Houston Foot Health Blog

Country Music Star Chely Wright Recovering From Foot Surgery

Mon, 19 Dec 2011 08:00:00 EST

Country star Chely Wright is recovering from surgery on her right foot. She had a painful Morton's neuroma removed and a bunion corrected. She wrote on Twitter about her recovery "Super bored with this foot surgery recovery. Can this be over now? Foot is really swollen and very painful. Ugh. Okay, chin up! i will survive."

Both Morton's neuroma excisions and bunion surgery are very common foot surgeries that we perform in our Houston podiatry practice. A Morton's neuroma is an inflamed nerve that causes intense pain in the ball of the foot. There is conservative treatment for a neuroma, including anti-inflammatory medication, padding, injection therapy, custom orthotics, and shockwave therapy. When these fail, surgery is certainly indicated. Surgery to treat a Morton's neuroma is very successful. It entails removal of the inflamed piece of nerve. Our patients often report an immediate relief of pain.

A bunion is a prominence of bone on the side of the big toe joint. It is caused by the pressures of walking causing the metatarsal bone to rotate and create a large bump on the side of the foot. Correcting a bunion involves repositioning the metatarsal bone back in alignment. This is accomplished by creating a surgical fracture, realigning the joint, and stabilizing the area with small screws. This is a common and successful surgery and many are surprised that they don't feel as much pain as they expected.

The key to a successful foot surgery and recovery is ensuring you are being treated by a superior foot surgeon. The foot surgeons at Foot & Ankle Institute of Texas are among the most experienced and respected in the field. If you are suffering from a painful Morton's Neuroma or Bunion, contact our office for a comprehensive evaluation.

The Bump In Your Arch May Be An Accessory Navicular

Wed, 14 Dec 2011 08:00:00 EST

Many people have a prominent bump above the arch of their foot. This can be caused by a small, extra bone known as an accessory navicular. While this bone has no function, it can become infllamed and painful. It is also embedded within the strong posterior tibial tendon which also has the potential to become inflamed and painful, especially in those with flat feet.

The treatment for an inflamed accessory navicular, known as Accessory Navicular Syndrome, is often managed through conservative means. In cases where conservative therapy fails to alleviate the arch pain, foot surgery may be recommended by your Houston foot and ankle surgeon.

If you have been suffering from a painful bump in your arch, do not suffer anymore. Relief can be found by visiting the Foot & Ankle Institute of Texas for a comprehensive evaluation to determine what treatment can provide the most complete relief. To learn more, read our informative article about accessory navicular syndrome.

Should Rio Ferdinand Get His Bunion Diagnosed By Twitter?

Tue, 13 Dec 2011 08:00:00 EST

Manchester United star Rio Ferdinand reached out to his Twitter followers to help him determine what the growth on his foot was. He received a bunch of jokes about the picture of his foot that he posted, before some followers told him that he is suffering from a bunion.

A bunion is a bump on the side of the great toe joint. It is generally caused because of inherited foot function, which causes the bones to shift and cause the bunion deformity. It also can be worsened by trauma, very common in soccer players. Soccer players routinely and notoriously wear their shoes too small for their feet, which causes excess pressure on the foot and can make a bunion deformity worse and more painful. Furthermore, the nature of the sport, with starting, stopping, kicking, and pivoting also puts excessive force on the foot.

The pain from a bunion can be alleviated with padding and changing shoe style, size, and width. This may not always be an option. It also does not always alleviate the pain. In these cases, surgery will be necessary to correct the bunion deformity and realign the joint.

Most importantly it is vital to not wait before you get your foot evaluated. As a bunion worsens, the procedure to correct it changes and effects the postoperative course. Don't turn to Twitter like Rio! Contact the Foot & Ankle Institute of Texas to be evaluated by a foot surgeon and learn your options.

Don't Let An Ankle Fracture Go Untreated

Mon, 12 Dec 2011 08:00:00 EST

Too many people write off a sprained ankle and don't get it treated properly. Unfortunately, many of those assumed sprains are actually an ankle fracture. An ankle fracture is a break in one of the bones that form the ankle joint.

While sprains and fractures both present with pain, swelling, and bruising, the fractured or broken ankle will have pain and symptoms that continue longer. If a broken ankle is not treated properly, it can lead to infection, arthritis, continued swelling and pain, and deformities of the foot and ankle.

If a broken ankle is in good position, immobilization and keeping the pressure off of the limb may be sufficient. If the fracture is displaced or otherwise in poor position, surgery to repair the fracture may be necessary. This may involve the placement of screws and plates, bone grafts, ankle fusions, or ankle replacements depending on the severity of the fracture and the assessment of your ankle surgeon.

If you think that you sprained your ankle, but it just won't heal right, be sure to get it examined and properly treated. Contact our Houston foot and ankle surgery office for an immediate appointments and see what your options for treatment are.

Don't Let High Heels Cause Foot Pain To Ruin Your Holidays

Fri, 09 Dec 2011 08:00:00 EST

The holiday season is upon us and out come the celebratory high heeled shoes to all of the holiday parties. Consistently wearing high heels can lead to problems, however.

As the heel is raised by shoes, pressure is moved forward onto the midfoot and the ball of the foot. This excess pressure can lead to pain in the joints of the midfoot and forefoot, which can lead to arthritis, and can make certain foot deformities, such as bunions and hammertoes, worse. The pressure in the forefoot can also cause an inflammation of the nerves, known as a Morton's neuroma.

Constantly raising the heel can also lead to strain and shortening of the calf muscles and achilles tendon. This can lead to painful conditions such as plantar fasciitis and achilles tendonitis. These conditions will not only cause pain when you wear high heels, but all shoes be painful.

One way to combat issues caused by high heels is to stretch out the muscles in the calf. Rolling a Thera-Band foot roller, especially when frozen, will stretch out the muscles under the foot and the cold will reduce the inflammation.

Preventing foot pain should be top of your holiday list. If you find it difficult and painful to stand at your holiday parties, contact Houston podiatrist Dr. Andrew Schneider to see how it can be solved quickly and easily.

James Bond Hurts His Foot on the Set of a Christmas Movie

Fri, 09 Dec 2011 08:00:00 EST

Former James Bond actor Roger Moore suffered a foot injury when filming the Christmas made-for-TV movie "A Princess For Christmas." The night before shooting wrapped, Moore tripped over a table and crushed his foot. He continues to have pain several months later.

Just this week I saw a new patient referred to me by a local emergency center. She essentially did the same thing to her foot that Sir Roger did. The injury caused one of the bones in her big toe to be broken into several pieces. I operated on her today and it was tough putting her back together again. Think of it like a living 3D jigsaw puzzle. Takes longer than you'd expect to get it together, it is often frustrating, but overall it's fun!

So many people minimize foot injuries and foot fractures thinking that there is nothing that can be done for them. Most often, we either splint toes, wear special shoes or boots, and rest fractures in our feet so they can heal. If this patient did not come for treatment, however, her foot would have healed in a bad position and she would have had both a deformity of the bone, as well as painful arthritis, for the long term. By having the broken foot repaired with surgery, the bone will heal properly and completely.

If you trip over something in the house and end up with a painful, bruised, and swollen foot, be sure to get immediate care. You'll have piece of mind knowing what the injury is and wil be able to have it treated so it does not become an ongoing problem. Contact our Houston podiatry office for an immediate appointment and evaluation.

Stress Fracture Takes Houston Forward Out For The Season

Sun, 04 Dec 2011 08:00:00 EST

The Houston Cougars will be without the services of their forward Mikhail McLean due to a stress fracture in his right foot. The injury will keep him out for this season.

McMcLean is scheduled to have surgery to repair the fracture. He is expected to return to the court for the 2012-20113 season at full strength.

Stress fractures are sometimes written off as just a minor injury, but they should not be ignored. With continued pressure, the fracture is likely to completely break and worsen. Many stress fractures do not require surgery. Most rely on immobilization in a fracture boot to heal properly. If someone is particularly hard on their foot, such as an athlete like McLean, surgery may be recommended to heal the fracture quicker.

There is a myth that if your foot is broken, that you cannot move it or walk on it. This is completely false. In fact, a stress fracture is often walked on since there is minimal bruising and not as much pain as a complete break in the bone. If your foot has become swollen and constantly painful, don't wait to get it checked. Visit your Houston podiatrist for an x-ray to ensure that everything in your foot is properly intact.

Large Study Determines Why Some Wounds Heal Without Amputation

Fri, 02 Dec 2011 08:00:00 EST

A Swedish study of diabetic foot ulcers resulted in interesting data about what is needed for a wound to heal without amputation. The study included nearly 2,500 participants, which is one of the largest studies involving diabetic foot wounds.

The study found that ulcers that were more superficial were more likely to heal. Fortunately, Houston wound specialists are often able to make deeper wounds progress to become superficial and healed. Another criteria for healing was the length of time since the person became diabetic. This can also be mitigated by ensuring the diabetes remains in control.

