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Mooresville Office 143 Joe Knox Avenue Mooresville, NC 28117 (704) 662-3660 |
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Foot & Ankle Associates Blog
Do you have pain in your feet? Have you ever tried an orthotic to treat this pain? Many people have bought orthotics or shoe inserts from a sporting goods store or drug store to try and treat their foot pain and for many people these temporary generic orthotics do provide some relief. But for others this does not meet their pain relief expectations. For these people a custom made orthotic from a foot and ankle specialist may be indicated.
Custom orthotics from a foot and ankle specialist can be used to treat a plethora of foot and ankle ailments. Some of these indications include but are not limited to plantar fasciitis (heel or arch pain), Achilles tendon pain, bunions, hammertoes, neuroma, athletic injuries, calluses, and corns to name a few. Custom orthotics place your foot in an ideal position for your body to function in and can relieve pain throughout your body.
Not all “custom” orthotics are the same. Only a medical professional specializing in foot and ankle pathology, such as a podiatrist, can truly analyze your feet for subtle biomechanical abnormalities and design the correct custom orthotic for you.
Don’t be fooled by poor imitations claiming to be “custom” orthotics, make an appointment today with our physicians Dr. Ades, Dr. Shapiro, and Dr. Robinson. If you think a custom orthotic may help your foot and ankle pain please contact our office online at www.footandankleassociates.com or by phone at (704) 662-3660.
Do you have or know anyone with Chronic Heel Pain (Plantar Fasciitis/Heel Spur Syndrome) or Achilles Tendon ailments? These respective problems are usually managed quite well with conservatives measures, such as avoidance of non supportive shoes, anti-inflammatories, ample rest, stretching, and avoidance of aggravating activities. In rare instances, if first and second line of treatments fail to gain significant relief for patients, cast immobilization and physical therapy may be needed. Luckily, these measures are able to effectively manage upwards of 90% of people with these ailments.
Unfortunately, there are a small percentage of patients that have exhausted standard and reasonable treatments. Traditionally, surgery has been a viable option when all else fails. However, in recent years, physicians have been able to offer their patients with these ailments with alternative non surgical treatments, with one being called Platelet Rich Plasma.
Platelet rich plasma (PRP) is a great non surgical treatment for Heel Pain due to Plantar Fasciitis(Heel Spur Syndrome) and chronic conditions of the Achilles Tendon. The idea is that these ailments are stuck in a chronic inflammatory or degenerative state, resistant to the normal healing process. PRP has many growth factors or components that can help heal these conditions stuck in chronic phases. It is obtained by using a patient's own blood which is drawn at the office and spun to separate the different components of whole blood. After separation of blood components, your doctor will inject the PRP obtained from the sample of blood into the area of problem after local anesthetic block.
Heel Pain due to Plantar Fasciitis (heel spur syndrome) and problems of the Achilles Tendon are not the only ailments that could benefit from Platelet Rich Plasma (PRP). PRP also has an application in major surgeries of the foot and ankle for those patients deemed a risk with healing problems, as determined by your doctor and medical history. Also, the diabetic population with chronic wounds can benefit from the healing properties of PRP.
In short, Platelet Rich Plasma can be a viable alternative treatment. If you or someone you know has chronic heel pain or Achilles problems, this may be a great alternative to surgery.
For more information regarding Platelet Rich Plasma, please call the office @ (704) 662-3660 to schedule an appointment.
Dr. James Robinson recently moved from Youngstown, Ohio where he completed a three year residency in foot and ankle surgery at Valley Care Health System, one of the oldest and most well-regarded podiatric residency programs in the United States. Dr. Robinson received his doctorate of podiatric medicine from the New York College of Podiatric Medicine in New York City in 2008.
Dr. Robinson is Board Qualified in foot surgery by the American Board of Podiatric Surgery, is an Associate of the American College of Foot and Ankle Surgeons, and is a member of the North Carolina Foot and Ankle Society and the American Podiatric Medical Association.
Dr. Robinson is experienced in the non-surgical and surgical treatment of athletic injuries, arthritis, flatfeet, diabetic foot conditions, bunions, hammertoes, heel pain, ingrown toenails and other foot and ankle conditions.
Dr. Robinson enjoys sports, cooking, reading and spending time with his wife and daughter.
Dr. Robinson has privileges at Lake Norman Regional Medical Center in Mooresville and Presbyterian Hospital in Huntersville.
Dr. Robinson is available to see patients in our Mooresville, Huntersville and University clinics. Please feel free to call the office at (704) 662-3660 to make an appointment.
Feet endure tremendous pressures of daily living. An average day of walking brings a force equal to several hundred tons on them. They are subject to more injury than any other part of the body, underscoring the need to protect them with proper footwear.
Doctors of podiatric medicine are health care professionals trained for both palliative and surgical care of the foot and ankle. They also are fully qualified to recommend selection of the right pair of shoes, or address other aspects of foot health, for all members of the family.
Children’s Shoes
When a child begins to walk, shoes generally are not necessary. Allowing an infant to go barefooted indoors, or to wear only a pair of socks, helps the foot grow normally and develop its muscles and strength, as well as the grasping ability of toes.
As children grow more active, and their feet develop, the need for shoes becomes apparent. It becomes necessary to change shoe sizes at a pace that frequently surprises and even dismays parents, to allow room for growth.
When purchasing shoes for children, remember these tips:
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Examine the shoe itself. It should have a firm heel counter (stiff material on either side of the heel), adequate cushioning of the insole, and a built-in arch. It should be flexible enough to bend where the foot bends—at the ball of the foot, not in the middle of the shoe.
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The child’s foot should be sized while he or she is standing up and fully weight-bearing.
