Celebrities like Kim Kardashian and Snooki have been chastised for wearing heels during pregnancy, and rightfully so. Both wearing heels and pregnancy shift a woman’s center of gravity; the resulting combination means that pregnant women are more likely to fall while wearing heels (which is exactly what happened to Snooki last year). In addition, wearing constrictive heels also worsens another problem that women suffer during pregnancy: swelling. With this in mind, I thought I’d share why this occurs and what pregnant women can do to reduce this common pregnancy problem.

Swelling in the legs and feet, (sometimes referred to as “cankles” – a combination of
“calf” and “ankles”) is a common problem during pregnancy. As women’s bodies change during pregnancy, they retain fluids. These fluids pool at the lowest point of gravity, causing the legs and feet to swell. This swelling increases as the day progresses, so pregnant women wishing to avoid swollen feet should take frequent breaks from long periods of standing. Sitting down and putting your feet up lessens the effect of gravity, and promotes the fluids to return to your body. Pregnant women (or their loved ones) can also try to massage the area, starting at the toes and moving towards the knee, to reduce swelling.

Shoe choice can also have a major effect on the amount of swelling. Pregnant women should wear comfortable, supportive shoes whenever possible. Heels are not only dangerous for pregnant women as explained above, but also can increase swelling because they can be constrictive and not allow fluids to go back to the rest of the body. Tight socks should be avoided for similar reasons; instead, compression stockings or support hose that are specially designed to return fluids to the body are available over the counter and from your doctor.

While some amount of swelling is normal during pregnancy, excessive swelling can be a sign of bigger problems. If you or a pregnant loved one is concerned about feet swelling or other foot issues during pregnancy, make an appointment with any of our doctors for an examination.

Eric Polansky, DPM

    When a patient with a bunion comes to my office I often hear the same sad tale.  “My mother always made me wear shoes that were too small for me when I was a child.”  This rubs me the wrong way, because I know better.  First of all, I was raised in the South, and I know better than to blame mama.  Secondly, I know that the real cause of a bunion is usually not tight fitting shoes.  The most common cause of a bunion is genetics, and it pains me to say it, but you just might be able to blame Mama for that.

    A bunion is a foot deformity on the outside of your big toe joint.  Bunions develop over time due to improper foot motion and abnormal joint stress.  After awhile this motion and stress forces the bone and soft tissue at the base of the big toe into an abnormal position, creating a bony prominence (a bump, if you will) and instability. 

    Most bunions occur in woman (actually 9 times more than occur in men).  Since women generally wear tighter, higher-heeled shoes than men, it’s no surprise that many women blame their bunions on tight shoes.  The fact is that their XX chromosomes and family are mostly to blame.  Tight, high-heeled shoes may contribute to development of the deformity, can cause bunions to progress quicker, and they certainly make bunions more symptomatic.   Most women with a bunion can attest to the fact that daily wearing of peep toe, pointy toe, or very high-heeled shoes make a bunion very painful.  For those with flat feet ballet flats will usually feel more comfortable, but their lack of support can be a developing bunion’s best friend. 

    When choosing shoes, be reasonable.  I tell my patient’s that there’s nothing wrong with wearing those sexy Christian Louboutin heels to dinner or a nice event.  They just shouldn’t be your everyday shoes.  The APMA has given its Seal of Acceptance to shoes that have room for your piggies (and your bunion), a reasonable heel height, and a supportive arch.  To see the shoes with the Seal visit APMA.org/Seal. 

    So, the question remains, what can be done after you have a bunion?  There are several conservative options that patients can try as well as surgical correction.   I have already touched on better shoe choices, so I won’t belabor the point.  Get shoes that fit your feet- period.  You may also find padding and strapping devices helpful at relieving the pressure on an inflamed bunion.  At Advanced Food and Ankle Care we have several options in this category, and we can help in choosing the one that is right for you.  Often over the counter anti-inflammatories such as Ibuprofen provide pain relief from a bunion.  I often prescribe oral or topical anti-inflammatories for my patients, and I find that these offer satisfactory relief.  Custom orthotics are a great option, especially for an early or developing bunion.  These help correct mal-alignment problems and can keep a bunion from developing further.  They can also relieve some of the pressure on the great toe joint.  Cortisone injections can be very effective at relieving the painful joint inflammation a bunion can cause.  Some patients even find relief from physical therapy and yoga.  All of these conservative treatments can help relieve the pain caused by they bunion, but they will not get rid of the bump that is already there. 

    Surgery is warranted if your bunion is painful and interferes with your quality of life.  Your particular surgical procedure depends on where in your foot the deformity is originating from and how severe your bunion is.  The doctors at Advanced Foot and Ankle Care perform well over 100 bunion surgeries every year, and we would be happy to evaluate your bunion and decide which treatment would be best tailored to you. 

    In April 2013 the American Podiatric Medical Association (APMA) launched its spring campaign, “Beat Bunion Blues” with informative posters, a video, and even a Beat Bunion Blues Pinterest pinboard.  I will leave you with these 5 bunion facts, provided by the APMA:

#1. Bunions are two to nine times more common in women than in men.

#2. 55% of American women have bunions.

#3. Wearing high heels may increase your risk of developing bunions.  The narrow toe box and increased pressure on the front of the foot can put the toe joints out of alignment.

