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By Dr. Kuvent, November 9, 2010 3:50 pm

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,

Do you have diabetes? If so, you’re one of over 23 million Americans who do, and that number is growing by one and a half million each year. Now, you need to know that even though you’re a “number” when it comes to counting those with the disease, you are an important individual and you have to power to take steps, no matter how big or small, toward overcoming this devastating disease. Continue reading 'Calling all Diabetics!'»

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By Dr. Kuvent, October 13, 2010 9:58 am

A common misconception about podiatrists is that all they do is trim toenails and fix “broken feet”. While it seems valid for you to default to a dermatologist when you notice a wart or other skin abnormality on one or both of your feet, you should know that podiatrists can be very knowledgeable about skin conditions. After all, just about every foot we see is covered by skin! Plantar warts are simply warts on the bottom of your feet. The word “plantar” just refers to the bottom of the foot. It is possible to get warts on your toes or even the tops of your feet as well. Plantar warts can be extremely painful, and if you have multiple warts along the bottom of your feet, you’ve probably experienced pain with walking or running. Continue reading 'What can a Podiatrist do about Warts? Shouldn’t I see a Dermatologist?'»

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By Dr. Kuvent,

Summer is officially over, and hopefully so are those extremely scorching hot days! With more reasonable temperatures comes more opportunities to be outside. Whether you’re an avid marathoner or a casual trail runner, whether you’re a touch football enthusiast or the parent of a household of kids eager to take you on in a family Super Bowl, chances are you’ve been outside more in the past few weeks than possibly all summer long. If you’re legs aren’t ready for the sudden increase in usage, you may quickly find yourself back inside, on the sidelines, leaving your kids to play alone and your running shoes left back in the closet. Achilles tendonitis is the culprit and proper prevention is the best cure – so read on active American, read on! Continue reading 'No Longer an Excuse for Laziness – What You need to know about Achilles Tendonitis'»

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By Dr. Kuvent,

Most of our kids have been back in school for at least a few weeks, if not longer, and some of you may have noticed they aren’t wearing their “Back to School Shoes” as eagerly as they once did. It’s no secret that sometimes children have a tendency to lose interest in some things quicker than others, but just to be safe, you may want to inquire about their shoes to make sure they aren’t hurting their feet. If their feet feel fine, and they’ve decided there is a different pair of shoes they now like better, the rest of this blog article may not help you with your situation; however, if you find out your precious child’s feet hurt in their new shoes, then the following is a list of several things to look for in selecting a quality, foot-friendly pair of shoes.

There are three main things to look for when buying shoes for your child:

1. A Stiff Heel: Squeeze the heel to make sure it does not collapse because if it does, it will not provide adequate rear foot support.

2. Proper Flexibility: Hold the front of the shoe and bend it back to see if the shoe gives where your child’s foot naturally flexes while he or she is walking or running. Don’t worry, as strong as you may be, you won’t break the shoe (unless it’s a pair of glass slippers for your little princess).

3. No Rotini Noodles: Holding the shoe at both ends, twist it in opposite directions with your hands. The middle of the shoe should not twist! This stiffness provides good mid-foot support. If you’re going to spend any amount of money on a pair of shoes for yourself, let alone your children, that shoe should pass all three of these simple tests.

The American Podiatric Medical Association (APMA) gives what is called their “Seal of Acceptance” to shoes, and other products, that promote foot health. A shoe that bears this marking of approval has been tested by foot and ankle doctors who understand the complexity of the foot while both standing and in motion. The APMA provides a list of products on their website, but you can simply look for this seal on the box of shoes to see if it is approved.

When buying shoes for your child, you should ALWAYS take your child with you! This will ensure a proper fit in both length and width.

The myth of breaking shoes in needs to be dispelled here and now. Shoes need to be comfortable the first time your child tries them on in the store. If there is any show of discomfort in the store, you need to try a new pair, regardless of a sales price or special clearance tag.

Shoes should not be inherited! While hand-me-downs can have a place, passing shoes from one kid to another can not only spread fungus such as athlete’s foot (if present), but can also cause significant harm to your younger child’s feet. Everyone walks in their own unique way. Over time, shoes develop what are called “wear patterns” specific to their owners. If you try to pass shoes on from one person to another, it may actually cause damage to the second person wearing them, which may end up costing you more in the long run.

Shoe size is merely a guide. Your kid’s feet need to be measured each time you buy them a new pair of kicks. Most sales associates can aid you in determining the correct shoe size for your child.

