Fall Prevention for the Elderly

During the past several decades, the elderly population in the United States has been steadily increasing.  This trend is expected to continue.  This continued growth will place burdens on the nations healthcare system.

For older people, falls present a serious risk of injury or even death.  Prevention of falls in older adults is a top health priority in the United States.
                    
A comprehensive fall risk assessment and subsequent intervention to identify risks is an effective strategy to reduce falls in older people.  Traditional prevention programs have targeted muscle weakness of the legs, general balance improvements, medication intervention and environmental modifications.  Foot problems, however have been relatively neglected.  Footwear selection is important for older adults and could impact the risk of falling.  Use of non-slip socks can also be of value.  The use of custom made orthotics or insoles in the proper shoes also can provide significant improvement in regard to the prevention of falls.  Foot and ankle exercises that increase strength, flexibility, balance and functional ability are all valuable in the prevention of falls in older people.

Dr. Evan B. Kelner D.P.M.

OCEAN TOWNSHIP OFFICE

1398 Highway 35

Ocean, NJ 07712

(732) 988-0070

TOMS RIVER OFFICE

191 Highway 37 W

Toms River, NJ 08755

(732) 286-9200

Orthotics

One of the most common questions that I encounter from patients who suffer from heal or arch pain is what is the long term solution to this painful condition.  The answer often surprises them.  For many people suffering from foot pain, orthotics are the solution they are looking for.
                 
Orthotics are devises that fit into shoes or sneakers that correct the positional deficiency of the foot and provide the proper support that footwear itself cannot provide.  All orthotics though are not created equally.  Custom made orthotics are fabricated from an impression of the feet in a very specific position.  For some who's condition is not yet severe, off the shelf orthotics may adequately address the problem.  Beware however of claims of "instant custom made" orthotics such as those seen in some large stores.  These orthotics are generally low quality and very overpriced.
                 
A quality custom made orthotic will change the mechanical function of the foot.  It works dynamically during weight bearing activities like walking, running, and standing.  A good orthotic can prevent pain and deformities such as bunions, plantar fascitiis, and hammertoes.  They may even prevent surgery!
                 
Looking for a long term solution for foot pain?  Look into a great quality custom made orthotic.

Dr. Evan B. Kelner D.P.M.

OCEAN TOWNSHIP OFFICE

1398 Highway 35

Ocean, NJ 07712

(732) 988-0070

TOMS RIVER OFFICE

191 Highway 37 W

Toms River, NJ 08755

(732) 286-9200

                                                       

What is a corn and what can be done about it?

One of the most common complaints seen in my office in 23 years of private practice is the simple corn.  Everyone has heard of corns and many of us have experienced the pain of a corn, but do we really understand what it is?
             
A corn is a thickened, hardened area of skin normally caused by excessive pressure or friction on the skin.  Most often this is due to an enlargement of bone that rubs the skin against the shoe..  With repeated pressure the skin builds thickened layers of hard tissue that causes excessive pressure to the area.  The result can be pain with every step you take.
             
Treatment by a podiatrist would consist of carefully cutting out the hard tissue and thus relieving all the pressure it causes.  The problem is, corns often come back because the rubbing on the skin is still often there.  Changes in shoe type (generally softer, more accommodating shoes) will often be enough to prevent the corn from returning.  Foam toe spacers, toe sleeves or pads are also a good conservative way to prevent pressure to the toe.
             
Especially problematic is when a corn occurs under a toenail.  This is often due to an enlarged bony spicule or a bone spur.  This can cause considerable discomfort at or under the nail.  Surgical excision of the bone spur is often necessary.  The most effective way to treat this condition is to make a small opening in the tip of the toe and insert a small surgical instrument to reduce or eliminate the spur.  The bone spur can easily be removed with this technique and helps insure a lasting result.  Healing is usually fast and uneventful.
             
Whether by conservative methods, or by surgery, there is a solution to the problem of corns.

Dr. Evan B. Kelner D.P.M.

OCEAN TOWNSHIP OFFICE

1398 Highway 35

Ocean, NJ 07712

(732) 988-0070

TOMS RIVER OFFICE

191 Highway 37 W

Toms River, NJ 08755

(732) 286-9200

SELECTING WALKING SHOES

Walking shoes are different from street shoes or running shoes.  Designed specifically for walking, they are more rigid and offer greater support than running shoes, but they absorb less shock. To select walking shoes from the numerous brands available, you should know something about shoe construction.
 -  walking shoes are usually lighter in weight than street shoes, but heavier than running shoes
 -  if you have flat feet, you may need to consider additional support at the heel or midsole
        
When you buy shoes, tell the salesperson what your level of activity will be.  Try on shoes with the socks you would normally wear when walking.  The shoes should feel comfortable as you soon as you first try them on.
       
Try several styles to make sure you find your best fit.  Remember, the shoes must feel "friendly" on your feet immediately, there is no such thing as a breaking in period.

Dr. Evan B. Kelner D.P.M.

OCEAN TOWNSHIP OFFICE

1398 Highway 35

Ocean, NJ 07712

(732) 988-0070

TOMS RIVER OFFICE

191 Highway 37 W

Toms River, NJ 08755

(732) 286-9200

Do You Have Peripheral Arterial Disease (PAD)?

Peripheral Arterial Disease ( PAD) is a serious circulatory problem in which blood vessels that carry blood to limbs and organs become narrow or clogged.  It affects millions of Americans, most over age 50.  It may manifest as leg discomfort with walking.  People with PAD have an increased risk of stroke and heart attack.

Warning signs include;
   1) Cramping of legs or calves when walking a certain distance
   2) Toe or foot pain that keeps you awake at night
   3) Pale skin, shiny skin or hair loss of legs
   4) Cold feet
 
If you have any of these symptoms, you may be at risk.  With an non invasive doppler, my office can help determine if there is a circulation problem                                         

Dr. Evan B. Kelner D.P.M.

OCEAN TOWNSHIP OFFICE

1398 Highway 35

Ocean, NJ 07712

(732) 988-0070

TOMS RIVER OFFICE

191 Highway 37 W

Toms River, NJ 08755

(732) 286-9200

             

Heel Pain

Those of us, who follow sports, may have noticed that many star players in both football and basketball make headlines because they suffer from a painful condition called plantar fascitiis.  It is often described as feeling like walking on glass.
         
However, you don't have to be a world class athlete to suffer from plantar fascitiis.  Plantar fascitiis is an inflammation of a band of soft tissue that provides support to the foot.  Due to a variety of factors, a plantar fascial inflammation could make walking almost unbearable.
          
Traditional treatments include steroid injection, non-steroidal anti-inflammatory drugs,taping and padding, custom made orthotics, Extracorporeal shockwave therapy, physical therapy, and others including surgery.  If left untreated, the condition may become chronic.
           
If you are suffering from heel or arch pain, a podiatrist can help you "get back into the game"



                                                Evan B. Kelner DPM

                     1398 Highway 35 So.                        191 Highway 37 W.
                     Ocean, NJ 07712                              Toms River, NJ 08755
                     phone# 732-988-0070                       phone# 732-286-9200