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Dr. Karr is one of the top 2 podiatry surgeons to complete 100 lapiplasty procedures.

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Monday, 22 February 2021 00:00

Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.

The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.

Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.

Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.

It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture.  Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.

The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.

Monday, 15 February 2021 00:00

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Monday, 08 February 2021 00:00

In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.

If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.

Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.

You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.

Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.

Monday, 01 February 2021 00:00

Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.

A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Monday, 25 January 2021 00:00

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Monday, 18 January 2021 00:00

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

Monday, 11 January 2021 00:00

Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.

Monday, 04 January 2021 00:00

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

Monday, 28 December 2020 00:00

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

Monday, 21 December 2020 00:00

Although ankle sprains may not be as serious as a broken ankle, they should be given immediate attention and care. An ankle sprain can lead to a significant amount of pain, as well as limited mobility. They are often characterized by the swelling and discoloration of the skin. This occurs when the ligaments are stretched beyond their limits.

The simple act of walking can sometimes cause a sprain, which makes ankle sprains a very common injury that can happen to anyone. They occur when the ankle twists in an awkward way or rolls over itself, causing a pop or snap in the tendons around the ankle. Some people are more at risk than others. These include athletes who continually push their bodies to the limits and also people who have previously suffered accidents to the feet, ankles, or lower legs.

Most of the time, an ankle sprain is not severe enough for hospital attention. There are many at-home treatment options available, including propping the leg up above your head to reduce blood flow and inflammation, applying ice packs to the affected area as needed, taking over-the-counter pain relievers and anti-inflammatory medication, using an ACE bandage to wrap and support the injured ankle, and most importantly, remaining off your feet until the ankle has fully healed.

Despite this, an ankle sprain can turn into a severe injury that might require hospitalization. If the ankle ligaments or muscles are damaged from a tear or rip, that is one sign that the sprain is severe enough for hospital attention and possibly for surgery. Even after the surgery, the recovery process can be long. You may need to have rehabilitation sessions administered by your podiatrist to get your ankle back to full health.

The severity of your sprain might become apparent if you are unable to stand or walk, consistent pain occurs over a prolonged period of time, swelling is much more severe than initially present, or if you start to experience tingling or numbness. These signs may indicate that your ankle sprain might actually be a broken ankle, an injury that requires immediate medical attention.

Although they are not completely avoidable, ankle sprains can be curbed with some preventative treatment measures. These include wearing appropriate-fitting shoes that not only provide a comfortable fit, but also ankle support. It is also recommended to stretch before doing any kind of physical activity, as this will help lower your body’s chance for an injury.

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