Aging Feet: Can You Turn Back the Clock?

Let’s face it, we are all getting older.  Imagine the wear and tear on your feet from years of use and as our population ages, people are living longer and continue to be active.  Mobility is an area in life that is important to every age, but especially important to our aging population.  However, if foot problems make it difficult or impossible for our aging population to continue an independent lifestyle then it becomes a problem. And so far no one has found the ability to turn back the clock and restore our youthful years. 

Your feet can be the window to a podiatrist seeing symptoms of other conditions such as diabetes, arthritis, and circulatory disorder of the foot.  Crazy that our feet and their health can help prevent and warn us about other ailments in our body.  Foot problems can also lead to knee, hip, and lower back pain, which ultimately affect mobility.  

“Studies show that most Americans experience foot problems of a greater or lesser degree of seriousness at some time in their lives; nowhere near that many seek medical treatment, apparently because they mistakenly believe that discomfort and pain are normal and expectable.” 

It is not too late to take care of your aging feet.  Below are some tips to help you keep your feet healthy.

• Look at your feet often.  Make sure there are no cuts, blisters, or ingrown toenails.    
• If you are diabetic it’s important that you look at your feet every day.
• Dry feet thoroughly before you put socks or shoes on.
• Wear shoes that fit.  As you age your shoe size may change so it’s important to measure your feet before buying new shoes.  
• Take walks.  Walking is the best exercise for your feet.
• Trim or file your toenails straight across.
• Have your feet examined by a podiatrist twice a year.

If you would like to schedule an appointment to discuss how to keep your feet healthy and mobile please call our office. www.doctorgarvin.com

X-ray Machines 101

How do X-Ray Machines Work? 

An x-ray is an energetic wavelength of electromagnetic radiation that is emitted from within an x- ray machine at it’s generator. X-ray machines work very similarly to how light bulbs function. They receive their power from a wall outlet, as does a light bulb; through alternating current, or AC power. Through the use of a step-up, and step-down transformers, a diode (for conversion to direct current from alternating current), and a heating filament to boil off electrons; electrons are emitted from a cathode and directed towards a negatively charged anode by applying a strong potential difference in current. Once these electrons collide with a tungsten target found on the anode, photons are emitted and directed out of the x-ray machine and into the patient at their respective tissue. 

An example of a podiatric specific x-ray machine is pictured below.

Are x-ray machines safe? 

Before photons, in the form of x-ray radiation are absorbed by patient tissue they’re filtered, and aimed for precision and safety. A health care practitioners number one goal in using an x-ray machine is to maintain safety, all the while attempting to generate a high contrast image to be developed, and utilized in proper diagnosis of respective pathologies. To ensure that “soft radiation”, or low energy radiation (that is not useful for images) isn’t absorbed by the patient, aluminum filters are utilized. These filters are measured in millimeters, and are required by law to be used in all x-ray machines. In addition to the aluminum filter, lead aprons are worn by patients and x-ray technicians to prevent x-ray radiation from being absorbed unnecessarily, in relation to unaffected tissues. 

In short, yes, x-ray machines are made safe for use because physicians receive extensive education on how x-ray machines work, and what the ramifications of miss-use are. For example, the average podiatrist has received 2 years of radiology courses during podiatry school, 2 years of clinical experience in school under the observation of experienced physicians, and another 3-4 years during their tenure in residency programs to prepare them to use, and read x-ray machines and images known as radiographs. 

Why is it important for patients to have x-rays taken? 

Radiographs are extremely important in the diagnostic process that physicians 

must undergo to successfully treat a patient. Often times debilitating conditions pertaining to a patients foot, ankle, or lower leg are superficial, and an x-ray is not needed. However, once a physician is confident a condition is not diagnosable through superficial observation, percussion and palpation, x-rays are generally ordered to observe if a pathology exists in the bony tissue. 

Without a radiograph a physician would never be able to observe subcutaneous conditions 

affecting the bone, like foot and ankle fractures. A lack of radiographs would put all types of 

medicine back to an antiquated state that has not been prevalent since the early 1890’s, prior to Wilhelm Rontgen’s discovery of the x-ray. 

