Skip the Pedicure and see a Podiatrist!

 According to Wikipedia a pedicure is performed for “cosmetic, theraputic and medical purposes.” Now, it could simply be due to the fact that therapeutic is not even spelled correctly, or it could be due to the suspicion that arises when publicly accessed literature implies beauticians can perform “medical” procedures. Either way some red flags need to be raised when it’s been suggested a beautician is qualified to perform anything more than simple nail trimming and painting.  A few things to consider before your next pedicure:

•          Salons may try to re-use tools. This is a big issue for obvious reasons. Consider asking, or looking for clues of re-use next time a technician takes to those toes with a beauty tool. Every year there are many reported cases of Staph and sometimes-even MRSA infections due to nail salons re-using non-professionally sterilized tools. Believe it or not the liquid “antiseptic” solutions salons use generally only kill low-level pathogenicity microbes, rendering this practice fairly infective in actual disease prevention.

•          Although footbaths or whirlpools may seem like wonderful foot therapy if not properly cleaned with serious antiseptics after every single use they can harbor everything from HPV to MRSA.

•         Ingrown toenails (onychocryptosis) should never be attempted to be remedied by a nail technician! This is an actual medical condition that should only be treated with professionally sterilized tools by a health care professional such as a Podiatrist. Not only could the nail plate and bed be further damaged by an untrained individual, but serious infections are a huge risk as well.

•          Nail technicians want to augment your cuticles but this is a big “no-no”. Cuticles were put around your nails for a reason; they prevent infection as they make a seal between your nail plate and skin from the external environment.

These are just a few reasons to skip pedicures altogether and see the Podiatrist. If you still need further convincing check out one of the following links including articles written by US News, Huffington Post and the Washington Post…

US News article - Pedicure or Pedicurse?

Washington Post article

Huffington Post--5 Dangers awaiting you at the nail salon

**This blog, and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years, and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.

Runner's Toe

Have you noticed recurring blisters in the same areas on your feet? Have you experienced a small hematoma on the end of your 2^nd toe? Do you have pain in your big toe joint? These are all symptoms of poorly fitted shoes. Consider this; the average person walks 8,000-10,000 steps everyday according to the American Podiatric Medical Association (APMA). In conjunction to this terrific amount of repetition, the APMA also estimates that every step places about 1.5 times your body weight of force on your feet! Considering these two factors, it’s not difficult to see why in just a matter of days a variety of foot pathologies can arise simply due to ill-fitting footwear. Why chance your health by not having your shoes fitted by a Podiatrist? After all, preventative medicine is always more conducive to your budget than the alternative.

When Does Foot Pain Necessitate an Appointment?

When Does Foot Pain Necessitate an Appointment?

One thing it seems almost every person struggles with at some point in their life is when to pick up the phone and make that dreaded call to schedule a doctors appointment. For some this is easier than for others. However, I believe it’s safe to say no one is excited to make the call. Generally what this means for most people is they’ve finally succumbed to whatever kind of ailment they’re suffering from. Our goal at the Foot & Ankle Specialists of Treasure Coast is to offer a guideline of when pain is no longer acceptable nor considered a routine ache or result of aging. To objectify something such as pain that can seem to be quite subjective we offer a few simple questions to consider when determining whether or not that foot pain is “normal”, and whether or not a call to the local podiatrist is necessary.  To many this may seem like common sense but I can’t stress enough how many patients present with pain that is ten fold due to their blind hope of the ailment spontaneously resolving.  Without further ado…the questions:

1.    Is the pain linked to a traumatic event?

 i.e. did you drop something on your foot? Were you in a car accident? Did you walk through a dark room and severely stub your toe on the bedframe?

2.    Do NSAIDs and icing only dull the pain temporarily?

i.e. has the pain been present for more than 48 hours? Is it sharp and without resolve in spite of minor intervention like NSAIDs and icing?

3.    Is the painful area severely bruised and/or discolored?

4.    Is the area of insult infected?

 i.e. hot, red, swollen, tender, odorous?