Another critical factor was to ensure that there is good blood flow to the lower extremity. Every person with diabetes, whether in control or not. should have their circulation screened. This is an non-invasive test which takes approximately 30 minutes. Our office uses the PADnet system with excellent results and many limbs saved by taking measures to identify early onset Peripheral Arterial Disease.

If you are diabetic and have not had a comprehensive exam of your feet, including your circulation, contact our Houston podiatry office for an appointment.

Early Detection Of PAD Responsible For Drop In Amputations

Wed, 30 Nov 2011 08:00:00 EST

A study done in Malta is reverberating throughout the world. Over seven years, the number of lower extremity amputations performed has been reduced by 33%. What was responsible for this was an effort to screen diabetics for risk factors, especially Peripheral Arterial Disease (PAD).

Early detection of PAD allows for restoration of the blood supply, often with a minimally invasive procedure such as an angioplasty. This allows ulcerations to heal and lowers the risk of amputation significantly. Amputations of the lower extremity strain the healthcare system, since they usually command a 30 day hospital visit at a minimum. 10-20% of those amputated don't survive 30 days and only 5% returned to full function.

The goal of a podiatrist in Houston is to assess diabetic patients for PAD. In our practice, we use PADnet technology, which is a non-invasive test for PAD. This allows us to identify PAD early and seek intervention to minimize complications in the future. If you have diabetes and have not been screened for PAD, contact us for an appointment.

British Healthcare System Targets Bunion Surgery As "Low Priority"

Tue, 29 Nov 2011 08:00:00 EST

It is true that bunion surgery is elective surgery, however it does not mean that it is unnecessary surgery. This is what the British National Health Service would have us believe. They have recently ruled that bunion surgery will not be covered until the patient is in extreme and debilitating pain.

Not every case of bunions, or hallux valgus, are the same. In our Houston podiatry practice, we see patients with severe bunion deformities that offer no pain. We also see patients with minimal deformity in severe pain. Since pain is subjective, and the NHS system will look for objective signs of bunion progression, those that are in pain and require bunion surgery may not be eligible if the deformity is not deemed severe enough.

By no means does every bunion require surgery. In fact, we counsel patients every day, discouraging them from pursuing surgery for a bunion that is not symptomatic. That said, the decision for surgery should be a clinical one, not based on arbitrary criteria set forth by the government health system. Such choices are sacrificing the patient's health and well being for a cost savings.

Bunion surgery is not a cosmetic procedure. A bunion deformity causes pain that limits the shoes that one can fit into and the exercise that one can do. Left untreated, the patient suffering with a painful bunion is more at risk for other joints to start hurting, progressive arthritis, and instability which leads to falls. Hopefully the NHS in the UK will reevaluate their decision and reverse it in the future.

How Can Diabetics Survive The Holidays?

Thu, 24 Nov 2011 08:00:00 EST

The holidays can be difficult. It is estimated that people consume an average of 5,000 calories on Thanksgiving. For those keeping track, that's over twice what someone should consume in a day! This is too much for anyone, however it can be especially problematic for people with diabetes. Diabetics have to be particularly concerned since the carbohydrate-rich meals will break down into sugar.

Here are 7 strategies to survive the holidays while keeping your diabetes in check.

Shift your focus from food to family and friends Take the chance to reconnect with your those you don't get a chance to spend time with when you're busy at work.
Everything in moderation - Don't overdo it! The holidays are full of foods that you likely only eat a few times a year. Eat slowly and savor the flavors. Keep yourself to reasonable portions and say no to seconds. Watch your carbohydrate consumption...especially if you're going for dessert!
Eat before your holiday meal Skipping meals prior to your holiday meal is a poor strategy. You'll arrive hungry and will overeat. It will also make it difficult to keep your blood sugar in check.
Bring your own dish You have diabetes, but not everyone else does. Don't rely on others making food suitable for you to eat. Offer to contribute to the meal and bring your favorite, diabetes-friendly dish to the meal.
Be careful what you drink Remember that alcohol can play havoc with your blood sugar control. Drinks will also add lots of calories to your total intake. Limit yourself to just one or two drinks.
Stay active The holidays are a busy time, but make sure you take time each day to exercise. This will help you control both your diabetes and your weight during the holiday season.
Get back on track! If you fall into the holiday pitfall of overeating, don't beat yourself up. Stop eating for that night and resolve to wake up the next morning back in your regular routine. One slip up does NOT have to derail your health.

The holidays are a challenge to your diabetic health. Do your best to take care of yourself and be sure you stay healthy this holiday season.

Texans QB Matt Schaub Snubs Houston Foot Specialists For Opinion On His Injury

Tue, 22 Nov 2011 08:00:00 EST

Houston Texans quarterback Matt Schaub is scheduled to get another opinion on his foot injury on Wednesday. He is travelling to see a foot specialist in Charlotte, NC. This opinion has been delayed, since the doctor has been out of town. Schaub could have received superior care here in Houston, however.

Houston boasts some of the best foot and ankle surgeons in the country. Aside from disregarding the Texans' own team doctors, he is also overlooking world renowned podiatrists who could have already put him on the road to recovery. Instead, Schaub is still hobbling around untreated in a fracture boot. The Lisfranc injury he is dealing with needs definitive therapy, probably surgery, and delaying the treatment will not do him any favors.

I am proud to be part of a community that has offers some of the best in foot and ankle surgery. Dr. Sam Mendicino, Dr. David Blumfield, Dr. Asia Lo, and Dr. Vito Speciale all come to mind as the right choice to care for an injury such as Schaub's.

Regular Checkups Key To Saving Diabetic Feet

Tue, 22 Nov 2011 08:00:00 EST

How can we prevent the 60,000 lower extremity amputations performed on diabetics each year? The answer may be a simple one. Studies have shown that routine foot examinations can drastically reduce that number.

Diabetes can cause diabetic peripheral neuropathy, which is a numbing of the nerves in the feet. The numbness limits the amount of feeling that the diabetic has. This can cause them to miss issues that would ordinarily be painful. The most common of these is a diabetic foot ulcer.

There are several effective treatments for a diabetic foot ulcer, however many people delay treatment because they do not know that an ulcer is present. A regular diabetic foot evaluation helps to prevent this from happening by inspecting the feet and educating the diabetic patient on the proper care of their feet.

Diabetic foot ulcers are slow to heal, even with proper treatment, and the best way to treat them is to avoid them from occuring altogether. Having regular foot examinations and protecting the feet with therapeutic diabetic shoes are the best ways to keep your feet healthy for years to come.

Can High Heels Be Linked To The Economy?

Mon, 21 Nov 2011 08:00:00 EST

Does the height of high heels relate to the health of the economy? Researchers at IBM says that it does. Research has shown that heel heights tend to go up in a poor economy (interestingly, the same study shows skirt lengths shortening too). The reasoning is that women turn to high heels as a means of escape.

The economy may be turning around, however. Those who are monitoring social media are predicting a coming decrease in heel heights. This may not indicate a full economic recovery, however. Experts feel that it also can be a sign that people are beginning to reach a comfortable point with the economic downturn.

Who Else Can Wear Mario Batali's Orange Crocs?

Fri, 18 Nov 2011 08:00:00 EST

Celebrity Chef Mario Batali, well known from his own shows on Food Network as well as Iron Chef America, is also known for his signature orange Crocs that he wears in the kitchen, on red carpets, and even when at the White House. Who would think about wearing orange Crocs? Certainly not me...until recently.

I was at a meeting of the American Academy of Podiatric Practice Managment, of which I am a member of the Board of Trustees. Crocs is one of our champion corporate partners and was exhibiting at the meeting. Crocs has a specialized line known as CrocsRx as well as a line of Crocs Work shoes. While many are neutral colors, the orange Crocs were jumping out at me.

CrocsRx is a line of crocs that are specially made for a host of foot concerns. All of the CrocsRx line comes in higher quality materials and offers more support than the traditional retail Crocs. The Relief is a clog that offers a footbed that his heat moldable and is ideal for common foot problems such as bunions, hammertoes, heel pain, and arthritis. The Cloud line is ideal for diabetics and is even approved for coverage by Medicare under the therapeutic shoe bill. It comes in four widths and is constructed from a silver embedded material which offers protection from bacteria.

Crocs Work Shoes offers a washable clog that features a superior non-skid sole. It is approved to be used in the hospitality, food service, and healthcare environments. These shoes offer support, cushioning and protection for those working in the service industries. While you can rock the orange Crocs like Chef Batali, there are other colors to choose from as well.

I now have my pair of Mario Batali orange Crocs. While my wife has told me that I'm not permitted to wear them out of the house, I've already broken that rule. So far, the reviews are positive...I'm totally pulling them off!

