If you’ve ever walked barefoot across a gravel parking lot, you’re probably well-aware that human feet are very sensitive structures. That’s a good thing because it allows our feet to move and adjust to potentially damaging objects on the ground-such as a sharp stone or a piece of glass. Normally, we are able to avoid such objects with ease and protect ourselves from cuts, infections, and other risks. However, the greatest threat to our feet is more internal rather than external. It occurs when our nerves become damaged and that vital protective sensation in our feet is lost.
There are unfortunately MANY things which can lead to weakened or damaged nerves in our feet. One of the most common and well-known causes is diabetes. As individuals lose control of their blood sugars, the nerves particularly in the feet tend to become damaged and insensitive. Other metabolic issues such as B-vitamin deficiencies, alcoholism, and various toxins such as heavy metals can also lead to this problem. It’s pretty interesting to consider how certain health issues like Ulcerative colitis or Crohn’s disease can affect vitamin absorption to affect nerve function and indirectly the health of our feet!
Certain inherited and autoimmune disorders can also cause the feet to become insensitive. Things like Charcot-Marie-Tooth disease, Lupus, Guillain-Barre syndrome, allergic conditions, and blood disorders can all have this effect. Mechanical issues like an entrapped nerve or a spinal root problem may also be causing the problem. On top of these and other causes, the medications you are taking can also alter the nerve function in your feet. Various seizure medications, immunosuppressive agents, oral contraceptives, and tuberculosis drugs can all have this side effect.
Perhaps one of the biggest problems with nerve dysfunction to affect our feet simply occurs as we age. Often times, visual changes in combination with insensitive feet make it extraordinarily difficult for individuals to monitor the ground as well as the health of their feet. Believe it or not, it’s not uncommon for some people to have needles and other sharp objects lodged in their feet without them even knowing it! Not only can the individual not feel the object, but they’re also not able to see what may be a large and potentially-infected wound. This can be a huge hazard for those who live alone or do not have their feet checked regularly, as the infection can spread quickly and cause major damage.
Podiatrists have lots of experience dealing with insensitive feet. They’re able not only to closely monitor the various components of nerve degeneration, but they’re also able to check for infections, care for wounds, and determine whether a foreign body is actually lodged within the foot. Sometimes various objects show up within the foot on an X-ray which is not otherwise very obvious. If you suspect you’re having such a problem, contact your podiatrist immediately.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Friday, October 16, 2009
Thursday, September 3, 2009
Flat-Bottomed Feet
It’s kind of fun once in a while (under the right circumstances) to observe the various shapes, sizes, and different characteristics of peoples’ feet. Almost like our fingerprints, the particular formations of our own feet are unique to us, and like “the back of our hands”, we generally know them quite well. One of the most noticeable features of an individual’s foot is in the contour of the sole-whether it’s flat, high-arched, or somewhere in between. As with all foot types, those with “flat feet” have distinctive qualities and considerations which are all their own.
There are many technical terms to describe the anatomical structure associated with a flat foot. In general, however, most feet of this type have four common characteristics: a heel which is rotated outwards, a forefoot which is deviated outwards, a collapsed arch, and a rather stiff ankle with a limited ability to bend upwards towards the knee. Many people with these findings are worried, initially, that their ankles are “turning in”.
Although it’s commonly assumed that people are simply born with flat feet, in reality there are many etiologies which can lead to this finding. Tendon ruptures or imbalances, bony abnormalities, weakened ligaments, and vascular or nerve damage can all be contributive. Thus, while it’s typical to pick out a flat-foot deformity in babies or young children, it’s also not uncommon for adults or older children to experience the onset of a flat foot or the progression of symptoms.
