Risk Factors for Plantar Fasciitis

Plantar fasciitis remains a mysterious condition. Although the connective tissue at the bottom of each foot is subjected to a lot of daily wear, it is unknown why some people develop inflammation and others don’t. However, there are often specific factors that can be identified as increasing the risk of fascia strains. At Integrity Foot & Ankle Associates in Lorain, our podiatrists are specialists in sports medicine and offer comprehensive treatments for plantar fasciitis and other causes of foot pain, but our patients will need to do what they can to mitigate their risk factors.

Plantar fasciitis is common in distance runners, whose feet are subjected to an especially high amount of stress. It’s also seen in people whose jobs require them to be on their feet for most of the day, such as hairdressers, and in people whose shoes don’t allow them enough arch support. But people who are overweight are also at increased risk, as are people who are new to physical activity or who have recently returned to it. Researchers have noticed that people with plantar fasciitis often have tight calf muscles, suggesting that the plantar fascia is being overstretched to compensate for the heel being pulled upwards.

One bit of good news about plantar fasciitis is that it doesn’t usually appear in people who have heel spurs, so it’s probably possible to stretch the plantar fascia and Achilles tendon enough so that a heel spur won’t wear them down too much. The less good news is that plantar fasciitis is common in people with fallen arches. However, it may be possible to reinforce and arch without restoring to surgery, by making use of customized orthotics and physical therapy to strengthen the foot muscles. Patients should also make sure they are stretching their calf muscles before work-outs and giving them enough time to recover afterward.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Bones of the Foot

We talk a lot about the bones of the foot at Integrity Foot & Ankle Associates in Lorain. As podiatrists, we often perform surgeries and help people to recover from broken bones and other problems in their foot structure. We recognize that patients are more confident making decisions about their care when they feel comfortable with the language used in the office, so we wanted to briefly describe where each bone of the foot is and what they’re called.

The talus is the bone at the top of the ankle that the leg bones, the tibia and fibula, connect to. Below it is the calcaneus, or heel bone. In between the back of the foot and the mid-section are the tarsals, which form the curved ramp that is the foot’s arch. They are the navicular, which is in front of the talus, the cuboid, which is in front of the calcaneus on the outer side of the foot, and the three cuneiforms, which are in front of the navicular and, along with the cuboid, form a crescent-shape when seen from above.

The middle of the foot is made up of the five metatarsal bones. They are long and thin, with one connecting to each cuneiform and leading to the first three toes, and the remaining two connecting with the cuboid and leading to the outer two toes. The toes themselves are made up of bones called phalanges, with the big toe having two and the others each having three. The phalanges furthest back toward the metatarsals are called “proximal,” and the ones at the tips of the toes are called “distal.” The ball of the foot is where the proximal phalanges and metatarsals connect.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Juvenile Arthritis

Could arthritis be the cause of your child’s swollen feet? It’s possible. Recently, we of the Integrity Foot and Ankle Associates in Lorain discussed Sever’s disease, a common cause of foot pain in children. Since then we've felt it would be helpful to discuss another potential cause of ankle swelling in pediatric patients, and describe how it’s recognized and treated.

Juvenile arthritis is poorly understood, but we know it's an autoimmune condition. That means the body’s immune system is attacking healthy tissues, causing swelling, hot spots, and stiffness. Most cases of juvenile arthritis are oligoarticular, meaning that they only directly affect a small number of joints. However, the joint that is affected is often the ankle or knee. It is more common in girls and tends to strike during the first few years of a child’s life.

Oligoarticular arthritis is generally considered to be the most mild form of juvenile arthritis. The diagnostic process includes x-rays and blood tests for antibodies associated with autoimmune disorders. Treatment is conservative, usually consisting of non-steroidal antiinflammatory drugs and physical therapy to strengthen the muscles, allowing them to better support the joints. We especially encourage low-impact exercises that will also stretch the ankle without jostling it.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Hallux Rigidus

Your big toe plays a major role in the balance of your foot, so it’s a serious problem if your toe is becoming less flexible. Hallux Rigidus is a term that describes arthritis in the metatarsophalangeal, or MTP joint, which connects the big toe to the rest of the foot. We at the Integrity Foot & Ankle Associates of Lorain have helped a lot of people to manage this condition, but if it’s not caught early, it can cause permanent damage.

Some people have a genetic susceptibility to cartilage damage in their feet, but loss of cartilage can be exacerbated by overuse. If a person’s ankle rolls inwards, they’ll put a lot of stress on their MTP joint. A person who suffers from gout or has a rheumatoid condition will also have damaged cartilage, and as the bones of their toes rub together, they may grow a spur. This may cause a visible bump in the top of the foot that could be mistaken for a bunion, and a patient will likely feel pain in their big toe when they push off from the ground while walking. Some people also feel more pain in damp weather.

