The toes are the most distant part of the body from the heart. In order to supply blood to the foot, arteries must travel a great distance! To bring the “used” blood back to your heart, you have two sets of veins, complete with a complicated system of valves to prevent backflow against gravity. In our advanced years, many of these vessels can deteriorate. If this occurs, it may lead to circulatory troubles, which can lead to serious problems. Similarly to inadequate blood supply to the brain, heart and eyes, your feet can suffer dire consequences if they don’t get enough oxygen and nutrient-rich blood.

Some common signs and symptoms of inadequate circulation are listed below, each followed by a short explanation.

1. Swelling of the feet and ankles. This swelling can occur because fluid trapped in your legs has to go somewhere, so it leaves the blood vessels and collects in the surrounding tissue.
2. Cramps in the feet and calves while walking. The cramping may be due to inadequate oxygen supply being delivered to the muscles.
3. Inability to keep feet warm. Circulating blood is one way our bodies distribute and retain heat. Without proper circulation to your feet, they’re likely to feel cold, even if you wear several pairs of socks at a time.
4. Loss of fat tissue on the padded surfaces of the feet. Just like muscle or skin, fat is a living tissue, and without the lifeblood of circulation, it will wither away. A decrease in this padding will cause walking and standing to be more painful.
5. Chronic ulcers on the feet which fail to respond to treatment. Another important duty of blood and circulation is to carry different factors and “tools” to areas of injury to help in the healing process. Having decreased blood supply to an area like the foot is like having a damaged roof on your house, but no ladders to use in order to gain access to the roof to fix it.
6. Either no pulse or a bounding pulse in the arteries of the feet. A bounding pulse may suggest a blockage in the area, resulting in decreased blood supply to that area. A weak or absent pulse may be caused by heart failure, among other things.
7. Burning in the soles of the feet. This is related to problems with the nerves in your feet, and one cause can be decreased blood supply to the nerves and surrounding tissues.

By making an early diagnosis, your podiatrist can help prevent possible serious complications of having poor circulation to your lower legs and feet. If you’ve experienced any of the symptoms mentioned above, please call your local Chandler podiatrist for an appointment today.

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The lymphatic system has many functions. One of the main responsibilities is to absorb excess fluid, toxins, and debris from tissue and spaces in your body and return them to your circulation to be recovered or eliminated. Another function is to help maintain a balance of fluids in your body. It is composed of vessels, which are similar to arteries/veins to drain excess fluid, and nodes, which act like filters along the path of the vessels. When these structures get blocked or clogged, lymphedema can happen. Edema simply means “swelling”, which makes sense since patients with lymphedema have arms and legs that appear quite swollen.

You can be born with deformities that lead to lymphedema, however this is not nearly as common as acquiring it from a variety of causes such as surgery, node removal, trauma, infection, cancer, radiation, burns or blood clots.

People with lymphedema often experience a feeling of heaviness, tightness, or fullness of the affected limb. They also have pain, fatigue, dry skin, sores or blisters, thickened and painful toenails, and color changes to the skin.

There are various treatment options for lymphedema such as self-clearing massage techniques, low-stretch wraps, compression stockings and compression pump therapy. The key benefits to treatment include decreased swelling and hardness, less pain, clothes and shoes that fit better and healthier skin with less chance of ulcers, infections, and inflammation. There are however, several medical conditions that warrant caution intreating lymphedema, which is why you need to regularly see a doctor to make sure youare healthy enough for treatment.

If you feel you may have lymphedema in your legs and feet, you should see your podiatrist today as they can help initiate treatment options or set up a referral to a therapy center to aid in treating your lymphedema.

