Geriatrics and Podiatry
Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.
Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.
Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.
Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.
Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.
Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.
Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.
Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.
Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.
Managing Sever’s Disease
Sever's disease, also known as calcaneal apophysitis, is a common condition affecting active children and adolescents, particularly those aged eight to 14. It occurs when the growth plate at the back of the heel becomes inflamed, often due to repetitive stress from running or jumping. Symptoms typically include heel pain, tenderness, and discomfort during physical activities, which can sometimes lead to limping. Treatment for Sever's disease focuses on alleviating pain and inflammation. Wearing supportive footwear and using orthotics can help reduce strain on the heel. A podiatrist can diagnose and manage Sever's disease, providing tailored advice on proper footwear, stretching exercises, and activity modifications. If your child is experiencing heel pain, it is important to seek professional help. It is suggested that you schedule an appointment with a podiatrist to ensure effective treatment and support for your child's active lifestyle.
Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Lauryn Smith-Winton, DPM from S.W. Podiatry Group. Our doctor can treat your child’s foot and ankle needs.
Sever’s Disease
Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.
Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.
Symptoms
Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.
Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.
If you have any questions, please feel free to contact our office located in Waldorf, MD . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.
Sever's Disease
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.
Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.
The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.
The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.
Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.
Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.
Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.
Causes of Chronic Ankle Stability
Chronic ankle instability, or CAI, is a condition where the ankle frequently gives way, often following repeated sprains. It affects those who have had previous ankle injuries, particularly athletes or individuals engaging in high-impact activities. Women, people with hypermobile joints, and those with improper rehabilitation after an initial injury are at higher risk. The causes of CAI are complex and difficult to pinpoint, involving a combination of mechanical instability from loosened ligaments and neuromuscular factors, like impaired balance and body awareness. Repeated injuries can lead to muscle weakness and poor joint control, further contributing to instability. While strength training is often recommended, research on its effectiveness in preventing or treating CAI remains inconclusive. If you have chronic ankle instability, it is suggested that you consult a podiatrist for a comprehensive treatment plan.
Ankle pain can be caused by a number of problems and may be potentially serious. If you have ankle pain, consult with Lauryn Smith-Winton, DPM from S.W. Podiatry Group. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
Ankle pain is any condition that causes pain in the ankle. Due to the fact that the ankle consists of tendons, muscles, bones, and ligaments, ankle pain can come from a number of different conditions.
Causes
The most common causes of ankle pain include:
- Types of arthritis (rheumatoid, osteoarthritis, and gout)
- Ankle sprains
- Broken ankles
- Achilles tendonitis
- Achilles tendon rupture
- Stress fractures
- Bursitis
- Tarsal tunnel syndrome
- Plantar fasciitis
Symptoms
Symptoms of ankle injury vary based upon the condition. Pain may include general pain and discomfort, swelling, aching, redness, bruising, burning or stabbing sensations, and/or loss of sensation.
Diagnosis
Due to the wide variety of potential causes of ankle pain, podiatrists will utilize a number of different methods to properly diagnose ankle pain. This can include asking for personal and family medical histories and of any recent injuries. Further diagnosis may include sensation tests, a physical examination, and potentially x-rays or other imaging tests.
Treatment
Just as the range of causes varies widely, so do treatments. Some more common treatments are rest, ice packs, keeping pressure off the foot, orthotics and braces, medication for inflammation and pain, and surgery.
If you have any questions, please feel free to contact our office located in Waldorf, MD . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Ankle Pain
Pain experienced in the ankle can be caused by a multitude of conditions. While the most common cause is an ankle sprain, other possible problems can include arthritis, gout, ankle instability, an ankle fracture, nerve compression, or tendinitis. In more serious cases, ankle pain can be a sign of improper alignment of the foot or an infection.
Ankle pain can often be accompanied by symptoms such as redness, swelling, stiffness, and warmth in the affected area. Pain can be described differently depending on the condition: short, stabbing pain and a dull ache are some examples. If such symptoms are persistent and do not improve after time, be sure to schedule an appointment with your local podiatrist.