#4. 72% of Americans say that foot pain affects their daily life, but only 22% of Americans with foot pain have consulted a podiatrist.

#5. Up to 95% of patients who undergo bunion surgery are satisfied with the results.

If you would like to find out more about the APMAs “Beat Bunion Blues” campaign go to AMPA.org/Bunion.

Hillarie Amburgey, DPM

Those who watched the Elite Eight game of Louisville against Duke won’t easily forget the injury that guard Kevin Ware suffered during the game. After attempting to guard a shot taken by Duke, Ware landed awkwardly and fractured his tibia (shin bone). Those watching saw the bone protrude through the skin – this type of fracture is known as an “open fracture.” While fractures are a common sports injury, open fractures occur most often in contact sports like football. These fractures can occur in any bone, including the bones of the feet. Recently, UFC fighter Jon Jones suffered an open fracture of his big toe during a match against Tito Ortiz. Unlike Ware’s injury which stopped the game, Jones’ injury was not noticed until after the match was over.

These types of fractures are not only more gruesome than other fractures, but also more difficult to treat for two reasons. First the fact that bone is exposed increases the risk of infection. Before the fracture can be fixed, the bone must be cleaned to reduce the risk of infection. Second, whereas many fractures that don’t break the skin can be treated with a cast, the bone pieces in open fractures are often further apart and need to be held in place with special surgical hardware.

Open fractures can take between 6 months and a year to heal, which is more than the time required for fractures that don’t break the skin. While their injuries may have been gruesome, both Ware and Jones got prompt treatment to fix the fracture and should go on to heal just fine.

While open fractures may be more obvious than other fractures, all injuries with possible fractures need to be examined. Please make an appointment to see one of our four physicians at Advanced Foot and Ankle Care if you injure your lower leg or foot and suspect that one of the bones might be broken. If fractures are not properly identified and treated correctly, the bones may not heal, or they may heal in an inappropriate alignment, which can both be prevented with prompt care.

Dr. Jeffrey Carlson

Mankind has used light to treat diseases and various aliments for thousands of years now, so introducing our new cold laser therapy laser may not be new to some of you. Advanced Foot and Ankle Care has now acquired the Dynatronics cold laser to better our patients’ foot health in treating a variety of aliments including: ulcers (even those caused by diabetes), burns, skin flaps and grafts, broken bones, cartilage, tendon and ligament repair, arthritic pain due to osteoarthritis and rheumatoid arthritis, ankle sprains and plantar fasciitis.

The Dynatronics cold laser uses three types of light therapy: red, blue and infrared.

Red light helps promote the healing of skin wounds at low energy densities. Red light therapy is also one of the oldest forms of treatment ever conceived or used by humans.

Blue light helps kill bacteria and a number of skin infections including: MRSA and staph. Blue light therapy is rapidly gaining popularity because unlike UV, it does not have high propensity to damage normal tissue.

Infrared light is best for deep tissue injuries, pain relief, and resolution of inflammation and reduction of edema. Infrared light therapy is commonly used with red light at the same time.

At this time, cold laser therapy is considered cosmetic, therefore not covered by your insurance company. Advanced Foot and Ankle Care offers cold light therapy for $25 per treatment. Our patients are not required to see the doctor every session, therefore do not have to pay a co-pay at those sessions that they do not see the doctor. Typical treatments require 2-3 session per week until the area is healed.

Call our office and speak to one of our Patient Care Coordinators for more information or to schedule a consultation appointment with one of our four physicians at any one of our four locations: Troy OH, Piqua OH, Sidney OH, Huber Heights OH.

Dr. Eric Polansky, DPM

What do Albert Pujols, Kobe Bryant, and Eli Manning have in common? Besides all being athletes, they have all suffered from plantar fasciitis. Plantar fasciitis is the most common cause of heel pain in adults, and has affected many professional athletes during their career. Unfortunately, this condition also occurs in many adults who are not athletes, so read on to learn more about what plantar fasciitis is and how it is treated.

What is the plantar fascia anyway?

The plantar fascia is a thick band of tissue that runs from your heel bone to your toes. It helps support the arch of your foot. Plantar fasciitis results from stress to the tissue, and can be very painful.

What are the symptoms?

Most patients with plantar fasciitis complain of pain in their heels. Often, the pain is worst when getting out of bed in the morning, but gets better as you walk throughout the day. As the tissue stretches throughout the day, it becomes less painful to walk. Resting allows the tissue to return to its pre-stretched state, which makes the pain come back.

What treatments are available?

There are several treatments for plantar fasciitis. Conservative treatments include icing and stretching the plantar fascia. Orthotics and physical therapy might be needed for some patients. Others still might need a night splint, which is a device that keeps your foot in a fixed position overnight to help stretch the tissue.

Many patients know that corticosteroid shots in the heel can help with the pain of plantar fasciitis. While this is true, repeated shots to the plantar fascia can do more harm than good, so not all patients need cortisone shots.

Finally, it is important to talk to your doctor if you have heel pain, because several conditions can cause pain in the heel. If your heels hurt, make an appointment with any of our doctors for an examination and discussion on the best treatment options for you.

Eric Polansky, DPM