Don’t ignore big toe pain

The joint at the base of the big toe takes a beating each day. It has to bend with each step you take, gets jammed when you make quick stops or twisting motions, and deals with added stress when placed in high -heeled shoes.

While occasional pain in the big toe joint may occur from the daily grind, constant pain in the big toe joint could be a warning sign of a progressive, arthritic condition known as “hallux rigidus”. “Hallux refers to the big toe, and “rigidus “ indicates that the toe is rigid and cannot move. In the early states, when movement is only somewhat restricted, it is sometimes called “hallux limitus”. This joint stiffness gets worse over time, making it difficult for you to walk or stand for long periods of time.

Hallux rigidus may run in the family but can also be caused by repetitive stress from workplace or sports activities. Tradesmen who crouch and stoop a lot and avid golfers and tennis players are prone to developing hallux rigidus. An injury, such as a severe stubbing of the big toe, can also be a culprit for the condition.

It’s best to have your toe joint examined when you first notice pain while walking, standing, squatting, or bending over. If recognized and addressed early, the condition can be improved with conservative treatments such as shoe modifications, orthotic devices, medications, injection therapy, and physical therapy. But when the condition progresses and conservative attempts fail, surgery may be required to repair the damage from this painful condition.

Tasty holiday meals can trigger painful toes

With the most festive season of the year here, be aware that sudden changes in your diet can trigger painful gout attacks, especially in the feet.

Gout attacks are caused by the accumulation and crystallization of uric acid in joint tissues in susceptible individuals. Because the big toe joint is the coolest part of the body and uric acid is sensitive to temperature change, the big toe is most commonly affected area. However, other joints can also be involved.

Foods high in a chemical called purine contribute to uric acid buildup and we recommend patients who are prone to gout to avoid purine-rich items such as shellfish (shrimp, crab, etc.), organ meats (kidney, liver), red meat, red wine, and beer.

Gout can be treated with medications, diet changes, increasing consumption of appropriate fluids, and elevating and immobilizing the foot. It you are suffering from pain in your feet or ankles during this holiday season, call our office and make an appointment.

Assistant your diabetic loved one this autumn

November is National Diabetes Month, and an excellent reminder that the entire family should be involved with making sure that our diabetic loved ones stay healthy.

Here are some ways you can participate in healthy choices and actions with the whole family:

Plan meals carefully. Everyone can benefit from healthy   eating guidelines that your diabetic family member needs to follow.

Make fitness a part of your day.  Taking a walk together is a great way to help the entire family stay in shape, and to help your diabetic family member control blood sugars.

Feet can get cold on chilly autumn nights, so anyone with diabetes should wear socks to bed if their feet are cold.  They should never use a heating pad or hot water bottle.

Helped your family member check his or her.  Cuts, scratches, blisters, redness, and swelling can be detected early before they become a big problem.  So, inspect feet daily, and call our office of the first side of trouble.

Enjoying the fall colors and keep your feet safe

Autumn foliage is best enjoyed while hiking. Hiking, however, can often lead to injuries of the foot and ankle. Steep hills, slippery surfaces, and loose rocks can cause falls as well as stress to the muscles and tendons of the foot and ankle. Avoid problems such as heel pain, ankle sprains, and Achilles tendon injuries with these tips:

Use the right shoes:

Cross training athletic shoes don’t offer the support needed for hiking on uneven, steep, or slippery terrain. An investment in strong, well-insulated and moisture -proof hiking boots will lessen the stress on muscles and tendons and reduce the risk of injury. Look for shoes with a supportive shank: if the shoe bends in the middle, don’t buy it. Many hikers prefer high top hiking boots for more ankle support.

Easy does it:

Beginners should take on less difficult trails until they have mastered them , then move on to more difficult ones. Feet need to be in good physical condition to function properly, or else injuries may easily occur. Be sure to stretch the foot and ankle muscles, strengthen them, and do exercises to improve the sense of balance. This will improve your ability to deal with challenging terrain. Don’t attempt to take on more than your body is ready for; ease into your hiking routine before planning a long, strenuous trip. If you are injured , use  the RICE protocol: Rest, Ice, Compression, and Elevation. Then seek treatment at the nearest emergency facility or in our offices.

Hit the trails safely

Hiking is a great way to get exercise and fresh air while experiencing the beauty of changing seasons. Hiking-related injuries can range from relatively minor ailments such as blisters and bruises to more serious conditions, like stress fractures or ankle sprains.  These injuries may actually be seen as minor overuse injuries that will fix themselves.  Hikers may even attempt to treat the injuries by modifying their pace or by trying different shoes, but if left untreated, they can lead to  complications later.

