Athlete's foot

Athlete's foot is an infection of the feet caused by fungus. The medical term is tinea pedis. It may last for a short or long time and may come back after treatment.

The most common symptom is cracked, flaking, peeling skin between the toes. The affected area is usually red and itchy. You may feel burning or stinging, and there may be blisters, oozing, or crusting. In addition to the toes, the symptoms can also occur on

the heels.

What you need to do is keep your feet clean and dry, especially between the toes.

Wash your feet thoroughly with soap and water and dry the area very carefully and completely. We highly recommend "Fungasoap" available at our clinic and on our website.

Wear clean, socks and change your socks and shoes as often as necessary to keep your feet dry. At Advanced Foot Care Clinic we offer our patients with athlete's feet bamboo fiber socks that help wick away moisture from your feet. This will help to keep sweaty feet dry.

Athlete's foot almost always responds well to self-care,

although it may come back. Then it is necessary to see a podiatrist and he can prescribe antifungal medications.

The body normally hosts a variety of microorganisms, including bacteria and fungi. Some of these are useful to the body and others may, under certain conditions, multiply rapidly and cause infections.

Athlete's foot is contagious and can be passed through direct contact, or contact with items such as shoes, stockings, and shower or pool surfaces.

The diagnosis is based primarily on the appearance of your skin. If tests are performed, they may include: skin lesion KOH exam: which means skin scrapings in KOH show fungus under the microscope.

To prevent athlete's foot, follow these measures: Dry your feet thoroughly after bathin

g or swimming. Wear sandals or water shoes at a public shower or pool. Change your socks often to keep your feet dry. Use antifungal or drying powders to prevent athlete's foot. We recommend Zeasorb AF powder, available at our clinic. Wear shoes that are well ventilated and, preferably, made of natural material such as leather. It may help to alternate shoes each day, so they can dry completely between wearings. Avoid plastic-lined shoes.

Our website is www.vailfoot.com To make an appointment at Dr. T. F. Vail, DPM 419-423-1888

Fungasoap contains tea tree oil which is an antifungal itself. Just apply some of this soap to washcloth when showering and to your feet and rinse well. This helps to wash away bacteria and fungus from your skin. Be sure to apply to between the toes and dry thoroughly

foot drop

Foot drop or drop foot is a general term for difficulty lifting the front part of the foot. If you have foot drop you may drag the front of your foot on the ground when you walk. It isn't a disease but a sign of an underlying neurological, muscular or anatomical problem.

SYMPTOMS: Difficulty lifting the front part of your foot which is sometimes the only sign of foot drop. (2) dragging your foot on the floor as you walk. (3) slapping your foot down onto the floor with each step you take. (4) raising your thigh when you walk, as if you were climbing stairs.

Foot drop typically affects only one foot. Depending on the underlying cause, however, it is possible for both feet to be affected.

CAUSES: Fo

ot drop is caused by weakness or paralysis of the muscles below the knee involved in lifting the front part of the foot. The underlying causes of foot drop are varied. Often, neurological, muscular and anatomical problems overlap. There could be an injury to the muscles that control the ankle and toes . Sometimes nerve damage from an injury to the nerves in the lower spine or leg to the long-term nerve damage of diabetes can cause foot drop.

Various forms of muscular dystrophy, an inherited disease that causes progressive muscle weakness may contribute to foot drop.

TREATMENTS: Braces or splints on you ankle and foot that fits into your shoe can help hold your foot in a normal position. PHYSICAL THERAPY using exercises that strengthen your leg muscles and help you maintain the range of motion in your knee and ankle may improve gait problems associated with drop foot. NERVE STIMULATION sometimes stimulating the nerve that lifts the foot when you step improves foot drop. SURGERY in some cases where foot drop is permanent. Surgery that fuses ankle or foot bones or that transfers tendons to stronger leg muscles may be helpful to improve walking difficulties.

If you are experiencing some of these symptoms give Dr. T. F. Vail's office a call at 419-423-1888 to have your foot checked.

You could visit our online store at www.vailfoot.com and there are AFO braces that you may want to try. But it is best to get a podiatrist's opinion first before you try any bracing or splints.

Bunions

The medical term for bunions is Hallux Valgus and it is one of the most common problems seen in a podiatric office. A bunion is a prominent bump on the inside of the foot around the big toe joint. This is a bone protruding towards the inside of the foot. With continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe.

Another type of bunion wh

ich some people can experience is called a Tailor's bunion or a bunionette. This is on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.

This condition is experienced mostly by women because it can be caused by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion. Women have a tendency to wear dress shoes that are too small for their feet. Their toes are squeezed together in their shoes causing the first metatarsal bone to protrude on the side of the foot.

It is important for men

and women to realize that wearing dress shoes and boots, which are tapered in the toe area, can cause the bunion to worsen to the point where surgery may be necessary.

The best way to alleviate the pain with bunions is to wear properly fitting shoes. Shoes with a high, wide toe box is recommended for people with forefoot pain. Orthotics are also recommended for this condition to provide extra comfort, support and protection.

