Gregory Loo, DPM Board Certified Podiatrist and Surgeon

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Peripheral Artery Disease

Peripheral artery disease (PAD), or peripheral arterial disease, is a circulatory problem in which there is a reduction of blood flow to the limbs due to narrowed arteries. When peripheral artery disease develops, the extremities do not receive enough blood flow; this may cause symptoms to develop such as claudication, or leg pain when walking. The legs are the most common site of peripheral artery disease.

Claudication, or leg pain when walking, is one of several symptoms that can develop due to peripheral artery disease. Other symptoms caused by the disease include painful cramping in the hips, thighs, or calves after certain activities; leg numbness or weakness; coldness in the lower leg or foot; sores on the lower extremities that do not heal; hair loss on the lower extremities; and a missing or weak pulse in the lower extremities. In more severe cases, pain may even occur when the body is at rest or when lying down.

Peripheral artery disease is typically caused by atherosclerosis, a condition in which fatty deposits build up in the arterial walls and reduce blood flow. Smoking, diabetes, obesity, high blood pressure, and high cholesterol are some of the risk factors for peripheral artery disease.

If you are experiencing pain, numbness, or other symptoms in the lower extremities, see your healthcare professional immediately. Diagnosed peripheral artery disease can be treated with various medications, angioplasty and surgery, exercise programs, or alternative medicine. It is important to consult a healthcare professional to determine the best treatment for you.

Walking Shoes vs. Running Shoes

Although walking shoes and running shoes look similar, they have characteristics that make them different from each other. Runners should avoid running in walking shoes and vice versa. It is very important that you wear the proper footwear for the activity you are going to partake in, for you to avoid injury.

If you are looking to buy a new pair of running shoes, there are certain things you should look out for. One of the main components that makes up a good running shoe is flexibility. You should be able to bend and flex the forefoot of the shoe that you are purchasing. If you can bend the entire shoe in half with ease, this is a sign that the shoe does not have enough structure for your feet. Another feature you should look for is a low heel. Certain running shoes have a low heel to support runners who land on the ball of their feet. Lastly, you should look for the fit of the running shoe. You should visit the best running shoe store in your area to have your feet properly sized for the shoes in the store. Usually, the staff will be able to help recommend the best type of running shoe for your needs.

When you are walking, the body’s weight is evenly distributed on the foot. This influences the design of shoes made for walking. If you are looking to buy a pair of walking shoes, there are different features you should look for to determine which pair of shoes is best for you. Walking shoes should be flexible through the ball of the foot to allow for a greater range of motion through the roll of the forefoot. These shoes also should have greater arch support for the foot. If you plan on walking long distances or on hard surfaces, it is best that you wear shoes that have cushioning.

When trying on a new pair of shoes, the heel should fit snugly without slip. You should shop for shoes after a long walk, since your feet tend to swell throughout the day. Many people have one foot that is a different size than the other, so it is best that you have both feet measured when looking for your true size. You should also beware that sizes vary depending on the shoe brand. A certain size in one brand may be a different size in a different brand. Lastly, you should always walk around in shoes that you plan on buying. This will help you determine whether the shoes are comfortable and if they fit well on your feet.

Always look for good shoe construction when shopping for new sneakers. The upper part of the shoe should allow for adjustment through laces or straps. If you need help with shoe sizing or if you need custom orthotics for your feet, you should make an appointment with your podiatrist for assistance. He or she will be more than happy to help you with your shoe sizing needs.  

Blisters

Blisters are small pockets of fluid that occur on the top layers of the skin for several reasons. Friction, burns, and diseases are all known causes of blisters.  Smaller blisters are known as vesicles, while larger blisters are referred to as bulla. The fluid inside the bubble can be blood, pus, or serum; which is a clear liquid that protects the skin. In most cases, blisters are not a major health issue, but they can be an indicator of a more serious condition.  

Causes of blisters vary. Blisters are commonly caused by wearing poorly fitted shoes that rub against the foot. However, there are many other causes besides from friction; including burns, sunburn, insect bites, frostbite, poison ivy/oak, chemical exposure, impetigo, eczema, viral infections, and more.

Most blisters heal by themselves and do not require immediate medical care. If you have a blister, do not pop it since this may cause infection; it is advised to put a bandage over the blister to protect it. If the blister is large, causes pain, or if you have a fever, it is recommended that you see a doctor who can provide proper care. Blisters are easy to diagnose, and if considered prudent by the doctor, can easily be drained of fluid with a sterile needle as well.

To prevent blisters on the feet, wear shoes that fit properly and don’t cause rubbing. Socks can help prevent friction and it is recommended that you wear them if you are wearing shoes. Hand blisters can be avoided by wearing gloves during activities that cause friction against the hand. If you have a blister that pops, do not remove the dead skin, wash the area, apply antibiotic ointment, and cover with a bandage. It is okay in most cases to not seek immediate medical care for a blister if it was just caused by friction. However, if the blister causes pain or does not go away, it is suggested that you see a doctor for a diagnosis.

How to Handle a Long Work Day on Your Feet

In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.

If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.

Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.

You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.

Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.

Broken Ankle Causes, Differences, Symptoms and Treatments

The ankle is a hinged synovial joint made up of three bones: the tibia (shin bone), the fibula (outer ankle bone), and the talus (between the heel and leg). These three bones are bound, supported, and stabilized by strong, fibrous bands of tissue called ligaments.

A break in an ankle bone can be either traumatic or stress related. This injury may be referred to as a break or fracture. A traumatic fracture can result from tripping, twisting or rolling the ankle, falling, or by blunt impact to the ankle. These traumatic ankle breaks usually occur during sporting activities or accidents. Stress fractures, however, occur over time and are the result of repetitive stress to the ankle. These fractures sometimes occur when a new activity that engages the ankle is introduced, or when the level of activity is abruptly increased or intensified. 

There are various symptoms that accompany an ankle break. The most significant symptoms are pain and swelling that occurs in the ankle and sometimes spreads up from the foot to below the knee. Bruising or discoloration may develop eventually. It will be difficult or even impossible to put weight on the affected foot, and in severe cases there may be a visible deformity or even exposed bone.

It is very important to seek immediate treatment when an ankle break occurs or is suspected to have occurred, in order to allow the bone to properly heal and to avoid future complications such as stiff joints, limited range of motion, and osteoarthritis.

To diagnose a broken ankle, your podiatrist will first ask you to explain how the injury occurred and what your symptoms are. They will perform a thorough examination, checking for damage to nerves, blood vessels, and other structures around the injury site. They will also test your range of motion. An X-ray will need to be reviewed and, in some cases, an MRI or CT scan may be necessary.

Proper treatment of a broken ankle will depend on where and how severe the break is, how stable the ankle is, and whether the bone is displaced (misaligned or separated) or non-displaced (broken yet still aligned properly). 

Mild fractures (where the bone is non-displaced) may be treated by resting, icing, and elevating the ankle at first, followed by immobilization with a cast or walking boot. Pain and inflammation may be treated with acetaminophen. More severe or complicated fractures where bones or joints are displaced may require surgery. 

Recovery time will also vary, and it may take 4-6 weeks or longer for a broken ankle to heal. Your podiatrist will most likely order progressive X-rays or stress tests to be taken in order to monitor the healing process.

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