Lastly, take your child to see a podiatrist. One fast and easy appointment can help prevent foot problems that may occur later on in life. Podiatrists can analyze the way your child walks and stands, as well as look at his or her shoes for certain wear patterns. If anything odd or abnormal is noted, the doctor can prescribe therapies to promote proper foot health for your kids’ childhood and beyond!

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By Dr. Kuvent, September 14, 2010 4:35 pm

If you had to pick one bone in your foot to fracture, near the bottom of that list would be the ever important bone called the Talus. The talus lies on top of the calcaneus (or “heel bone”) and supports the two long bones of the lower leg. This bone is functionally responsible for transferring body weight during walking from the leg to the rest of the foot. It is involved in three different joints in the foot, including the ankle, and therefore is mostly covered with cartilage, similar to the cartilage found in other major joints of the body like the knees, hips and even between the vertebra in the spine. Needless to say, this bone is important!

Like most bones in the body, the talus has many different features around the bone, each of which comes with a unique list of problems that can arise. The main three portions of the talus are the body, neck and head, and of all the different features of the talus, the neck is more prone to fractures than the rest of the bone. Given this knowledge, it would make sense to put the talus toward the bottom of that list of bones to fracture. Unfortunately, our list doesn’t dictate which bones are fractured more often than others, as the talus is the second most fractured bone in the foot (second only to the calcaneus –another bone you’d probably rather not fracture).

Fractures involving the talus have been described for thousands of years. King Darius I of Persia (522 B.C.), father of King Xerxes, broke his talus by falling from his horse while hunting. In the 17^th century, it was common practice among doctors to just amputate the leg from the knee down if you fractured your talus severely enough because there was no other feasible way for doctors to repair the damage well enough to restore function to the foot.

At this point, it would make sense to finally address the title of this article in some fashion. Given that the neck is the most commonly injured site of the talus, it makes sense that it has been the subject of more discussions involving talar injuries than any other injury to this bone. You may find it interesting to know that during World War I, there was a high incidence of this particular injury in a specific group of people: pilots, or “Aviators”. Being that this was the first war involving the use of aircrafts, many wayward planes were seen plummeting to the ground with only a rudder foot pedal for the pilot to use in an attempt to crash land the aircraft. The force on the foot was enough to cleave the head of the talus from the neck; thus, the name “Aviator’s Fracture” was coined.

So what does this have to do with seatbelts and airbags? Well, today, this particular fracture is most commonly seen in motor vehicle accidents. Because seatbelts and airbags keep you as stationary as possible in a car crash, the foot is more vulnerable to the same forces that were seen in the feet of crashing pilots of WWI, and the talar head can be fractured from the neck and body of the talus. Luckily for you, should you ever suffer an Aviator’s Fracture, whether you were driving your car or crash landing an old fashioned airplane, podiatrists today are much more skilled than the doctors of the 17^th century and won’t need to amputate your foot. Instead, we have many surgical options to restore full function to your ankle, allowing you to recover much better than King Darius or those brave WWI pilots likely did! So please, continue wearing your seatbelts and using your airbags!

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By Dr. Kuvent,

Have you ever wondered how broken bones heal? If you’re among the masses that don’t realize bone is a living tissue, just as alive as your muscles and skin, then the thought of bone healing must be quite perplexing. Well, in order to put to rest a common misconception, let’s ask the question “Is bone alive?” The answer is simple: absolutely. Now, older, more “experienced” bones can be dry, brittle, and in the process of dying, but in the bodies of most individuals, bones are very much alive. Bones have their own nerves and blood vessels, and they perform different tasks, like storing important minerals such as calcium, zinc and potassium. Your bones are made up of hard material to give them strength and billions of living cells which help give them the ability to grow and to heal when they get damaged.

When you break a bone, say, in your foot, it will require a number of things to heal properly. Immobilization and compression are two important factors to provide optimal healing. If the pieces of broken bone are greater than one centimeter apart, it often won’t heal correctly or in a very timely fashion. For this reason, we try to reduce the fracture site between the pieces of bone to less than this distance, in order to facilitate the desired healing. We can use plates, screws, pins and other materials to hold the broken pieces together, which can provide both immobilization and compression.

Because bone is strong and complicated, it takes a long time to heal. In some cases, the bone won’t heal completely for over a year! Thankfully it won’t be years until you’re back on your feet, but rather around 3-4 months after the initial injury, the bone has formed what is called a “hard callus” around the fracture site and at this point it may be strong enough to walk on.

