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Monday, 12 August 2019 00:00

According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans.  Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases.  Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.

Complications of the disease may lead to several foot and ankle-related conditions.  The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat.  Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.

To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure.  Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation.  The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.

Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding.  These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form.  Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet.  The resulting deformity is a foot that is flattened and wider in appearance.

To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes.  Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces.  In more serious cases, surgery may be considered to treat more developed deformities.  Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

Monday, 05 August 2019 00:00

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Monday, 29 July 2019 00:00

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.

Monday, 22 July 2019 00:00

The human foot has 26 different bones, and the foot is divided into three parts: the hindfoot, the midfoot, and the forefoot. Each section of the foot is composed of a different amount of bones. For instance, the forefoot is made up of 19 bones. The midfoot is composed of five smaller bones called the navicular, cuboid, and three cuneiform bones. Lastly, the hindfoot is made up of only the talus and the calcaneus. The feet tend to be vulnerable to slipping and twisting; consequently, fractured bones within the foot are common. When a bone gets crushed, bent, twisted, or stretched it may become broken.

Many foot fractures occur through an accident or trauma. More specifically, common causes for broken feet are car accidents, falls, missteps, or overuse. If you have a broken ankle or foot, you may have one or more of the following symptoms: throbbing pain, swelling, bruising, tenderness, deformities, and difficulty walking.

There are some factors that may put you at a higher risk of developing a broken foot. People who participate in high-impact sports are more likely to develop foot fractures because of the stresses, direct blows, and twisting injuries involved in gameplay. Additionally, those who suddenly increase their activity level are more likely to suffer a stress fracture.

Unfortunately, there are different complications that may arise because of a foot fracture. For instance, arthritis may be caused by fractures that extend into the joints. Bone infections are also possible in open fractures due to the bone being exposed to bacteria. However, there are ways you can help prevent yourself from breaking your foot. One way to avoid fractures is to wear proper footwear. If you plan on going on a run, you should wear running shoes. You should also replace your shoes if you notice that they are becoming worn out. For runners, it is best to replace shoes every 300 to 400 miles.

Treatment for foot fractures usually consists of rest, ice, elevation, and compression (RICE). If you plan on wrapping your foot, try not to wrap it too tightly because doing so may cut off blood supply in the foot. You should also avoid walking on the fractured foot.

If you suspect you have a broken foot, you should see your podiatrist right away. It is important that you have someone bring you to your doctor, since driving with a broken foot can be dangerous. You should especially seek urgent care if you are experiencing numbness, pain, or deformities in your foot.

Monday, 15 July 2019 00:00

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.

Tuesday, 09 July 2019 00:00

Both running and walking are great exercises, but should a person wear the same shoes for both activities? The answer is no, because there is a difference between the way a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed differently. Before you begin any exercise program it is always recommended that you speak with your doctor or podiatrist.

Walking is a low impact exercise that is often recommended by doctors to their patients. While walking is a simple activity, it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you move, you will notice that your heel hits the ground first before your foot continues to roll forward and your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. This flexibility helps the walker push off with each step taken.

Because the heel hits the ground first when you walk, walking shoes are designed to absorb most of the shock. Walking shoes should therefore have a beveled or angled heel. The angle of the heel helps absorb the shock and reduces pressure from the ankles. This is especially important for speed walkers, as their feet will hit the ground twice as often as the normal walker.

When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise. If not done with the proper equipment, running may cause damage to the feet and legs. Running shoes are designed to be more lightweight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. Walking shoes often do not have the proper arch support that running shoes do.

A proper fitting shoe can make or break a runner or a walker. If the shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. Whether you will be running or walking, the right equipment can make all of the difference in the world.

Monday, 01 July 2019 00:00

Platelet rich plasma, or PRP, is blood taken from a patient and spun in a centrifuge, concentrating the amount of platelets and growth factors. This plasma, containing a very high concentration of platelets, is re-injected into the site of injury or damage, inducing the body to repair damage to muscle, tendons, ligaments, and soft tissue. Although the body does this naturally when an injury occurs, the PRP helps speed the healing process.