5.    Has the issue affected your regular sleep patterns?

6.    Has the issue affected the way you walk and any of your daily activities?

We strongly recommend that if you answered yes to 2 or more of any of the following 6 questions you should seek the evaluation of a podiatric physician. ***With the exception of question 4. In that case this is reason enough to see a healthcare clinician due to the potential for local infections to spread systemically and cause serious sickness and death, especially in the immunocompromised. Please keep in mind that the following is merely a list of questions, and not hard and fast rules.  For many people, any pain at all is more than enough cause to precipitate an appointment -this is never a bad rule to follow.

**This blog, and the medical information it presents is made possible by Dr. Michael Garvin of Port Saint Lucie, Florida. He has been practicing board certified podiatry for over 20 years, and accepts new patients. Visit his website for additional information here. To schedule an appointment, or find directions to his office click here.

Claw Toe

A claw toe is a deformity of the toe that is due to a soft tissue (musculature) imbalance. Claw toes most often present with a callus and/or pain at the ball of the foot, and on top of the toe at the most proximal joint.  The imbalances that cause this physical change in shape of the toe are extension at the metatarsophalangeal joint, flexion at the proximal phalangeal joint and flexion at the distal phalangeal joint. Normally, in healthy toes, there should be no extension or flexion at any toe joint during relaxation. However, in the claw toe, these series of musculature contractures are seen due to underlying pedal or bodily pathologies. These pathologies can include, but are certainly not limited to severe flat foot deformity (pes planus), excessive pronation, trauma to the foot, diabetes mellitus, Charcot-Marie-Tooth disease, multiple sclerosis, rheumatoid arthritis, cerebral palsy and more. 

If you think you have a claw toe(s), or suffer from any of the aforementioned diseases you should have your feet checked out by a podiatrist. Dr. Michael Garvin of Port St. Lucie, Florida has been practicing for years and has great experience at treating claw toes and many other pedal pathologies. His aim is always to treat the underlying cause of foot pain with minimally invasive techniques. Visit Dr. Garvin’s website for more information regarding his practice and treatment options.

Orthotics 101

An orthosis is a device used by podiatrists to correct an abnormality in a patient's gait, or provide additional cushion and control for a surgically corrected condition. Orthotics can be made out of a variety of different materials, and many times are made by a podiatrist in office. The materials chosen for fabrication of the device are generally contingent upon the condition being treated and cost effectiveness. Orthotics are often times one of a podiatrists favorite tools as it allows them to treat an extremely broad variety of foot-related ailments with a minimally invasive technique. Once the orthosis is made it can simply be placed into the patients shoe similarly as an insole would be.     

Most insurance companies will cover the cost of an orthotic and they’re often times the best treatment for patients. Especially patients who can’t afford to spend time off their feet with any kind of surgical recovery. Some conditions that are commonly treated with an orthotic, but certainly not limited to are bunions, tailors bunions, hallux limitus and rigidus, ankle equinus, plantar fasciitis, digital subluxations, Morton’s Neuroma, high arched feet/Pes Cavus, Diabetes related conditions, and many more. 

If you have any kind of foot related pain, or think you might be a candidate for an orthotic, don’t hesitate to call one of Dr. Michael Garvin’s offices in the Port Saint Lucie area in southeast Florida. 772-335-7171  Dr. Garvin has been practicing for years and has spent this time perfecting the art of healing and controlling patients foot problems with orthoses. 

A Look at The Gait Cycle & its Importance

The gait cycle can be defined as the interval of time from heel strike of a foot, to heel strike of that same foot, on the next step. In example, the gait cycle consists of a single footstep of say, the left foot that would take place during normal walking. To accomplish that single footstep made by the left lower extremity, the entire gait cycle must be executed. This is in addition to a great deal of other things that must take place for an individual to walk, but for simplification purposes we will only focus on the pedal aspects of the gait cycle. In essence, anytime an individual is walking they are repetitively carrying out the full gait cycle with each step that the individual takes.