Depending on the condition causing your ankle pain, different treatments may be prescribed by your podiatrist. For ankle sprains, the first step in treatment involves rest, ice, elevation, and compression. Be sure to avoid placing pressure on the ankle, use an ice pack several times a day, and use a compression bandage and elevation to reduce swelling. Other, more serious conditions may require the assistance of certain drugs and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or even cortisone injections.
Depending on the severity of your ankle pain and the condition behind it, recovery from ankle pain may take some time.
Consult with your foot and ankle doctor to best determine the cause of your ankle pain and the appropriate treatment.
Foot and Ankle Surgeries and Possible Complications
Common foot and ankle surgeries include bunion removal, or bunionectomy, ankle ligament repair, and Achilles tendon surgery. These procedures are often needed to correct structural deformities, repair torn ligaments, or treat chronic conditions that cause pain and dysfunction. Postoperative findings typically include swelling, bruising, and some discomfort, which are normal as the body heals. Recovery times vary depending on the procedure but often involve limited weight-bearing and targeted exercises to restore mobility and strength. Stitches are usually removed within two weeks, and patients may need to wear a protective boot or cast during the healing process. Possible complications include infection, delayed wound healing, nerve damage, or blood clots. In some cases, stiffness or reduced range of motion can occur. If you have had foot or ankle surgery, it is strongly suggested that you are under the care of a podiatrist who can closely monitor your healing.
Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Lauryn Smith-Winton, DPM of S.W. Podiatry Group. Our doctor will assist you with all of your foot and ankle needs.
When Is Surgery Necessary?
Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:
- Removing foot deformities like bunions and bone spurs
- Severe arthritis that has caused bone issues
- Cosmetic reconstruction
What Types of Surgery Are There?
The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:
- Bunionectomy for painful bunions
- Surgical fusion for realignment of bones
- Neuropathy decompression surgery to treat nerve damage
Benefits of Surgery
Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.
Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.
If you have any questions please feel free to contact our office located in Waldorf, MD . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Foot and Ankle Surgery
When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition. A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case. Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery. Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.
Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome. A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications. Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered. Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.
Care post-surgery will depend on the type of surgical procedure performed. Typically, all postoperative care involves rest, ice, compression, and elevation. To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes. He will also determine if and when you can bear weight. A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.
Hammertoe Deformities
Hammertoe deformities are one of the most common issues affecting the lesser toes, typically causing the joint in the middle of the toe to bend downward, resembling a hammer. This condition often results from an imbalance in the muscles, tendons, or ligaments that normally keep the toes straight. Causes include wearing tight or ill-fitting shoes, injuries, or underlying conditions such as arthritis or high arches. Symptoms include pain, stiffness, and difficulty straightening the affected toe. Over time, the deformity can cause friction against shoes, leading to painful corns, calluses, and inflammation. Pain occurs due to increased pressure on the bent joint and surrounding tissues. To relieve discomfort, one can switch to wider shoes with a soft, roomy toe box and use orthotic inserts. In severe cases, surgery may be needed to realign the joint and restore normal toe function. If you have a painful hammertoe, it is suggested that you visit a podiatrist for an exam and treatment.
Hammertoe
Hammertoes can be a painful condition to live with. For more information, contact Lauryn Smith-Winton, DPM from S.W. Podiatry Group. Our doctor will answer any of your foot- and ankle-related questions.
Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.
Symptoms
- Pain in the affected toes
- Development of corns or calluses due to friction
- Inflammation
- Redness
- Contracture of the toes
Causes
Genetics – People who are genetically predisposed to hammertoe are often more susceptible
Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur
Trauma – Direct trauma to the toes could potentially lead to hammertoe
Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe
Treatment
Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it
Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used
Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option
If you have any questions please contact our office located in Waldorf, MD . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
What Are Hammertoes?
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Ankle Fracture? Don’t Wait for Treatment
If you're suffering from an ankle fracture, professional attention shouldn't wait. Fractures may worsen over time and can make completing everyday activities incredibly difficult. See your specialist for treatment and guidance through the healing process.