Many injuries to the foot, especially those affecting tendons, do not heal well because poor blood supply to the area prevents healing platelets and growth factors carried by the blood from getting to the injury site. Platelet rich plasma (PRP) injections can help fix this problem and speed recovery.

This is the first regenerative treatment ever for damaged muscles, tendons, and ligaments. It avoids the need for surgery, and as it requires only the insertion of a needle, is minimally invasive. The injection of PRP is done with the use of ultrasound to ensure the proper placement of the platelets.

Once the first injection is received, the patient will return to the doctor's approximately 2 to 3 weeks later to be checked on how well the treatment is moving along. As with most treatments, each patient's response is different. Based on a patient's condition, the doctor will make the decision about how many more injections will be needed. Acute and chronic injuries will typically require more injections than mild ones.

Common injuries of the feet such as ankle sprains, Achilles tendonitis, and plantar fasciitis, as well as acute and chronic tendon and joint diseases like arthritis, can all be treated with PRP injections. For many, this therapy has lead to greatly reduced pain and increased function of the foot. Combining exercise or physical therapy with the PRP injections will help increase the success of the treatment.

This treatment, being minimally invasive, means that surgery can be avoided, in many cases, and recovery time cut down. Other benefits of PRP injections are a decrease in scar tissue and fibrosis to the damaged area, as well as increased range of motion, flexibility, and strength. The risks from using PRP injections as a treatment is very low. As the patient is injected with his own blood, there is no risk of rejection or of getting a disease from using another person's blood. As with any injection into the body, there is a risk of infection, but this is very rare. Research is showing that PRP may have an anti-bacterial property that would further decrease the risk of infection.

Monday, 24 June 2019 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.

Monday, 17 June 2019 00:00

The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three phalanges except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.

Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.

Another type of toe fractures is a stress fracture. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity instead of a single injury. Stress fractures occur when the muscles in the bone become too weak to absorb impact. Consequently, the toe bone becomes vulnerable to any pressure and impact it endures. Symptoms for a stress fracture in the toe include swelling without bruising, tenderness to the touch, pain that goes away with rest, and pain after walking or running.

If you suspect that you have a broken toe, you should make an appointment with your podiatrist. He or she will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more. 

Monday, 10 June 2019 00:00

Extracorporeal Shockwave Therapy (ESWT) is an alternative treatment method that is used for bone and soft tissue disorders in the foot and ankle. EWST is a noninvasive option for pain relief and it was originally created to help dissolve kidney stones. This therapy works by focusing impulses to target the area in pain. This method has been proven to show a reduction in the amount of nerve fibers that transmit painful impulses, which leads to a reduction in pain. Shockwave therapy can also expedite the tissue which would, in turn, increase the amount of new blood vessels that are formed.

Conditions that can be treated with shockwave therapy include Achilles pain and heel pain. People with plantar fasciitis may opt for this therapy and the results are usually great after 18 months. Additionally, this method can also be used to treat fractures that have failed to heal correctly. Anesthesia is not required to perform this treatment. It usually is not painful, but it can be uncomfortable.

The duration of treatment sessions usually lasts 5-15 minutes each. This procedure is safe since there is no risk of infection from wound complications, if you are looking to try shockwave therapy to heal plantar fasciitis, it may take 3-4 sessions to start working. After treatment, patients typically notice a dull pain in the area which was treated. However, this pain rarely lasts more than 24 hours.

Nevertheless, there are pros and cons that come along with Shockwave Therapy. The most obvious pro is that this treatment is noninvasive, meaning surgery will not be required. Another upside is that there have been very little complications that have been found with this procedure. On the other hand, those who opt for surgery are at risk for continued pain, wound problems, and infections. The biggest con for ESWT is that it is very expensive; it typically costs around $1,000 before insurance. Another con is that the effectiveness of the treatment is questionable. Usually, if this treatment is helpful, the difference is small.

If you are curious about Shockwave Therapy, you should talk to your podiatrist to see if this treatment method is right for you. At times, patients will find that there are other treatment options that are more efficient for their individual cases.

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