Athlete’s Foot

Just got back from a family vacation where we got to stay at the fabulous, four-star, Hilton Hotel. It had this amazing pool built like a tropical paradise. As someone who particularly loves water sports, I went swimming every day. Needless to say, I thought my vacation was fantastic. It wasn’t until I got home that I noticed something ajar. My feet were exceptionally dry. 

This is a true story, everyone! The soles of my feet looked terrible, particular my heels. It was cracked and scaling. No amount of lotion, cream, or even petroleum jelly could appease my symptoms. Luckily, I study podiatry. I knew that there might be a hidden culprit behind all this who goes by the alias… tinea pedis.

I thought to myself that I must expose this tinea pedis for what it really is to the general public who might not be aware. Thus, listen closely as I tell you how to spot tinea pedis and stop it dead in its tracks.

Tinea pedis can also go by its street name, Athlete’s Foot. It is an infection of the foot by a fungus of the genus, Trichophyton. It is a Trich-y fungus that normally causes a scaly rash which can be itchy, stinging, or burning. The rash tends to start in the toes. Some forms of severe Athlete’s Foot can go on to cause blisters or ulcers. Other forms of athlete’s foot can simply cause dryness and scaling on the soles of the feet that extends slightly up the sides of the feet (such is the case of my situation). This later form of Athlete’s Foot can often be mistaken for eczema or dry skin, but can’t be cured unless the fungus is treated.

The worst part about tinea pedis is that it is contagious. It can spread from one area of the body to another, or from person to person. Damp socks or shoes can exacerbate the condition. The fungal organism likes to grow under humid conditions. This means that if you tend to have sweaty feet, then you are more prone to the infection. Environments like locker rooms, public showers, or even swimming pools (gasp!) are common breeding grounds for the infection as well. 

It is best to see a doctor should you find suspicious skin symptoms on your feet. Call us at 1-310-652-3668 to schedule an appointment today if you think tinea pedis has affected you. A proper diagnosis can lead to the appropriate treatment that will get rid of your symptoms more effectively. In the meantime, have a nice day and keep those feet dry and clean!

The POP Heard Around The Bay

The buzz around the NBA world lately has been around some sad news. If you’ve been following the NBA finals, then you too would know about Kevin Durant’s story. Arguably the best basketball player in the world went out of Game 5, two nights ago, with one of the scariest athletic injuries: the Achilles injury.

If you don’t know what happened, then check it out at https://twitter.com/ProFootballDoc/status/1138277876539650049

The link above will show you a specific video of Kevin Durant tearing his Achilles tendon mid game. Orthopedic surgeon, Dr. David Chao, will even go on to say that he believes it is a complete Achilles tendon rupture. (Source: https://www.sandiegouniontribune.com/sports/nba/story/2019-06-11/nba-finals-kevin-durant-achilles-injury-warriors-free-agency)

While official word from the NBA, i.e. MRI results, have yet to be released, we already know that this injury is bad, bad news as is.

The Achilles tendon is the largest tendon in your body. It connects the large muscles (gastrocnemius and soleus) in your calf to your heel bone (calcaneus). You greatly need it for all the basics of sports activities such as running and jumping. Heck, you need it for just walking!

The Achilles tendon injury is usually the event of a tear in the tendon around 4 to 6 cm above the heel. In some cases, it can happen closer to the heel with such a force that it breaks off a part of the calcaneus.

This injury typically happens in the patient population age 30 to 50 and is sports related. It happens often to a special group of people dubbed, “Weekend Warriors”. Think adults who like to pick up sports on the weekends.

Should you think that you have experienced an Achilles injury like Kevin Durant’s, then ice and elevate your leg. We recommend that you schedule an appointment with your doctor as soon as possible. Your doctor will check for many things such as:

  • Swelling and discoloration in the area
  • Tendon gap
  • Tender and pain

A clinical examination called, “The Thompson Test” will be performed to test the remaining strength and function of your Achilles tendon.

Treatment for this injury can go in either direction between non-operative and operative. Non-operative treatment will require immobilization of the leg, typically by a cast, then rehabilitation. Operative treatment means that the Achilles tendon will be surgically exposed and repaired via suturing. Operative treatment also undergoes an immobilization period and then physical therapy.

Operative treatment is usually recommended for patients who are athletically active. This will most likely be Kevin Durant’s route. Recovery from an Achilles tear can range from anywhere between 4 months to a year. Needless to say, it is a serious injury that requires great attention.

We wish Kevin Durant the best of luck in this process. If you or someone you know may have suffered an Achilles injury, then please give us a call at 1-310-652-3668 to schedule an appointment immediately.

 

Posterior Tibial Tendon Dysfunction (PTTD)

The tibialis posterior muscle is a muscle found in the back of your leg. It is specifically located posterior to (aka behind) your tibia bone (aka a leg bone)! Surprise, surprise. This muscle helps invert and plantar flex your foot at the level of your ankle.

