DVT is a condition in which a blood clot (a blockage) forms in vein located deep within the leg. These clots most commonly occur in the veins of the leg, but they can also develop in other parts of the body. If the clot breaks loose and travels through the bloodstream, it can lodge in the lung. This blockage in the lung, called a pulmonary embolism, can make it difficult to breathe and may even cause death.

Certain people are more at risk than others for developing DVT. Some examples of risk factors include varicose veins, blood clotting disorders, pregnancy or recent childbirth, obesity, and heart disease. People over 40 years old, those who have had recent surgery, or those who are immobile through inactivity or wearing a cast are also more at risk for DVT.

Some people with DVT in the leg have either no warning signs at all or very vague symptoms. If any of the following warning signs or symptoms are present, it is important to make an appointment with our office for an evaluation:

• Swelling in the leg
• Pain in the calf or thigh
• Warmth and redness of the leg

If you have risk factors for DVT and plan on taking a long trip this season, follow these tips to reduce the likelihood of developing a blood clot:

• Exercise legs every 2 to 3 hours to get the blood flowing back to the heart. Walk up and down the aisle of a plane or train, rotate ankles while sitting, and take regular breaks on road trips.
• Stay hydrated by drinking plenty of fluids; avoid caffeine and alcohol.
• Consider wearing compression stockings.

Going barefoot heightens risk for puncture wounds, which require different treatment from cuts because the tiny holes often harbor foreign matter under the skin,says Victor J. Quijano Jr. DPM, PhD, AACFAS, a member of the American College of Foot and Ankle Surgeons. Glass, nails, needles and seashells are common offenders. Regardless of the substance, anything that remains in the wound increases your chances for complications.

Puncture wounds in the feet too often are superficially treated, according to Dr. Quijano, and it is best to get proper care within the first 24 hours to make sure anything that might be embedded in the wound is removed. Dr. Quijano notes research suggests 10 percent of puncture wounds do result in serious infection, but such complications can be prevented with prompt and appropriate medical attention.

The depth and relative cleanliness of a puncture wound are the main factors determining possible infection risk.

Studies show 60 percent of patients who required incision and drainage of a puncture wound had something embedded, says Dr. Quijano. With the increasing prevalence of drug-resistant bacteria, even healthy people are getting potentially life-threatening staph infections. So if you step on something and the skin is broken, get treated right away.

Treatment involves a thorough cleaning to decrease infection risk. Tetanus shots often are needed. Following treatment, the wound should be monitored carefully at home.

Sometimes an infection can develop later and migrate to the bones, says Dr. Quijano. So if the wound stays red, swollen and sore after a few days, go back to the doctor for further treatment. In all cases, a puncture wound on your foot should never be taken lightly.

To make an appointment with Dr. Quijano, contact the Chelmsford podiatry office at (978) 441-9241 or the Newburyport podiatry office at (978) 463-0086. You can also visit New England Foot & Ankle podiatry web site at www.NEFootAnkle.com.

Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease - a foot amputation.

Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions,says Jerold H. Fleishman, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet.

Loss of sensation inhibits the body’s normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.

Dr. Fleishman says foot and ankle surgeons use a variety of surgical and non-surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes.

Daily self exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected, Dr. Fleishman says. If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing.

An estimated seven in 10 diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, says Dr. Fleishman, prevents foot loss.

In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can’t improve blood circulation and foot function, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.

Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:

• Keep your blood sugar under control to help minimize cardiovascular and blood circulation problems
• Lose weight, don’t smoke and adhere to prescribed dietary, medication and exercise regimen. At least once a day, examine your feet for cuts and other small wounds you may not feel
• Never walk barefoot, outdoors and indoors
• Cut nails carefully straight across and not too short; never trim corns and calluses yourself
• Wash your feet every day in lukewarm water; dry carefully
• Choose comfortable shoes with adequate room for the toes
• Wear clean, dry, non-bulky socks; change daily
• Shake pebbles or bits of gravel out of your shoes before wearing
• Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don’t seem to be healing

To make an appointment with Dr. Fleishman contact the Chelmsford podiatry office at (978) 441-9241 or the Newburyport podiatry office at (978) 463-0086. You can also visit New England Foot & Ankle podiatry web site at www.NEFootAnkle.com.

Old wives tales and myths like that example are fun to laugh at. We believed them as children. Step on a crack and youb’ll break your mother’s back.But there are other myths that are no laughing matter, especially when they involve your health.