Proper preparation before hikes can decrease the risk of injury.  Here are some easy ways to keep hikes safe:

–Wear properly fitting shoes or boots to protect toes from blisters and toenails from bruises.

–Condition and break in footwear  before your hike.

–Wear moisture- wicking socks to protect feet from the cold, and  excessive sweating.

–Be familiar with the hiking route and know your options for assessing medical assistance.

–Carry first aid supplies, such as bandages and wraps to help protect and stabilize injured feet ankles.

If you suffer a severe injury while on a hike, go to the nearest emergency room for treatment.  For less than emergent injuries or for follow-up care, call our office for appointment.

Back to school backpack injuries

The children are returning to school soon, and all will be carrying their backpacks! Unfortunately, backpacks are often a source of injury, and many recent studies have brought attention to these risks.

Wearing heavy backpacks cause the body to lean forward, risking falls and putting strain on the lower back. The shoulders hunch forward, and the muscles along the spine and ribcage are irritated. As expected, the frequently seen painful areas include the neck, shoulders, and back. However, a recent Italian study found that carrying backpacks can cause pain in the forefoot and arch, especially in overweight children.

Another interesting study of children ages 6-18 years seen in a hospital emergency department for “backpack injuries” found that 89% did not involve the usual bodily locations. The head or face was injured in 22% of patients; the wrist or elbow in 13%; the foot or ankle in 12%; and shoulder in 12%. The mechanisms of injury were wearing backpack, 13%; tripping over backpack, 28%; and getting hit by backpack, 13%!

Injury prevention begins with selection of the appropriate backpack. It should have wide, well-padded shoulder straps, a padded back section, a waist strap, and should be lightweight.

The fully loaded backpack should not weigh more than 10-15% of the child’s weight. The child should be instructed to drop off books and other heavy items into their locker throughout the day if possible. Pack only essential items, and place the heavier items low toward the center of the backpack. Always tighten straps to keep load close to the back. Always use both shoulder straps to carry the backpack. If the child complains of neck, back, or shoulder pain, or pain or numbness of the hands or feet, evaluate the weight of the backpack and its proper use and fit. If the symptoms persist, seek medical advice.

Love those flip-flops?

Flip-flops sandals of every color, design, and material are always popular in the summertime for everyone. But, while these types of sandals are fun, they shouldn’t become the mainstay of your footwear wardrobe.

Wearing flip flops too often can result in foot problems. With no arch support, and no stability, flip flops cause abnormal stress on the plantar fascia (the band of tissue that extends from the heel to the base of the toes).The resulting condition, known as “plantar fasciitis”, usually causes pain in the heel immediately upon arising in the morning or after periods of inactivity during the day.

Plantar fasciitis can be a persistent problem that takes a long time to treat. The best way to deal with the condition is to avoid it in the first place by wearing supportive footwear that provides sufficient shock absorption.

It is not necessary to completely avoid the popular footwear style. But, to save yourself from a lot of unnecessary pain, think of your flip as your dessert, not he main dish in your summer wardrobe and wear them sparingly.

Summer running: Beware the sun

Running in the Florida summer presents its own set of challenges.  Many runners decrease their mileage during this time of year, while others change their  routines to run in the cooler morning or evening hours.  Still others stop running altogether during the summer (not recommended).

Sun exposure is both healthy and dangerous for the skin.  Sun exposure is healthy because it stimulates the body to produce vitamin D.  It can be unhealthy because sun exposure can damage the skin, leading to wrinkles and, even worse, skin cancers.

Sun exposure stimulates the production of vitamin D, thus its nickname as the “sunshine vitamin”.  Vitamin D is also found in many foods.  It has several functions in the body, especially the regulation of bone mineralization.  A lack of vitamin D results and the condition of softening of the bones called osteomalacia.  The pediatric form of osteomalacia is called rickets.  Vitamin D has also been shown to be useful in reducing blood pressure and depression.  It stimulates immune system function and may protect against certain cancers.

In addition to vitamin D production, sun exposure activates a chemical called nitric oxide, large amounts of which are stored in the skin.  Nitric oxide dilates blood vessels, reducing blood pressure, which lowers the risk of heart disease and stroke.  It also increases blood flow to the muscles, increasing power and endurance.

Now the bad news.  The ultraviolet (UV) rays of the sun damage skin.  Up to 90% of age spots and wrinkles are due to sun exposure.  Worse, UV rays cause skin cancer.  Up to 20% of Americans will get some type of skin cancer in their lifetimes.  There are 3 main types of skin cancer: Basal cell carcinoma (BCC); squamous cell carcinoma(SCC); and malignant melanoma.  The BCC and SCC are known as non-melanotic cancers and are not as dangerous as the melanoma. In  the USA, there are 80,000 deaths annually from all skin cancers, with 49,000 from melanoma and 31,000 from non-melanotic cancers.