The tibialis posterior tendon attaches to your navicular bone, which means that it is what helps maintain the arch of your foot. When this tendon is in distress, your arch support will decrease. This often results in “flatfoot” deformity. The medical terminology for this disorder is Posterior Tibial Tendon Dysfunction, and its nickname is “adult-acquired flatfoot”.

This condition typically affects just one foot, but some patients can develop it in both feet. If not treated, it will worsen gradually. Symptoms include pain and swelling of the tendon, located mostly behind your inside ankle bone. Your foot will appear flat. Some patients go on to complain difficulty walking on their tip toes.

If any of these symptoms apply to you, it’s best to make an office visit today to seek treatment. As mentioned, the tendon dysfunction can progress to a more severe condition, such as arthritis which involves your bones. Treatment of Posterior Tibial Tendon Dysfunction will depend on your unique case but can include physical therapy or orthotics.

Feel free to make an appointment at your convenience by calling 1-310-652-3668. Have a wonderful rest of your day!

 

Ingrown Toenails

 

The other day, I began noticing an inexplicable irritation in my big toe. Upon examination, I noticed that my toenail was the source of irritation. Annoyed, I realized that I was suffering from an ingrown toenail. Have you ever had one? If you have, then I think you would agree with me when I say, I hate ingrown toenails!

An ingrown toenail is when the toenail does not grow straight out in its nail bed as it should. It can grow crooked, at a slant, or simply overgrow. Often, it will irritate the side of your toenail known as the lateral nail fold or paronychium. You might notice swelling and redness around the area. Sometimes, there may even be an infection.

 

While most people try to take care of their own ingrown toenails, there are certain cases that require professional medical help. If your ingrown toenail is severe, I would suggest coming into our office for us to correct it for you. Most importantly, patients who have diabetes or any other condition that impairs blood flow in the lower extremities have a higher risk of complications. These patients should not try to remove their own ingrown toenails at home.

 

The causes for an ingrown toenail can vary. For some, it is caused by wearing shoes that are tight around the area of the toes, causing pressure on their toenails. For others, it can be from cutting their toenails too short, unevenly, or not straight across. Some may have injured their toenail through trauma. Then there are a minority group of people who were born with abnormally curved toenails.

Whatever the cause may be, untreated ingrown toenails can have severe consequences. Should the ingrown toenail become infected, some cases could lead to a more serious bone infection known as osteomyelitis. Again, patients with diabetes or existing vascular problems should be weary of these greater complications since their healing abilities are impaired due to lack of blood flow. Patients with diabetes may have loss of sensation as well, and so, might not even notice when they have an open wound. If this may be you, then please call our office at 1-310-652-3668 for a comprehensive foot exam. Better safe than sorry!

 

Bunions are fun for no one.

Happy New Year, everyone! We hope that you’ve enjoyed yourself whilst surrounded by love ones. We notice that many people have been enjoying lots of holiday parties as of late. Good for you if this includes you! Though if you are anything like my mother, then often times you come home complaining about a very specific foot pain in regards to… bunions!

What is a bunion for the lucky individuals who don’t know? A bunion is a bony bump found on the top of your foot near your big toe. It is a problem when the bony bump protrudes or over grow, often causing superficial pain of the skin that covers it.

A common cause and aggravator of bunions are tight and narrow shoes. Think heels! Thus, those who suffer from bunions tend to be older, adult females who have adapted to wearing tight and narrow shoes for most of their lives. However, bunions can easily be found outside of this demographic as well, due to other causes dealing with inherited bone structure, applied physical stresses, or medical conditions such as arthritis.

Bunion symptoms are generally pain and discomfort localized to the area of the bony bump. You can have swelling, redness, and soreness. Your skin may develop corns or calluses. Your big toe may have reduced mobility.

Here at our office, we are happy to treat bunions of all shapes and sizes. Conservative and surgical options are available to our patients depending on the severity of the bunion and the comfort levels of the patient. We encourage you to make an appointment with us today if your bunion adds inconveniences in your day such as: pain, discomfort, unable to fit shoes, hard to move your big toe, or the bony bump is simply too large for your preference. Call us at 1-310-652-3668 at any time!

Alex Smith Injury

Here at Foot & Ankle Doctors, Inc., we are hoping that everyone has had a marvelous Thanksgiving and will continue to enjoy the holiday season. We wish your days are filled with warmth, joy, and good food.

As we progress into winter, we are still in the thick of football season. In the podiatric field, sports injuries rarely go unnoticed by us since sports medicine is a large component of our practice. That is why when Alex Smith of the Redskins injured his leg in the game against the Texans on November 18, we cringed with worry.

