Treatment for HAV and bunions ranges from non-surgical to surgical care, depending on the severity of the deformity.  It is important to realize that HAV is a progressive process, meaning that it will continue to worsen without intervention.  The goal of non-surgical treatment is to decrease pain and slow development of the deformity, but it cannot completely eliminate HAV or the bunion.  Ice and anti-inflammatory medications will decrease the swelling at the prominence.  Wearing shoes with a wider toe box and avoiding high heels will reduce pressure and pain on the side of the foot.  A podiatrist may create custom orthoses that will decrease pronation and slow the progression of the HAV.  A podiatrist can also provide special padding that will help decrease pain at the bunion site from shoe gear.

Progression of the deformity may cause severe pain that will not respond to non-surgical treatment.  Often, HAV causes the big toe to drift so far over that it impinges on the other toes, creating more pain and other deformities.  In these circumstances, surgery may be necessary to fix the deformity and eliminate the associated pain.  There are numerous surgical options available for treatment of the problem.  Surgery typically involves removal of the bunion and realignment of the big toe with the other bones of the foot, using pins or screws to hold the bones in place.

While you may love the breeze that hits your feet in flip-flops, this lightweight, open style comes at the cost of support.  Most sandals are thin, flexible, and offer little arch support for the feet.  This leaves flip-flop wearers with the potential to develop arch pain, heel pain, or plantar fasciitis.  The lack of support can also worsen foot deformities, such as bunions and decreased motion of the first joint (hallux limitus), which tend to become more prominent when feet are allowed to pronate in shoes without an arch.  The top of a typical shoe normally serves to keep it on the foot. Except for a thin strap between the toes, flip-flops lack an upper portion, meaning that the feet have to work harder to keep them on.  Feet do this by flexing the toes, which serves as an anchor to prevent the sandal from falling off.  Besides causing pain, this can also aggravate existing hammertoes (toes that are always contracted).

The open nature of flip-flops creates a potential for injury to the person wearing them.  The lack of protection allows the foot to be easily cut or bruised, and there is no barrier against bacteria, leading to possible infection.  This is especially important for those with diabetes, who are prone to even minor wounds quickly turning into serious infections.

So with these concerns in mind, what should you choose for your next stroll on the beach?  Steer clear of flip-flops and go for a sandal with a back and supportive straps that cover the top of the foot.  Choose one with plenty of arch support and minimal flexibility in the sole.  If you can bend the sole in half, it is much too flexible!  With comfortable, supported feet, you will be on your way to plenty of fun in the sun.

The great toe (or hallux) is the site of the common disorder hallux limitus.  The condition causes decreased range of motion of the big toe, specifically in the metatarsal-phalangeal joint.  Simply put, hallux limitus is a stiff large toe that has decreased movement and causes considerable discomfort, either in the big toe itself, or other areas of the foot.  Normally the big toe will flex to provide the force necessary to push off the ground when walking.  But when the range of motion in the toe is decreased, it is difficult to push off the ground and painful to walk.

There are two types of hallux limitus.  In structural hallux limitus, the patient experiences limited motion when moving the toe at rest and when walking.  With functional hallux limitus, motion is normal during rest but decreased when walking.   As the condition progresses, joint degeneration will occur, increasing the problem and possibly leading to a bony prominence (dorsal exostosis) at the joint.  Hallux limitus can also worsen until the toe loses its motion entirely, a condition known as hallux rigidus.

There are several reasons a person may develop hallux limitus.  The cause may be structural; a long metatarsal bone or a square-shaped metatarsal head can make a person more likely to develop the condition.  Trauma or injury to the big toe can lead to joint degeneration and limited motion later in life.  Arthritis is also a common cause.

Treatment options vary depending on the severity of the condition.  In patients with minimal joint degeneration, the goal of treatment is to help increase motion at the toe.  This can be done with orthoses that help improve joint movement.  In patients who have progressed to more severe stages of hallux limitus, the goal of treatment is often to restrict motion at the joint to help alleviate pain.  This may require a different type of orthoses that limit joint movement, or rocker bottom shoes that decrease the propulsion necessary at the toe joint when walking.

Some patients may need to seek surgical options if conservative treatment does not help.  There are several surgical treatments available, including corrective osteotomy to treat structural deformities, as well as arthrodesis to fuse the joint and eliminate painful motion.

The month of chocolates and valentines has arrived and love is in the air. Since many of us neglect our feet throughout the year, this season of caring is the perfect time to show our feet some extra love and attention.

There are many products available to help keep your feet feeling special. Our office has tested most, and has chosen what we believe to be the very best foot products. These include an array of foot creams and lotions to revitalize, moisturize and soften dry skin, and to aid in nature’s natural healing process.

