Archive for the ‘Clinical’ Category

Five Tips to Fix Your Aching Feet

thumbnailFive Tips to Fix Your Aching Feet


Patrick A. DeHeer, DPM

Your feet are often the most neglected and ignored part of your body, until they hurt. Then each step or minute of standing reminds you how much you depend on your feet. Foot pain is not normal, and often signifies an underlying problem. You can take some simple steps on your own initially for your pain, but if these fail to help you should seek professional care.

1. Proper Shoe Gear

Shoes are a very important initial treatment if you are experiencing foot pain. Here are some suggestions about shoes for aching feet.

Get your foot measured by a qualified shoe fitter for both length and width, preferably at the end of the day.

Wear the correct type of shoe for the type of activities you are doing. For everyday walking consider a cross trainer or running shoe if possible. If you must wear dress shoes, visit a good shoe store for recommendations and make sure you try on several pairs.

Alternate which shoes you wear daily.

You should replace worn shoes.

2. Arch Support and Shock Absorption

Arch support and shock absorption can go a long way to decrease foot pain. However, this can be a confusing due to the abundance of products available. Here are some tips to consider for an over-the-counter arch support.

A support that is entirely soft acts as a cushion only and does not provide any support to your foot.

Look for something costing in the range of $25 – 75; anything more is not worth the extra money and you would be better off with a custom made device from a professional.

Look for an arch support that is multi-layer with soft shock absorbing materials on the top and bottom with some type of supportive plastic material in the middle.

3. Stretching

Tightness of the Achilles tendon (heel cord) is a common cause or component of several foot conditions. Stretching of the Achilles tendon is very helpful, but must be done correctly.

Start facing a wall with one leg in front of the other and the toes pointing straight ahead.

Lean into the wall with both hands against it.

Bend the front knee and keep the back knee straight.

As you lean forward, you should feel a slight stretch in your calf. Hold this for 10 seconds, and come back out of the stretch. This counts as one stretch.

Perform this 10 times on the back leg.

Switch legs and perform 10 times on the other leg.

4. RICE Therapy

RICE therapy is commonly used for acute conditions and simply stands for Rest, Ice, Compression and Elevation.

Rest: You may need to discontinue any activities that aggravate your foot pain.

Ice: 20 minutes three to four times a day. If you have poor circulation or are diabetic, you should avoid ice.

Compression: Ace wrap or compression type of bandage. Avoid if you have poor circulation or are diabetic.

Elevation: Elevate the affected area when possible to heart level.

5. OTC Anti-inflammatory Medication

Take an over-the-counter anti-inflammatory medication, such as Ibuprofen or Acetaminophen, according to package instructions and precautions if you are able. If there is a question about you being able to take an anti-inflammatory, please consult your physician.

Categories: Articles, Clinical, Tips

New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation


New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation

Research Results Presented at APMA’s 98th Annual Scientific Meeting  

Bethesda, MD – Essential foot care by a podiatrist has now been statistically proven to reduce hospitalization and amputation in adults with diabetes, according to a first of its kind study conducted by Thomson Reuters. The study was presented by Vickie R. Driver, MS, DPM, during the American Podiatric Medical Association’s (APMA) 98th Annual Scientific Meeting in Seattle, July 15-18, 2010. The presentation highlighted the dramatic impact that even a single visit to a podiatrist can have on patients with diabetes.

The study, which was sponsored by APMA, examined records for more than 32,000 patients with diabetes, ages 18-64, and compared health and risk factors for those who had podiatry visits to those who did not. Researchers found that care by a podiatric physician (defined as at least one preventative, pre-ulcer visit) was associated with a nearly 29 percent lower risk of amputation and 24 percent lower risk of hospitalization. Diabetic foot complications are the leading cause of non-traumatic lower limb amputation in the U.S. 

“The results of this study undeniably support visits to a podiatrist being critical to a diabetes patient’s health and well being,” said APMA member Dr. Driver. “No longer can care by a podiatrist be considered optional for those with diabetes, and the earlier a podiatrist is included in the diabetes management team, the better quality of life for the patient and greater health-care cost savings for all involved. This study clearly allows us to understand both the clinical and economic value of a podiatrist, in the team approach to saving diabetic patients’ feet.”

The study was conducted using Thomson Reuters’ MarketScan Research Databases, which house fully integrated, de-identified health-care claims data extensively used by researchers to understand health economics and outcomes. Studies based on MarketScan data have been published in more than 130 peer-reviewed articles in the past five years.

Lead researcher Teresa Gibson, PhD, director of health outcomes research at Thomson Reuters said, “Using the MarketScan Databases, we statistically matched patients with diabetes and foot ulcers who had visited a podiatrist with like patients who had not. The analysis of the data indicates that patients who had seen a podiatrist in the year prior to the onset of a foot ulcer had significantly lower rates of any amputation and hospitalization than those who had not.”
For additional information on the study, visit

New Study Proves Care by Podiatrists Dramatically Decreases Lower Limb Amputation

Categories: Articles, Clinical

Case Study: Healing A Chronic Wound In A Patient With Charcot Foot And PAD | Podiatry Today


Case Study: Healing A Chronic Wound In A Patient With Charcot Foot And PAD


Stephanie C. Wu, DPM, MSc

This author provides an intriguing case study detailing the diagnostic workup and treatment of a chronic wound complicated by Charcot foot and peripheral arterial disease (PAD).

