Comments (0)

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'»

Comments (0)

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!

Comments (0)

By Dr. Kuvent, July 19, 2010 9:34 am

Have you ever paid much thought to your toenails? Perhaps you enjoy painting them or getting a pedicure, delicately prepping them for the next big event in which you can display them to the world in your newest pair of designer sandals. Or maybe your inner John Wayne prevents you from dolling them up, and you’d rather take your pair of hedge cutters, lop them off and be done with it. Either way, chances are you don’t think of them with every step you take, unless they are painful and cause you trouble. One very common culprit of a painful toe/toenail is an ingrown toenail.

An ingrown toenail occurs when the sharp edge of the nail grows down into the skin of the toe. This usually causes pain, and may involve redness and swelling around the nail. When this happens, it’s usually a good idea to take care of the problem promptly. This will avoid prolonged irritation by the nail, which in turn can increase the chances of harboring infection, not to mention the longer you wait, the longer you’ll likely be in pain.

There are a number of potential causes of ingrown toenails. Two of the more common ones are wearing ill-fitting shoes and neglecting the importance of trimming your toenails properly. Having poor eyesight or being physically unable to reach your toes easily can also make it difficult to properly trim your nails. Also, if you’re one of those people who have a tendency to pick or tear at the corners of your toenails with your fingers, just know that you can increase the likelihood of developing an ingrown toenail by continuing this seemingly harmless habit. Unfortunately for some people, being prone to ingrown toenails is just in their DNA. You may have toenails that are simply too large for your toes It is also possible that you were born with curved nails that grow downward, into the skin. Although the big toe is the usual suspect, harboring the greatest potential for developing an ingrown toenail, any toenail can become ingrown.

There are a few practices you may want to either begin, or continue if you already employ them, to help prevent the development of an ingrown toenail. First, you may soak your feet in warm water to soften the nails, being sure to use a clean bowl or tub. When trimming your nails, always use a clean, sharp nail trimmer or cutter, and try to trim your toenails straight across as opposed to tapering or rounding off the corners, as this may only put you at an increased risk of developing an ingrown toenail. Also be sure not to trim your nails too short.

 If you have diabetes, poor blood circulation, any kind of nerve damage, or an infection around your toenail, absolutely do NOT try to treat an ingrown toenail on your own. Go to your podiatrist right away. For the rest of you, while there are some home remedies for ingrown toenails that may work, it is usually best to see your local podiatrist, who as a foot specialist, is the most qualified doctor to deal with such a problem.

Comments (0)

By Dr. Kuvent, June 25, 2010 2:12 pm

“Arch Pain” is a common term used by many to describe symptoms that may occur in the arch of the foot. One of the most common findings in a patient with arch pain is inflammation of the tissues within the midfoot (you know, that portion of the foot further down from the ankle and heel, but closer than the toes). You may know where the arch of the foot is on your own feet, but what is involved in forming this arch? A tight band of tissue called the “plantar fascia” connects the heel bone to the toes, forming the arch. Now, this band of tissue is very important in ensuring that the foot performs as it should mechanically, and it is important in walking because of its role in transferring weight from the heel to the toes with each step. When this arch-forming tissue becomes irritated and inflamed, it causes that infamous “arch pain” and patients may experience severe pain even with the simplest of movements.

Knowing that the plantar fascia is an important structure in forming the arch of the foot should lead you to believe that plantar fasciitis (a commonly used medical term meaning inflammation of the plantar fascia) is the most common cause of arch pain. Symptoms of plantar fasciitis include pain right away in the morning when you first get out of bed or pain with long walks or prolonged periods of standing. If you experience arch pain early in the morning, chances are it is due to the plantar fascia becoming tight while you sleep. Upon waking up and walking to the kitchen for your morning cup of coffee, the plantar fascia is still tight from your slumber and it gets irritated when it stretches out during walking. This in turn makes the already difficult walk (depending on the amount of sleep you get) to the kitchen even more difficult due to intense pain.

The best treatment for plantar fasciitis is often a combination of some simple stretching exercises, anti-inflammatory medications such as Advil, and inserts for your shoes to help support your arches, which reduces the amount of stretching of your plantar fascia. If these conservative treatments aren’t enough to take care of your pain, you should see a podiatrist to discuss other options.

Another cause of arch pain involves collapse of the midfoot, placing excess stress on the arch. This stress affects the plantar fascia, as well as some tendons running along your ach and the joints of the midfoot. Over time, excessive stress on the midfoot joints can result in arthritis.