Sandal weather is here - Prepare your feet!

What are Corns and Calluses?

Corns and calluses are both formed by hyperkeratosis. This term simply means a thickening of the skin. These can form on many of the superficial surfaces of the body (most commonly on the feet!) for a variety of reasons. Typically, corns are sore and painful due to the friction that is occurring at the site, which is also their cause. Calluses are also caused by a thickening of the skin, but are more often associated with the excess synthesis of skin at a site as a protective mechanism. For example, many people develop calluses on their hands due to repetitive work like gardening. Calluses are also formed at areas of abnormal bony synthesis like bones spurs. 

Why should you be concerned about a Corn or Callus?

Hyperkeratosis certainly isn’t a reason to visit the emergency room. However, it is an important concern because it means that excessive use, and abnormal friction is occurring at that localized area of epidermis (most outer layer of skin). This is not only a cosmetic issue, but is often times painful and debilitating depending on severity. More importantly than the buildup of skin itself though, is the actual cause of the localized hyperkeratosis. This excess production of localized dermis is generally due to things such as poor fitting shoes, abnormalities of the toes, like hammertoes, unusual bony prominences such as bunions, and abnormalities of an individual's gait. All of these conditions are great reasons to setup an appointment with Dr. Michael Garvin! His goal is to empathetically alleviate his patient’s foot ailments with as minimally invasive procedures as possible.

 

To make an appointment, simply call one of his offices, both located in Port St. Lucie, Florida; the East office- 772-335-7171, & the West office-772-871-6020, or e-mail him at info@doctorgarvin.com . http://doctorgarvin.com/contact.html

Ingrown Toenails

Onychocryptosis

An ingrown toenail, medically deemed onychocryptosis, is a very common complaint among patients in a podiatry office.  This condition usually begins with mild tenderness along the edge of a toenail where a portion of the nail border has penetrated the skin.  Over time, the toe may become increasingly painful to touch with localized redness and inflammation.  An infection may develop where the toe exhibits warmth, and pus begins to drain from the site where the nail has pierced the skin.

The severity of the nail’s appearance will vary.  Some will have a nail that appears incurvated and deeply embedded into the skin; others may have a small spike in a corner that penetrates down into the nail bed. Aside from penetrating the skin, a nail can apply pressure in the nail fold area without breaking the skin causing discomfort and mild pain.  This is not technically an “ingrown nail.”

Causes of ingrown nails range can from genetics to an improper shoe size wherein a shoe’s toebox can place pressure on the nail.  Direct trauma to the nail such as stubbing a toe, can alter the way in which the nail grows.  Nail fungus can alter the nails growth pattern as well. Preventative measures include proper nail trimming wherein the nail should be cut straight across without tapering the corners.  Proper fitting shoes can also help prevent ingrown nails.  It is best to seek advice from your podiatrist, and avoid “bathroom surgery.” 

Podiatric treatment for an ingrown nail that’s infected involves antibiotics in addition to soaking the foot in Epsom Salt.  It is important to keep an infection clean and monitor it daily for signs of worsening inflammation.  If a nail is simply ingrown but not infected, Dr. Garvin may trim the nail border to see if the nail will grow back properly.  In the case of reoccurring ingrown nails, Dr. Garvin will perform a simple surgical procedure that will remove the entire nail border permanently.

Our goal here at Foot and Ankle Specialist of the Treasure Coast is to keep you healthy and walking comfortably. There are often many conservative options for treatment with surgery typically the last one implemented. So stay healthy and keep your feet pain free!

Shin Splints

Shin Splits - What exactly are they? 

Have you ever had that sharp pain radiate through your leg after your daily run or walk?

That condition, which is commonly referred to as “Shin Splints” , is a slow healing and painful disorder in the shins usually caused by exercise such as: running, jumping, swimming, cycling, dancing or other high impact sports. In fact, 10-15% of all runners’ related pain or injuries are due to this syndrome.

There are two types of shin splints also known as medial tibial stress syndrome (MTSS), anterior and posterior. The most common shin splint is anterior. Anterior shin splints are often due to over striding or training at a pace that doesn’t allow for healing of the tibialis anterior muscle. Posterior shin splints (also called posterior tibial tendonitis) are a less common condition that is often due to pronation (flattening of the arch).

