Gregory Loo, DPM Board Certified Podiatrist and Surgeon
Featured
Featured
Tuesday, 16 April 2024 00:00
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
Monday, 09 December 2019 00:00
Cracked heels may make you want to think twice about showing off your feet in warmer weather. However, cracked heels may be harmful to more than just the appearance of your feet. If deep fissures and cracks develop in your heels, they may make walking and standing painful for you. Additionally, these openings make way for germs to enter through your skin and cause infection.
There are several different causes of cracked heels. One of the most common reasons for this ailment is dry skin. This problem may make your keeps feel rough tight and itchy. Dry skin may be caused by cold air, extremely hot water, harsh soaps, and aging. Skin disorders such as eczema and psoriasis may eventually lead to dry skin. In some cases, complications may arise from cracked heels. Some of these complications are a loss of feeling in the heel, cellulitis, or a diabetic foot ulcer.
There are ways you can try to prevent getting cracked heels. One of the best ways to do so is to avoid wearing flip flops and sandals because these shoes increase your risk of drying out your feet. You should also avoid wearing shoes with a tall skinny heel, because these shoes cause your heel to expand sideways. At night, you should slather on a thick moisturizing cream on your feet and then cover them in socks to keep your feet moisturized overnight. Drinking water to stay hydrated is also a good way to ensure that your skin doesn’t become dry.
If you suffer from a severe case of cracked feet, you should make an appointment with your podiatrist to see what treatment methods are best for you.
Tuesday, 09 April 2024 00:00
Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.
The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.
Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.
Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.
It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture. Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.
The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.
Tuesday, 02 April 2024 00:00
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
Tuesday, 26 March 2024 00:00
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Monday, 15 March 2021 00:00
The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.
Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.
Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.
Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.
If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.
Tuesday, 19 March 2024 00:00
Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking.
Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.
Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.
The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.
Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.
An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.
Tuesday, 12 March 2024 00:00
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
Tuesday, 05 March 2024 00:00
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If the bone is removed, it is then replaced with prostheses, synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
Tuesday, 27 February 2024 00:00
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is the thick band of tissue that connects the heel bone to the toes. When this band of connective tissue becomes inflamed, plantar fasciitis occurs. Fortunately, this condition is treatable.
There are several factors that may put you at a greater risk for developing plantar fasciitis. One of the biggest factors is age; plantar fasciitis is common in those between the ages of 40 to 60. People who have jobs that require them to be on their feet are also likely to develop plantar fasciitis. This includes factory workers, teachers, and others who spend a large portion of their day walking around on hard surfaces. Another risk factor is obesity because excess weight can result in extra stress being placed on the plantar fascia.
People with plantar fasciitis often experience a stabbing pain in the heel area. This pain is usually at its worst in the morning, but can also be triggered by periods of standing or sitting. Plantar fasciitis may make it hard to run and walk. It may also make the foot feel stiff and sensitive, which consequently makes walking barefoot difficult.
Treatment for plantar fasciitis depends on the severity of the specific case of the condition. Ice massage applications may be used to reduce pain and inflammation. Physical therapy is often used to treat plantar fasciitis, and this may include stretching exercises. Another treatment option is anti-inflammatory medication, such as ibuprofen.
If you suspect that you have plantar fasciitis, meet with your podiatrist immediately. If left untreated, symptoms may lead to tearing and overstretching of the plantar fascia. The solution is early detection and treatment. Be sure to speak with your podiatrist if you are experiencing heel pain.
