
Geriatrics and Podiatry
Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.
Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.
Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.
Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.
Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.
Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.
Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.
Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.
Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.
Vascular Testing to Help Determine Peripheral Arterial Disease
Some of the symptoms of peripheral arterial disease (PAD) can include pain, weakness, numbness, loss of hair on your legs, bluish-colored skin on the feet or calves, poor toenail growth, pain or cramps in your legs when walking, and wounds on your feet and legs that are slow to heal. To properly diagnose this vascular condition, your podiatrist may need to know your Ankle Brachial Index (ABI). Simply put, the ABI compares the blood pressure in the arm with the blood pressure in the ankle. Blood pressure during the heart’s contracting/pumping (systolic) phase is slightly higher in the ankle than it is in the arm for healthy people. Determining the ABI is a very simple and non-invasive procedure, using just a blood pressure cuff and a Doppler instrument. The patient lies down and rests for ten minutes. Then, blood pressure is taken at the upper arm, followed by the ankle. The ankle’s blood pressure is then divided by the arm’s blood pressure. An ABI ratio between 1.0 to 1.4 is considered normal. An ABI ratio of 0.9 or less usually indicates PAD—with moderate cases typically ranging between 0.4 to 0.7, and more severe cases falling below 0.4. If you are experiencing any symptoms of PAD, contact a podiatrist right away for a full examination and to see if your ABI should be analyzed.
Vascular testing plays an important part in diagnosing disease like peripheral artery disease. If you have symptoms of peripheral artery disease, or diabetes, consult with one of our podiatrists from Foot Care Centers of Palm Beach. Our doctors will assess your condition and provide you with quality foot and ankle treatment.
What Is Vascular Testing?
Vascular testing checks for how well blood circulation is in the veins and arteries. This is most often done to determine and treat a patient for peripheral artery disease (PAD), stroke, and aneurysms. Podiatrists utilize vascular testing when a patient has symptoms of PAD or if they believe they might. If a patient has diabetes, a podiatrist may determine a vascular test to be prudent to check for poor blood circulation.
How Is it Conducted?
Most forms of vascular testing are non-invasive. Podiatrists will first conduct a visual inspection for any wounds, discoloration, and any abnormal signs prior to a vascular test.
The most common tests include:
- Ankle-Brachial Index (ABI) examination
- Doppler examination
- Pedal pulses
These tests are safe, painless, and easy to do. Once finished, the podiatrist can then provide a diagnosis and the best course for treatment.
If you have any questions, please feel free to contact our office located in Boynton Beach, FL . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Vascular Testing in Podiatry
In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.
Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.
Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.
Why Live with Pain and Numbness in Your Feet?
How Did I Get a Foot Wart?
Plantar warts are rough growths that appear on the skin of the foot in response to a human papillomavirus (HPV) infection. This virus can enter the body through cuts or cracks in the skin. You can come in contact with HPV through direct skin-to-skin contact with an infected person, or through indirect contact with an infected surface, such as the towels, socks, shoes, or personal hygiene products of somebody who is carrying the virus. Warmth and moisture contribute to the virus’ growth, which is why people who wear closed shoes and socks and those who have sweaty feet are more likely to develop plantar warts. Plantar warts typically occur on parts of the foot that experience pressure and friction, such as the balls and heels of the feet. If you have a plantar wart, it is suggested that you see a podiatrist for treatment.
Plantar warts can be very uncomfortable. If you need your feet checked, contact one of our podiatrists from Foot Care Centers of Palm Beach. Our doctors will assist you with all of your foot and ankle needs.
About Plantar Warts
Plantar warts are the result of HPV, or human papillomavirus, getting into open wounds on the feet. They are mostly found on the heels or balls of the feet.
While plantar warts are generally harmless, those experiencing excessive pain or those suffering from diabetes or a compromised immune system require immediate medical care. Plantar warts are easily diagnosed, usually through scraping off a bit of rough skin or by getting a biopsy.