From bunions to broken toes, foot and ankle surgeon Victor J. Quijano Jr. DPM, PhD, AACFAS, has heard it all. Dr. Quijano treats patients at offices in Chelmsford and Newburyport. He shares five myths about foot care and the realities behind them.

Myth: Cutting a notch in a toenail will relieve the pain of ingrown toenails.

Reality: When a toenail is ingrown, the nail curves downward and grows into the skin. Cutting a notch in the toenail does not affect its growth. New nail growth will continue to curve downward. Cutting a notch may actually cause more problems and is painful in many cases.

Myth: My foot or ankle can’t be broken if I can walk on it.

Reality: It’s entirely possible to walk on a foot or ankle with a broken bone. It depends on your threshold for pain, as well as the severity of the injury, says Dr. Quijano. But it’s not a smart idea. Walking with a broken bone can cause further damage.

It is crucial to stay off an injured foot until diagnosis by a foot and ankle surgeon. Until then, apply ice and elevate the foot to reduce pain.

Myth: Shoes cause bunions.

Reality: Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types make a person prone to developing a bunion. While wearing shoes that crowd the toes together can, over time, make bunions more painful, shoes themselves do not cause bunions.

Although some treatments can ease the pain of bunions, only surgery can correct the deformity.

Myth: A doctor can’t fix a broken toe.

Reality: Nineteen of the 26 bones in the foot are toe bones.

What I tell patients is, there are things we can do to make a broken toe heal better and prevent problems later on, like arthritis or toe deformities, Dr. Quijano says.

Broken toes that aren’t treated correctly can also make walking and wearing shoes difficult. A foot and ankle surgeon will x-ray the toe to learn more about the fracture. If the broken toe is out of alignment, the surgeon may have to insert a pin, screw or plate to reposition the bone.

Myth: Corns have roots.

Reality: A corn is a small build-up of skin caused by friction. Dr. Quijano says many corns result from a hammertoe deformity, where the toe knuckle rubs against the shoe. The only way to eliminate these corns is to surgically correct the hammertoe condition.

Unlike a callus, a corn has a central core of hard material. But corns do not have roots. Attempting to cut off a corn or applying medicated corn pads can lead to serious infection or even amputation. A foot and ankle surgeon can safely evaluate and treat corns and the conditions contributing to them.

To make an appointment with Dr. Quijano, contact the Chelmsford podiatry office at (978) 441-9241 or the Newburyport podiatry office at (978) 463-0086. You can also visit New England Foot & Ankle podiatry web site at www.NEFootAnkle.com.

Puncture wounds and cuts: Wear shoes to protect your feet from puncture wounds and cuts caused by sea shells, broken glass and other sharp objects. Don’t go in the water if your skin gets cut because bacteria in oceans and lakes can cause infection. To avoid complications from a puncture wound, see a foot and ankle surgeon for treatment within 24 hours.

Jellyfish stings: Remember that a jellyfish washed up on the beach can still sting if you step on it. If their tentacles stick to the foot or ankle, remove them, but protect your hands from getting stung too. Vinegar, meat tenderizer or baking soda reduce pain and swelling. Most jellyfish stings heal within days, but if they don’t medical treatment is required.

Sunburns: Feet get sunburn too. Rare but deadly skin cancers can occur on the foot. Don’t forget to apply sunscreen to the tops and bottoms of your feet.

Burns: Sand, sidewalks and paved surfaces get hot in the summer sun. Wear shoes to protect your soles from getting burned, especially if you have diabetes.

Ankle injuries, arch and heel pain: Walking, jogging and playing sports on soft, uneven surfaces like sand frequently leads to arch pain, heel pain, ankle sprains and other injuries. Athletic shoes provide the heel cushioning and arch support that flip-flops and sandals lack. If injuries occur, use rest, ice, compression and elevation to ease pain and swelling. Any injury that does not resolve within a few days should be examined by a foot and ankle surgeon.

Diabetes risks: The 20 million Americans with diabetes face serious foot safety risks at the beach. The disease causes poor blood circulation and numbness in the feet. A diabetic may not feel pain from a cut, puncture wound or burn. Any type of skin break on a diabetic foot has the potential to get infected and ulcerate if it isn’t noticed right away. Diabetics should always wear shoes to the beach, and remove them regularly to check for foreign objects like sand and shells that can cause sores, ulcers and infections.

