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By Dr. Kuvent, January 24, 2012 9:41 pm

Oftentimes, people involved in sports want to know how to deal with Achilles tendonitis. It usually happens during running, or other form of workout. It comes in the form of an uncomfortable pain in the ankle and heel area. However, you don’t need to be an athleteto have problems with your Achilles.

How to Deal with Achilles Tendonitis – Causes

Achilles tendonitis is a common medical condition, which occurs due to irritation and inflammation of the tendon on the rear of the ankle. Arthritis and infection can also be underlining causes of Achilles tendonitis.

How to Deal with Achilles Tendonitis – Symptoms

• Weakness or sluggishness in your lower leg
• You might have a bump on your Achilles that is due to swelling
• Lower leg weakness
• Mild pain in the heel and lower leg area when you finish with a sporting activity
• Stiffness and pain upon awakening, that loosens up later in the day
• A popping sound when you try to move your Achilles

How to Deal with Achilles Tendonitis – Diagnosis

Your podiatrist usually diagnoses Achilles tendonitis after a thorough physical examination. This also includes an ultrasound and x-ray.

Your podiatrist will also want to know about any history of other pain you have had in your legs or feet. You will be questioned about the kind of shoes you wear, and any other weaknesses you have had in your legs.

How to Deal with Achilles Tendonitis – Treatment

• R.I.C.E. – The immediate treatment of Achilles tendonitis is rest, ice and elevation of your foot for the first 48 hours after your injury.
• NSAIDs – Non-steroidal anti-inflammatory drugs help to reduce the inflammation and pain. The most common is ibuprofen.
• See a Podiatrist – If the pain is severe and it lasts more than a few days, you need to have it examined by a podiatrist. Performing some First Aid and relieving the immediate pain is good, but trying to self-diagnose your injury can be dangerous. In more severe cases, surgery might be needed.
• Physical Therapy – This includes strengthening and stretching exercises.

How to Deal with Achilles Tendonitis – Prevention

• Warm Up – Before you perform any strenuous activities, such as running, you need to do some light jogging and perform other quick exercises, like jumping jacks. After that, you need to do some good stretching exercises to help loosen up the muscles and tendons.
• Wear Proper Shoes – You need to get a pair of comfortable shoes that are suited for your training. Don’t use everyday walking shoes to do any serious jogging or running. If you are serious about your hobby or sport, you need proper fitting footwear.

Achilles tendonitis can affect everything you do, because it’s necessary to walk around every day. If you begin feeling pain in your Achilles, you should give it some rest. If the pain is persistent, you need to see a podiatrist.

Discover a professional’s way of how to treat Achilles tendonitis. If you are in the Chandler, AZ., you can locate a highly qualified podiatrist, by visiting Advanced Foot Care with Dr. Robert Kuvent, DPM.

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By Dr. Kuvent, December 20, 2011 1:07 pm

Before you learn how to treat hammertoes, it’s important to understand about this medical condition. A Hammertoe is a disfigurement caused in the second, third, or fourth toes. Hammertoe can affect multiple toes at once, or you can just have one toe that is deformed.

The disfigurement caused by hammertoe is not only a cosmetic worry, but it can cause excruciating pain, too. Therefore, it’s necessary to get treatment early on. The only way how to treat hammertoes in advanced stages is surgery. Continue reading 'How to Treat Hammertoes'»

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By Dr. Kuvent, March 22, 2011 6:54 pm

On a typical Arizona day, you probably won’t experience temperatures cold enough to cause this to happen, unless of course you’re an early riser who ventures out while the air is still crisp. For those readers who live or travel to colder environments, it may be more important for you to know about avoiding the possible dangers of the cold as it pertains to your little toes.

Continue reading 'Chilly Enough to Turn Your Toes Blue'»

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By Dr. Kuvent, November 29, 2010 7:28 pm

Gout affects approximately 1–2% of Americans at some point in their lives, and it has increased in frequency in recent decades. The recent increase is thought to be related, at least in part, to changes in the way we eat. Historically, gout was known as the “Disease of kings” or “Rich Man’s Disease” as the wealthy were the only people who could afford to excessively eat the foods that triggered gout attacks like seafood, red meat and wine. Today they are readily available in a typical American diet, and while these foods are not the only cause of gout, they play a role in causing significant pain in over 3 million Americans. Continue reading 'Gout: The Disease of Kings'»

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By Dr. Kuvent, November 9, 2010 9:09 am

We all know what fractures are. Many of you have probably fractured a bone or two in your lives. You fall out of a tree or get violently tackled on the football field and suddenly you’re in the hospital and the doctor is telling you you’ve got a broken bone. While this is easily understood by most, when prefaced by the term “stress”, people are often confused when they’re told they have a fracture. It’s not uncommon for podiatrists to hear this response after telling a patient they have a stress fracture: “but doctor, I don’t remember any trauma to my foot”. While they may not recall any specific traumatic event causing the fracture, the patient indeed suffered trauma significant enough to cause a fracture, it just wasn’t the type of “trauma” everyone thinks of when discussing fractures. Continue reading 'The Dreadmill: Common Causes of Stress Fractures'»

