Tuesday, March 6, 2018

Achilles Tendonitis

One of the most common overuse injuries seen in runners is Achilles tendonitis.  The Achilles tendon runs from the back of the leg to the heel bone.  Prolonged running can lead to the over-development of the Achilles tendon.  This, in turn, causes shortening of the muscles that comprise the Achilles tendon.  Eventually, the Achilles tendon tightens.  When the body glides over the foot, as it does when running, the Achilles tendon is stretched.  It is sometimes stretched to the point of tearing.  The tendon soon becomes inflamed and causes tendonitis.
Proper stretching exercises may be the only treatment needed to clear up this condition.  Heel lifts in the shoes can also help.  Ice, massage, non-steroidal anti-inflammatory drugs and physical therapy can also be beneficial.  Foot orthotics may also be needed to control abnormal motion of the heel when running.
Remember, don't over train.  Stop if you get sore or tired.  Always wear good, supportive, comfortable running shoes.  Have fun and be careful.

Evan Kelner, DPM
Diabetic Shoes

An essential part of any comprehensive plan to prevent diabetic foot ulcers is proper footwear.  If the shoe is worn out or not fitting quite right, rubbing can occur.  This repetitive trauma can cause blisters, corns, callouses, infections and ultimately ulcers.  For diabetics who suffer from neuropathy, the lack of protective sensation is an especially dangerous factor in causing diabetic ulcers.
Fortunately for diabetics with documented risk factors, such as poor circulation or neuropathy, Medicare as well as other insurances allow for dispensing of diabetic shoes and heat molded inserts.  These shoes and inserts must be prescribed and professionally fitted by a qualified foot care specialist.
No longer are diabetic shoes exclusively black, bulky and ugly.  Today's diabetic shoe choices include many attractive styles and colors, indistinguishable from other shoes.
The inserts are heat molded to ensure total contact with the feet.  This prevents the rubbing and friction that causes corns, callouses, and wounds.
If you have diabetes and are concerned that your feet are at risk of complications, contact our office.  We provide a comprehensive foot exam and can determine if you qualify for diabetic shoes.  Wearing proper shoes can ensure that you continue to walk through life with healthy and happy feet.

Evan Kelner, DPM                 (732) 988-0070                   (732) 286-9200

Wednesday, January 31, 2018

Stress Fractures of the Feet

Stress fractures are "hairline" fractures brought on by repetitive stress to an area, often a foot.  The most common area for this injury to occur are the metatarsal bones or "long bones".
As opposed to traumatic fractures, where there is separation of bone at the fracture site or joint, there is no displacement of the fracture.  Often the fracture cannot be seen on an X-ray until about 10 days after the fracture occurs.  The fracture is visualized only when a bony "callous" forms to help secure and heal the fracture.
Stress fractures rarely require surgery.  Off-loading weight to the site will allow the fracture to heal over time.  This can be accomplished with either a surgical shoe or a walking boot.  Sometimes a bone stimulator or physical therapy may be needed.  If left untreated, the fracture site may become a source of chronic pain or arthritis.
After the fracture heals, attention should be directed at preventing recurrence.  An orthotic, placed in the shoe, should alleviate the stress to the affected area, and prevent the fracture from happening again.  This is particularly effective for athletes.  
If your are experiencing prolonged foot pain, do not delay- you may have a stress fracture.

Wednesday, December 27, 2017

Pregnancy and Podiatry

One would not normally associate pregnancy with the practice of podiatry.  On further examination though, pregnancy does greatly affect the legs and feet.
As the body prepares for delivery, hormones facilitate stretching of the ligaments throughout the body, including the feet.  As the ligaments relax, the foot loses structural integrity and allows the foot to flatten out.  This can cause general foot pain, particularly in the arches.  It may also cause back aches, and pain in the knees and thighs, as a result of faulty foot structure.  These stretched ligaments may require several months to return to normal, after delivery.  Fortunately, arch supports or orthotics may support the feet and provide the proper alignment to prevent the excessive strain that causes the pain.
Other common problems associated with pregnancy include varicose veins, phlebitis and calcium deficiency.  Plantar warts may appear during the first trimester, but soon disappear after delivery.
Walking, compression stockings, supportive shoes and orthotics could alleviate or control many of the foot and leg problems that pregnancy can cause.