For treatment of beach-related foot injuries, contact Dr. Fleishman at (978) 441-9241 in Chelmsford and (978) 463-0086. You can also get more information about your foot care at our web site www.NEFootAnkle.com

“Walking is great exercise and one of the most reliable forms of transportation,” says Timothy M. Downs, DPM, FACFAS, a foot and ankle surgeon with offices in Chelmsford and Newburyport. “But if your feet aren’t in the best shape or you don’t have the right shoes, too much walking can cause foot problems.”

According to Dr. Downs, good foot care is essential if you plan to subject your feet to long periods of walking. Some simple foot care tips include:

* Wear thick, absorbent socks (acrylic instead of cotton).
* Dry feet thoroughly after bathing, making sure to dry between toes. Use powder before putting on shoes.
* Nails should be cut regularly, straight across the toe.
* Bunions, hammertoes or any other serious foot problems should be evaluated by a foot and ankle surgeon.

“The right shoe is also important to healthy walking,” says Dr. Downs. “The ideal walking shoe should be stable from side to side, and well-cushioned, and it should enable you to walk smoothly. Many running shoes will fit the bill.”

He adds there are also shoes made specially for walking. Walking shoes tend to be slightly less cushioned, yet not as bulky, and lighter than running shoes. Whether a walking or running shoe, the shoes need to feel stable and comfortable.

Warming up exercises to help alleviate any muscle stiffness or pulled muscles are also advised before walking. Loosening up the heel cords (Achilles and calf) and thigh muscles before a walk is especially effective.

“If you’re not accustomed to long walks, start slowly and rest if your feet start hurting,” says Dr. Downs. “And above all, have fun.”

Contact our Chelmsford and Newburyport podiatry offices at (978) 441-9241 and (978) 463-0086 (respectively) for more information. Our podiatrists are members of the American College of Foot and Ankle Surgeons (ACFAS).

For more information about foot health, visit our web site at www.NEFootAnkle.com

Timothy M. Downs, DPM, FACFAS, a foot and ankle surgeon with offices in Chelmsford and Newburyport Massachusetts, says ankle sprains are one of the most common sports injuries he treats this time of year.

“As people emerge from their winter hibernation and start to get active again, they can injure their ankles playing sports such as basketball, baseball, tennis and soccer,” Dr. Downs says.

Anyone who injures an ankle requires prompt medical treatment, whether it’s their first sprain or their fifth. Rest, ice, compression and elevation (R.I.C.E.) can reduce swelling and pain until the ankle can be evaluated and treated by a foot and ankle surgeon. A sprain may not always be a sprain; the ankle could be fractured.

Dr. Downs notes that many athletes develop chronic ankle instability from repeated ankle sprains, causing their ankle to frequently “give way.” In some cases these players may require surgery. Proper rehabilitation of an ankle sprain reduces the likelihood of developing chronic ankle instability.

Dr. Downs shares three spring ankle sprain prevention tips:

1. Perform warm-up stretches and exercises before playing sports.
2. Wear the right shoes for the sport. For example, don’t wear running shoes for sports that involve a lot of side-to-side movement, such as tennis and basketball.
3. Wear an ankle brace if you’re recovering from an injury or have repeatedly sprained your ankle.

Dr. Downs is a member of the ACFAS and board certified in foot surgery. He and his colleagues, Dr. Jerold Fleishman and Dr. Victor Quijano provide podiatric foot and ankle care at New England Foot and Ankle.

Springtime is here and a local foot and ankle surgeon cautions weekend gardeners that their yards could become “toe-away” zones if they’re not careful when operating rotary-blade lawn mowers.

Each year, some 25,000 Americans sustain injuries from power mowers, according to the U.S. Consumer Products Safety Commission.

“Although the number of accidents has steadily declined since the 1982 adoption of federal safety standards, we still see too many foot injuries from power lawnmowers,” say Timothy M. Downs, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). “The blades whirl at 3,000 revolutions per minute and produce three times the kinetic energy of a .357 handgun. Yet we see patients who have been hurt while operating a mower barefoot! Foot injuries range from dirty, infection-prone lacerations to severed tendons to amputated toes.”

If a mower accident occurs – with just a minor injury – Dr. Downs says immediate treatment is necessary to flush the wound thoroughly and apply antibiotics to prevent infection. Superficial wounds can be treated on an outpatient basis, but more serious injuries usually require surgical intervention to repair tendon damage, deep clean the wound and suture it. Tendons severed in lawnmower accidents generally can be re-attached surgically unless toes have been amputated.