As a special consideration to my patients and readers, Crocs has agreed to offer 20% off on any online purchase of CrocsRx or Crocs Work Shoes. Here's how it works:

Visit www.CrocsRx.com
Click on the "Patients" tab on the top of the page, located in the gray shaded area
At the top of the next page, enter "40011561" in the field requesting a "Doctor's Code"
You will then receive 20% off any CrocsRx and/or Work products displayed on the page that follows
Happy Shopping!!

Kristen Stewart Limping From Foot Pain At Twilight Premiere

Wed, 16 Nov 2011 08:00:00 EST

Kristen Stewart was seen limping around in her Jimmy Choo's at the premiere of the 3rd Twilight film. Stewart seemed to have enough of the shoes and got rid of them as soon as she could. That was right after walking the red (well, actually it was black) carpet outside the Nokia Theater for a showing of The Twilight Saga: Breaking Dawn - Part 1.

Stewart reportedly injured her foot on the set of her upcoming film Snow White and the Huntsman, in which she plays Snow White. The injury occured during a stunt for the film. While she said the injury wasn't bad, the pain was worsened by wearing the heels at the premiere.

She stated that her feet usually hurt in heels, but the injury made it worse and she was planning to get out of them ASAP.

So many women suffer through pain when wearing heels, but you don't have to sacrifice comfort for fashion. If you find that the shoes that you most want to wear are hurting you, visit your Houston podiatrist for an evaluation. You can probably have the best of all worlds...to look good and to feel good.

How Can Visiting A Podiatrist SAVE $3.5 Billion?

Tue, 15 Nov 2011 08:00:00 EST

The Journal of the American Podiatric Medical Association (APMA) published a study showing astounding findings related to diabetic foot care. The study showed that if a person at risk for developing a diabetic foot ulcer visited a podiatrist one time prior to complications setting in, the US healthcare system could save $3.5 billion. The study was based on studying 500,000 patients' medical records.

That savings equals approximately $20,000 per person over a three year period. This is the savings for people covered by Medicare or private insurance. The study did not include those who were uninsured, which would likely have increased the savings since those people are at greater risk for developing foot complications related to diabetes.

Diabetes effects 26 million people of which 7 million are undiagnosed. Unfortunately, many will be diagnosed with a serious complication, such as a diabetic foot ulcer, which will already put their life and limb at risk. Diabetes causes in excess of 65,000 lower limb amputations in one year. Many of these amputations could have been prevented, if only evaluated by a podiatrist prior to complications occuring.

As a podiatrist in Houston, TX, we see people with diabetes who are at risk for foot complications. Many of our diabetic patients, however, only visit twice a year to ensure everything checks out okay. The most important action for anyone with diabetes is to form a relationship with a podiatrist. While you may have no complications now, having that relationship could ultimately save your life or limb if one occurs.

Want More Information About Matt Schaub's Lisfranc Injury?

Tue, 15 Nov 2011 08:00:00 EST

As was reported yesterday, Houston Texans' quarterback Matt Schaub has suffered a season-ending injury to his right foot. The injury he is being treated for is a Lisfranc injury.

Our phone has been ringing off the hook, both as a podiatrist in Houston and as a Houston Texans fan. Just what is a Lisfranc injury and what does it mean for Schaub and our team?

I wrote an article about Lisfranc injuries in order to provide the information you need to know what Schaub is dealing with, what the treatment is, and how long we will be without him.

You can find the article in the Patient Education section of our website.

Houston Texans QB Matt Schaub Out With Foot Injury

Mon, 14 Nov 2011 08:00:00 EST

Usually I write about sports stars and celebrity's foot pain and injuries to allow me to inform about preventing and treating these situations. This one hits close to home, though...

Houston Texans quarterback Matt Schaub played a stellar game yesterday against the Tampa Bay Buccaneers, beating them soundly 37-9. The Texans now boast a promising 7-3 record, despite losing Andre Johnson and Mario Williams to injuries earlier in the season. Schaub reportedly injured his right foot during a quarterback sneak in yesterday's game. While he initially stayed in, he had to leave the game because of overwhelming pain. He was seen leaving the complex wearing a walking boot on his right foot.

It has already been announced that Schaub will miss the next game in TWO weeks (next week the Texans have a bye). Backup quarterback Matt Leinart will start that game.

What can the injury be? Details haven't been released yet. An ankle sprain would have been reasonably visible on replays. My suspicion (and only a guess) is that the injury could be a fracture. A common football injury is a Jones fracture, or a fracture of the base of the fifth metatarsal bone. This happens with a sudden twist of the foot when it is planted on the ground. The fracture, unfortunately is reasonable unstable and usually requires foot surgery to treat.

Hopefully we'll learn more about Matt Schaub's injury in the coming days and learn more about the future of the Texans' season.

UPDATE: It was just released that Matt Schaub will indeed be out for the remainder of the season. He has suffered a Lisfranc injury, which is less common injury that results a series of fractures in the midfoot. The Lisfranc joint is between the tarsal bones and the bases of the metatarsals. While the injury can be stable, and not requiring surgery, surgical correction of this injury is most common. Correction involves stabilizing the injury with fixation, usually utilizing plates and screws. While some athletes return from this injury, it can be career threatening.

Wishing the best to Matt Schaub on his upcoming surgery and hoping to see his return in the 2012 season. Also, good luck to Matt Leinart for leading the team to continued victory.

Are Your Shoes Killing You? The High Heel Dilemma.

Wed, 09 Nov 2011 08:00:00 EST

Are High Heel shoes getting out of hand? The average heel height on women's shoes have gone up from 3 inches to 5 inches over the past few years. Along with that, women's visits to the doctor with foot, toe, and ankle complaints have risen 75%. In our Houston podiatry office, we regularly see women coming through with pain directly related to wearing high heeled shoes.

High heels can directly cause or influence a variety of foot complications. They can influence foot deformities such as bunions and hammertoes. They can cause heel pain, plantar fasciitis, stress fractures, and pain in the ball of the foot caused by a Morton's neuroma. Studies have also shown a thickening and shortening of the Achilles tendon related to extended use of high heels. High heels also alter the posture and how the body is aligned. This puts excess pressure on the knees and can cause them to break down and become arthritic.

Is the answer to never wear high heels? Absolutely not! But to wear them in moderation is key to allow years of enjoyment in the future. If you find it difficult to wear high heels because of foot pain, call our Houston podiatry office for an immediate consultation.

World Diabetes Day Celebrated With 2000 FREE Diabetic Foot Testing Kits Available

Wed, 09 Nov 2011 08:00:00 EST

November is Diabetes Awareness Month and many companies and organizations are working to raise awareness and do their part to save lives and limbs. The numbers of people effected by diabetes continues to grow, with an estimated 440 million to be affected in the next 20 years.

Along with those increased numbers is the increased complications associated with diabetes, such as diabetic foot ulcers. Because of decreased sensation, known as diabetic peripheral neuropathy, patients with diabetes are at greater risk of developing a foot ulcer that can progress to an amputation. Studies have shown that regular assessment by a podiatrist in Houston will greatly reduce the chances of foot complications of diabetes. That said, fewer than 50% of diabetics have been assessed by a podiatrist for an annual foot exam.

Anodyne Therapy, LLC is providing foot assessment kits to those who call 1-800-521-6664 or visit www.anodynetherapy.com/diabetesday from November 14-18 to request their free kit. The kit will allow you to assess the sensation of your feet and alert you to any deficiency.

If you suspect that you are experienced a diabetic foot complication, contact our Houston podiatry office for an immediate appointment.

Billy Idol Is Recovering From Foot Surgery

Wed, 09 Nov 2011 08:00:00 EST

Rocker Billy Idol has tweeting a series of photos taken after a recent foot surgery. He says in his posts that he had "Minor surgery on foot this AM to correct malformation of foot due to hitting a truck tire in road a year ago feels ok though." While we don't know details beyond that, if the surgery is resulting from a prior injury it could well be to manage arthritis that might have formed.

Even an injury that is seemingly minor at the time can result in arthritis, especially if it impacts the joint. For instance, Houston football fans are familiar with turf toe. Growing up, it seemed ridiculous that a sprained great toe could keep a professional football player out of the game for so long. Understanding the injury now, it is a major trauma to the great toe joint which, if not properly treated at the time, can become stiff and arthritic. It becomes so painful that foot surgery is ultimately the best and only effective treatment.

Bone surgery typically takes 6-8 weeks to heal and, depending on the surgery, that is at least how long Billy Idol will have to wait to be back in stage form. But 80's hard rock fans don't fret. I'm sure Billy will be back rocking the stage near you. Feel better Billy Idol!

If you have suffered a foot or ankle sprain or injury that you think is minor, it is worth visiting your Houston foot surgeon to have it checked. Treating an injury properly will help to avoid surgery in the future.