While the NFL categorized it as an ankle injury, we have knowledge that Smith specifically suffered a broken tibia and fibula after his leg twisted unnaturally from a tackle by J.J. Watt and Kareem Jackson. Given its degree, such an injury can be career ending.

Immediate medical attention is recommended when an incident like that occurs. Depending on the physical and radiological findings, surgery may be necessary to correct deformities found. Such was the case of Alex Smith.

However, misfortune doubled down on Smith as news broke out revealing surgical complications. Smith is now said to be dealing with post-surgical infection–a condition that will only worsen his prognosis.

We are currently wishing Mr. Smith the best as he continues to recover from his injury. A broken leg is a very severe condition to endure that requires extremely professional care. Should you ever believe that you have broken a bone in your ankle or foot, then call us immediately at 310-652-3668 for prompt treatment. Thank you, and again, happy holidays!

 

Ankle Sprains

Summer has ended, and we are now in the thick of fall. This season plants us right in the midst of various major league sports, and athletes everywhere are beginning to collect injuries. Most recently, Russell Westbrook of the Oklahoma City Thunder suffered what is known as the most common athletic injury of all time: the ankle sprain.

Ankle sprains occur when the ligaments of the ankle are pulled beyond their limits and overstretch or tear. The most typical incident of an ankle sprain happens when you roll your ankle inward. Although this injury is categorized as the most common athletic injury of all time, it can happen to any ambulatory person of any background.

Ligaments of the ankle are of the strongest fibrous tissues in the body, and they help keep the alignment of our leg bones in proper position. When we twist or unnaturally bend our ankles, we tend to injure the lateral ligaments of our ankle the most. Fun fact: the anterior talofibular ligament is the most commonly injured ligament of the ankle.

When an ankle sprain occurs, you can expect to see swelling or bruising around the area. It can be tender to touch or walk on. If the ankle sprain is severe enough and the ligament is completely torn, the pain can be comparable to a broken bone.

To diagnose an ankle sprain, a podiatric physician would perform a physical examination that involves palpation of the ankle and testing its range of motion. Depending on the location and degree of replicated pain, your podiatrist can pinpoint the ligament damaged and its degree of damage. X-rays may be ordered to rule out bone injury.

The good news is that the majority of ankle sprains can be treated conservatively and without surgery. Most podiatrists will recommend that you give it RICE. This isn’t to be confused with the edible grain, but is an acronym for “Rest, Ice, Compression, and Elevation”.

  • It is advised that you rest your injured ankle and avoid walking on it. Limit the amount of weight you place on your ankle while it is trying to heal. Ankle braces and crutches may be necessary depending on the patient.
  • Ice your ankle intermittently to control the swelling, but remember to do it properly to avoid skin damage and frostbite. Do not place ice directly on the skin. Do not apply the ice for more than twenty minutes at a time.
  • Add compression to the ankle to further control swelling. Be mindful of your own pain levels while compressing.
  • Elevate your foot while in a comfortable seated or reclined position. It is ideal to keep the foot above the level of the heart.

Treatment of the ankle sprain can be managed at home, but if further complications arise, then make an appointment with our office today by calling 310-652-3668 at your convenience.

Plantar Fasciitis

By chance, have you been dealing with foot pain lately? When you get out of bed in the morning, do the first few steps cause discomfort in the heel of your foot? If so, then you may want to read on. There is a likely chance that you suffer from a common condition known as Plantar Fasciitis. It is categorized as an overuse injury localized to the sole of the foot. Its symptomatic origin is from the long, flat, band-like ligament that connects the calcaneus (heel bone) to the metatarsals and phalanges (toe bones). This ligament is known as the plantar fascia, hence the condition’s name.

 

Plantar Fasciitis (PF) is called an overuse injury because it manifests when repeated impacts cause the ligament to stretch and sometimes tear. Those who have a recent history of weight gain or have dramatically increased the amount of walking, standing, or running in their daily activities may experience an onset of PF. Additionally, those with tight calf muscles are more prone to getting PF due to the anatomical connections between the tendon behind the ankle (Achilles tendon) and the plantar fascia ligament. However, people with flat feet or very high arches are both equally affected by PF.

 

Treatment for PF can range from stretching to surgery, but it’s best to start with the former. Should the pain be too intolerable at first, it might be best to rest the foot until inflammation has subdued. During this period, you may apply ice on and off the area of pain, for no longer than 20 minutes at a time. Over the counter NSAIDs (i.e. ibuprofen) may be taken as directed on the bottle. Note that medicine and icing will only treat PF in short term. It is important to incorporate stretching in the plan to treat PF in long term. Low-stress exercises to stretch the Achilles tendon and plantar fascia are the key goals in therapy.

Surgery should always be the last resort, only after all other options have been exhausted. If the aforementioned noninvasive treatments do not help alleviate your symptoms, then scheduling an office visit would be beneficial. Other treatment options that can be explored are orthotics or injections.