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There should be about one-half inch of space (or a thumb’s width) between the tip of the toes and the end of the shoe. The child should be able to comfortably wiggle his or her toes in the shoe.
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Have the child walk around the store for more than just a few minutes wearing the shoe with a normal sock. Ask the child if he or she feels any pressure spots in the shoe. Feel the inside of the shoe for any staples or irregularities in the glue that could cause irritation. Examine where the inside stitching hits the foot. Look for signs of irritation on the foot after the shoe is worn.
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Shoes should not slip off at the heels. Children who tend to sprain their ankles will do better with high-top shoes or boots.
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Both feet should be measured, and if they are two different sizes, shoes should be chosen that fit the larger foot best.
Women’s Shoes
Women inflict more punishment on their feet in part from improper footwear that can bring about unnecessary foot problems. Some of the problems result from high-heeled shoes (generally defined as pumps with heels of more than two inches). Doctors of podiatric medicine believe such heels are medically unsound and attribute postural and even safety problems to their use.
To relieve the abusive effects of high heels, women can limit the time they wear them, alternating with good quality sneakers or flats for part of the day.
They can also vary heel height. There are comfortable and attractive “walking” pumps (also called “comfort” or “performance” pumps) for work and social activities, that blend fashion considerations and comfort. These pumps offer athletic shoe-derived construction, reinforced heels, and wider toe room.
Activity has a bearing on the considerations; wearing the right shoe for a particular activity is probably as important a factor in the choice of shoes as any.
Perhaps the best shoe for women is a walking shoe with laces (not a slip-on), a polymerized composition sole, and a relatively wider heel with a rigid and padded heel counter, no more than three-quarters of an inch in height.
Men’s Shoes
The best shoes for men are good quality oxford styles, shoes ordinarily associated with wing-tip or cap toe designs. Also suitable are slip-ons, dressy loafers, and low dress boots.
Men as well as women should buy shoes for work, leisure, and special activities, matching the shoe to the activity.
Male (and female) office workers should earmark three to five pairs of shoes for business hours—general oxfords and loafers for men; pumps and oxfords for women. Cushioned-sole shoes that give good support are essential for those who spend most of their working days on their feet.
There is no question about the need for foot protection for those who work in heavy industry. Safety shoes and boots—those that are waterproof or water-resistant, with insulated steel toe caps and soles of non-conducting materials—help prevent injuries to the feet and reduce the severity of injuries that do occur.
Shoes for Athletics
Different sports activities call for specific footwear to protect feet and ankles. Sports-specific athletic shoes are a wise investment for serious athletes, though perhaps a less critical consideration for the weekend or occasional athlete; nevertheless, it’s a good idea to use the correct shoe for each sport. Probably a more important consideration is the condition of the shoe—don’t wear any sport or other shoes beyond their useful life.
Athletic footwear should be fitted to hold the foot in the position that’s most natural to the movement involved.
For example, a running shoe is built to accommodate impact, while a tennis shoe is made to give relatively more support and permit sudden stops and turns. For sports, “cross trainers” are fine for a general athletic shoe, such as for physical education classes. But if a child is involved more heavily in any single sport, he or she should have a shoe specifically designed for that sport.
Shoe Care
For longer service, keep shoes clean and in good repair. Avoid excessive wear on heels and soles. Give your shoes a chance to breathe—don’t wear the same pair two days in a row (you prolong the life of shoes by rotating their use). Never wear hand-me-down shoes (this is especially important for children).
Seal of Acceptance
The American Podiatric Medical Association awards its Seal of Acceptance to a wide variety of shoes (and shoe-related products), which have been deemed to enhance a consistently applied program of daily foot care and regular professional treatment.
The intent of such endorsements is to make a significant contribution to the foot health and foot health education of the public.
For a list of shoe companies holding the APMA Seal of Acceptance, visit the APMA's online seal information.
Buying Tips
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Have your feet measured while you’re standing.
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always try on both shoes, and walk around the store.
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Always buy for the larger foot; feet are seldom precisely the same size.
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Don’t buy shoes that need a “break-in” period; shoes should be comfortable immediately.
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Don’t rely on the size of your last pair of shoes. Your feet do get larger, and lasts (shoemakers’ sizing molds) also vary.
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Shop for shoes later in the day; feet tend to swell during the day, and it’s best to be fitted while they are in that state.
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Be sure that shoes fit well—front, back, and sides—to distribute weight. It sounds elementary, but be sure the widest part of your foot corresponds to the widest part of the shoe.
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Select a shoe with a leather upper, stiff heel counter, appropriate cushioning, and flexibility at the ball of the foot.
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Buy shoes that don’t pinch your toes, either at the tips, or across the toe box.
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Try on shoes while you’re wearing the same type of socks or stockings you expect to wear with the shoes.
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If you wear prescription orthotics—biomechanical inserts prescribed by a podiatric physician—you should take them along to shoe fittings.
What Is Hammertoe?
Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.
Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.
Causes
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.
Hammertoes may be aggravated by shoes that don’t fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn.
Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.
Symptoms
Common symptoms of hammertoes include:
- Pain or irritation of the affected toe when wearing shoes.
- Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
- Inflammation, redness, or a burning sensation
- Contracture of the toe
- In more severe cases of hammertoe, open sores may form.
Diagnosis
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Hammertoes are progressive – they don’t go away by themselves and usually they will get worse over time. However, not all cases are alike – some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non-surgical Treatment
There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors.
A number of non-surgical measures can be undertaken:
- Padding corns and calluses.Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.
- Changes in shoewear.Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels – conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
- Orthotic devices.A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.
- Injection therapy.Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
- Medications.Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Splinting/strapping.Splints or small straps may be applied by the surgeon to realign the bent toe.
When Is Surgery Needed?
In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed.
Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
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