Billy Idol on WhoSay
Billy Idol on WhoSay

Is Running While Pregnant Safe? Houston Podiatrist Discusses

Tue, 08 Nov 2011 08:00:00 EST

Houston may be one of the most improbable running cities. The one thing we have going is the flat terrain. Other than that, our air quality is poor, our allergens are high, and not to mention our heat and humidity. These all play a factor as to how safe running is while a woman is pregnant.

Amber Miller was 39 weeks pregnant when she participated in and completed the Chicago Marathon. Shortly thereafter she had her baby. This raises the issue about what are safe parameters to run for fitness and certainly to compete at an advanced level. It is recommended for pregnant women to participate in exercise for 30 minutes a day.

Your best bet is to consider your current fitness level. If you were not one who exercised ever, pregnancy isn't the time to start. If, however, you were fit coming in, exercise should be safe for you and your baby. It is best, of course, to seek the advice of your obstetrician for a definitive answer.

This article was featured on www.active.com and explores this topic in depth.

Liza Minnelli Had Surgery For A Broken Foot

Tue, 08 Nov 2011 08:00:00 EST

Singer and actress Liza Minnelli has undergone surgery to treat a broken foot. She reportedly fractured her foot in an accident last weekend. It is unclear how she broke her foot, however she did have to pull out of a luncheon for the Police Athletic League's Woman of the Year luncheon where she was to be honored.

Many people have the misunderstanding that there is nothing that can be done for a broken foot. This could not be further from the truth. This is actually confusion with a similar saying about a broken toe, which incidentally is also false. Both are serious medical conditions that should be diagnosed and treated quickly.

If you continue to walk on a broken foot, you run the risk of displacing the fracture. At that point it can only be corrected with surgery. Surgery for a broken foot will, in most cases, involve pins, screw, and/or plates to stabilize the fracture. If a fractured foot is recognized and treated early, and the bone is in good position, surgery can be avoided. In those cases, the foot and ankle will be immobilized with a cast or fracture walker boot. Depending on the location and stability of the fracture, you may be able to walk in the boot or you may need to use crutches to keep the pressure off of the foot. A foot fracture typically heals in six to eight weeks.

Aside from increasing the possibility of surgery, an untreated foot fracture will often lead to arthritis. This can take a situation that could have only been temporarily painful into one that is chronically painful. If this happens, surgery to correct it is more extensive, the results less predictible, and the aftereffects less appealing.

If you have suffered an injury, even if it is just a "twist" of your foot or ankle, it is best to call our Houston podiatry office to have an x-ray taken. This way you can ensure that you have the most complete evaluation and the proper treatment.

Kids Should Walk on the Sole (Not Side) of their Shoes

Mon, 17 Oct 2011 08:00:00 EST

There are a few things that happen when you become a Houston podiatrist. One is that you are constantly looking at the shoes people wear, which is gratifying from a job security perspective. Another is that we're constantly watching people walk. Sometimes this joins together and we see people, especially children, walking so poorly that they're not really walking on their shoes.

Lately I've been seeing a lot of this. Kids with feet so flat...so collapsed...that they're walking on the SIDE of their shoes, not even on the sole at all. As much as it looks painful for the child to walk, you'd be surprised that the child is probably not feeling much pain. After all, they're the only feet that they've ever known and, while uncomfortable, they're probably feeling this as "normal." The kids would know differently if they were able to try on your feet, but we can't do that yet!

Kids are also very resilient. They are much more flexible and plyable, which makes their feet adapt. You may not even see a child initially complaining about their feet. Instead, look for your kid to not want to walk or run. While shopping, you may find him sitting on the floor when he just can't walk anymore. He also may be tripping a lot when he runs.

When you look at the bottom of your child's shoe, you may see the sole more worn down on the great toe and arch side. In severe cases, you may not even see much wear on the shoe, but rather wear and tearing on the side of the shoe. I've seen kids with feet so flat that they are practically walking on the side of their feet.

Take a look at how your son or daughter walks. If it doesn't look right, it probably isn't! Don't wait for your child to complain. The earlier we can intervene to correct the way your child walks, whether it be with a prefabricated insole, custom orthotic, sports ankle-foot orthotic, or, in extreme cases, foot surgery, the better your child will feel and more active he or she will be for all the years to come.

Toning Shoes Take First Hit For Deceptive Advertising

Thu, 06 Oct 2011 08:00:00 EST

Podiatrists have been saying that this fad of toning shoes is just that...a passing fad. We have said that these toning shoes only build instability and, for many, can potentially cause more problems than they solve. Yet people continuously buy into the advertising claims that these shoes increase the muscle tone of their legs and butt.

Last week, the Federal Trade Commission announced a settlement with Reebok for deceptive advertising relating to their line of toning shoes, including the EasyTone walking shoes and flip flops and the RunTone running shoes. The FTC specifically had issue with unsubstantiated claims made by Reebok relating to these shoes.

Reebok claimed that wearing their toning shoes would increase tone and strength of the muscles of the buttock by over 25% and by over 10% in the calf and hamstrings. It turns out that these claims were not quite backed up by solid scientific evidence. In fact, the company is now barred from making any claim that is not substantiated by scientific evidence, including their strengthening and toning properties, health and fitness benefits, or misrepresenting scientific studies. Reebok was ordered to pay $25 million in customer refunds.

This decision and penalty may well be the first sign of the toning shoe fad calming down. Certainly it will make the shoe industry take notice, especially with other high profile toning shoes by Sketchers, New Balance, and others with similar claims. If you are wondering if your toning shoes are doing you any good, or if they're doing you harm, schedule an appointment at our Houston podiatry office to find out.

September is PAD Awareness Month

Sat, 24 Sep 2011 08:00:00 EST

Peripheral Arterial Disease (PAD) occurs when blood flow is restricted into the legs and feet. It occurs due to narrowing of the arteries and is a very serious condition. People often don't know they have PAD until severe conditions occur, including heart attack and stroke. September is PAD awareness month. Word must spread about this potentially deadly situation.

PAD is a silent killer. In fact in the early stages of PAD, most have no symptoms at all. About 25% of people feel cramping in their legs when they walk distances, known as claudication. This occurs due to the oxygen deficiency from the lack of blood flow. As the PAD progresses, the pain can continue at night and disturb your sleep. Wounds and ulcers can develop on your feet as well. These wounds are slow to heal and put you at risk for infection which can lead to amputation.

So what can you do to prevent and control PAD?

Quit Smoking! Set a date to quit and get help if you need it.
Lower your blood pressure. Ideally it should be lowered below 140/90. If you have diabetes, get it lower than 130/80.
Lower your bad cholesterol. Your LDL should be less than 100 mg/dl. If you are at high risk for a heart attack or stroke, lower it below 70 mg/dl
Manage your blood sugar. Diabetics should reach a Hemoglobin A1C level below 7. Be sure to take proper care of your feet!
Talk to your doctor about antiplatelet medication. Taking medication such as aspirin will help to prevent clotting.
Follow a healthy eating plan. This can help control your blood pressure, cholesterol, and blood glucose.
Excercise regularly. You should exercise for 30 minutes 3-4 times a week.

Remember, finding and treating PAD early can help keep your legs healthy, lower your risk of for heart attack or stroke, and save your life and limbs. At Tanglewood Foot Specialists, we use PADnet to evaluate your lower extremity for PAD so it can be identified early and treated quickly. It is a non-invasive, in-office test that takes about 30 minutes to perform.

Halle Berry Breaks Her Foot In Spain

Thu, 22 Sep 2011 08:00:00 EST

Academy Award winning actress Halle Berry broke her foot in Spain, where she is filming the movie Cloud Atlas. She was walking in Mallorca, she stepped wrong and heard a crack. She went to the hospital where they casted her foot. The filming is going to continue and they'll shoot around her as she recovers.

Will casting be enough to treat a fractured foot? Often it will be. She sought treatment immediately and she was immobilized, which bodes well. If the fracture is in good alignment, immobilization for 6-8 weeks should allow the fracture to heal completely.

There are times, however, where a foot fracture is not in good position. Other times, there are areas of the foot that have a poor blood supply and need to have more intervention. In these cases, foot surgery is necessary to secure the fracture with screws, pins, or plates. This allows for bone healing to occur properly and offers more assurance and confidence that the fracture will heal with full strength and function.

If you twisted your foot, it is best to get it checked immediately to make sure nothing is broken. If it is, the sooner you are treated by a podiatrist in Houston, the better off you will be. Wishing Ms. Berry a quick and complete recovery!

What Happens In Vegas...Will Make Your Feet Scream!

Tue, 20 Sep 2011 08:00:00 EST

I had the great honor to be presenting at the Top Practices Summit in Las Vegas this weekend talking to podiatrists on how to enhance their practices. But all work and no play won't hack it...especially in Vegas. Great food and incredible shows (highly recommend Cirque du Soleil's Love) need to be explored. And exploration wears on your feet.