Dr. Downs says children under the age of 14 and adults over age 44 are more likely to be injured from mowers than others. He says anyone who operates a power mower should follow a few simple precautions:

• Don’t mow a wet lawn. Losing control from slipping on rain-soaked grass is the leading cause of foot injuries caused by power mowers.
• Wear heavy shoes or work boots when mowing – no sneakers or sandals.
• Mow slowly across slopes, never go up and down.
• Never pull a running mower backward.
• Keep the clip bag attached when operating a power mower to prevent projectile injuries.
• Use a mower with a release mechanism on the handle that automatically shuts it off when the hands let go.
• Always keep children away from the lawn when mowing it.

For further information about foot and ankle problems, contact the New England Foot & Ankle Podiatry office at (Chelmsford) (978) 441-9241 or (Newburyport) (978) 463-0086, or visit the web site at www.NEFootAnkle.com.

As millions of avid golfers get ready for another season of pars and bogeys, they should be aware of potentially serious foot problems that can result from years of playing the game.

Although golf is not considered a rigorous sport, the physical act of repeatedly swinging a golf club in practice and on the links can lead to a condition known as hallux limitus, a jamming and deterioration of the big toe joint.

According to Timothy M. Downs, DPM, FACFAS, the movement and weight transfer that occur during the swing’s follow through can cause this problem and other chronic foot ailments. Dr. Downs is a member of the American College of Foot and Ankle Surgeons with podiatry offices in Chelmsford and Newburyport MA.

“When golfers follow through on their swing, they can overextend the big toe joint on the back foot,” says Dr. Downs. “Those who have played the game avidly for several years eventually can wear out the cartilage or jam the big toe joint. The likely outcome, if left untreated, is painful arthritis in the big toe, which would make it very difficult to continue playing golf.”

Golfers who have pain and swelling around the big toe joint or have less mobility in this area than other parts of the foot should visit a foot and ankle surgeon for an examination and appropriate treatment. A history of trauma to the big toe area and bone structure also can precipitate the condition. Individuals with a long first metatarsal bone (big toe), for example, are more susceptible to joint compression and hallux limitus.

“If golfers experience pain in the big toe area when playing, they should consider it a warning sign that intervention is necessary before the joint becomes arthritic,” says Dr. Downs. “In most situations, orthotics can be prescribed to provide relief, but others with advanced cases may require surgery.”

Another foot problem that is common in golfers is a neuroma or pinched nerve at the bottom of the foot. The weight transfer to the front foot that occurs in the follow through applies pressure that, over time, can cause a pinched nerve.

Dr. Downs also advises golfers not to wear shoes that have a spike located directly beneath the ball of the foot. “The pressure from that single spike, magnified by the several thousand steps taken during an average round, can cause intense pain and swelling in the ball of the foot,” he says.

Dr. Downs says any pair of golf shoes can be made more foot friendly without sacrificing traction by removing the poorly located spikes.

For more information on foot conditions that affect athletes, contact the New England Foot & Ankle podiatry offices at (978) 441-9241 (Chelmsford) or (978) 463-0086, or visit their web site at www.NEFootAnkle.com.

Footwear has come a long way since Roman armies conquered an empire wearing only sandals on their feet. But what’s old is new again. Recent market research reveals sales of men’s sandals jumped 20 percent between 2005 and 2007.

Along with the growing popularity of men’s sandals come more aches and pains for male feet. Timothy M. Downs, DPM, FACFAS, a foot and ankle surgeon with offices in Chelmsford and Newburyport Massachusetts, says the wrong sandal could cause men problems including heel pain, Achilles tendonitis, pain in the big toe and even breaks and stress fractures in some of the foot’s 26 bones.

Dr. Downs recommends men shopping for a man sandal – or “mandal” as some people call it – look for a sturdy, cushioned, supportive sole and padded straps. Men with diabetes should consult their foot and ankle surgeon before wearing sandals.

Despite what many men may tell themselves, foot pain is not normal. Contact Dr. Downs’ office at  (978) 441-9241 to have your painful foot checked out by a surgeon who is educated, trained and experienced in treating foot and ankle conditions. Dr. Downs belongs to the 6,000 member American College of Foot and Ankle Surgeons (ACFAS), a national medical association of foot and ankle surgeons. For more information on foot and ankle conditions visit the New England Foot & Ankle web site at www.nefootankle.com.