In general, newborns or very young children should have a foot structure which is rotated inwards. As the child ages and begins to walk, the feet gradually tend to rotate outwards to a relatively strait position by the age of six or seven years old. In contrast, feet which are already rotated outwards in the first year of life are certainly not detrimental but can often be easily corrected thanks to the flexible bone quality at that age. A series of casting is the typical mode of correction. On the other hand, there are also more rigid deformities which must be approached more aggressively. These issues can surface in later years when the child may exhibit signs such as tripping, limping, and low activity levels.
As alluded to earlier, there are a number of subtle and not so subtle causes which can progress to a flat-foot deformity in adults and adolescents as well as children. At any rate, flat feet are usually treated based on the symptoms and desired activity levels of the patient. Podiatrists take into account the anatomy, biomechanics, radiographic changes, overlying skin, and other factors when assessing a symptomatic flat foot. There are a wide variety of treatment options-both conservative and invasive-which are available. Feel free to discuss any thoughts you may have with your podiatrist. Your concerns are their concerns!
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
There are many technical terms to describe the anatomical structure associated with a flat foot. In general, however, most feet of this type have four common characteristics: a heel which is rotated outwards, a forefoot which is deviated outwards, a collapsed arch, and a rather stiff ankle with a limited ability to bend upwards towards the knee. Many people with these findings are worried, initially, that their ankles are “turning in”.
Although it’s commonly assumed that people are simply born with flat feet, in reality there are many etiologies which can lead to this finding. Tendon ruptures or imbalances, bony abnormalities, weakened ligaments, and vascular or nerve damage can all be contributive. Thus, while it’s typical to pick out a flat-foot deformity in babies or young children, it’s also not uncommon for adults or older children to experience the onset of a flat foot or the progression of symptoms.
In general, newborns or very young children should have a foot structure which is rotated inwards. As the child ages and begins to walk, the feet gradually tend to rotate outwards to a relatively strait position by the age of six or seven years old. In contrast, feet which are already rotated outwards in the first year of life are certainly not detrimental but can often be easily corrected thanks to the flexible bone quality at that age. A series of casting is the typical mode of correction. On the other hand, there are also more rigid deformities which must be approached more aggressively. These issues can surface in later years when the child may exhibit signs such as tripping, limping, and low activity levels.
As alluded to earlier, there are a number of subtle and not so subtle causes which can progress to a flat-foot deformity in adults and adolescents as well as children. At any rate, flat feet are usually treated based on the symptoms and desired activity levels of the patient. Podiatrists take into account the anatomy, biomechanics, radiographic changes, overlying skin, and other factors when assessing a symptomatic flat foot. There are a wide variety of treatment options-both conservative and invasive-which are available. Feel free to discuss any thoughts you may have with your podiatrist. Your concerns are their concerns!
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Tuesday, July 7, 2009
Down and Gout
The condition known as “Gout” has been written about and unfortunately suffered from for centuries. Egyptian societies as far back as 2600 B.C. as well as many historical figures such as King Henry VIII, Benjamin Franklin, and even Phil Jackson have had experiences with it. The condition has even been noted in various animal species including dinosaur specimens! Traditionally, gout was referred to as “Rich man’s disease” because it was mostly the wealthy who could afford the protein-rich foods which would lead to the onset of symptoms.
Today, gout is still a big problem which tends to affect many older men and post-menopausal women. Some contributing factors include high blood pressure, heart problems, diabetes, kidney problems, and being overweight. It can also develop as a consequence of other conditions such as blood disorders or organ transplants. But what, exactly, is gout?!
Gout develops as a result of the chemistry in your blood. As various proteins within the body are broken down, their contents need to be excreted. When your body has problems getting rid of all those “protein pieces” an overabundance results, and the body starts to deposit it within joints and other odd places. One of the first and most common places affected is at the ball of your foot, making it hot, red, swollen, and painful. Other areas that can potentially be affected are the Achilles tendon, finger joints, ears, elbows, wrists, knees, and other foot joints. Diets that contain high amounts of meat, seafood, and alcohol (especially beer) can contribute to this process.