In Vegas the hotels themselves are an attraction themselves. In fact talking to my podiatrist colleagues, they were bemoaning the fact that THEIR feet were hurting from walking the strip. Others were nursing blisters. It's no surprise looking at the shoes that most women wear in Vegas. I'll admit, they look good...but they're not practical to walk long distances.

Speaking about high heels, I'm not naive enough to think that the women who read this will shift to flats and running shoes while visiting Las Vegas. But you know that there are the heels that you can wear out dancing all night and those that you can only wear from the car to the restaurant. When packing for Vegas make sure you bring the right ones!

If you bring the wrong shoes with you, you'll be sorry! Wear them out the first night and have a great time, but if you end up with painful blisters, you are going to not enjoy the rest of your nights as much. Don't let a poor shoe choice impact your vacation! No one wants to be forced into tennis shoes at night? The price of beauty doesn't have to be pain.

If you're planning a trip to Vegas, Europe, Disneyworld, or anywhere you'll be doing a lot of walking, and you just can't find shoes that will are comfortable, give us a call and schedule a visit. Let's find the reason why and let us help you make your next trip entirely pain-free.

Back to School Means Back to Shoes

Mon, 15 Aug 2011 08:00:00 EST

Although it will still feel like summer in Houston for a while, the kids are heading back to school very soon. After a couple of months of wearing mostly Crocs, sandals, flip-flops, or no shoes at all, you may encounter some resistance to getting those school shoes back on their feet. It's just one more transition that you have to face when school starts.

Children's feet are extremely sensitive. While some don't like going without shoes because of sensitivity when they are barefoot, most enjoy the freedom of not being enclosed in a shoe. When he spends the summer with unconstrained feet, they adapt to the loose fit and freedom. Most schools require that students wear closed shoes. The kids quickly go from freedom to foot captivity. They'll complain that their shoes are hurting them, but the likely truth is they feel suffocated.

In the weeks before school start it is important to prepare your children to return to shoes. Try on their current school and athletic shoes to ensure they still properly fit. Kid's feet grow fast and you need to make sure that your kids aren't justified in their complaining. Be ready to take them shoe shopping!

As school approaches, gently remind them that they will need to wear appropriate shoes for school. Have them break in new shoes prior to school to make sure the school year starts without a hitch. By the time school starts, your kids and their shoes will be ready to go.

I'm not naive to realize that there is some wishful thinking in this plan...after all I have three kids myself. Try not to just throw your kids from zero to school shoes and the transition will at least be a bit better. Just remind them...they still have weekends!

What If I Don't Treat My Diabetic Foot Ulcer?

Tue, 09 Aug 2011 08:00:00 EST

Diabetic foot ulcers are a very serious condition related to advanced diabetes. It is an open sore on the foot that is caused by increased pressures beneath the foot. As pressure builds, many diabetics won't feel the discomfort or pain, because their feet are numb from diabetic peripheral neuropathy. The pressure builds and the skin ultimately breaks down and an ulcer forms.

As unsettling as a diabetic foot ulcer appears, it is amazing to me that not all diabetics rush to get the ulcer evaluated. I am a Houston podiatrist and regularly see patients coming in for an initial check of a diabetic foot ulcer and many don't even know how long the wound has been there. Some have been present for weeks and others for months while the patients were waiting to see if it would heal on its own.

An untreated diabetic foot ulcer is very dangerous indeed. Without eliminating the pressure in the area of the wound, the wound will continue to deepen, extending through the skin and into the muscles, tendons and bone. This puts the foot at an exceptional risk to become infected. As it stands, someone with diabetes is at greater risk of developing an infection. Adding a diabetic foot ulcer to the mix is like rolling out the red carpet for one.

An infected diabetic foot is a medical emergency, always requiring antibiotics, often resulting in a hospital stay and requiring surgery to clear the infection. Surgery to drain the infection add additional risk and reduces the function of the foot. Because of many diabetics' poor circulation, the surgical wound may not heal well, but is necessary to save the life and limb of the patient.

An infected foot that does not resolve or heal can lead to amputation. The amputation can be of a toe, part of the foot, or even the leg. Once an amputation occurs, the chances for additional amputation is very high. Amputations decrease the life expectancy and quality of life of the patient.

Pretty scary, right? The scariest part is that this is seen by podiatrists every day, including those in Houston, where we have a high prevalence of diabetes. Don't become a statistic. If you or someone you love has a diabetic foot ulcer, get it treated immediately to prevent it from getting out of control.

How are Insoles Like Canned Orange Juice?

Thu, 04 Aug 2011 08:00:00 EST

There are a few things that I just don't understand how they are still used and bought by people. These are items that at one time served a purpose but now just don't cut it. Take canned orange juice, for instance. I don't mean concentrate (that's a totally different story) but rather juice that comes in a soda can. Simply put, it tastes terrible. The cartoned juice is so far superior, it's a wonder that they still make juice in cans.

I feel similarly about insoles that are available in the foot care aisle of pharmacies and supermarkets. These insoles, made by Dr. Scholl's and others companies, used to be the only game in town. Because of improvements in technology and materials, as well as a better understanding of the mechanical needs of the foot and ankle, far superior insoles are available. Brands like Spenco and Superfeet are available in sporting good stores and running shoe stores and offers more support to the foot. The comfort and support they provide are exponentially better than the Dr. Scholl's style. Here's a test, take the insole and crumple it into a ball. If you can do it, like you can do with most Dr. Scholl's insoles, it is only offering minimal support.

In my Houston podiatry office, I dispense Powerstep insoles. These insoles are the top line off-the-shelf insoles available only through podiatrists. The insoles themselves have been developed by a podiatrist and offer immediate relief for conditions such as plantar fasciitis, heel pain, Achilles tendon pain, and arch pain. Powersteps can also be found for purchase online. They have different styles to allow them to be worn in different shoes.

Canned juice and ineffective insoles are two products that should go the way of the rotary phone and floppy disk drive. Let's embrace the newer products that are better and work better for us. The it will be time to improve on those.

Is That A Target On Your Ingrown Toenail?

Tue, 02 Aug 2011 08:00:00 EST

An ingrown toenail is a simple concern, with a simple causes, and simple treatment...but man, oh, man does it hurt! Anyone who has suffered with an ingrown toenail knows that it is as if there is a target painted on the toe. Everyone steps on it: your kids, your dog, total strangers. Their all out to get you. This is why your best off getting your ingrown toenails treated as soon as possible by a foot doctor in Houston. The relief is immediate.

There are three causes of ingrown toenails. The first is when the nail is too wide for the nail bed. This causes the nail to grow beneath the skin on both sides. It could be painless, but when there is excess pressure on the area due to shoes or injury, the area becomes inflamed and infected.

The second cause of ingrown toenails is when the nail becomes curved. This can happen due to injury, an infection of fungus, or can naturally occur as part of the aging process. The pain from an ingrown toenail of this type is due to the pressure from the shoe driving the nail down into the skin. Persistent pressure can also cause this to become infected.

Finally an ingrown toenail problem can be caused by improperly trimming the toenail. Known as "bathroom surgery," this typically happens when someone is overzealous when trimming their toenails. Ironically, it most commonly occurs when the person is trying to avoid an ingrown toenail. The overaggressive trimming often leads to a toenail infection.

Many people are frightened about the ingrown toenail surgery, but most feel that it is something they should have not put off. It's never as bad as you remember, or certainly as bad as your friend experienced. It is a simple in-office procedure that starts with the toe being numbed (ok, that's the only part that hurts...promise). The procedure itself takes less than ten minutes and is painless. Restrictions after the surgery are minimal and most leave in their own shoes.

If you have suffered with ingrown toenails, it is time to visit us at the Ingrown Toenail Center of Houston in Tanglewood Foot Specialists. Break the cycle of pain and get the target off of your foot!

Skin Cancer On Your FOOT?

Thu, 28 Jul 2011 08:00:00 EST

We often think of malignant melanoma, or skin cancer, as something that only effects areas of our body that gets too much sun. Because of this, dangerous lesions go under diagnosed, especially on the feet and lower legs. Your Houston podiatrist is uniquely positioned to identify these suspicious lesions and perform a biopsy to ensure it is not cancerous.

Some patients are apprehensive about having a biopsy performed. Some feel that if a lesion has always been there, it couldn't be bad. Others are nervous about the simple biopsy procedure. Still others are concerned about bad news. The truth is, while most biopsies performed come back as normal, the lesions that are caught in early stages of malignancy are worth the effort.

Even skin lesions that always have been there can evolve to become malignant. A mole that was once small can grow in size and thickness. This is a sign of malignancy. A lesion that was once nice and round but becomes irregular is also a concern, as is one that is not uniformly one color. These lesions should be further investigated.

