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A new treatment option which combines ultrasound waves and steroid injections was found to be effective in patients suffering from plantar fasciitis, according to a groundbreaking study from the University of Genoa in Italy.

The plantar fascia is a connective tissue in the heel that stretches the bottom length of your foot. Plantar fasciitis is the inflammation of this connective band, causing heel pain and overall discomfort while walking or standing. Although the condition is completely treatable, traditional methods can take up to a year to start being effective.

These conventional treatments include arch support, night splints, certain exercises, and overall rest and staying off your feet. The previous effective method for curing plantar fasciitis was shockwave therapy, in which sound waves are directed to the area where the pain is being experienced, often the heel. Despite the success of shockwave therapy, it could be considered somewhat slow, requires several sessions before any results are noticed, and is comparably expensive. However, even shockwave therapy does not cure the pain caused by plantar fasciitis in every patient.

The study, conducted by Luca M. Sconfienza, M.D., examined the effects of a new technique that combined ultrasound-guided methods, similar to shockwave therapy, with a steroid injection directly the plantar fascia. Because of the added steroid injection, the method becomes a one-time outpatient procedure involving a small amount of local anesthesia, in which a needle punctures the affected area and causes a small amount of bleeding that aids in the heeling of the fascia. This technique is referred to as dry-needling.

Dr. Sconfienza determined that 42 of the 44 patients involved in the new procedure had their symptoms, including pain, disappear entirely within three weeks. “This therapy is quicker, easier, less painful, and less expensive than shockwave therapy,” Dr. Sconfienza stated. “In cases of mild plantar fasciitis, patients should first try non-invasive solutions before any other treatments. But when pain becomes annoying and affects the activities of daily living, dry-needling with steroid injection is a viable option.”

Monday, 22 June 2015 00:00

Ankle Foot Orthotics For Athletes

Ankle and foot orthotics, known as AFOs, are custom-made inserts, shaped and contoured to fit inside a shoe and used to correct an irregular walking gait or provide cushioning. Orthotics come in a variety of different models and sizes, including both over the counter and customizable variants. Customizable ones should be prescribed through a podiatrist who specializes in customized footwear and orthotics design and management.

AFOs are often used by athletes including track and field runners, cyclists, professional dancers, ice skaters, and even golfers. They benefit a lot from custom made AFOs by preventing injuries from occurring and provide cushioning to keep pain levels down to a minimum. Ankle foot orthotics allow for the correct positioning of the feet and also act as shock absorbers to help keep pressure and stress off the foot and ankle. They can also relieve back pain and hip pain while restoring balance and improving an athlete’s performance.

The way they help alleviate pain is by controlling the movement of both your feet and ankles. They are custom designed by a podiatrist or orthopedic specialist to help treat foot problems such as flat feet, spurs, arthritis of the ankle or foot, ankle sprains, weakness, and drop foot, a condition in which the patient cannot raise their foot at the ankle joint.

With custom orthotics, a patient will go through a complete examination of the foot and ankle, followed by the ankle and foot being cast and fitted for the proper orthotic. Depending upon the final result of the tests, a stretching treatment is created with specific shoe fitting in mind. After they have been fitted to the shoes, adjustments can be made in order to get the perfect fit and completely fill out the shoe. Evaluations are then usually set up to monitor the patient in the coming weeks to see how they are adjusting.

AFOs are also available over the counter and are more common than custom fit ones. Athletes that have generally low aches and pains in the foot, ankle, or lower back area can use an over the counter version of these orthotics. Weight is still distributed evenly throughout the bottom of the foot thanks to the arch support they give, but when an injury or ailment occurs, it is usually not enough to try and remedy it with an over the counter version. In either case, a podiatrist will be able to offer the best advice and treatment when it comes to foot and ankle orthotics and handle all your foot care needs.

Monday, 18 May 2015 08:42

Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually 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, although there is 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, 04 May 2015 00:00

What to Know About a Broken Toe

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma, as they will be able to diagnose the injury and recommend the appropriate treatment options. 

Athletes will often sustain sprained ankles; they are one of the most common injuries sports players receive. It is general knowledge that sprained ankles are painful and debilitating conditions that often keep players off their feet and away from activity. Once an ankle is sprained, the occurrence of re-injury is much more likely.

After sustaining a sprained ankle, the sports medicine doctor and physical therapist recommended the RICE method as a method to get back on one’s feet and get back into playing sports. RICE is an acronym that stands for rest, ice, compression, and elevation—the four things one should do to recover from a sprained ankle.

Along with the RICE method, an athlete should wear an ankle brace to help alleviate the pain and secure the ankle until it has fully healed. A brace will stabilize the ankle as well as prevent it from sustaining other more serious injuries. People often suffer from sprained ankles due to weak ligaments located in or near the ankle; because an ankle brace keeps the ligaments in the foot from experiencing excessive movement, injuries can be avoided.