Evan Kelner DPM

Friday, November 24, 2017

Arthritis of the Feet

Arthritis of the feet is such a common condition, it is often overlooked or just ignored.  About 80% of people over 40 years of age have arthritic changes in the feet.  For serious inflammatory arthritic conditions of the feet, such as Rheumatoid Arthritis, medications are needed to keep the disease under control.
The vast majority suffer from degenerative or osteoarthritis.  This condition can range from non-symptomatic to disabling.  Most problems due to osteoarthritis involve stiffness or soreness of the joints, lack of motion, formation of bone spurs, hammertoes and bunions.
For most, wearing well cushioned, lace-up supportive footwear can be enough to keep the feet comfortable.  If that is not adequate, stretching exercises, non-steroidal anti-inflammatory drugs, steroid injections, physical therapy, and topical analgesic creams can all help.  For severe instances of osteoarthritis, such as rigid joints, painful bunions and hammertoes, surgical correction may be indicated.
Many of my patients who suffer from painful foot arthritis benefit from arch supports or orthotics.  These devices relieve the pain by supporting the feet in their proper position and alleviating stress and strain to the joints.  Orthotics may provide long term relief for this chronic problem.
f you suffer from foot pain, call us today.  Relief may be closer than you think.

Evan Kelner DPM, with offices in Ocean Township and Toms River.  We can be reached at (732) 988-0070 or (732) 286-9200

Leg Cramps at Night                                        

(referenced from Yale's Podiatric Medicine)

During an office visit, it's not unusual for a patient to casually ask me if there is anything they can do about legs cramps when they are in bed at night.
Cramps in the legs usually occur as a result of abnormal muscle positions and impaired circulation.  It manifests as involuntary muscular contractions with pain and partial, or complete, loss of function.  Circulation is usually disrupted.  Other causes of night cramps include deformities of the feet, nutritional deficiency-especially vitamin B deficiency and potassium imbalance.  Night cramps are common in pregnancy, calcium-phosphorus imbalance and fatty metabolism.  Excessive urination is also a common cause.
Unnatural anatomical positions, in certain occupations, result in cramps, aching pains, moderate shortening of the calf muscles or hamstrings.
Treatments naturally depend upon the cause.  Often the control of foot strain and pull on the calfs can be relieved with orthotics, proper foot wear and stretching.  Vitamins and minerals may be helpful.  Quinine capsules, muscle relaxants, and tranquilizers may be helpful, as well as antihistamines such as Benadryl.  Large doses of aspirin also appear to help the condition.  For smokers, cessation of tobacco use may also help.  If symptoms persist, blood chemistry studies may be in order.
If you or a family member is suffering from foot or leg pain, relief may be only a call away.

Evan Kelner DPM
(732) 988-0070 or (732) 286-9200

Thursday, October 19, 2017

Visiting The Bata Shoe Museum

This past week while on vacation, my wife and I visited the Bata Shoe Museum in Toronto, Canada.  As a podiatrist, I am acutely aware of the shoes my patients wear, so naturally, I thought a trip to the shoe museum would be an interesting diversion.
We were not disappointed.  The museum provided a rich account of, not only the various types of shoes worn around the world and through the ages, but also how footwear was influenced by culture, tradition, art, history, religion, the elements, and yes, style.  From practical to the improbable, the shoes from various regions and time periods provided great insight into their respective cultures.  Examples of displays ranged from primitive grass lined shoes, women's shoes of ancient China, waterproof seal intestine boots of Inuits, boots worn on the moon and platform shoes of rock stars from the 70's.
Although an interesting experience, my wife and I are both grateful to have been born in the time and place we were!

Evan Kelner DPM