We also can recommend products for excessive perspiration and foot odor, in addition to soothing foot powders and foot soaks to relieve aching feet.

A foot massage can relieve tension and rejuvenate tired feet.  Can’t talk anyone into a foot massage? Then trying rolling your feet on a rolling pin or water bottle.

Fungal nails and athletes foot can be unsightly, uncomfortable and can lead to other health problems. There is a new treatment that is safe and effective for fungal nails and associated skin conditions. This product is available only through a physician’s office and is not available in pharmacies, stores or on the Internet.

During this season of love and caring, why not take some time to treat your feet to something special?  Visit our office to learn more about how to keep your feet feeling healthy and loved.

Gout.  This condition is caused by a buildup of uric acid crystals in a joint, causing redness, swelling, and severe pain.  It most commonly occurs in the great toe. According to the Gout and Uric Acid Education Society, those who are obese are four times more likely to develop gout than those who are not overweight.  Along with weight loss, eating fewer amounts of certain foods, such as red meat, and reducing alcohol intake can help reduce the risk of gout attacks.

Flat feet.  Obesity puts more stress on the feet, which can cause them to become more flat (known as pronation).  This can cause pain, or in severe cases, may lead to Posterior Tibial Tendon Dysfunction, a condition that causes further deformities.  By decreasing weight, the load on the feet is reduced, and can help minimize these effects.  Flat feet may require shoe inserts that can help reduce pain and other related symptoms.

Plantar fasciitis.  This condition develops when the band of tissue on the bottom of the foot known as the plantar fascia becomes inflamed.  Increased body weight puts stress on the tissue and can intensify the associated heel pain.  Since it is also caused by overuse, if you already have plantar fasciitis and are trying to lose weight, it is important to consult a podiatrist to get into the appropriate shoe gear for your exercise regimen.  Swimming or other non-weight-bearing activities will also put less stress on the feet and can decrease symptoms.

Arthritis. Excess body weight puts a greater load on the body, which means that joints of the lower extremity have to work harder.  This can cause osteoarthritis to develop in joints such as the knee and ankle.  Losing weight will help decrease the stress on these joints, as well as the resulting pain.  In addition, mild exercise keeps joints moving and may help with pain management in those who already have arthritis.

One of the best ways to endure the long winter is to get out and enjoy it. However,  do so by protecting yourself from frostbite:

• Always dress in layers. Avoid cotton clothing in the winter months. Wear two layers of socks, and insulated boots. As an added protection, wear a pair of Neoprene Toe Covers (such as ‘Toe Gators’) under your socks.

• If you get wet, get indoors immediately and get into dry clothes and foot gear.

• If you notice numbness in your feet, hands, ears or any other part of your body, take shelter indoors to warm up completely before returning outdoors.

                   The Podiatrist’s Role in Healthcare

Looking into healthcare options can be overwhelming.  However, understanding how the variety of healthcare professionals can help you is an important key to maintaining a healthy lifestyle.  Like many other medical specialists, podiatrists play an important role in the overall health and wellbeing of patients.

Podiatrists receive extensive training in foot and ankle care.  After four years of undergraduate education, students attend one of the nine podiatric medical colleges around the country and then complete a three-year residency program.  While podiatrists receive specialized training in their scope of practice, they also obtain a thorough overall medical education.  This well-rounded educational experience means that podiatrists are qualified physicians who specialize in the lower extremity.  All podiatrists are trained in surgery and clinical care, and many also choose to further specialize in areas such as sports medicine, orthopedics, pediatrics, or wound care.

This unique training and experience allows podiatrists to provide a complete and targeted approach to caring for the foot and ankle.  There are many reasons to visit a podiatrist, ranging from regular checkups to surgical care.  Those with diabetes should visit podiatrists regularly for routine foot care, in order to prevent disease complications such as ulcers and amputations.  Others visit podiatrists regularly for the treatment of arthritis and sports injuries, as well as nail care.  Podiatrists are also trained in surgery and trauma, so they perform Achilles tendon reconstructions and ankle arthroscopy, as well as elective surgeries to fix bunions and hammertoes.

Podiatric physicians have the unique knowledge and expertise to make them a valuable part of the healthcare team.  You can learn more about the field of podiatry and how it can meet your needs by visiting http://www.apma.org, or by scheduling an appointment at Adirondack Tri-State Podiatry.

We look forward to helping you achieve good foot health, which is so important to your overall health and well being.

Although foot care is our specialty and focus, we at Tri-State Podiatry truly care about the person attached to those feet. 