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By Dr. Kuvent, November 4, 2009 12:26 am

Many of us tend to think of spurs as being those old, pointed metal devices worn by cowboys on their heels in order to persuade (if that’s the right word) their horses into picking up the pace. You probably don’t think about it often, but many people are walking around today with intrinsic spurs coming off their actual heel bones! Unlike cowboy spurs, these spurs are made of bone and are actually a forward projection of the lower aspect of the “calcaneus” or heel bone. They play a unique and interesting role in the etiology of heel pain.

Much of the heel pain seen by podiatrists today is due to “plantar fasciitis” which is an inflammation of the connective tissue band running from the bottom of your heel to the base of your toes. Sitting just above and adjacent to the plantar fascia are numerous muscles which help the foot to maneuver. These structures are all closely attached to a small area on that front bottom part of the heel bone. As you might imagine, this creates a great amount of tension in that part of the heel, and over time the constant pulling of those soft tissues on the bone can lead to the development of a bony protrusion towards the direction of pull. Age, genetics, biomechanics, and other factors may all influence this phenomenon.

If you were to look at a foot model or an X-ray of a heel spur, you might be fairly surprised as they can get up to half an inch long and appear sharp-almost like a hook protruding from the heel. Actually, much of the pain involved is NOT due to the spur but rather to the inflamed soft tissues in the area. Thus, more often than not, treatment is aimed at relieving tension and irritation in the soft tissues as well as evaluating them for tears and other pathology.

Whether a spur is present or not, you should definitely visit your podiatrist if you’re having significant heel pain. He or she can evaluate it clinically and then order an X-ray or other test to see if spurring is actually present. A spur may in fact be causing the pain if it gets large enough and starts to compress on nerves in the area. The doctor can also evaluate the nature of the spur, which in some cases may help to rule out hormonal issues, arthritic disorders, and other systemic conditions. Furthermore, imaging and other diagnostic measures can help to indicate whether something else entirely-such as a fracture-is causing the pain.

Though often an incidental finding, heel spurs in certain cases can become critical to the evaluation and treatment of heel irritation. They may be the key to relief.

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By Dr. Kuvent, October 27, 2009 11:05 pm

If you’ve ever walked barefoot across a gravel parking lot, you’re probably well-aware that human feet are very sensitive structures. That’s a good thing because it allows our feet to move and adjust to potentially damaging objects on the ground-such as a sharp stone or a piece of glass. Normally, we are able to avoid such objects with ease and protect ourselves from cuts, infections, and other risks. However, the greatest threat to our feet is more internal rather than external. It occurs when our nerves become damaged and that vital protective sensation in our feet is lost.

There are unfortunately MANY things which can lead to weakened or damaged nerves in our feet. One of the most common and well-known causes is diabetes. As individuals lose control of their blood sugars, the nerves particularly in the feet tend to become damaged and insensitive. Other metabolic issues such as B-vitamin deficiencies, alcoholism, and various toxins such as heavy metals can also lead to this problem. It’s pretty interesting to consider how certain health issues like Ulcerative colitis or Crohn’s disease can affect vitamin absorption to affect nerve function and indirectly the health of our feet!

Certain inherited and autoimmune disorders can also cause the feet to become insensitive. Things like Charcot-Marie-Tooth disease, Lupus, Guillain-Barre syndrome, allergic conditions, and blood disorders can all have this effect. Mechanical issues like an entrapped nerve or a spinal root problem may also be causing the problem. On top of these and other causes, the medications you are taking can also alter the nerve function in your feet. Various seizure medications, immunosuppressive agents, oral contraceptives, and tuberculosis drugs can all have this side effect.

Perhaps one of the biggest problems with nerve dysfunction to affect our feet simply occurs as we age. Often times, visual changes in combination with insensitive feet make it extraordinarily difficult for individuals to monitor the ground as well as the health of their feet. Believe it or not, it’s not uncommon for some people to have needles and other sharp objects lodged in their feet without them even knowing it! Not only can the individual not feel the object, but they’re also not able to see what may be a large and potentially-infected wound. This can be a huge hazard for those who live alone or do not have their feet checked regularly, as the infection can spread quickly and cause major damage.

Podiatrists have lots of experience dealing with insensitive feet. They’re able not only to closely monitor the various components of nerve degeneration, but they’re also able to check for infections, care for wounds, and determine whether a foreign body is actually lodged within the foot. Sometimes various objects show up within the foot on an X-ray which is not otherwise very obvious. If you suspect you’re having such a problem, contact your podiatrist immediately.

