Dr. Kennan T. Runte, DPM, FACFAS
Dr. Panah Nabili, DPM
152 Catherine Lane, Suite F
Grass Valley, CA 95945
Grass Valley, CA 95945
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Tuesday, 02 November 2021 00:00
Obesity is a common problem in American society. Approximately one third of the U.S. population is obese. Obesity is defined as a body mass index greater than 30. Obesity has the power to affect different aspects of the body, and one of the most common problems it causes is foot pain. There have been many studies that found a connection between an increased BMI and foot problems. A simple activity such as walking up a flight of stairs can increase pressure on the ankle by four to six times.
Being overweight causes the body to compensate for the extra weight by changing the way it moves. Consequently, people who struggle with obesity commonly have arch problems in their feet. Obesity causes the arch to break by stretching the ligaments and tendons that hold the bones in the foot together. When the arch lowers, the foot may eventually fall flat. Collapsed foot arches fail to provide adequate shock absorption which eventually leads to foot pain. Other conditions that may be caused by flat feet are pronation, plantar fasciitis, weak ankles, and shin splints.
Foot problems that are caused by obesity may be treated by wearing proper footwear. Proper shoes will allow your feet to have better circulation around the arch and ankle. Additionally, those with obesity often discover that typical heel pain remedies are not effective for them. They will find that their plantar fascia is easily injured, and it is often inflamed. The best way to treat this problem is to implement lifestyle changes. A few good ways to improve your diet are to reduce calories, fill up on fruits and veggies, and to limit sugars.
Custom foot orthotics can prevent foot problems if you’re carrying excess weight or are trying to lose weight. The purpose of orthotics is to provide shock absorption to decrease the amount of stress on the joints to prevent arthritis.
Tuesday, 26 October 2021 00:00
A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.
Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.
A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.
Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.
For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.
Tuesday, 19 October 2021 00:00
In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.
Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.
Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.
Tuesday, 12 October 2021 00:00
The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.
The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.
If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.
Tuesday, 29 June 2021 00:00
Broken ankles are a serious injury that can lead to an inability to walk, function, and also cause a significant amount of pain. A broken ankle is a break in one of the three bones in your body that connect at the ankle joint: the tibia, the fibula, and the talus. The tibia and fibula are your two primary leg bones that connect at the knee, which sit directly upon the talus bone. This is protected by a fibrous membrane that allows for movement in the ankle joint. A broken ankle is usually caused by the foot rolling under or twisting too far, causing one of these three bones to snap.
A broken ankle is different from an ankle sprain, which occurs when the ankle ligaments are ripped or torn but no bones have been broken. A sprain can still be very severe, causing bruising in the foot and an inability to hold your own weight, much like a broken ankle would. If you’re unable to stand, and suspect that you have a broken ankle, the first thing to do would be to get an immediate X-ray to determine the severity of the break.
A common cause of broken ankles is when the ankle is rolled over with enough pressure to break the bones. This usually happens during exercise, sports, or other physical activity. Another common cause is a fall or jump from a tall height.
One immediate treatment for pain relief is elevating the foot above your head to reduce blood flow to the injured area. You can also apply ice packs to your ankle to help reduce swelling, redness, inflammation, and pain. After these initial steps, getting a cast and staying off your feet as much as possible will aid in the recovery of the broken ankle. The less movement and stress the ankle has to endure, the more complete it will heal. A doctor can determine if surgery is needed in order to heal correctly. In these cases, an operation may be the only option to ensure the ability to walk properly again, followed by physical therapy and rehabilitation.
It is highly important to determine if surgery is needed early on, because a broken ankle can become much more severe than you realize. If not professionally treated, the broken ankle will inhibit your walking, daily functioning, and produce a large amount of pain. Treating your broken ankle early on will help prevent further damage to it.
Tuesday, 05 October 2021 00:00
Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.
Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.
The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.
Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.
Tuesday, 28 September 2021 00:00
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
Tuesday, 21 September 2021 00:00
A corn is a lesion that forms in the skin of the foot, and it is typically circular in shape, small in size, and thick and rough in texture. A corn generally occurs as a result of repeated pressure on the skin; one example of this is the rubbing of a shoe against the skin. Corns differ from calluses in that their central cores are harder in texture.
A corn is a relatively common condition with a wide variety of treatment options. If a corn becomes overly uncomfortable or painful, consult with your podiatrist; he can determine the best method of treatment that is appropriate for you. Corns may return if the underlying cause of its development is not treated or removed. Avoid removing corns at home, as improper removal may cause infection.
A callus, similar to a corn, is an area of skin that has become thickened due to repeated pressure and rubbing. The rubbing causes the skin to create a layer of protective skin, which is the formed callus. Calluses can differ in size between people, and they can also become painful.
Multiple treatments are available for calluses. At-home treatment and removal should be avoided, as this can potentially lead to infection. Your podiatrist can best determine the cause of your calluses and suggest the treatment most appropriate for you.
Tuesday, 14 September 2021 00:00
The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.
The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.
An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.
Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.
Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health.
It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.
Tuesday, 07 September 2021 00:00
Blisters are pockets of fluid that occur under the top layer of your skin. These fluid pockets are usually filled with pus, blood, or serum. Blisters may itch or hurt and can appear as a single bubble or in clusters.
The most common types of blisters are friction blisters. This type of blister may be caused by wearing shoes that are too tight. Friction blisters can also occur on the hands. A change in temperature may also cause blisters on the feet. In the freezing air, frostbite on your toes can lead to blisters, as well as sunburn from hot weather.
The best way to treat a blister is to keep it clean and dry. Most blisters will get better on their own. Once the skin absorbs the fluid within the blister, it will flatten and eventually peel off. You should avoid popping your blister unless you podiatrist does it for you. Additional treatment options include applying an ice pack to the blister or using over-the-counter blister bandages to cover the affected area.
If your blister becomes discolored, inflamed, or worsens it is advised that you speak to your podiatrist. Blisters that are yellow, green, or purple may be infected and require immediate medical attention. Blisters that are abnormally colored may be a sign of a more serious underlying health condition such as herpes.