The onset of shin splints is most common after exercise, caused by high impact training, excessive training, poor technique, or improperly fitting shoe wear. Dr. Garvin can determine if you require properly fitting footwear or an orthotic to prevent a re-occurrence of shin splints.

Interestingly some studies have suggested that shin splints are actually more common in women possibly caused by decreased physical fitness, smaller muscle size or standing for long periods of time and wearing high-heeled shoes.

If you are suffering from shin splints make an appointment to see Dr. Garvin as soon as possible by calling his office at 772-335-7171. Dr. Garvin will immediately address the inflammation of soft tissue known as shin splints with ice, non-steroidal anti-inflammatory drugs and physical therapy. Patients may also be advised to decrease the duration or intensity of their exercise, change their footwear or add an orthotic, then slowly build back up their exercise routine.

Bunions

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe. The big toe generally turns in toward the second toe and the tissues surrounding the joint becomes swollen, tender and often painful. Bunions occur more commonly in women and can sometimes run in families, making some individuals genetically pre-disposed to this condition. People born with abnormal bones in their feet are more likely to form a bunion. Wearing narrow-toed, high-heeled shoes can also lead to the development of a bunion. The condition may become painful as extra bone and a fluid-filled sac grows at the base of the big toe.

Most common reasons for the development of a bunion:                  

• If the foots shape puts too much pressure on the big toe joint.
• Because bunions can run in families, some experts believe that the inherited shape of the foot makes some people genetically pre-disposed to developing a bunion.
• If the foot rolls inward or pronates too much when walking. 
• Flat Feet.
• Wearing shoes that are too tight.

Any of these situations can apply significant pressure on the big toe joint, which over time; will force the big toe out of alignment, bending it toward the other toes.

Early diagnosis is critical. When a bunion first begins to develop, taking a few simple steps such as wearing foam pads on the foot to protect the bunion, or devices called spacers to separate the first and second toes at night can help avoid a worsening of the condition.

If the bunion gets worse, resulting in severe deformity or pain, surgery is the most effective approach to realign the toe, relieve the pain and remove the bony bump (bunionectomy). There are many different surgical techniques that can be used to treat this condition depending on the individual’s situation.

To help our patients get relief from bunion pain Dr. Garvin might recommend, wearing wider shoes, orthotics, or foot pads. Treatment such as oral anti-inflammatories and injections can also help to relieve discomfort. However, Dr. Garvin can perform same day procedures, which will have patients comfortable after just a few weeks of recovery.

Warts on your feet?

Commonly known as plantar verrucae, the plantar wart is caused by the Human Papillomavirus. The virus attacks the skin through direct contact, entering through possibly tiny cuts and abrasions in the outermost layer of the skin. Infection typically occurs from moist walking surfaces such as showers or swimming pools. After the infection, warts may not become visible for several weeks or months. Because of pressure on the sole of the foot, the wart is pushed inward and a layer of hard skin may form over the wart. Depending on where the warts are located, some may cause pain when walking. A common misconception about plantar warts is that they have roots which can grow deep into the tissues and attach to the bone. This is not true. A wart only grows in the top layer of skin and although the wart may extend slightly deeper, this is generally due to walking, putting pressure on the affected area and pushing the wart deeper into the tissue.

Because plantar warts are spread by contact with moist walking surfaces, they can be prevented by not walking barefoot in public areas such as showers or communal changing rooms (wearing flip flops or sandals helps), not sharing shoes and socks, and avoiding direct contact with warts on other parts of the body or on other people. Humans build immunity with age, so infection is less common among adults than children. The virus can survive many months without a host, making it highly contagious. There are many different treatments for warts including topical acid, freezing, laser and surgery to name a few.

Warts on the bottom of the foot can look a lot like calluses, so when in doubt, it is best to have it looked at by a Dr. Garvin. So if you or a loved one is suffering with a painful wart that just won’t go away, call Dr. Garvin’s office today at 772-335-7171 and schedule an appointment.