The exact course and underlying cause of each specific case is quite variable. Usually, the first attack happens at night and affects a single joint causing extreme tenderness and may even cause skin sloughing. From there, the timing and pattern of involvement is anyone’s guess, but what is known is that the disorder is nearly always progressive and affects more joints with each new flare-up. Eventually, this can lead to permanent deformity and disability.
Thankfully, gout can often be controlled through some proactive and protective measures. If you develop warm, stiff, and tender joints anywhere in your feet, your podiatrist may take a small sample from the joint for examination to confirm the diagnosis. From there, he will probably put you on a regimen of some standard medications aimed to control the underlying causes. Again, this will vary depending on your particular case. You can also do your part by focusing your diet on vegetables and dairy products and trying to avoid an excess of meat, shellfish, and alcohol. Keep in mind that the foot is by far the biggest target of gout, so early diagnosis and prevention is key to maintaining your future mobility and well-being.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Today, gout is still a big problem which tends to affect many older men and post-menopausal women. Some contributing factors include high blood pressure, heart problems, diabetes, kidney problems, and being overweight. It can also develop as a consequence of other conditions such as blood disorders or organ transplants. But what, exactly, is gout?!
Gout develops as a result of the chemistry in your blood. As various proteins within the body are broken down, their contents need to be excreted. When your body has problems getting rid of all those “protein pieces” an overabundance results, and the body starts to deposit it within joints and other odd places. One of the first and most common places affected is at the ball of your foot, making it hot, red, swollen, and painful. Other areas that can potentially be affected are the Achilles tendon, finger joints, ears, elbows, wrists, knees, and other foot joints. Diets that contain high amounts of meat, seafood, and alcohol (especially beer) can contribute to this process.
The exact course and underlying cause of each specific case is quite variable. Usually, the first attack happens at night and affects a single joint causing extreme tenderness and may even cause skin sloughing. From there, the timing and pattern of involvement is anyone’s guess, but what is known is that the disorder is nearly always progressive and affects more joints with each new flare-up. Eventually, this can lead to permanent deformity and disability.
Thankfully, gout can often be controlled through some proactive and protective measures. If you develop warm, stiff, and tender joints anywhere in your feet, your podiatrist may take a small sample from the joint for examination to confirm the diagnosis. From there, he will probably put you on a regimen of some standard medications aimed to control the underlying causes. Again, this will vary depending on your particular case. You can also do your part by focusing your diet on vegetables and dairy products and trying to avoid an excess of meat, shellfish, and alcohol. Keep in mind that the foot is by far the biggest target of gout, so early diagnosis and prevention is key to maintaining your future mobility and well-being.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Tuesday, May 26, 2009
Diabetic Ulcers
Over ten million people in the United States suffer from diabetes mellitus. Also known as “the sugars” or just simply diabetes, the two main forms -Type I and Type II- both result in a higher level of glucose in the blood which can cause problems throughout the body. Unfortunately with this condition, your feet are at especially high risk.
Roughly two thirds of diabetics will experience a condition known as peripheral neuropathy in which the nerves of the feet and lower legs become damaged so that individuals will start to lose muscle function, reflexes, and most importantly the sensation of their lower limbs. As nerves become compromised, it becomes more difficult for the diabetic to protect and care for his or her feet. In most cases, both feet are affected, and the sensory loss begins in the toes, then spreads gradually across the foot and through the ankle. Eventually this leads to abnormal walking, unsteadiness, and a diminished ability to perceive pain or temperatures.
The sensory loss of diabetes is made even worse by other complications. The disease not only causes stiffness in the joints and blood-flow problems, it also compromises kidney function which can ultimately make it more difficult for wounds to heal. Diabetics are also more vulnerable to infections because their immune systems are weakened, and the excess sugar in the blood becomes food for bacteria, making it easier for them to survive and spread. In addition, diabetes causes weakened vision so it becomes even harder for individuals to balance or examine their feet properly.