A 60-year-old male presented to the clinic complaining of a recurrent ulcer on the bottom of his foot for the past six months. The patient states his ulcer heals when he does not put weight on his foot but the ulcer opens up again once he starts walking. The patient denies pain to the area and notes that he washes his foot with 1% betadine solution everyday.

   He says he previously received treatment for the ulcer that included the use of VAC therapy (KCI) and a skin graft, which did not incorporate into his skin. The patient also notes a previous bone biopsy that was taken when the wound was deeper and it was negative for osteomyelitis.

Read full article: Case Study: Healing A Chronic Wound In A Patient With Charcot Foot And PAD | Podiatry Today

Categories: Clinical

Ancient body clock discovered that helps to keep all living things on time


Ancient body clock discovered that helps to keep all living things on time

26 January 2011

The mechanism that controls the internal 24-hour clock of all forms of life from human cells to algae has been identified by scientists.

Not only does the research provide important insight into health-related problems linked to individuals with disrupted clocks – such as pilots and shift workers – it also indicates that the 24-hour circadian clock found in human cells is the same as that found in algae and dates back millions of years to early life on Earth.

Two new studies out tomorrow, 27 January, in the journal Nature from the Universities of Cambridge and Edinburgh give insight into the circadian clock which controls patterns of daily and seasonal activity, from sleep cycles to butterfly migrations.

One study, from the Institute of Metabolic Science at the University of Cambridge, has for the first time identified 24-hour rhythms in red blood cells. This is significant because circadian rhythms have always been assumed to be linked to DNA and gene activity, but – unlike most of the other cells in the body – red blood cells do not have DNA.

Read the full Article: Ancient body clock discovered that helps to keep all living things on time

Bionic Legs Help the Paralyzed Walk Again

This is a very touching story, to see a person who was never meant to walk, be able to walk again with the assistant of new technology. Her emotion and happiness shines through. From a wheelchair to independent steps. A marvelous future for many others like her.

New Regenerative medicine as outlined in CNN.

February 25, 2010 1 comment
Categories: Clinical

Understanding Metatarsalgia



“In each foot, five metatarsal bones run from your arch to your toe joints. The first metatarsal is shorter and thicker than the other four bones, which are usually similar in size. During the push-off phase when you walk, jump or run, your body weight is transferred to your toes and metatarsals. The first and second metatarsal bones take the brunt of this force.”   Read more…

Categories: Clinical

ExtraCorporeal Shock Wave Therapy for Plantar Fasciitis


Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of heel pain and is sometimes called a heel spur. Plantar fasciitis is the correct term to use when there is active inflammation.

Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead. Acute plantar fasciitis is defined as inflammation of the origin of the plantar fascia and fascial structures around the area. Plantar fasciitis or fasciosis is usually just on one side. In about 30 per cent of all cases, both feet are affected.

The natural history of this condition is that left alone (untreated), it will eventually go away on its own. Another term for this kind of response is to say that plantar fasciitis is usually self-limiting. That’s why many studies using a placebo (pretend treatment) get good results no matter how it’s treated.

But sometimes, the problem lasts a long time. When it doesn’t go away, doctors say it’s recalcitrant, which means it’s chronic. The painful symptoms limit movement and function, which can reduce quality of life. Finding a way to treat patients with chronic plantar fasciitis is important.

In this study, the use of radial extracorporeal shock wave therapy (rESWT) was compared with a placebo treatment in patients with recalcitrant plantar fasciitis. Shock wave therapy is a newer form of nonsurgical treatment. It uses a machine to generate shock wave pulses to the sore area. Radial shock waves apply the energy at a specific point of tenderness and then the force of the vibration spreads out over a larger area. The pattern of vibrational energy released looks like the shape of a megaphone.

Read Entire Article….

Categories: Clinical

Foot and Ankle Injuries

xrays Myth Busters!

The American Podiatry Medical Association (APMA) has a great article on Foot and Ankle Injuries. They discuss the myths that are often asserted as truth by people, who think treatment is not often necessary. An in-depth look at dismissing these myths, and good tips for treatment of such injuries.

Myth: “If you have a foot or ankle injury, soak it in hot water immediately.” 

Read more….

Categories: Clinical

Understanding Nail Fungus: Interview with Joaquin Diaz,DPM

got-fungus podcast

Bonus Pod-cast: Tina Del Buono interviews Dr. Diaz on Onychomycosis, more commonly known as nail fungus.

Feel free to also visit the link to Wikipedia’s infomation page on nail fungus.

podcast-2 Listen: to podcast

Categories: Clinical, Podcasts