A biopsy is a minor, in-office procedure that requires a small amount of anesthesia injected beneath the lesion. Depending on the type of lesion, a small section is either shaved off or removed with a sterile "punch." In most cases the site of the biopsy is dressed with antibiotic cream and a bandaid. The biopsy is sent to a lab where a specialist evaluates the biopsy under a microscope and results are usually received in only a few days.

If the a diagnosis of malignant melanoma is returned, the result is most likely a more thorough removal of the lesion in the operating room. Your podiatrist will also likely refer you to another specialist to ensure it was an isolated lesion and incident of melanoma.

Don't take an unusual skin lesion for granted. A biopsy is your insurance to make sure that any problem is identified and resolved early. Waiting will only cause additional issues in the future. If you or a family member notice a mole, bump, or patch on the skin of the foot, ankle, or leg, contact Dr. Schneider to have it properly evaluated.

Answer: Game Show Host Who Tore His Achilles Tendon While Chasing A Burglar

Thu, 28 Jul 2011 08:00:00 EST

And the question: Who is Alex Trebek?

Jeopardy! host Alex Trebek was in San Francisco to attend a National Geographic World Championship. He saw a woman breaking into his hotel room and he was able to chase her down. Unfortunately, in the chase, he tore his Achilles tendon and is scheduled to undergo surgery on Friday.

The Achilles tendon is one of the strongest tendons in the body and is under great tension. When a complete rupture occurs, it feels like you get shot in the back of the leg. It is a serious injury that must be treated immediately.

If the tendon is in good position, a rupture may be treated with a non-weightbearing cast. The foot is pointed in a downward position when casted to allow the tendon ends to meet and heal. Because of the tension in the tendon, the end coming down the leg often reflects up, much like snapping an elastic band. In this case, the tendon needs to be repaired surgically. This is the procedure that Alex Trebek will undergo.

Even after surgery, immobilization and non-weight bearing will be necessary. That will be followed by physical therapy to regain strength, function, and range of motion. It's a long ordeal, and Trebek will need a stool on Jeopardy! for a while, but he'll be on the road to recovery shortly.

Even Hagar the Horrible Knows To See A Podiatrist

Wed, 27 Jul 2011 08:00:00 EST

If you are an avid comic strip reader, you surely saw what happened when Hagar went to his trust medicine man to treat a foot problem. Didn't see it? Check it out here:

Family doctors, internists, and other generalists serve an incredibly important purpose. They are the quarterbacks for our personal healthcare. In these complex days of multiple specialists, each prescribing medication for their particular system. The family doctor is the physician who makes sure all care is coordinated.

Because the generalist kneeds to know basic care of all health systems, they do not have a certain amount of depth in some areas. For instance, a pediatrician can certainly prescribe antibiotics for a child's ingrown toenail, however, that physician may not be the best choice to perform ingrown toenail surgery.

Hagar recognizes this and plans on seeing a podiatrist. The good news is that we have a fantastic network of physicians in Houston who recognize the benefit consulting a specialist and send many patients to our office for evaluation and care of their foot problems. If you are being treated for a foot issue that isn't getting well, ask your doctor for a referral to a podiatrist.

When Should NON-Custom Orthotics Cost $400?

Tue, 26 Jul 2011 08:00:00 EST

I don't like when people are taken advantage of. Someone in pain will do anything possible to relieve it. This is especially true for foot pain. Foot pain impacts every aspect if your life - work, play, vacation, exercise...everything. That is why I love being a Podiatrist in Houston. I get to work together with my patients to eliminate their pain and allow then to return to their beloved activities as soon as possible.

I had one such patient see me in the office recently. He had been suffering from arch pain that was hurting constantly and it was effecting his entire work day and, most importantly, his ability to play with his young children. Although he planned on scheduling an appointment with a podiatrist, he passed a store called Ideal Feet and thought he'd stop in. He admitted to me on his first visit to our office that it was a big mistake.

During his visit to the retail store, he was evaluated by a salesman who told him he was suffering from plantar fasciitis, a common cause of heel and arch pain, and would benefit from orthotics. He then took an ink imprint of his foot to shoe how his arch drops. He was presented with a pair of hard-rubber insoles, or non-custom orthotics, and told to wear them and his heel pain would resolve. The price tag: about $400. About what a pair of custom orthotics would cost, if insurance doesn't cover them.

There is a time and a place for an off the shelf insole. There are several brands that offer good support, such as Powerstep, Spenco, and Superfeet. In fact, we have Powersteps available in our office. Such an insole should only be an investment of $30 to $60! No insole that is not custom-made should cost more.

After trying a few different pair of insoles from Ideal Feet, the staff determined that they didn't have the right solution for him and, to their credit, offered him store credit. Since the store carries excellent shoes, his money will not be wasted. I give them credit for that since there are similar stores that have an absolute no-return policy. Since that time he has received a comprehensive biomechanical examination in our office, custom orthotics, and appropriate treatment for his heel and arch pain and is well on the road to recovery.

Shoes Play a Major Role in Preventing Falls

Fri, 22 Jul 2011 08:00:00 EST

Accidental falls in the elderly population has been targeted as a major focus on preventative healthcare by both the National Institute of Health and the Center for Disease Control. One in three seniors over age 55 have suffered a fall and the cost of treating falls will grow to over $50 billion by 2020.

While some falls are unavoidable, there is much we can do to prevent many accidental falls. The first is to focus on the shoes worn by seniors. It is very important that shoes are properly fitted. The feet should be measured each time you are being fitted for shoes, since the foot size can change. Resist buying shoes by size alone, since the sizes are not always consistent. The front of the shoe should have about 1/2" between the end of the longest toe and the end of the shoe.

To help prevent falls, the foot should be stable in the shoes. They should be securely fastened with laces or Velcro. The sole should be solid and non-skid. People with any imbalance or risk for falls should avoid shoes with rocker soles, such as Skechers Shape-ups or MBT. These shoes are designed to promote instability and change the center of gravity. Not the right shoe if balance is an issue.

When selecting an appropriate shoe, lightweight is better. The shoe should have extra depth, especially if you are trying to accommodate an AFO to improve balance, such as the Moore Balance Brace. The shoe should have a stable heel counter and should never be slip on.

Talking precautions to prevent a fall is an investment that will pay dividends. Houston Podiatrist Dr. Andrew Schneider and his team are committed to identifying risk factors making you or your loved one prone to a fall. We will suggest the proper shoes to be sure that you are stable and safe.

We DON'T Have To Think About Every Step We Take...Thankfully!

Wed, 06 Jul 2011 08:00:00 EST

Walking...it's something we take for granted, unless somthing happens that makes us focus on it. As it stands, we learn to walk at about age one and then we're off to the races. Even then, we don't teach our children how to walk. We support and encourage them and they figure it out on their own. Imagine if you had to think about every step you take. It doesn't sound too hard at first thought, but in practice it is quite impossible.

I took my family to the Houston Museum of Health & Medical Science where they had an exhibit called Star Wars: Where Science Meets Imagination. They had one interactive display of a pair of robotic legs and you could contol the hip and knee of each limb. The goal was to get it to walk from one side of the platform to the other. Sounds easy? While watching, most weren't able to do it. Then came my 10 year old son Ariel, a major Star Wars fan, who had a go at it. This was his second attempt:

OK...he made it look easy.

In reality, having to control each joint individually leads to a disjointed and, well, robotic gait. And he didn't even have to worry about he ankle or anything about the foot! We're so fortunate that our brains are able to process at the speed and efficiency which it does in order to integrate all of our body functions. This simple experience made me grateful and helped me understand, in a very small way, the effort that victims of stroke and other brain injuries have to go through to rehabilitate.

Do You Feel Like Your Feet Are Encased In Wax?

Thu, 30 Jun 2011 08:00:00 EST

A common comment that I hear from my patients is that their feet is numb. Not the "usual" numb that you may feel from time to time. This is the kind of numb that people feel and describe that they feel like they are wearing multiple pair of socks, even when they weren't. They feel like their feet are encased in wax. It doesn't hurt, but it's not right. These patients are suffering from peripheral neuropathy.

Peripheral neuropathy is a condition where the nerves to the lower extremity no longer function efficiently and effectively. This can result in a burning or stinging pain or a sensation of numbness. Both are bothersome to those who suffer from it. Although diabetes is a common cause of peripheral neuropathy, it is far from the only cause. In fact, it is unfortunately common to not find a cause for peripheral neuropathy at all. These factors make it difficult to treat. It also leads to frustration when symptoms linger.

There a number of medications that have been marketed for pain from neuropathy. These include Lyrica, Cymbalta, and Neurontin. These are only effective when the neuropathy presents with pain and often have side effects. For neuropathy where it feels like the feet are numb as if they are encased in wax, vitamin supplements have often proven to be effective in alleviating the symptoms.

