Cold Weather and the Feet

As the temperatures dip in Chicagoland, my concerns again turn to keeping the body, and especially the feet, safe during these freezing days. The toes are at high risk for cold injuries such as frostbite during these frigid days, so it is essential to wear warm socks and boots and to limit time outside. Signs of an injury due to the cold can include tingling, numbness, burning, color changes to the feet or toes (redness can turn to a gray, blue, yellow, or mottled discoloration), pain, difficulty with movement or stiffness, and eventually blistering (often after rewarming of the skin). Elderly patients and people with chronic diseases like peripheral vascular disease (poor blood flow), diabetes, and other conditions are at very high risk for frostbite. Frostbite can lead to nerve damage, chronic pain, future cold sensitivity, ulcerations, gangrene, infection, limb loss, and loss of life, so it is important to stay warm. If you have signs of a cold injury, it is important to report to the nearest Emergency Department for care.

My feet ache...Why shoes are important.

Every day, I have patients come into my office with vague foot and ankle pain. In many cases, there are actual structural issues that are causing the pain: bunions, hammer toes, flat feet, high arches, etc. However, to compound the problem, the patients are frequently wearing the wrong shoes. What do I mean by wrong shoes? Shoes that can be twisted, rolled into a ball, bent in half, or that have heels that I can compress or bend are often the wrong type of shoes for foot and ankle pain. These shoes are also not ideal for any type of foot, as they can lead to foot and ankle issues down the road, and this is especially important with growing children. Certain shoes do not support the foot and allow it to function efficiently. Additionally, they can cause structures to be overused or strained, and this can lead to inflammation of tendons, muscles, fascia (often, heel pain) and nerves, and this can result in pain. Patients can develop stress fractures of bones due to improper shoe gear choices, as well. Some of these issues can be chronic and recurrent if the same bad shoes are selected day after day. This is obviously, a tricky problem for working professionals, but supportive shoes with or without a custom orthotic device can help with foot pain. Foot pain? Give us a call, 708-763-0580, or schedule on oakparkpodiatry.com or zocdoc.

Why shoes are important for people with Bunions!

A bunion occurs when there is a bump in the area of the big toe, and bunions can be inherited or caused when certain bones shift over time due to poor mechanics, flat feet, arthritis, trauma, or other conditions. Surgery is the one way to deal with this problem, as the bump can be removed and the bones realigned. However, surgery cannot create a perfect toe and is often challenging for busy people, as it may require time off of work, driving, and most activities. Conservative options for bunion pain are favored by many of my patients and can include ice, medicine for pain or inflammation, taping and padding, orthotic devices, and shoegear modifications. The purpose of this blog is to stress the importance of proper shoegear for people with bunions. Shoes must have a larger toe box so that there is no rubbing of the bunion on the shoe. Additionally, the material of the shoe is important, as harder materials are more irritating than softer materials in the toe area that give and stretch. Shoes that are more rigid on the bottom or have a slight rocker tend to feel better for people with bunion pain. If the shoe can be bent under the forefoot or twisted, the bunion may be aggravated. If you have a bunion and are in pain, give us a call, 708-763-0580, or schedule on zocdoc or oakparkpodiatry.com for added convenience.

Heel Pain-Part 3

There are some patients that have heel pain that is not caused by plantar fasciitis. Another frequent cause of heel pain is a stress fracture of the heel bone or calcaneus. The calcaneus is the biggest bone in the foot and can become injured from repetitive microtrauma (walking on a hard surface all day, running, jogging, marching), an injury (falls, jumps) and other causes. Poor bone density, chronic diseases (diabetes, peripheral vascular disease,cancer,autoimmune diseases), poor biomechanics, and poor shoegear can also contribute to an injury of the heel bone. Injuries to the calcaneus may be visible on x-rays, but sometimes, a more advanced test like an MRI may be needed to properly visualize the fracture or injury. Stress fractures of the calcaneus require immobilization. On some occasions, bone stimulators or surgery are indicated for severe cases. Heel pain? Give us a call, 708-763-0580.

