Thursday, July 23, 2009

What's up with the Media's Interest in Cankles???

The term "cankle" is not a medical term, diagnosis or medical condition. It most commonly refers to thick ankles. The width of these ankles make it difficult to distinguish the normal anatomy of the muscles, tendons and bones of the lower leg. People come in all shapes and sizes and thick ankles may be due to obesity, pregnancy, conditions causing chronic ankle swelling or may simply be hereditary. Exercise directed at the muscles of the lower leg may help define the muscles and thereby reducing the nondescript appearance.

It is however, important to differentiate ankles with this persistent thickness in anatomy from those that develop the condition suddenly or even gradually. Many systemic conditions can cause gradual swelling of the ankles (examples include kidney disease, venous disease and heart disease) and certainly trauma can cause acute or sudden swelling. A deep vein thrombosis can also cause a swollen lower leg and ankle.

A podiatric physician, also known as a podiatrist, should examine any new swelling or thickness to rule out injury, trauma or damage to the tendons in the leg and ankle. Two very common tendons that would cause thick ankles are the Achilles tendon and the posterior tibialis tendon that supports the ankle and arch. Ankle sprains, both old and new, cause thickness around the outside of the ankle. Swelling of the ankles and lower leg is treated frequently by podiatrists using a soft cast, known as an unna boot.

It is also common for women beyond their forties to develop fatty ankles due to fat deposits around and below the ankle. Often, these deposits put pressure on the nerves and can be problematic.

Monday, July 20, 2009

Feet: The Good, the Bad and the Ugly

When is Foot Surgery Simply Cosmetic and When is it Medically Necessary

Women – feet – shoes- they are a natural triad, a trinity to some and a piece of modern day life.

Women – feet – shoes- a passion many women have. I hesitate to say most; but certainly many women are fixated on their feet almost as much as their shoes. Most of my female patients evaluate and critique their feet as they would any other body part. Many women feel embarrassed to show their feet and I can’t tell you how many women have told me that they feel as if they are going to the gynecologist when they have to take off their shoes!

Many foot problems are unsightly. Hammertoes produce crooked toes. Bunions and other deformities cause disfigurement. Masses of fat tissue generate bulging of the ankles. Problems with the arch tendon can produce flat feet. Fungus cause thick toe nails.

Many unsightly foot issues become medical problems. Long toes can result in jamming in shoes and eventually produce hammertoes, pain at the ball of the foot and even tearing of ligaments. Deformities such as bunions and hammertoes can cause arthritis. Fat deposits become symptomatic with irritation of the nerves. Flat arches can instill pain, fatigue and tearing of the arch tendon. Thick nails can cause infection.

While most foot problems are hereditary, shoes certainly have a role in the affect they have on our daily lives. This is especially true for women. Women love shoes - although I can’t say that shoes love women! Many shoes inhibit the natural motion of the feet and can contribute to the development of deformities and other foot problems. Nonetheless, women love their shoes and most women will simply not give up the style, look and elegance that their carefully selected shoes provide!

Health feet, desired shoe wear and daily life styles represent a trinity to the sole of many women! Podiatric physicians that are sensitive to these three aspects of life can assist women in making the right choices to satisfy the heart, body and sole!

Treating foot problems is a challenge for many primary doctors, but podiatric physicians are trained in the biomechanics or function of the foot. The weight we bear and steps we take everyday directly influence the conditions, abnormalities and appearance of our feet. And because we walk on our feet, many foot problems are progressive. Usually, conservative treatment is enough to balance these factors and render our steps pain free, but often surgery is needed to correct a problem and/or prevent future problems.

Foot surgery, when performed by a qualified podiatric surgeon, is safe and usually uncomplicated. Foot surgery, of course, carries the same risks that other elective surgeries have, but most surgeries involving the foot get you back on your feet within weeks if not days. Foot surgery is performed for all different problems including those that cause unsightly conditions.

Despite their shoe wear, women are entitled to feet that are healthy, feel good and look great! It is the job of the treating podiatrist to determine which treatments will be most successful. Treatments may involve surgery and it is important to understand the risks. Surgery has a role in the management of foot problems associated with foot structure, shoes and daily life style. Foot health is intimately tied to foot structure and when it comes to the feet, it is often difficult to separate the truly cosmetic procedures from those that are medically necessary.

Cosmetic Foot Surgery

I was recently interviewed by the Chicago Tribune on cosmetic foot surgery. The reporter, Dawn Trice, spent almost an hour interviewing me and she really came to understand the effects of biomechanics, weight and walking on the feet! Many conditions that seem to be "cosmetic" such as long toes, really do have medical consequences.

Check out the article and let me know what you think!

Saturday, July 4, 2009

Ankle Pain - Not What You Think!

Most people associate ankle pain with an ankle sprain - pain at the outside of the ankle. But does anyone ever experience pain along the inside of the ankle?

Gradual or occasional pain behind the ankle bone on the inside of the ankle could be the start of a serious problem with the tendon that supports the arch. Many women, as they enter their 40's, begin to have excessive pressure on the posterior tibialis tendon, the strong tendon that helps hold up the arch.

Extra weight, increased activities, flat feet, and shoes with a lack of arch support all contribute to this problem. If untreated and allowed to progress, the tendon can become inflammed, tear and even rupture. This is one condition that pays to treat it early on!

Treatment differs depending on the stage of progression it is in, but will always include reducing the stress on the tendon. Pain or discomfort may be present but one common sign is that your arch seems to have "fallen."

I should know! Not only do I treat Posterior Tibial Tendon Dysfunction (PTTD), but I have started to show signs of it as well!!