Now, just because bone can heal doesn’t guarantee you’ll be back on the softball diamond or walking down the beach in 3-4 months. There are complications with healing, and it is imperative that you follow the doctor’s orders in order to avoid these complications. Problems with healing include “delayed union” in which the healing has not advanced at the proper rate, and “nonunion” in which every aspect of the healing process has stopped. A delayed union requires strict immobilization to fully heal, while a nonunion may require either a device called a “bone stimulator” to promote healing or in severe cases a bone graft can be used to heal the bone completely. Another barrier to proper bone healing can be yourself, if you don’t listen to your doctor’s orders. When patients walk on their “broken foot” too soon after surgery, they risk breaking the screws or pins placed in their bones which removes both factors (immobilization and compression), as well as potentially damaging and delaying the natural bone healing process. This is why casts and boots are implemented, as uncomfortable as they may be, because they help prevent you from placing too much weight onto the fractured bone should you need to walk on it.

Another thing to keep in mind is that if you have a surgery to correct a bunion or a hammertoe, for example, when your doctor cuts your bone, they have created a fracture, and the same healing principles apply. So, if you’ve been treated by a podiatrist for a broken bone in your foot or a corrective surgery such as a bunion repair, you should now know that your bones are alive and capable of healing themselves. You have a responsibility to yourself to keep off the affected foot, until you’ve been given clearance by your doctor, even if it doesn’t hurt anymore, because a lot goes into healing bone, and you must give it time to take place properly.

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By Dr. Kuvent, August 16, 2010 11:46 am

If you have a bunion on the outside of your foot, where the 5th toe meets the 5th metatarsal bone of the foot, you don’t just have a bunion, you have a Tailor’s Bunion. And if you have a Tailor’s Bunion, you can blame those who lived during the Renaissance period for your pain. You read that correctly, people who lived in the 14th century were responsible, at least in part, for the profession that eventually led to the naming of the Tailor’s Bunion. First, a brief history lesson, then more about your condition.

During the Middle Ages, clothing was merely a means of concealing the body. Then came the Renaissance period, where people sought to accentuate the human form not only in the arts but in the fabric they wore on their backs. Gone were the days of wearing a loose robe that had been so easily created from a single piece of cloth. People began shortening, tightening, cutting, piecing, and sewing swatches of fabric together in an eventually successful attempt to bring into prominence the contours of the human body. This, ladies and gentlemen, marked the emergence of tailoring and, as a matter of fact, the birth of fashion itself. It is not too difficult to imagine that with a growing demand for shaped clothing, came also a growing need for someone who could shape the clothes. First came the “cutter”, whose job was to make the patterns. Then came the “tailor”, who did the sewing.

Now, fast-forward a few hundred years, and you could find tailors in every town or city, sitting crossed legged in their shops, sewing away at their newest conceived design. Consequently the outside of their feet, especially the heads of the 5th metatarsals, would be rubbed on the floor with such vigor that it began to hurt. They would go on to develop prominences, or “bunions” on the outsides of their feet, which was simply the body’s way of protecting itself. This is exactly how the Tailor’s Bunion got its name.

Your next question, logically enough, may be how is it that you can have a Tailor’s Bunion if you are in fact not a tailor, and perhaps you don’t even sit crossed legged. The answer is again related to fashion: inappropriate shoe wear. Just like it’s cousin, the bunion on the big toe, a Tailor’s Bunion can form as a result of wearing shoes with a tight toe box. Increased pressure of the foot against the inside of your shoes can, over time, result in the metatarsal bone moving and ultimately the formation of a bunion. In patients with wide feet, a Tailor’s Bunion tends to be one of the more common complaints because even though these patients have wide feet, they still tend to wear standard sized shoes, which leads to increased pressure on the sides of the feet, particularly the toe joints.

Whether you have wide feet, you’re a tailor who still sits on the floor crossed-legged, or you have a Tailor’s Bunion for some other reason, the good news is that this problem is most often completely curable. If you have pain associated with your bunion, you can use over the counter anti-inflammatory drugs and pain killers to help alleviate your pain. If your pain has persisted for a long time or if the drugs don’t help your pain, then your doctor may decide it’s time to recommend surgery. Wearing appropriate shoes is

another important aspect of treating a Tailor’s Bunion. These special shoes, or any shoe geared towards people with wide feet, can be very effective in avoiding the development of a bunion or reducing the pain associated with bunions. These shoes are best used in conjunction with bunion pads, and in many cases can make your everyday activities much easier on your feet.