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Gout is a medical condition that is typically characterized by recurring attacks of short-lived inflammation in joints, usually the big toe joint. The affected area will bered, tender, hot and swollen. Gout can, however, present as kidney stones or kidney problems as well. Caused by raised levels of a substance known as “uric acid” in the blood, gout results in uric acid crystals getting deposited into joints, tendons, and surrounding tissues. Uric acid is a chemical that is created in your body when you breakdown substances called “purines”. Now where do purines come from? Purines are a normal occurring, necessary part of life! They are needed to form the very DNA that makes life possible. Purines can be found in some foods and drinks, such as certain meats, dried beans, beer, and wine. While diet and lifestyle is a contributing factor, genetics, certain medications and underlying medical conditions also play a role in the development of gout.

While the most common appearance of gout is the red, tender, hot and swollen joint, it can present in a number of different ways. While the big toe is most often affected, other areas such as the heels, knees, wrists and fingers may also be affected. Joint pain usually occurs during the night because your body temperature is lower, which facilitates the formation of the crystals. Other symptoms that may occur along with the joint pain include feeling tired and running a fever.

Your podiatrist can have a good clinical suspicion of gout simply based on talking with you and looking at the painful area, however the diagnosis is confirmed by visualization of crystals in your joint fluid under a microscope.

Thankfully gout is treatable. Your doctor may start with NSAIDs, or he or she may decide to use more powerful drugs to improve your symptoms. Once the current gout attack has subsided, you can lower your levels of uric acid via lifestyle changes, including limiting your consumption of red meat, seafood and alcohol. Occasionally, patients may experience frequent attacks, and may be treated with various drugs to provide long-term prevention.

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A stress fracture is a very small fracture in a bone, and is sometimes referred to as a “hairline fracture”. These fractures can occur anywhere in the body’s 200+ bones; however, by far and away the most common place to suffer a stress fracture is in the foot. This is because the feet bear the weight of the entire body. Often times, stress fractures are related to “overuse”, usually resulting from sports, overtraining, or sudden increases in activity without proper conditioning. Sports like running, basketball, football and even tennis are common activities where athletes develop stress fractures. While participation in some activities put you at an increased risk for the development of stress fractures than others, it is important to realize any physical activity where the foot is put under high stress or subjected to repetitive forces and high impact landings can lead to a stress fracture.

One common activity is running on the treadmill, or rather the “dreadmill”. When running on a treadmill, at the same speed and the same incline setting for long periods of time, you’re essentially taking your foot and slamming it over and over again on a hard surface in the exact same spot. This is a good way to cause a stress fracture in your foot. To prevent this, if you must use a treadmill, try changing the speed and incline you run at frequently, so as to mimic running outside more closely. This way you’ll constantly be adjusting how your foot strikes the ground, which dampens the stress placed on any one spot in the foot.

Stress fractures are more common in women than men, for one main reason: osteoporosis. This is compounded by two other common conditions in women: eating disorders and irregular menstrual cycles. These two conditions contribute to the development of osteoporosis, which can occur very early in life and should not be considered a problem only in older women. Now, this is not to say men aren’t also susceptible to stress fractures, because they can get them, it’s just important for women to be aware of the increased risk of stress fractures.

The most common locations in the foot for a stress fracture are the second and third metatarsals (long bones of the foot which run between the midfoot and the toes). They can also occur in the heel and in a bone located at the top of the midfoot and in front of

the ankle called the “navicular”. Stress fractures in this funny sounding bone are particularly difficult to heal because of inadequate blood supply.

Some common symptoms you may experience should you suffer a stress fracture are pain that starts gradually, gets worse with weight-bearing activities and slowly gets better with rest, possible swelling, tenderness to touch and possible bruising.

If you have a painful area in your foot, you can’t remember doing anything to hurt it in the recent past, and you frequently participate in physical activities like the ones described above or you’ve just started exercising more often, you should consider seeing a podiatrist. He/she can perform a few simple tests in the office to rule out other possible causes and will be able to pick up on a stress fracture, should that indeed be what is causing you problems. Your doctor will be able to give you the proper treatment and help you get back to your normal activities as soon as possible.

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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.

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