The ultimate fear of a diabetic foot is an ulcer. This is rather common, and occurs when the patient develops a wound from stepping on a needle or other object when walking barefoot. The patient doesn’t feel anything, and thus rarely addresses or even notices the wound. Eventually it becomes infected and serious, potentially life-threatening results can follow.
If you have diabetes, you should definitely pay close attention to the condition and health of your feet. Avoid walking barefoot as much as possible, and schedule a visit at least once annually with your podiatrist. He or she, along with other specialists, will play a critical role in the management of your feet and overall health. Prevention and management are huge with diabetes.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Roughly two thirds of diabetics will experience a condition known as peripheral neuropathy in which the nerves of the feet and lower legs become damaged so that individuals will start to lose muscle function, reflexes, and most importantly the sensation of their lower limbs. As nerves become compromised, it becomes more difficult for the diabetic to protect and care for his or her feet. In most cases, both feet are affected, and the sensory loss begins in the toes, then spreads gradually across the foot and through the ankle. Eventually this leads to abnormal walking, unsteadiness, and a diminished ability to perceive pain or temperatures.
The sensory loss of diabetes is made even worse by other complications. The disease not only causes stiffness in the joints and blood-flow problems, it also compromises kidney function which can ultimately make it more difficult for wounds to heal. Diabetics are also more vulnerable to infections because their immune systems are weakened, and the excess sugar in the blood becomes food for bacteria, making it easier for them to survive and spread. In addition, diabetes causes weakened vision so it becomes even harder for individuals to balance or examine their feet properly.
The ultimate fear of a diabetic foot is an ulcer. This is rather common, and occurs when the patient develops a wound from stepping on a needle or other object when walking barefoot. The patient doesn’t feel anything, and thus rarely addresses or even notices the wound. Eventually it becomes infected and serious, potentially life-threatening results can follow.
If you have diabetes, you should definitely pay close attention to the condition and health of your feet. Avoid walking barefoot as much as possible, and schedule a visit at least once annually with your podiatrist. He or she, along with other specialists, will play a critical role in the management of your feet and overall health. Prevention and management are huge with diabetes.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Tuesday, May 19, 2009
Pleading the Fifth
It’s probably a good thing most people don’t type or play an instrument with their toes. Do you remember piano lessons growing up? Straining your hand to complete that chord with your pinky finger? The small “pinky” toe of the foot can experience its own unique set of complications from a variety of causes. One specific condition afflicting the fifth toe is called a Tailor’s bunion. Unfortunately, you don’t need to fix clothes to experience one.
The most common type of bunion affects the ball of the foot, and usually shows up as a bony, joint problem on the inside of the foot. It usually results in the big toe pointing outwards. A near mirror image of this condition is called a “Tailor’s bunion” which is very similar though less common. As one might expect, the key problem area with this condition is in the joint area just behind where the fifth toe starts, and it often results in the fifth toe pointing inwards. Usually, the bone and other structures in the area will become enlarged or inflamed, and the toe may be rotated inwards.
A whole host of varying biomechanical factors can lead to the development of a Tailor’s bunion. While some may claim that pronation, or an outwardly-rotated heel is the root cause, that alone is usually only part of the problem. Other issues may be involved in the forefoot or even the calf muscles. Either way, what often ends up happening is that the fifth toe loses its stability and becomes excessively mobile. This, in conjunction with first toe issues, can be associated with a “splayfoot” deformity in which all of the toes become unnecessarily spaced.
Over time, the underlying process of a Tailor’s bunion will become more evident as the stress of walking and forces from the ground begin to take their effects. Bony changes may occur on the top, bottom, or outside of that area behind the fifth toe, along with accompanying skin changes. Arthritis and inflammation in the area are also a likely.