Obesity and Heel Pain

This is the second blog on heel pain, and as September is Childhood Obesity Awareness Month, it is important to know that obesity causes foot problems for adults and kids. One of the main causes of plantar fasciitis (the leading cause of heel pain) is an increase in weight. For some people, this can be five pounds that they gain over the winter, but for others, it can be the extra pounds that they carry around every day for many years. For those with heel pain that are obese or have gained some weight recently, it is important to consider dietary changes and exercise to shed some pounds. Many people have such significant heel pain that they cannot run, walk, or do other weightbearing exercises. Some great alternatives are biking, swimming, and water exercises. These are gentler on the feet and also good forms of cardiovascular exercise. There are many other causes of heel pain, but Childhood Obesity Awareness Month made me think that this would be a great topic for this week's blog. Dr. Bender, 708-763-0580, oakparkpodiatry.com

Heel Pain-Part 1

The heel bone or calcaneus is the largest bone in the foot and has many important soft tissue structures that attach to it. The most common cause of heel pain is plantar fasciitis, which is inflammation of the band that extends from the bottom of the heel along the arch. Plantar fasciitis can occur with weight or activity changes, gait abnormalities, based on foot structure abnormalities, injury or trauma, overuse, and sometimes no cause can be identified. Typically, there is pain after rest (sitting at a desk, getting up from bed) with plantar fasciitis, but pain can also occur at a lesser level during the day in some patients or be aggravated by exercise or activity. Common treatments of plantar fasciitis include the following: icing, stretching, changing shoegear, no barefoot walking, medicine, injections, strapping the foot, orthotic devices, physical therapy, and night splints. There can be other causes of heel pain, so if the condition is not improving after 2-4 weeks, x-rays, MRI, and immobilization may be needed for the pain. Dr. Bender, 708-763-0580 oakparkpodiatry.com

Painful Fifth Toe-Broken Toe

One of the most common reasons a fifth toe is tender (and swollen) is because it is broken. Every week, I have patients come into the office stating they bumped their little toe on something (the bed, a table, a chair, toys, a pet), and it is not improving. There are three bones in the fifth toe, and they are called phlanages. These bones are very small, and because this toe is on the outside of the foot, it is easy to injure. A good clinical exam in the office and x-rays are the best ways to diagnose a broken toe. Sometimes the fracture or break is hard to see on x-ray since the bones are so small. Treatment options for a broken fifth toe are strapping, surgery shoes, antiinflammatory medicine, ice, rest, and very occasionally surgery. Fractured bones often take 6-8 weeks to heal if properly diagnosed and treated. Certain diseases and conditions can delay healing in some patients. Does your little toe hurt? Give us a call, 708-763-0580.

Ouch! Another cause of a Painful 5th Toe

Last week's blog focused on one cause of a painful 5th toe, which is a lister corn. This week we will focus on one of the most basic reasons the fifth toe can hurt, and that is a contracted toe. Two forms of a contracted fifth toe are called the hammer toe (contracted toe with no curvature) and digiti quinti varus (curved and contracted). These toes can be flexible, which means they can be straightened out, or rigid (do not flatten out). Contracted toes can lead to pain, corns, swelling, blisters, and in some cases open sores. Some patients do not like the way their toe looks and come into the office complaining of the contraction, which can be accompanied by discoloration (darkening or redness). There are many ways of dealing with these problamatic toes: padding, shoes with a bigger toe box, trimming painful corns, and surgery to straighten out the toes. Does your toe hurt? Give us a call, 708-763-0580. Dr. Bender

Painful 5th toe! What is a lister corn?

At least one new patient per day comes in complaining of a painful baby toe. I will write a series of blogs over the next few weeks about the fifth or "baby" toe over the next few weeks. The little toe often has problems as it is shorter than the rest, often not perfectly straight, and rubs on our shoes. Plus, since it is on the outside of the foot and small, it can get injured more easily. Today's blog will focus on the lister corn. This is a corn that develops on the side of the fifth toenail. Patients often complain of a split nail or fungal nail when they have this condition. The area is thicker than the nail on most occasions and can be very irritating because of the thickness and subsequent rubbing against the shoe. Additionally, the toe itself may be in a curved position with this condition, which makes it easier to develop a lister corn. In office treatments for this condition include trimming, padding, and changes in shoe gear. Pointed or tight shoes and shoes made of harder materials may aggravate the lister corn. Additionally, surgery to straighten the toe and remove any prominent bone under the corn may be needed. Toe pain? Give us a call, 708-763-0580. Dr. Bender

Ouch-What do I do about my twisted ankle?