There is a particular tendon that helps support the arch and prevents it from collapsing. When excess stress is placed on the midfoot, this tendon becomes overstressed, which can result in tearing, inflammation, pain and eventual breakdown of the tendon. This may require therapy, being placed in a cast, or even surgery.

If you are experiencing any of the discussed symptoms of arch pain, make an appointment with your local podiatrist to determine the best course for relieving your pain and making your morning walk to the kitchen easier!

Comments (0)

By Dr. Kuvent, March 17, 2010 9:49 am

One of the most interesting aspects of the lower extremity is how many systemic diseases tend to show up in the feet, ankles, and lower legs. Diabetes is, of course, an obvious example, but there are also many diseases affecting the blood vessels which tend to show up in the lower limbs either before or during the time that they begin to affect other vital organs of the body. Many of these disorders will demonstrate predictable skin manifestations which help to offer clues about the underlying disease process.

          ‘Vasculitis’ is a general term referring to a state of inflammation or damage to the arteries or veins which transport blood throughout our body. There are many different diseases within this category which can affect different-sized blood vessels as well as different organs. However, many of the disorders result when the immune system causes damage to the walls of a blood vessel which in turn allows blood cells to leak out of these vessels. This can lead to skin lesions of the feet and lower legs which typically involve both extremities and may be severely painful.

          One important thing to keep in mind about vasculitis is that different conditions can present with a variety of different symptoms. Some diseases will involve painful blistering or ulceration of the skin while others will result in skin color changes, pain with walking, or nail pathology. Besides immune system malfunctions, other causes of vasculitis include infections, various types of cancer, and drug reactions. Similarly, the long-term and systemic prognoses of these diseases can vary widely. If left unchecked, some of these disorders may go on to cause blindness or other severe outcomes.

          Unfortunately, it isn’t possible to discuss each of the different vasculitis conditions here. However, if you would like a professional opinion, an appointment with your local Chandler podiatrist is certainly worth your while. He can perform several simple exams and help to sort out the possibilities in order to differentiate your symptoms from other possible skin or blood vessel disorders. Ultimately, he may recommend a biopsy to confirm the diagnosis before deciding on the appropriate therapy.

          While vasculitis may seem like merely an irritating rash of the feet or lower legs, in reality it is a systemic disease which can affect your joints, nerves, heart, lungs, kidneys, or GI tract. Therefore, early screening and detection is very important. The symptoms of the lower extremity may be just the tip of the iceberg.

Comments (0)

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.

Comments (0)

By Dr. Kuvent, September 22, 2009 12:17 pm

As the Fall sports season gets underway, many fans and athletes are excited for another year of events and competition. Though no one can predict exactly what will happen this year, athletic injuries are always a given. One of the most common injuries associated with football players is referred to as “Turf toe”. While this may sound like a relatively benign issue, it can actually prove devastating to athletes, teams, and even non-athletes who encounter this condition. Even NFL stars such as Deion Sanders, Darren McFadden, and LaDainian Tomlinson have missed significant playing time because of this injury.

Turf toe basically results from hyperextension or an excessive upward bending of the first toe at the ball of the foot. There’s a major joint in this area with many important structures which can each be easily damaged in such an injury. This scenario commonly results when an individual’s foot-with the heel raised and the forefoot about to push off-receives a direct force down and through the ball of the foot. The end result is usually pain, swelling, and stiffness of the joint which, of course, depends on the extent of the injury.

The phrase “turf toe” has actually become somewhat of a junk term to refer to any traumatic injury of the big toe joint. In reality, it is a unique entity which separates it from other similar issues. For example, “sand toe” is a separate injury involving hyper-flexion or a downward over-bending of the big toe which is often seen in volleyball players. Turf toe actually ranks third in frequency behind knee and ankle injuries in football players, and though not as common as ankle injuries, it results in more missed playing time. The issue has become more prevalent over the years for several reasons. First, many sporting events now take place on synthetic surfaces like AstroTurf which have more friction and don’t allow the toes to adapt as well to various forces. Secondly, whereas older athletic cleats had a metal plate in the forefoot to limit excessive bending, newer models are generally more flexible (for speed) and less shock-absorbing.

