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Posts for: March, 2015

On March 26th, 1934 the United Kingdom instituted the first driving test. Today, there are over 250 millions cars on the road in the United States alone. Many things can affect our ability as drivers, but did you know that your foot health and even the shoes you are wearing could impact your driving performance?

FLIP FLOPS

About one third of all drivers wear flip-flops behind the wheel. Flip-flops are said to be the cause of almost 1.4 million accidents or near misses every year. One in nine motorists admit that their flip-flop got stuck under the pedal causing delayed reactions. There are plenty of statistics to back up the facts, but let’s do some math:

The average reaction time to fully engage the brakes on a car is lengthened by 0.13 seconds when wearing flip-flops. At a speed of 60 miles per hour, this would mean travelling more than an extra ten feet before coming to a stop. Do you leave an extra ten feet between you and the car in front of you every time you wear flip=flops? I’m thinking your answer is no.

Flip-flops provide almost no security for your feet. In fact, they can even fall off while you are driving and get wedged beneath the pedals. You may be thinking that if you just slip them off, that would be better. While driving barefoot is not technically illegal in the United States, it is frowned upon, as your feet can easily slip off the pedal. If you are in an accident and the police determine that your lack of footwear contributed to the situation, you can be cited for reckless driving.

HIGH HEELS

Flip-flops are actually considered more dangerous than high heels behind the wheel, perhaps because both men and women wear them, but that doesn’t mean that high heels are in any way safe. Think about the last pair of stilettos you wore, how easy are they to walk in? For most women, high heals make walking a challenge. Why would we think that driving would be any different?

One of the downfalls to high heels is the lack of stability the actual heel provides. With a small surface area and steep angle, the heel cannot rest on the floor evenly which means the chances of your foot slipping off the pedal are increased. Sadly, the majority of women decide to put fashion before safety.

Experts recommend packing a second pair of shoes to wear in the car and change into your high heels (or flip-flops) when you reach your destination. Remember, there are plenty of pairs of shoes out there, but only one of you. Protect yourself, your loved ones, and every other driver on the road by choosing proper footwear.

 

Statistics provided by:

http://goo.gl/sA3J0F - http://goo.gl/N6F9gS - http://goo.gl/c8i2JM


On March 17th every year, millions of people gather to join in the celebration of Saint Patrick’s Day. St. Patrick is considered the patron saint of Ireland and is credited with bringing Christianity there. March 17th was the day of St. Patrick’s death. For the devoutly religious, church services and a temporary reprieve from Lenten promises is the perfect way to celebrate. For the rest of us, it’s pinching people not wearing green clothing and drinking oddly-colored green beer.  In fact, I only own one green shirt and I keep it solely for the purpose of wearing on St. Patrick’s Day.

Although it is an uncommon condition, one type of green you don’t want to be seen wearing is gangrene. Gangrene arises from restricted blood flow, usually to the lower extremities. The skin and underlying tissue are not receiving adequate amounts of oxygen and they slowly begin to necrotize (die). This is a serious and potentially life threatening ailment. Gangrene is generally not something that will “just spring up”. There are risk factors and warning signs and knowing these will help you avoid complications.

 

WHO IS AT RISK?

Gangrene has two primary causes: lack of blood supply and infection. Lack of blood supply can develop from many pre-existing conditions including: diabetes, atherosclerosis (blood vessel disease), vascular disease, Reynaud’s disease, smoking, obesity, injury, immunosuppression, and certain medications. Gangrene resulting from infection usually occurs after a bad injury that isn’t treated properly or from a wound following a medical procedure or as a complication of another injury such as a burn or frostbite.

 

TYPES OF GANGRENE

There are two major types of gangrene and a couple of more rare ones. The most common type is dry gangrene. This type of gangrene takes days or even months to develop and generally stems from a preexisting vascular condition. Signs of dry gangrene vary with severity and location, but generally start with a cool and numb feeling in the affected area. Skin will change from healthy to brown, blue, or black accompanied by evidence of excessive dryness and shrinkage.  Eventually the body will slough off the affected area (meaning the tissue will fall off completely). While fatalities from dry gangrene are rare, it is still important to get treatment immediately because as tissue death progresses, more extreme measures may have to be taken to correct it. It is also not uncommon for dry gangrene areas to become infected and progress to wet gangrene, which is much worse.