Symptoms
- Lesions on the bottom of your feet, usually rough and grainy
- Hard or thick callused spots
- Wart seeds, which are small clotted blood vessels that look like little black spots
- Pain, discomfort, or tenderness of your feet when walking or standing
Treatment
- Freezing
- Electric tool removal
- Laser Treatment
- Topical Creams (prescription only)
- Over-the-counter medications
To help prevent developing plantar warts, avoid walking barefoot over abrasive surfaces that can cause cuts or wounds for HPV to get into. Avoiding direct contact with other warts, as well as not picking or rubbing existing warts, can help prevent the further spread of plantar warts. However, if you think you have developed plantar warts, speak to your podiatrist. He or she can diagnose the warts on your feet and recommend the appropriate treatment options.
If you have any questions please feel free to contact our office located in Boynton Beach, FL . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Plantar Warts
Plantar warts are growths that typically appear on the heels or other weight-bearing areas of the feet. These warts are caused by the human papillomavirus (HPV). The virus enters the body through breaks in the skin, such as cuts, that are on the bottom of the feet. Plantar warts are more likely to affect children and teenagers, people with weakened immune systems, people who have a history with plantar warts, and people who walk barefoot in environments exposed to a wart-causing virus.
If you suspect you have plantar warts, you may have the following symptoms: pain or tenderness while walking, a lesion that interrupts the ridges in the skin of your foot, small fleshy lesions on the bottom of the foot, or a callus where a wart has grown inward over a well-defined spot on the skin.
HPV causes plantar warts to form and is very common. There are more than 100 kinds of the virus in existence. However, only a few of them cause warts on the feet. The other types of HPV are likely to cause warts on other parts of the body.
If you have plantar warts, your podiatrist may try different treatment methods depending on your specific case. Some treatments for plantar warts are peeling medicines (salicylic acid), freezing medicines (cryotherapy), or surgical procedures. Laser treatments and vaccines are also used to treat plantar warts.
Sports Related Foot and Ankle Injuries
Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.
Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.
Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.
Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.
It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.
Cuboid Syndrome Can Cause Pain on the Outside of Your Feet
Cuboid syndrome occurs when the cuboid bone in the midfoot becomes partially dislocated (subluxes). This can occur during an acute injury such as an inversion sprain of the ankle, or over time from jumping, running, etc., which can place repetitive strain on the muscle which attaches to the lateral (outer) side of the foot. When the cuboid bone subluxes, this can prevent surrounding bones from moving properly. It is believed that having flat feet, or a gait where your foot rolls inward when you walk may put you at higher risk of developing cuboid syndrome. Symptoms of cuboid syndrome can include lateral foot pain which worsens in the morning or during activity, swelling and tenderness in the area, an overall feeling of weakness or difficulty when walking, running or jumping. If you believe you may have cuboid syndrome, make an appointment with a podiatrist as soon as possible. They will use a variety of imaging and physical tests to assess your condition and create a comprehensive treatment plan to guide the cuboid bone back into position and relieve pain and swelling.
Cuboid syndrome, also known as cuboid subluxation, occurs when the joints and ligaments near the cuboid bone in the foot become torn. If you have cuboid syndrome, consult with one of our podiatrists from Foot Care Centers of Palm Beach. Our doctors will assess your condition and provide you with quality foot and ankle treatment.
Cuboid syndrome is a common cause of lateral foot pain, which is pain on the outside of the foot. The condition may happen suddenly due to an ankle sprain, or it may develop slowly overtime from repetitive tension through the bone and surrounding structures.
Causes
The most common causes of cuboid syndrome include:
- Injury – The most common cause of this ailment is an ankle sprain.
- Repetitive Strain – Tension placed through the peroneus longus muscle from repetitive activities such as jumping and running may cause excessive traction on the bone causing it to sublux.
- Altered Foot Biomechanics – Most people suffering from cuboid subluxation have flat feet.
Symptoms
A common symptom of cuboid syndrome is pain along the outside of the foot which can be felt in the ankle and toes. This pain may create walking difficulties and may cause those with the condition to walk with a limp.
Diagnosis
Diagnosis of cuboid syndrome is often difficult, and it is often misdiagnosed. X-rays, MRIs and CT scans often fail to properly show the cuboid subluxation. Although there isn’t a specific test used to diagnose cuboid syndrome, your podiatrist will usually check if pain is felt while pressing firmly on the cuboid bone of your foot.