It’s always important to wear shoes with sufficient room in the toe box, but that’s especially true if you’re experiencing MTP stiffness. If your stiffness has already progressed, you might need to wear a shoe with a rocker-shaped bottom to compensate for your big toe’s inability to help you move. We can provide nonsteroidal antiinflammatory drugs to reduce swelling, and can provide corticosteroid injections in more advanced cases. Many people find corrective orthotics helpful. It may also be possible for us to remove a bone spur surgically. However, patients need to see us before too much irreplaceable cartilage is lost or our options will be more limited, and it’s better to see us before spurs develop.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Caring for Toenails

If you’re thinking of wearing open-toed shoes or going barefoot in the summer, you’re probably paying more attention to the shape of your toenails. But if you aren’t caring for them, correctly, you’re increasing your risk of developing a hangnail. At the Integrity Foot & Ankle Associates in Lorain, we can assist people who have conditions such as neuropathy that make it dangerous for them to cut their nails themselves. But for everyone else, we have some tips on good nail care.

Generally, it’s safer to cut your nails when they’re dry. This makes them less likely to bend and tear under the pressure of the clippers. They should be cut frequently enough to not grow beyond the edge of the toes, but they shouldn’t be cut extremely close to the nail plate. This will mean cutting them about every six weeks, for most people. Each nail should be cut straight across. Cutting them in a rounded shape increases the risk they’ll grow into the sides of the toe, especially if a person wears tight shoes or hose. Once the nail has been cut, the jagged edges can be filed down a little.

It’s common to have separate clippers for the fingernails and toenails, since toenails are thicker and keeping clippers separate limits the spread of bacteria. A person who has very thick toenails may need to wet them before cutting, in which case they should be patted dry afterward. The cuticle should not be cut; it may be pushed back, but cutting it could result in an infection.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

Causes of Fallen Arches

If you’ve recently felt pain in the sides of your ankles or a bump developing on the bottom of your foot, you may be in the process of developing a flat foot. While that’s hardly good news, we at the Integrity Foot & Ankle Associates of Lorain are experts at treating this condition. But flat feet can be caused by several things and treatment may vary depending on which of them is responsible, so let’s take a closer look at the causes of ankle degeneration and arch collapse.

Our feet are largely shaped by the posterior tibial tendon, so it’s one of the first things we look at when a person’s foot is getting flatter. The posterior tibial tendon stretches from the thigh to the inside of the foot, and when it frays, the arch of the foot may sag. Fraying is usually due to wear-and-tear, but it could have been the result of an acute injury. It’s also possible that a ligament that is more centrally located or in the back of the foot has frayed. Degeneration is more likely to occur when a person is suffering from diabetes, which damages the nerves and makes it difficult for someone to feel pain from injured tissues. Another potential complicating factor is arthritis, in which the cartilage supporting the ankle joints would be worn away, causing the bones to develop spurs that might also compress nerves.

It might not be possible to determine whether you have a serious structural problem with your foot just by looking at it. Some people have more flexible arches than others. But if you are in pain, or you know diabetes might prevent you from feeling pain and you suspect something is wrong, don’t hesitate to schedule an appointment with us. We can devise a minimally invasive plan to restore your foot’s function, but the earlier you get treatment, the easier it will be.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.

 

National Juvenile Arthritis Month

Could arthritis be the cause of your child’s swollen feet? It’s possible. Last month, we of the Integrity Foot and Ankle Associates in Lorain discussed Sever’s disease, a common cause of foot pain in children. But since July is National Juvenile Arthritis Awareness Month, we felt it would be appropriate to acknowledge another possible cause of ankle swelling in pediatric patients, and describe how it’s recognized and treated.

Juvenile arthritis is poorly understood, but is an autoimmune condition. That means the body’s immune system is attacking healthy tissues, causing swelling, hot spots, and stiffness. Most cases of juvenile arthritis are oligoarticular, meaning that they only directly affect a small number of joints. However, the joint that is affected is often the ankle or knee. It is more common in girls and tends to strike during the first few years of a child’s life.

Oligoarticular arthritis is generally considered to be the mildest form of juvenile arthritis. The diagnostic process includes x-rays and blood tests for antibodies associated with autoimmune disorders. Treatment is conservative, usually consisting of non-steroidal anti-inflammatory drugs and physical therapy to strengthen the muscles, allowing them to better support the joints. We especially encourage low-impact exercises that will also stretch the ankle without jostling it.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.