If you have a Tailor’s Bunion, you should consult your local Podiatrist today to see what course of action is best for you to return to your regular activities, whether that be a physically demanding job, daily exercise or becoming the next big Design Star!

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By Dr. Kuvent, August 3, 2010 8:25 am

Do your footprints look different than everyone else’s at the beach? If so, chances are you could be a flatfooted individual.

Having flat feet is a common condition involving a collapsed arch, which allows the entire bottom of your foot to come in contact with the ground. There are many various causes of flat feet.

First off, flat feet are normal in infants and toddlers because the arch has not fully developed, so don’t be alarmed if you’re a new parent or grandparent and you happen to notice those precious little feet are flat as a board. The arches will likely develop sometime in childhood and by early adulthood, your little Jack or Jill should have normal arches in their feet.

This being said, a person can be born with flat feet that won’t develop normal arches. The best explanation for this is the simple fact that everyone is different. Some people are tall, some are short; some people have long skinny fingers, others have short stubby ones, and the rest of us tend to fall somewhere in between. If you were born with flat feet, they may or may not cause problems later in your life.

If your child complains of painful feet and they appear to be flat footed, it may be caused by a condition in which two or more of the bones in the foot have fused together. This will limit the motion allowed within the joints of the feet, and often results in a flat foot or two.

Now, if you, like most little ones, had the “normal” flat foot when you were a baby, and then developed proper arches as you grew, there is still a chance you could develop flat feet. This condition, when developed later in life tends to cause pain and possibly other symptoms, such as developing arthritis in the feet. Unfortunately, there are many different factors that can contribute to the development of flat feet, and therefore it is nearly impossible to prevent. Some causes include the position in which a child sits or sleeps or having other various abnormalities in the leg or thigh. More severe causes include trauma to or rupture of ligaments or tendons in the foot. Two more common causes of acquired flat feet in adults are “Posterior Tibial Tendon Dysfunction” (in which that particular tendon – the Posterior Tibial Tendon – malfunctions) and having a tight Achilles tendon (which causes the foot to flatten).

Your local Chandler podiatrist at Advanced Foot Care is experienced in treating flat feet both conservatively and surgically. If you have painful flat feet, don’t simply continue to walk down the beach with those funny looking footprints, call today for an appointment!

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By Dr. Kuvent, July 21, 2010 9:03 am

Have you ever wondered why calluses form or what can be done to prevent them? Most of us, at one point or another, have had a callus on either our feet or hands, or maybe even both. But just because you’ve had them doesn’t necessarily mean you know what calluses are, why they form, or perhaps more importantly, how you can be rid of them!

Calluses are areas of thickened skin that develop in response to repeated friction and pressure. They can develop on any part of the body, but are commonly seen on the hands and feet. Believe it or not, they are one way the body attempts to protect the skin and the structures beneath it from getting damaged. If you’re not familiar with thick calluses, find someone who works with their hands, perhaps a construction worker or maybe a musician, and ask them to show their hands to you. They’ll likely have thick calluses on their palms and/or fingertips. These calluses help protect their fingers and palms while playing their stringed instruments or working on the job.

Calluses can of course develop on the feet, usually on the soles under the heel or up under the ball of the feet. This is because these two spots on the feet bear most of the pressures of walking or standing. While this may not be a problem, calluses can become so thick, they start causing pain because of increased pressure.

Unless you happen to live somewhere that allows you to go barefoot all the time, there is a chance your calluses are due to some structural abnormality in your feet. This is why you should use all home care products for removing calluses with caution; while you may be able to remove the callus on your own, temporarily relieving your pain, you may be ignoring more serious conditions that may require medical attention. Some examples of problems in the feet that may cause calluses are flat feet, hammertoes, or bunions. Like many problems of the feet, wearing ill-fitting, narrow shoes are also a risk factor for developing calluses. Wearing shoes that are extra wide and deep, have soft soles and/or lower heels may help to prevent calluses. These shoes avoid placing increased pressure on areas of your feet that weren’t designed to handle the abnormal pressures.

Whether painless or unbearable, calluses have the potential to cause complications. Calluses can harbor infection that leads to pus-like drainage, increased pain, swelling of the feet, and even a fever if the infection becomes widespread throughout the body. In the event this happens, it usually requires antibiotics to clear up. This can be particularly serious in the diabetic population because diabetics tend to have more difficulty in healing properly than non-diabetics.

If you have a bothersome callus, a quick and easy appointment with a podiatrist may be all you need to diagnose the underlying cause of your calluses. Your doctor can shave down the callus in the meantime, relieving your pain, making each step easier and more comfortable.