You should definitely check with your podiatrist if you have any of these symptoms. Because the causes behind this condition are variable, it’s good to devise a treatment plan that will work for you. Orthoses are effective for treating some Tailor’s bunions, but not others. Like many conditions, the treatment comes down to the individual.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
The most common type of bunion affects the ball of the foot, and usually shows up as a bony, joint problem on the inside of the foot. It usually results in the big toe pointing outwards. A near mirror image of this condition is called a “Tailor’s bunion” which is very similar though less common. As one might expect, the key problem area with this condition is in the joint area just behind where the fifth toe starts, and it often results in the fifth toe pointing inwards. Usually, the bone and other structures in the area will become enlarged or inflamed, and the toe may be rotated inwards.
A whole host of varying biomechanical factors can lead to the development of a Tailor’s bunion. While some may claim that pronation, or an outwardly-rotated heel is the root cause, that alone is usually only part of the problem. Other issues may be involved in the forefoot or even the calf muscles. Either way, what often ends up happening is that the fifth toe loses its stability and becomes excessively mobile. This, in conjunction with first toe issues, can be associated with a “splayfoot” deformity in which all of the toes become unnecessarily spaced.
Over time, the underlying process of a Tailor’s bunion will become more evident as the stress of walking and forces from the ground begin to take their effects. Bony changes may occur on the top, bottom, or outside of that area behind the fifth toe, along with accompanying skin changes. Arthritis and inflammation in the area are also a likely.
You should definitely check with your podiatrist if you have any of these symptoms. Because the causes behind this condition are variable, it’s good to devise a treatment plan that will work for you. Orthoses are effective for treating some Tailor’s bunions, but not others. Like many conditions, the treatment comes down to the individual.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Tuesday, May 5, 2009
Rheumatoid Arthritis and your feet
Rheumatoid Arthritis, or RA, is a systemic disease in which your body’s immune system begins to attack some of its own tissues including the cartilage in your joints. It affects about 3 million people in the United States. The disease is seen three times more often in women than men, but it tends to affect all ethnic groups equally.
While RA can lead to weight loss (in this case, NOT a good thing!) and a mild fever, the hallmark feature is a persistent inflammation in the joints of both hands and both feet. Some of the earliest signs include morning stiffness which can last for over an hour, joint swelling, and energy loss. A generalized, overall feeling of discomfort is also pretty common.
RA can have a huge impact on your feet and quality of life. The severity of the disease may fluctuate, but over time, it may lead to various degrees of joint destruction, deformity, and a decrease in functional status. These changes are brought about by the ability of the disease to cause permanent damage to tendons, ligaments, cartilage, and bone. This in turn can cause biomechanical problems leading to bunions, hammertoes, nerve and blood vessel damage, and other issues. Raynaud’s phenomenon-in which blood flow is diminished in response to temperature changes or emotional stress-has also been noted.
Your podiatrist, in conjunction with your rheumatologist, should play a critical role in managing the health of your feet if you develop RA. Periodic assessments can be made to monitor the progression of the disease and prevent long-term complications. Conservative measures such as orthotics or pharmacologic treatments can be administered when needed. Additionally, surgical intervention is available to correct structural abnormalities associated with the disease. As an example, 20-35% of RA patients will develop “rheumatoid nodules” which are subcutaneous swellings commonly found near the Achilles tendon or sole of the foot. If these become painful or noticeable, your podiatrist can intervene surgically to remove them and eliminate the symptoms.
By taking a proactive approach and discussing your condition with your podiatrist, you can minimize the effects of RA on your feet, and maximize your overall health.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
While RA can lead to weight loss (in this case, NOT a good thing!) and a mild fever, the hallmark feature is a persistent inflammation in the joints of both hands and both feet. Some of the earliest signs include morning stiffness which can last for over an hour, joint swelling, and energy loss. A generalized, overall feeling of discomfort is also pretty common.