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By Dr. Kuvent, October 22, 2009 8:47 pm

Considering the nearly endless discussion on healthcare reform these days and the constant presence of ads from pharmaceutical companies, it’s not much of a stretch to think that our country must be pretty sick! Actually, if you were to guess, what would you say is the number one cause of disability for people over the age of 18 in the US? If you were to say “joint problems” you’d be correct. “Arthritis” or a painful condition of the joints unfortunately affects tens of millions of Americans. One especially debilitating example of this is called “osteoarthritis”.

Osteoarthritis or “Degenerative Joint Disease” is the most common form of arthritis. Unlike Rheumatoid arthritis, it is not due to inflammation or to an autoimmune process. Rather, osteoarthritis typically results from the simple wear and tear that joints undergo in the normal progression of life. Over time, the cartilage which ‘pads’ the joint wears down until eventually the end of one bone starts to grind against the adjacent bone. As you might expect, this can be exquisitely painful and lead to structural damage within the bone itself. Eventually, inflammation along with weak ligaments and muscles can also become a part of the problem.

Multiple factors including genetics, dietary habits, and biomechanical issues may predispose one to developing osteoarthritis. A previous traumatic incident or a history of inflammation may be contributive as well. Typically, people tend to experience symptoms which progressively get worse towards the end of the day and are localized to a joint on just one side of the body (not both sides-as in RA). Individuals may also suffer from stiff or sore joints which oddly tend to flare up prior to a change in weather patterns. Finally, bony enlargements in joint areas are also not uncommon.

While degenerative joint disease can affect nearly any joint within the body, the ball of the foot is one of the most commonly affected areas. For this reason, podiatrists have lots of experience in addressing this condition. Thankfully, unlike many disorders affecting the bones or joints, osteoarthritis can usually be diagnosed on X-ray and doesn’t often require an MRI or more invasive test for confirmation. This and other clinical findings can help your podiatrist to rule out other potential scenarios such as RA, gout, or fractures.

Once the diagnosis of osteoarthritis has been established, the doctor will discuss with you an appropriate treatment regimen tailored to your needs. This will typically include modalities aimed at pain relief and include conservative measures like physical or occupational therapy, management programs, and assistive devices. Various medications may also be administered to help with pain relief. Finally, more aggressive measures might include things like joint remodeling surgeries or injections with gelatinous materials to cushion the joint.

Adequate motion within the joint spaces of our feet is critical for maintaining our mobility. When osteoarthritis begins to compromise that motion, your podiatrist can help to maximize joint function and your quality of life.

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By Dr. Kuvent, August 3, 2009 4:24 am

If you saw the 2004 film Troy, you may have winced at the scene towards the end of the movie where Brad Pitt’s character Achilles has an arrow shot into his heel. Despite his unstoppable presence up to this point, the incident renders him practically helpless, and he soon dies unable to remove the fateful arrow. Most people have at least heard reference to this story from Greek mythology, and an “Achilles Heel” has come to refer to any personal weakness which leaves one weak and vulnerable. The reference is a good one as many people know-for such an inconspicuous part of the body, a damaged Achilles can be truly crippling.

Despite the classic reference, the “Achilles” does not actually refer to the heel at all, but rather to the major tendon behind the ankle which inserts into the heel bone. The problem arises when this tendon becomes inflamed, irritated, or damaged and results in what is called Achilles “tendinitis” or “tendinosis”. This can really mean a lot of different things. The issue may arise from the way the heel rolls when it strikes the ground, which may in turn be related to imbalances within the forefoot. Due to the anatomy of the ankle, the middle portion of the Achilles tendon actually has a rather weak blood supply which can also make the tendon susceptible to injuries.

Achilles tendinitis is actually classified by whether it occurs within the tendon itself or at the insertion site where the tendon meets the heel bone. An injury may manifest in many different ways and include tenderness, swelling, thickening of the tendon, “crackling” sounds, a bony heel bump, or changes in walking patterns. You’d probably be surprised at all the different things that can contribute to Achilles problems. They include overuse, poor training habits, and mechanical imbalances as well as some systemic conditions like elevated cholesterol, the use of certain antibiotic medications, age, the shape of your heel bone, and even certain blood types.

Podiatrists typically address issues of the Achilles by first performing a history and physical. This will likely include some simple exams to rule out muscular causes and get to the bottom of the problem. After this, they may order further diagnostic exams such as X-rays, MRIs, or even ultrasounds. These tests can reveal the extent of the injury and whether there is bony involvement or if the tendon has ruptured. After that, the doctor will discuss with you the treatment options which can vary from simple self-treatment at home to mechanical correction through orthotic inserts to surgical intervention.

The Achilles is the strongest, thickest tendon in the body, and critical to many important functions such as walking. Therefore, it’s important to keep it in good working order, even if you don’t have plans to invade Troy anytime soon.