Every week, I run into friends or patients around town who say they twisted their ankle and want to know what to do. Often, there is pain and swelling with an injured ankle. Plus, it may be hard to walk! The ankle is a complex structure made up of three bones: tibia, fibula, and talus. Additionally, there are numerous tendons, ligaments, and other soft tissue structures that hold it together and help it to function. In the office, after examining the ankle, we occasionally do x-rays to make sure the bones are not broken. The one problem with ankle injuries is that the soft tissue structures may be injured and do not show up on x-ray. Sometimes, additional testing with an MRI is necessary to determine the extent of the soft tissue injury. Frequently, the ligaments on the outside of the ankle are the ones injured with an ankle sprain or injury. There are a variety of ways to treat ankle injuries and often depend on the severity of the injury: walking boots, casts, strapping or taping, injections, medications, physical therapy, rest, ice, and on occasion, surgery. So, what should you do on your own if you injure your ankle? It is important to begin RICE. Rest. Ice. Compression (an ace bandage or something similar). Elevation. Other things that may help include anti-inflammatory medicine like motrin and supportive shoes or boots if you must walk. Barefoot walking, house shoes, and flip flops are discouraged when the ankle is injured due to the lack of support. Sore ankle? Give us a call, 708-763-0580, or schedule on zocdoc.com for added convenience.

Fourth of July and the Feet

Holidays can be challenging on the feet. I have posted several blogs on shoes that are not supportive, foods and alcohol that can cause gout (beer, wine, shrimp, red meat, cheese), walking barefoot, walking on irregular surfaces, and being more active than usual. However, the Fourth of July also brings on the risks of fireworks. I am originally from Indiana, where fireworks are still legal, but in Illionis, fireworks are often illegally used and pose risks to the feet. Burns to the feet are an obvious concern with fireworks, but more serious injuries can occur and include open sores (cuts, abrasions) and loss of a limb if fireworks are improperly used. If you have an injury from a firework, it is essential to call 911 or visit the nearest emergency department for proper treatment. Happy 4th of July, and Be safe Chicagoland!

Why Antibiotics did not cure my Ingrown Nail

Ingrown nails are a common reason why patients come into my office. Many patients have tried a course of oral antibiotics given to them by their primary care or ER doctor, and the ingrown nail may be better for a period. However, the nail edge may soon become painful and infected again. Why? When a nail becomes ingrown, it usually causes a cut in the skin along that border or there is a piece of sharp nail that is stuck in that border. Our nails (even though they are ours) are considered foreign objects, and since they are stuck in the border with an open sore or a sharp piece of remaining nail, they need to be removed so that the area can properly heal. Often topical antiobiotic ointment and soaking are used after the nail border or sharp left over piece are removed to help clear the infection. Oral antibiotics may also be used if the infection is severe. However, the nail border must be removed for the antibiotics to work. Ingrown toenails can be a recurrent and annoying problem. Give us a call if you are suffering from this foot condition. 708-763-0580 or schedule on zocdoc.com.

Why do my feet SMELL?

Smelly feet are a frequent complaint in my office, especially as the temperatures rise. In fact, I was buying my morning coffee yesterday and was flagged down by a grandfather who wanted to know how to combat his grandson's odorous feet. Warm feet, socks, and shoes are the perfect habitat for fungi, bacteria, and viruses to thrive in because they like warm, moist environments. These organisms often cause the odor. Our feet have thousands of sweat glands, especially on the bottoms. Sports, anxiety, warm temperatures, pregnancy, obesity, certain diseases, and genetics can play a role in how sweaty a person's feet are on a regular basis. Daily bathing with extra attention to cleaning the areas between the toes is essential. Keeping the feet dry with anti fungal sprays and powders and wearing and regularly changing socks can also help. Additionally, socks that wick away moisture are very helpful and keeping the feet dry and reducing odor. Not wearing socks at all can increase the foot odor and make the shoes smell. Letting shoes air out over night in a well ventilated area is very helpful, and it is even better to rotate the shoes that are worn (alternating each day). Finally, spraying shoes out with lysol or a shoe deodorizer each day is a good way to reduce the odor in the shoes. Occasionally, prescription antiperspirants may also be needed to keep the feet dry and odor free. Foot problems? Give us a call, 708-763-0580.

Why You Should Not Walk Barefoot!

The warm weather is here, and I have seen lots of people shedding their shoes and walking barefoot. Although tempting, free, and fun, walking barefoot can pose many risks to the feet both inside and outside the house. I have had patients recently who stepped on objects while barefoot in their own homes. Simple things like hardwood floors and pet hair can easily penetrate the bottom of the foot and cause pain, open sores, and infection. Additionally, broken glass, toothpicks, and other objects on the floors of our homes can puncture our feet. Even dropping an object on a bare foot in the house (cans, bottles, etc.) can cause a puncture wound, fracture (break), soft tissue injury, or swelling. Outside, the risks of barefoot walking increase dramatically, and people can step on more serious things, which can include rocks, nails, wood, and many other materials. Additionally, barefoot walking outside exposes the foot to cuts and abrasions from sharp surfaces. I have also had patients burn their skin while walking barefoot outside on hot sand. Choosing a supportive and protective shoe for inside and outside the house will stabilize the foot and also generally sheild it from some of these dangers. Foot pain? Give us a call, 708-763-0580.