Another common injury many athletes experience are foot and ankle fractures. Stress fractures in particular often occur when there is an increase in athletic training for an athlete. There are two types of stress fractures: stable and displaced. Stable stress fractures are marked by a lack of shifting in bone alignment, whereas displaced stress fractures are characterized by bones that are not properly aligned.

Stress fractures warrant an immediate trip to the hospital or doctor. Treatment for stress fractures often involves significant rest and refraining from taking part of the sport that caused the injury. Strenuous activities should also be avoided. Certain doctors or specialists have the ability to specifically determine what in an athlete’s training caused the stress fracture.

If this can be pinpointed, the athlete can therefore adjust his or her training accordingly without having to worry about refraining from playing the sport. Special attention must be paid to treatment for foot and ankle injuries such as sprained ankles and stress fractures. Athletes should be sure to rest before engaging in activity. With great care and attention to treatment comes a faster and more successful recovery.

Monday, 06 April 2015 00:00

Hyperhidrosis of the Feet

Plantar hyperhidrosis, or hyperhidrosis of the feet, affects approximately 1-2% of Americans. Plantar hyperhidrosis is characterized by excessive sweating in the feet not set by other causes such as exercise, fever or anxiety. Many people affected by plantar hyperhidrosis also suffer from palmar hyperhidrosis, or excessive seating of the hands, in addition.

Normally sweating is a process used by the body’s sympathetic nervous system to cool itself and maintain a steady internal temperature. In individuals affected by hyperhidrosis, the sympathetic nervous system produces far more sweat than actually needed.
Plantar hyperhidrosis is considered a primary hyperhidrosis, as secondary hyperhidrosis refers to excessive sweating in areas other than the feet, armpits or hands. Secondary hyperhidrosis could indicate other medical conditions such as Parkinson’s disease, hyperthyroidism and menopause.

Symptoms of plantar hyperhidrosis include athlete’s foot, infections, blisters and foot odor. Due to the continual moisture, socks and shoes can rot, creating an additional odor that can ruin the materials and cause socks and shoes to need frequent replacement. In addition to physical symptoms, this disorder can also affect emotional health as this disorder can be embarrassing.

Hyperhidrosis can persist throughout an individual’s life if left untreated. Fortunately, there are several treatment options available. A common first approach is using a topical ointment often containing aluminum chloride, an ingredient found in antiperspirants. Another treatment method is using Botox, which is injected directly into the foot, and can effectively minimize the sweat glands in the injected area. These injections need to be repeated every 4 to 9 months.

If either of these treatments prove ineffective, oral prescription medications may be taken to alleviate the symptoms. As with any treatment, some will experience relief while others do not. Another method that reportedly provides relief is going barefoot.

A final approach to fighting plantar hyperhidrosis is through surgery, although it is less successful on those with hyperhidrosis in the feet as opposed to hands. Surgery is only recommended when the sweating is severe and other treatments have failed to work. This type of surgery involves going into the central nervous system and cutting nerves to stop transmission of signals telling the foot to sweat.

Monday, 30 March 2015 00:00

What Are Ankle/Foot Orthosis?

Ankle-foot orthosis are braces worn at the ankle that encompass some or all of the foot. Diseases that affect the musculature or weaken the affected area require orthosis to strengthen the muscles or rehabilitate them and other joints of the foot and ankle. Tight muscles that need to be lengthened and loosened also benefit from orthosis.

When we think of diseases that affect the musculature we think of the big boys: muscular dystrophy, cerebral palsy, polio and multiple sclerosis. We rarely think that arthritis and stroke can affect the musculature, but these are both conditions that can negatively affect the muscles in your foot and ankle.

However, the good news is that whatever trauma there is that affects those muscles, there is a way to correct it. The orthosis helps to control range of motion, provide support by stabilizing walking, correct deformities, and manage pain loads. A podiatrist would be consulted for those who have experienced direct trauma to the foot or ankle, have an arthritic condition that is affecting their joints, or has developed another kind of muscular disease.

Before the advent of modern orthosis devices, it wasn’t uncommon to see polio victims wearing metal braces from mid thigh to the bottom of the foot, or children wearing metal braces around their ankle and foot. However, both designs and materials have improved dramatically, allowing for new levels of comfort, functionality, and appearance. Many orthosis are now made from plastics in the shape of an L and designed to fit inside a corrective shoe. These can be rigid, buckling at the calf and extending the length of the foot to support the ankle. This same design except with a hinged ankle provides support while walking by normalizing the gait. In the past, boots lined with leather and fiberboard provided the rigidity needed for correction and support. Now corrective shoes are available with built up soles to correct the gait or manage pain by sharing it with another area when the foot spreads during walking.