One of the things we enjoy about coming to work each day is not only helping people become more active by relieving foot pain, but also learning about our patients’ daily lives and experiences. 

Recently, Dr. Donela was treating a patient in our Massachusetts office. She lives in the Berkshires, and is a Biology teacher at the local high school. 

In the course of conversation, it was discovered that Dr. Donela and Jackie were fellow alumni from Walt Whitman High School in Huntington Station, New York (Long Island). 

On a subsequent visit, they both shared their yearbooks with each other and realized that, in spite of the nearly 20 year spread in graduation years, they both had the same teacher. Interestingly, he was their Biology teacher. 

This is a picture of Dr. Donela and Jackie with their yearbooks. The staff enjoyed listening to all the reminiscing.

Connecting with people is what is so rewarding about what we do.

The falling leaves, cool air, and Halloween decorations sprouting up around the neighborhood can only mean one thing: winter is on the way. Sandal weather is officially over and it’s time to trade in the flip flops for something a little bit warmer.

In the world of feet, the switch to enclosed shoes is more than a matter of fashion. Several nail and skin disorders tend to thrive in the winter months when feet are snuggled up in warm socks and shoes. Xerosis, or “winter itch,” is rough, dry skin that gets worse with cold weather and other irritants. Dry skin may lead to heel fissures, or cracks in the skin that may be very deep and painful.  Keeping skin moisturized can help prevent these fissures from forming.

Hyperhidrosis, or excessive sweating, also becomes more evident in the winter months, when enclosed shoes are the norm. Excessive sweating causes slipping in shoes, foot odor, and an increased potential for developing other conditions, such as fungal infections of the foot. Tinea pedis, commonly known as Athlete’s Foot, is a condition that appears to cause dry, scaly skin on the feet. However, creams and lotions will not cure the problem since tinea is caused by a fungal infection. Instead, applying a topical anti-­fungal medication will take care of the symptoms. Keeping feet dry and wearing clean, cotton socks can help prevent the infection from recurring.

Fungal infections are not limited to the skin. Onychomycosis is a fungal nail infection that causes thickened, discolored toenails. It often occurs secondary to another condition, such as a weakened immune system. It may occur after injury to the nail, which gives fungi an opportunity to grow in an area that has less protection. Onychomycosis can be treated by topical or oral anti-­‐fungal medications. With an overwhelming supply of over-the-­counter medications offered for these common conditions, many people try to treat the problem themselves. But self treatment can take a long time and may even become expensive.

Visiting a podiatrist is very important for proper diagnosis of skin and nail conditions.
A podiatrist can take a sample to determine the cause of the condition, rather than relying only on appearances for diagnosis. Xerosis and tinea pedis may look similar, but they stem from two very different causes and are not treated the same way. To get the patient on the  road to recovery more quickly, it is important to treat the condition with the proper  medication from the start.

Podiatrists also have many products and treatments that are  more effective and targeted than their drugstore counterparts. As winter sets in, don’t  forget to show your feet the proper care they deserve by keeping them warm and healthy.

Doctors of Podiatric Medicine (podiatrists) are the leading experts in treating the causes of foot and ankle pain. As a patient, understanding the causes and processes of pain can help you understand the treatments your podiatrist offers. Lower extremity pain may result from local injury or overuse to an area, as in Achilles Tendinitis, or from a larger disease process, such as diabetes.
Complications of Diabetes may cause Peripheral Neuropathy, which is a loss of feeling in the hands and feet, accompanied by burning pain, numbness and tingling. Through a simple in-office procedure, podiatrists can utilize a new therapeutic approach to the evaluation and treatment of Peripheral Neuropathy.  Podiatrists provide the much-needed preventative foot care for those suffering from Diabetes or other diseases.

There may be several different causes for a painful foot or ankle condition. For example, heel pain may be caused by a bruise on the heel bone, the tightening of a band of tissue called the plantar fascia (Plantar Fasciitis), or entrapment of a nerve. Since there are numerous causes of pain, there are also countless different treatments to relieve it. Podiatrists offer many non-invasive treatments that can ease pain and lead to recovery.
Extracorporeal (meaning ‘outside the body’) radial wave therapy is an innovative treatment that uses shock waves to treat conditions such as Plantar Fasciitis and Tendinitis. Other more traditional therapies, such as prescription orthotics, shoe modification, and bracing have stood the test of time in helping to reduce pain and prevent further injury.

Podiatrists are highly trained to diagnose and treat foot pain. They understand better than anyone that foot pain is not normal, which is why they can help you
live with healthier, pain-free feet  ~  the real normal.