Why Checking your Feet is Important

All diabetic patients that enter a podiatry office, are given lengthy instructions about checking their feet. We want them to check for new openings, redness, swelling, drainage, color changes, new moles, blisters, or any new change. However, checking the feet is important for all of us. I had a recent patient who came to the office with swelling and a new black spot on the bottom of the foot. Obviously, swelling is important, and it is essential to see why the patient has it. However, a new black, brown, yellow, white, purple or red spot is something that should also be checked by the foot doctor. Often, these color changes have a straight forward cause and treatment, but sometimes, they can be a form of skin cancer that needs to be diagnosed and treated. The bottom of the foot, in-between the toes, and nails are important areas of the foot where changes can occur, and people do not even notice. If you see something new or different on your foot, get it checked! Dr. Bender, 708-763-0580.

Supportive Shoes-Why are they so Important?

Every day, I encounter people with major foot pain. AND, every day, I find that many of those people are wearing shoes that are bad for their feet-too tight, too pointed, too flexible, too high, too flat..... The patient is often shocked when I twist, bend, or even roll their shoe up into a ball! Bad shoes are not the only reason many of these patients have foot pain, but the poor choice in shoes is often not helping the already injured, inflamed, or irritated foot. Supportive shoes should not bend in half, be easily twisted, or rolled up. The foot counts on the support from our shoes to function properly all day. Walking, climbing stairs, jogging to the train, rapidly shifting to the side to grab something, jumping, kneeling to garden or pick something up, and many other actions can be achieved more easily with a supportive shoe. High heels, many styles of flip flops, ballet flats, and pointed shoes often do not stabilize the foot and can actually put the foot in danger. Next time you are shopping, pick out shoes that are good for your feet! If your foot hurts, give us a call, 708-763-0580, or visit oakparkpodiatry.com.

April is Foot Health Awareness Month

Often, people do not pay any attention to their feet until they hurt! All of the sudden, they are sitting in my office and completely perplexed about why they are having this new pain, swelling, or other issue with their feet. The feet are complicated structures that help us move around all day during our regular activities but also help us exercise, climb steps, drive, and achieve many other functions during the day. Each foot contains 28 bones and multiple tendons, ligaments, muscles, nerves, and blood vessels. Thus, there are many things in the foot that can get injured by overuse, a twist or fall, dropping some thing on the foot, stubbing the toe, and many other causes. In addition to actual accidents, poor circulation, obesity, nerve damage, poor bone density, and a variety of diseases (diabetes, cancer, arthritis, and other conditions) can cause the foot to develop problems. It is important to wear supportive shoes that stabilize the foot. High heels, ballet flats, pointed shoes, flip flops, and other shoes can injure our feet. Additionally, shoes should be made of a material that does not rub on our feet or toes,and there should not be seams that irritate our feet. It is also important to inspect the feet daily for any changes. All diabetic patients are instructed to look at the tops and bottoms of the feet each day, but this is a good practice for all of us to get into as part our our daily routines. If you notice something that is new or does not look right, it is important to see a podiatrist to get it checked out. Blisters, color changes, new swelling, new pain, drainage, and other conditions should be checked by a foot specialist. For more information on your feet, visit oakparkpodiatry.com or apma.org. Keep your feet healthy! Dr. Bender, 708-763-0580.

Blood Sugar and your FEET

Diabetes is a serious disease and affects an ever growing number of people in the United States. There is an even larger number of pre-diabetics in the United States who do not even know that they are at an increased risk of developing diabetes. These individuals have elevated blood sugars which are not high enough to put them in the category of Type 2 Diabetes, but they will probably develop it over the next ten years if no intervention for blood sugar control is implemented. Normal blood sugar is between 70-99 mg/dL, and for diabetics and healthy feet, blood sugars should range from 70-120 mg/dL. When levels exceed this range for long periods, nerve damage (neuropathy) and circulation (blood flow) problems can develop, the skin can open up and develop ulcers, the risk of infection increases due to impaired immunity, and healing is delayed. A combination of medication, exercise, a proper diet, reduction of stress, and other factors can be used to control the blood sugar and keep the feet healthy. If you are a diabetic with elevated blood sugars and foot problems, give us a call, 708-763-0580.