The gait cycle is comprised of two major components; stance phase which is also known properly as closed kinetic chain, and the swing phase which is also known as open kinetic chain motion. To be precise, 62% of the gait cycle is occupied by the stance phase, or when the foot is in contact with the ground (weight bearing portion). The other 38% of the gait cycle is naturally comprised of swing phase, or when the foot is not in contact with the ground.

In podiatry it is imperative to dissect, and analyze these two major components of the gait cycle, and the gait cycle in whole. This allows a doctor to understand, diagnose, and treat all of the lower extremity pathologies that exist due to irregularities in an individual’s gait cycle.

To further review these components of the gait cycle, stance phase, or the weight bearing portion of the gait cycle can be sub-divided into three phases. Those are the contact period (when the foot initially strikes the ground), mid-stance, and toe-off (also known as propulsion). During contact period, the heel of the foot being observed is striking the ground, and almost simultaneously the forefoot of the same foot, is loaded with the force that is being transferred from the hind-foot to forefoot (this is when the majority of pronation* occurs). Next, mid-stance is immediately taking place. This is a transitional period that takes place after the contact period, but before the same heel lifts off the ground, and toe-off (propulsion) occurs. Supination** of the foot starts during mid-stance period, and does not end until immediately after toe-off. Lastly, propulsion or toe-off occurs. This is the third portion of the stance, or weight bearing phase of the gait cycle. Throughout toe-off the foot is being supinated, and the momentum of the lower extremity and the upper body is being directed forward to make forward progress (walking or running).

After these three sub-phases of the stance phase have occurred, the foot is immediately carried into swing phase. During swing phase the foot is elevated from the ground, and is being carried forward by a variety of the lower extremity musculature. This non-weight bearing portion of the gait cycle is where the most visually evident portion of forward progress is made.

To summarize, the complete gait cycle consists of stance phase and swing phase. Stance phase is further divided into contact, mid-stance and toe-off periods. Again, immediately after toe-off, swing phase takes place, and ends once the heel of this same foot strikes the ground again, to start the whole process over, hence the term gait cycle. Walking or running simply consists of the complete gait cycle alternating between the two limbs of an individual. In essence, the gait cycle of each foot has a converse relationship. For example, while the left foot is in stance phase, the right foot is in swing phase. This succinct process occurs throughout every step that is taken and most people have no idea it even exists. To clarify any potential confusion, there are certainly short periods in most gait cycles where both feet may be contacting the ground, or especially in running, both feet are not in contact with the ground. Yet, in general, the cycle occurring at each foot is alternating in a conducive manner for walking or running.

With a vast majority of the pathologies that podiatrists like Dr. Michael Garvin see, certain portions of a patients gait cycle have abnormalities that cause improper force transfer, and eventually translate to some type of disease manifestation-“something has to give”. These abnormalities of the gait cycle can occur for a great variety of reasons. These causes are all hugely important in the overall treatment, and prevention of further injuries to the patient’s foot, and their overall health. Dr. Garvin recognizes this, and does his best as a Podiatric physician to observe, listen, address, and heal his patients. 

If you feel you have an abnormal gait, or you have any kind of pain while walking, do not wait until you injure yourself to see a doctor. Call Dr. Garvin’s office and make an appointment at the East office- 772-335-7171, or the West office-772-871-6020, in Port St. Lucie Florida. Or e-mail him at info@doctorgarvin.com .

Below is a schematic of the gait cycle.

 
Below is a list of pathologies commonly seen in the lower extremity that often times manifest due to poor biomechanics (abnormalities in the gait cycle):

• Hallux Valgus (Bunion)
• Tailor’s Bunion
• Plantar Fasciitis
• Hammer Toe(s)
• Claw Toe(s)
• Generalized Heel pain
• Morton’s Neuroma
• Hallux Rigidus (“Pump Bump”)
• Shin Splints
• Tarsal Tunnel Syndrome

*pronation consists of tri-plane motion of the foot; dorsiflexion, eversion & abduction of the foot.
**Supination consists of tri-plane motion of the foot; plantarflexion, inversion & adduction of the foot.