The podiatrist would prescribe this orthosis in the rigid L shape because the foot moves on a hinge. If the hinge isn't functioning as intended due to an injury or malformation, the muscles tighten up, thus making it difficult to flex the foot. When we walk, the foot flexes and muscles stretch. This brace or orthosis would support the ankle and musculature during flexion of the foot, in much the same way a knee brace works. Corrective shoes are for people whose feet hit the ground backward, causing tight muscles and arch problems. Wedges and rocker bars on the heels correct the step to heel first and rock onto the ball of the foot, resulting in relaxed musculature and strengthened ankles.

Appearance also counts when we consider a particular support device, especially if the item is intended for regular, daily wear. The L shaped orthosis is contoured to the calf and flesh-colored, fitting into a sneaker or dress shoe. At present, corrective shoes are more attractive than past models, enabling patients wear such devices with greater comfort and confidence.

Monday, 23 March 2015 00:00

Hammertoe: No Walk in the Park!

Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.

Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.

A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.

In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.

If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.

Some tips on feet may include purchasing shoes at mid-day as your feet are smaller in the morning and swell as the day progresses. Ensure that she shoes you buy are both the same size and have the store stretch shoes at painful points to provide for optimum comfort.

Thursday, 05 March 2015 00:00

Working on Your Feet

Overworking your feet can put stress on your entire body, so taking care of your feet is an absolute priority for overall good health. Standing all day can cause a myriad of different conditions such as bunions, callouses, and plantar warts. These conditions are all very painful but can be avoided with proper foot care, which includes both proper posture and good shoe choices to contribute to the overall health of your feet.

A good place to start is choosing a show that has a negative heel which places the heel slightly lower than the ball of the foot, as shoes designed this way are best for your foot health. Having a job that keeps you on your feet all day makes it an especially a good idea to spend the extra money on a good pair of shoes. And most definitely purchase your shoes from a reputable manufacturer who puts foot health at the forefront of their goals. Having a job that keeps you on your feet all day makes it an especially a good idea to spend the extra money on a good pair of shoes.

The feet were not designed to be enclosed for hours on end. In fact, incorporating some "barefoot" time into your daily routine is not a bad idea to improve overall foot health. There are some other simple things that you can do to help alleviate pain and pressure on the feet from standing all day.

One of the first things you can do is perform some simple foot exercises and some common yoga moves to improve the function of your feet. Foot work outs that aid in your movement will stimulate blood flow and muscles of your feet. Yoga exercises that stretch your feet out flat on the floor can be very beneficial for you if you work on your feet all day. It can also help stretch and relax the calf muscles and Achilles tendon, both of which can become problem areas if not taken care of. You can perform these exercises every day during your daily routine, at the office, at the gym, or even before you go to bed simply stretching your feet out can do wonders for your foot health.

Foot pain that occurs every day because you work for long hours on your feet may lead you to think that this pain is inevitable. However, it does not have to be. Foot stretches and proper footwear work well in alleviating foot pain and preventing further foot problems.

With a little effort and some education, you can keep your feet healthy and feeling good. If your feet hurt, your whole body will eventually feel the effects over time. Start taking care of your feet today!

 
Monday, 23 February 2015 13:02

Keeping Children's Feet Healthy

As a parent, your most important job is taking care of your children in every possible way. You watch what they eat, you protect them from harm, but it is important to be proactive in taking care of their health, especially when it comes to their feet. Having healthy, well taken care of feet in childhood is crucial in helping eliminate problems later in life, especially in the back and legs. As children grow, their feet require different types of care. Here are some ways you can help keep your children's feet healthy, from birth to school age.

Babies require a lot of care in general, but don't forget their feet. Since babies don't walk yet, their feet can be easy to overlook, but it is still important to take care of them. In the first year of life a baby's feet grow and change very much, so it is important that you do not put any tight shoes or socks on your baby's feet. Let your baby stretch and kick her feet so he or she can feel comfortable.

When a baby turns into a toddler, they are now on the move and it is important that your toddler has comfortable and protective shoes to walk in. Now is the time you may notice different things about your child's feet, but know that children at this age are just getting the feel for walking, so don't be alarmed if they seem to walk funny. It is normal for a toddler to be unsteady on their feet.

When your child gets older and leaves the toddler stage behind, it is now important that you teach them how to take care of their own feet. Show them proper cleaning and hygiene so that their feet do not develop fungus or infection. Since children are constantly running and playing, it is also important to watch out for injury or pain. Children are still growing, and certain injuries can effect the bones growth and development so it is vital to have all injuries checked by a doctor as soon as possible. Comfortable shoes that cushion the foot and provide protection from hours of rough play are highly recommended.

Children and babies are constantly growing and developing, and it is your job as a parent to make sure that nothing is hindering their ability to mature at a normal rate. This includes properly taking care of the feet, as healthy feet are important in order to live a normal, fulfilling life. 
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