Exercise and the Feet

Over the last two months, I participated in two challenging stair climb events in Chicago-Hustle up the Hancock and the Lurie Kids Climb at the AON Bulding. These events support excellent causes that I believe in, but they also offer me a challenge. Because my office and family life can be very busy, along with the numerous committees and groups I am involved with, I am concerned that I may not make exercise a priority in my life. This is the case with most of us, as we have so many different things in our lives that need our attention. Therefore, I made a commitment, set a goal, and spent months walking, running on the treadmill, and in the pool preparing for these events. Exercise is excellent for our bodies, and it is great for our FEET! Regular exercise helps with our circulation and blood flow to the feet. This brings oxygen and nutrients to our feet that are needed for walking, standing, running, and other weightbearing activities. Exercise keeps our muscles, tendons, and ligaments strong and healthy so they can perform as they are supposed to in our feet. Exercise also helps control or prevent certain diseases. In the example of diabetes, exercise is very helpful at reducing and controlling blood sugar, which keeps the nerve and blood flow healthy. It also allows for stronger immunity for fighting infections. Biking and swimming are great forms of exercise for people with foot problems. However, if you need a more specific exercise plan for your foot issue, come in for a visit! 6931 W. North Ave., Oak Park, IL. Exercise is great-give it a shot! 708-763-0580.

MRI and Foot Pain

With the cold, wet weather, people are coming to my office with the complaint of foot or ankle pain that is not getting better after they twisted it. The foot is a complicated part of the body with 28 bones and many small muscles, tendons, and ligaments that hold it all together. There are some injuries that are very easy to diagnose, and others that are more challenging. A podiatry exam, x-rays, and occasionally, more advanced tests like MRI or CT scans may be necessary to diagnose a problem. At my office, we use a foot and ankle radiologist for all of our readings on MRI exams, so that we can provide our patients with the most thorough diagnosis. Conventional x-rays can show bone and joint problems in many cases. However, small bones, bones that overlap on x-rays, stress fractures, bone contusions, soft tissue injuries, and other conditions may not show up on a regular x-ray. MRIs are very good for looking at soft tissue problems but can also pick up some of the bone conditions that may not be visible on x-rays in the office. If you require an MRI for your foot condition, we often are required by your insurance to get an approval number before we can schedule your test. Additionally, after your exam, the foot and ankle radiologist may need 3 business days to complete your reading. We are here to help and find a good solution for your foot pain! Give us a call-708-763-0580.

The Super Bowl and What is Jublia?

For the second year in a row, there has been a Jublia ad during the Super Bowl. Jublia is a topical anti-fungal prescription therapy for fungal toenails. It is applied daily to the outside of the toenail, and it is a newer treatment for onychomycosis or fungal toenails. Fungal toenails often appear thick, discolored, crumbly, and can have an irregular shape or contour. Often, a biopsy is taken of the toenail to confirm that it is fungal. There are oral, topical, and laser treatments for fungal toenails, and no matter which option is chosen, it takes 9-12 months for a toenail to grow out. Do you have an irregular toenail? Give us a call! 708-763-0580 Dr. Bender

What is the calcaneus?

Our heel bone is also known as the calcaneus, and it is the biggest bone in the foot. On the back of the calcaneus, the gastrocnemius, plantaris, and soleus attach as the Achilles Tendon and are very important for us to walk and run. On the bottom of the calcanues, there are also several muscles that attach and are important for various foot functions. The plantar fascia also attaches on the bottom of the heel bone, and this is a common area of the foot that becomes inflamed in patients, requiring a podiatry visit.

Obesity and the Feet

The new year is here, and many of us have started thinking about shedding pounds and losing weight. Weight gain can cause a variety of foot aches and pains, including plantar fasciitis or heel pain, tendonitis, ankle sprains, arthritis, capusulitis, bursitis, stress fractures, and other conditions. Added pounds stress the normal structures in the feet and alter the way we walk and the way the structures function. Over time, this leads to pain. Many chronic health conditions can also lead to or be related to obesity and foot pain in some patients: peripheral vascular disease, diabetes, arthritis, depression, renal failure, heart disease, strokes, and others. This can complicate the foot pain and make treatment more important. Finding a weight loss solution that is effective and not harmful to the feet is essential. Swimming, water aerobics, biking, and sitting exercises are often the best options, but there are other forms of exercise that may work as well. Finding supportive shoes and possibly orthotic devices or inserts that provide cushioning and stability to the foot are very important. Additionally, a variety of treatments can be employed by a podiatrist to reduce your pain and make weight loss easier at the same time: padding, medicine, physical therapy, and other treatments. Foot pain? Give us a call 708-763-0580.