“Wet (also sometimes termed "moist") gangrene is the most dangerous type of gangrene because if it is left untreated, the patient usually develops sepsis and dies within a few hours or days. Wet gangrene results from an untreated (or inadequately treated) infection in the body where the local blood supply has been reduced or stopped by tissue swelling, gas production in tissue, bacterial toxins, or all of these factors in combination.” (http://www.medicinenet.com/gangrene/article.htm) Early symptoms of wet gangrene start with aching pain and swelling. A foul smelling discharge or pus will appear around ulcerations and the dying tissue takes on a moist, black appearance. Infection can also lead to gas buildup inside the body tissues, so you may feel a crackling under the skin where gas is trapped.

 

HOW IS GANGRENE DIAGNOSED?

If you see any discoloration of the skin accompanied by numbness, get yourself to the doctor right away. If dry gangrene is suspected, your doctor will perform an angiography, which will show them how much blood is flowing in the affected tissues. For wet gangrene, blood cultures are used to determine the type of infection and MRIs are used to show the extent of damaged tissue or spread of gas. Removal (debridement or amputation) of the affected area is often necessary along with antibiotic treatment. Wounds can also be treated with hyperbaric oxygen treatment in conjunction to other methods.

HOW DO I AVOID GANGRENE?

Avoiding gangrene is generally easy. For diabetics this means maintaining steady glucose levels and checking your feet regularly. This should be a daily activity for those with vascular conditions affecting the feet. If you have any injury to an extremity (such as your toes), especially if it is a burn or cut, get treatment right away. Preventing infection is an important step to preventing gangrene. In short, as I have said many times before, just pay attention to your feet.

If you suspect that you have signs of gangrene, contact our doctors immediately to make an appointment. Early diagnosis and treatment is important to reduce complications and speed healing time.


Let’s look back to March 31st, 2013. The “Elite Eight” game between the Louisville Cardinals and Duke University had six and a half minutes left in the first half. “It came on such a seemingly innocuous play. Kevin Ware was running toward the perimeter to close out on a 3-point shot from Duke’s Tyler Thornton with 6:33 left in the half. He jumped to challenge the shot, and while in the air, turned back to see the play. He then landed on his right leg, which kept going toward the bench while the rest of his body stopped. The leg snapped.” (http://goo.gl/0cWWvm). 

Ware suffered a compound fracture, a break severe enough to extrude through the skin. The video is gruesome and many players and fans couldn’t handle seeing the stomach wrenching injury. I don’t recommend watching it if you are squeamish, but here is the link: http://goo.gl/k0r9MB  With over two hours of surgery and a rod installed through the right tibia, Ware’s leg was reset. He now faced months of recovery time and physical therapy.

Fast forward to August 1st, 2014. During a U.S. national team scrimmage match, Paul George jumped to block a shot from right under the basket. He came down with his foot against the stanchion and the unthinkable happened; his leg snapped. Again, this video is not the most pleasant and should only be watched with discretion: http://goo.gl/0PnpLc (the slow motion view happens around the 1:00 mark.) George suffered a compound fracture of the tibia and fibula bones. He was rushed to the hospital and into surgery. Like Ware, his leg was reset with a metal rod for support. Also like Ware, George faced months of recovery time and physical therapy.

Compound fractures like these are not common sports injuries, but they certainly are gruesome. In fact, these types of fractures are usually only found in severe car and motorcycle accidents or falls from significant heights. The real question on everyone’s mind was how the heck did this happen? Sure, Ware’s leg might have simply succumbed to the power of torque and perhaps the stanchion and angle of the landing were to blame for George’s fractures. But how common are these injuries and how can athletes protect themselves from the same fate?

One contributing cause could be the presence of a prior stress fracture. With the constant running, jumping, and landing during a basketball game, players’ bones are getting a constant beating. Now multiply that same pressure extended out over a whole season and a stress fracture is not an unlikely injury. Remember, any pain is unnatural. If a player feels throbbing or shooting pain with exercise, they need to be examined for stress fractures, especially if the pain subsides with rest and then reoccurs. Treating these micro fractures can help prevent a more serious injury like the compound fractures of these two players.

The Ohio State basketball team is screened at the beginning of every season for vitamin D, calcium, and other nutrient deficiencies. Vitamin D and calcium may be the single most important factors in bone strength. People who live in sunny climates and spend time outdoors can absorb almost all the vitamin D they need directly from the sun.