The BCC is the mildest form of skin cancer.  It usually appears as a raised, smooth, pearly bump on exposed skin.  It also has visible blood vessels, which often bleed.  BCCs rarely spread to other parts of the body (metastasize) and are rarely fatal.

The SCC is more dangerous than the BCC.  It can appear as thickened patches or hard nodules.  It can also bleed or ulcerated.  It metastasizes more frequently than BCCs.

Melanomas are the most dangerous skin cancers.  Globally, 232,000 are reported annually, of which 55,000 are fatal.  Melanomas often begin as moles that change size and shape.  Melanomas are highly metastatic to other organs and then become more difficult if not impossible to cure.

You should check your body for new or changing moles at least monthly.  Any suspicious lesion should be brought to the attention of your physician.  If you are at risk for skin cancers (fair skin, history of previous skin cancers, etc.), an annual skin cancer screening by a dermatologist may be in order

Fortunately, it is possible to enjoy the benefits of the sun while preventing the risks.  This is accomplished by applying sunscreens.  Today’s sunscreens are very effective in blocking UV radiation.  Use one with an SPF (sun protection factor) of at least 30, which will block 97% of UV rays.  Use one that is sweat and water resistant, and apply often to exposed areas.

Unfortunately, the majority of runners still do not understand the risk of sun exposure.  A Runners World survey of 1550 runners found a 36% never wore sunscreen, 36% rarely use it, 19% usually use it, and 9% always do.

The scalp and face can be protected by wearing a book wide brimmed hat. This is very important as skin cancers often affect these areas.  Hats also keep the sun out of the eyes.

UV rays can also penetrate clothing.  A system of UV protection provided by fabric has been developed called UPF (ultraviolet protection factor) rating.  For example, holding with a UPF of 50 allows only 1/50th of UV rays to penetrate.

Finally, consider the eyes.  UV exposure can lead to the development of cataracts.  Wear sunglasses of block 99-100% of UV rays.  This will also prevent BCCs that often form around the nose and eyelids.

In summary, the heat and humidity of summer should not prevent the enjoyment of running.  Remember to stay hydrated and to protect  your skin and eyes from UV rays.

Golfers: Don’t be handicapped with foot pain

This summer when you head to your favorite golf course, make sure  your feet are in shape before you approach the tee.

Many golfers don’t realize that foot pain can be an obstacle to the perfect golf swing. As your body transfers weight from one foot to the other during your swing, the nerves in the ball of your foot may become compressed or irritated and can cause pain.

Another source for pain may be from your big toe joint. When you follow through on your golf swing, the big toe joint on the back foot may bend too far, eventually wearing out the cartilage or jamming the joint. The wear and tear can lead to painful arthritis.

Heel pain can also make it uncomfortable for you to keep a solid stance during critical parts of your swing.

If these areas are causing you discomfort, call our office to schedule an appointment. There are many treatment options available to help keep your golf swing pain free.


Safety Tips For Barefoot Summer

Whether you are walking on the beach, wandering your local park, or

enjoying your own backyard, going barefoot on your adventure is one of the many simple pleasures of summertime.  But bare feet need to beware.  Every summer, our office treats patients for cuts, puncture wounds, and other barefoot injuries.  To help you and your family avoid similar injuries, we are sharing some tips for a safer barefoot summer.


This type of injury can embed unclean foreign objects deep inside your foot and trap bacteria.  A puncture wound must be cleaned properly and monitored throughout the healing process.  This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles of the foot.


Many patients are surprised to learn that skin cancer, including the most serious form, melanoma, does occur on the feet.  In fact, melanoma of the foot is particularly dangerous because people rarely think to look for it on their feet , which may result in a later stage diagnosis and poor prognosis for recovery.


It’s best to keep your feet protected to avoid cuts and abrasions from rough surfaces and sharp objects hidden beneath sandy beaches and to prevent contact with bacteria, viruses, and fungi that can skin conditions such as warts and athlete’s foot.


Going barefoot can increase your risk for athlete’s foot, warts, calluses, and other problems.  Inspect feet regularly for any changes or signs of problems.  The earlier a skin condition is detected, the easier it is to treat.


Every year, people lose toes from mowing the lawn barefooted.  Others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Murky rivers, lakes and ponds can conceal sharp   objects underwater.  Plus, those with diabetes should never go barefoot, even indoors, because  their nervous system may not feel and injury and their circulatory system will struggle to heal breaks in the skin.