Other conservative treatments include using forefoot products such as bunion sleeve, or

bunion night splints. These conservative treatments can limit the progression of the bunion formation, and relieve pain.

This is a picture of a bunion sleeve which has a gel that fits over the sore bunion area. It helps to protect the bunion from rubbing in the shoe and provides comfort.

This can be found at our website at www.vailfoot.com. There are many other products for bunions also on this website.

If you experience any of these symptoms just give our office a call at 419-423-1888 to set up an appointment Dr. T. F. Vail, DPM

Sesamoid injuries in the foot

A sesamoid is a bone embedded in a tendon. They are found in several joints in the body. In the foot the sesamoids are two pea-shaped bones located in the ball of the foot beneath the big toe joint.

Acting as a pulley for tendons, the sesamoids help the big toe move normally and provide leverage when the big toe "pushes off" during walking and running. They also serve as a weight-bearing surface of the first metatarsal bone , which is the long bone connected to the

big toe and absorbs the weight placed on the ball of the foot when walking or running.

Sesamoid injuries can involve the bones, tendons, and surrounding tissue in the joint. They are often associated with activities requiring increased pressure on the ball of the foot like running, basketball, football, golf, tennis and ballet. Also people with high arches are at risk for developing sesamoid problems.

There are three types of sesamoid injuries:

Turf toe is an injury of the soft tissue surrounding the big toe joint. It usually occurs when the big toe joint is extended beyond its normal range. There is immediate, sharp pain and swe

lling. It may affect the entire big toe joint and limits the motion of the toe. Sometimes a pop is felt at the moment of injury.

Fracture: A break in a sesamoid bone can be either acute or chronic. An acute fracture is caused by trauma, a direct blow or impact to the bone. Produces immediate pain and swelling at the site of the break but usually does not affect the entire big toe joint. A chronic fracture is a stress fracture which is a hairline break usually caused by repetitive stress or overuse. A stress fracture produces longstanding pain in the ball of the foot beneath the big toe joint. It is aggravated with activity and relieved with rest.

Sesmoiditis is an overuse injury involving chronic inflammation of the sesamoid bones and the tendons involved with those bones. It is caused by increased pressure to the sesamoids. It is a dull, longstanding pain beneath the big toe joint.

The podiatrist may try padding in the shoe to cushion the inflamed area or the toe may be taped or strapped to relieve the area of tension. Or the foot may be placed in a cast. Crutc

hes may be used to prevent placing weight on the foot. Oral medications like nonsteroidal anti-inflammatory drugs like ibuprofen are often helpful. There may be physical therapy ordered for strengthening and ultrasound. Steroid injections into the joint to reduce pain and inflammation may be used and custom made orthotics may be prescribed for long-term treatment

check out our online store at www.vailfoot.com for powersteps to help support your foot if you are unable to come into the office for custom made orthotics.

If you live in the area and experiencing pain in the ball of your foot give Dr. T. F. Vail's office a call at 419-423-1888 to set up an appointmnet.

flat feet

Posterior tibial tendon dysfunction is one of several terms to describe a painful, progressive flatfoot deformity in adults.

This is a progressive, symptomatic deformity resulting from gradual stretch of the tibialis posterior tendon as well as the ligaments that support the arch of the foot.

Most flat feet are not painful, particularly those in children. In adults there can be pain because soft tissues have been torn. The deformity progresses or worsens because once the ligaments and tendon are lost, nothing can take their place to hold up the arch of the foot.

A person with flat feet has a greater load placed on the posterior tibial tendon which is the main tendon supporting the arch of the foot. With aging it leads to decreased strength of muscles, tendons and ligaments. The blood supply diminishes to tendons as arteries narrow. Heavier, obese patients have more weight on the arch and have greater narrowing of arteries due to artherosclerosis. In some people the posterior tibial tendon finally gives out or tears.

This is a slow, gradual stretching followed by inflammation and degeneration of the tendon. Once the posterior tibial tendon stretches, the ligaments of the arch stretch and tear. The bones of the arch then move out of position with body weight pressing down from above. The foot rotates inward at the ankle in a movement called pronation. The arch appears collapsed, and the heel bone is tilted to the inside.

The most accurate diagnosis is made by a podiatrist by observing the foot while the patient is walking. The affected foot appears more pronated and deformed compared to the unaffected foot. Muscle testing will show a strength deficit.

An MRI can show tendon injury and inflammation but cannot be relied on with 100% accuracy.

The inflammation and tendon injury will respond to rest, protected ambulation in a cast, as well as anti-inflammatory therapy. Follow-up with custom-molded orthotics are critical to maintain stability of the foot after initial symptoms have been calmed.

Long-term use of a foot brace is required to stop progression of the deformity without surgery.

In cases where orthotics and braces have failed surgery is the next alternative. The goal of surgery is to eliminate pain, stop progression of the deformity and improve mobility of the patient. Procedures commonly used to correct the condition include tendon debridement, tendon transfers and joint fusions.

If you think you may have flat feet, give Dr.T. F. Vail's office a call at 419-423-1888 to set up an appointment to see what can best benefit your feet.