Treatment
Just as the range of causes varies widely, so do treatments. Some more common treatments are ice therapy, rest, exercise, taping, and orthotics.
If you have any questions, please feel free to contact our office located in Boynton Beach, FL . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Cuboid Syndrome
Cuboid syndrome mostly affects athletes, although it can affect non-athletes too. It is also known as cuboid subluxation or cuboid fault syndrome. This condition occurs when joints and ligaments near the cuboid bone of the foot are damaged, or when the cuboid bone itself is dislodged from its natural position. It is usually marked by pain on the outer side of the foot, which may be persistent or may come and go. Cuboid syndrome can be difficult to diagnose unless it becomes severe and more noticeable. Your doctor will likely ask questions about when the pain began and how long it has been present, and will put pressure on the cuboid bone to determine if that area is the origin of the pain.
Causes of Cuboid Syndrome
- Any repetitive stresses placed on the foot due to athletic activities are a common cause of cuboid syndrome.
- Although it develops over time, it is possible that this syndrome can occur all of sudden due to a single event or injury.
- Over-pronation can exacerbate the condition if not corrected.
Disagreements Amongst Podiatrists Regarding Cuboid Syndrome
- Some refer to it as the dislocation of the calcaneal-cuboid joint only.
- Other podiatrists see it as an injury of the ligaments located nearby, which also involves the cuboid bone.
It is very important that when you experience any kind of pain on the side of your foot, you should seek medical care right away. If a subluxed cuboid is caught early, your feet may respond well to the treatment, and you can get back into sports or other activities again as soon as the pain subsides.
What Can Custom Orthotics Do for My Foot Condition?
Custom orthotics are prescription devices that fit in shoes and are designed to distribute weight more evenly across the feet and minimize pressure on any given area. They can also correct an abnormal gait, reduce pain, and improve foot alignment. Since they are designed to address specific conditions and the individual foot structure of the patient, fit is critical. After a podiatrist examines the patient and diagnoses their underlying condition, they may determine that orthotics can be beneficial. They will then take an impression of the patient’s foot, usually with a 3D laser scan or plaster cast. Specific materials will be chosen to address the patient’s particular condition, and the orthotic will be created. The patient will come in for a fitting and any further customizations needed to ensure the device fits the patient’s shoes and is comfortable will be made. Orthotics can be prescribed for conditions such as arthritis, plantar fasciitis, heel spurs, bunions, hammertoes, flat feet, high arches and more. If you have any of these conditions, it is suggested that you make an appointment with a podiatrist to see if orthotics may be beneficial for you.
If you are having discomfort in your feet and would like to try orthotics, contact one of our podiatrists from Foot Care Centers of Palm Beach. Our doctors can provide the care you need to keep you pain-free and on your feet.
What Are Orthotics?
Orthotics are inserts you can place into your shoes to help with a variety of foot problems such as flat feet or foot pain. Orthotics provide relief and comfort for minor foot and heel pain but can’t correct serious biomechanical problems in your feet.
Over-the-Counter Inserts
Orthotics come in a wide variety of over-the-counter inserts that are used to treat foot pain, heel pain, and minor problems. For example, arch supports can be inserted into your shoes to help correct overarched or flat feet, while gel insoles are often used because they provide comfort and relief from foot and heel pain by alleviating pressure.
Prescription Orthotics
If over-the-counter inserts don’t work for you or if you have a more severe foot concern, it is possible to have your podiatrist prescribe custom orthotics. These high-quality inserts are designed to treat problems such as abnormal motion, plantar fasciitis, and severe forms of heel pain. They can even be used to help patients suffering from diabetes by treating foot ulcers and painful calluses and are usually molded to your feet individually, which allows them to provide full support and comfort.
If you are experiencing minor to severe foot or heel pain, it’s recommended to speak with your podiatrist about the possibilities of using orthotics. A podiatrist can determine which type of orthotic is right for you and allow you to take the first steps towards being pain-free.
If you have any questions please contact our office located in Boynton Beach, FL . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.