However, many athletes can find themselves deficient from the hours upon hours of indoor practicing. Midwestern and Northeastern teams are at particular rick due to the weather patterns that keep us indoors for a good portion of the year. (Hmmm, does it seem like a coincidence that Ware played for Kentucky and George played for Indiana?) Calcium comes from the foods we eat, but if we aren’t eating the right food, we could find ourselves with weakening bones from calcium deficiency. Even if we are getting enough calcium, if we lack vitamin D, then our bodies won’t absorb calcium as efficiently.

It should be clear by now that a healthy diet is as important to injury prevention as proper training and proper medical care are. If you play sports or have a sports player in your home, make sure they are taking in essential nutrients, including supplemental vitamin D and make sure that they aren’t ignoring the warning signs of a minor injury that could lead to something bigger. Should you expect as dramatic an injury as Kevin Ware and Paul George suffered? Well, no, but it wouldn’t hurt to drink a few glasses of milk and go see your podiatrist if you suspect injury. 


While it may not feel like it, summer is just around the corner and that means it’s sandals weather. We want our feet to look their best so we need to make sure they are healthy. One unsightly (and painful) condition we should take care of is our ingrown toenails. An ingrown toenail occurs when the edges of your toenail grow down into your skin rather than straight out. This usually affects the big toe, although it can happen to any toe, and is quite painful.

How do I know if I have an ingrown toenail?

Ingrown toenails are not fun. If you experience pain, redness, swelling, or unusual warmth in your toe, it could be an ingrown toenail. Some people may only experience slight discomfort and tenderness at the edges of the toenails. Even if your condition doesn’t seem that bad, the digging nail can cause ruptures in the skin through which bacteria can enter and lead to infection. Signs of an infection include spreading redness, changes in skin temperature, swelling, and pus around or leaking from the ingrown area. Some ingrown toenails can be treated at home, but it is still important that you see a podiatrist, especially if you see signs of infection or if you have other conditions such as diabetes.

Why did I get an ingrown toenail?

There are many causes of ingrown nails.

  • Improper trimming of the toenails. Nails should be cut straight across using a proper pair of nail clippers. Do not round the edges of the nails or if you do, do so only slightly with a nail file.
  • Wearing tight fitting or pointed toe shoes will press the toes together and put pressure on the nails. This can bend the nails, causing them to grow down into the skin.
  • Acute injuries or repetitive trauma to the toes can cause ingrown toenails. This is common among athletes such as soccer players.
  • Ingrown toenails also run in the family. Some families have more naturally rounded toenails and/or more upturned bones. These characteristics can lead to ingrown toenails.

What are my homecare options?

There are plenty of online tutorials that tell you how to deal with ingrown toenails. The fact is, while some of these remedies may help alleviate symptoms for a time, they will not solve an ingrown toenail and can actually make things worse. Take an over the counter pain reliever if needed to reduce swelling and discomfort. Another easy thing to do is to soak your feet in warm water. This can soften the skin around the nail, making it possible for you to gently massage the edge of the nail away from the skin. Do this several times a day, wrap the toe in fresh gauze, and make sure to wear shoes that give your toes plenty of room.

Do not try to cut your toenail! Repeated cutting of the nail will make things worse. Remember, when you see your podiatrist cutting your ingrown toenail, they are using specialized sterile tools and have years of training and experience. Doing it yourself in your bathroom at home is not the same thing. If you are a diabetic or have a circulatory disorder, do not attempt any home remedy. Make an appointment with your podiatrist right away.

What will my podiatrist do?

First, your podiatrist will evaluate your ingrown toenail and ask about the causes and symptoms. If the ingrown toenail is not infected and not severely ingrown, your doctor may be able to simply cut a small portion of the nail away and prescribe a topical treatment to avoid infection. A process called Partial Nail Plate Avulsion may also be recommended for those with chronic ingrown toenails. During this procedure, the doctor will inject the toe with an anesthetic and fully remove the side of the nail that is ingrown.

I just can’t stress it enough; your feet are a very important part of your overall health. Caring for them properly is essential. This means paying attention to them and treating any conditions that may arise. Even if an ingrown toenail seems like a little matter, it can lead to more serious health problems and put a damper on our summer sandal wearing. If you think you have an ingrown toenail, call to make an appointment today and we can get your feet looking pretty in no time!