Neuremedy is a medical food neuropathy vitamin containing a fat-soluble form of thiamine, which is Vitamin B1. Metanx is another medical food that has a multitude of vitamins and nutrients that aids in nutritionally supporting the nerves. Both are without interactions to other medications and carry no side effects. If effective, these vitamins must be taken on an ongoing basis to continue their effect.

I can't guarantee that you will realize relief by utilizing any of these medications, vitamins, and therapies, since everything works differently for different people. I do know that many with neuropathy are told that nothing can be done. That can't be farther from the truth. Give your podiatrist in Houston, TX a call and see if one or more is right for you.

How Are You Dressing Your Diabetic Foot Ulcer?

Tue, 28 Jun 2011 08:00:00 EST

When we were kids, our moms would typically tell us to keep a cut or skinned knee open, especially at night, so it could "breathe." How much breathing does an open wound do? The answer is none. You need to protect the wound with an antibiotic ointment so it does not become infected and covered with a bandage. This principle is no different for a diabetic foot ulcer.

There are many diabetics with foot ulcers that I see as a podiatrist in Houston, TX, who still feel mom's principle is best. They just keep is open so air can get to it and assume it will heal. This is not sufficient to heal a diabetic foot ulcer and can ultimately be devastating. A diabetic wound does not need air, it needs an optimal environment for the wound to heal. This will Include the use of a wound dressing, which will come in the form of a gel or pad. The use of an over-the-counter antibiotic cream or ointment is not sufficient to achieve the protection and healing you will need. These dressings are formulated to protect from infection, absorb drainage, and provide an optimal environment for the wound to heal. Some of these dressings are changed by each patient daily, but others remain untouched for up to a week.

If a wound does not show significant signs of healing, which is seeing closure of more than 50% in four weeks of treatment, the dressing choice needs to be reassessed. We then consider a more advanced form of dressing for diabetic foot ulcers know as advanced biological dressings. These are dressings composed of bioengineereed living cells that bring large amounts of cells needed for healing to occur. They also form a scaffold across the wound to allow healing to occur from within the wound, rather than just from the edges of the ulcer. These dressings, such as Dermagraft and Apligraf, are an important step in ensuring the diabetic foot ulcer will completely heal.

Studies have shown that the longer a diabetic foot ulcer remains unhealed, the greater the chances that it will become infected and lead to amputation. When selecting the right podiatrist to care for your open diabetic foot ulcer in Houston, TX, it is important to make sure that you will have all dressings options at your disposal. Don't just let your wound breathe itself healed. The risk is too great.

Diabetes Claims the Leg of Guitar Hero Leslie West

Tue, 21 Jun 2011 08:00:00 EST

It was reported that legendary guitarist Leslie West had his right leg amputated below the knee on Monday. West is diabetic and had swelling in his leg over the weekend. Guitarist for 60's rock group Mountain, West had performed at Woodstock and is well known for hits such as "Mississippi Queen" among others.

It was reported that an infection had started in West's foot and had spread into the bloodstream. The amputation was necessary to save his life. The condition was complicated by the presence of Peripheral Arterial Disease (PAD) which is a common complication associated with diabetes. West was scheduled to play in Biloxi, MS when he entered the hospital. Despite doctors attempting to save his limb for two days, it was determined that amputation was necessary.

It cannot be understated how important an association with a podiatrist is for all people with diabetes. If West's PAD was detected earlier, it could have been addressed with medication or a procedure to improve the blood flow to the foot. This could have allowed the infection to be in better control or possibly could have prevented it entirely. There also could have been added protection implemented for the foot. This could have included therapeutic shoes, multidensity insoles, and diabetic socks.

Without protection, the diabetic foot is at risk for developing an open wound known as a diabetic foot ulcer. This break in the skin on the bottom of the foot often develops from a callus that breaks down. People with diabetes offer suffer from diabetic peripheral neuropathy which does not allow them to feel the pain associated with these wounds. A diabetic foot ulcer has a great tendency to become infected because of the poor circulation associated with PAD.

Could regular visits to the podiatrist have saved Leslie West's leg? Of course there are times where a limb cannot be saved. However, the life of a rock star on the road likely did not make this possible. Let's take the opportunity to learn from this situation and hope that many will be inspired to visit their podiatirst and take the first step to keep both legs, both feet, and all ten toes intact. I wish Leslie West a speedy recovery and strength as he starts to overcome this situation. I'm sure he'll be back with guitar in hand in no time.

My Achilles Tendon is Killing Me!

Mon, 20 Jun 2011 08:00:00 EST

Over the past few months I've had some on and off issues with my Achilles tendon. It flares up and I limp a bit...hear a bunch of "The foot doctor needs a foot doctor" comments from my Houston podiatry patients. As I write this I'm route to North Carolina where I was invited to speak at their state podiatry meeting.

Once an Achilles tendon is inflamed, it doesn't take much to make it worse. In my case running through the Houston airport trying to catch my flight (Thanks TSA!!!) in shoes not conducive to running. When I got up to deplane at my connection, I was hurting. I stopped in the Charlotte airport to pick up some overpriced Aleve which is helping but I really need to beat this thing.

The problem is that the Achilles tendon is not very easily treated. Oral anti-inflammatory medication are not always effective. We are limited in what can be injected into and around the Achilles tendon too. For instance, a cortisone injection can never be used to treat the Achilles tendon, since there is a risk that the tendon would weaken and rupture.

Restricting the motion around the tendon is another option. When I get home (or if a vendor at the conference has one for me) I will wear a gauntlet ankle brace to rest the tendon. I'll also use some Biofreeze to treat the tendon topically. If that doesn't work, a fracture walker will rest it even more. Add to that physical therapy and possibly some shockwave treatments, I should have this thing licked. Sounds involved? Sounds complicated? Sound frustrating? It is!

Treating Achilles tendinitis requires tremendous patience and strict adherence to the treatment plan. The biggest challenge will be to follow my own advice. In law, they say when you defend yourself you have a fool as a client. I'm pretty sure that would apply in my case as well! Doctor...heal thyself!!

Don't Work Out In High Heels Like Coco!

Wed, 08 Jun 2011 08:00:00 EST

Just when I thought I've seen it all! My wife texted me the other day to call her because she has a good blog topic for me. She just saw a commercial for a new reality show featuring rapper and actor Ice-T and his wife Coco on the E! network called Ice Loves Coco. In the clip, it shows Coco working out in high heels. Don't believe me, check out the photo!

Why is this a problem? First and foremost, exercise requires a stable base of support. This is especially true for squats, like Coco is doing in the picture. Wearing a high heel, shifts the center of gravity forward. By doing so, it increases the stress on the front of the legs and top of the feet. This also causes the muscles in the back of the leg, such as the Achilles tendon, to work harder.

Lifting weights in high heels can cause excess contracture in the muscles, to the point where they are shortening themselves. That probably doesn't mean much for Coco now, since she's probably in heels 24-7, but someday she will pay the toll that it is taking on her body. Injuries that can result from excercising in high heels include Achilles tendinitis, stress fractures, heel pain, and pain in the ball of the foot.

Because of the inherant instability of high heels, she is also putting herself at risk for sprained ankles, knee injury and pain, and other traumatic injuries. What should Coco be wearing instead of high heels? Well honestly I can say...ANYTHING ELSE! I would prefer athletic shoes, sneakers, or running shoes. But if she chose to work out barefoot instead, I would support that if she wasn't wearing high heels!

Excercise stresses your joints enough. You don't have to add pressure to them by wearing high-heel shoes...it will only make it worse.

Why Is Fall Prevention So Important?

Mon, 06 Jun 2011 08:00:00 EST

Over the past few months, we have made a concerted effort to identify patients who are at risk for falls. In truth, this is a "red alert" situation in Houston and nationwide. Someone's "first fall" can be devastating to their quality of life and can even lead to their death. It can end mobility as they know it and can quickly transition a spouse or child into a caregiver role.

I work with SafeStep, a company that deals with various types of mobility-related products, such as fracture walkers, diabetic shoes, and braces. Their owner is a podiatrist who I know well and, knowing my focus on fall prevention, asked me to write a post for his blog to educate my colleagues about fall prevention and why it is so important for the care of their patients.

I'm happy to share that blog post with you. Even though it is written for the professional, and not the public, I believe the message is universal. You can read it on the SafeStep blog. Please return to this site and leave comments!

This Week I Feel I Made A Difference

Thu, 02 Jun 2011 08:00:00 EST

Every doctor makes a difference in their lives of their patients every day. It is the nature of the business. Someone comes into our Houston office in pain, with an injury, or a concern and we address it and do our best to offer immediate relief. When immediate relief is not possible, we lay out a plan on how relief will come in the future. Either way, our patients should leave the office feeling better.

Sometimes it goes even farther than that...