Podiatrists typically address turf toe cases by first assessing the symptoms and possibly ordering and x-ray or an MRI to determine the extent of the damage. Based on these findings, they can classify the injury, give an accurate prognosis, and implement proper treatment. Mild cases may involve simple taping and plate splinting of the toe with return to activity in a few days. More serious cases may require the use of crutches or casting and may necessitate up to six weeks of missed playing time. Very severe cases might warrant a surgical approach to repair soft tissue structures, remove bony fragments, or provide other corrective measures. It all depends on the particular case.

Whether in sports or everyday life, traumatic injuries are certainly not fun. Thanks, however, to proper treatment and our bodies’ healing abilities, they can often be managed effectively.

Comments (0)

By Dr. Kuvent, May 6, 2009 11:55 am

You’re on a mission, for the perfect pair of shoes. There’s an event, a wedding, a game–whatever, you NEED those shoes. You get to your favorite shoe store and you see them through the window…glowing from a glorious pedestal display. AND their 50% off! Today is YOUR day.

You rush into the store, scan down the available sizes, and…just 2 pairs? One that’s 2 sizes too big, the other is a 1/2 size too small. Just your luck. Well who cares, it’s just a half a size smaller, maybe I’ll just take out the insole or something…

Maybe you can relate or maybe you have a pair of shoes you’ve been holding onto for over a decade…
Women often buy dress shoes that come to a narrow point or lack sufficient padding–and sure, this causes blistering, soreness, corns, and calluses. But, did you know you can have changes in your bones from wearing ill-fitting shoes? Maybe you’ve heard of hammer-toes, here the toes start curl up a little at one joint and back down t the other, it can be a pretty gnarly deformity. As you can imagine, this “hammering” can become VERY painful. The bones of your toes can overlap each other, curl into each other, and be permanently scrunched upwards by those shoes you HAD to have…they are physically changing your bone structure! And if your bones of your feet are changing, the MUSCLES of your legs and feet (that attach to those bones) are forced to change too. Yes, it’s painful, just like any other muscle, when it’s pulled and strained–but think about it. These are the muscles of your legs and feet! You’re on them ALL the time. Some of your muscles are forced to work overtime, which pushes the others out of their alignment too. This repeated pulling, tugging at your muscles is actually effecting how you walk. Over time, you can lose stability in your ankles and literally morph the way you walk. It’s kind of like the tires on your car–if they fall out of alignment it pulls you one way or the other–and ultimately makes it difficult to steer…
See? IT IS A BIG DEAL. IT IS TIME TO GET YOUR FEET ALIGNED…

Stay tuned for the next blog for some helpful suggestions, tips, and pointers to find your next (truly) perfect pair of shoes…
and yes, it’s time to get rid of those sneakers from 1983…

Comments (0)

By Dr. Kuvent, April 10, 2009 3:43 am

Preventing Prom Shoe Pain

As spring time rolls around, thousands of high school students and parents are no doubt highly anticipating that big event of the year: Prom. Many girls look forward to this night as a huge event in their high school years and hope to fill it with lots of great memories. There are, of course, many logistical preparations to make, but finding the right pair of shoes is truly critical in making this night a success.

Prom shoes on average cost $50-80, although there are many discounts available and shoes to fit any budget. A big issue is finding the right compromise between style and comfort. Many girls want to find shoes that look great, but heels that are too high can be a simple cause for a ruined Prom. The standard heel heights are usually 2”, 3”, and 5”, but it’s strongly recommended that girls choose a heel height similar to what they’re used to wearing on a daily basis. Consider your date’s height and how much you intend to dance. Both should be important factors when choosing high-heeled shoes.

If you’re not comfortable with heels, basic flats or wedge shoes may be a good substitute. These should be chosen as an alternative to kicking off heels later in the evening because many gowns are hemmed to floor length, and going barefoot will cause the dress to drag along the ground. Therefore, it’s also a good idea to have the shoes available at your first dress fitting so as to minimize alteration costs by maintaining a consistent hemline.
Since our feet actually swell during the day, it’s a good idea to go shoe shopping in the afternoon or evening to find a pair that will fit your feet most comfortably. Wear the shoes around the house for a few days prior to the big night in order to allow them to conform to your feet. Also, consider the Prom location and floor surface. You may want to scuff the bottoms of your shoes with sandpaper for more traction to make walking and dancing easier.

With simple planning and foresight, you can choose a pair of shoes that will leave an impression on your friends, family, and date-NOT on your feet!