Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

Rare Foot Conditions

A podiatrist will be able to address a variety of rare foot conditions, particularly the ones that affect children. The most common are Kohler’s disease, Maffucci syndrome, and Freiberg’s disease. They can be properly diagnosed by having an X-ray taken, but in more serious cases an MRI may be needed. Kohler’s disease generally affects younger boys and bone deterioration may result from an interruption of blood supply. Children who have Kohler’s disease may find relief when the affected foot is rested, and a special boot is worn. Benign growths in the long bones of a child’s foot may lead to the development of bone lesions, and this is known as Maffucci syndrome. People who have this condition find mild relief when custom-made orthotics are worn. Freiberg’s disease targets the ball of the foot and can typically affect pre-teen and teenage girls. The metatarsal bone becomes deteriorated and flattened, and common symptoms include swelling and stiffness. A cast is often necessary to wear with this disease as it can help to reduce existing pain. Erythromelalgia is a rare foot condition, and its cause is unknown. Symptoms of this disease can include intense burning pain and the feet may appear red or feel warm. Relief may be found when the affected foot is immersed in ice water. It can also be beneficial to elevate the foot frequently. If your child complains of foot pain, it is strongly suggested that you consult with a podiatrist who can diagnose and treat rare foot conditions. 

Various Causes of Ankle Pain

Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.

Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains. 

An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.

Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.

Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.

Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.

Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuriesflat feet, or an infection in the ankle.

Stress Fractures of the Foot and Ankle

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

Ankle Sprains

Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over-the-counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain occurs over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate-fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.

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.

How to Stretch Your Feet

Your feet endure a great amount of stress each day from constantly allowing us to move around. It is important to stretch your feet to help prevent them from becoming injured. Your toes may easily deform into unhealthful positions if they are not stretched.

One of the most common reasons for toe deformities are the shoes you may be wearing. Shoes that are too tight may fold and shift the toes out of place. Heeled shoes may also push your toes upward. Forcing your toes into an unnatural position which may cause the muscles to tighten and prevent them from reverting to normal length. Another common reason is improper use of foot muscles. Many people fail to use the muscles in their feet or toes when they walk. Lastly, the positioning of your feet while walking may also cause toe deformities. If you walk with your feet facing outward, your “push-off” phase is on the side of your big toe instead of the bottom of your foot. This may cause the big toe to eventually tighten into a new shifted position.

There are many reasons why stretching your toes may be helpful. One reason is that healthy spacing may aid in avoiding calluses and other injuries that are caused by rubbing.  Stretching will also prevent you from developing toes that curl, hammertoes, or bunions.

A great way to stretch your toes is to place them in your hands and bend them all downward; this will help you stretch the top of your foot. Next, you should repeat this process but instead bend them upward enough to feel a nice stretch in the bottom of your foot. You should then try to pull each toe apart from the next and pull any toes that are bent upward until they are back downward.

If you are looking to practice stretching your entire foot, you can try a towel stretch. This is done by sitting on the floor with your legs in front of you. Take a towel and wrap it around your toes. Afterward, pull the towel toward you with your toes and hold this position for 15 to 30 seconds before releasing. Practice this stretch for three sets. Another stretch your feet are towel lifts. This is done by sitting in a chair and trying to pick a towel up from the ground with your toes. Try lifting the towel with your little toes for five sets before switching feet.

If you are an athlete, or exercise often, it is especially important for you to practice stretching your feet. Those who suffer from foot pain caused by poor footwear, plantar fasciitis, or long hours of standing at work may also benefit from foot exercises.

Gout

Gout is a form of arthritis that is caused by a buildup of uric acid crystals in the joints. This considered to be one of the most frequently recorded medical illnesses throughout history. Gout occurrences in the US have risen within the past twenty years and the condition now affects 8.3 million people which is 4% of all Americans. Researchers have found that gout affects men more than women and African-American men more than white men. 

Symptoms of gout are warmth, swelling, discoloration, and tenderness in the affected joint area. The small joint on the big toe is the most common place for a gout attack to occur.

People who are obese, gain weight excessively, drink alcohol heavily, have high blood pressure, or have abnormal kidney function are more likely to develop gout. Furthermore, certain drugs and diseases are likely to increase levels of uric acid in the joints which eventually leads to gout. You are also more likely to develop gout if you eat a lot of meat and fish.

Many who experience gout attacks will experience repeated attacks over the years. Some people who have gout symptoms, may never have them again, but others may experience them several times a year. If you have gout symptoms throughout the year, you may have recurrent gout. Those who have gout should also be careful about their urate crystals collecting in their urinary tract, because this may lead to kidney stones.

Diagnosis for gout is done by checking the level of uric acid in the joints and blood. Your podiatrist may also prescribe medicine to reduce uric acid buildup in the blood, which will help prevent any gout attacks.

To treat gout, your podiatrist may also prescribe you Anti-inflammatory medication (NSAIDs) which will relieve the pain and swelling of a gout episode and it can also shorten a gout attack. Maintaining a healthy diet is also a proven method to prevent gout attacks. 

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

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