A couple of weeks ago, we received a call from a patient inquiring about a leg wound he has had for a long time. He is a burn victim and has had to have several surgeries over the years. The last surgery on the back of his leg near his Achilles tendon did not heal well and left him with an open wound. The doctor treating the wound has used a dressing method that has not allowed the wound to heal well. He was frustrated and concerned. He was visiting his daughter in Florida and through a series of coincidences, heard about MicroVas, a therapy that is designed to increase circulation to non-healing wounds. Upon returning to Houston, he investigated who had this therapy to offer and found my website.

He called and my front office team leader asked me what she should do, since he was set to leave for Alaska in 11 days for a three month work assignment. Eventhough we were booked, I told her to work him in that day. I explained to him and his wife that usually MicroVas, while effective, requires several weeks of therapy to close a wound. We could use it every day, but I was unsure how effective it would be. He wanted to give it a try.

The results he received from the MicroVas therapy was staggering. In nine treatments, we were able to reduce the size of the wound, which had not progressed in months, to almost half of what it was. Needless to say, he was thrilled! The dilemma we had was that this therapy was not available in Alaska. I suggested another wound healing therapy that I use on diabetic foot ulcers called Dermagraft.

Dermagraft is a bioengineered human skin substitute that serves as a biological dressing. While wounds generally heal from the outside in, Dermagraft forms a matrix of cells across the wound, enabling it to close more centrally as well. I have used Dermagraft to heal the most limb-threatening ulcers with great results. Unfortunately, Dermagraft was only now starting to be available in Alaska, and mostly in Anchorage which would be an eight hour round trip for my patient.

My representative for Dermagraft (who is awesome) contacted the rep in Alaska who reached out to the few podiatrists in the area close to where my patient was going to work. Fortunately, he found a forward thinking physician who was willing to try this therapy on my recommendation, despite not having used it before. I am sure it will be very successful healing my patient and I am excited to see him when he returns to Houston.

Let's look bigger picture. This podiatrist is now going to be able to use Dermagraft on his other patients with diabetic foot ulcers. In fact, Alaska has a growing number of cases of diabetes, in the native population and beyond, that will benefit from this therapy that until now has been unavailable anywhere in the state. The number of limbs and lives that can be saved by this therapy being available in Alaska will be immeasurable.

I truly feel like I made a difference this week.

Are Calluses Protecting You When You Run?

Fri, 27 May 2011 08:00:00 EST

My wife is an avid runner. 5K, 10k, half-marathons, marathons, and triathlons. We are on our way back home to Houston from Scottsdale, AZ where I was attending and speaking at a podiatry conference and she took the opportunity to go for some runs without the humidity of home. She also hit the spa for some pampering...a massage and pedicure.

She is not one to typically get a pedicure and allowed the technician to remove her running calluses with a callus file. While she liked her feet without the calluses, she had some trouble the next day when she went for her run. She found that the areas at her feet that had the calluses were now blistered. What's the answer? Never get a pedicure again?

Calluses are an area of thickened skin in response to increased pressure. The callus forms to protect the skin and ensure it is not damaged by the pressure. The thickening of the skin, however, can increase the pressure and cause the calluses to become painful. In these cases, seeing a foot doctor in Houston can allow your podiatrist to pare the hard skin and relieve the pressure. You can also thin a callus by using a pumice stone or pumi-bar. Stay away from more abrasive files, such as the Ped-Egg.

If a callus is mild, and does not cause any pain, don't worry about removing them. They are simply doing their job in protecting your foot from extra pressure. Do keep them controlled by applying foot cream to them. This will prevent them from overgrowing, drying, and cracking.

There's no reason to not get a pedicure. Just be sure to communicate with the technician exactly what you do or do not want done. This way you won't have any surprises on your next run.

Achilles Tendon Injury is Keeping Tiger Woods Out of the Game

Wed, 18 May 2011 08:00:00 EST

Golf superstar Tiger Woods had to drop out of the Players Championships this week after only playing the first nine holes of his first round. The reason: an injured left knee and Achilles tendon. This is not the first time Tiger has dealt with an Achilles tendon injury and has undergone several knee surgeries in the past.

Achilles tendon injuries are prevalent in serious golfers. This is because of the amount of walking on uneven terrain, the unusual positions some golfers have to get into to hit the ball and the pivoting involved with the golf swing. The injury happened for Tiger in a tournament a few weeks earlier when he was crouching to get a shot in the rough.

Achilles tendon injuries are frustrating and difficult to heal. They are sometimes responsive to oral anti-inflammatory medications, but not always. The typical "go to" method of treating sports injuries, the cortisone injection, can never be used in and around the Achilles tendon. Because of a section of poor circulation around the insertion of the Achilles tendon, cortisone could cause it to rupture, which is devastating. Other means of healing Achilles tendinitis, is immobilization, custom orthotics to address the mechanics and lessen the pull on the tendon, physical therapy, and night splints. Newer technologies, such as Extracorporeal Shockwave Therapy, have been proven to break up the inflammation and eliminate the Achilles tendon issue.

The most frustrating part of an Achilles tendon injury is the waiting. Unfortunately for Tiger, the only way he will be able to return to the top of his game is to fully rehabilitate his Achilles tendon to ensure it is back to full function. If you are suffering with an Achilles tendon injury, don't wait for it to go away on its own. Contact your Houston podiatrist for an appointment.

Do Young Girls NEED Skechers Shape-Ups?

Mon, 16 May 2011 08:00:00 EST

Skechers Shape-Up shoes have become tremendously popular. The shoes, with their rocker sole design, are marketed as toning shoes. The rocker sole provides a shift in the center of gravity and causes the posterior muscles in the ankle, calf, thigh, and buttocks to work harder. According to the company, this can lead to a more toned appearance to the legs and rear end. The use of these shoes have been questionable for all adult men and women, with the American Council on Exercise dismissing these claims, but now Skechers is marketing these shoes to young girls.

According to the Skechers website, the shoes start at size 2, the typical size for a 7 year old girl. There are many who are up in arms about the statement this makes on body image for girls and that 7 year-olds should not have to worry about their appearance. Add to that, the terrible message that it is something unique to girls and not boys (the shoes are not being made or marketed to young boys...only girls). As a father of a 6 year old daughter, I agree whole-heartedly with this. As a podiatrist in Houston, I have other concerns about the shoes being marketing to kids.

The technology that the Shape-Ups use, a rocker-bottom sole that creates an unstable base of support, is not what children should be wearing on their feet. A child's foot needs to function with their normal mechanics, not the compensation that the Skechers force it into doing. Kids using a shoe that creates such instability can lead to a number of foot problems.

One major issue that can arise with a child using an unstable rocker-sole shoe is a sprained ankle. A child twisting their ankle when using a shoe like a Skechers Shape-Up can cause torn ligaments in the ankle, which will lead to an unstable ankle and cause future ankle sprains. Weakened ankles due to sprains is something that can stay with a child throughout their entire life.

Another issue related to these shoes is the weight being forced to the front of the foot. This can lead to serious injuries like a stress fracture in the midfoot or forefoot. It also can lead to trauma to the toenails from hitting the front of the shoe and becoming an ingrown toenail.

I don't recommend Skechers shape-ups for most of my adult patients in my Houston podiatry practice. I would NEVER recommend them for any developing boy or girl to wear. Parents be warned! Shame on you Skechers for marketing your product to young girls when it is, at best, unneccesary and, at worst, harmful.

High Heeled Shoes Keep Getting Higher and Causing Problems

Fri, 13 May 2011 08:00:00 EST

Good Morning America had a segment today about the ever-increasing height of women's high-heeled shoes. Where 3 inches is average and 4 inches is considered too high by many, shoes are now 8 inches high...even as high as an 11 inch stiletto heel!

They interviewed Kelly Ripa, co-host of "Live With Regis & Kelly" who is well-known for her high heels. She even wore high heels with crutches after suffering a stress fracture in her hip! She started the "High Heel-a-thon" which is a charity footrace of 150 yards. A Houston Podiatrist's dream! Imagine the injuries from that race!

Lately there have been a rash of high profile spills due to high heels. Lady Gaga, Beyonce, and Mariah Carey all took very public falls during performances because of their high heels. In fact, in my Houston podiatry office, I'm seeing a significant amount of serious ankle sprains due to women twisting off of their high heeled shoes. Because the foot only bends so much, the higher heel heights require a platform beneath the toe. This gives the ankle extra height to twist on the way down and causes a more serious injury.

Consistently wearing high heels also causes problems with the Achilles tendon. Keeping the heel elevated causes the Achilles tendon to shorten, causing problems such as Achilles tendinitis, which is an inflammation where the Achilles tendon attaches to the heel. The extreme shoes can also exacerbate pain from a bunion.

Will I say not to ever wear high-heeled shoes? Definitely not! (Besides, you wouldn't listen anyway!) Just be aware of how much walking you will be doing and the surface where you will be walking. And if you think you may end up on stage dancing....be careful!