structurally sound for a high arched foot could be quite problematic. We recommend that if you have a cavus foot type that you be evaluated by a podiatrist. Lastly, if you have a child that has this type of foot it would be best if the patient is evaluated because early detection is the key to healthier and less problematic scenarios that will occur in the foot.