Our Fall Newsletter is now out!  Check out our 2017 Fall informational newsletter, highlighting what you need to know to help take care of your feet and ankles.

In This Issue:

  • My Toes Are Bending!
  • Achilles Tendon Pain
  • Can You Prevent Bunions From GEtting Worse?
  • Ten Weird and Strange Foot Facts
  • Recipe of the Season: Health Chicken Salad

Foot Health Fall Newsletter_2017
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Achilles Tendon Pain

By: Wyatt Wiedenfeld, DPM

Achilles tendon discomfort is a common complaint that brings many patients to our office. While Achilles tendonitis is a familiar term, there are multiple pathologies that can occur in the Achilles tendon region resulting in different diagnoses. This is why a thorough physical and radiographic examination are essential, as the treatments for these can differ.
Depending on the diagnosis, conservative treatment consists of NSAIDs, rest, immobilization in walking boot, decreasing activity, stretching, physical therapy, and heel lifts. Night splints are useful to continuously stretch the tendon while you sleep and encourage healing. Custom orthotics are a valuable therapy to control foot instability and over/under pronation that contributes to increased strain on the Achilles tendon.
One of the most significant factors that influence recovery with conservative treatment is early diagnosis and the duration of your symptoms. Irreversible damage can occur in the tendon, such as thickening and formation of scar tissue, in as little as 8 to 12 weeks. (1, 2) If these changes occur, more aggressive treatments need to be considered.  All the doctors at Foot Healthcare Associates are well rehearsed in regenerative medicine and minimally invasive procedures, and these methods have excellent results in treating pathology of the Achilles tendon when more aggressive therapy is necessary.
Platelet-rich plasma (PRP) injection is a regenerative medicine treatment modality that can be performed in the office. PRP is a concentration of platelets derived from a small amount of your own blood that is withdrawn and centrifuged. These platelets carry high concentrations of growth factors and proteins that will subsequently lead to enhanced healing when injected back into the tissue, directly into the Achilles tendon where it is needed the most. Of additional benefit, the physical action of the injection into the diseased tendon stimulates the tissue and restarts the inflammatory and healing process, which is augmented by the PRP. In medical literature, one study reviewed 83 achilles tendons that had a single injection of PRP with 92% recovery satisfaction rate and would have the procedure again if needed. (3)
While there are multiple treatments available for Achilles tendon discomfort, we work with you to find the best option to heal you as quickly as possible. Surgical options are available as well that all the doctors at Foot healthcare associates excel in with excellent results for our patients, however we understand patients would like to avoid surgery if possible, and early conservative treatment with regenerative medicine is one way to make this possible.
1.Schepsis et al. Surgical management of Achilles tendon overuse injuries. American journal of Sports medicine. 1994.
2.Kvist et al. The operative treatment of chronic calcaneal paratenonitis. JBJS. 1980.
3.Guelfi et al. Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy. Foot Ankle Surgery. 2015.

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My Toes Are Bending!

Hammer Toe
A hammertoe is a painful condition where the joints of the toe bend abnormally into the ground. It is a very common condition that affects the 2nd, 3rd, 4th, and 5th toes.  Hammertoes can be caused by poorly fitting shoes, an unstable foot type, genetics or trauma.
Initially, a hammertoe can be reducible, but as it worsens the toe becomes rigid without movement, leading to further problems. In unsupportive shoes, the toe will rub in the footwear leading to calluses, corns and open sores.  Hammertoes can also have pain, redness, swelling and even a burning sensation.
In order to diagnosis a hammertoe, your foot and ankle specialist will do a physical exam and take x-rays. There are various conservative and surgical treatment options available to correct a hammertoe.
Nonsurgical/Conservative care:

  • Padding, Splinting, Strapping
  • Footwear changes
  • Orthotics
  • Anti-inflammatory injections/oral medication

Surgery is done when all other treatments have failed. There are different types of surgical procedures and one is chosen based on the patient’s level of deformity.
This is a progressive condition and will get worse over time. It is therefore important to get Podiatric care as soon as possible if you suspect you have a hammertoe.
Written by:
Dr. Sophia Barnett, DPM

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Can You Prevent Bunions From Getting

Bunions are very common in the U.S. In fact, 23% of
Americans age 18-65, and 35% of those over age
65, have at least one bunion.
A bunion is an enlarged big toe joint. This painful
deformity can run in families and can also be caused
by wearing shoes that are too narrow or even a foot
injury. Patients with flat feet, inflammatory joint
disease or arthritis are more susceptible to bunions.
With a bunion, the big toe can move out of place and push against the smaller toes. It may
be painful to walk and difficult to find comfortable shoes. Because bunions protrude, the
inside of your shoe will rub against it causing irritation and calluses.
Treating Bunions
If you observe a bunion on your big toe joint or if you have pain in this area, especially when
wearing shoes, please give us a call.
The first step in treating a bunion is to change your footwear so your toes have plenty of
room. Then we will work to reduce your pain and relieve the pressure on your toes with:
• Custom-fitted orthotics to help stabilize and reposition the joint.
• Shoe padding to relieve inflammation and friction.
• A night-time splint that can help realign the joint.
• A cortisone injection to reduce inflammation.
• Special exercises for flexibility and mobility.
If these measures don’t give you enough relief from the pain, we will discuss a
bunionectomy where the bunion is removed and the toe is realigned.
Keep Bunions from Getting Worse with These Tips
• Our feet flatten as we age and you may add a shoe size or two. Always have both feet
professionally measured each time you shop for shoes.
• Choose shoes made of quality materials that fit well.
• Avoid footwear that crowds the toes, putting excess pressure on the joints. Narrow high
heels are particularly problematic in causing and aggravating bunions.
• Select shoes with wide and deep toe boxes and flatter heels.
• Stay away from shoes that make your foot slide forward as these will jam your toes into
the toe of the shoe.
Remember – bunions will not heal by themselves! Without proper treatment, this deformity
will cause more pain and complications like chronic bursitis or arthritis may develop.

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10 Weird and Strange Foot Facts
As Halloween approaches and our thoughts turn to allScary Halloween Feet things scary and bizarre, we thought you would enjoy our
list of 10 weird and strange facts about your feet. Enjoy!

• Your foot and ankle are strong, mechanical structures

with 26 bones as well as 33 joints and more than 100
muscles, tendons, and ligaments.
• Most people have one foot that is larger than the other.
• Every time your heel lifts off the ground when walking,
your toes are forced to carry one-half of your body
• No wonder your feet sweat – there are 250,000 sweat
glands in your feet!
• 75% of Americans will experience foot problems at one
time during their lives.
• Women have 4 times as many foot problems as men –
in part because of wearing high heels.
• The average person takes 8,000 to 10,000 steps every
day. That adds up to about 115,000 miles over a
lifetime – enough to circle the earth 4 times!
• Toenails and fingernails grow faster during hot weather,
the teenage years and pregnancy.
• In an average day of walking, the total forces on your feet can add up to hundreds of
tons – the equivalent of a fully-loaded cement truck!
• The record for the world’s largest feet belongs to Matthew McGrory who wears U.S.
size 28 1/2! The average men’s size is 10 1/2.
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