RA can have a huge impact on your feet and quality of life. The severity of the disease may fluctuate, but over time, it may lead to various degrees of joint destruction, deformity, and a decrease in functional status. These changes are brought about by the ability of the disease to cause permanent damage to tendons, ligaments, cartilage, and bone. This in turn can cause biomechanical problems leading to bunions, hammertoes, nerve and blood vessel damage, and other issues. Raynaud’s phenomenon-in which blood flow is diminished in response to temperature changes or emotional stress-has also been noted.
Your podiatrist, in conjunction with your rheumatologist, should play a critical role in managing the health of your feet if you develop RA. Periodic assessments can be made to monitor the progression of the disease and prevent long-term complications. Conservative measures such as orthotics or pharmacologic treatments can be administered when needed. Additionally, surgical intervention is available to correct structural abnormalities associated with the disease. As an example, 20-35% of RA patients will develop “rheumatoid nodules” which are subcutaneous swellings commonly found near the Achilles tendon or sole of the foot. If these become painful or noticeable, your podiatrist can intervene surgically to remove them and eliminate the symptoms.
By taking a proactive approach and discussing your condition with your podiatrist, you can minimize the effects of RA on your feet, and maximize your overall health.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
Tuesday, April 14, 2009
The Diabetic foot
It is a poignant statistic: every 30 seconds, a lower limb is lost to diabetes somewhere in the world. If you have Diabetes, proper foot care is very important. Poor foot care with diabetes can lead to serious health problems. So why does Diabetes affect the foot so severely? Diabetes damages the nerves, hence damage can occur in your feet and any injury will no be detected – this is called peripheral neuropathy. Diabetes also affects circulation. Poor circulations leads to poor healing in the foot. Diabetes slows down the immune system and makes you more prone to infections. The immune system is further slowed down by poor circulation to the foot.
So how can you take care of your feet? Inspect your feet daily. Check for cuts, redness, blisters, swelling and nail problems. Use of magnifying glass if your notice anything or have poor eyesight. Ask a family member to inspect your feet if you are unable to. Wash your feet gently with soap and water (always check the temperature of the water before). Be gently in washing your feet, use a soft towel or sponge. Make sure to dry between toes! If your feet are dry, use moisturizer to keep the skin from itching or cracking. Cut your nails carefully, don’t forget to file the edges! Never trim corns or calluses, bathroom surgery can lead to a slew of complications, let the doctor do the job. Your socks and shoes are the most important aspect of preventative care. Wear clean, dry socks every day, wear them around the house and even to bed. Do not use tight elastic, or thick bulky socks. Always inspect your shoes for any wear/tear and for any pebbles that might have gotten in. Most importantly: keep your blood sugar levels in check! And Get periodic foot exams. See your podiatrist on a regular basis for an examination to help prevent the foot complications of diabetes.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
So how can you take care of your feet? Inspect your feet daily. Check for cuts, redness, blisters, swelling and nail problems. Use of magnifying glass if your notice anything or have poor eyesight. Ask a family member to inspect your feet if you are unable to. Wash your feet gently with soap and water (always check the temperature of the water before). Be gently in washing your feet, use a soft towel or sponge. Make sure to dry between toes! If your feet are dry, use moisturizer to keep the skin from itching or cracking. Cut your nails carefully, don’t forget to file the edges! Never trim corns or calluses, bathroom surgery can lead to a slew of complications, let the doctor do the job. Your socks and shoes are the most important aspect of preventative care. Wear clean, dry socks every day, wear them around the house and even to bed. Do not use tight elastic, or thick bulky socks. Always inspect your shoes for any wear/tear and for any pebbles that might have gotten in. Most importantly: keep your blood sugar levels in check! And Get periodic foot exams. See your podiatrist on a regular basis for an examination to help prevent the foot complications of diabetes.
Advanced Foot Care
Robert E. Kuvent, DPM
3225 S Alma School Rd
Chandler, AZ 85248
480.917.2300
http://www.yourfeetfixer.com
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