Monday, April 9, 2018

Limb Length Discrepancy


                    
An often overlooked cause of foot, leg and back problems is limb length discrepancy.  Limb length discrepancy is when one leg is longer than the other.  This results in an imbalance of the entire body when standing or walking.  The torso tilts in the direction of the shorter limb.  The spine then compensates forming an "S" shape rather than a straight spine.  This can cause lower back pain, hip pain, foot pain, and nerve compression, most notably sciatica.
                    
A measurement of the legs must be taken to determine the extent of the limb length disparity.  If the leg length difference is small, often one or more full length insoles, placed in the shoe of the shorter leg, can compensate for the problem.  This, of course, works much better with a deeper, lace up shoe that affords more room.  If the disparity is significant, then an outersole extension can be applied to the bottom of the shoe.  In this instance, a prescription is needed to have the shoe modified by a shoe repair specialist.  The modification of the shoe is barely noticeable.
                    
Although physical therapy and manipulation may relieve the symptoms of limb length discrepancy, relief is usually temporary.  The symptoms return because the underlying problem remains unaddressed.
                    
If conventional treatments are not providing long term relief for back, leg or foot problems, consider the possibility of one leg being longer than the other, and seek the medical advise of a podiatrist.

Evan Kelner, DPM

Celebrity Foot Problems

                    
Many of us watch events on television, such as the red carpet photo sessions at the Academy Awards, to see what our favorite celebrities are wearing.  We notice the designer clothes, make-up and even their shoes.  What we may not notice though, is their feet.
                    
At the cost of looking stylish, many female celebrities wear very high heeled shoes to accentuate their legs.  Sometimes, the price is higher than they think.  One can 'google" celebrity foot problems, red carpet, to see an array of very unenviable foot problems.  Some of the most beautiful and glamorous women in the world are revealed to have swollen feet, cracked heels, crushed toes and ill-fitting shoes.  There are even photos of stars walking barefoot at the Cannes Film Festival, presumably because their high heeled shoes were too uncomfortable.  Many movie stars suffer from the same bunions, blisters, hammertoes and other problems that many of us easily relate to.
                    
Remember, no matter how glamorous a favorite star may appear, no one is perfect!


Evan Kelner, DPM

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.